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The greater occipital nerve is a nerve of the head. It is a
spinal nerve A spinal nerve is a mixed nerve, which carries motor, sensory, and autonomic signals between the spinal cord and the body. In the human body there are 31 pairs of spinal nerves, one on each side of the vertebral column. These are grouped into the ...
, specifically the medial branch of the dorsal primary ramus of cervical spinal nerve 2. It arises from between the first and second
cervical vertebrae In tetrapods, cervical vertebrae (singular: vertebra) are the vertebrae of the neck, immediately below the skull. Truncal vertebrae (divided into thoracic and lumbar vertebrae in mammals) lie caudal (toward the tail) of cervical vertebrae. In ...
, ascends, and then passes through the semispinalis muscle. It ascends further to supply the skin along the posterior part of the
scalp The scalp is the anatomical area bordered by the human face at the front, and by the neck at the sides and back. Structure The scalp is usually described as having five layers, which can conveniently be remembered as a mnemonic: * S: The ski ...
to the
vertex Vertex, vertices or vertexes may refer to: Science and technology Mathematics and computer science *Vertex (geometry), a point where two or more curves, lines, or edges meet *Vertex (computer graphics), a data structure that describes the position ...
. It supplies sensation the
scalp The scalp is the anatomical area bordered by the human face at the front, and by the neck at the sides and back. Structure The scalp is usually described as having five layers, which can conveniently be remembered as a mnemonic: * S: The ski ...
at the top of the
head A head is the part of an organism which usually includes the ears, brain, forehead, cheeks, chin, eyes, nose, and mouth, each of which aid in various sensory functions such as sight, hearing, smell, and taste. Some very simple animals ...
, over the ear and over the
parotid glands The parotid gland is a major salivary gland in many animals. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. They are the largest of the salivary glands. Each parotid is wrapped around the man ...
.


Structure

The greater occipital nerve is the medial branch of the dorsal primary ramus of
cervical spinal nerve 2 The cervical spinal nerve 2 (C2) is a spinal nerve of the cervical segment.American Medical Association ...
. It may also involve fibres from cervical spinal nerve 3. It arises from between the first and second
cervical vertebrae In tetrapods, cervical vertebrae (singular: vertebra) are the vertebrae of the neck, immediately below the skull. Truncal vertebrae (divided into thoracic and lumbar vertebrae in mammals) lie caudal (toward the tail) of cervical vertebrae. In ...
, along with the lesser occipital nerve. It ascends after emerging from below the suboccipital triangle beneath the
obliquus capitis inferior muscle The obliquus capitis inferior muscle () is the larger of the two oblique muscles of the neck. It arises from the apex of the spinous process of the axis and passes laterally and slightly upward, to be inserted into the lower and back part of the tr ...
. Just below the superior nuchal ridge, it pierces the
fascia A fascia (; plural fasciae or fascias; adjective fascial; from Latin: "band") is a band or sheet of connective tissue, primarily collagen, beneath the skin that attaches to, stabilizes, encloses, and separates muscles and other internal organs ...
. It ascends further to supply the skin along the posterior part of the
scalp The scalp is the anatomical area bordered by the human face at the front, and by the neck at the sides and back. Structure The scalp is usually described as having five layers, which can conveniently be remembered as a mnemonic: * S: The ski ...
up to the
vertex Vertex, vertices or vertexes may refer to: Science and technology Mathematics and computer science *Vertex (geometry), a point where two or more curves, lines, or edges meet *Vertex (computer graphics), a data structure that describes the position ...
.


Function

The greater occipital nerve supplies sensation to the
scalp The scalp is the anatomical area bordered by the human face at the front, and by the neck at the sides and back. Structure The scalp is usually described as having five layers, which can conveniently be remembered as a mnemonic: * S: The ski ...
at the top of the
head A head is the part of an organism which usually includes the ears, brain, forehead, cheeks, chin, eyes, nose, and mouth, each of which aid in various sensory functions such as sight, hearing, smell, and taste. Some very simple animals ...
, over the ear and over the
parotid glands The parotid gland is a major salivary gland in many animals. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. They are the largest of the salivary glands. Each parotid is wrapped around the man ...
.


Clinical significance

Problems with the greater occipital nerve may be a cause of cervicogenic headaches. These may be referred to as occipital neuralgias. A common site, and usually misdiagnosed area of entrapment for the greater occipital nerve, is at the
obliquus capitis inferior muscle The obliquus capitis inferior muscle () is the larger of the two oblique muscles of the neck. It arises from the apex of the spinous process of the axis and passes laterally and slightly upward, to be inserted into the lower and back part of the tr ...
. These may be treated with a temporary nerve block.


Occipital pain management

Most people with tension headaches experience increasing intensity with time, and report pain originating in the back of the head (occipital) moving to the front of the head (supraorbital). Neurostimulation is sometimes used to treat tension headaches that originate from the occipital nerve.Migraine Treatment Technology Explained http://www.reedmigraine.com/treat/conditions


Notes


Additional images

Gray784.png, Dermatome distribution of the trigeminal nerve Gray790.png, The nerves of the scalp, face, and side of neck. Lateral head anatomy detail.png, Lateral head anatomy detail


External links


Image at theberries.ns.ca
* http://www.dartmouth.edu/~humananatomy/figures/chapter_47/47-2.HTM * http://www.dartmouth.edu/~humananatomy/figures/chapter_47/47-6.HTM {{Authority control Spinal nerves