Axial Muscles of the Head, Neck, and Back

Learning Objectives

  • Identify the axial muscles of the face, head, and neck
  • Identify the movement and function of the face, head, and neck muscles


The skeletal muscles are divided into axial (muscles of the trunk and head) and appendicular (muscles of the arms and legs) categories. This system reflects the bones of the skeleton system, which are also arranged in this manner. The axial muscles are grouped based on location, function, or both. Some of the axial muscles may seem to blur the boundaries because they cross over to the appendicular skeleton. The first grouping of the axial muscles you will review includes the muscles of the head and neck, then you will review the muscles of the vertebral column, and finally you will review the oblique and rectus muscles.

Muscles That Create Facial Expression

The origins of the muscles of facial expression are on the surface of the skull (remember, the origin of a muscle does not move). The insertions of these muscles have fibers intertwined with connective tissue and the dermis of the skin. Because the muscles insert in the skin rather than on bone, when they contract, the skin moves to create facial expression (Figure 1).

The left panel in this figure shows the anterior view of the facial muscles, and the right panel shows the lateral view. Figure 1. Muscles of Facial Expression. Many of the muscles of facial expression insert into the skin surrounding the eyelids, nose and mouth, producing facial expressions by moving the skin rather than bones.


The orbicularis oris is a circular muscle that moves the lips, and the orbicularis oculi is a circular muscle that closes the eye. The occipitofrontalis muscle moves up the scalp and eyebrows. The muscle has a frontal belly and an occipital (near the occipital bone on the posterior part of the skull) belly. In other words, there is a muscle on the forehead (frontalis) and one on the back of the head (occipitalis), but there is no muscle across the top of the head. Instead, the two bellies are connected by a broad tendon called the epicranial aponeurosis, or galea aponeurosis (galea = “apple”). The physicians originally studying human anatomy thought the skull looked like an apple.

The majority of the face is composed of the buccinator muscle, which compresses the cheek. This muscle allows you to whistle, blow, and suck; and it contributes to the action of chewing. There are several small facial muscles, one of which is the corrugator supercilii, which is the prime mover of the eyebrows. Place your finger on your eyebrows at the point of the bridge of the nose. Raise your eyebrows as if you were surprised and lower your eyebrows as if you were frowning. With these movements, you can feel the action of the corrugator supercilli. Additional muscles of facial expression are presented in Table 1.

Table 1. Muscles in Facial Expression
Movement Target Target motion direction Prime mover Origin Insertion
Brow
Furrowing brow Skin of the scalp Anterior Occipitofrontalis, frontal belly Epicraneal aponeurosis Underneath the skin of the forehead
Unfurrowing brow Skin of the scalp Posterior Occipitofrontalis, occipital belly Occipital bone; mastoid process (temporal bone) Epicraneal aponeurosis
Lowering eyebrows (e.g., scowling, frowning Skin underneath the eyebrows Inferior Corrugator supercilii Frontal bone Skin underneath the eyebrow
Nose
Flaring nostrils Nasal cartilage (pushes nostrils open when cartilage is compressed) Inferior compression; posterior compression Nasalis Maxilla Nasal bone
Mouth
Raising upper lip Upper lip tissue Elevation Levator labii superioris Maxilla Underneath skin at the corners of the mouth; orbicularis oris
Lowering lower lip Lower lip Depression Depressor labii inferioris Mandible Underneath skin of the lower lip
Opening mouth and sliding lower jaw left and right Lower jaw Depression, lateral Depressor angulus oris Mandible Underneath skin at the corners of the mouth
Smiling Corners of the mouth Lateral elevation Zygomaticus major Zygomatic bone Underneath skin at the corners of the mouth (dimple area); orbicularis oris
Shaping of lips (as during speech) Lips Multiple Orbicularis oris Tissue surrounding the lips Underneath skin at the corners of the mouth
Lateral movement of cheeks (e.g., sucking on a straw; also used to compress air in mouth while blowing) Cheeks Lateral Buccinator Maxilla, mandible; sphenoid bone (via pterygomandibular raphae) Orbicularis oris
Pursing of lips by straightening them laterally Corners of the mouth Lateral Risorius Fascia of the parotid salivary gland Underneath skin at the corners of the mouth
Protrusion of lower lip (e.g, pouting expression) Lower lip and the skin of the chin Protraction Mentalis Mandible Underneath skin of the chin
Raising upper lip Upper lip Elevation Levator labii superioris Maxilla Underneath skin at the corners of the mouth; orbicularis oris

