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The Deep Neck Muscles

The Deep Neck Muscles

Just like we have interwoven layers of superficial and deeper myofascia that make up the soft tissue of our torso, pelvis, legs, and arms, we also have more superficial layers and deep layers of muscles in the neck. In this article, we’ll continue our exploration of the neck muscles by looking at the deeper layers of neck muscles. We’ll learn which muscles comprise those deep layers, where they’re located, and what their main actions are. We’ll also go over some of the especially important functions of these muscles.

There are different ways that we can categorize this group of deep neck muscles. To help you connect the muscles to their shared functions, in the list below we’ll group these muscles by some of their main actions. It’s important to keep in mind, however, that all of these muscles have more than one action. And, as with the more superficial neck muscles we discussed in our last article, most of these deep neck muscles are found in pairs. Therefore, they have both bilateral and unilateral actions as well.

Let’s take a look at the deep neck muscles I cover in this article.

Deep muscles of the neck

Erector spinae – cervical portions

Each of the erector spinae muscles which we have covered already in a different article, have portions that are specific to the cervical spine. This group of cervical muscles is the most superficial of the muscles we’ll look at in this article. They include:

  • Spinalis cervicis
  • Iliocostalis cervicis
  • Longissimus cervicis
  • Longissimus capitis

Deep neck extensors

  • Semispinalis cervicis
  • Semispinalis capitis
  • Multifidus (cervical segments)
  • Rotatores (cervical segments)

Deep neck flexors

  • Longus colli
  • Longus capitis
  • Rectus capitis lateralis 
  • Rectus capitis anterior

Head extension and postural holding of the head – Suboccipitals 

  • Rectus capitis posterior major
  • Rectus capitis posterior minor
  • Obliquus capitis superior
  • Obliquus capitis inferior

Deep neck muscle locations

Remember that muscle attachments vary from person to person. It’s important to keep this in mind as I describe ranges of attachments for the deep neck muscles in this article. If you read other anatomy references, you’ll notice that the attachment points for the deep neck muscles are listed slightly differently in different sources. The variability from person to person is the reason for these differences. In this section of the article, I’ll describe the broad location of the deep neck muscles. For more specific descriptions of the muscle attachments, scroll down and you’ll find those listed at the end of this article.

Cervical portions of the erector spinae muscles

Spinalis cervicis (sometimes called spinalis colli) attaches to the cervical vertebrae, the lower section of the ligamentum nuchae, and the upper thoracic vertebrae. Iliocostalis cervicis (sometimes called iliocostalis colli) attaches to the mid to lower cervical vertebrae and to the angle of the ribs 3 – 6. Longissimus cervicis (sometimes called longissimus colli) attaches to most of the cervical vertebrae and to the upper thoracic vertebrae. Finally, longissimus capitis attaches at one end to the mastoid process, that bony bump behind your ear. At its other end, it attaches to the upper thoracic vertebrae and lower cervical vertebrae.

Deep neck muscles: extensors (the transversospinalis group)

The transversospinalis group is the name for the group of deep spinal muscles that lay underneath the erector spinae group. They include the semispinalis cervicis, semispinalis capitis, and a cervical section of the multifidus and the rotatores. Let’s take a look at where these deep neck muscles are located.

Semispinalis cervicis and semispinalis capitis

Individual sections of semispinalis cervicis span five or six vertebrae and attach to most of the cervical vertebrae and the upper thoracic vertebrae. The semispinalis capitis attaches at its proximal end to the occipital bone of our skull and then attaches to most of the cervical vertebrae and the upper thoracic vertebrae.

Multifidus and rotatores (the cervical portions)

The individual sections of the cervical multifidus span two to four vertebrae. They attach to most of the cervical vertebrae. The cervical portions of the rotatores are a little smaller. They span one or two vertebrae and attach along the cervical spine. Some anatomists further divide the rotatores group and consider the sections that span one vertebra as rotatores brevis and the sections that span two vertebrae as rotatores longus.

The Deep Neck Muscles

Deep neck flexors

On the front of our neck, we have a group of deep neck muscles that often don’t get a lot of attention. Those muscles are collectively referred to as the deep neck flexors. They include longus colli, longus capitis, rectus capitis lateralis, and rectus capitis anterior.

