Apical ligament: Difference between revisions

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'''Original Editor '''- [[User:Rachael Lowe|Rachael Lowe]]
'''Original Editor '''- [[User:Rachael Lowe|Rachael Lowe]]  


'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} &nbsp;
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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== Description  ==
== Description  ==
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Spans between the second cervical vertebra in the neck and the skull. It lies as a fibrous cord in the triangular interval between the alar ligaments.  
Spans between the second cervical vertebra in the neck and the skull. It lies as a fibrous cord in the triangular interval between the alar ligaments.  
Tubbs et al<ref name="Tubbs" /> investigated the structure and function of the apical ligament in 20 adult cadavers. Anatomically, they found the ligament was absent in 20% of specimens. The ligament was on average 7.5 mm long and 5.1 mm wide. Structurally, the ligament is a small aggregation of elastic fibers surrounding a core of notochordal remnant – essentially it represents a rudimentary nucleus pulposus that is the remnant of notochord seen at other vertebral levels.


== Attachments  ==
== Attachments  ==


Arises from the apex of the odontoid process on the [[Axis]] to the anterior margin of the foramen magnum. It blendes with the deep portion of the [[Anterior atlanto-occipital ligament|anterior atlanto-occipital membrane]] and superior crus of the [[Transverse ligament of the atlas]].
Arises from the tip of the odontoid process on the [[Axis]] (usually from a small coronal groove located there) and inserts into the anterior rim of the foramen magnum at the basion (mid-point).  
 
The apical ligament is separated anteriorly from the&nbsp;[[Anterior atlanto-occipital ligament|anterior atlanto-occipital membrane]] by a thin layer of fat and connective tissue. Posteriorly it is separated from the superior crus of the cruciform ligament by an intervening layer of connective tissue. The [[Tectorial membrane|tectorial membrane]] is found further dorsally, posterior to the cruciform ligament. Laterally the alar ligaments extend from the odontoid to the medial aspect of the condyles of the occipital bone. There is no blending or contact between the [[Alar ligaments|alar ligament]] and the apical ligament.<br>


== Function  ==
== Function  ==


== Pathology  ==
Best described as a vestigial structure that offers no significant added stability to the craniocervical junction<ref name="Tubbs">Tubbs RS, Grabb P, Spooner A, Wilson W, Oakes WJ. [http://www.ncbi.nlm.nih.gov/pubmed/10763691 The apical ligament: anatomy and functional significance]. J Neurosurg. 2000 Apr;92(2 Suppl):197-200.</ref>. &nbsp;
 
== Examination ==


== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
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== References  ==
== References  ==


<references />  
<references /><br>  


[[Category:Anatomy]] [[Category:Cervical_Anatomy]]
[[Category:Anatomy]] [[Category:Cervical Spine]] [[Category:Ligaments]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Cervical Spine - Anatomy]]  [[Category:Cervical Spine - Ligaments]]

Latest revision as of 13:40, 23 August 2019

Original Editor - Rachael Lowe

Top Contributors - Rachael Lowe, Kim Jackson, Evan Thomas, George Prudden and WikiSysop

Description[edit | edit source]

Upper cervical ligaments.png

Spans between the second cervical vertebra in the neck and the skull. It lies as a fibrous cord in the triangular interval between the alar ligaments.

Tubbs et al[1] investigated the structure and function of the apical ligament in 20 adult cadavers. Anatomically, they found the ligament was absent in 20% of specimens. The ligament was on average 7.5 mm long and 5.1 mm wide. Structurally, the ligament is a small aggregation of elastic fibers surrounding a core of notochordal remnant – essentially it represents a rudimentary nucleus pulposus that is the remnant of notochord seen at other vertebral levels.

Attachments[edit | edit source]

Arises from the tip of the odontoid process on the Axis (usually from a small coronal groove located there) and inserts into the anterior rim of the foramen magnum at the basion (mid-point).

The apical ligament is separated anteriorly from the anterior atlanto-occipital membrane by a thin layer of fat and connective tissue. Posteriorly it is separated from the superior crus of the cruciform ligament by an intervening layer of connective tissue. The tectorial membrane is found further dorsally, posterior to the cruciform ligament. Laterally the alar ligaments extend from the odontoid to the medial aspect of the condyles of the occipital bone. There is no blending or contact between the alar ligament and the apical ligament.

Function[edit | edit source]

Best described as a vestigial structure that offers no significant added stability to the craniocervical junction[1].  

References[edit | edit source]

  1. 1.0 1.1 Tubbs RS, Grabb P, Spooner A, Wilson W, Oakes WJ. The apical ligament: anatomy and functional significance. J Neurosurg. 2000 Apr;92(2 Suppl):197-200.