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SKULL & ORBIT see handouts
ORBITAL REGION
Fronto-Zygomatic suture – over outer canthus, palpate w/finger tips
Superior Orbital Notch – located in sup. orbital rim, (highest point of
curve.
Supercilliary Ridge – palpated bilaterally @ the most medial aspect
of the orbit.
Glabella – located on frontal bone. Flattened midline area between
(2) ridges, differs from one subject to another.
Nasion – ½” below glabella
Nasolacrimal Canal – inner cantus of eye, located by pressing lightly
when eye is closed.
Anterior Nasal Spine – “False Spine” @ acanthion,.
Zygomatic Arch – palpate don lateral aspect of head.
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SKULL & ORBIT
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REGION
Mastoid Process – push auricle of ear forward and palpate.
Pre-auricular point – on root of Zygomatic arch, verified by
feeling faint pulse of the superficial temporal artery over that
bone.
Head of mandible – palpate by pushing tragus up w/ moving
jaw from side to side.
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REGION
SKULL & ORBIT
MASTOID PROCESS
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LINES AND POINTS
OML (radiographic)
IOML (Reids)
EAM
GML
Auricular line - @ rt. angles to IOML through EAM
Interpupilary Line
AML
GAL
Inion – (EOP) unmistakably found
Lambda – 3”in. above inion (meeting of lamboid and
Sagittal suture)
Inner cantus
Outer cantus
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SKULL & ORBIT
VESSELS:
1. Common carotid artery – behind anterior border of
sternomastoid muscle. Runs from SC.jt to level of upper border
of thyroid cartilage. (c-4) it divides into internal and external
carotids.
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VESSELS:
2. External carotid artery – after bifurcation @tragus divides
into maxillary and superficial temporal arteries.
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VESSELS:
3.Maxillary artery – feeds maxilla and facial bones.
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VESSELS:
4. Superficial temporal – feeds the scalp. (ant. &
post. brain
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VESSELS:
SKULL & ORBIT
5.Internal carotid artery – runs upward entering
skull through carotid canal in temporal bone.
Supplies the ant. 2/3 of the brain with blood. It
eventually unites w/the opposite int. car. &
vertebral art. via the Circle of Willis & basilar art.
@ the base of the brain.
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The circle of Willis (also called the cerebral
arterial circle or arterial circle of Willis) is a
circle of arteries that supply blood to the brain.
It is named after Thomas Willis (1621-1673),
an English physician.[1]
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6. Vertebral artery – runs up back of neck
through the vertebral foramina in the
transverse processes. (C-1 – C-6)
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Venous Sinuses of the skull: are channels
between the two layers of the dura matter
(outer)
Venous Sinuses
Dura Matter
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Venous Sinuses: Blood Drains,→
1. SSS (Superior Sagittal Sinus) runs from
glabella to inion. →
2. Transverse Sinus - @ inion it travels lat. to
a pt. opp. the base of the mastoid process.→
3. Jugular foramen – where blood leaves
skull and transverse sinus becomes internal
jugular vein►►►► empties into subclavian
vein….
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FIVE LOBES OF THE BRAIN
1. Frontal – ant. above orbits & nasal cavities, lower
border is ½” above fronto-zygomatic suture.
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FIVE LOBES OF THE BRAIN
2. Temporal – lower border corresponds approx. to the
upper border of Zygoma.
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FIVE LOBES OF THE BRAIN
3. Occipital – continuation of temporal lobe runs above
Zygomatic arch down to the EOP.
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FIVE LOBES OF THE BRAIN
4. Parietal – lies in posterior cranial fossa below level of
inion.
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FIVE LOBES OF THE BRAIN
5. Insula – lies behind occipital bone “5th Lobe”
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FIVE LOBES OF THE BRAIN
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MAJOR FISSURES OF THE BRAIN
Fissures divide the lobes of the brain
1. Longitudinal Fissure – divide the cerebrum into (2)
hemispheres. Separation is complete ant/post., however, the
hemispheres are connected by a band of white fibers in the
center called the Corpus Callousum. The long. Fissure also
contains Falx Cerebri which is an extension of the dura matter.
