OSTEOLOGY

The Skull

The Skull
1. The skull is divided into two parts: Neurocranium- which forms a protective case or vault around the brain Viscerocranium- which forms the anterior part of the skull including the orbits, nasal cavities and upper/lower jaw bones
Viscerocranium Neurocranium

2.

6/24/2011

The Skull
Frontal coronal suture Parietal

Occipital

Temporal Sphenoid
6/24/2011 3

The Skull

Lacrimal

Nasal Zygomatic
Nasal

Inferior Nasal Conchae Inferior

Maxilla
maxilla

Nasal conchae

Vomer
6/24/2011

Mandible

Vomer

Mandible
4

Frontal Bone
Squamous (flat) portion forms the skeleton of the forehead Fontal bone forms the roof of the orbit
Nasion Frontal bone

Frontal Bone

Squamous portion

Glabella
Glabella

Nasion

Nasion is an area where the frontal bone intersects with the nasal bones Glabella- smooth, slightly depressed area located just superior to the nasion
6/24/2011

Orbital portion

Frontal Bone
Supraorbital marginmarks the boundary between the squamous and orbital portions Supraorbital notch or foramen is for the passage of the supraorbital nerve and vessels A prominent ridge just superior to the supraorbital margin is the superciliary arch (more pronounced in males) Zygomatic process of the frontal bone articulates with the zygomatic bone
Supraorbital notch Superciliary arch

Zygomatic process

Supraorbital margin

6/24/2011

Zygomatic Bones
Cheek bones Forms a portion of the lateral wall of the orbit Frontal Process of the zygomatic bone articulates with the frontal bone Temporal process of the zygomatic bone articulates with the temporal bone Zygomaticofacial foramensmall foramen for passage of 6/24/2011 zygomaticofacial nerve the
Zygomaticofacial foramen
7

Frontal process

Temporal process

Maxillae
Forms the upper jaw Alveolar processes of the maxillae includes the sockets and supporting bone for the maxillary teeth Maxillae form the floor of the orbit Large infraorbital foramen for passage of the infraorbital nerve & vessels Surrounds most of the pear-shaped piriform aperture
6/24/2011 8

Infraorbital foramen Alveolar process Piriform aperture

Maxilla

Maxillae
Frontal processes of the maxillae articulates with the frontal bone Zygomatic processes of the maxillae articulates with the zygomatic bones Anterior nasal spinesharp prominence at inferior aspect of the piriform aperture Intermaxillary suturesite where the two maxilla are united in the median plane
6/24/2011

frontal process

Anterior nasal spine

Zygomatic process

Intermaxillary suture

 Seen within the piriform aperture are the scrolled middle nasal conchae (part of the ethmoid bone) & the inferior nasal conchae Vomer bone along with the perpendicular plate of the ethmoid bone which together form the bony nasal septum can also be identified with the piriform aperture

Perpendicular plate

Middle & Inferior concha

Vomer

6/24/2011

10

Mandible
U-shaped bone with alveolar process that houses the mandibular teeth Mental foramen- located inferior to 2nd premolar for passage of the mental nerve and vessels Mental protuberance- a triangular elevation of bone that forms the prominence of the chin Mental tubercle- located just lateral to the protuberance Body is the horizontal Alveolar process portion Ramus is the vertical portion
6/24/2011

Ramus

Body Mental foramen

Mental protuberance

11

Osteology

Lateral Aspect of the Skull

Lateral Aspect of the Skull

1. Parietal bone 2. Frontal bone 3. Occipital bone 4. Temporal bone 5. Sphenoid bone 6. Mandible 7. Zygomatic bone 8. Maxillae 9. Lacrimal bone 10. Nasal bone

2. 9. 5. 10. 7. 4.

1.

3.

8.

6.

