Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
INTIKHAB ALAM 58 
SAJJAD AHMAD 29
CONTENTS 
ATLAS AND AXIS 
ATLANTO-OCCIPITAL JOINT 
o Ligaments 
o Movements 
o Muscles help in movements 
o Clinical asp...
INTIKHAB ALAM 58
ATLAS AND AXIS ANATOMY: 
 The atlas is the topmost 
vertebra and chief 
peculiarity of atlas is that it 
has no body, it ...
DEFINITION 
 The atlanto-occipital 
joint (articulation 
between the atlas and 
the occipital bone) 
consists of a pair 
...
LIGAMENTS 
 The ligaments 
connecting the bones 
are: 
Two articular capsules 
Posterior atlanto-occipital 
membrane: 
...
SECONDARY LIGAMENTS 
 The ligamenta flava 
join laminae of adjacent 
vertebral arches. 
 The interspinous 
ligaments exp...
MOVEMENTS 
 The movements permitted in this joint are: 
 flexion and extension in the Sagittal axis, 
which give rise to...
MUSCLES HELP IN MOVEMENT 
o Flexion is produced 
mainly by the action of 
longi capitis ,rectus 
capitis anteriores and 
s...
MUSCLES HELP IN MOVEMENT 
 The recti laterales 
are concerned in 
the lateral 
movement, 
assisted by the 
trapezius, spl...
CLINICAL ASPECTS 
 Headaches can arise from many different sources 
including dysfunctional muscles, tears in the 
ligame...
SAJJAD AHMAD 29
DEFINITION: 
The joint formed b/w atlas 
and axis in the upper part 
of the neck. 
 Synovial in nature. 
 Atlanto-axial...
LIGAMENTS 
The following four ligaments 
stabilize these joints: 
 Apical ligament: Connects the 
dens to the foramen mag...
ARTICULAR CAPSULE 
 The atlanto-axial articular 
capsules are thick and 
loose, and connect the 
margins of the lateral 
...
MOVEMENTS: 
 Lateral AAJ Movement: 
It is a synovial joint which allows only gliding. The 
opposed articular surfaces of ...
INTERSTING FACT 
Owl can 
rotate its head 
upto 270°. 
 This rotation 
compensate 
for their 
ooccular 
immobility.
MUSCLES HELP IN MOVEMENTS: 
 The principal muscles by 
which these movements 
are produced are the 
Sternocleidomastoideu...
MUSCLES ORIGIN INSERTION MOVEMENTS 
obliquus capitis 
inferior 
spinous process 
of the axis 
transverse 
process of atlas...
CLINICAL ASPECTS: 
 Death by judicial hanging may 
be due to the rupture of the 
transverse ligament of atlas or 
fractur...
CLINICAL ASPECTS: 
 Pathological softening of the transverse and 
adjacent ligaments usually resulting from 
disorders of...
CLINICAL ASPECTS: 
 Sometimes inflammation in the craniovertebral area 
may produce softening of the ligaments of the 
cr...
BLOOD SUPPLY AND INNERVATIONS
INNERVATION: 
• AAJ and AOJ nerves are supplied by the C1 and C2 
nerves.
BLOOD SUPPLY: 
 No blood supply, very 
dependent certain 
physiological factors 
for health and 
restoration after injury...
Different movements of head
POINTS TO BE NOTE 
 Bursa: it is a fluid filled sac that helps reduce friction. 
 Ligamentum flavumat craniovertebral re...
TIME OF YOUR ATTENTION
Which ligament prevents excessive rotation 
of these atlanto-axial joints? 
a)Crucite 
b)Apical 
c)Check 
d)Alar 
e)Both c...
How many atlanto-axial joints are there? 
a)Two 
b)Three 
c)Four
What Is the superior continuation of 
posterior longitudenal ligament? 
a)Ligamentum flavum 
b)Accessory ligament 
c)Membr...
What type of movement AAJ and AOJ do 
respectively? 
a)Flexion ,extention and rotation 
b)Gliding and rotation 
c)Rotation...
Which one is rudimentary of notochord? 
a)Accessory ligament 
b)Crucite ligament 
c)Transverse ligament 
d)Apical ligament
COMMON SITE OF FRACTURE OF AXIS? 
a)Posterior arch 
b)Anterior arch 
c)Spinous process 
d)Odontoid process
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Atlantoaxial and occipital joint
Upcoming SlideShare
Loading in …5
×

Atlantoaxial and occipital joint

this is a presentation on atlanto-axial and atlanto-occipital joints. after reading this, most of you will know about atlas and axis, joint type, anatomy of joint, movements allowed by joint and its clinical considerations.