Muscles That Move the Eyes

The movement of the eyeball is under the control of the extrinsic eye muscles, which originate outside the eye and insert onto the outer surface of the white of the eye. These muscles are located inside the eye socket and cannot be seen on any part of the visible eyeball (Figure 2 and Table 2). If you have ever been to a doctor who held up a finger and asked you to follow it up, down, and to both sides, he or she is checking to make sure your eye muscles are acting in a coordinated pattern.

The left panel shows the lateral view of the muscles for the right eye, and the right panel shows the anterior view of the muscles for the right eye. Figure 2. Muscles of the Eyes. (a) The extrinsic eye muscles originate outside of the eye on the skull. (b) Each muscle inserts onto the eyeball.


Table 2. Muscles of the Eyes
Movement Target Target motion direction Prime mover Origin Insertion
Moves eyes up and toward nose; rotates eyes from 1 o'clock to 3 o'clock Eyeballs Superior (elevates); medial (adducts) Superior rectus Common tendinous ring (ring attaches to optic foramen) Superior surface of eyeball
Moves eyes down and toward nose; rotates eyes from 6 o'clock to 3 o'clock Eyeballs Inferior (depresses) medial (adducts) Inferior rectus Common tendinous rind (ring attaches to optic foramen) Inferior surface of eyeball
Moves eyes away from nose Eyeballs Lateral (abducts) Lateral rectus Common tendinous ring (ring attaches to optic foramen) Lateral surface of eyeball
Moves eyes toward nose Eyeballs Medial (adducts) Medial rectus Common tendinous ring (ring attaches to optic foramen) Medial surface of eyeball
Moves eyes up and away from nose; rotates eyeball from 12 o'clock to 9 o'clock Eyeballs Superior (elevates; lateral (abducts) Inferior oblique Floor of orbit (maxilla) Surface of eyeball between inferior rectus and lateral rectus
Moves eyes down and away from nose; rotates eyeball from 6 o’clock to 9 o’clock Eyeballs Superior (elevates); lateral (abducts) Superior oblique Sphenoid bone Surface of eyeball between superior rectus and lateral rectus
Opens eyes Upper eyelid Superior (elevates) Levator palpabrae superioris Roof of orbit (sphenoid bone) Skin of upper eyelids
Closes eyelids Eyelid skin Compression along superior–inferior axis Orbicularis oculi Medial bones composing the orbit Circumference of orbit

Muscles That Move the Lower Jaw

In anatomical terminology, chewing is called mastication. Muscles involved in chewing must be able to exert enough pressure to bite through and then chew food before it is swallowed (Figure 3 and Table 3). The masseter muscle is the main muscle used for chewing because it elevates the mandible (lower jaw) to close the mouth, and it is assisted by the temporalis muscle, which retracts the mandible. You can feel the temporalis move by putting your fingers to your temple as you chew.

The left panel of this figure shows the superficial chewing muscles in face, and the right panel shows the deep chewing muscles. Figure 3. Muscles That Move the Lower Jaw. The muscles that move the lower jaw are typically located within the cheek and originate from processes in the skull. This provides the jaw muscles with the large amount of leverage needed for chewing.


