Anatomy for Dentistry

Lecture 5
Muscles of the Head & Neck
Somite-derived
&
Fascial compartments
by
John McGeachie
School of Anatomy & Human Biology
The University of Western Australia
 Learning Objectives

To understand the basic design &
development of the Head & Neck

To understand the musculature of Head &
Neck & the innervation patterns

To appreciate fascia & fascial
compartments of Head & Neck
Muscles of Neck & Head
May appear to be very complex
Muscles of Neck & Head
May appear to be very complex
But they must be studied in groups

The best way is according to their

Embryological origin
 Muscles of Neck & Head
Embryology
All muscles of neck & head develop from
one of two embryological origins

1. Somites - segmental body “building

blocks” of mesoderm
2. Pharyngeal arches – special masses of
mesoderm which develop with the foregut
structures (jaws, face, palate, pharynx &
larynx)
Muscular System – Somites

The CNS
is
always
a
tube

Somites
 Muscles – Somite development

These are bilateral

segmental blocks
of mesoderm
which develop either
side of the midline,
starting at day 20
Week 5 ~Week 10
 Muscular System – Somites

The CNS
is
Cut always Cut
a
tube

Somites
 Muscles – Myotome development

Muscles form from

The myotome
part of somites,
other
parts are the
Dermatomes
to the skin & 4 weeks

Sclerotomes
Transverse sections through embryos
to the vertebrae
Myotome
migration
Dorsally
to form
extensor
muscles
&
ventrally
for flexor
muscles
Transverse sections through embryos

5-6 weeks
 Myotome-derived muscles
Dorsal & Ventral masses
Examples of the
myotome masses
in the thorax
Dorsal mass
Nerve supply – DPR
Ventral mass
Nerve supply – VPR
 Dorsal myotome masses
form the Extensor muscles
Problem
The first muscle seen in the back is the
Trapezius - a “ring in” from the
pharyngeal arches
This will be dealt with later under the
pharyngeal arch-derived muscles
 Dorsal
muscles
Trapezius
the ring in
shown
on one side
only
Dorsal Splenius
Capitis
mass Semi-spinalis
Capitis
Superficial
Trapezius
(ph. arch)

Longissimus
Capitis
(not shown)
 Sterno Splenius
Mastoid Capitis
Muscle Muscle

Action Action
Head forwards & Head backwards &
turning turning
 Dorsal myotome masses
form the Extensor muscles
Extensor muscles
All have deep equivalents attaching to the
cervical vertebrae
Splenius capitis = splenius cervicis
Semispinalis capitis = Semispinalis cervicis
Longissiumus capitis = Longissiumus cervicis
Extensor Erector

muscles Spinae muscles

Cervicis
muscles

Longissimus
Semispinalis
Splenius
(not shown)
 Dorsal
myotome
masses
Sub-occipital
muscles
Rectus capitis
posterior minor
&
posterior major
Oblique – superior
&
Oblique – inferior

Actions -
to move the head and C1 & C2
during nodding and rotation.
Stability is also critical here
 Dorsal
myotome
masses
in neck &
head

Summary
view
showing
all
layers
 Ventral muscle masses
There are 3 groups

Superficial group – strap muscles

Deep anterior vertebrals – pre-vertebral

Lateral vertebrals – scalene muscles

Ventral
muscle
masses

Overview
Ventral muscle masses

Heck - another “ring-in”

Sternomastoid - like Trapezius
is also
developed from the
Pharyngeal arches
Ventral
muscle
masses

Sterno-
Mastoid
Flexes the
head
or turns
head
forward to
one side
Ventral group - strap muscles
Connect the thoracic
inlet with the
laryngeal skeleton

Sterno-hyoid
Thyro-hyoid
(deep to sterno-hyoid)
Omo-hyoid
Sterno-thyroid

Note: Geniohyoid is
also one of this group
 Strap
muscles

Actions
To depress
the hyoid &
thyroid
during recoil
from
swallowing
 Ventral muscle mass
Prevertebral muscles - flexors
There are 3 muscles
Rectus capitis anterior
Longus capitis
Longus cervicis
(Longus colli)
 Ventral muscle mass
Lateral vertebral muscles (Scalenes)

Rectus capitis lateralis

Scalenus medius
& posterior
Scalenus anterior
Scalenus posterior
 Ventral muscle mass
Lateral vertebral muscles (Scalenes)

Scalene muscles
Are composites
of many
small muscles
attached
to vertebral
anterior tubercles
Scalene = uneven triangle
Scalene =
uneven triangle
 Ventral muscle mass
Lateral vertebral muscles

Levator
Scapulae
has
migrated
off to
the
scapula

Anterior view Posterior view

 Myotome-derived muscles
Two important masses
Eye:extra-ocular muscles Tongue muscles
 Myotome-derived muscles
Extra-ocular muscles