Longitudinal Fissure
Corpus Callousum
Falx Cerebri
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MAJOR FISSURES OF THE BRAIN
Fissures divide the lobes of the brain
2. Transverse Fissure – separates the cerebrum from the
cerebellum
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MAJOR FISSURES OF THE BRAIN
Fissures divide the lobes of the brain
3. Central Fissure *Rolando Fissure – separates frontal &
parietal lobes.
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MAJOR FISSURES OF THE BRAIN
Fissures divide the lobes of the brain
4. Lateral Fissure *Sylvian Fissure – separates frontal &
parietal lobes above & temporal below
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MAJOR FISSURES OF THE BRAIN
Fissures divide the lobes of the brain
5. Parietal/Occipital Fissure– separates parietal lobes &
occipital lobe
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ANATOMY
Cerebrum:
* largest and most prominent part of the human brain
* governs all higher mental processes
* stimulates sensation, controls motor activities.
* center for reason, intellect, memory, language, and
consciousness.
* Has (2) hemispheres and is separated by a
longitudinal fissure.
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ANATOMY
Midbrain/Mesencephalon:
* smallest aspect of brainstem
* extends from the Pons to the diencephalon
* rests on sphenoid bone
* involved in hearing and visual reflexes
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ANATOMY
Diencephalon:
* located between the cerebrum & mesencephalon
* consists of several structures and is near the 3rd
ventricle.
* houses the thalamus and hypothalamus glands
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Layers of material
before the brain:
ANATOMY
A. Skull
B. Periostem
C. Dura mater
D. Subdural space
E. Arachnoid
F. Subarachniod (vessels lie here)
G. Pia mater
H. The brain
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ANATOMY
Gray Matter:
-Groups of cell bodies and their dendrites
- on surface of brain called – Cortex
- deep within the brain – Nuclei
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ANATOMY
White Matter:
-Bundles of axons and their myelin sheaths sheets
-Forms the conduction pathways of nerve tracts which
propagate messages from one area of gray mater to the
next
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ANATOMY
Meningies:
-Covering of the brain into (3) layers,
-A. pia matter- inner – (attached to brain)
-B. arachnoid – middle
-C. duramater – outer – (spinal cord)
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ANATOMY
Meningies:
- pia matter- inner – (attached to brain)
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ANATOMY
Meningies:
- arachnoid - middle
Arachnoid cyst;
sonogram
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ANATOMY
Meningies:
- duramatter – outer – (spinal cord)
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ANATOMY
Brainstem: includes,
-Medulla
-Pons
-Midbrain
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ANATOMY
Brainstem: Medulla Oblongata
-Most inferior portion of the brain stem
-Continuous w/spinal cord
-Contains vital centers that regulate;
-Heartbeat, respiration and blood pressure
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ANATOMY
Brainstem: Pons
-Bridge
-Lies just above medulla and is cont. with it
-Connective link for various aspects of the brain
-Relays info. Between cerebrum and cerebellum
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ANATOMY
Brainstem: Midbrain
-smallest aspect of brainstem
-extends from the Pons to the diencephalon
-rests on sphenoid bone
- involved in hearing and visual reflexes
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ANATOMY
Ventricles:
-Fluid filled cavities within the brain where CSF flows.
-CSF flows from the lateral ventricle to the 3rd ventricle,
through the cerebral aqueduct to the 4th ventricle then into the
subarachnoid space.
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Ventricles: Various Imaging Modalities
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CSF (Cerebral Spinal Fluid)
-Baths the brain and spinal cord
-Provides a protective cushion
-Formed in the Choroid Plexus
-Contains H2O,electrocytes, and
proteins
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Choroid Plexus
-Specialized structure in the
ventricles
-Produces CSF
-Start as tiny blood ves. within the
3rd vent. & lat. vent.’s
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Cerebellum
-Second largest aspect of the brain
-Responsible for smooth coordinated movement
The cerebellum (Latin: "little brain") is a
region of the brain that plays an important
role in the integration of sensory perception
and motor control.
