The Head

DMS 110C
Anatomical Review of the Head

● The principal bony structure of the head is the skull, which is specially
adapted to house and protect the brain.
● The head is the location of the special sensory organs of vision,
hearing, equilibrium, taste and smell, which provide information
concerning our surroundings
Osseous Components

● The bony framework of the head is called the skull. This is the most
complex osseous structure of the body and it consists of 22 bones
connected by immovable joints called sutures
● Some of the bones surround a large cranial cavity that contains the
brain
● The superior surface of this region is covered by the scalp
● Some skull bones adjacent to the nasal cavity contain air filled spaces,
called paranasal sinuses
● Many of the bones in the skull have holes or opening called foramina,
that serve as the passageways for nerves and vessels
 Cranium

The eight bones of the cranium surround the cranial cavity, which houses the brain.

● Frontal bone forms the forehead and superior part of the orbit of the eye
● Two parietal bones form most of the top of the cranium
● Two temporal bones form a portion of the sides and base of the cranium.
● The single ethmoid bone is located b/w the eyes and forms most of the medial wall of
each orbit.
● The single sphenoid bone lies at the base of the skull anterior to the temporal bones. It
forms the anterior-lateral portion of the cranium and lateral walls of the orbit
● The single occipital bone forms the posterior portion and part of the base of the cranium.
It has a large hole, the foramen magnum, for passage of the spinal cord and the vertebral
vessels
Floor of the cranial cavity
The floor of the cranial cavity is subdivided into anterior, middle and
posterior cranial fossae

● Anterior cranial fossa is formed by portions of ethmoid,

sphenoid and frontal bones. It contains the frontal lobes of the brain
● Middle cranial fossa is composed of the sphenoid and temporal
bones. It contains the temporal lobes of the brain
● Posterior cranial fossa is formed by the sphenoid,temporal and
occipital bones. It contains the cerebellum, pons and the medulla
oblongata
 Calvaria and Scalp
● The domelike superior portion of the cranium is the calvaria or skullcap.
● It is composed of the superior portions of the frontal, parietal and occipital bones.
● The calvaria is covered by the scalp.
● The scalp has five layers
● Skin: The outermost layer
● Connective tissue: The second layer beneath the skin is composed of highly vascular
subcutaneous CT.
● Aponeurosis: The third layer consists of two thin muscles connected by a broad flat
tendon or aponeurosis
● Loose connective tissue: The fourth layer consists of loose CT, contains numerous
vessels, which connect the veins of the scalp with intracranial venous sinuses.
● Periosteum or pericranium: fifth layer covers the skull bones
● Remember SCALP
● S= Skin C= Connective tissue A= Aponeurosis L= Loose connective tissue P
= Periosteum
Face
The facial portion of the skull consists of 14 bones

● Two maxillae form the upper jaw

● Two palatine bones form the posterior portion of hard palate
● Two zygomatic bones form the prominence of the cheeks
● Two small nasal bones join in the midline to form the bridge of the
nose
● Two thin lacrimal bones which form the part of orbital cavity
● Vomer bone forms the inferior portion of nasal septum
● Two inferior nasal conchae that form the lateral walls of the nasal
cavities
● The mandible forms the lower jaw
Paranasal Sinuses
● The paranasal sinuses are air filled spaces in some of the bones adjacent to the
nasal cavity
● The four sets of paranasal sinuses are named according to the bone in which they
are located
➢ Frontal sinus
➢ Ethmoid sinus
➢ Sphenoid sinus
➢ Maxillary sinus

Foramina of the Skull

● Foramina are openings in bones that serve as passageways for nerves and blood
vessels
● These foramina allow the vessels that transport blood and the nerves that must
pass through the skull on their way to and from the brain.
Muscular Components

● Numerous muscles are located in the head, many of them small and
difficult to separate from the adjacent muscles
● They are difficult to isolate even by imagining techniques
● These muscles have functional significance because they deal w/
facial expression and the chewing of food
Brain
● The predominant structure in the cranial cavity is the brain
● It is composed of organized regions of white matter and gray matter
● The white matter consists of nerve fibers that are covered w/ a white
fatty substance called myelin
● The gray matter consists of nerve cell bodies and unmyelinated fibers
● Fluid filled spaces, called ventricles, are located within the brain and
are surrounded by brain tissues
● The brain is separated from the cranial bones by layers of connective
tissue called meninges, that help protect the surface of the brain
Regions of the Brain
For descriptive purposes, the brain may be divided into the cerebrum, diencephalon,
brainstem and cerebellum