6/24/2011

13

Parietal Bones
Paired bones that form the lateral & superior cranium Temporal Lines- mark the attachment site of the temporalis muscle & fascia Articulates with frontal bone via coronal suture Articulates with occipital bone via lambdoid suture Pterion-site where 4 cranial bones articulateimportant clinical 6/24/2011 implications
pterion
Coronal suture Temporal lines Parietal Lambdoid suture

14

Temporal Bones
Paired bones that form the inferior lateral aspect of skull Temporal bone is described as having a flat squamous portion and a mastoid process (site of attachment of several muscles)
Mastoid process

Squamous

Zygomatic arch extends anteriorly to articulate with the zygomatic bone

Zygomatic arch
15

6/24/2011

Temporal Bones
External acoustic meatus (ear canal) and the pointed styloid process are considered to be located the tympanic portion of the temporal bone Styloid process serves as the attachment site for several muscles and the stylohyoid ligament
Styloid process
6/24/2011 16

External acoustic meatus

Temporal Bones
Mandible and a portion of the zygomatic arch removed in this view Located on the inferior aspect of the arch is a small bony protrusionarticular tubercle that is important in the mechanics of the TMJ Mandibular fossa- deep recess that accepts the condyle of the mandiblealso important region of the TMJ
6/24/2011

Articular tubercle

Mandibular fossa

17

Zygomatic bone
Forms major portion of the cheek Temporal process that articulates with the the zygomatic arch
Frontal process

Zygomatic arch

Frontal process that articulates with the frontal bone Zygomaticofacial foramen small foramen generally visible
6/24/2011

Temporal process

Zygomaticofacial foramen

18

Occipital Bone
Forms the posterior aspect of the skull Articulates with the parietal bone via the lambdoid suture Prominent palpable elevation located posteriorly is the external occipital protuberance
Lambdoid suture

External Occipital protuberance

6/24/2011

19

Sphenoid Bone
Irregular shaped bone that forms a portion of the orbit, lateral aspect of skull and a portion of the cranial base Sphenoid can be divided into 4 parts: Greater wing Lesser wing Pterygoid processes Body Some portions of the sphenoid can only be seen inside the cranial cavity

Sphenoid Bone

1. 2. 3. 4.

6/24/2011

20

4 portions of Sphenoid Bone

Portion of zygomatic arch and mandible removed in this view Greater wing articulates with the temporal, parietal & frontal bones at the pterion
Greater wing

Pterygoid processes are two thin plates of bone that serve as attachment sites for muscles Pterygoid hamulus-small hook of bone extending from the medial pterygoid platetensor veli palatini tendon courses around this 6/24/2011
Pterygoid process

Pterygoid hamulus

21

Maxillae
Portion of zygomatic arch and mandible removed in this view Posterior aspect of the maxillae is referred to as the tuberosity of maxillae Small alveolar foramina for the posterior superior alveolar nerves & vessels Pterygomaxillary fissuretear-drop shaped fissure between the sphenoid and Alveolar tuberosity of the maxillae foramen Pterygopalatine fossa is a small but important space located medial to the fissure
6/24/2011

Pterygomaxillary Fissure

Tuberosity of maxilla

22

Lateral Aspect of Skull

Nasal bone can also identified as it articulates with the frontal bone and the maxillae Lacrimal bone- which houses the lacrimal sac van be identified within the orbit Prominent anterior nasal spine at the inferior aspect of the piriform aperture
6/24/2011

Lacrimal bone

Nasal bone

Nasal spine

23

Mandible
Condylar process is located at the superior part of the ramus and involved in the articulation of the mandible with the temporal bone (TMJ) Coronoid process is located just anterior and serves as the attachment site for the temporalis muscle Angle of mandible is between the ramus and body
6/24/2011

Condylar process Angle

Coronoid process

24

Mandible
Condylar Process
Infant

Coronoid process

Mandibular foramen

Mylohyoid line Lingula Ramus Alveolar Part (crest) Mental foramen Body
6/24/2011 25

Mandible
Mandibular notch Condylar process

Ramus

Body Mental spines Bone loss due to tooth loss

6/24/2011 26

Calvaria
Bregma

Emissary foramen- small, inconsistent (not always present) foramina for passage of emissary veins Bregma- is the landmark formed by the intersection of the sagittal & coronal sutures Lambda-is the landmark formed by the intersection of the sagittal & lambdoid sutures
6/24/2011