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THIRD VENTRICLE
- Lies in middle of forebrain
- Superior to the Sella Turcica
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Fourth Ventricle
-Lies in the hindbrain
The fourth ventricle has a characteristic
diamond shape in cross-sections of the
human brain. It is located within the pons
or in the upper part of the medulla.
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Lateral Ventricle’s
-One in each hemisphere of the cerebrum separated by
the corpus callosum
- Communicate with each other
The lateral ventricles are part of the
ventricular system of the brain. Classified
as part of the telencephalon, they are the
largest of the ventricles.
corpus callosum
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Lateral Ventricle Communications (4)
1. Foramen of Monro (Interventricular) – connects
lateral ventricle to upper part of third ventricle.
SEE HANDOUT…
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Lateral Ventricle Communications (4)
2. Foramen of MAGENDIE – extends from
midline of roof of the 4th ventricle to the
subarachnoid space.
The median aperture of the brain (or foramen of
Magendie) is an opening in the hollow nerve tube,
connecting the fourth ventricle of the brain with the
subarachnoid space.
SEE HANDOUT…
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Lateral Ventricle Communications (4)
3. Foramen of LUSCHKA – extends from the
roof of the lateral recesses of the 4th ventricle
to the subarachnoid space.
SEE HANDOUT…
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Lateral Ventricle Communications (4)
4. Aqueduct of Sylvius (cerebral) – connects
posterior portion of 3rd ventricle to the 4th
ventricle.
SEE HANDOUT…
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Old CSF
Is disposed of through osmosis through the arachnoid
villi on the top of the brain and filters into the
bloodstream.
Osmosis is the spontaneous net movement
of water across a semipermeable membrane
from a region of low solute concentration to a
solution with a high solute concentration,
down a solute concentration gradient.
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Falx Cerebri
The falx cerebri, so named from its sickle-like form, is
a strong, arched fold of dura mater which descends
vertically in the longitudinal fissure between the
cerebral hemispheres. It is also attached to the
occipital bone.
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GLANDS
1. Pituitary Gland:
-Located in st.
-Endocrine gland
-Master gland, secretions stimulate
-other endocrine glands
-Stimulates growth
The pituitary gland, or hypophysis,
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GLANDS
Endocrine glands are glands that
secrete their product (hormones)
directly into the blood rather than
through a duct. This group contains
the glands of the Endocrine system.
The main Endocrine glands include
the pituitary gland, the pancreas, the
gonads, the thyroid gland and the
adrenal glands. Other organs which
are not so well known for their
endocrine activity include the stomach,
which produces such hormones as
ghrelin.
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GLANDS
2. Thalmus
-Influences mood
-Between cerebrum and midbrain
-Rely station
The Thalamus
The thalamus is the way-station of the brain's
networks. It has three circuits running through its
walnut sized core.
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GLANDS
3. Pineal Gland
-Endocrine gland that influences the
onset of puberty
-Calcifies over later in life
-Located in body of thalamus
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STRUCTURES
Caudate Nucleus
-located in the center of all white matter
-Center of cerebrum
-Island of gray matter
-Basal-ganglia (posture)
The basal ganglia (or basal nuclei) are a
group of nuclei in the brain interconnected
with the cerebral cortex, thalamus and
brainstem. Mammalian basal ganglia are
associated with a variety of functions:
motor control, cognition, emotions and
learning.
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STRUCTURES
Corpus Callosum
-vast nerve tracts
-Allow communication between the (2) hemispheres
The corpus callosum is a structure of the
mammalian brain in the longitudinal fissure
that connects the left and right cerebral
hemispheres. It is the largest white matter
structure in the brain, consisting of 200-250
million contralateral axonal projections. It is
a wide, flat bundle of axons beneath the
cortex. Much of the inter-hemispheric
communication in the brain is conducted
across the corpus callosum.
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STRUCTURES
Peduncles
-white
matter that allows
communication between different
aspects of the brain.