Cerebrum
● The largest portion of the brain
● Consists of two cerebral hemispheres connected by the corpus callosum.
● The longitudinal fissure , deep cleft b/w the two cerebral hemisphere
● The surface of the cerebrum has numerous convolutions, which increase the
surface area of the cerebral cortex. The ridges are called gyri and furrows b/w
them called sulci
● These sulci divide the cerebrum into lobes like frontal lobe, parietal lobe,
temporal lobe and occipital lobe
Diencephalon
● The diencephalon is centrally located.
● It surrounds the third ventricle and consists of the epithalamus, thalamus and
hypothalamus
Brainstem
● The brainstem is subdivided into the midbrain, the pons and the
medulla oblongata
● The midbrain is located b/w the diencephalon and the pons
● The pons appears as a prominent band of fibers b/w the midbrain and
medulla oblongata. Most of the fibers connect to the cerebellum but
some of the fibers extend from the cerebellum to the parts of the
brain
● The medulla oblongata is conical in shape and extends from the pons
to the foramen magnum, where it continuous w/ the spinal cord
Cerebellum
● It is situated posterior to the pons and the medulla oblongata and
occupies the posterior cranial fossa
● It consists of two cerebellar hemispheres connected by a central
vermis, which resembles a coiled up worm
● The cerebellum plays an important role in the control of muscle
tone, balance and the coordination of muscular activity of the body
Ventricles of the Brain
● Ventricles are fluid filled cavities in the brain. These ventricles include the
two lateral ventricles, the third ventricle and the fourth ventricle
● Lateral Ventricle is located within each cerebral hemisphere. The major
portion is located in the parietal lobe. Each lateral ventricle communicates
w/ the third ventricle by a small opening called the interventricular foramen
● Third Ventricle is a narrow midline chamber enclosed by the diencephalon.
The third ventricle communicates w/ the fourth ventricle by a long cerebral
aqueduct also known as aqueduct of Sylvius.
● Fourth Ventricle lies internal to the pons and the medulla oblongata at the
level of the cerebellum. Two openings, called the foramina of Luschka, and
a single opening called the foramen of Magendie. The ventricles
communicate w/ the subarachnoid space through these three openings
Choroid Plexus
● is a group of specialized vascular structures located in the ventricles.
● The choroid plexus produce the cerebrospinal fluid by filtration and
secretion.
● The fluid originates in the ventricles and circulates through the foramina into
subarachnoid space around the brain and spinal cord.
● From there the fluid is reabsorbed into the venous system and returned to
the heart as part of the blood.

Meninges
● three connective tissue membranes called meninges, covers the brain.
● These meninges are the dura mater, the arachnoid mater and the pia mater.
● Cerebrospinal fluid circulates in the subarachnoid space b/w the arachnoid
and the pia mater.
 Arterial Blood Supply of the Brain
Blood is supplied to the brain by two pairs of arteries, the internal carotid arteries and the
vertebral arteries

Internal Carotid Artery

● The first branch is ophthalmic artery
● The cerebral portion of the internal carotid artery divides into the anterior cerebral
and middle cerebral arteries.
● The two anterior cerebral arteries pass forward and medially towards the
longitudinal fissure,where they are connected by a small anterior communicating
artery. The two arteries then run parallel in the longitudinal fissure and gives off
branches to supply the frontal and parietal lobes.
● The middle cerebral artery passes through the lateral fissure to spread out over
the lateral surface of the brain
● Another branch of the internal carotid artery, the posterior communicating
artery, runs posteriorly to anastomose w/ the posterior cerebral arteries.
Vertebral Arteries
● The right and left vertebral arteries, which are branches of the
subclavian arteries, courses superiorly through the the transverse
foramina of the cervical vertebrae.
● As they pass through the foramen magnum, they pierce the dura
mater to enter the subarachnoid space. The right and left vertebral
arteries join to form the basilar artery.
● The basilar artery then divides into two posterior cerebral arteries ,
which supply the occipital lobe
 Circle of Willis

● The typical configuration at the base of the brain shows the vessels
anastomosis to form a circle called the circus arteriosus cerebri or circle of
willis
● This circle is formed by the internal carotid arteries, the anterior cerebral
arteries, the anterior communicating artery, the posterior cerebral arteries
and the posterior communicating artery.
● Berry aneurysms often occurs in the vessels of the circle of Willis
 Venous Drainage of the Head
● Venous channels that drain blood from the brain and the meninges are
called sinuses. They are located b/w the endosteum of the calvaria and the
meningeal dura or b/w two layers of dura mater. Venous sinuses have no
valves.
● superior sagittal sinus
● inferior sagittal sinus
● straight sinus
● transverse sinus
● The sigmoid sinus which is a continuation of transverse sinus loops over
the temporal bone to the jugular foramen where it becomes the internal
jugular vein.
● A large cavernous sinus is located on each side of the sphenoid bone, is
drained by small petrosal sinuses that enters into the sigmoid sinus or into
the internal jugular vein
Orbital Cavity
● The orbital cavity is a pyramid shaped structure with apex, base and
four triangular walls
● Apex is formed by the optic foramen in the posterior part of the orbit
● Base is formed by the zygomatic, maxillary and frontal bones
● The walls are formed by zygomatic bone, lacrimal bone, maxilla and
orbital plates of palatine and frontal bone.
● Contents of the orbital cavity are eyeball and extrinsic ocular muscles
that are associated with movements of the eye.
Vascular supply of the orbit

● Most of the vascular supply to the orbital contents is by ophthalmic

artery, a branch of the internal carotid artery
● The most important branch of the ophthalmic artery is the central
artery of the retina. It supplies the retina and if blocked by a tumor,
thrombus or massive edema result in sudden blindness.
● Venous drainage of the orbital cavity is by the superior and inferior
ophthalmic veins, which enters the cavernous sinus.