Splenius Capitis

The Splenius capitis is a posterior muscle of the neck.

Anatomical Attachments:

• Origin: Attaches to the ligamentum nuchae and the spinous processes of C7 vertebra and the upper 3 or 4 thoracic vertebra.
• Insertion: Attaches to the mastoid process and at the lateral aspect of the nuchal line.

Action: Collectively, with the Splenius cervicis, extends the head and neck; and laterally flexes and rotates the head to the ipsilateral side.

Synergist: Semispinalis capitis and cervicis, Splenius cervicis, Spinalis cervicis, Interspinales, Longissimus cervicis, Iliocostalis cervicis, Multifidus.

Antagonist: Sternocleidomastoid; Longus colli and capitis; Scalenus anterior, medius, and posterior.

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Nerve Supply: Lateral branches of the dorsal primary division of the middle and lower cervical nerve.

Vascular supply: The muscular branches of the occipital and superficial branch of the transverse cervical arteries.

• Primary: The pain refers to the top of the head on the ipsilateral side.
• Satellite or associated triggers: Levator scapulae, and Posterior cervical muscles.

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Trigger Point Signs and Symptoms: Headaches, neck pain, blurring of vision, pain on the crown of the head.

Trigger Point Activating and Perpetuating Factors: Postural stresses e.g. bird-watching, sleeping without proper head support; acceleration/deceleration injury, sudden cooling of muscles, prolonged forward head bending.

Differential Diagnosis: (Segmental, Subluxation, Somatic dysfunction) C1 radiculopathy (Bulging Prolapsed, Herniated Disc), C2 dysfunction, Occipitoatlantal dysfunction, Acceleration/Deceleration injury (Whiplash), Military neck (Absence of normal cervical spine lordosis), Cervical Spine Hyperlordosis, Vertebral vascular disorder, Cerebral aneurysm, Cerebral neoplasm (Brain cancer), Subacute meningitis, Encephalitis, Migraine headaches, Post concussion syndrome, Fibromyalgia, Polymyositis, Systemic lupus erythematosus, Osteoporosis, Osteoarthritis, Eye strain, Ocular disease, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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