Download Internal Carotid Artery and Jugular Foramen

Internal Carotid Artery
and Jugular Foramen
Carotid
Canal
Jugular
Foramen
Image courtesy of Tabby Kennedy, MD
Coronal Image – Meninges
• Supratentorium
– Cerebral hemispheres
•
•
•
•
Frontal Lobes
Parietal Lobes
Occipital Lobes
Temporal Lobes
Falx
Tentorium
• Infratentorium
– Cerebellum
– Brain Stem
Image courtesy of Tabby Kennedy, MD
Lateral view – Dural Sinuses
Digital subtraction angiography
Lateral view – Straight Sinus
MR angiography
Frontal view – Dural Sinuses
Digital subtraction angiography
Course of the Internal Carotid Artery:
Petrous (C2)
Carotid
Canal
Cervical (C1)
Image courtesy of Tabby Kennedy, MD
Course of the Internal Carotid Artery:
Petrous (C2)
Carotid
Canal
Image courtesy of Tabby Kennedy, MD
Course of the Internal Carotid Artery:
Petrous (C2)
Carotid
Canal
Image courtesy of Tabby Kennedy, MD
Course of the Internal Carotid Artery:
Petrous (C2)
Petrous
segment
ICA
Image courtesy of Tabby Kennedy, MD
Lacerum
Course of the Internal Carotid Artery:
Lacerum (C3)
Image courtesy of Tabby Kennedy, MD
Course of the Internal Carotid Artery:
Cavernous (C4)
Cavernous
segment
ICA
Image courtesy of Tabby Kennedy, MD
Course of the Internal Carotid Artery:
Cavernous (C4)
Cavernous
segment
ICA
Anatomy at a Glance
Faiz & Moffat
Image courtesy of Tabby Kennedy, MD
Course of the Internal Carotid Artery:
Cavernous (C4)
Image courtesy of Tabby Kennedy, MD
Frontal View - Internal carotid artery
MR angiography
Posterior communicating artery
MR angiography – axial view
Anterior communicating artery
MR angiography – axial view
Terminal Branches Internal Carotid Artery
Anterior cerebral artery
Middle cerebral artery
MR angiography – axial view
Posterior Circulation – Lateral view
Digital subtraction angiography
view of vertebral artery
PosteriorFrontal
Circulation
– injection
Frontal view
Digital subtraction angiography
Coronal View - Posterior Circulation
Posterior Cerebral Arteries
Superior Cerebellar Arteries
Basilar Artery
Right Vertebral Artery
Left Vertebral Artery
CN III – not seen, but
this is where it travels
Ventricular System
Foramen of Monro = interventricular foramen
Cerebral aqueduct = aqueduct of midbrain
Neuroanatomy: An Illustrated Colour Text ©2015
Ventricular System
Lateral Ventricles
Ventricular System
Interventricular Foramen
Foramen of Monro
Ventricular System
3rd Ventricle
Lateral Ventricles
Ventricular System
Aqueduct of midbrain
Cerebral Aqueduct
Ventricular System
Aqueduct of midbrain
Cerebral aqueduct
Ventricular System
Aqueduct of midbrain
Cerebral aqueduct
Ventricular System
4th Ventricle
Anterior Cranial Fossa
• Anterior/Inferior: Frontal bone
• Medial: Ethmoid bone
• Posterior: Body and lesser wings of the sphenoid
Image courtesy of Tabby Kennedy, MD
Olfactory Nerve/ Cribriform Plate
Image courtesy of Tabby Kennedy, MD
Cranial Nerve I: Olfactory Nerve
Olfactory Bulb
Crista Galli
Cribriform
Plate
Nerve fibers located on the nasal septum extend through the cribiform plate and
form the olfactory bulb and olfactory tract
