Cervical plexus: the sensory nerve supply of the neck
Quick facts
- Formation
- Anterior rami of the first four cervical nerves (C1 to C4).
- Sensory branches
- Lesser occipital, great auricular, transverse cervical and supraclavicular.
- Territory
- Skin of the neck, of the area behind and below the ear and of the supraclavicular area.
- Relationship with the platysma
- The platysma is moved by the cervical branch of the facial nerve, not by the cervical plexus.
The cervical plexus is a network of nerves formed by the anterior rami of the first four nerves of the cervical spine (C1 to C4). It lies deep to the sternocleidomastoid muscle and divides into sensory branches, which carry sensation to the skin of the neck, and motor branches, which control deep muscles of the neck.
What are the sensory branches?
The cutaneous branches emerge at the posterior border of the sternocleidomastoid, at a point well known to anesthesiologists, and fan out.
| Branch | Territory |
|---|---|
| Lesser occipital | Skin behind the ear and the posterior scalp |
| Great auricular | Earlobe, angle of the jaw and area over the parotid |
| Transverse cervical | Anterior skin of the neck |
| Supraclavicular | Skin over the collarbone and upper chest |
The great auricular is the one most cited in HOF, because it supplies the skin over the angle of the jaw and the parotid, areas close to the jawline.
Why does the cervical plexus matter in HOF?
The neck and the lower third of the face share the same superficial neuroanatomy, and this has practical consequences.
- Post-surgical numbness: in face and neck surgery, the earlobe can be left numb from injury to the great auricular nerve. The professional treating such a patient should know it is not a filler complication.
- Superficial blocks: the superficial cervical plexus block is used in neck surgery, and produces numbness of the cervical skin.
- Submental area and double chin: the skin of the neck has sensory supply from the plexus, but the muscles of the area, such as the platysma, are controlled by the cervical branch of the facial nerve. Confusion between the two nerve supplies is common.
- Neck lines: treating horizontal neck lines requires distinguishing skin, platysma and deep planes.
What precautions apply to neck procedures?
The neck has important superficial structures, such as the external jugular veins, the submandibular gland and lymph nodes, and deep ones, such as the carotid and the thyroid. Detailed anatomical knowledge is therefore a prerequisite, and the approach belongs to the qualified professional, according to the rules of their professional council.
Also known as: plexus cervicalis.
Frequently asked questions
Does the cervical plexus control the platysma?
No. Platysma movement comes from the cervical branch of the facial nerve. The cervical plexus carries sensation to the skin of the neck, not movement to the platysma.