The Seated & Supine TLA Tests (ventral and lateral) evaluate attachment of which structure?

• A. Neural structures attachment
• B. Transverse ligament attachment
• C. Alar ligaments
• D. Rib joints

Answer: (B)

The Seated & Supine TLA Tests focus on the stability provided by the transverse ligament of the atlas, which holds the dens against the anterior arch of the atlas as part of the cruciform ligament. These maneuvers stress the attachment site of that ligament between the dens and the atlas. If the ligament is intact, the dens stays properly aligned and the motion remains within normal limits; if the ligament is compromised or its attachment is lax, you may see excessive movement or instability, indicating dysfunction at this attachment. The alar ligaments have a different role (connecting the dens to the occipital bones and limiting rotation), neural structures aren’t a ligament, and rib joints are unrelated to this craniovertebral region.