Table 3. Muscles of the Lower Jaw
Movement Target Target motion direction Prime mover Origin Insertion
Closes mouth; aids chewing Mandible Superior (elevates) Masseter Maxilla arch; zygomatic arch (for master) Mandible
Closes mouth; pulls lower jaw in under upper jaw Mandible Superior (elevates); posterior (retracts) Temporalis Temporal bone Mandible
Opens mouth; pushes lower jaw out under upper jaw; moves lower jaw side-to-side Mandible Inferior (depresses); posterior (protracts); lateral (abducts); medial (adducts) Lateral pterygoid Pterygoid process of sphenoid bone Mandible
Closes mouth; pushes lower jaw out under upper jaw; moves lower jaw side-to-side Mandible Superior (elevates); posterior (protracts); lateral (abducts); medial (adducts) Medial pterygoid Sphenoid bone; maxilla Mandible; temporo-mandibular joint
Although the masseter and temporalis are responsible for elevating and closing the jaw to break food into digestible pieces, the medial pterygoi and lateral pterygoid muscles provide assistance in chewing and moving food within the mouth.

Muscles That Move the Tongue

Although the tongue is obviously important for tasting food, it is also necessary for mastication, deglutition (swallowing), and speech (Figure 4 and Table 4). Because it is so moveable, the tongue facilitates complex speech patterns and sounds.

Muscles that Move the Tongue Figure 4. Muscles that Move the Tongue


Table 4. Muscles for Tongue Movement, Swallowing, and Speech
Movement Target Target motion direction Prime mover Origin Insertion
Tongue
Moves the tongue down; sticks tongue out of the mouth Tongue Inferior (depresses); anterior (protracts) Genioglossus Mandible Tongue undersurface; hyoid bone
Moves tongue up; retracts the tongue back into the mouth Tongue Superior (elevates); posterior (retracts) Styloglossus Temporal bone (styloid process) Tongue undersurface and sides
Flattens tongue Tongue Inferior (depresses) Hyoglossus Hyoid bone Sides of tongue
Bulges tongue Tongue Superior (elevation) Palatoglossus Soft palate Side of tongue
Swallowing and speaking
Raises the hyoid bone in a way that also raises the larynx, allowing the epiglottis to cover the glottis during deglutition; also assists in opening the mouth by depressing the mandible Hyoid bone; larynx Superior (elevates) Digastric Mandible; temporal bone Hyoid bone
Raises and retracts the hyoid bone in a way that elongates the oral cavity during deglutition Hyoid bone Superior (elevates); posterior (retracts) Stylohyoid Temporal bone (styloid process) Hyoid bone
Raises the hyoid bone in a way that presses the tongue against the roof of the mouth, pushing food back into the pharynx during deglutition Hyoid bone Superior (elevates) Mylohyoid Mandible Hyoid bone; median raphe
Raises and moves the hyoid bone forward, widening the pharynx during deglutition Hyoid bone Superior (elevates); anterior (protracts) Geniohyoid Mandible Hyoid bone
Retracts the hyoid bone and moves it down during later phases of deglutition Hyoid bone Inferior (depresses); posterior (retracts) Omohyoid Scapula Hyoid bone
Depresses the hyoid bone during swallowing and speaking Hyoid bone Inferior (depresses) Sternohyoid Clavicle Hyoid bone
Shrinks distance between thyroid cartilage and the hyoid bone, allowing production of high-pitch vocalizations Hyoid bone; thyroid cartilage Hyoid bone: inferior (depresses); thyroid cartilage: superior (elevates) Thyrohyoid Thyroid cartilage Hyoid bone
Depresses larynx, thyroid cartilage, and hyoid bone to create different vocal tones Larynx; thyroid cartilage; hyoid bone Inferior (depresses) Sternothyroid Sternum Thyroid cartilage
Rotates and tilts head to the side and forward Skull; cervical vertebrae Individually: medial rotation; lateral flexion; bilaterally; anterior (flexes) Sternocleidomastoid; semispinalis capitis Sternum; clavicle Temporal bone (mastoid process); occipital bone
Rotates and tilts the head to the side and backwards Skull; cervical vertebrae Individually: lateral rotation; lateral flexion; bilaterally: anterior (flexes) Splenius capitis; longissimus capitis Sternum; clavicle Temporal bone (mastoid process); occipital bone
Tongue muscles can be extrinsic or intrinsic. Extrinsic tongue muscles insert into the tongue from outside origins, and the intrinsic tongue muscles insert into the tongue from origins within it. The extrinsic muscles move the whole tongue in different directions, whereas the intrinsic muscles allow the tongue to change its shape (such as, curling the tongue in a loop or flattening it).

