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 neuron, motor, Sensory neuron, sensory, and Autonomic nervous system, autonomic signals between the spinal cord and the body. In the human body there are 31 pairs of spinal nerves, one on each s ...

, specifically 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 arises from between the first and second

cervical vertebrae In tetrapods, cervical vertebrae (: 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 saurop ...

, ascends, and then passes through the

semispinalis muscle The semispinalis muscles are a group of three muscles belonging to the transversospinales. These are the semispinalis capitis, the semispinalis cervicis and the semispinalis thoracis. Location The semispinalis capitis (''complexus'') is situate ...

. It ascends further to supply the skin along the posterior part of the

scalp The scalp is the area of the head where head hair grows. It is made up of skin, layers of connective and fibrous tissues, and the membrane of the skull. Anatomically, the scalp is part of the epicranium, a collection of structures covering th ...

to the vertex. It supplies sensation to the

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 ani ...

, over the

ear In vertebrates, an ear is the organ that enables hearing and (in mammals) body balance using the vestibular system. In humans, the ear is described as having three parts: the outer ear, the middle ear and the inner ear. The outer ear co ...

and over the parotid glands.

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 The cervical spinal nerve 3 (C3) is a spinal nerve of the cervical segment The spinal cord is a long, thin, tubular structure made up of nervous tissue that extends from the medulla oblongata in the lower brainstem to the lumbar region of the v ...

. It arises from between the first and second

, along with the

lesser occipital nerve The lesser occipital nerve (or small occipital nerve) is a cutaneous spinal nerve of the cervical plexus. It arises from second cervical (spinal) nerve (C2) (along with the greater occipital nerve). It innervates the skin of the back of the up ...

. It ascends after emerging from below the

suboccipital triangle The suboccipital triangle is a region of the neck bounded by the following three muscles of the suboccipital group of muscles: * Rectus capitis posterior major - above and medially * Obliquus capitis superior - above and laterally * Obliquus capit ...

beneath the

obliquus capitis inferior muscle The obliquus capitis inferior muscle () is a muscle in the upper back of the neck. It is one of the suboccipital muscles. Its inferior attachment is at the spinous process of the axis; its superior attachment is at the transverse process of the ...

. Just below the superior nuchal ridge, it pierces the

fascia A fascia (; : fasciae or fascias; adjective fascial; ) is a generic term for macroscopic membranous bodily structures. Fasciae are classified as superficial, visceral or deep, and further designated according to their anatomical location. ...

. It ascends further to supply the skin along the posterior part of the

up to the vertex.

Function

The greater occipital nerve supplies sensation to the

at the top of the

, over the

and over the parotid glands.

Clinical significance

Problems with the greater occipital nerve may be a cause of

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 ...

s. These may be referred to as

occipital neuralgia Occipital neuralgia (ON) is a painful condition affecting the posterior head in the distributions of the greater occipital nerve (GON), lesser occipital nerve (LON), third occipital nerve (TON), or a combination of the three. It is paroxysmal, l ...

s. A common site, and usually misdiagnosed area of entrapment for the greater occipital nerve, is at the

. These may be treated with a temporary

nerve block Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. #Local anesthetic nerve block, Local anesthetic nerve block (sometimes referred to as simply "nerve b ...

Occipital pain management

Most people with

tension headache Tension headache, stress headache, or tension-type headache (TTH), is the most common type of primary headache. The pain usually radiates from the lower back of the head, the neck, the eyes, or other muscle groups in the body typically affecting b ...

s 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.

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