Coronal suture

Sagittal suture

Emissary foramen

Lambda

Lambdoid suture
27

Calvaria
Inferior aspect of the skull cap presents several Diploe features: Vascular grooves for branches of the middle meningeal artery Granular Foveolae- pits formed by arachnoid granulations (site of CSF transfer) Groove for the superior sagittal sinus-large venous channel within the dura mater Diploe- cancellous bone containing red marrow
6/24/2011

Grooves for middle meningeal artery

Granular foveolae

Groove for superior sagittal sinus

28

Infant Skull

Superior & Lateral Aspects

Infant Skull
Bones forming the calvaria & some parts of the cranial base develop by Anterior intramembranous ossification Whereas-most parts of the cranial base develop by endochondral ossification Bones in the infant skull are separated by areas of fibrous tissue membranes- the fontanelles: Anterior Sphenoidal Posterior Mastoid sphenoidal 6/24/2011

Posterior

Mastoid

30

Infant Calvaria
Anterior Fontanelle (soft spot) is the future site of the bregma By about 18-24 monthsthe surrounding bones fuse together and is no longer palpable Posterior Fontanelle is triangular and marks the future site of the lambda Fusion of surrounding bones occurs by about 12 months
6/24/2011 Fontanelles-

Anterior fontanelle

Posterior fontanelle

31 membranous gaps (soft spots) in skull that permit growth

Infant Skull
Mastoid & sphenoidal fontanelles fuse early in infancy Palpation of fontanelles during infancy enables physicals to determine: 1. Growth progress of the frontal & parietal bones 2. Degree of hydration of the infant (a depressed fontanelle indicates dehydration) 3. Level of intracranial pressure-bulging fontanelle indicates increased pressure on the brain

Anterior

Posterior

Sphenoidal

Mastoid

6/24/2011

32

Osteology

External Aspect of the Cranial Base

Cranial Base
1. 2. 3. 4. 5. 6. Inferior aspect of the skull presents six different bones: Palatine processes of the maxillae Palatine bone Sphenoid bone Vomer Temporal Occipital bone Numerous foramina can also be identified

1 2 3 5 4

6/24/2011

34

Cranial Base- Palate Base Hard palate is formed by the palatine processes of the maxillae and the horizontal plates of the palatine bone Small prominence projecting posteriorly form the hard palate in the median plane is the posterior nasal spine

Palatine processes Horizontal plate of the Palatine bone

Posterior nasal spine

6/24/2011

35

Cranial Base- Palate Base Posterior to the central incisors is a small depression-incisive fossa with a pair of canalsincisive canals for the passage of the nasopalatine nerves Posterolaterally are the greater & lesser palatine foramen for passage of the nerves & vessels of the same name
6/24/2011 36

Incisive canals Greater and Lesser Palatine foramina

Cranial Base-Vomer Base-

Vomer-thin, flat unpaired bone in the midline that forms a major portion of the bony nasal septum On either side of the vomer are two large openings- choanae (posterior nasal apertures)

Vomer

Choanae

6/24/2011

37

Cranial Base- Sphenoid Base-

Three parts of the sphenoid bone can be appreciated on the inferior aspect of skull:
Greater wing Lateral pterygoid plate Medial pterygoid plate

1. Greater wing 2. Medial pterygoid plate 3. Lateral pterygoid plate Pterygoid fossa is between the two pterygoid plates

6/24/2011

38

Cranial Base- Sphenoid Base Foramen ovale for passage of the mandibular division (V3) of the trigeminal nerve Foramen spinosum- for passage of the middle meningeal artery
Foramen spinosum

Foramen ovale Auditory Tube-groove

Groove for the pharyngotympanic (auditory) tube lies medial to spinosum

39

6/24/2011

Cranial Base- Temporal Base Mastoid processprominence located posteriorly on the temporal bone Mastoid serves as the attachment site for the SCM and posterior belly of the digastric muscles External acoustic meatus (EAM) is located just anterior to the mastoid
6/24/2011

