Posterior atlantooccipital membrane

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Posterior atlantooccipital membrane
Gray305.png
Posterior atlantooccipital membrane and atlantoaxial ligament. (Posterior atlantooccipital membrane is topmost gray region at center.)
Details
Identifiers
Latin membrana atlantooccipitalis posterior
TA98 A03.1.08.004
TA2 1633
FMA 25006
Anatomical terminology

The posterior atlantooccipital membrane (posterior atlantooccipital ligament) is a broad but thin membrane [1] [2] :99 extending between the posterior margin of the foramen magnum above, and posterior arch of atlas (first cervical vertebra) below. It forms the floor of the suboccipital triangle.

Contents

The membrane helps limit excessive movement of the atlanto-occipital joints. [2] :99

Anatomy

Attachments

The superior attachment of the membrane at the posterior margin of the foramen magnum, and its inferior attachment is at the superior margin of the posterior arch of atlas (cervical vertebra C1). [1] [2] :99 [3] :426

The membrane additionally attaches posteriorly (by a soft tissue bridge which may contain muscle or tendon fibres [1] ) to the recti capitis posteriores minores mucles, [4] [1] and anteriorly to the dura mater. [1]

Innervation

The membrane is innervated by the spinal nerve C1. [3] :426

Relations

At either lateral extremity, [3] :426,430 the membrane is pierced by the vertebral artery [3] :426,430,452 and cervical spinal nerve C1. [3] :426 The free border of the membrane arches over the artery and nerve, [5] and is sometimes ossified (converting the passage for the vertebral artery into a foramen). [3] :426

Laterally, the membrane blends with the articular capsules. [1]

It is superficial/anterior to the dura mater of the spinal canal (onto which it attaches). [4] [1] The membrane overlies the grooves for vertebral arteries, vertebral venous plexuses, and cervical spinal nerves C1. [1]

The membrane forms the floor of the suboccipital triangle. [1] [2] :125 [3] :430 It is deep to the recti capitis posteriores minores mucles (which attach onto the membrane [4] [1] ), [4] and the obliqui capitis superiores muscles. [5]

Clinical significance

The membrane may be pierced with a needle at the midline superior to the arch of atlas [3] :440 to access the cisterna magna. [2] :894 [3] :440

Research

In 2015, Scali et al. revisited the anatomy of the posterior atlantooccipital membrane via plastination. Their findings revealed that the PAO membrane superiorly consisted of periosteum of the occiput, whereas inferiorly it formed part of the dura at the cerebrospinal junction, terminating at the level of the third cervical vertebra (rather than attaching to the posterior arch of the atlas). [6] It is believed that this anatomical arrangement permits a superiorly located anchor point for epidural bridging structures and allows dural tensile forces to act in a summated synchronized manner. The author's hypothesize that this complex area assists with outflow of cerebrospinal fluid.[ citation needed ]

See also

Additional images

Related Research Articles

<span class="mw-page-title-main">Atlas (anatomy)</span> First cervical vertebra of the spine which supports the skull

In anatomy, the atlas (C1) is the most superior (first) cervical vertebra of the spine and is located in the neck.

<span class="mw-page-title-main">Suboccipital nerve</span>

The suboccipital nerve is the dorsal primary ramus of the first cervical nerve (C1). It exits the spinal cord between the skull and the first cervical vertebra, the atlas.

<span class="mw-page-title-main">Dura mater</span> Outermost layer of the protective tissues around the central nervous system (meninges)

In neuroanatomy, dura mater is a thick membrane made of dense irregular connective tissue that surrounds the brain and spinal cord. It is the outermost of the three layers of membrane called the meninges that protect the central nervous system. The other two meningeal layers are the arachnoid mater and the pia mater. It envelops the arachnoid mater, which is responsible for keeping in the cerebrospinal fluid. It is derived primarily from the neural crest cell population, with postnatal contributions of the paraxial mesoderm.

<span class="mw-page-title-main">Cervical vertebrae</span> Vertebrae of the neck

In tetrapods, cervical vertebrae are the vertebrae of the neck, immediately below the skull. Truncal vertebrae lie caudal of cervical vertebrae. In sauropsid species, the cervical vertebrae bear cervical ribs. In lizards and saurischian dinosaurs, the cervical ribs are large; in birds, they are small and completely fused to the vertebrae. The vertebral transverse processes of mammals are homologous to the cervical ribs of other amniotes. Most mammals have seven cervical vertebrae, with the only three known exceptions being the manatee with six, the two-toed sloth with five or six, and the three-toed sloth with nine.

<span class="mw-page-title-main">Obliquus capitis inferior muscle</span>

The obliquus capitis inferior muscle is a muscle in the upper back of the neck. It is one of the suboccipital muscles. Its inferior attachment is at the spinous process of the axis; its superior attachment is at the transverse process of the atlas. It is innervated by the suboccipital nerve. The muscle rotates the head to its side.

<span class="mw-page-title-main">Obliquus capitis superior muscle</span>

The obliquus capitis superior muscle is a small muscle in the upper back part of the neck. It is one of the suboccipital muscles. It attaches inferiorly at the transverse process of the atlas ; it attaches superiorly at the external surface of the occipital bone. The muscle is innervated by the suboccipital nerve.

<span class="mw-page-title-main">Vertebral artery</span> Major arteries of the neck

The vertebral arteries are major arteries of the neck. Typically, the vertebral arteries originate from the subclavian arteries. Each vessel courses superiorly along each side of the neck, merging within the skull to form the single, midline basilar artery. As the supplying component of the vertebrobasilar vascular system, the vertebral arteries supply blood to the upper spinal cord, brainstem, cerebellum, and posterior part of brain.