  • Login to see the comments

Atlantoaxial and occipital joint

  1. 1. INTIKHAB ALAM 58 SAJJAD AHMAD 29
  2. 2. CONTENTS ATLAS AND AXIS ATLANTO-OCCIPITAL JOINT o Ligaments o Movements o Muscles help in movements o Clinical aspects ATLANTO-AXIAL JOINT o Ligaments o Movements o Muscles help in movements o Clinical aspects BLOOD SUPPLY AND INNERVATIONS
  3. 3. INTIKHAB ALAM 58
  4. 4. ATLAS AND AXIS ANATOMY:  The atlas is the topmost vertebra and chief peculiarity of atlas is that it has no body, it is ring like and consist of anterior and posterior arch and two lateral masses.  Axis, the 2nd cervical vertebra has a concave under side and convex from side to side. The most distinctive characteristic of this bone is strong odontoid process, the dens.
  5. 5. DEFINITION  The atlanto-occipital joint (articulation between the atlas and the occipital bone) consists of a pair of condyloid joints.  The atlanto-occipital joints are synovial socket-type joints; the sockets are shallow in infancy and deepen with age.
  6. 6. LIGAMENTS  The ligaments connecting the bones are: Two articular capsules Posterior atlanto-occipital membrane: extend from anterior arch of atlas to posterior margin of foramen magnum. Anterior atlanto-occipital membrane: extend from anterior arch of atlas to anterior margin of foramen magnum.
  7. 7. SECONDARY LIGAMENTS  The ligamenta flava join laminae of adjacent vertebral arches.  The interspinous ligaments expand to form the ligamentum nuchae which inserts along the posterior foramen magnum and external occipital condyle.
  8. 8. MOVEMENTS  The movements permitted in this joint are:  flexion and extension in the Sagittal axis, which give rise to the ordinary forward and backward nodding of the head.  slight lateral motion, lateral flexion to one or other side in the Frontal axis(titling of head).  It's where the nodding action of the head occurs.
  9. 9. MUSCLES HELP IN MOVEMENT o Flexion is produced mainly by the action of longi capitis ,rectus capitis anteriores and sternocleidomatoid(ante rior fibers) o Extension by the rectus capitis posteriore major and minor, the obliquus capitis superior, the semispinalis capitis, splenius capiitis, longissimus capitis, sternocleidomas toideus and upper fibers of the trapezius
  10. 10. MUSCLES HELP IN MOVEMENT  The recti laterales are concerned in the lateral movement, assisted by the trapezius, splenius capitis, semispinalis capitis, and the sternocleidomasto ideus of the same side, all acting together.
  11. 11. CLINICAL ASPECTS  Headaches can arise from many different sources including dysfunctional muscles, tears in the ligaments, misalignment of the vertebral bodies, injury to cervical facets and degenerative discs.  The joint bewteen the two structures is susceptible to traumatic injury and degeneration.  Excessive flexion could rupture the supraapinous ligament.  Posterior atlanto-occipital membrane ossification cause migraine headaces due to compresion of artery.
  12. 12. SAJJAD AHMAD 29
  13. 13. DEFINITION: The joint formed b/w atlas and axis in the upper part of the neck.  Synovial in nature.  Atlanto-axial joint is of complicated nature and consist of three distinct joints;  One is found between the dens of the axis and the anterior arch of the atlas.  Two are located between the lateral masses of the 1st cervical vertebra and the superior articular facets of the 2nd cervical vertebra.
  14. 14. LIGAMENTS The following four ligaments stabilize these joints:  Apical ligament: Connects the dens to the foramen magnum of the occipital bone.  Alar ligaments: Connect the dens to the lateral margins of the foramen magnum.  Cruciate ligament: Attaches the dens to the anterior arch of the atlas and the body of the axis to the foramen magnum of the occipital bone.  Tectorial membrane: Starts at the skull and becomes the posterior longitudinal ligament.
  15. 15. ARTICULAR CAPSULE  The atlanto-axial 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.
  16. 16. MOVEMENTS:  Lateral AAJ Movement: It is a synovial joint which allows only gliding. The opposed articular surfaces of the atlas and axis are not reciprocally curved but are flat; when therefore, the upper facet glides forward on the lower it also descends; the fibers of the articular capsule are relaxed in a vertical direction, and will then permit movement in an antero-posterior direction. Medial AAJ Movement: This joint allows the rotation of the atlas (and, with it, the skull) upon the axis i.e round the dens. The extent of rotation being limited by the alar ligaments.
