Greater occipital nerve
The greater occipital nerve is a cutaneous nerve, the thickest in the body, that innervates the skin from the upper neck, over the occiput, up to the vertex of the scalp 1-3.
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Terminology
The greater occipital nerve has also been known in the past - confusingly - as the nerve of Arnold. But as any student of neuroanatomy knows, the auricular branch of the vagus nerve (X) is usually called Arnold's nerve.
The use of the eponym 'Arnold' for the greater occipital nerve is now felt to be erroneous, based upon a historical misattribution. Therefore, by extension, the use of the term Arnold neuralgia, for occipital neuralgia, is also suspect and should be discarded. This has been written up in a nice, well-researched paper by a couple of Spanish neurologists, which was published in 2019 5.
Gross anatomy
Origin
The greater occipital nerve arises from the medial branch of the dorsal ramus of C2 1-3. By contrast, the lesser occipital nerve arises from the ventral ramus of C2.
Course
The greater occipital nerve emerges between axis (C2) and the obliquus capitis inferior muscle, hooking underneath the later and piercing semispinalis capitis (3 cm inferior and 1.5-2 cm lateral to the occipital protuberance) before ascending deep to trapezius fascia and eventually piercing trapezius (2.5 cm lateral to the occipital protuberance) 3. It continues to ascend to the occiput.
Branches and supply
It may divide into several branches before piercing trapezius. It supplies the skin over the occipital bone and the upper posterior neck.
Relations
The greater occipital nerve runs with the occipital artery in the apex of the posterior triangle 1-3.
Related pathology
Related Radiopaedia articles
Anatomy: Head and neck
- skeleton of the head and neck
-
cranial vault
- scalp (mnemonic)
- fontanelle
-
sutures
- calvarial
- facial
- frontozygomatic suture
- frontomaxillary suture
- frontolacrimal suture
- frontonasal suture
- temporozygomatic suture
- zygomaticomaxillary suture
- parietotemporal suture (parietomastoid suture)
- occipitotemporal suture (occipitomastoid suture)
- sphenofrontal suture
- sphenozygomatic suture
- spheno-occipital suture (not a true suture)
- lacrimomaxillary suture
- nasomaxillary suture
- internasal suture
- basal/internal
- skull landmarks
- frontal bone
- temporal bone
- parietal bone
- occipital bone
- skull base (foramina)
-
facial bones
- midline single bones
- paired bilateral bones
- cervical spine
- hyoid bone
- laryngeal cartilages
-
cranial vault
- muscles of the head and neck
- muscles of the tongue (mnemonic)
- muscles of mastication
-
muscles of facial expression
- occipitalis muscle
- circumorbital and palpebral muscles
- nasal muscles
- buccolabial muscles
- elevators, retractors and evertors of the upper lip
- levator labii superioris alaeque nasalis muscle
- levator labii superioris muscle
- zygomaticus major muscle
- zygomaticus minor muscle
- malaris muscle
- levator anguli oris muscle
- risorius muscle
- depressors, retractors and evertors of the lower lip
- depressor labii inferioris muscle
- depressor anguli oris muscle
- mentalis muscle
- compound sphincter
- orbicularis oris muscle
- incisivus superior muscle
- incisivus inferior muscle
- muscle of mastication:
- elevators, retractors and evertors of the upper lip
- muscles of the middle ear
- orbital muscles
- muscles of the soft palate
- pharyngeal muscles
- suprahyoid muscles
- infrahyoid muscles
- intrinsic muscles of the larynx
- muscles of the neck
- accessory muscles of the neck
- deep cervical fascia
-
deep spaces of the neck
- anterior cervical space
- buccal space
- carotid space
- danger space
- deep cervical fascia
- infratemporal fossa
- masticator space
- parapharyngeal space
- stylomandibular tunnel
- parotid space
- pharyngeal (superficial) mucosal space
- perivertebral space
- posterior cervical space
- pterygopalatine fossa
- retropharyngeal space
- suprasternal space (of Burns)
- visceral space
- surgical triangles of the neck
- orbit
- ear
- paranasal sinuses
- nose
- oral cavity
- pharynx
- larynx
- viscera of the neck
- blood supply of the head and neck
-
arterial supply
-
common carotid artery
- carotid body
- carotid bifurcation
- subclavian artery
- variants
-
common carotid artery
- venous drainage
-
arterial supply
- innervation of the head and neck
-
cranial nerves
- olfactory nerve (CN I)
- optic nerve (CN II)
- oculomotor nerve (CN III)
- trochlear nerve (CN IV)
-
trigeminal nerve (CN V) (mnemonic)
- trigeminal ganglion
- ophthalmic division
- maxillary division
- mandibular division
- abducens nerve (CN VI)
- facial nerve (CN VII)
-
vestibulocochlear nerve (CN VIII)
- vestibular ganglion (Scarpa's ganglion)
- glossopharyngeal nerve (CN IX)
-
vagus nerve (CN X)
- superior laryngeal nerve
- recurrent laryngeal nerve (inferior laryngeal nerve)
- (spinal) accessory nerve (CN XI)
- hypoglossal nerve (CN XII)
- parasympathetic ganglia of the head and neck
- greater occipital nerve
- third occipital nerve
-
cervical plexus
- muscular branches
- longus capitis
- longus colli
- scalenes
- geniohyoid
- thyrohyoid
-
ansa cervicalis
- omohyoid (superior and inferior bellies separately)
- sternothyroid
- sternohyoid
- phrenic nerve
- contribution to the accessory nerve (CN XI)
- cutaneous branches
- muscular branches
- brachial plexus
- pharyngeal plexus
-
cranial nerves
- lymphatic drainage of the head and neck
- embryological development of the head and neck
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