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MuscleNecksuperficialDraft

SternocleidomastoidMusculus sternocleidomastoideus

Large, superficial rope-like muscle on the side of the neck that turns the head to the opposite side and bends the neck.

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LatinMusculus sternocleidomastoideus
Origin
  • Sternal head: upper front surface of the manubrium of the sternum
  • Clavicular head: upper border and front of the medial third of the clavicle
Insertion
  • Lateral surface of the mastoid process of the temporal bone
  • Lateral half of the superior nuchal line of the occipital bone
Action
  • One side: rotates the head so the face turns to the opposite side
  • One side: laterally flexes the neck to the same side
  • Both sides: flex the neck
  • Both sides, with the head fixed: lift the sternum as an accessory muscle of breathing
NerveAccessory nerve (CN XI) (C2–C3 (sensory/proprioceptive))
NameNamed after its attachments: sternum (sterno-), clavicle (cleido-) and mastoid process.

Palpation

  1. Client supine; sit at the head of the table.
  2. Ask the client to turn the head slightly away from the side you are palpating; the muscle stands out as a rope from behind the ear to the top of the sternum.
  3. Take a gentle pincer grip on the muscle belly between thumb and fingers, lifting it away from the deeper structures of the neck.
  4. Ask the client to lift the head slightly off the table with the face still turned away; feel both heads firm up and follow them down to the sternum and clavicle.

Landmarks: Mastoid process

The sternocleidomastoid divides the side of the neck into an anterior and a posterior triangle, so it is the main landmark for finding other neck muscles. The Scalenes and Splenius capitis lie just behind its back edge. The thin Platysma lies over its lower part.

Local precaution: the carotid artery and jugular vein run just deep to and in front of this muscle. Use a light pincer grip on the muscle itself, avoid sustained deep pressure on the front of the neck, and work one side at a time.

It shares its motor nerve, the accessory nerve, with Trapezius. Remember that the SCM turns the face away from its own side; Splenius capitis turns it towards its own side.

Techniques

  • Effleurage — Long, gliding strokes with the whole palm that spread the medium, warm the tissue and link the other strokes together.
  • Petrissage — Kneading strokes that compress, lift and squeeze the muscle away from the bone, working the tissue between the hands.
  • Passive stretching — The therapist gently moves a relaxed limb to lengthen a muscle to a point of mild stretch and holds it there, with no effort from the client.

Works with

  • Scalenes — Three paired muscles (anterior, middle and posterior) at the side of the neck that side-bend the neck and lift the first two ribs in deep breathing.
  • Longus colli — Deep muscle on the front of the cervical and upper thoracic spine that flexes the neck and slightly rotates it.
  • Trapezius — Large diamond-shaped muscle of the upper back and neck that moves and stabilises the scapula.

Opposes

  • Splenius capitis — Broad, strap-like muscle at the back of the neck that extends the head and turns and tilts it to the same side.
  • Semispinalis capitis — Thick, rope-like muscle beside the cervical spine, deep to trapezius and splenius, that extends the head and helps tilt and turn it.

Sources

  1. Wikipedia, Sternocleidomastoid muscle
  2. Gray's Anatomy (1918), IV. Myology 5b: The Lateral Cervical Muscles (Public domain; Bartleby edition read via the Internet Archive.)