<span class="mw-page-title-main">Rectus capitis posterior major muscle</span> Tendon

The rectus capitis posterior major is a muscle in the upper back part of the neck. It is one of the suboccipital muscles. Its inferior attachment is at the spinous process of the axis ; its superior attachment is onto the outer surface of the occipital bone on and around the side part of the inferior nuchal line. The muscle is innervated by the suboccipital nerve. The muscle acts to extend the head and rorate the head to its side.

<span class="mw-page-title-main">Rectus capitis posterior minor muscle</span> Tendon

The rectus capitis posterior minor is a muscle in the upper back part of the neck. It is one of the suboccipital muscles. Its inferior attachment is at the posterior arch of atlas; its superior attachment is onto the occipital bone at and below the inferior nuchal line. The muscle is innervated by the suboccipital nerve. The muscle acts as a weak extensor of the head.

<span class="mw-page-title-main">Occipital artery</span>

The occipital artery is a branch of the external carotid artery that provides arterial supply to the back of the scalp, sternocleidomastoid muscles, and deep muscles of the back and neck.

<span class="mw-page-title-main">Inferior thyroid artery</span> Artery of the neck

The inferior thyroid artery is an artery in the neck. It arises from the thyrocervical trunk and passes upward, in front of the vertebral artery and longus colli muscle. It then turns medially behind the carotid sheath and its contents, and also behind the sympathetic trunk, the middle cervical ganglion resting upon the vessel.

<span class="mw-page-title-main">Ascending pharyngeal artery</span>

The ascending pharyngeal artery is an artery of the neck that supplies the pharynx.

<span class="mw-page-title-main">Deep cervical vein</span>

The deep cervical vein is the vena comitans of the deep cervical artery. The vein is formed in the suboccipital region by the convergence of communicating branches of the occipital vein, veins draining the suboccipital muscles, and veins from the venous plexuses that surround cervical nerves. The vein and corresponding artery then pass in between the semispinalis capitis muscle and the semispinalis colli muscle. The vein passes anterior-ward in between the transverse process of the 7th cervical vertebra and the neck of the first rib to terminate in the vertebral vein.

<span class="mw-page-title-main">Posterior meningeal artery</span> Meningeal branch of the ascending pharyngeal artery

The posterior meningeal artery is one of the meningeal branches of the ascending pharyngeal artery. It passes through the jugular foramen to enter the posterior cranial fossa. It is the largest vessel supplying the dura of the posterior cranial fossa.

<span class="mw-page-title-main">Suboccipital triangle</span>

The suboccipital triangle is a region of the neck bounded by the following three muscles of the suboccipital group of muscles:

<span class="mw-page-title-main">Transverse ligament of atlas</span>

In anatomy, the transverse ligament of the atlas is a broad, tough ligament which arches across the ring of the atlas posterior to the dens to keep the dens in contact with the atlas. It forms the transverse component of the cruciform ligament of atlas.

<span class="mw-page-title-main">Tectorial membrane of atlanto-axial joint</span> Ligament in the spinal canal in the head joint area

The tectorial membrane of atlanto-axial joint is a tough membrane/broad, strong band representing the superior-ward prolongation of the posterior longitudinal ligament.

<span class="mw-page-title-main">Anterior atlantooccipital membrane</span>

The anterior atlantooccipital membrane is a broad, dense membrane extending between the anterior margin of the foramen magnum (superiorly), and the anterior arch of atlas (inferiorly).

<span class="mw-page-title-main">Posterior branches of cervical nerves</span>

The posterior branches of cervical nerves branch from the dorsal rami of the cervical nerves.

The myodural bridge or miodural ligament is a bridge of connective tissue that extends between the suboccipital muscles and the cervical spinal dura mater, the outer membrane that envelops the spinal cord. It provides a physical connection between the musculoskeletal and nervous systems, and the circulation of cerebrospinal fluid. Its importance has been highlighted by various authors.

References

  1. 1 2 3 4 5 6 7 8 9 10 Standring, Susan (2020). Gray's Anatomy: The Anatomical Basis of Clinical Practice (42th ed.). New York. p. 840. ISBN   978-0-7020-7707-4. OCLC   1201341621.{{cite book}}: CS1 maint: location missing publisher (link)
  2. 1 2 3 4 5 Moore, Keith L.; Dalley, Arthur F.; Agur, Anne M. R. (2018). Clinically Oriented Anatomy (8th ed.). Wolters Kluwer. ISBN   978-1-4963-4721-3.
  3. 1 2 3 4 5 6 7 8 9 Sinnatamby, Chummy (2011). Last's Anatomy (12th ed.). ISBN   978-0-7295-3752-0.
  4. 1 2 3 4 Standring, Susan (2020). Gray's Anatomy: The Anatomical Basis of Clinical Practice (42th ed.). New York. p. 848. ISBN   978-0-7020-7707-4. OCLC   1201341621.{{cite book}}: CS1 maint: location missing publisher (link)
  5. 1 2 Gray, Henry (1918). Gray's Anatomy (20th ed.). p. 296.
  6. Frank Scali; Matthew E Pontell; Lance G Nash; Dennis E Enix (2015). "Investigation of meningomyovertebral structures within the upper cervical epidural space: a sheet plastination study with clinical implications". The Spine Journal. 15 (11): 2417–2424. doi:10.1016/j.spinee.2015.07.438. PMID   26210227.