Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
CRANIUM 03. 02.2014 Kaan Yücel M.D., Ph.D. https://yeditepeanatomyfhs122.wordpress.com Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium The skeleton of the head is the skull. We rather use the ancient Greek term “cranium”, e.g. the cranial nerves. The skull has 22 bones, excluding the ossicles of the ear. Except for the mandible, which forms the lower jaw, the bones of the skull are attached to each other by sutures, are immobile, and form the cranium. The part that is covering the cranial cavity and the brain in it is called neurocranium. The skeleton of the face is called viscerocranium or facial skeleton. It is the lower part of the cranium. Out of the 22 bones in the skull, 8 of them are in the neurocranium. They are: • 1 Frontal bone; the bone in the front of the head • 1 Occipital bone; the bone at the back of the head • 2 Parietal bones; “paries” means wall, and these though bones are on the lateral sides of the skull. • 2 Temporal bones; “temple” has two meanings “time” and “temple”. Time can make more sense for the temporal bones, as where they are the hair becomes grey first. • 1 Sphenoid bone in the middle (Greek sphēnoeidēs wedge-shaped) • 1 Ethmoid bone again in the middle (In Moore’s textbook it is part of the facial skeleton,though) The skeleton of your face is made up by the remaining 14 bones of the cranium. The inferior and anterior parts of the frontal lobes of the brain occupy the anterior cranial fossa, the shallowest of the three cranial fossae. The fossa is formed by the frontal bone anteriorly, the ethmoid bone in the middle, and the body and lesser wings of the sphenoid posteriorly. The butterfly-shaped middle cranial fossa has a central part composed of the sella turcicae on the body of the sphenoid and large, depressed lateral parts on each side. The bones forming the lateral parts of the fossa are the greater wings of the sphenoid and squamous parts of the temporal bones laterally and the petrous parts of the temporal bones posteriorly. The posterior cranial fossa, the largest and deepest of the three cranial fossae is formed mostly by the occipital bone, but the dorsum sellae of the sphenoid marks its anterior boundary centrally and the petrous and mastoid parts of the temporal bones contribute its anterolateral “walls.” Sutura is that form of articulation where the contiguous margins of the bones are united by a thin layer of fibrous tissue; it is met with only in the skull. The major suturae in the skull are; coronal, lambdoid, and sagittal suturues. The skeleton of your face is made up by the remaining 14 bones of the cranium They are: • Two Nasal bones • Two Maxillæ • Mandible • Two Lacrimal bones • Two Zygomatic bones • Two Palatines • Two Inferior Nasal Conchæ • Vomer The viscerocranium forms the anterior part of the cranium and consists of the bones surrounding the mouth (upper and lower jaws), nose/nasal cavity, and most of the orbits (eye sockets or orbital cavities). The viscerocranium consists of 14 irregular bones: 2 singular bones centered on or lying in the midline (mandible and vomer) and 6 bones occurring as bilateral pairs (maxillae; inferior nasal conchae; and zygomatic, palatine, nasal, and lacrimal bones). http://www.youtube.com/yeditepeanatomy 2 Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium 1. SKULL The skeleton of the head is the skull. We rather use the ancient Greek term “cranium”, e.g. the cranial nerves. The skull has 22 bones, excluding the ossicles of the ear. Except for the mandible, which forms the lower jaw, the bones of the skull are attached to each other by sutures, are immobile, and form the cranium. Suture is also a term used in surgical practices as “surgical stitching of a wound”. Actually suture in anatomy is a type of articulation where two articulation surfaces come together along a line, just like you sew them with a needle. We can divide the cranium into two or three parts. Generally into two! Let’s see, there is one part enclosing the brain; protecting the brain, and there is another part which makes the skeleton of your face. The part that is covering the cranial cavity and the brain in it is called neurocranium. The skeleton of the face is called viscerocranium or facial skeleton. It is the lower part of the cranium. Here the “viscera” means organ, and on your face there is a list of organs; your mouth, your nose, your eyes. The prefix neuro in the term neurocranium just refers to the “nerve” telling you that this part of the skeleton of the head covers the brain and meninges (the membrane covering the brain) within the cranial cavity. A third part of the skeleton of the head? The part that covers the upper part of the head; calvaria (skullcap) “kafatası” in Turkish might be considered as a third part. If you add it into the neurocranium, then the cranium has two parts. Ok? So the neurocranium has one roof (calvaria) and one floor; the base (base of the skull) basicranium. Question: which bones make up the neurocranium? Out of the 22 bones of the cranium, 8 of them belong to the neurocranium. Some of them are paired which means you can find one on the right side, and one on the left side, and some of them are single. 