EAM

Mastoid process

40

Cranial Base- Temporal Base Styloid process- thin bony process extending inferior & anteriorly Styloid serves as attachment site for numerous muscles & ligaments Mandibular fossaarticular surface that accepts the condyle of the mandible forming the TMJ
6/24/2011 41

Mandibular fossa

Styloid process

Cranial Base- Temporal Base Two important foramen can be identified on the inferior aspect of the temporal bone: Stylomastoid foramenlocated between the mastoid & styloid processes is a small foramen for the passage of the facial nerve (CN VII) Carotid canal- passage for the internal carotid artery into the cranial cavity
6/24/2011 42

Carotid canal

Stylomastoid foramen

Cranial Base- Occipital Base Occipital bone forms the posterior and inferior aspects of the skull Foramen Magnum- a large foramen for passage of the spinal cord Foramen magnum divides the occipital bone into 3 parts: 1. Basilar Region 2. Condylar Region 3. Squamous Region
6/24/2011

1 2

Foramen magnum
3

43

Cranial Base- Occipital Base-

Basilar portion presents a small tuberclepharyngeal tubercle for attachment of the pharyngeal constrictors Foramen lacerum (jagged-shaped) is located lust lateral to the basilar portion

Foramen lacerum

Pharyngeal tubercle

6/24/2011

44

Cranial Base- Occipital Base Condylar portion presents the occipital condyles that articulate with the atlas Jugular foramen- large foramen between the occipital & temporal bones for passage of cranial nerves: IX, X, XI and the internal jugular vein

Jugular foramen

Occipital condyle

Hypoglossal canal

Hypoglossal canal for passage of the hypoglossal nerve (CN XII)

45

6/24/2011

Cranial Base- Occipital Base Squamous portion presents the palpable external occipital protuberance Superior & inferior nuchal lines project laterally and are sites for muscular attachments

Superior & inferior nuchal lines

External occipital protuberance

6/24/2011 46

Osteology

Internal Aspect of the Cranial Base

Cranial Base
Internal aspect of the cranial base is divided into three major regions or fossae:

Anterior cranial fossa

1. Anterior cranial fossa 2. Middle cranial fossa 3. Posterior cranial fossa These three fossae lie at different levels and form the bowl-shaped floor of the cranial cavity

Middle cranial fossa

Posterior cranial fossa

6/24/2011

48

Anterior Cranial Fossa

Ethmoid

Frontal lobes of the brain occupies the anterior cranial fossa

Orbital portion of the frontal bone

Fossa is formed by the: 1. Orbital portion of the frontal bone 2. Ethmoid bone in the middle 3. Lesser wing of the sphenoid

Lesser wing of the sphenoid

6/24/2011

49

Anterior Cranial Fossa

Frontal crest- a median bony extension from the frontal bone Crista
galli Frontal crest

Foramen cecum

Foramen cecum is located at the base of the crest and is a small foramen for passage a vessels during development Crista galli- ridge of bone projecting superiorly from the ethmoid bone and serves as the attachment for the cerebral falx
6/24/2011 50

Anterior Cranial Fossa

On either side of the crista galli is a sievelike Cribriform plate for passage of the olfactory axons into the cranial cavity Optic canal for passage of the optic nerve (CN II) and the ophthalmic Optic canal artery can be appreciated within the lesser wing of the sphenoid

Cribriform plate

6/24/2011

51

Middle Cranial Fossa

Temporal lobes of the brain occupy the middle cranial fossa

Greater wing of sphenoid

Fossa is formed by the: 1. Greater wing of the sphenoid 2. Squamous portion of the temporal bone 3. Petrous portion of the temporal bone

Squamous portion temporal bone

Petrous portion temporal bone

6/24/2011

52

Middle Cranial Fossa

Sella turcica- the saddlelike bony formation located on the superior aspect of the body of the sphenoid Sella turcica is surrounded by anterior & posterior clinoid processes

Sella turcica

Anterior and Posterior clinoids

6/24/2011

53

Middle Cranial Fossa

Sella turcica is composed of three parts:

