Punctum nervosum

Punctum nervosum, also known as Erb’s point or the nerve point of the neck, is a point half way along the posterior border of the sternocleidomastoid muscle from which all cutaneous branches of the cervical plexus converge and become superficial.

Gross anatomy

The punctum nervosum is located on the posterior border of the sternocleidomastoid muscle approximately midway between the origin of the muscle at the superior aspect of the manubrium and the insertion of the muscle on the lateral aspect of the mastoid process. All four cutaneous branches of the cervical plexus pierce the investing layer of the deep cervical fascia and emerge from the posterior border of the sternocleidomastoid muscle at this point, becoming superficial and fanning out to cover the skin of the neck and head. The four nerves that diverge from Erb's point are:

• lesser occipital nerve
• greater auricular nerve
• transverse cervical nerve
• supraclavicular nerves

Related pathology

The punctum nervosum is targeted in a superficial cervical plexus block that provides anesthesia to the skin of the periauricular regions and anterolateral neck.