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Because of its location the ligamentum nuchae froms a septum that divides the posterior aspect of the neck in the midline providing an attachment for several muscles.
These muscles are the trapezius , splenius capitis, rhomboid minor and serratus posterior superior. The ligamentum nuchae attaches superiorly to the inion external occipital protuberance and the midline of the occipital bone. Inferiorly it attaches to the spinous process of C7 vertebra prominens.
This thin membrane runs from the posterior margin of the foramen magnum to the upper border of the posterior arch of C1. It is interesting to note that although most of the cranial dura are innervated by the trigeminal nerve CNV , the infratentorial portion the portion inferior to the cerebellar tent is innervated by upper cervical nerves.
It is tempting to speculate how working the suboccipital soft tissue elements might have a positive impact on relieving cervicogenic headaches. We may be able to effect this end by using several different techniques, including craniosacral, Swedish and counterstrain, among others. Of further interest for consideration would be to review the anatomy of the transition of the dura from the cranium to the vertebral canal. The cranial dura is comprised of two layers: the outer or endosteal layer, and the inner or meningeal layer.
These two layers are contiguous throughout most of the cranial cavities, except where they part to allow for the formation of the dural sinuses. The outer layer also ends at its attachment around the foramen magnum.
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