Posterior atlantooccipital membrane

The posterior atlantooccipital membrane (posterior atlantooccipital ligament) is a broad but thin membrane. It is connected above to the posterior margin of the foramen magnum and below to the upper border of the posterior arch of the atlas.

Posterior atlantooccipital membrane
Posterior atlantooccipital membrane and atlantoaxial ligament. (Posterior atlantooccipital membrane is topmost gray region at center.)
Latinmembrana atlantooccipitalis posterior
Anatomical terminology

On each side of this membrane there is a defect above the groove for the vertebral artery which serves as an opening for the entrance of the artery. The suboccipital nerve also passes through this defect.

The free border of the membrane arches over the artery and nerve and is sometimes ossified.

The membrane is deep to the Recti capitis posteriores minores and Obliqui capitis superiores and is superficial to the dura mater of the vertebral canal to which it is closely associated.

In 2015, Scali et al. revisited the anatomy of the posterior atlantooccipital membrane via plastination. Their findings revealed that the PAO membrane superiorly consisted of periosteum of the occiput, whereas inferiorly it formed part of the dura at the cerebrospinal junction, terminating at the level of the third cervical vertebra (rather than attaching to the posterior arch of the atlas).[1] It is believed that this anatomical arrangement permits a superiorly located anchor point for epidural bridging structures and allows dural tensile forces to act in a summated synchronized manner. The author's hypothesize that this complex area assists with outflow of cerebrospinal fluid.

Additional images


  1. Frank Scali; Matthew E Pontell; Lance G Nash; Dennis E Enix (2015). "Investigation of meningomyovertebral structures within the upper cervical epidural space: a sheet plastination study with clinical implications". The Spine Journal. 15 (11): 2417–2424. doi:10.1016/j.spinee.2015.07.438. PMID 26210227.

This article incorporates text in the public domain from page 296 of the 20th edition of Gray's Anatomy (1918)

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