Suboccipital muscle group

Last revised by Dr Leon Chau on 04 Mar 2022

The suboccipital muscle group contains four paired muscles, three of which pairs belong to the suboccipital triangle. These muscles all lie below the occipital bone and are responsible for postural support of the head, as well as extension, lateral flexion and rotation. As these muscles are small and act in unison, they will be discussed in this single article, rather than individual articles.

The suboccipital triangle is paired and consists of three muscles: rectus capitis posterior major, obliquus capitis superior, and obliquus capitis inferior. The function of the muscles in this triangle are to extend and rotate the head.

  • rectus capitis posterior major muscle
  • obliquus capitis superior muscle
    • superolateral boundary of the suboccipital triangle
    • origin: upper surface of the transverse process of the atlas
    • insertion: lateral half of the inferior nuchal line on the occipital bone
    • action: lateral flexion of the head
  • obliquus capitis inferior muscle
    • inferolateral boundary of the suboccipital triangle
    • larger of the two obliquus muscles
    • origin: outer surface of the bifid spinous process of the axis, below the rectus capitis posterior major
    • insertion: transverse process of the atlas
    • action: rotate the head on the atlantoaxial joint ipsilaterally

The floor is formed by the posterior arch of the atlas and the posterior atlantooccipital membrane. The roof is the semispinalis muscle, greater occipital nerve (C2), occipital artery. The triangle contains the vertebral artery and suboccipital nerve (C1).

The rectus capitis posterior minor is separate from the suboccipital triangle and lies deep to the rectus capitis posterior major.

  • rectus capitis posterior minor muscle
    • origin: tubercle on the posterior arch of the atlas
    • insertion: medial part of the inferior nuchal line of the occipital bone
    • action: weak extender of the head

Whiplash injuries can cause muscle spasm and disruption between the normal agonist-antagonist relationship between the left and right suboccipital muscle groups 4.

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Cases and figures

  • Figure 1: cervical plexus labeled
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  • Figure 2: nerve to rectus capitis lateralis, longus capitis and rectus capitis anterior
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  • Figure 3: deep back muscles (Gray's illustration)
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  • Figure 4: deep neck muscles (Gray's illustration)
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