Image courtesy of Tabby Kennedy, MD
Cranial Nerve I: Olfactory Nerve
Image courtesy of Tabby Kennedy, MD
•
•
•
•
Middle Cranial Fossa
Central: Sella turcica
Anterior: Greater wings of the sphenoid
Lateral: Squamous portion of the temporal bones and parietal bones
Posterior: Petrous parts of the temporal bones
Image courtesy of Tabby Kennedy, MD
Foramina and Apertures
Foramina/Aperture
Optic canals
Contents
Optic nerves (CN II) and ophthalmic arteries
Superior orbital fissure
Ophthalmic veins; CN III, IV, ophthalmic nerve (CN V1) and
VI
Foramen rotundum
Maxillary nerve (CN V2)
Foramen ovale
Mandibular nerve (CN V3) and accessory meningeal artery
Foramen spinosum
Middle meningeal artery and vein and meningeal branch
of CN V3
Foramen lacerum
Internal carotid artery passes over foramen, but does not
go through it
Image courtesy of Tabby Kennedy, MD
Normal Pituitary and
Cavernous Sinus
Image courtesy of Tabby Kennedy, MD
Cranial Nerve II: Optic Nerve
Optic
Canal
Optic
Nerve
Origin: Globe
Course: Orbit, Optic Canal, Optic Chiasm, Tract, Thalamus
Not a true Cranial Nerve: Extension of the diencephalon
Image courtesy of Tabby Kennedy, MD
Optic Canal
Anterior
Clinoid
Optic Canal
Image courtesy of Tabby Kennedy, MD
Cranial Nerve III:
Oculomotor Nerve
Origin: Midbrain
Course:
•Cistern (passes between
posterior cerebral artery and
superior cerebellar artery)
•Cavernous sinus
•Superior Orbital Fissure
CN III
Cerebral Peduncle
•Orbit
Exit Skull base: Superior Orbital
Fissure
Image courtesy of Tabby Kennedy, MD
Cranial Nerve III:
Oculomotor Nerve
Origin: Midbrain
Course:
•Cistern (passes between
posterior cerebral artery and
superior cerebellar artery)
Cavernous
Sinus
CN III
•Cavernous sinus
•Superior Orbital Fissure
•Orbit
Exit Skull base: Superior Orbital
Fissure
Image courtesy of Tabby Kennedy, MD
Superior Orbital Fissure
Anterior Clinoid
Process
Optic Canal
SOF
Superior Orbital
Fissure
Image courtesy of Tabby Kennedy, MD
Cranial Nerve IV: Trochlear Nerve
Origin: Posterior Midbrain
Course:
•Posterior origin
•Travels anteriorly through cistern
•Cavernous sinus
•Superior orbital fissure
•Orbit
Innervation: Superior Oblique
Muscle
Image courtesy of Tabby Kennedy, MD
Cranial Nerve V: Trigeminal Nerve
Origin: Pons
Course:
•Cistern
•Trigeminal ganglion
CN V
Divides into (3) branches: V1
Ophthalmic , V2 Maxillary , V3
Mandibular
V1 and V2 pass through the
cavernous sinus before exiting the
skull. V3 does not pass through the
cavernous sinus
Image courtesy of Tabby Kennedy, MD
V1:Superior Orbital Fissure
Anterior Clinoid
Process
Optic Canal
SOF
Superior
Orbital
Optic Canal
Fissure
Anterior Clinoid
Process
Image courtesy of Tabby Kennedy, MD
V2: Foramen Rotundum
Foramen
Rotundum
Image courtesy of Tabby Kennedy, MD
V2: Inferior Orbital Fissure
Image courtesy of Tabby Kennedy, MD
V2: Infraorbital Canal/Foramen
Image courtesy of Tabby Kennedy, MD
V3: Foramen Ovale
Image courtesy of Tabby Kennedy, MD
Foramen
Spinosum
Foramen
Ovale
V3: Foramen Ovale
Cranial Nerve VI: Abducens Nerve
Origin: pontomedullary
junction
Course:
•Cistern
•Cavernous sinus