1 Frontal bone; the bone in the front of the head 1 Occipital bone; the bone at the back of the head 2 Parietal bones; “paries” means wall, and these though bones are on the lateral sides of the skull. 2 Temporal bones; “temple” has two meanings “time” and “temple”. Time can make more sense for the temporal bones, as where they are the hair becomes grey first. 1 Sphenoid bone in the middle (Greek sphēnoeidēs wedge-shaped) 1 Ethmoid bone again in the middle As you see only the temporal bones and the parietal bones above them are paried (bilateral), and the other four bones are single (unilateral) which make the eight bones of the neurocranium. The neurocranium has a dome-like roof, the calvaria (skullcap), and a floor or cranial base (basicranium). http://twitter.com/yeditepeanatomy 3 Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium The bones forming the calvaria are mainly the paired temporal and parietal bones, and parts of the unpaired frontal, sphenoid, and occipital bones. The frontal bone, parietal bones, and occipital bone make up the superior part of the calvaria or the calva (skullcap). The bones forming the base of the cranium are mainly parts of the sphenoid, temporal, and occipital bones. The ethmoid bone is an irregular bone that makes a relatively minor midline contribution to the neurocranium but is also part of the viscerocranium. Watch out! Although there is only a minor contribution of the ethmoid bone to the neurocranium, it is counted under the bones of the neurocranium. Clue: Smelling. The skeleton of your face (viscerocranium; as we have three organs: from superior to inferior- eyes, nose, tongue) is made up by the remaining 14 bones of the cranium. Figure 1. Skull bones (lateral view) http://images.tutorvista.com/content/locomotion-animals/human-skull-structure.jpeg 2. BONES OF THE NEUROCRANIUM 2.1. FRONTAL BONE (OS FRONTALE) Figure 2. Frontal bone http://www.bleaching-dental.com/img/news/126.jpg The biggest part of the brain (one third of a brain hemisphere); the frontal lobe mostly resides on the frontal lobe. The frontal bone forms the forehead. It also contributes to the formation of two cavities; the orbital cavity where the eyes are located and the nasal cavity (the cavity inside your nose). http://www.youtube.com/yeditepeanatomy 4 Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium The frontal bone consists of two portions: squama (etymology: Latin, squama: scale; squama frontalis)- vertical portion corresponding with the region of the forehead orbital portion (frontal orbit; orbita frontalis)– horizontal partion enters into the formation of the roofs of the orbital and nasal cavities Figure 3. Frontal bone, squamous part http://virtual.yosemite.cc.ca.us/rdroual/Lecture%20Notes/Unit%202/chapter_6_axial_skeleton_copy%20with%20figures.htm So you should take the frontal bone as two pieces; one flat surface (squama) and one horizontal surface forming the roof of the orbit (the nest for the eye). From now on, if a cranial bone has a flat, smooth surface, it will be named as squamous part (just like the one in the occipital bone, back of the head; squama means scale; just like a scale of a fish). 2.2. PARIETAL BONES The two parietal bones unite and form the sides and roof of the cranium. Each bone is irregularly quadrilateral in form. The external surface is convex, smooth, and marked near the center by an eminence, the parietal eminence (tuber parietale). Crossing the middle of the bone in an arched direction are two curved lines, the superior and inferior temporal lines. Figure 4. Parietal bones (anterior view) http://aftabphysio.blogspot.com/2010/09/bones-of-skull.html http://twitter.com/yeditepeanatomy 5 Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium 2.3. TEMPORAL BONES The temporal bones are situated at the sides and base of the skull. The temporal bone has the temporal lobe on which is important for a long list of functions including memory, emotional memory, hearing. It has the canal that goes to the ear. The temporal bone contributes most of the lower portion of the lateral wall of the cranium. Each temporal bone has three parts which are separated from each other by a cartilaginous tissue in the newborn. Later on, the three parts are united and become as one single bone. 1) Squamous part 2) Tympanic part 3) Petromastoid