Expansion
Great auricular, lesser occipital, supraclavicular, transverse cervical, GLST meet at Erb's point
Mnemonic
“GLAS”, the four cutaneous branches emerging at Erb’s point, the midpoint of the posterior border of sternocleidomastoid:
- G - Greater auricular (C2, C3), over the parotid and angle of the jaw
- L - Lesser occipital (C2), behind the ear
- A - Anterior (transverse) cutaneous nerve of the neck (C2, C3)
- S - Supraclavicular (C3, C4), over the clavicle and upper chest
“They all come out at one point, so one block anaesthetises the lot”, which is the basis of the superficial cervical plexus block for carotid endarterectomy and neck surgery.
The greater auricular nerve supplies the skin over the parotid, which is why parotid surgery leaves numbness of the earlobe, and why it is the graft of choice for facial nerve repair.
C3 and C4 supply skin down to the second rib, which is why the shoulder tip refers pain from the diaphragm (C4 via the phrenic nerve).
Expansion
- G - Great auricular nerve
- L - Lesser occipital nerve
- S - Supraclavicular nerves
- T - Transverse cervical nerve