•Superior orbital fissure
•Orbit
Innervation: Lateral
rectus muscle
Image courtesy of Tabby Kennedy, MD
Posterior Cranial Fossa
• Anterior central: dorsum sellae of the sphenoid
• Anterolateral: petrous and mastoid parts of the temporal
bones
• Posterior: occipital bone
Image courtesy of Tabby Kennedy, MD
Foramina and Apertures
Foramina/Aperture
Foramen magnum
Jugular foramen
Contents
Medulla, vertebral arteries,
CN XI
CN IX, X, and XI; internal jugular vein
Hypoglossal canal
Hypoglossal nerve (CN XII)
Internal acoustic meatus
Facial nerve (CN VII) and vestibulocochlear nerves
(CN VIII)
Groove for sigmoid sinus
Sigmoid sinus
Image courtesy of Tabby Kennedy, MD
Cranial Nerves VII: Facial Nerve
Origin: Pontomedullary junction
Course:
6 Segments
Cisternal
Intracanalicular
Labyrinthine
Tympanic
Mastoid
Extracranial
Branches:
GPN, Chorda Tympani, Stapedius,
Muscles of facial expression
Image courtesy of Tabby Kennedy, MD
Internal Auditory Canal (IAC)
Internal Auditory Canal
Internal Auditory Canal
Image courtesy of Tabby Kennedy, MD
Cisternal and Intracanalicular
Vestibulocochlear Nerve
Facial Nerve
Cochlear Nerve
Sup Vestib Nerve
Inf Vestib Nerve
Image courtesy of Tabby Kennedy, MD
Geniculate Ganglion
Geniculate Ganglion
Greater Petrosal Nerve
Tympanic Segment Facial Nerve
Image courtesy of Tabby Kennedy, MD
Tympanic Segment Facial Nerve
Tympanic Segment
Image courtesy of Tabby Kennedy, MD
Mastoid Segment Facial Nerve
Mastoid Segment
Image courtesy of Tabby Kennedy, MD
Mastoid Segment Facial Nerve
Stylomastoid Foramen
Image courtesy of Tabby Kennedy, MD
CN VIII: Vestibulocochlear Nerve
Sensory Nerve
Cochlea: Cochlear division (hearing)
Vestibular division (balance):
Semicircular canals
Course:
•Internal Auditory Canal
•Cistern
•Pontomedullary junction
Image courtesy of Tabby Kennedy, MD
Intracanalicular Facial Nerve
Porus Acusticus
Anterior
Facial Nerve
Posterior
Superior Vestibular Nerve
7-up, Coke down
Cochlear Nerve
Inferior Vestibular Nerve
IAC
Image courtesy of Tabby Kennedy, MD
Jugular Foramen
Groove for the
sigmoid sinus
Two different appearances of the jugular foramen.
Image courtesy of Tabby Kennedy, MD
CN IX:
Glossopharyngeal
Nerve
• Branchial arch 3
• Exits through jugular
foramen
• Innervation
– Stylopharyngeus mm
– Posterior 1/3 tongue
taste
– Gag reflex
Netter’s Correlative Imaging: Neuroanatomy
CN X: Vagus Nerve
Exits through jugular foramen
Innervation:
All muscles of larynx, pharynx
and soft palate
•
Except stylopharyngues (IX) and
tensor veli palatini (V3)
Sensory - Larynx and small
portion of pharynx, external
ear, posterior cranial fossa
meninges
Taste buds on epiglottis
Viscerosensory thoracic /
abdominal organs
Netter’s Correlative Imaging: Neuroanatomy
CN XI: Spinal
Accessory Nerve
Exits through jugular
foramen
Innervation:
Sternocleidomastoid
Trapezius
Netter’s Correlative Imaging: Neuroanatomy
Cranial Nerve XII: Hypoglossal Nerve
Hypoglossal Canal
Origin: Medulla
Course: Cistern
Exits skull base through hypoglossal canal
Innervation: Muscles of the tongue
Image courtesy of Tabby Kennedy, MD