  17. 17. INTERSTING FACT Owl can rotate its head upto 270°.  This rotation compensate for their ooccular immobility.
  18. 18. MUSCLES HELP IN MOVEMENTS:  The principal muscles by which these movements are produced are the Sternocleidomastoideus and Semispinalis capitis of one side, acting with the Longus capitis, Splenius, Longissimus capitis, Rectus capitis posterior major, and Obliqui capitis superior and inferior of the other side.
  19. 19. MUSCLES ORIGIN INSERTION MOVEMENTS obliquus capitis inferior spinous process of the axis transverse process of atlas rotates the head to the same side obliquus capitis superior transverse process of atlas occipital bone above inferior nuchal line extends the head, rotates the head to the same side rectus capitis posterior major spinous process of axis inferior nuchal line extends the head, rotate to same side rectus capitis posterior minor posterior tubercle of atlas inferior nuchal line medially extends the head
  20. 20. CLINICAL ASPECTS:  Death by judicial hanging may be due to the rupture of the transverse ligament of atlas or fracture of the dens of axis. As a result, the atlas is dislocated from the axis and compresses the spinal cord with fatal outcome.  Fractures of the dens make up about 40% of axis fractures.  When the transverse ligaments of the atlas ruptures the dens is set free resulting in atlanto-axial subluxation or incomplete dislocation of the medial-atlanto axial joint.
  21. 21. CLINICAL ASPECTS:  Pathological softening of the transverse and adjacent ligaments usually resulting from disorders of connective tissue may also cause atlanto-axial subluxation. Down syndrome exhibits laxity or agenesis of the ligament.  Dislocation owing to transverse ligament rupture or agenesis is more likely to cause spinal cord compression than that resulting from fracture of the dens.
  22. 22. CLINICAL ASPECTS:  Sometimes inflammation in the craniovertebral area may produce softening of the ligaments of the craniovertebral joints and cause dislocation of the atlanto-axial joints.  Alar ligaments are weaker than the transverse ligament of the atlas. Consequently combined flexion and rotation of the head may tear one or both alar ligaments.  Although uncommon, atlanto-axial rotation may compress the C2 spinal nerve. This may be followed by prolonged severe headaches and excruciating cervico-occipital pain.
  23. 23. BLOOD SUPPLY AND INNERVATIONS
  24. 24. INNERVATION: • AAJ and AOJ nerves are supplied by the C1 and C2 nerves.
  25. 25. BLOOD SUPPLY:  No blood supply, very dependent certain physiological factors for health and restoration after injury however vertebral artery (important source of brain blood supply) passes through cervical vertebrae and it may supply these areas.
  26. 26. Different movements of head
  27. 27. POINTS TO BE NOTE  Bursa: it is a fluid filled sac that helps reduce friction.  Ligamentum flavumat craniovertebral region has less elastic fibers, and more collagen fibers for providing greater stability and called posterior atlanto-axial and atlanto-occipital membranes.  Posterior Longitudinal Ligament become tectorial ligament in the craniovertebral region much broader and stronger.  The Anterior Longitudinal Ligament becomes anterior atlanto-occipital membrane and the anterior atlantoaxial membrane in the craniovertebral region.
  28. 28. TIME OF YOUR ATTENTION
  29. 29. Which ligament prevents excessive rotation of these atlanto-axial joints? a)Crucite b)Apical c)Check d)Alar e)Both c and d
  30. 30. How many atlanto-axial joints are there? a)Two b)Three c)Four
  31. 31. What Is the superior continuation of posterior longitudenal ligament? a)Ligamentum flavum b)Accessory ligament c)Membrana tectorai d)Crucite ligamentum e)Supraspinous ligament
  32. 32. What type of movement AAJ and AOJ do respectively? a)Flexion ,extention and rotation b)Gliding and rotation c)Rotation and flexion,extention d)Tilting and rotation
  33. 33. Which one is rudimentary of notochord? a)Accessory ligament b)Crucite ligament c)Transverse ligament d)Apical ligament
  34. 34. COMMON SITE OF FRACTURE OF AXIS? a)Posterior arch b)Anterior arch c)Spinous process d)Odontoid process

×