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The Cervical Plexus
The cervical plexus
 The cervical plexus is a network of nerves
  formed by communications between the
  anterior rami of the upper 4 cervical
  nerves.
 It lies posterior to the internal jugular vein
  and the SCM muscles.
The Spinal Nerve
The cervical plexus
The cervical plexus
Branches of the
Cervical Plexus
Branches of the
        Cervical Plexus

 A. Superficial or Cutaneous Branches


 Deep branches or muscular and
 communicating branches
A. Superficial or
Cutaneous Branches
1. Ascending branches
   a. Lesser occipital nerve
   b. Great auricular nerve
   c. Nervus cutaneous colli

2. Descending branches
   a. Medial supraclavicular
   b. Intermediate supraclavicular
   c. Lateral supraclavicular
1. Ascending branches
a. Lesser
   occipital
   nerve

c. Great
   auricular
   nerve

c. Transverse
   cervical nerve
a. Lesser occipital nerve

- Comes from the second
cervical ventral ramus and
sometimes also from the third


- supplies the skin on the
upper third of the medial
auricular aspect

-connects with the posterior
branch of the great auricular
nerve.
b. The Great Auricular Nerve

 This is the largest ascending
  branch.

 It arises from the second and
  third cervical rami, encircles
  the posterior border of the
  sternocleidomastoid

 supplies the skin over the
  mastoid process and on the
  back of the auricle, the lobule
  and concha.
c. Transverse Cutaneous Nerve
 This arises from the second
   and third cervical rami, curves
   round the posterior border of
   the sternocleidomastoid

 distributed to the skin of the
   upper anterior areas of the
   neck and anterolaterally to the
   skin of the neck, as low as the
   sternum.
2. Descending branches

a. Medial
supraclavicular

b. Intermediate
supraclavicular

c. Lateral
supraclavicular
Supra Clavicular Nerves
 These arise by a common trunk from the third and fourth cervical
     ventral rami and emerge from the posterior border of the
     sternocleidomastoid, to descend under the platysma and the deep
     cervical fascia;

     3 branches:
1.   The medial supraclavicular nerves supply the skin as far as the
     midline and as low as the second rib. They supply the
     sternoclavicular joint.
2.   The intermediate supraclavicular nerves cross the clavicle to supply
     the skin over the pectoralis major and deltoid down to the level of
     the second rib
3.   The lateral supraclavicular nerves supply the skin of the upper and
     posterior parts of the shoulder.
Deep branches or
  muscular and
 communicating
    branches
1. Lateral branches:

b.      Muscular branches
        going to the
        following:

      i. SCM
      ii. Trapezius
     iii. Levator scapula
     iv. Scalenius medius
      v. Scalenius posterior

b. Communicating
     branches to spinal
     accessory nerves
Deep Branches—Lateral Series

Muscular branches
  Sternocleidomastoid    C2, 3, 4
  Trapezius              C2, (3)
  Levator scapulae       C3, 4
  Scalenus medius        C3, 4

Communicating branches
  Accessory Nerve        C2, 3, 4
2. Medial branches:

a. Muscular branches going to the following muscles:
          i. Prevertebral muscles
         ii. Infrahyoid muscles thru the ansa hypoglossi
        iii. Diaphragm thru the phrenic nerve

  b. Communicating branches to the vagus, hypoglossal and
sympathetic nerves

    c. Phrenic nerve is the most important branch because it
supplies the diaphragm which is the chief muscle for respiration.
It is derived from cervical nerves 3, 4, and 5.
Communicating and Muscular
             Branches
           (Medial Series)
Communicating branches with
  Hypoglossal               C1, 2
  Vagus                     C1–4
  Sympathetic               C1, 2

Muscular branches to
  Rectus capitis lateralis           C1
  Rectus capitis anterior            C1, 2
  Longus capitis                     C1–3
  Longus colli                       C2–4
  Inferior root of ansa cervicalis   C2, 3
 Phrenic nerve                       C3–5
The Ansa Hypoglossi
 Formed by spinal nerves C1, C2, and C3.

 3 parts:
      1. Superior root    C1
            - innervates the superior belly of
                   omohyoid

      2. Inferior root    C2, C3

      3. Loop of ansa cervicalis
            - innervates the sternothyroid,
            sternohyoid, inferior belly of omohyoid
The cervical plexus
The Phrenic nerve
 Arises from the converging APR of spinal
  nerves C3, C4, and C5.
 This is the sole motor supply to the
  diaphragm, and also contains widespread
  sensory fibres.
The cervical plexus
Give your loved ones the
warmest hugs and kisses you
       can give today!!

