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Sutures, joints and ligaments 55

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17

18

 

 

10

 

 

 

 

 

 

 

17

 

 

 

9

 

6

 

 

 

 

4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16

 

 

 

 

 

6

 

4

18

 

15

 

 

16

 

 

 

 

 

 

28

 

 

 

 

 

 

 

8

 

 

 

 

 

 

 

32

 

 

 

21

 

5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27

 

 

 

 

 

 

12

 

23

 

20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

 

 

 

25

 

 

13

 

 

31

 

 

 

28

 

6

 

 

 

5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24

19

7

 

 

 

8

 

 

A

Skull from left

 

 

 

 

 

 

 

 

 

 

B

Right orbit, anterior view

 

 

 

 

2

 

3

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

 

 

 

 

 

 

 

 

 

 

 

 

 

15

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

 

 

 

2

6

 

 

 

 

 

6

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

9

 

 

 

 

 

7

 

 

 

 

9

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17 14

 

 

 

16

 

 

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

26

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

 

 

 

 

 

 

 

19

 

 

 

 

 

 

28

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Skull, anterior view

 

 

 

 

 

 

 

 

 

Base of skull, superior view

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

 

 

 

 

 

 

 

 

 

 

D

 

33

34

EHard palate, inferior view

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

a

a

56 Sutures, joints and ligaments

1

 

1

CRANIAL SYNCHONDROSES.

Synchondroses

15

Intertransverse ligaments. Ligg. intertransver-

 

 

cranii (craniales). Cartilaginous joints between

 

saria. Narrow ligaments between transverse

 

 

 

skull bones. Most are temporary and become

 

processes of vertebrae. C

 

 

 

 

2

 

 

ossified.

 

 

 

16

Interspinal ligaments. Ligg. interspinalia. Broad

 

2

Spheno-occipital synchondrosis. Synchondro-

 

ligaments between adjacent spinous processes.

 

 

3

 

 

sis

spheno-occipitalis. Developmental

car-

 

B

 

 

 

 

tilaginous joint postero-inferior to the sella tur-

17

Supraspinal

ligaments. Ligg. supraspinalia.

 

 

 

 

 

 

cica between the sphenoid and occipital bones. A

 

 

 

 

Longitudinal ligaments connecting the tips of

4

 

 

 

3

Sphenopetrosal synchondrosis. Synchondrosis

 

the spinous processes. C

 

 

 

sphenopetrosa. Cartilaginous

union between

18

Ligamentum nuchae. Sagittal extension of the

 

 

 

5

 

 

the sphenoid and petrous bones in the lateral

 

 

continuation of the foramen lacerum, for trans-

 

supraspinalligamentsintheupperneckregion.B

 

 

 

19

Anterior longitudinal ligament. Lig. longitudi-

 

 

 

mission of the lesser petrosal nerve. A

 

6

4

Petro-occipital synchondrosis. Synchondrosis

 

nale anterius. Longitudinal ligament attached to

 

 

 

petro-occipitalis.

Anteromedial cartilaginous

 

the ventral surface of the vertebral bodies. B

 

 

 

 

 

 

 

7

 

 

continuation of the jugular foramen. A

 

20

Posterior longitudinal ligament. Lig. longitudi-

 

4 a Intraoccipital synchondroses. Synchondroses

 

nale posterius. Longitudinal ligament connect-

 

 

 

 

 

 

intraoccipitalis. Cartilaginous

joints between

 

ing the intervertebral discs. It is attached to the

8

 

 

 

 

 

developmental parts of the occipital bone.

 

dorsal surface of the vertebral bodies and thus

 

5

Posterior intraoccipital synchondrosis. [Syn-

 

lies on the anterior wall of the vertebral canal. It

 

 

9

 

 

chondrosis intra-occipitalis posterior]. Develop-

 

fuses with the tectorial membrane from the 3rd

 

 

 

cervical vertebrae upward. B

 

 

 

mental synchondrosis between the posterior

21

Sacrococcygeal joint. Articulatio sacrococcy-

 

 

 

 

 

 

and lateral ossific centers of the occipital bone. It

10

 

 

 

 

usually disappears within 1−2

years after birth.

