The C2 dermatome covers the back of the scalp from the occiput up toward the vertex, plus skin around the angle of the jaw and behind the ear. There is no C1 dermatome in most people because the C1 root usually has little or no sensory component. The face itself belongs to the trigeminal nerve, not to C2.
| Nerve root | C2 |
|---|---|
| Area | Back of the head (occiput) and posterior scalp, plus skin over the angle of the mandible and around the ear |
| How to test | Light touch and pinprick are compared side to side at the ISNCSCI key sensory point: at least 1 cm lateral to the external occipital protuberance (or about 3 cm behind the ear). |
| Nerve Supply | Greater occipital nerve; Lesser occipital nerve; Great auricular nerve |
Carries touch, pain and temperature sensation from this strip of skin to the spinal cord through the C2 dorsal root.
Occipital headache with scalp tenderness or tingling can come from C2 irritation, for example in upper cervical arthritis, atlantoaxial instability or occipital neuralgia. The sharp border between C2 skin and trigeminal skin on the face is useful: numbness that crosses onto the face suggests a cranial nerve or brainstem cause rather than a cervical root. Dermatome maps differ between sources (Foerster, Keegan and Garrett, and modern evidence-based maps disagree), and neighbouring dermatomes overlap, so borders are approximate.
Shooting or stabbing pain over the back of the scalp from irritation of the greater or lesser occipital nerves, which carry C2 fibres.
Irritation of the C2 root by arthritis of the C1-C2 joints or instability can cause occipital pain and altered scalp sensation.
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