Recti Capitis Posteriores Minores
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The rectus capitis posterior minor (or rectus capitis posticus minor, both being Latin for ''lesser posterior straight muscle of the head'') arises by a narrow pointed tendon from the tubercle on the posterior arch of the
atlas An atlas is a collection of maps; it is typically a bundle of maps of Earth or of a region of Earth. Atlases have traditionally been bound into book form, but today many atlases are in multimedia formats. In addition to presenting geographic ...
, and, widening as it ascends, is inserted into the medial part of the inferior nuchal line of the
occipital bone The occipital bone () is a neurocranium, cranial dermal bone and the main bone of the occiput (back and lower part of the skull). It is trapezoidal in shape and curved on itself like a shallow dish. The occipital bone overlies the occipital lobe ...
and the surface between it and the
foramen magnum The foramen magnum ( la, great hole) is a large, oval-shaped opening in the occipital bone of the skull. It is one of the several oval or circular openings (foramina) in the base of the skull. The spinal cord, an extension of the medulla oblon ...
, and also takes some attachment to the spinal
dura mater In neuroanatomy, dura mater is a thick membrane made of dense irregular connective tissue that surrounds the brain and spinal cord. It is the outermost of the three layers of membrane called the meninges that protect the central nervous system. ...
. The synergists are the
rectus capitis posterior major The rectus capitis posterior major (or rectus capitis posticus major, both being Latin for ''larger posterior straight muscle of the head'') arises by a pointed tendon from the spinous process of the axis, and, becoming broader as it ascends, is in ...
and the
obliquus capitis superior The obliquus capitis superior muscle () is a small muscle in the upper back part of the neck and is one of the suboccipital muscles and part of the suboccipital triangle. It arises from the lateral mass of the atlas bone. It passes superiorly a ...
. Connective tissue bridges were noted at the
atlanto-occipital joint The atlanto-occipital joint (''Capsula articularis atlantooccipitalis'') is an articulation between the atlas bone and the occipital bone. It consists of a pair of condyloid joints. It is a synovial joint. Structure The atlanto-occipital joint ...
between the rectus capitis posterior minor (RCPm) muscle and the dorsal spinal dura. Similar connective tissue connections of the
rectus capitis posterior major The rectus capitis posterior major (or rectus capitis posticus major, both being Latin for ''larger posterior straight muscle of the head'') arises by a pointed tendon from the spinous process of the axis, and, becoming broader as it ascends, is in ...
have been reported recently as well. The perpendicular arrangement of these fibers appears to restrict dural movement toward the spinal cord. The ligamentum nuchae was found to be continuous with the posterior cervical spinal dura and the lateral portion of the occipital bone. Anatomic structures innervated by cervical nerves C1-C3 have the potential to cause headache pain. Included are the joint complexes of the upper three cervical segments, the dura mater, and spinal cord. The dura-muscular (myodural) and dura-ligamentous connections in the upper cervical spine and occipital areas may provide anatomic and physiologic answers to the cause of the
cervicogenic headache Cervicogenic headache is a type of headache characterized by chronic hemicranial pain referred to the head from either the cervical spine or soft tissues within the neck. The main symptoms of cervicogenic headaches include pain originating in the ne ...
. The level of strain at which RCPm muscle fibers began to tear as a result of overstretching has been estimated to be 30%. This would be expected to put them at risk of injury during whiplash-type distortions when the occipitoatlantal (OA) joint is flexed upon impact. Tearing of the muscle fibers would result in fatty infiltration (FI) that would be expected to impact the functional relationship between the RCPm muscles and the pain sensitive spinal dura.Kong A, Van der Vliet A, Zadow S. MRI and US of Gluteal Tendinopathy in Gretear Trochanteric Pain Syndrome.https://link.springer.com/article/10.1007/s00330-006-0485-x While FI and/or a reduction in the cross sectional area (CSA) of active muscle would not be expected to be the direct cause of chronic headache, it is known that muscle pathology will result in functional deficits. We propose that pathology in RCPm muscles will compromise the normal functional relationship between the RCPm and the pain sensitive dura mater and result in referred head and neck pain. This could help to explain manipulation's efficacy in the treatment of cervicogenic headache.


Additional images

File:Rectus capitis posterior minor muscle animation small.gif, Position of rectus capitis posterior minor muscle (shown in red). Animation. File:Rectus capitis posterior minor muscle lateral.png , Lateral view of
human skull The skull is a bone protective cavity for the brain. The skull is composed of four types of bone i.e., cranial bones, facial bones, ear ossicles and hyoid bone. However two parts are more prominent: the cranium and the mandible. In humans, the ...
(rectus capitis posterior minor shown in red.) File:Gray129.png, Occipital bone. Outer surface.


See also

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Atlanto-occipital joint The atlanto-occipital joint (''Capsula articularis atlantooccipitalis'') is an articulation between the atlas bone and the occipital bone. It consists of a pair of condyloid joints. It is a synovial joint. Structure The atlanto-occipital joint ...
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Rectus capitis lateralis The rectus capitis lateralis, a short, flat muscle, arises from the upper surface of the transverse process of the atlas, and is inserted into the under surface of the jugular process of the occipital bone. Additional images File:Rectus capitis ...
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Rectus capitis posterior major muscle The rectus capitis posterior major (or rectus capitis posticus major, both being Latin for ''larger posterior straight muscle of the head'') arises by a pointed tendon from the spinous process of the axis, and, becoming broader as it ascends, is in ...
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Rectus capitis anterior muscle The rectus capitis anterior (rectus capitis anticus minor) is a short, flat muscle, situated immediately behind the upper part of the Longus capitis. It arises from the anterior surface of the lateral mass of the atlas, and from the root of its t ...


References


External links

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PTCentral
{{Authority control Muscles of the head and neck