Abstract
Objectives
This review systematically assesses literature relating to five muscles and one ligament connected to sexually dimorphic cranial landmarks – the nuchal crest and mastoid process – used for sex estimation in anthropology: the upper trapezius,
semispinalis capitis, sternocleidomastoid, splenius capitis, and longissimus capitis muscles and the nuchal ligament. Although
these soft tissues are not commonly grouped together in anatomical literature, they are anthropologically relevant in relation to
cranial sex estimation. This review demonstrates how anatomical analyses can inform anthropological research and illustrates the
benefit of multidisciplinary studies.
Methods
A systematic literature review was conducted following PRISMA (preferred reporting items for systematic reviews and
meta-analyses) guidelines and included journal articles and texts that discussed attachment sites, muscle architecture, function,
and sexual dimorphism of the soft tissues in of interest.
Results
A total of 804 publications were assessed with a final number of 64 relevant texts, including 53 primary scientific articles and 11 textbooks. Upper trapezius and sternocleidomastoid were the most widely studied, while longissimus capitis and the
nuchal ligament were the least. Additionally, there was limited consistent data on muscle architecture, attachment site morphology (entheses), sexual dimorphism, and population variation in these studies.
Conclusion
This paper highlights the need for more detailed architectural and enthesis data from diverse sex and population
groups, and interdisciplinary research that will improve understanding of sexual dimorphism in humans. This can be applicable in
clinical anatomy when assessing injury rates between males and females, and in anthropology, when estimating sex from the
skeleton