Third Occipital Nerve

Description

Arcing from the dorsal ramus of C3, the third occipital nerve (nervus occipitalis tertius) courses superiorly and medially across the upper cervical region toward the suboccipital scalp. Lateral to the cervical spinous processes it threads between the semispinalis capitis and splenius capitis, then emerges more superficially near the posterior border of the sternocleidomastoid as it approaches the occipital area. Deep to the overlying temporalis region and posterior to the auricle, accompanying cervical dorsal cutaneous branches can be appreciated in relation to the superficial veins and deeper arterial channels. This is a left lateral head and neck presentation with muscles, vessels, and nerves color coded for rapid orientation. Third occipital neuralgia is a common clinical reason to seek this exact morphology: the nerve is frequently irritated where it crosses the C2 to C3 zygapophysial (facet) joint and pierces adjacent posterior cervical musculature. Pain referral to the lower occiput can mimic greater occipital neuralgia, but targeted C2 to C3 medial branch blocks or radiofrequency neurotomy depends on knowing that the third occipital nerve is the superficial continuation of the C3 medial branch. Small structure, big consequence. This lateral relationship to the posterior cervical muscles also aligns with the surgical corridor for posterior approaches to the upper cervical spine, where iatrogenic injury can produce persistent dysesthesia. Use this illustration for teaching dorsal rami organization in gross anatomy, demonstrating cervicogenic headache pathways in pain medicine curricula, or illustrating procedural landmarks in a chapter on C2 to C3 facet interventions and occipital nerve blocks. It also suits patient education materials explaining posterior neck pain patterns after whiplash or upper cervical facet arthropathy. Anatomical accuracy verified by SciePro's Medical Advisory Board.