In anatomy, a cerebral peduncle is a
band of neurons, resembling a stalk,
which connect varied parts of the brain
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ANATOMY
Cranium (8) Bones
-surround and protect the brain
Occipital (1)
Temporal (2)
Sphenoid (1)
Ethmoid (1)
Parietal (2)
Frontal (1)
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ANATOMY
Cranium (8) Bones
Occipital (1)
-Forms inferiorposterior portion of
the cranium
-Foramen magnum
-Prominent bump, EOP, Inion
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ANATOMY
Temporal (2)
-Contain many complex structures
-Forms both sides of the base of the
cranium.
-Ant.- Zygomatic Arches,
-Petrous pyramids
-TMJ, EAM, IAM
-Hearing, balance, equilibrium
-Jugular foramina & Carotid canals
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ANATOMY
Sphenoid (1)
-Butterfly shaped bone
-(3) Major parts; a. body, b. lesser
wings, c. greater wings
-Body contains the ST, houses the
pituitary gland(hypophysis)
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ANATOMY
Ethmoid (1)
-Smallest of cranial fossa bones
-Cube shaped, divides into (4) parts; 1. Horizontal portion
(cribriform plate)(horizontal plate) contains olfactory nerves,
Crista galli which anchors the brain to the anterior cranial
fossa.
2. Vertical portion (perpendicular plate) – forms
bony nasal septum 3&4. two lateral masses (labyrinths),
thin walls containing Ethmoid air cells. Also contain middle
and superior nasal conchae (turbinate's)
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ANATOMY
Ethmoid
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ANATOMY
Parietal (2)
-2
sides form most of the cranium
-Superior aspect (vertex) each side is
somewhat square in shape and have a
concave internal surface.
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ANATOMY
Frontal (1)
Vertical portion:
-Squamous (forehead), anterior vault
-Frontal sinuses
-glabella
Horizontal Portion
-Forms roof of ea. Orbit (orbital plate)
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ANATOMY
FACIAL BONES (14)
Nasal (2)
Lacrimal (2)
Maxilla (2)
Zygoma (2)
Palantine (2)
Inferior Nasal Conche (2)
Vomer (1)
Mandible (1)
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ANATOMY
FACIAL BONES (14)
Nasal (2)
The nasal bones are two small oblong
bones, varying in size and form in different
individuals; they are placed side by side at
the middle and upper part of the face, and
form, by their junction, "the bridge" of the
nose.
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ANATOMY
FACIAL BONES (14)
Lacrimal (2)
The lacrimal bone, the smallest and most
fragile bone of the face, is situated at the
front part of the medial wall of the orbit. It
has two surfaces and four borders.
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ANATOMY
FACIAL BONES (14)
Maxilla (2)
The maxilla (plural: maxillae) is a fusion of
two bones along the palatal fissure that
form the upper jaw. This is similar to the
mandible, which is also a fusion of two
halves at the mental symphysis
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ANATOMY
FACIAL BONES (14)
Zygoma (2)
The zygomatic bone (malar bone) is a
paired bone of the human skull. It
articulates with the maxilla, the temporal
bone, the sphenoid bone and the frontal
bone. It forms part of the orbit and is
commonly referred to as the cheekbone
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ANATOMY
FACIAL BONES (14)
Palantine (2)
The palatine bone is a bone in the palate
(Latin palatum; unrelated to palatium
'palace', from which other senses of
palatine derive
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ANATOMY
FACIAL BONES (14)
Inferior nasal conchae (2)
The inferior nasal concha (Inferior
Turbinated Bone) is one of the turbinates in
the nose. It extends horizontally along the
lateral wall of the nasal cavity [Fig. 1] and
consists of a lamina of spongy bone, curled
upon itself like a scroll.
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ANATOMY
FACIAL BONES (14)
Volmer (1)
The Vomer (from Latin vomer, -ĕris,
"ploughshare") is one of the unpaired facial
bones of the skull. It is located in the
midsagittal line, and touches the sphenoid,
the ethmoid, the left and right palatine
bones, and the left and right maxillary
bones
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ANATOMY
FACIAL BONES (14)
Mandible (1)
The mandible (from Latin mandibūla,
"jawbone") or inferior maxillary bone is,
together with the maxilla, the largest and
strongest bone of the face [citation needed]. It
forms the lower jaw and holds the lower
teeth in place.