 

gea. Connection between the sacrum and coc-

 

 

 

A

 

 

 

 

 

cyx; it is frequently a true joint, but often occurs

11

6

Anterior intraoccipital synchondrosis. [Syn-

 

as a synchondrosis. D

22

 

 

 

 

 

 

chondrosis intra-occipitalis anterior]. Develop-

Superficial

dorsal

sacrococcygeal ligament.

 

 

 

12

 

 

mental cartilaginous joint between the anterior

 

Lig. sacrococcygeum posterius (dorsale) superfi-

 

 

and lateral ossific centers of the occipital bone

 

ciale. D

 

 

 

 

 

beginning at the anterior circumference of the

23

Deep dorsal sacrococcygeal ligament. Lig.

13

 

 

foramen magnum. Disappears during the 6th

 

 

 

sacrococcygeum posterius (dorsale) profun-

 

 

 

year of life. A

 

 

 

 

dum. D

 

 

 

7

Sphenoethmoidal

synchondrosis. Synchon-

 

 

 

14

24

Ventral sacrococcygeal ligament. Lig. sacro-

 

 

drosis spheno-ethmoidalis. Cartilaginous pre-

 

 

 

 

coccygeum anterius (ventrale).

 

 

 

cursor of the spheno-ethmoidal suture. See

 

 

 

 

25

Lateral sacrococcygeal ligament. Lig. sacro-

15

 

 

page

54.7.

 

 

 

 

8

JOINTS OF VERTEBRAL COLUMN. THORAX

 

coccygeum laterale. D

 

26

Atlanto-occipital

joint. Articulatio atlanto-

16

 

 

AND

SKULL. Articulationes columnae

verte-

 

 

bralis. Thoracis et cranii. The connections of the

 

occipitalis. Joint between the atlas and the occip-

 

 

 

 

 

 

 

vertebral column, thorax and skull.

 

 

ital bone. See page

59 A B

17

 

 

 

 

9

Intervertebral symphysis. Symphysis inter-

27

Anterior atlanto-occipital membrane. Mem-

 

 

 

vertebralis. Union between adjacent vertebral

 

brana atlanto-occipitalis anterior. Membranous

18

 

 

bodies.

 

 

 

 

connection between the arch of the atlas and the

10

Intervertebral disc. Discus intervertebralis. An

 

occipital bone. It lies in front of the apical liga-

 

 

 

 

 

elastic plate consisting of ring-shaped fibrous

 

ment of the dens. B

 

19

 

 

 

 

 

 

lamellae, fibrocartilage, and a central gelatinous

28

Anterior atlanto-occipital ligament. [Lig.

 

 

 

nucleus located on either side of a vertebral

 

atlanto-occipitale anterius]. Thickened portion

20

 

 

body, between the adjacent vertebrae. B C

 

of the atlanto-occipital membrane emanating

 

11

Anulus fibrosus. Annular fibrous connection

 

from the anterior tubercle.

 

 

21

 

 

between adjacent vertebral bodies consisting of

29

Posterior atlanto-occipital membrane. Mem-

 

 

obliquely oriented connective tissue fibers ar-

 

brana atlanto-occipitalis posterior. Connection

 

 

 

 

 

 

 

ranged in alternating directions. B

 

 

between the arch of the atlas and the occipital

22

 

 

 

 

12

Nucleus pulposus. Gelatinous, semifluid mass

 

bone situated in the posterior wall of the verte-

 

 

 

forming the central core of an intervertebral

 

bral canal. B

 

 

 

 

 

 

 

 

23

 

 

disc. B

 

 

 

30

Lateral atlanto-occipital membrane. Lig.

13

Ligamenta flava. Yellow ligaments. Elastic net-

 

atlanto-occipitale laterale. Oblique tract of fibers

24

 

 

works of roughly parallel fibers between the

 

extending from the transverse process of the

 

 

vertebral arches. B

 

 

 

 

atlas to the jugular process of the occipital bone.

