Anatomy: Bones of the Head

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Questions and Answers

If a neurosurgeon is planning a surgery that requires access to the cranial cavity, which of the following should be considered in relation to the skull's structural components?

  • The presence of the diploe layer, which consists of dense bone for added protection against trauma.
  • The exclusive presence of compact bone throughout the calvaria, ensuring uniform strength.
  • The calvaria's construction of two compact bone layers separated by spongy bone. (correct)
  • The outer table being thinner than the inner table, providing less resistance to external forces.

In a forensic investigation, a skull is found with a fracture at the pterion. Which of the following is the most immediate and life-threatening concern related to this type of injury?

  • The risk of an extradural hematoma due to rupture of the middle meningeal artery. (correct)
  • Compromise of the dural venous sinuses leading to thrombosis.
  • Potential damage to the facial nerve causing paralysis of facial muscles.
  • Increased intracranial pressure due to cerebrospinal fluid leakage.

During a complex surgical procedure involving the base of the skull, a surgeon needs to differentiate between the anterior, middle, and posterior cranial fossae. Which of the following landmarks is most critical for distinguishing the middle from the posterior cranial fossa?

  • The petrous part of the temporal bone. (correct)
  • The lesser wing of the sphenoid bone.
  • The squamous part of the occipital bone.
  • The cribriform plate of the ethmoid bone.

A patient presents with a fracture that involves a bony fragment depressed below the normal skull convexity. Which of the following represents the most significant potential consequence of this type of fracture?

<p>Secondary arterial and venous damage leading to hematoma formation and primary brain injury. (C)</p> Signup and view all the answers

A patient is diagnosed with a compound fracture of the skull following a traumatic injury. Which of the following concerns should be prioritized in the initial management of this patient?

<p>The potential for infection to enter through the breach in the skin. (C)</p> Signup and view all the answers

A surgeon is preparing to perform a craniotomy to access a deep-seated brain tumor. Understanding the arrangement of the cranial cavity's roof is crucial for this procedure. Which of the following accurately describes the composition of the cranial cavity's roof?

<p>A dome-shaped structure consisting of the frontal bone anteriorly, the paired parietal bones in the middle, and the occipital bone posteriorly. (A)</p> Signup and view all the answers

During the planning of a complex surgical approach to the skull base, a surgical team must consider the foramen ovale. Which of the following best describes its anatomical significance?

<p>It allows for the passage of the mandibular nerve (CN V3), a major component of the trigeminal nerve. (C)</p> Signup and view all the answers

In assessing a patient with multiple facial fractures, the integrity of the maxilla is of particular concern due to its extensive articulation with other facial bones. Which of the following is NOT a process of the maxilla?

<p>Mandibular (B)</p> Signup and view all the answers

When describing the mandible, which statement accurately portrays its structural and functional characteristics within the skull?

<p>It is composed of a single bone formed by the fusion of two halves during development, providing structural integrity. (C)</p> Signup and view all the answers

A surgeon is reviewing the anatomy of the temporal bone prior to a mastoidectomy. Which of the following structures is NOT directly associated with the temporal bone?

<p>Crista galli (D)</p> Signup and view all the answers

Following a motor vehicle accident, a patient exhibits signs of a basilar skull fracture. Which of the following anatomical regions is LEAST likely to be involved in this type of injury?

<p>Zygomatic arch (B)</p> Signup and view all the answers

A patient presents with a fracture of the zygomatic bone affecting the orbital region. Which of the following is the most likely consequence of such a fracture?

<p>Diplopia and enophthalmos due to disruption of the orbital walls. (D)</p> Signup and view all the answers

A patient is diagnosed with a Le Fort III fracture. What anatomical consequence is most likely to manifest as a result of this injury?

<p>Complete craniofacial separation involving the maxilla, zygomatic bones, and orbits. (C)</p> Signup and view all the answers

A construction worker falls and hits the back of their head, resulting in damage to the posterior cranial fossa. Which of the following structures would most likely be affected?

<p>Cerebellum (D)</p> Signup and view all the answers

A patient involved in a high-speed collision presents with multiple facial fractures. Which bone, due to its unique anatomical characteristics as the largest and only mobile bone of the face, is critical for assessing occlusion and jaw function?

<p>The mandible because of its role in jaw function. (C)</p> Signup and view all the answers

A neurologist is examining a patient with suspected nerve damage resulting from a skull fracture. If the foramen lacerum is involved, which of the following nerves is LEAST likely to be directly affected?

<p>Facial nerve (CN VII) (A)</p> Signup and view all the answers

A patient presents with anosmia (loss of smell) following a head trauma. Which bone is most likely involved in causing this condition?

<p>Ethmoid bone (B)</p> Signup and view all the answers

In a post-mortem examination, a forensic pathologist notes that the skull exhibits characteristics typical of the calvaria. Which of the following features would be most indicative of this region of the skull?

<p>The arrangement of two tables of compact bone separated by a layer of diploe. (A)</p> Signup and view all the answers

A team of paleontologists discovers a hominid skull with a prominent horizontal fracture line across the midface. Which of the following best describes the potential impact on structures associated with the maxilla if the fracture lies along a Le Fort I plane?

