{"id":1320,"date":"2020-08-05T05:31:35","date_gmt":"2020-08-05T05:31:35","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/head-and-neck\/neurovasculature\/innervation\/cervical-plexus\/"},"modified":"2021-11-21T19:52:51","modified_gmt":"2021-11-21T17:52:51","slug":"cervical-plexus","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/skull-head-and-neck\/neurovasculature\/innervation\/cervical-plexus\/","title":{"rendered":"Cervical plexus"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><div class=\"intro\">The cervical plexus is a paired network of nerve loops and branches formed by the anterior rami of C1-5 spinal nerves. It provides sensory and motor innervation to structures in the neck.<\/div><\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/07\/cervical-plexus.png\" target=\"_blank\" title=\"Cervical plexus\"><img decoding=\"async\" src=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/07\/cervical-plexus-600x256.png\" alt=\"\" class=\"wp-image-17129\"\/><\/a><figcaption><strong>Figure 1. Schematic drawing of the cervical plexus<\/strong><\/figcaption><\/figure>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Description<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">The cervical plexus consists of the following components:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Ansa Cervicalis<\/strong><\/li><li><strong>C1 branches<\/strong><\/li><li><strong>C1 &amp; C2 branches<\/strong><\/li><li><strong>C2 &amp; C3 branches<\/strong><\/li><li><strong>C3 &amp; C4 branches<\/strong><\/li><li><strong>C3-C5 branch (Phrenic nerve)<\/strong><\/li><li><strong>Cranial nerves<\/strong><\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">The schematic drawing above (Figure 1.) represents all the major paths and branches you should know; it would be extremely useful to practice drawing it!<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Location<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<ul class=\"wp-block-list\"><li>The cervical plexus is located at the lateral cervical region<\/li><li>Underneath the sternocleidomastoid<\/li><li>Anterolateral to the levator scapulae and middle scalene muscles<\/li><li>Its cutaneous branches are visible at the posterior edge of the sternocleidomastoid (also called&nbsp;<strong>Erb\u2019s point<\/strong>)<\/li><li>The&nbsp;<strong>ansa cervicalis<\/strong>&nbsp;can be found embedded within the carotid sheath<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Ansa cervicalis<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<p class=\"wp-block-paragraph\">The ansa cervicalis is a loop formed by two roots:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Ansa cervicalis superioris<\/strong>&nbsp;(superior root) coming from C1 and C2<\/li><li><strong>Ansa cervicalis inferioris<\/strong>&nbsp;(inferior root) coming from C2 and C3<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">This loop provides motor innervation to the&nbsp;<strong>infrahyoid muscles<\/strong>:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>Omohyoid superior<\/li><li>Sternohyoid<\/li><li>Sternothyroid<\/li><li>Omohyoid inferior<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">The first two are innervated mainly by the superior root, while the last two are by the inferior root.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The superior root of ansa cervicalis shares its connective with the&nbsp;<strong>hypoglossal nerve&nbsp;(CN XII)<\/strong>.&nbsp;<br>Although they run together, there\u2019s no sharing of nervous information between the two.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">C1 branches<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<ul class=\"wp-block-list\"><li>The branches that come out of C1 are nerves that provide motor innervation to the&nbsp;<strong>geniohyoid&nbsp;<\/strong>and&nbsp;<strong>thyrohyoid<\/strong>&nbsp;muscles<\/li><li>These nerves emerge after the hypoglossal nerve is no longer sharing the connective tissue with the ansa cervicalis.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">C1 &amp; C2 branches<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">Consists of a branch that contributes to the&nbsp;<strong>vagus nerve (CN X)&nbsp;<\/strong>as well as 3 motor branches that provide motor innervation to the deep muscles of the neck:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Rectus capitis anterioris<\/strong><\/li><li><strong>Longus capitis<\/strong><\/li><li><strong>Rectus capitis lateralis<\/strong><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">C2 &amp; C3 branches<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n\n<p class=\"wp-block-paragraph\">Consists of cutaneous branches that provide sensory innervation via the following nerves:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Greater auricular<\/strong>&nbsp;\u2014 Innervates the skin of most of the ear and around it down to the neck<\/li><li><strong>Lesser occipital<\/strong>&nbsp;\u2014 Innervates the skin 2-5cm around the ear down to the neck<\/li><li><strong>Transverse cervical<\/strong>&nbsp;\u2014 Innervates the skin of the anterior neck region<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/07\/cutaneous-head-neck.png\" target=\"_blank\" title=\"Cervical plexus\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/07\/cutaneous-head-neck-573x600.png\" alt=\"\" class=\"wp-image-17130\"\/><\/a><figcaption><strong>Cutaneous innervation of the head<\/strong><\/figcaption><\/figure>\n\n\n<\/span><span class=\"block-heading\" id=\"header_7\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">C3 &amp; C4 branches<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_7\">\n\n\n<p class=\"wp-block-paragraph\">Form the&nbsp;<strong>supraclavicular nerves<\/strong>.