14 Zygapophysial joints. Articulationes zy-

25gapophysiales. Joints between articular processes of vertebrae. C

Sutures, joints and ligaments 57

2 3

4

6

5

ASkull of newborn, inferior view

58.8

 

58.6

29

 

27

 

 

 

 

18

 

13

18

 

 

10

13

16

 

101211

19

20

BLigaments of cervical vertebral column, medial view

 

14

 

 

 

15

 

 

17

 

10

 

 

 

 

15

 

 

CLigaments of vertebral column and ribs, lateral view

8.22

25

21

22

23

D Coccygeal ligaments, posterior view

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

a

a

58 Sutures, joints and ligaments

1

 

1

Lateral atlanto-axial joint. Articulatio atlanto-

16

Superior costotransverse ligament. Lig. co-

 

 

axialislateralis.Jointbetweentheinferiorarticu-

 

stotransversarium superius. Ligament extend-

 

 

 

lar facet of the atlas and the superior articular

 

ing from a rib to the next higher transverse

 

 

 

 

2

 

 

facet of the axis. A B

 

 

 

 

process. E

 

 

 

2

Median atlanto-axial joint. Articulatio atlanto-

17

Lateral costotransverse ligament. Lig. costotr-

 

3

 

 

axialis mediana. Articulation between the atlas

 

ansversarium laterale. Ligament extending from

 

 

and the dens of the axis. C

 

 

 

 

the end of a transverse process to the corre-

 

 

 

 

 

 

 

 

3

Alar ligaments. Ligg. alaria. Paired ligaments ex-

 

sponding rib. D

 

4

 

 

 

 

tending from the dens of the axis to the lateral

18

Lumbocostal ligament. Lig. lumbocostale. Deep

 

 

 

margin of the foramen magnum. A B

 

layer of the thoracolumbar fascia. Fibrous con-

 

 

 

 

5

4

Apical ligament of the dens. Lig. apicis dentis.

 

nectionbetweenthecostalprocessofthelumbar

 

 

 

Unpaired ligament extending from the apex of

 

vertebrae,thetwelfthrib,andtheedgeofthepel-

 

 

 

the dens to the anterior margin of the foramen

 

vis.

 

 

6

 

 

 

 

 

 

 

magnum. A C

 

 

 

 

 

19 Costotransverse foramen. Foramen costotrans-

 

5

Cruciform ligament of atlas. Lig. cruciforme

 

 

versarium.Openingfortheintercostalnervesbe-

7

 

 

atlantis. Cruciate ligament consisting of the two

 

tween the superior costotransverse ligament

 

 

 

following ligamentous bands (6, 7) located be-

 

and the neck of the rib. E

 

 

 

 

 

 

 

 

 

tween the dens and the tectorial membrane. B

20

Sternocostal

joint. Articulationes

sterno-

8

 

 

6

Longitudinal

fasciculi

of

cruciform liga-

 

 

costales. Articulations between the costal car-

 

 

 

ment. Fasciculi

longitudinales.

Connective

 

 

 

 

 

tilage and sternum. F

 

9

 

 

tissue tracts from the body of the axis to the ante-

 

 

 

 

21

Intra-articular sternocostal ligament. Lig. ster-

 

 

 

riormarginoftheforamenmagnum.Theyaresit-

 

 

 

uatedbehindthedensanditsapicalligament.BC

 

nocostale intra-articulare. Ligament within the

10

 

 

 

7

Transverse

ligament of

atlas. Lig. transver-

 

articular cavity between the costal cartilage and

 

 

sternum, especially pronounced at the 2nd rib. F

 

 

 

sum atlantis. Part of the cruciform ligament of

 

11

 

 

22

Radiate sternocostal ligaments. Ligg. sterno-

 

 

the atlas passing behind the dens and extending

 

 

 

transversely from one side of the atlas to the

 

costaliaradiata.Fibertractslocatedinfrontofthe

 

 

 

 

 

 

 

other. It holds the dens in position. B C

 

sternocostal joint and radiating from the end of

12

 

 

 

8

Tectorial

membrane.