part The squamous part has the appearance of a large flat plate, forms the anterior and superior parts of the temporal bone, contributes to the lateral wall of the cranium. The zygomatic process is an anterior bony projection from the lower surface of the squamous part of the temporal bone that initially projects laterally and then curves anteriorly to articulate with the temporal process of the zygomatic bone to form the zygomatic arch. The squamous part lies just lateral to the greater wing of the sphenoid. It participates in the temporomandibular joint. It contains the mandibular fossa, which is a concavity where the head of the mandible articulates with the base of the skull. The tympanic part of the temporal bone is immediately below the origin of the zygomatic process from the squamous part of the temporal bone. The external acoustic opening (pore) is the entrance to the external acoustic meatus (canal), which leads to the tympanic membrane (eardrum). On the lateral edge of the temporal bone lies the cone-shaped mastoid process projecting from its inferior surface. The mastoid process is a prominent structure and is the point of attachment for several muscles. Immediately lateral to the basilar part of the occipital bone is the petrous part of the temporal bone. The apex forms one of the boundaries of the foramen lacerum, an irregular opening filled in life with cartilage. The large opening between the occipital bone and the petrous part of the temporal bone is the jugular foramen.This foramen is very important as major structures pass through this foramen. The vein draining the brain exits the skull through the jugular foramen. Three of the 12 pairs of cranial nerves pass through the jugular foramen and go to their destinations exiting the cranium. Anterosuperior to the jugular foramen is the internal acoustic meatus for the passage of two other cranial nerves. One of them is the nerve for the muscles of the face, and the other is good for the hearing and balance. The styloid process is needle-shaped bone marking. It projects from the lower border of the temporal bone anteromedial to the mastoid process. The styloid process is a point of attachment for numerous muscles and ligaments. The stylomastoid foramen, transmitting the nerve for the muscles of the face lies (CN VII; Facial http://www.youtube.com/yeditepeanatomy 6 Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium nerve – CN= Cranial nerve) posterior to the base of the styloid process; between the styloid process and the mastoid process. Figure 5. Temporal bone http://medicinembbs.blogspot.com/2011/02/skull-anatomy.html 2.4. SPHENOID BONE The sphenoid bone is situated at the base of the skull in front of the temporal bones and basilar part of the occipital bone. It somewhat resembles a bat with its wings extended, and is divided into a median portion; body, two great and two small wings extending outward from the sides of the body, and two pterygoid processes which project from it below. Just anterior to each anterior clinoid process is a circular opening in the lesser wing of the sphenoid (the optic canal), through which the ophthalmic artery and optic nerve [II] pass as they exit the cranial cavity to enter the orbit. The optic canals are usually included in the middle cranial fossa. The sella turcica[e] (L. Turkish saddle) is the saddle-like bony formation on the upper surface of the body of the sphenoid, which is surrounded by the anterior and posterior clinoid processes. Clinoid means “bedpost,” and the four processes (two anterior and two posterior) surround the hypophysial fossa, the “bed” of the pituitary gland, like the posts of a four-poster bed. The sella turcica is composed of three parts: 1) The tuberculum sellae (horn of saddle): a variable slight to prominent median elevation forming the posterior boundary of the chiasmatic sulcus (optic groove) and the anterior boundary of the hypophysial fossa. It lies behind the chiasmatic groove. On both ends of the tuberculum sellae are middle clinoid processes. 2) The hypophysial fossa (pituitary fossa): a median depression (seat of saddle) in the body of the sphenoid that accommodates the pituitary gland (L. hypophysis). http://twitter.com/yeditepeanatomy 7 Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium 3) The dorsum sellae (back of saddle): a square plate of bone projecting superiorly from the body of the sphenoid. It forms the posterior boundary of the sella turcica, and its prominent superolateral angles make up the posterior clinoid processes. On each side of the body of the sphenoid, four foramina perforate the roots of the cerebral surfaces of the greater wings of the sphenoids: Superior orbital fissure: Located between the greater and the lesser wings, it opens anteriorly into