The extrinsic muscles all include the word root glossus (glossus = “tongue”), and the muscle names are derived from where the muscle originates. The genioglossus (genio = “chin”) originates on the mandible and allows the tongue to move downward and forward. The styloglossus originates on the styloid bone, and allows upward and backward motion. The palatoglossus originates on the soft palate to elevate the back of the tongue, and the hyoglossus originates on the hyoid bone to move the tongue downward and flatten it.

Everyday Connections: Anesthesia and the Tongue Muscles

Before surgery, a patient must be made ready for general anesthesia. The normal homeostatic controls of the body are put “on hold” so that the patient can be prepped for surgery. Control of respiration must be switched from the patient’s homeostatic control to the control of the anesthesiologist. The drugs used for anesthesia relax a majority of the body’s muscles.

Among the muscles affected during general anesthesia are those that are necessary for breathing and moving the tongue. Under anesthesia, the tongue can relax and partially or fully block the airway, and the muscles of respiration may not move the diaphragm or chest wall. To avoid possible complications, the safest procedure to use on a patient is called endotracheal intubation. Placing a tube into the trachea allows the doctors to maintain a patient’s (open) airway to the lungs and seal the airway off from the oropharynx. Post-surgery, the anesthesiologist gradually changes the mixture of the gases that keep the patient unconscious, and when the muscles of respiration begin to function, the tube is removed. It still takes about 30 minutes for a patient to wake up, and for breathing muscles to regain control of respiration. After surgery, most people have a sore or scratchy throat for a few days.

Muscles of the Anterior Neck

The muscles of the anterior neck assist in deglutition (swallowing) and speech by controlling the positions of the larynx (voice box), and the hyoid bone, a horseshoe-shaped bone that functions as a solid foundation on which the tongue can move. The muscles of the neck are categorized according to their position relative to the hyoid bone (Figure 5). Suprahyoid muscles are superior to it, and the infrahyoid muscles are located inferiorly.

This figure shows the front view of a person’s neck with the major muscle groups labeled. Figure 5. Muscles of the Anterior Neck. The anterior muscles of the neck facilitate swallowing and speech. The suprahyoid muscles originate from above the hyoid bone in the chin region. The infrahyoid muscles originate below the hyoid bone in the lower neck.


The suprahyoid muscles raise the hyoid bone, the floor of the mouth, and the larynx during deglutition. These include the digastric muscle, which has anterior and posterior bellies that work to elevate the hyoid bone and larynx when one swallows; it also depresses the mandible. The stylohyoid muscle moves the hyoid bone posteriorly, elevating the larynx, and the mylohyoid muscle lifts it and helps press the tongue to the top of the mouth. The geniohyoid depresses the mandible in addition to raising and pulling the hyoid bone anteriorly.

The strap-like infrahyoid muscles generally depress the hyoid bone and control the position of the larynx. The omohyoid muscle, which has superior and inferior bellies, depresses the hyoid bone in conjunction with the sternohyoid and thyrohyoid muscles. The thyrohyoid muscle also elevates the larynx’s thyroid cartilage, whereas the sternothyroid depresses it to create different tones of voice.

Muscles That Move the Head

The head, attached to the top of the vertebral column, is balanced, moved, and rotated by the neck muscles (Table 5). When these muscles act unilaterally, the head rotates. When they contract bilaterally, the head flexes or extends. The major muscle that laterally flexes and rotates the head is the sternocleidomastoid. In addition, both muscles working together are the flexors of the head. Place your fingers on both sides of the neck and turn your head to the left and to the right. You will feel the movement originate there. This muscle divides the neck into anterior and posterior triangles when viewed from the side (Figure 6).

