Posterior Major Rectus Capitis

Description

Arising from the spinous process of the axis (C2), the rectus capitis posterior major runs superolaterally to insert on the lateral part of the inferior nuchal line of the occipital bone, just lateral to the midline. A lateral view of the skull and cervical spine places the muscle deep in the posterior neck, tucked beneath the splenius capitis and semispinalis capitis, and immediately inferior to the occiput. The atlas (C1) lies superior to the axis, and the posterior arch of C1 and the occipitoatlantal region provide bony landmarks for the suboccipital compartment. This is the workhorse extensor and ipsilateral rotator within the suboccipital muscle group, so the C2 to occiput relationship matters when teaching coupled upper cervical motion and head posture mechanics. Clinically, the rectus capitis posterior major sits adjacent to the vertebral artery as it curves around the posterior arch of the atlas and near the greater occipital nerve as it emerges from the dorsal ramus of C2, an anatomic neighborhood implicated in cervicogenic headache and occipital neuralgia. Small muscle, high stakes. Use this illustration for gross anatomy lab guides covering the suboccipital region, neuromusculoskeletal education on deep cervical extensors, and surgical or pain management references that need clean bony landmarks for C1 to C2 orientation. Anatomical accuracy verified by SciePro's Medical Advisory Board.