Membrana tectoria.

 

the costal cartilage to the sternum. F

 

 

 

 

Bilayered continuation of the posterior longi-

23

Sternal membrane. Membrana sterni. Mem-

13

 

 

 

 

tudinal ligament. It passes from the axis to the

 

branous covering of the anterior surface of the

 

 

 

anterior margin of the foramen magnum and is

 

sternum formed by the fibers of the radiate ster-

 

 

 

 

14

 

 

continuous with the dura-periosteal layer of the

 

nocostal ligaments. F

 

 

 

skull base. C

 

 

 

 

 

24 Costoxiphoid ligaments. Ligg. costoxiphoidea.

 

 

 

 

 

 

 

 

 

9

JOINTS OF THORAX. Articulationes thoracis. Ar-

15

 

Fiber tracts extending downward from the 7th

 

 

ticular connections of the skeleton of the thorax.

 

costal cartilage to the xiphoid process.

 

 

10

COSTOVERTEBRAL

JOINTS. Articulationes cos-

25 External intercostal membrane. Membrana in-

16

 

 

tovertebrales. Joints between the ribs and verte-

 

 

 

tercostalis externa. Continuation of the external

 

 

 

brae. D

 

 

 

 

 

 

 

intercostal muscles at the sternal end of the in-

 

11

Joints of rib heads. Articulatio capitis costae

 

17

 

tercostal space. F

 

 

 

(costalis). Articular unions

that

connect the

26

Internal intercostal membrane. Membrana in-

 

 

 

 

 

 

headsoftheribswiththevertebralbodiesandin-

18

 

 

tervertebral discs. D

 

 

 

 

tercostalis interna. Continuation of the internal

 

 

 

 

 

 

intercostal muscles near the vertebral end of the

 

12

Radiate ligament of head of rib. Lig. capitis

 

 

 

intercostal space. E

 

19

 

 

costae radiatum. Ligament radiating predomi-

 

 

 

 

26 a Sternocostal

synchondrosis of the

first rib.

 

 

nantlyfromtheanteriorsideoftheheadofaribto

 

 

 

the adjacent vertebral body and intervertebral

 

Synchondrosis sternocostalis costae primae.

20

 

 

 

 

 

disc. D E

 

 

 

 

 

 

27

Interchondral joints. Articulationes interchon-

 

 

13 Intra-articular

ligament

of head of rib. Lig.

 

drales. Articulations between the costal car-

 

 

21

 

 

capitis costae intra-articulare. Ligament extend-

 

tilages, usually between those of ribs 6−9. See

 

 

ing from the crest of the head of the rib to the in-

 

page 7 D

 

 

 

 

 

 

 

 

 

 

 

tervertebraldisc.Itliesbetweenthetwoarticular

28 Costochondral joints. Articulationes costoch-

22

 

 

 

 

facets of the head of the rib. E

 

 

 

 

 

 

 

ondrales. Unions between the bony and car-

 

14

Costotransverse joint. Articulatio costotrans-

 

tilaginous parts of ribs without an articular cav-

23

 

 

versaria. Joint between the articular surface of

 

ity.

 

 

 

 

 

the tubercle of the rib and the transverse process

 

 

 

 

 

 

 

of the corresponding vertebra. D

 

 

 

 

 

2415 Costotransverse ligament. Lig. costotransversarium. Ligament between the neck of a rib and

25the transverse process of the corresponding vertebra. D

Sutures, joints and ligaments 59

3 4 3

1

ADens of axis with ligaments, posterior view

6 4 8

7

2

6

CLigaments between atlas, axis and occipital bone

16

12

19

19

26

13

5 3

6

7

1

6

BAtlanto-occipital articulation, posterior view

17

15

15

14

11 10

12

DLigaments of vertebral column and ribs, on right in cross section

23

25

20

22

20

21

E

Ligaments of vertebral column and ribs

F

Sternocostal articulations

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

a

a