The left panel shows the lateral view of the neck. The middle panel shows the superficial neck muscles, and the right panel shows the deep neck muscles Figure 6. Posterior and Lateral Views of the Neck. The superficial and deep muscles of the neck are responsible for moving the head, cervical vertebrae, and scapulas.


Table 5. Muscles That Move the Head
Movement Target Target motion direction Prime mover Origin Insertion
Rotates and tilts head to the side; tilts head forward Skull; vertebrae Individually: rotates head to opposite side; bilaterally: flexion Sternocleidomastoid Sternum; clavicle Temporal bone (mastoid process); occipital bone
Rotates and tilts head backward Skull; vertebrae Individually: laterally flexes and rotates head to same side; bilaterally: extension Semispinalis capitis Transverse and articular processes of cervical and thoracic vertebra Occipital bone
Rotates and tilts head to the side; tilts head backward Skull; vertebrae Individually: laterally flexes and rotates head to same side; bilaterally: extension Splenius capitis Spinous processes of cervical and thoracic vertebra Temporal bone (mastoid process); occipital bone
Rotates and tilts head to the side; tilts head backward Skull; vertebrae Individually: laterally flexes and rotates head to same side; bilaterally: extension Longissimus capitis Transverse and articular processes of cervical and thoracic vertebra Temporal bone (mastoid process)

Muscles of the Posterior Neck and the Back

The posterior muscles of the neck are primarily concerned with head movements, like extension. The back muscles stabilize and move the vertebral column, and are grouped according to the lengths and direction of the fascicles.

The splenius muscles originate at the midline and run laterally and superiorly to their insertions. From the sides and the back of the neck, the splenius capitis inserts onto the head region, and the splenius cervicis extends onto the cervical region. These muscles can extend the head, laterally flex it, and rotate it (Figure 7).

The top left panel shows a lateral view of the muscles of the neck, and the bottom left panel shows the posterior view of the superficial and deep muscles of the neck. The center panel shows the deep muscles of the back, and the right panel shows the deep spinal muscles. Figure 7. Muscles of the Neck and Back. The large, complex muscles of the neck and back move the head, shoulders, and vertebral column.


The erector spinae group forms the majority of the muscle mass of the back and it is the primary extensor of the vertebral column. It controls flexion, lateral flexion, and rotation of the vertebral column, and maintains the lumbar curve. The erector spinae comprises the iliocostalis (laterally placed) group, the longissimus (intermediately placed) group, and the spinalis (medially placed) group.

The iliocostalis group includes the iliocostalis cervicis, associated with the cervical region; the iliocostalis thoracis, associated with the thoracic region; and the iliocostalis lumborum, associated with the lumbar region. The three muscles of the longissimus group are the longissimus capitis, associated with the head region; the longissimus cervicis, associated with the cervical region; and the longissimus thoracis, associated with the thoracic region. The third group, the spinalis group, comprises the spinalis capitis (head region), the spinalis cervicis (cervical region), and the spinalis thoracis (thoracic region).

The transversospinales muscles run from the transverse processes to the spinous processes of the vertebrae. Similar to the erector spinae muscles, the semispinalis muscles in this group are named for the areas of the body with which they are associated. The semispinalis muscles include the semispinalis capitis, the semispinalis cervicis, and the semispinalis thoracis. The multifidus muscle of the lumbar region helps extend and laterally flex the vertebral column.

Important in the stabilization of the vertebral column is the segmental muscle group, which includes the interspinales and intertransversarii muscles. These muscles bring together the spinous and transverse processes of each consecutive vertebra. Finally, the scalene muscles work together to flex, laterally flex, and rotate the head. They also contribute to deep inhalation. The scalene muscles include the anterior scalene muscle (anterior to the middle scalene), the middle scalene muscle (the longest, intermediate between the anterior and posterior scalenes), and the posterior scalene muscle (the smallest, posterior to the middle scalene).

Self-Check Questions

Take the quiz below to check your understanding of the Axial Muscles of the Head, Neck, and Back:

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