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The Skull

Ehab ZAYYAN, MD, PhD

The skull is composed of separate bones


united at immobile joints called sutures.
Sutural ligaments: between the bones
TMJ: the only mobile joint in the skull
Skull bones: external and internal tables of
compact bone separated by spongy bone
called diplo
Outer and inner periosteum

Anatomical position
Frankfort horizontal plane

The cranium is in the anatomical position when the inferior margin of


the orbit and the superior margin of the external acoustic meatus lie
in the same horizontal orbitomeatal or Frankfort horizontal plane, a
standard craniometric reference

Cranium (Skull)
1. Neurocranium
a) Clavaria
b) Cranial base
2. Viscerocranium (face
bones)
Total : 22 bones

Neurocranium
Formed from the mesenchyme of the neural
crest
Clavaria and skull base (basocranium)

Frontal bone
Parietal bones
Occipital bone
Temporal bones
Sphenoid bone
Ethmoid bone

1
2
1
2
1
1

Frontal

Clavaria

Frontal
Parietal
Occipital
Temporal

Skull base

Occipital
Temporal
Sphenoid
Ethmoid

Frontal
Parietal
Occipital
Temporal
Sphenoid
Ethmoid

Frontal
Ethmoid
Sphenoid
Temporal
Occipital
Parietal

Viscerocranium
(Facial skeleton)
Develop from the embryonic mesenchyme
of the pharyngeal arches
Consists of the bones surrounding the
mouth (upper and lower jaws), nose/nasal
cavity, and most of the orbits (eye sockets
or orbital cavities)

Facial bones (viscerocranium)


Zygomatic bones

Maxillae

Nasal bones

Lacrimal bones

Vomer

Palatine bones

Inferior conchae

Mandible

Maxilla
Mandible
Zygoma
Nasalis
Lacrimal

Maxilla
Mandible
Zygoma
Nasalis
Lacrimal

Maxilla
Palatine
Zygoma
Ethmoid
and
vomer

Mid- sagittal section


medial nasal wall

Ethmoid
Vomer
Maxilla
Palatine
Nasalis

Lateral nasal wall

Nasalis, maxilla, ethmoid, inferior


concha, palatine

The maxillae contribute the greatest part


of the upper facial skeleton, forming the
skeleton of the upper jaw, which is fixed
to the cranial base.
The mandible forms the skeleton of the
lower jaw, which is movable because it
articulates with the cranial base at the
temporomandibular joints (TMJs).

Pneumatized bones of the skull

Frontal
Ethmoid
Sphenoid
Maxilla
Temporal

Several bones of the cranium


are pneumatized bones,
which contain air spaces (air
cells or larger sinuses),
presumably to decrease their
weight. The total volume of
the air spaces in these bones
increases with age.

Paranasal sinuses

Paranasal sinuses x-ray

Pneumatization of the temporal bone

Geometric points of the skull

Pterion (G. wing): Junction of the greater wing of


the sphenoid, squamous temporal, frontal, and
parietal bones; overlies course of anterior division
of middle meningeal artery
Lambda (G. the letter L): Point on calvaria at
junction of lambdoid and sagittal sutures
Bregma (G. forepart of head): Point on calvaria at
junction of coronal and sagittal sutures
Vertex (L. whirl, whorl): Superior point of
neurocranium, in the middle with the cranium
oriented in anatomical (orbitomeatal or Frankfort)
plane

Asterion (G. asterios, starry): Star shaped;


located at junction of three sutures:
parietomastoid, occipitomastoid, and lambdoid
Glabella (L. smooth, hairless): Smooth
prominence; most marked in males; on the
frontal bones superior to root of nose; most
anterior projecting part of forehead
Inion (G. back of head): Most prominent point of
external occipital protuberance
Nasion (L. nose): Point on cranium where
frontonasal and internasal sutures meet

Frontal bone

Frontal sinuses

Parietal bones

Parietal bone internal surface

Occipital bone

Occipital bone internal surface

Temporal bone
1.
2.
3.
4.
5.

Squamous
Mastoid
Petrous
Styloid
Tympanic

Adult skull

Neonatal skull

At birth the mastoid process and the bony external


canal of the tympanic part are absent.