The first of these deep neck muscles on the front of the neck, longus colli, varies in its attachment points from person to person. It's often described as having three sections, a superior, an inferior section, and an intermediate or vertical section. The sections of this muscle attach at various points to the cervical and first couple of thoracic vertebrae. Longus capitis attaches at its proximal end to the base of the occipital bone and at its distal end to the cervical vertebrae.

The other two deep neck muscles in this flexor group are rectus capitis lateralis and rectus capitis anterior. Rectus capitis lateralis attaches at its superior end to the occipital bone. At its inferior end, it attaches to C1. Rectus capitis anterior attaches to the base of the occipital bone at its superior end. At its inferior end, it also attaches to C1.

Head extensors/suboccipitals

The suboccipital muscles are all deep neck muscles that are found, as the name of this group suggests along the base of the skull, the occiput. Most of this group of deep neck muscles attaches to the occipital bone and either C1 or C2. Scroll to the appendix of this article for more specific attachment details. 

Actions of the deep neck muscles in movement and posture

Cervical portions of the erector spinae muscles

As I covered in my previous article, Exploring The Erector Spinae Muscles, each of the erector spinae muscles along the back has a section specific to the cervical spine. The cervical parts of spinalis, longissimus, and iliocostalis all work together. When they act bilaterally, they extend the neck. When they contract unilaterally, they can do lateral flexion of the neck.

Deep neck extensors

The deep neck extensor muscles, and deep neck flexors muscles, work together to balance the forward/back action and position of the neck. We could consider them the “core” of our neck in the forward/backward direction. Specifically, the semispinalis cervicis and semispinalis capitis extend the head and neck when they’re working bilaterally. When either of those muscles acts unilaterally, they can do lateral flexion of the head and neck to the same side (ipsilateral). They can also rotate the head and neck to the opposite side (contralateral) when acting unilaterally.

Deep to the cervical portions of the erector spinae muscles, we have the multifidus muscles of the neck. Deep to the multifidus muscles, we find the rotatores of the neck. When these muscles act bilaterally, both the multifidus and rotatores work along with the cervical parts of the erector spinae and contribute to extension of the neck. Unilaterally, the multifidus muscle does lateral flexion of the neck to the same side and rotation of the neck to the opposite side. Unilaterally, the rotatores act to rotate the neck to the opposite side.

Deep neck flexors

To balance the actions of the many deep muscles on the back of our neck that extend the neck, we have a group of deep muscles on the front of the neck that flex the neck. Longus colli and longus capitis act to flex the neck when they work bilaterally. Unilaterally, longus colli does lateral flexion of the neck to the same side and rotation of the neck to the opposite side. Longus capitis rotates of the neck to the same side when acting unilaterally.

Rectus capitis lateralis and rectus capitis anterior primarily have a stabilization function, specifically at the atlantooccipital joint (where the head meets C1). However, rectus capitis anterior also assists in flexion of the neck when acting bilaterally. When working unilaterally, rectus capitis lateralis can also assist with lateral flexion of the head on the neck to the same side, specifically at the atlantooccipital joint.

Head extensors/suboccipitals

One of the important functions of this group of deep neck muscles is stabilizing the position of the head on the neck, rather than as prime movers. Additionally, with the actions of these muscles, it's important to keep in mind that we’re talking about movement of the head here, not movements of the neck. These are small, deep muscles and there is some inconsistency among anatomy references about which movements each of these suboccipital muscles assist with. 

What is consistent is that they contribute to hyperextension of the head on the neck. Remember that hyperextension here just means extension past the point of neutral in anatomical position. It’s a normal movement. Because of its location and fiber direction, obliquus capitis superior also does lateral flexion of the head to the same side. For similar reasons of location and fiber direction, obliquus capitis inferior also does rotation of the head to the same side. The other three suboccipital muscles may also contribute to rotation of the head to the same side, however, anatomy references don’t all agree on this movement.

