What is the most superior attachment point of the nuchal ligament?

• A. Occipital Condyle
• B. External Occipital Protuberance (EOP)
• C. Superior Nuchal Line
• D. External Occipital Crest

Answer: (B)

The nuchal ligament anchors strongest at the very top of the occipital bone, the external occipital protuberance. This midline bump sits at the highest point on the skull, making it the most superior attachment point. From there, fibers extend downward to connect to the cervical spinous processes, with some fibers tracing to the superior nuchal line as they spread laterally. The other landmarks sit lower or are not the primary anchoring point: the occipital condyles are lower and more lateral, the external occipital crest is a midline ridge below the protuberance, and the superior nuchal line is a lateral continuation at a lower level.