Neonatal temporal bone


Squamous part
Petrous part
Tympanic part

Nasal bones
Anterior nasal
aperture

Zygomatic bone
Cheeks prominence
Orbital cavities
Zygomatic arch
Zygomaticofacial
& zygomaticotemporal
nerve foraminae

Maxilla
Upper jaw - anterior
part of hard palate lateral wall of nasal
cavity - floor of
orbital cavities
Intermaxillary
suture
Infraorbital foramen
Alveolar processes
Ant nasal spine
Maxillary sinus

Palatine bones

Vomer

Vomer, medial nasal wall

Bony nasal septum


Maxillary crest
Vomer
Perpendicular plate of the ethmoid

Medial nasal wall

Inferior concha, lateral nasal wall

Superior and middle nasal conchae: parts of


the ethmoid bone
Inferior nasal concha is a separate bone

Lateral nasal wall

Paranasal sinuses

Paranasal sinuses x-ray

The mandible

Condyle
Coronoid process
Ramus
Body
Alveolar process
Mental
protuberance
Angle

Body of the mandible

Lateral surface
Symphysis menti
Mental foramen mental nerve and vessels

Medial surface
Mental spines
genioglossus and
geniohyoid
Mylohyoid line
Submandibular
fossa
Sublingual fossa
Digastric fossa

Ramus of the mandible

Coronoid process
Condyloid process (head)
Neck
Mandibular notch
Masseter muscle attachment

Mandibular foramen inferior alveolar nerve and


vessels mandibular canal mental foramen
Lingula : attachment of sphenomandibular
ligament

Anterior view of the skull


Frontal bone
Superciliary arches
Supraorbital notch
Articulation with
maxillae, nasal
bones, zygomatic
bones

Anterior view of the skull

Orbital margins

Sup: frontal bones


Lat: zygomatic bones
Inf: maxillae
Medial: maxillae and frontal bones

Nasal bones
and anterior
nasal
aperture

Maxilla
Intermaxillary
suture
Infraorbital foramen
Alveolar processes
Ant nasal spine
Canine fossa

Zygomatic bone
Cheeks prominence
Orbital cavities
Zygomatic arch
Zygomaticofacial
& zygomaticotemporal
nerve foraminae

The mandible

Lateral view of the


skull

Coronal suture: frontal and parietal bones


Sagittal suture: two parietal bones
Lambdoid suture: parietal and occiptal bones

Frontal bone
Parietal bone
Occipital bonesquamous part
Temporal bone:
squamoustympanicmastoid- styloidzygomatic
process
Greater wing of
sphenoid

Pterion
The thinnest part of
the lateral wall of the
skull
Anterioinferior corner
of the parietal bonegreater wing of
sphenoid bone
Overlies the anterior
division of the middle
meningeal artery and
vein.

Superior and inferior temporal lines


Temporal fossa
Infratemporal fossa
Pterygomaxillary fissure

Infratemporal fossa

Pterygopalatine fossa
A small space behind and below the orbital
cavity
Pterygomaxillary fissure infratemporal
fossa (laterally)
Sphenoplatine foramen nasal cavity
(medially)
Foramen rotundum skull (superiorly)
Inferior orbital fissure orbit (anteriorly)

Posterior view of the skull


Sagittal suture
Lambdoid suture
Parietomastoid
suture
External occipital
protuberence:
attachment to
muscles and
nuchal ligament
Superior nuchal
lines

Superior view
of the skull

Coronal suture
Sagittal suture
Lambdoid suture

Inferior view of the skull

Inferior view of the skull- Palate

Hard palate
Palatal processes of the maxilla
Horisontal plates of palatine bones
Incisive fossa and foramen
Greater and lesser palatine foramina
Choanae (posterior nasal apertures)
Vomer

Inferior view of the skull- Sphenoid

Medial pterygoid plates


Pterygoid hamulus
Lateral pterygoid plates
Foramen ovale
Foramen spinosum

Temporal
Auditory tube: in the
interval between the
greater wing of the
sphenoid and the
petrous part of the
temporal bone

Foramen lacerum
Medial end of petrous
part of the temporal basilar part of the
occipital - greater wing
of sphenoid.
During life it is closed
with fibrous tissue. Few
small vessels pass thru
it. GSPN may pass too.

