1 62 HEAD AND NECK 



in the superficial fascia between the great occipital and the median plane. 

 It is the medial division of the posterior branch of the third cervical nerve, 

 and it supplies the skin of the medial and lower part of the posterior portion 

 of the scalp and the adjacent part of the skin of the back of the neck. 

 Trace it upwards to its termination and downwards to the point where it 

 pierces the deep fascia covering the trapezius. At a still lower level look 

 for the medial divisions of the posterior branches of the other cervical 

 nerves. They are variable in number and position, but those which are 

 present will be found piercing the deep fascia over the trapezius, at a short 

 distance from the median plane, and running downwards and laterally 

 towards the posterior triangle. 



After the cutaneous nerves have been found remove the remains of the 

 superficial fascia and the deep fascia from the surface of the trapezius. 



The Terminal Part of the Great Occipital Nerve. The 



great occipital nerve is the large medial division of the 

 posterior branch of the second cervical nerve. It enters the 

 posterior part of the scalp, after piercing the upper part of the 

 trapezius and the deep fascia of the back of the neck, and 

 ramifies in the superficial fascia of the scalp over the occipital 

 bone and the posterior part of the parietal bone, accompanying 

 the branches of the occipital artery, and communicating with 

 the great auricular and small occipital nerves. 



Arteria Occipitalis. After emerging from between the 

 trapezius and the sterno-mastoid, at the apex of the posterior 

 triangle, or piercing the upper part of the trapezius, the terminal 

 part of the occipital artery passes through the deep fascia of 

 the back of the neck and enters the superficial fascia of the 

 posterior part of the scalp. It anastomoses with its fellow of 

 the opposite side, and with the posterior auricular and the 

 superficial temporal arteries. As a rule, it breaks up into two 

 main branches, a lateral and a medial. The medial branch 

 gives off cutaneous twigs and a meningeal branch, which passes 

 through the parietal foramen and anastomoses with a branch 

 of the middle meningeal artery. Through the same foramen, 

 passes an emissary vein which connects the occipital veins 

 with the superior sagittal (longitudinal) sinus. 



Musculus Trapezius. The trapezius and latissimus dorsi 

 constitute the first layer of the muscles of the back. Only 

 that part of the trapezius which lies above the level of the 

 seventh cervical spine belongs to the dissector of the head and 

 neck ; the lower part and the latissimus must be cleaned by 

 the dissector of the arm, but the dissector of the head should 

 take the opportunity to revise his knowledge of the whole 

 origin and insertion of the muscle. It arises from the medial 

 third of the superior nuchal line of the occipital bone, 



