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The Nuchal and Supraspinous Ligaments.

(new-kal) (soopra-spy-nus)

showing the skull and spine with the nuchal ligament and supraspinous ligaments that attach to each vertebra. These ligaments form one continuous structure  midline at the posterior (back) of the body.  The nuchal and supraspinous ligaments follow the contour of the spine when seen from the side. When these structures are aligned i.e. in a straight line on the median plane they appear as a straight line from the front or back. From the side the nuchal ligament can be seen to be a 'leaf' of tissue in the back of the neck, like a blade maybe. It should be possible to palpate the nuchal ligament in the neck, but imbalance and misalignment make this harder.

From 'head to tail' at the posterior (back) of the body, the nuchal ligament and supraspinous ligament form a continuous strip of connective tissue on the body's midline.

The Nuchal Ligament

Also known as the ligamentum nuchae.

  nuchae = "nape" (back of the neck).

the nuchal ligament in the back of the neck attaching to the skull and cervical vertebrae. Quite hard to describe: the nuchal ligament is a 2D (rough edged) and roughly triangular ligament when seen from the side, like a leaf or a blade of connective tissue inserting onto the bones of the neck, a bumpy edge as it attaches to the different shaped vertebrae. The most external surfaces should be smooth, running down the back of the neck. The nuchal ligament carries on as the supraspinous ligament from the base of the neck. The supraspinous ligament is a cord/rope like structure. When the nuchal ligament and supraspinous ligament as seen from the back they should form a straight line when they are free to move into alignment.

The nuchal ligament - a leaf of connective tissue, midline in the back of the neck attaching to the skull and cervical vertebrae (neck bones).

The nuchal ligament attaches to the external occipital protuberance (the midline bump on the back of the skull) and the median nuchal line of the skull.

Attaches to the spinous processes of the cervical vertebrae.

At the base of the neck, at the 7th (last) cervical vertebra, the nuchal ligament continues as the cord-like supraspinous ligament.

The nuchal ligament is fibro-elastic, consisting of tough collagen fibres with elastic fibres too.

You should be able to easily feel the nuchal ligament in your neck (I could not!). Extend your head backward and press your fingers on the midline of the back of your neck. Then tilt your head forward and should be able to feel the nuchal ligament 'popping out' as it tightens to limit the forward bending of your head and neck.

off-center front view of the trapezius muscle and where they attach.

The nuchal ligament forms a septum - " a dividing wall" - between the upper parts of the trapezius muscles.

Supraspinous Ligament.

The supraspinous ligament attaches to each vertebra from the last cervical, all 12 thoracic vertebrae and the lumbar vertebrae to l3 l4 or l5.    The supraspinous ligament attaches to each spinous process that sticks out from each vertebrae.  Like a rope over a row of pillars on the median plane.

Continuous with the nuchal ligament, the supraspinous ligament is a strong, fibrous cord that attaches to the spinal column from the base of the neck to the lower back.

The supraspinous ligament attaches to the spinous processes of the seventh cervical vertebra, the twelve thoracic vertebrae and the upper lumbar vertebrae, usually terminating at L3, L4 or L5.

The collagen fibres of the supraspinous ligament are arranged in bundles and layers.   The deepest fibres connect to the spinous processes of adjacent vertebrae, the middle fibres run between 2-3 vertebrae and the most superficial fibres span 3-4 vertebrae.

At the points of attachment to the tips of the spinous processes fibrocartilage is developed in the ligament. Intimately blended with the interspinal ligaments and neighbouring fascia.

the trapezius muscles from neck to mid-back and the supraspinous ligament continuing to the lumbar area, a thin cord down the midline of the back of the spine.
the nuchal ligament attaching to the back of the skull, running down the back of the neck, becoming the supraspinous ligament to the sacrum.  The left and right trapezius muscles attach to the nuchal ligament and thoracic part of the supraspinous ligaments on the median plane, our midline.  The nuchal and supraspinous ligaments should align with the linea alba at the front of the body between the rectus abdominis muscles. Note the size and shape of the trapezius muscles - large, kite-like sheets of muscle that extend out towards the shoulders from midline head to mid-back.

The left and right trapezius muscles emerge from the nuchal ligament and the thoracic portion of the supraspinous ligament.   Focusing on activating the trapezius muscles allows us to feel the relative positioning of these midline ligaments.

The nuchal and supraspinous ligaments should be free to fully extend and align with the linea alba on the median plane when the body is free of restrictions and has a has a full range of movement.

The anterior longitudinal ligament is the longest anatomical structure on the body's midline, running the entire length of the spine attaching to the anterior (front) of each vertebrae. Unimportant to the healing process, I mention it now to be complete.

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