the orbit. Foramen rotundum (round foramen): Located posterior to the medial end of the superior orbital fissure. Foramen ovale (oval foramen): A large foramen posterolateral to the foramen rotundum. Foramen spinosum (spinous foramen): Located posterolateral to the foramen ovale. The foramen lacerum (lacerated or torn foramen) is not part of the crescent of foramina. This ragged foramen lies posterolateral to the hypophysial fossa and is an artifact of a dried cranium. In life, it is partly closed by a cartilage plate. Figure 6. Sphenoid bone (anterior view) http://virtual.yosemite.cc.ca.us/rdroual/Lecture%20Notes/Unit%202/chapter_6_axial_skeleton_copy%20with%20figures.htm Figure 7. Foramina in the sphenoid bone (superior view) and other openings http://medchrome.com/wp-content/uploads/2011/05/skull-superior.jpg http://www.youtube.com/yeditepeanatomy 8 Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium 2.5. OCCIPITAL BONE The occipital bone is situated at the back and lower part of the cranium. It is trapezoid in shape and curved on itself. It is pierced by a large oval aperture, the foramen magnum, through which the cranial cavity communicates with the vertebral canal. The foramen magnum is the most prominent feature of the cranial base. The major structures passing through this large foramen: spinal cord (where it becomes continuous with the medulla oblongata of the brain) meninges (coverings) of the brain and spinal cord vertebral arteries spinal accessory nerve (CN XI). The four parts of the occipital bone are arranged around the foramen magnum: 1) The curved, expanded plate behind the foramen magnum is named the squama. 2) The thick, quadrilateral piece in front of the foramen is called the basilar part. 3) On either side of the foramen is the lateral (condylar) portion of the occipital bone. The cranial base is formed posteriorly by the occipital bone, which articulates with the sphenoid bone anteriorly. The external occipital protuberance, is usually easily palpable in the median plane; however, occasionally (especially in females) it may not be prominent. The superior nuchal line marks the superior limit of the neck. It extends laterally from each side of the protuberance. The inferior nuchal line is less distinct. On the lateral parts of the occipital bone are two large protuberances, the occipital condyles. The cranium articulates with the vertebral column by the occipital condyles. 2.6. ETHMOID BONE Gk, ethmos, sieve sifter, eidos, form The etmoid bone is exceedingly light and spongy, and cubical in shape; it is situated at the anterior part of the base of the cranium, between the two orbits, at the roof of the nose, and contributes to each of these cavities. It consists of four parts: a horizontal or cribriform plate, forming part of the base of the cranium; a perpendicular plate, constituting part of the nasal septum; and two lateral ethmoidal labyrinths. The crista galli (L. crest of the cock) is a thick, median ridge of bone posterior to the foramen cecum (frontal bone), which projects superiorly from the ethmoid. On each side of the ridge called crista galli, located in the frontal bone, is the sieve-like cribriform plate of the ethmoid. Its numerous tiny foramina transmit the olfactory nerves (CN I) from the olfactory areas of the nasal cavities to the olfactory bulbs of the brain, which lie on this plate. SMELLING!!! http://twitter.com/yeditepeanatomy 9 Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium Figure 8. Ethmoid Bone http://medical-dictionary.thefreedictionary.com/ethmoid+bone Figure 9. Ethmoid bone’s location in the skull http://www.daviddarling.info/images/ethmoid_bone.jpg 3. CRANIAL FOSSAE The five bones that make up the skull base are the ethmoid, sphenoid, occipital, paired frontal, and paired parietal bones. The skull base can be subdivided into 3 regions: the anterior, middle, and posterior cranial fossae. 3.1. ANTERIOR CRANIAL FOSSA Parts of the frontal, ethmoid, and sphenoid bones form the anterior cranial fossa. The anterior cranial fossa is above the nasal cavity and the orbits, and it is filled by the frontal lobes of the cerebral hemispheres 3.2. MIDDLE CRANIAL FOSSA The middle cranial fossa consists of parts of the sphenoid and temporal bones. The butterfly-shaped middle cranial fossa has a central part composed of the sella turcice on the body of the sphenoid and large, depressed lateral parts on each side. The middle cranial fossa is posteroinferior to the anterior cranial fossa. The bones forming the lateral parts of the fossa are the greater wings of the sphenoid and squamous parts of the temporal bones laterally and http://www.youtube.com/yeditepeanatomy 10 Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium the petrous parts of the temporal bones posteriorly. The lateral parts of the middle cranial fossa support the temporal lobes of the brain. 