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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The axis or second cervical vertebrae is the strongest of the cervical group. It shows similarity to typical cervical vertebrae with some obvious exceptions:

  • odontoid peg or dens:
    • sited anteriorly in the midline
    • results from fusion with body of atlas
    • facet on its anterosuperior surface projects superiorly onto facet of anterior arch of atlas
    • pointed at apex where apical ligament attaches
    • bevelled sides are origins of alar ligaments
    • posteriorly flat surface lying anterior to transverse ligament
  • vertebral canal: oval and broader in coronal plane
  • body: connects to odontoid process medially and superiorly; superior articular processes and transverse processes laterally; and pedicles posterolaterally
  • pedicles: relatively short and sited at junction of lamina, transverse process and body
  • superior articular facet: the key weight-transmitting structure articulating with inferior facets of atlas
    • slightly convex and face superolaterally
    • permit rotation of atlas on axis
  • inferior articular facet:
    • at junction of pedicles and laminae
    • slightly concave
    • surface slopes anteriorly and inferiorly
  • transverse processes:
    • relatively small
    • contain foramen transversarium
    • no anterior tubercle
    • bounded by costotransverse lamella
  • laminae: broad and project posteriorly to spinous process in median plane
  • spinous process:
    • bifid
    • relatively large allowing use as a palpation landmark

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