Conclusion

The deep neck muscles are an important group for understanding both neck function and dysfunction. Our deep neck muscles do more of our postural maintenance, but they also assist other muscles with movement. Knowing the attachments and main actions of the deep neck muscles can help us understand when they are working well and when something is out of balance.

References

Jung B., A.C. Black, B.S. Bhutta. 2024. Anatomy, Head and Neck, Neck Movements. [Updated 2023 Nov 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557555/

Myers, T. Chapter 12: The Neck and Cranium (Part 1): Touring the Motor Cylinder. In: Body3 A Therpist’s Anatomy Reader.

Roijezon, U., G. Jull, M. Djupsjobacka, S.E. Salomoni, P.W. Hodges. 2021. Deep and superficial cervical muscles respond differently to unstable motor skill tasks. Human Movement Science. 80:102893. 9pgs.

Appendix: Specific attachments of the deep neck muscles

Cervical portions of the erector spinae muscles

Spinalis cervicis (sometimes called spinalis colli) attaches at the proximal end to the spinous processes of C2-C4 and at the distal end to the lower section of the ligamentum nuchae and C6 or C7 to T1 or T2. Some anatomists also describe a spinalis capitis muscle that has the same distal attachments as spinalis cervicis, but proximally it becomes part of semispinalis capitis.  

Iliocostalis cervicis (sometimes called iliocostalis colli) attaches at the proximal end on the transverse processes of C4-C6 and at the distal end on the angle of the ribs 3 – 6.

Longissimus cervicis (sometimes called longissimus colli) attaches at its proximal end on the transverse processes of C2-C6 and at its distal end on the transverse processes of T1-T5.

Longissimus capitis attaches at its proximal end on the mastoid process, that bony bump behind your ear. At its distal end, it attaches to the transverse processes of T1-T5 and the articular processes of C5-C7.

Deep neck extensors (the transversospinalis group)

Semispinalis cervicis

At its proximal end, the individual sections of semispinalis cervicis attach to the spinous processes of C2 to C5. Each section then spans five or six vertebrae to attach at the distal end to the transverse processes of T1 to T5 or T6.

Semispinalis capitis

The semispinalis capitis attaches at its proximal end to the occipital bone of our skull. It then attaches at its distal end to the articular processes of C3 or C4 to C7 and the transverse processes of T1 to T6 or T7.

Multifidus (the cervical portions)

The attachments of the individual sections that make up the cervical multifidus attach at their proximal end to the spinous processes of C2 to C7. Each small muscular section of the multifidus then spans from two to four vertebrae to attach at the distal end to the articular processes of C4-C7.

Rotatores (the cervical portions)

At their proximal end, the rotatores attach to the spinous processes of the cervical vertebrae. They then span one or two vertebrae to attach at their distal end to the transverse processes of the cervical vertebrae. 

Deep neck flexors

The first of these, longus colli, varies in its attachment points from person to person and is often further described as having three sections, a superior, an inferior section, and an intermediate or vertical section. For our purposes here, understand that the sections of this muscle attach at various points to the transverse processes or bodies of the vertebrae between C1 and T3. The second of these deep flexor muscles, longus capitis, is a little easier to describe specific attachments for. Longus capitis attaches at its proximal end to the base of the occipital bone. At the distal end, longus capitis attaches to the transverse processes of C3 to C6.

The other two muscles in this deep flexor group are rectus capitis lateralis and rectus capitis anterior. Rectus capitis lateralis attaches at its superior end to the jugular process (a bony protrusion) on the occipital bone. At its inferior end, it attaches to the transverse processes of C1. Rectus capitis anterior attaches to the base occipital bone at its superior end. At its inferior end, it also attaches to the transverse process of C1.

Head extensors/suboccipitals

Rectus capitis posterior major attaches at its superior end to the occipital bone. At its inferior end, it attaches to the spinous process of C2. Rectus capitis posterior minor also attaches at its superior end to the occipital bone. At its inferior end, it attaches to C1. At its superior end, obliquus capitis superior attaches to the occipital bone. At its inferior end, it attaches to the transverse process of C1. The obliquus capitis inferior attaches at its superior end to the transverse processes of C1 and at its inferior end to the spinous process of C2.

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