Atlanto-axial joint

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Atlanto-axial joint
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Details
System skeletal
Identifiers
Latin articulatio atlantoaxialis mediana, articulatio atlantoaxialis lateralis
MeSH D001268
FMA 25524
Anatomical terminology

The atlanto-axial joint is a joint in the upper part of the neck between the atlas bone and the axis bone, which are the first and second cervical vertebrae. It is a pivot joint.

Contents

Structure

The atlanto-axial joint is a joint between the atlas bone and the axis bone, which are the first and second cervical vertebrae. It is a pivot joint.

There is a pivot articulation between the odontoid process of the axis and the ring formed by the anterior arch and the transverse ligament of the atlas.

Lateral and median joints

There are three atlanto-axial joints: one median and two lateral: [1]

Ligaments

The ligaments connecting these bones are:

Capsule

The atlantoaxial articular capsules are thick and loose, and connect the margins of the lateral masses of the atlas with those of the posterior articular surfaces of the axis.

Each is strengthened at its posterior and medial part by an accessory ligament, which is attached below to the body of the axis near the base of the odontoid process, and above to the lateral mass of the atlas near the transverse ligament.

Clinical significance

Because of its proximity to the brain stem and importance in stabilization, fracture or injury to the atlanto-axial joint can cause serious problems. Common trauma and pathologies include (but are not limited to):

The dens: significant depression on the skull can push the dens into the brainstem, causing death. The dens itself is vulnerable to fracture due to trauma or ossification.

Transverse ligament: Should the transverse ligament of the atlas fail due to trauma or disease, the dens is no longer anchored and can travel up the cervical spine, causing paralysis. If it reaches the medulla death can result. Alar ligaments: stress or trauma can stretch the weaker alar ligaments, causing an increase in range of motion of approximately 30%.

Posterior atlanto-occipital membrane: genetic traits can sometimes result in ossification, turning the groove into a foramen.

Arthritis

Osteoarthritis may occur at the atlanto-axial joint. [4] This involves classic pathophysiology, such as loss of articular cartilage, osteophytes visible with radiography, and bone thickening with a narrow joint space. [4] Conservative management is usually effective, involving analgesics. [4] Surgery may be used in severe cases, and may have good outcomes. [4]

Abnormal widening

Normal atlanto-dental joint on projectional radiography. Normal atlanto-dental joint on X-ray.jpg
Normal atlanto-dental joint on projectional radiography.

A widening of the atlanto-axial joint, as measured between the posterior surface of the anterior arch of atlas and the front of the odontoid process, indicates an injury to the transverse atlantal ligament. [5] Normally, this atlanto-dental distance is less than 2 mm, sometimes a maximum of 3 mm is accepted in men and 2.5 mm in women. [5]

Related Research Articles

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<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.

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<span class="mw-page-title-main">Axis (anatomy)</span> Second cervical vertebra of the spine

In anatomy, the axis is the second cervical vertebra (C2) of the spine, immediately inferior to the atlas, upon which the head rests.

<span class="mw-page-title-main">Calcaneus</span> Bone of the tarsus of the foot

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

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<span class="mw-page-title-main">Talus bone</span> One of the foot bones that forms the tarsus

The talus, talus bone, astragalus, or ankle bone is one of the group of foot bones known as the tarsus. The tarsus forms the lower part of the ankle joint. It transmits the entire weight of the body from the lower legs to the foot.

<span class="mw-page-title-main">Lateral parts of occipital bone</span>

The lateral parts of the occipital bone are situated at the sides of the foramen magnum; on their under surfaces are the condyles for articulation with the superior facets of the atlas.

<span class="mw-page-title-main">Atlanto-occipital joint</span> Articulation between the occipital bone and the cervical atlas

The atlanto-occipital joint is an articulation between the atlas bone and the occipital bone. It consists of a pair of condyloid joints. It is a synovial joint.

<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">Posterior longitudinal ligament</span> Ligament connecting vertebral bodies of all of the vertebrae

The posterior longitudinal ligament is a ligament connecting the posterior surfaces of the vertebral bodies of all of the vertebrae of humans. It weakly prevents hyperflexion of the vertebral column. It also prevents posterior spinal disc herniation, although problems with the ligament can cause it.

<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">Occipital condyles</span> Undersurface protuberances of the occipital bone in vertebrates

The occipital condyles are undersurface protuberances of the occipital bone in vertebrates, which function in articulation with the superior facets of the atlas vertebra.

<span class="mw-page-title-main">Cruciate ligament of atlas</span> Ligament forming part of theatlanto-axial joint

The cruciate ligament of the atlas is a cross-shaped ligament in the neck forming part of the atlanto-axial joint. It consists of the transverse ligament of atlas, a superior longitudinal band, and an inferior longitudinal band.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

<span class="mw-page-title-main">Vertebral column</span> Bony structure found in vertebrates

The vertebral column, also known as the backbone or spine, is the core part of the axial skeleton in vertebrate animals. The vertebral column is the defining characteristic of vertebrate endoskeleton in which the notochord found in all chordates has been replaced by a segmented series of mineralized irregular bones called vertebrae, separated by fibrocartilaginous intervertebral discs. The dorsal portion of the vertebral column houses the spinal canal, a cavity formed by alignment of the neural arches that encloses and protects the spinal cord.

<span class="mw-page-title-main">Vertebra</span> Bone in the vertebral column

Each vertebra is an irregular bone with a complex structure composed of bone and some hyaline cartilage, that make up the vertebral column or spine, of vertebrates. The proportions of the vertebrae differ according to their spinal segment and the particular species.

References

  1. Federative Committee on Anatomical Terminology (1998). Terminologia anatomica: international anatomical terminology. Thieme. pp. 27–. ISBN   978-3-13-114361-7 . Retrieved 17 June 2010.
  2. Carmine D. Clemente (2010). Clemente's Anatomy Dissector. Lippincott Williams & Wilkins. pp. 361–. ISBN   978-1-60831-384-6 . Retrieved 17 June 2010.
  3. "Lateral atlantoaxial joint". Medcyclopaedia. GE. Archived from the original on 2012-02-05.
  4. 1 2 3 4 Harata, S.; Tohno, S.; Kawagishi, T. (1982-03-01). "Osteoarthritis of the atlanto-axial joint". International Orthopaedics. 5 (4): 277–282. doi:10.1007/BF00271083. ISSN   1432-5195.
  5. 1 2 Rojas, C.A.; Bertozzi, J.C.; Martinez, C.R.; Whitlow, J. (2007). "Reassessment of the Craniocervical Junction: Normal Values on CT". American Journal of Neuroradiology. 28 (9): 1819–1823. doi: 10.3174/ajnr.A0660 . ISSN   0195-6108. PMC   8134200 . PMID   17893223.

Bibliography