Pre-otic
Myotomes
Pre = before
Otic = ear
 Myotome-derived muscles
Tongue muscles

Occipital
Somites
Myoblasts
migrate
Occiput to
Latin for tongue

Back of head
 Myotome-derived muscles
Innervation
GOLDEN RULE
All dorsal myotomes are supplied by
Dorsal (posterior) primary rami

All ventral myotomes are supplied by

Ventral (anterior) primary rami
 See Myotome-derived muscles
“Additional
Material” Innervation
Muscles
migrate
dorsally to
form
extensor
muscles
&
ventrally for
flexor
muscles
The nerves go dorsally and ventrally
With the muscle masses
 Dorsal mass

DPR

DPR

Myotome
derived muscles
Innervation

See
“Additional Ventral mass

Material”
CERVICAL
FASCIA
 Fascial layers of neck or
Cervical fascia
Fascia is Latin for a “band” or wrapping -
of connective tissue
* It is important for containing groups of
structures
* It can direct the spread of infection
 Fascial layers of Neck
or Fascial Compartments

In the neck, the Cervical Fascial layers

divide the neck into compartments
But
Firstly - what is “superficial fascia”?
 Fascial
Compartments

Superficial
fascia
is just
subcutaneous
tissue
fat
& areolar
tissue
 Fascial
Compartments

Investing
Deep
Cervical
Fascia
Tough
sheet
around
muscles

Note: Platysma
Is outside the
Investing Fascia
 Fascial
Compartments

Investing
Deep
Cervical
fascia
over
Sterno-
mastoid
CERVICAL FASCIAL COMPARTMENTS
CERVICAL FASCIAL COMPARTMENTS

Investing deep
Cervical Fascia
CERVICAL FASCIAL COMPARTMENTS

Vertebral Fascia

Investing deep
Cervical Fascia
CERVICAL FASCIAL COMPARTMENTS

Vertebral Fascia

Investing deep
Cervical Fascia

Visceral Fascia
CERVICAL FASCIAL COMPARTMENTS

Vertebral Fascia

Investing deep
Cervical Fascia
Vascular fascia = Carotid Sheath

Visceral Fascia
 Cervical
fascial
compartments

Detailed
Anatomy
The End
Additional material

Nerve supply of
Myotome-derived
muscles
 Myotome-derived muscles
Innervation

This may appear to be complex but

once the embryology is understood
it is very easy to determine
Myotome-derived muscles
Innervation
All myotome-derived muscles
Are supplied by
General Somatic Motor nerves
What does that mean?
 Myotome-derived muscles
Innervation
GOLDEN RULE
All dorsal myotomes are supplied by
Dorsal (posterior) primary rami

All ventral myotomes are supplied by

Ventral (anterior) primary rami
 Myotome-derived muscles
Innervation
The myoblast
masses
migrate
dorsally to
form
extensor
muscles
&
ventrally for
the flexor
muscles The nerves go dorsally and ventrally
With the muscle masses
 Myotome-derived muscles
Innervation
D
Examples of the myotome
masses in the thorax
Dorsal mass
Nerve supply – D/PPR

Ventral mass
Nerve supply – V/APR

V
 Myotome-derived muscles-
Innervation
All dorsal myotome masses
are supplied by Doral Primary Rami
&
All ventral myotome masses
are supplied by Ventral Primary Rami
 Myotome-derived muscles-
Innervation
How does this work in practical anatomy?
 Myotome-derived muscles-
Innervation

Dorsal primary rami

are all segmental
If a muscle covers
many segments
it has many
segmental
nerves
Sub-occipital
muscles
Innervation
Dorsal primary
rami
are all segmental
If a muscle covers
a few segments
it has a few
segmental
Nerves
Eg. C1 & C2
Actions -
to move the head and C1 & C2
during nodding and rotation.
Stability is also critical here
 Myotome-derived muscles-
Innervation
GOLDEN RULE
All dorsal myotomes are supplied by
Dorsal (posterior) primary rami

All ventral myotomes are supplied by

Ventral (anterior) primary rami
 Innervation of Myotome-derived muscles

Ventral muscles
are also
supplied
by
segmental
VPR
Myotome-derived muscles
Innervation
Ventral Primary Rami
for
Strap muscles
Heck - this is tricky!
WHY?
 Myotome-derived muscles
Innervation
Because the first 4 cervical nerves have to
supply superficial structures in the neck
WHY?
Because the lower cervical nerves have
been taken off to the upper limb as the
brachial plexus
 Myotome-derived muscles
Innervation
Heck - what is to be done?
Well - the APR of C1-4 form a plexus
The Cervical Plexus
Note: Plexus means a plait or braid - this is what
the nerve bundles look like
 Innervation of strap muscles

Cervical plexus
to the
strap
muscles via
the Ansa
Cervicalis
= loop in
the neck
Additional material

The End