Tuberculum sellae

1. Hypophyseal fossa (pituitary fossa) 2. Tuberculum sellae (saddle horn) 3. Dorsum Sellae (back of the saddle) Sella turcica- essentially houses and guards the pituitary gland

Hypophyseal fossa

Dorsum sellae

6/24/2011

54

Middle Cranial Fossa

Middle cranial fossa presents five important foramina:

1. Superior orbital fissure for passage of CNs III, IV, V1 & VI & ophthalmic veins 2. Foramen rotundum which transmits the maxillary nerve (V2) 3. Foramen ovalewhich transmits the mandibular nerve (V3)
6/24/2011

Superior orbital fissure Foramen rotundum

Foramen ovale

55

Middle Cranial Fossa

4. Foramen spinosum which transmits the middle meningeal artery 5. Foramen lacerumnothing is transmitted vertically thru this foramen although the internal carotid artery and some nerves pass across the Foramen lacerum foramen horizontally Grooves for the greater & lesser petrosal nerves are located along the anterior slope of the petrous portion of the temporal bone
56

Foramen spinosum

Petrosal grooves

6/24/2011

Middle Cranial Fossa

Petrous portion of the temporal bone houses the middle and inner ear cavities Arcuate eminencemarks the roof of the anterior semicircular canal of the inner ear cavity Trigeminal impression is located just anteromedial the eminence-which marks the location of the sensory ganglion of the trigeminal nerve
57

Trigeminal impression

Arcuate eminence

6/24/2011

Posterior Cranial Fossa

The largest & deepest of the three fossae Cerebellum, pons and medulla occupy the posterior fossa Formed mainly by the occipital bone and the petrous & mastoid portions of the temporal bone
Occipital bone Temporal bone Petrous portion

6/24/2011

58

Posterior Cranial Fossa

Clivus marks the anterior portion of the occipital bone Foramen magnumlarge foramen that marks the transition from the medulla to the spinal clivus cord Posterior to the foramen magnum is the internal occipital crest and internal occipital protuberance
6/24/2011

Occipital crest

Internal occipital protuberance

59

Posterior Cranial Fossa

Broad grooves show the horizontal course of the transverse and S-shaped sigmoid sinuses (both dural venous sinuses)

Sigmoid sinus empties into the large jugular foramen which also transmits several Jugular cranial nerves: foramen 1. Glossopharyngeal (CN IX) 2. Vagus (CN X) 3. Accessory (CN XI)

Groove for the Sigmoid sinus Transverse Sinus groove

6/24/2011

60

Posterior Cranial Fossa

Internal acoustic meatus is located just anterosuperior to the jugular foramen Internal acoustic meatus transmits the facial nerve (CN VII) and vestibulochochlear nerve (CN VIII) along with the labyrinthine artery Hypoglossal
canal

Internal acoustic meatus

Hypoglossal canal for the hypoglossal nerve (CN XII) lies superior to the margin of the foramen magnum
6/24/2011 61

Cribrifrom plate-CN I

Superior Orbital Fissure CN III, IV, V1 & VI Optic Canal CN II Foramen Rotundum- CN V2 Foramen Ovale-CN V3

Hypoglossal Canal CN XII Internal Acoustic MeatusCN VII & VIII

Jugular Foramen- CN IX, X and XI

6/24/2011 62

Osteology of the Orbit

Seven bones articulate to make each orbit:
superior

1. Frontal 2. Zygomatic 3. Maxillary 4. Lacrimal 5. Ethmoid 6. Palatine 7. Sphenoid

lateral

7 2

5 3

medial

inferior

6/24/2011

63

Osteology of the Orbit

Optic canal- transmits the optic nerve and ophthalmic artery Superior orbital fissuretransmits CN III, IV, V1 & VI Inferior orbital fissure & groove- transmits the infraorbital vessels & nerve Anterior & posterior ethmoidal foraminatransmits vessels & nerves with same name
6/24/2011

Optic canal

Ethmoidal foramina

Superior orbital fissure

Inferior orbital fissure & groove

64