Zygomatic
process
Articular tubercle
Mandibular fossa
Petrotympanic
fissure: separates
the mandibular
fossa from the
tympanic plate.
The chorda
tympani nerve
exists from it

Carotid canal
Jugular foramen
Styloid process
Stylomastoid foramen

External acoustic meatus

Suprameatal crest
Suprameatal triangle (Mcewen triangle)
Suprameatal spine (spine of Henle)

Jugular foramen: notch


on the petrous
temporal and notch on
the occipital bones.
Foramen magnum
Basilar part of the
occipital bone
Pharyngeal tubercle
Occiptal condyles:
articulate with atlas
The occiptal canal
passes superior to the
condyles
Extarnal occipital
protuberence and
superior nuchal lines.

Occipital

Neonatal skull
Large cranium to face ratio
Mandible and maxilla are short
Bones are mobile on each others and
connected by fibrous tissue or cartilage
Anterior fontanelle: closes at 18 months of
age
Posterior fontanelle: closes at 1 year of
age
Mastoid process not present at birth.

Clinical
Fontanelles enables us to:
Follow up the progress of growth of the
infant
Detect dehydration
The state of intracranial pressure
Take samples of the CSF

Internal surface of the skull


Vault of the skull
Coronal, sagittal and
lambdoid sutures
Groove for the superior
sagittal sinus
Grooves for the
branches of the middle
meningeal vessels
Granular pits for
archnoid granulations

Base of the skull


Anterior cranial fossa
Sphenoid lesser wing

Middle cranial fossa


Temporal bone petrous part

Posterior cranial
fossa

Anterior cranial fossa

Frontal bone
Frontal crest (attachment for falx cerebri)
Lesser wing of the sphenoid
Anterior clinoid process (attachment to tentorium
cerebelli)
Orbital plates

Cribriform plate of the ethmoid: olfactory nerve bundles


Crista galli
Foramen cecum (small vein from nose to SSS)
Anterior ethmoid foramen: anterior ethmoid nerve and
vessels
Posterior ethmoid foramen: posterior ethmoid nerve and
vessels

Middle cranial fossa

Median part: body of sphenoid


Lateral part: greater wing of sphenoid and
squamous part of temporal bone

Body of the sphenoid bone

Sulcus chiasmaticus (prechiasmatic groove)


Optic canal
Tuberculum sella
Sella turcica (contains the hypophysis)
Dorsum sella
Posterior clinoid processes

Optic canal: optic nerve, opthalmic artery


Superior orbital fissure:
- lacrimal, frontal, nasociliary branches of
the opthalmic nerve (V1)
- Oculomotor, trochlear, abducent nerves
- Superior ophthalmic vein

Foramen rotundum
- maxillary nerve
Foramen ovale
- mandibular nerve
- lesser superficial petrosal nerve
- accessory meningeal artery
Foramen spinosum
- middle meningeal artery
- meningeal branch of the mandibular nerve

Foramen lacerum: usually closed by


cartilage and fibrous tissue. Occasionally
the GSPN
Carotid canal: internal carotid artery. The
artery runs in the side of the sphenoid
body to reach the cavernous sinus
Impression of the trigeminal ganglion:
lateral to the foramen lacerum, on the
apex of the petrous part of the temporal
bone

Greater petrosal nerve hiatus groove


for GSPN passes to foramen lacerum
joins the deep petrosal nerve nerve
of the pterygoid canal (Vidian nerve)
Lesser petrosal nerve hiatus groove
for the lesser petrosal nerve foramen
ovale otic ganglion in the infratemporal
fossa

Posterior cranial fossa


Foramen magnum
- Medulla oblangata
- Meninges
- Vertebral arteries
- Spinal roots of the accessory nerves

Jugular foramen
- Inferior petrosal sinus
- CN 9, 10, 11
- Sigmoid sinus internal jugular vein
Internal acoustic meatus: facial nerve
and vestibulucochlear nerves
Hypoglossal canal: hypoglossal nerve

Groove for the occipital sinus


Internal occipital crest
Internal occipital protuberance
Groove for the transverse sinus
Groove for the sigmoid sinus
Groove for the superior petrosal sinus
Clivus

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