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(Netter Basic Science) Frank H. Netter - Atlas of Human Anatomy-Elsevier (2018)

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Atlantooccipital Junction

2

Vertebral artery

Posterior margin

of foramen magnum

Posterior atlantooccipital

membrane

Posterior arch of atlas (C1)

Nuchal ligament

Posterior atlantoaxial membrane

Spinous process of axis (C2)

Ligamentum flavum

Hypoglossal canal

Tectorial membrane

Apical ligament of dens

Superior longitudinal band of

cruciate ligament of atlas

Anterior atlantooccipital membrane

Anterior arch of atlas (C1)

Articular cavity

Dens of axis (C2)

Transverse ligament of atlas

Inferior longitudinal band of

cruciate ligament of atlas

Anterior longitudinal ligament

Posterior longitudinal ligament

Posterior nasal spine

Lowest

level of

occipital bone

McGregor’s line, from posterior nasal spine of

hard palate to lowest point of occipital bone.

Average normal position of tip of dens is 1.32 mm

above this line, with standard deviation of 2.6 mm

as measured on standard lateral radiograph. Tip 4.5 mm

above line is considered to indicate basilar impression.

Abnormalities of dens, most

often associated with skeletal

dysplasias such as Klippel-Feil,

Down, or Morquio syndromes

Hypoplastic dens

Os odontoideum with fibrous union and narrowing of

vertebral canal with head in extension

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