title: An anatomical basis for blocking of the deep cervical plexus and cervical sympathetic tract using an ultrasound-guided technique.
abstract: BACKGROUND
  A selective blocking method for the cervical plexus and the cervical sympathetic trunk has not yet been established.
  
  
  METHODS
  We performed a detailed examination of the neck anatomy using 28 cadavers. The pattern of local anesthetic distribution after injection in 2 healthy volunteers was imaged using computed tomographic scan.
  
  
  RESULTS
  The deep cervical plexus was located in the groove between the longus capitis and scalenus medius muscles. The cervical sympathetic trunk was located on the anteromedial surface of the longus capitis. Although anesthetic injected into the longus capitis was confined to the muscle, it infiltrated into neighboring structures including the C2 to C5 roots and sympathetic trunk.
  
  
  CONCLUSIONS
  The longus capitis muscle is a suitable landmark for blocking the cervical plexus and trunk.
authors.affiliation: Department of Anatomy (Macro), Dokkyo Medical University, Mibu, Tochigi, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Usui
authors.forename: Toshiya
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kakinuma
authors.forename: Keisuke
authors.initials: K
authors.lastname: Watanabe
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Kitajima
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Matsuno
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D002102:Cadaver; D002572:Cervical Plexus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D009334:Neck Muscles / Q000000981:diagnostic imaging / Q000294:innervation*; D009407:Nerve Block / Q000379:methods*; D013564:Sympathetic Nervous System / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local