3.3. POSTERIOR CRANIAL FOSSA The posterior cranial fossa consists mostly of parts of the temporal and occipital bones with small contributions from the sphenoid and parietal bones. It is the largest and deepest of the three cranial fossae and contains the brainstem (midbrain, pons, and medulla) and the cerebellum. Figure 10. Cranial fossae http://tmjc.com.ne.kr/tmj/info/drinfo/images/tm6-6.jpg 4. SUTURA Sutura is that form of articulation where the contiguous margins of the bones are united by a thin layer of fibrous tissue; it is met with only in the skull. 4.1. CORONAL SUTURE Parietal bones articulate with the frontal bone in their front, forming the coronal suture. 4.2. LAMBDOID SUTURE Parietal bones articulate with the occipital in their behind, forming the lambdoid suture. 4.3 .SAGITTAL SUTURE Parietal bone articulates with its the opposite side, forming the sagittal suture. Vertex, the most superior point of the calvaria, is near the midpoint of the sagittal suture. The coronal suture separates the frontal and parietal bones, the sagittal suture separates the parietal bones, and the lambdoid suture separates the parietal and temporal bones from the occipital bone. 5. FONTANELLES The bones of the calvaria of a newborn infant are separated by membranous intervals. They include the anterior and posterior fontanelles and the paired sphenoidal and mastoid fontanelles. Palpation of the fontanelles during infancy, especially the anterior and posterior ones, enables physicians to determine the: • Progress of growth of the frontal and parietal bones. http://twitter.com/yeditepeanatomy 11 Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium • Degree of hydration of an infant (a depressed fontanelle indicates dehydration). • Level of intracranial pressure (a bulging fontanelle indicates increased pressure on the brain). The anterior fontanelle, the largest one, is diamond or star shaped; it is bounded by the halves of the frontal bone anteriorly and the parietal bones posteriorly. Thus it is located at the junction of the sagittal, coronal, and frontal sutures, the future site of bregma. By 18 months of age, the surrounding bones have fused and the anterior fontanelle is no longer clinically palpable. The posterior fontanelle is triangular and bounded by the parietal bones anteriorly and the occipital bone posteriorly. It is located at the junction of the lambdoid and sagittal sutures, the future site of lambda. The posterior fontanelle begins to close during the first few months after birth; and by the end of the 1st year, it is small and no longer clinically palpable. The sphenoidal and mastoid fontanelles fuse during infancy and are less important clinically than the midline fontanelles. Figure 11. Fontanelles http://medical-dictionary.thefreedictionary.com/fontanelle 6. SKELETON OF THE FACE The lower and anterior part of the cranium is the facial skeleton (viscerocranium). The skeleton of the face is made up by 14 bones. Two Nasal bones Two Maxillæ Mandible Two Lacrimal bones Two Zygomatic bones Two Palatines Two Inferior Nasal Conchæ Vomer The viscerocranium forms the anterior part of the cranium and consists of the bones surrounding the mouth (upper and lower jaws), nose/nasal cavity, and most of the orbits (eye sockets or orbital cavities). The viscerocranium consists of 14 irregular bones: 2 singular bones centered on or lying in the midline (mandible and http://www.youtube.com/yeditepeanatomy 12 Dr.Kaan Yücel yeditepeanatomyfhs122.wordpress.com Cranium vomer) and 6 bones occurring as bilateral pairs (maxillae; inferior nasal conchae; and zygomatic, palatine, nasal, and lacrimal bones). The maxillae and mandible house the teeth—that is, they provide the sockets and supporting bone for the maxillary and mandibular teeth. 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. Several bones of the cranium (frontal, temporal, sphenoid, and ethmoid bones) are pneumatized bones, which contain air spaces (air cells or large sinuses), presumably to decrease their weight. The total volume of the air spaces in these bones increases with age. HARD PALATE (BONY PALATE) The hard palate (bony palate) is formed by the palatine processes of the maxillae anteriorly and the horizontal plates of the palatine bones posteriorly. The paired palatine processes of each maxilla meet in the midline at the intermaxillary suture, the paired maxilla and the paired palatine bones meet at the palatomaxillary suture, and the paired horizontal plates of each palatine bone meet in the midline at the interpalatine suture. Figure 12. Hard palate http://www.gla.ac.uk/ibls/US/cal/anatomy/cleftpalate/final/hardp975.htm http://twitter.com/yeditepeanatomy 13