Regional Anesthesia - Cervical Plexus Block for Regional Anesthesia of the Neck
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Anatomy. The cervical plexus lies in the paravertebral region of the upper four cervical vertebrae (Fig. 18.3). It is formed from the ventral rami of the C1–C4 spinal nerve roots. It is deep to the sternocleidomastoid muscle (SCM) and anterior to the middle scalene muscle, in continuity with the nerve roots forming the brachial plexus. The plexus has superficial and deep branches. The superficial branches pierce the cervical fascia anteriorly, just posterior to the SCM, and supply the skin of the back of the head, side of the neck, and anterior and lateral shoulder. The deep branches supply the muscles and deep structures of the neck and form the phrenic nerve.