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 geographi ...

, and, widening as it ascends, is inserted into the medial part of the

inferior nuchal line Inferior may refer to: * Inferiority complex * An anatomical term of location * Inferior angle of the scapula, in the human skeleton * ''Inferior'' (book), by Angela Saini * ''The Inferior'', a 2007 novel by Peadar Ó Guilín See also *Junior (d ...

of the occipital bone 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 oblonga ...

, and also takes some attachment to the spinal dura mater. 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 i ...

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 join ...

between the rectus capitis posterior minor (RCPm) muscle and the dorsal spinal dura. Similar connective tissue connections of the

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 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 ...

s 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 n ...

. 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 (rectus capitis posterior minor shown in red.) File:Gray129.png, Occipital bone. Outer surface.

References

External links

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PTCentral
{{Authority control Muscles of the head and neck