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The cervical plexus

  • 3.  The cervical plexus is a network of nerves formed by communications between the anterior rami of the upper 4 cervical nerves.  It lies posterior to the internal jugular vein and the SCM muscles.
  • 8. Branches of the Cervical Plexus  A. Superficial or Cutaneous Branches  Deep branches or muscular and communicating branches
  • 10. 1. Ascending branches a. Lesser occipital nerve b. Great auricular nerve c. Nervus cutaneous colli 2. Descending branches a. Medial supraclavicular b. Intermediate supraclavicular c. Lateral supraclavicular
  • 11. 1. Ascending branches a. Lesser occipital nerve c. Great auricular nerve c. Transverse cervical nerve
  • 12. a. Lesser occipital nerve - Comes from the second cervical ventral ramus and sometimes also from the third - supplies the skin on the upper third of the medial auricular aspect -connects with the posterior branch of the great auricular nerve.
  • 13. b. The Great Auricular Nerve  This is the largest ascending branch.  It arises from the second and third cervical rami, encircles the posterior border of the sternocleidomastoid  supplies the skin over the mastoid process and on the back of the auricle, the lobule and concha.
  • 14. c. Transverse Cutaneous Nerve  This arises from the second and third cervical rami, curves round the posterior border of the sternocleidomastoid  distributed to the skin of the upper anterior areas of the neck and anterolaterally to the skin of the neck, as low as the sternum.
  • 15. 2. Descending branches a. Medial supraclavicular b. Intermediate supraclavicular c. Lateral supraclavicular
  • 16. Supra Clavicular Nerves  These arise by a common trunk from the third and fourth cervical ventral rami and emerge from the posterior border of the sternocleidomastoid, to descend under the platysma and the deep cervical fascia; 3 branches: 1. The medial supraclavicular nerves supply the skin as far as the midline and as low as the second rib. They supply the sternoclavicular joint. 2. The intermediate supraclavicular nerves cross the clavicle to supply the skin over the pectoralis major and deltoid down to the level of the second rib 3. The lateral supraclavicular nerves supply the skin of the upper and posterior parts of the shoulder.
  • 17. Deep branches or muscular and communicating branches
  • 18. 1. Lateral branches: b. Muscular branches going to the following: i. SCM ii. Trapezius iii. Levator scapula iv. Scalenius medius v. Scalenius posterior b. Communicating branches to spinal accessory nerves
  • 19. Deep Branches—Lateral Series Muscular branches Sternocleidomastoid C2, 3, 4 Trapezius C2, (3) Levator scapulae C3, 4 Scalenus medius C3, 4 Communicating branches Accessory Nerve C2, 3, 4
  • 20. 2. Medial branches: a. Muscular branches going to the following muscles: i. Prevertebral muscles ii. Infrahyoid muscles thru the ansa hypoglossi iii. Diaphragm thru the phrenic nerve b. Communicating branches to the vagus, hypoglossal and sympathetic nerves c. Phrenic nerve is the most important branch because it supplies the diaphragm which is the chief muscle for respiration. It is derived from cervical nerves 3, 4, and 5.
  • 21. Communicating and Muscular Branches (Medial Series) Communicating branches with Hypoglossal C1, 2 Vagus C1–4 Sympathetic C1, 2 Muscular branches to Rectus capitis lateralis C1 Rectus capitis anterior C1, 2 Longus capitis C1–3 Longus colli C2–4 Inferior root of ansa cervicalis C2, 3 Phrenic nerve C3–5
  • 22. The Ansa Hypoglossi  Formed by spinal nerves C1, C2, and C3.  3 parts: 1. Superior root C1 - innervates the superior belly of omohyoid 2. Inferior root C2, C3 3. Loop of ansa cervicalis - innervates the sternothyroid, sternohyoid, inferior belly of omohyoid
  • 24. The Phrenic nerve  Arises from the converging APR of spinal nerves C3, C4, and C5.  This is the sole motor supply to the diaphragm, and also contains widespread sensory fibres.
  • 26. Give your loved ones the warmest hugs and kisses you can give today!!