Third Lesser Occipital Nerve, Gross Anatomy

Description

Positioned along the posterolateral neck, the third lesser occipital nerve is traced as a superficial cutaneous branch arising from the cervical plexus, classically from the ventral ramus of C3, then ascending toward the scalp just posterior to the auricle. Its course is shown emerging at the posterior border of the sternocleidomastoid near the nerve point of the neck (punctum nervosum), then running superiorly in the superficial fascia toward the mastoid region and lateral occiput. Nearby cranial and cervical nerves radiate across the face, scalp, and upper neck, with the skull sutures and upper cervical vertebrae providing fixed bony reference points. Blue venous channels accompany the neurovascular pathways around the occipital and postauricular regions. Clear identification of this nerve matters because sensory symptoms behind the ear and over the lateral occiput are often mislabeled as greater occipital neuralgia or migraine when the C2 and C3 territories overlap. In posterior scalp blocks, selective anesthetic placement at the posterior border of the sternocleidomastoid can target the lesser occipital nerve while sparing deeper structures, and this illustration helps discriminate its superficial trajectory from the deeper suboccipital musculature where the greater occipital nerve (C2 dorsal ramus) travels. A small nerve. Easy to miss. Medical educators can drop this figure directly into head and neck anatomy modules, cervical plexus teaching labs, and pain medicine lectures covering occipital nerve blocks, cervicogenic headache, and postauricular dysesthesia after neck dissection or mastoid surgery. It also suits ENT, neurosurgery, and interventional pain publications that need a clean depiction of cutaneous innervation landmarks in relation to the skull base and upper cervical spine. Anatomical accuracy verified by SciePro's Medical Advisory Board.