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ANATOMY
ORBITS (2)
In anatomy, the orbit is the cavity or socket
of the skull in which the eye and its
appendages are situated.
It can also mean the skin which surrounds
the eye of a bird.
In the adult human, the volume of the orbit
is 30 ml, of which the eye occupies 6.5 ml.
[1]
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ANATOMY
ORBITS
-Cone shaped structure
-Surrounds and protects the eyeball (Oculus
Bulbous)
-Created by the junction of the sphenoid,
frontal and Ethmoid bone of the cranium
-Also created by the junction of the Lacrimal,
palatine, maxillary and Zygoma bones of the
face.
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ANATOMY
ORBITS (3) OPENINGS
1. Superior Orbital Fissure
2. Inferior Orbital Fissure
3. Optic Canal
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SUTURES
1. Squamous Suture- on the
side of the cranium, joins
temporal and parietal bone.
2. Coronal Suture – runs
transversely across the top of
the cranium and is the
articulation between
thefrontal and parietal bones.
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SUTURES
3. Sagittal Suture –
articulation between
parietal bone and MSP.
4. Lambdoidal Suture –
posterior in cranium and
joins the occipital and
parietal bones.
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CEREBRAL VASCULAR SYSTEM
-Thin and weak, have no valves.
-Allows blood to flow in either direction, this is a problem
because it may create a route for blood-borne-pathogens to
pass from the body to the brain and the brain to the body….
The blood-brain barrier (BBB) is a membranic structure that
acts primarily to protect the brain from chemicals in the blood,
while still allowing essential metabolic function. It is composed of
endothelial cells, which are packed very tightly in brain capillaries.
This higher density restricts passage of substances from the
bloodstream much more than endothelial cells in capillaries
elsewhere in the body. Astrocyte cell projections called astrocytic
feet (also known as "glial limitans") surround the endothelial cells
of the BBB, providing biochemical support to those cells. The
BBB is distinct from the similar blood-cerebrospinal fluid barrier, a
function of the choroidal cells of the choroid plexus.
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VENOUS DRAINAGE (3) SEGEMENTS
(Sinuses)
1. Cerebral – drains superficial and deep innerlying veins (drains into the dural).
2. Dural – receives blood from the cerebral veins.
(drains into the internal jugular segment).
3. Internal Jugular Segment- begins with the
sigmoid sinus. (drains out into jugular foramen).
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Cranial
CORONAL
Nerves
Numbered from anterior to posterior,
according to their attachment to the
brain…All have specific functions;
touch, smell, sight, hearing, etc…..
Cranial nerves are nerves that emerge
directly from the brain in contrast to spinal
nerves which emerge from segments of the
spinal cord. Although thirteen cranial
nerves in humans fit this description,
twelve are conventionally recognized. The
nerves from the third onward arise from the
brain stem.
Olfactory Nerve (CN1) – “Smell” (18-20) small nerve bundles.
Optic Nerve (CN2) – “Sight” arise from optic retina.
Oculomotor Nerve (CN3) – “moves eye” emerges from midbrain.
Trochlear Nerve (CN4) – “muscle” controls sup. orbital muscle.
Trigeminal Nerve (CN5) – “sensory” (3) divisions, ophthalmic,
maxillary and mandibular.
Abducens Nerve (CN6) – “motor impulses” lat. movement of eye.
Facial Nerve (CN7) – “taste” facial nerves and 2/3 of the tongue.
Vestibulocochlear Nerve (CN8) – “sound” picks up sounds &
interrupts.
Glossopharyngeal Nerve (CN9) – “motor” impulses, monitors
blood.
VagusNerve (CN10) – “stimulates” pharynx, larynx, thoracic &
abdomen viscera.
Accessory Nerve (CN11) - “stimulates” pharynx, palatine &
larynx.
Hypoglossal Nerve (CN12) -“muscle” muscle of tongue.