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The supraclavicular nerves are located underneath the platysma muscle, piercing it and supplying the skin above it<\/li><li>These nerves split to&nbsp;<strong>medial<\/strong>,&nbsp;<strong>intermediate<\/strong>, and&nbsp;<strong>lateral<\/strong>&nbsp;branches that supply sensory innervation to the skin over the clavicle, shoulder and superolateral pectoralis major<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><a href=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/cutaneous_innervation_clavicular_chest.png\" target=\"_blank\" title=\"Cervical plexus\"><img decoding=\"async\" src=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/cutaneous_innervation_clavicular_chest.png\" alt=\"\" class=\"wp-image-4074\"\/><\/a><\/figure><\/div>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/meddists.com\/wp-content\/uploads\/2019\/07\/thorax_muscles_nerves.png\" target=\"_blank\" title=\"Cervical plexus\"><img decoding=\"async\" src=\"https:\/\/meddists.com\/wp-content\/uploads\/2019\/07\/thorax_muscles_nerves-600x449.png\" alt=\"\" class=\"wp-image-14846\"\/><\/a><figcaption><strong>Muscles and cutaneous innervation of the thoracic wall<\/strong>&nbsp;(Credit: Grant\u2019s dissector)<\/figcaption><\/figure>\n\n\n<\/span><span class=\"block-heading\" id=\"header_8\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">C3-C5 branch (Phrenic nerve)<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_8\">\n\n\n<ul class=\"wp-block-list\"><li>In the neck, the&nbsp;<strong>phrenic nerve<\/strong>&nbsp;can be found on the surface of the anterior scalene muscle.<\/li><li>As it descends downwards, it passes between the&nbsp;<strong>subclavian vein&nbsp;<\/strong>and&nbsp;<strong>artery<\/strong><\/li><li>It continues into the thorax and&nbsp;<strong>pericardium<\/strong>&nbsp;(the connective tissue covering the heart) and finally terminates in the diaphragm<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/07\/supraclavicular-region.png\" target=\"_blank\" title=\"Cervical plexus\"><img decoding=\"async\" src=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/07\/supraclavicular-region-600x534.png\" alt=\"\" class=\"wp-image-17131\"\/><\/a><figcaption><strong>Right supraclavicular region (some structures were cut and removed)<\/strong><\/figcaption><\/figure>\n\n\n<\/span><span class=\"block-heading\" id=\"header_9\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Functions<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_9\">\n\n\n<ul class=\"wp-block-list\"><li>Provides the motor innervation to the diaphragm, causing inspiration<ul><li>Since there are two phrenic nerves innervating the diaphragm \u2014 each nerve is responsible for its own side of the diaphragm, and can work independently (although they are synchronized at the level of the brain-stem)<\/li><\/ul><\/li><li>Provides sensory innervation as well to the pericardium and the mediastinal pleura -Pain sensations conveyed by this nerve are usually felt at the skin (above the clavicle)<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_10\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Origin<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_10\">\n\n\n<p class=\"wp-block-paragraph\">Formed mainly by C4, with contributions from C3 and C5.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_11\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Clinical information<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_11\">\n\n\n<ul class=\"wp-block-list\"><li>Damage to the phrenic nerve (during surgery, for example) may paralyze the side of the diaphragm of the affected side. If both phrenic nerves are cut, the patient won\u2019t be able to breathe on his own (resulting in death).<\/li><li>An irritation of the diaphragmwill stimulate the phrenic nerve, and may be felt as pain in the shoulder, as its sensory roots has the same nerve roots as the phrenic nerve (the dermatome of the shoulder is C5).<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Remember:<\/strong>&nbsp;<strong>C3-4-5 keeps the diaphragm alive!<\/strong><\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_12\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Cranial nerves associated with the cervical plexus<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_12\">\n\n\n<ul class=\"wp-block-list\"><li>As mentioned before, the&nbsp;<strong>hypoglossal nerve<\/strong>&nbsp;shares its connective tissue with the ansa cervicalis, and does not participate in the innervation of the cervical plexus<\/li><li>The&nbsp;<strong>spinal accessory nerve (CN XI)<\/strong>, however, is formed by the<strong>&nbsp;first 5 spinal nerve<\/strong>&nbsp;segments, entering the foramen magnum and later exiting through the posterior jugular foramen<\/li><\/ul>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Description<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Location<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Ansa cervicalis<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">C1 branches<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">C1 &amp; C2 branches<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">C2 &amp; C3 branches<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">C3 &amp; C4 branches<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">C3-C5 branch (Phrenic nerve)<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Functions<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Origin<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Clinical information<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Cranial nerves associated with the cervical plexus<\/h3><\/div>","protected":false},"excerpt":{"rendered":"<p>Description The cervical plexus consists of the following components: Ansa Cervicalis C1 branches C1 &amp; C2 branches C2 &amp; C3 branches C3 &amp; C4 branches C3-C5 branch (Phrenic nerve) Cranial nerves The schematic drawing above (Figure 1.) represents all the major paths and branches you should know; it would be extremely useful to practice drawing [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1159,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1320","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cervical plexus &#8211; 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