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The nuchal ligament is a at the back of the that is continuous with the supraspinous ligament.


Structure
The nuchal ligament extends from the external occipital protuberance on the and median to the of the seventh cervical vertebra in the lower part of the neck.
(2025). 9780443066122, Elsevier/Churchill Livingstone.

From the anterior border of the nuchal ligament, a fibrous lamina is given off. This is attached to the posterior tubercle of the atlas, and to the spinous processes of the cervical vertebrae, and forms a septum between the muscles on either side of the neck.

The and splenius capitis muscle attach to the nuchal ligament.


Function
It is a tendon-like structure that has developed independently in humans and other animals well adapted for running. In some , particularly and , the nuchal ligament serves to sustain the weight of the head.


Clinical significance
In Chiari malformation treatment, decompression and duraplasty with a harvested nuchal ligament showed similar outcomes to pericranial and artificial grafts.


Other animals
In sheep and cattle, it is known as the paxwax. It relieves the animal of the weight of its head.

The nuchal ligament is unusual in being a ligament containing more as well as collagen, allowing for stretch and recovery to its original form.Virginia Studdert, Clive Gay, Douglas C. Blood, Saunders Comprehensive Veterinary Dictionary, p. 1252, Elsevier Health Sciences, 2011 . Other ligaments are made mostly of viscoelastic fibers, a material two orders of magnitude stiffer, which cannot retain their original shape when extended past a certain point or for a prolonged period of time.

Structurally, the nuchal ligament is formed with the association of both proteins as well as type III collagen (45%). The collagen fibrils share a consistent size as well as pattern which gives the ligament its tensile strength. The elastin on the other hand is a protein that allows for flexibility. These two elements of the nuchal ligament maintain a complex balance which allows the constant weight bearing of the head along with multidirectional movement without damaging the durability of the ligament through over-use/stretching.

In most other , including the great apes, the nuchal ligament is absent or present only as a thin fascia.Swindler, D. R., and C. D. Wood. 1973 An Atlas of Primate Gross Anatomy. Seattle: University of Washington Press As it is required for running, not all animals have one.

All (and all living - wolves, foxes, and wild dogs) possess a similar ligament connecting the spinous process of their first thoracic (or chest) vertebrae to the back of the axis bone (second cervical or neck bone), which supports the weight of the head without active muscle exertion, thus saving energy.Wang, Xiaoming and Tedford, Richard H. Dogs: Their Fossil Relatives and Evolutionary History. New York: Columbia University Press, 2008. pp.97-8 This ligament is analogous in function (but different in exact structural detail) to the nuchal ligament found in ungulates. This ligament allows dogs to carry their heads while running long distances, such as while following scent trails with their nose to the ground, without expending much energy.

In horses, the can spread onchocerca cervicalis by living in the nuchal ligament, causing .

(2025). 9780702047718, Saunders.


Meat industry
In the , the nuchal ligament is referred to as paddywhack (also spelled pandywack; also called back strap or paxwax).
(2025). 9781909248557, Oxford Symposium.

The word is mentioned in a dictionary of South-west Lincolnshire dialect as a synonym of paxwax (originally faxwax; compound of "hair" + "to grow"). "paxwax", Oxford English Dictionary Online, retrieved 10 October 2021 . Hence, paddywack has been in use with this meaning since at least 1886.Robert Eden George Cole, A Glossary of Words Used in South-west Lincolnshire, English Dialect Society, 1886 .

Dried paddywhack is commonly packaged and sold as a dog treat, hence the phrase, "Knick-knack, paddywhack, give the dog a bone" in the nursery rhyme, This Old Man . Paddywack is unpalatable as a human food because it cannot be softened or tenderised, but it makes a good natural dog chew.

(2025). 9781788793957, Ryland Peters & Small.
It is classed as by the meat industry.

==Additional images==

seen from outside ( are identified at left)]]


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