processes are so short, certain superficial muscles (the trapezius and splenius capitis) attach to the nuchal ligament rather than directly to the vertebrae; the nuchal ligament itself attaching to the spinous processes of C2–C7 and to the posterior tubercle of the atlas. The superior and inferior articular processes of cervical vertebrae have fused on either or both sides to form articular pillars, columns of bone that project laterally from the junction of the pedicle and lamina. The articular facets are flat and of an oval form: the superior face backward, upward, and slightly medially. the inferior face forward, downward, and slightly laterally. The transverse processes are each pierced by the foramen transversarium, which, in the upper six vertebrae, gives passage to the vertebral artery and vein, as well as a plexus of sympathetic nerves. Each process consists of an anterior and a posterior part. These two parts are joined, outside the foramen, by a bar of bone that exhibits a deep sulcus on its upper surface for the passage of the corresponding spinal nerve. The anterior portion is the homologue of the rib in the thoracic region, and is therefore named the costal process or costal element. It arises from the side of the body, is directed laterally in front of the foramen, and ends in a tubercle, the anterior tubercle. The posterior part, the true transverse process, springs from the vertebral arch behind the foramen and is directed forward and laterally; it ends in a flattened vertical tubercle, the posterior tubercle. The anterior tubercle of the sixth cervical vertebra is known as the carotid tubercle or Chassaignac tubercle (for Édouard Chassaignac). This separates the carotid artery from the vertebral artery and the carotid artery can be massaged against this tubercle to relieve the symptoms of supraventricular tachycardia. The carotid tubercle is also used as a landmark for anaesthesia of the brachial plexus and cervical plexus. The cervical spinal nerves emerge from above the cervical vertebrae. For example, the cervical spinal nerve 3 (C3) passes above C3. Atlas and axis The atlas (C1) and axis (C2) are the two topmost vertebrae. The atlas (C1) is the topmost vertebra, and along with the axis forms the joint connecting the skull and spine. It lacks a vertebral body, spinous process, and discs either superior or inferior to it. It is ring-like and consists of an anterior arch, posterior arch, and two lateral