Page 359 - Kinesiology of the musculoskeletal system foundations for physical rehabilitation

Chapter 9 Axial Skeleton: Osteology and Arthrology 335

Atlanto-occipital Anterior view Anterior longitudinal ligament (cut) FIGURE 9-41. An anterior view illustrates the connective
joint capsule Occipital bone tissues associated with the atlanto-occipital joint and the
Exposed C1 Atl as Anterior atlanto-occipital atlanto-axial joint complex. The right side of the atlanto-
atlanto-axial C2 Ax is membrane occipital membrane is removed to show the capsule of the
C3 Transverse process atlanto-occipital joint. The capsule of the right atlanto-axial
(apophyseal) joint C4 Atlanto-axial (apophyseal) (apophyseal) joint is also removed to expose its articular
Posterior joint capsule surfaces. The spinal cord and the bodies of C3 and C4 are
removed to show the orientation of the posterior longitudinal
longitudinal Apophyseal joint capsule ligament.
ligament (cut)
C5
Anterior
longitudinal
ligament (cut)

Posterior view
Occipital bone

Occipital condyle Posterior FIGURE 9-42. A posterior view illustrates the connective
Atlanto-occipital joint atlanto-occipital tissues associated with the atlanto-occipital joint and atlanto-
membrane axial joint complex. The left side of the posterior atlanto-
Dens Transverse process occipital membrane and the underlying capsule of the
Atlanto-axial (apophyseal) (atlas) atlanto-occipital joint are removed. The laminae and spinous
processes of C2 and C3, the spinal cord, and the posterior
joint capsule Vertebral artery longitudinal ligament and tectorial membrane are also
removed to expose the posterior sides of the vertebral bodies
Lamina and the dens.
Ligamentum flavum

Spinous process (C5)

Superior view

Anterior longitudinal ligament (cut) Anterior tubercle FIGURE 9-43. A superior view of the dens and
Anterior arch its structural relationship to the median atlanto-
Alar ligament Dens (axis) axial joint. The spinal cord is removed and the
Synovial cavities Transverse process tectorial membrane is cut. Synovial membranes
Superior articular facet are in blue.
Transverse ligament of atlas Transverse foramen

Tectorial membrane (cut) Atlas Posterior arch
Vertebral canal Axis

Posterior tubercle

Spinous process

the cranium to the upper cervical spine. As discussed, the ment, the tectorial membrane attaches to the basilar part of
transverse ligament of the atlas makes firm contact with the the occipital bone, just anterior to the rim of the foramen
posterior side of the dens (see Figure 9-43). Just posterior to magnum.188 There is limited published information on the
the transverse ligament is a broad, firm sheet of connective function of the tectorial membrane. Based on attachments,
tissue called the tectorial membrane (see Figure 9-40 and Figure however, the ligament likely provides generalized multidirec-
9-43). As a continuation of the posterior longitudinal liga- tional stability to the craniocervical junction.