<p>Detachment of the hard palate and alveolar process from the rest of the maxilla. (A)</p> Signup and view all the answers

Following a traumatic injury, a patient presents with a fracture involving the anterior cranial fossa. Which clinical findings would be most indicative of a fracture in this region?

<p>Periorbital ecchymosis and cerebrospinal fluid rhinorrhea. (B)</p> Signup and view all the answers

A skull is recovered during an archeological dig, and researchers note the presence of a distinct sagittal suture. Between which two bones does this suture lie?

<p>Parietal bones (D)</p> Signup and view all the answers

An anatomist is describing the boundaries of the anterior cranial fossa to medical students. Which of the following best defines its anterior and posterior borders, respectively?

<p>Frontal bone and lesser wing of sphenoid bone (A)</p> Signup and view all the answers

A patient exhibits a fracture of the nasal bone. Which of the following articulations is LEAST likely to be directly affected?

<p>Temporal bone (D)</p> Signup and view all the answers

A patient is being evaluated for a possible fracture of the palatine bone. Which functional aspect of the head and neck is most likely to be compromised by such a fracture?

<p>Mastication and speech (A)</p> Signup and view all the answers

During a physical exam, the TMJ is being palpated. What bony structure is being assessed?

<p>Mandibular condyle (D)</p> Signup and view all the answers

Upon reviewing a patient's CAT scan, the physician identified a fracture near the cribriform plate. Which of the following signs and symptoms would warrant further investigation to confirm injury to this region?

<p>Anosmia (D)</p> Signup and view all the answers

The mandible is innervated by which terminal branch of the trigeminal nerve?

<p>Trigeminal branch V3 (C)</p> Signup and view all the answers

During a routine ENT appointment, your patient is suffering from excessive nose bleeds. After further investigation the physician determines the vomer is involved. What portion of the nasal cavity does the vomer form?

<p>Inferior (C)</p> Signup and view all the answers

During a surgical procedure, the greater wing of the sphenoid bone is resected. What anatomical structure is at high risk of injury?

<p>Middle meningeal artery (C)</p> Signup and view all the answers

During a routine root canal, the dentist accidentally damages the incisive fossa. What structures run through this region?

<p>Nasopalatine nerve (C)</p> Signup and view all the answers

Which of the following bone is not part of the neurocranium?

<p>Vomer (A)</p> Signup and view all the answers

During a skull based surgery, the surgeon requests the use of a drill bit to form an opening in the skull. To avoid injury of the meninges, the burr should open:

<p>The diploe (A)</p> Signup and view all the answers

During surgical planning, if the surgeon noted the involvement of the occipital condyle, what region of the skull are they focusing on?

<p>Occipital bone (D)</p> Signup and view all the answers

What structures of the skull traverse the jugular foramen? (Select all that apply)

<p>Vagus nerve CN X (A), Spinal accessory nerve CN XI (B), Glossopharyngeal nerve CN IX (C), Internal jugular vein (D)</p> Signup and view all the answers

During a head and neck exam, the patient has difficulty with mastication and limited ability to move the mandible. What two bone is likely involved in this disability? (Select all that apply)

<p>Temporal bone (B), Mandible (D)</p> Signup and view all the answers

What bone of the skull serves no articulation point with any other bones?

<p>Hyoid bone (B)</p> Signup and view all the answers

Which foramina is part of the anterior cranial fossa?

<p>Optic Canal (A)</p> Signup and view all the answers

Which of the following foramina is located in the posterior cranial fossa?

<p>Internal acoustic canal (C)</p> Signup and view all the answers

Due to an accident, the patient has lost the function of his buccinators muscle due to injury to the:

<p>Buccal branch of facial nerve VII (C)</p> Signup and view all the answers

In the adult skull, what bone articulates with the frontal, parietal, temporal, ethmoid, and sphenoid bones?

<p>Zygomatic Bone (B)</p> Signup and view all the answers

Flashcards

What is the skull?

The skeleton of the head.

What is the calvaria?

The upper part of the cranium.

What is the base of the skull?

The lowest part of the cranium.

What are bones of the calvaria?

Flat bones consisting of two compact bone tables separated by diploe.

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What is the diploe?

Spongy bone layer between compact tables in calvaria.

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What is the cranial cavity?

Space within the cranium that houses the brain and related structures.

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What is the roof of the cranial cavity?

Dome-shaped roof that protects the superior aspect of the brain.

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What divides the floor of the cranial cavity?

Anterior, middle, and posterior cranial fossae.

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What is located in the anterior cranial fossa?

Frontal lobes.

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What is located in the middle cranial fossa?

Temporal lobes.

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What is located in the posterior cranial fossa?

Cerebellum, pons, and medulla oblongata.

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What is the pterion?

The weakest lateral part of the skull where four bones meet.

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What causes fracture at the pterion?

Rupture of middle meningeal artery.

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What causes compound fractures?

A fracture of the bone together with a breach of the skin allowing for the possibilities of infection.

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What is the mandible?

Largest and strongest bone of the face; only mobile bone of skull.

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What is the body of the mandible?

Horizontal portion forming the anterior part of the mandible.

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What is the ramus of the mandible?

Vertical portion forming the posterior part of the mandible.

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What is the maxilla?

Forms the upper jaw and supports the orbits.

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What is the palatine bone?

A paired, flat, irregular facial bone.

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What is the vomer?

Unpaired facial bone that forms the inferior part of the nasal septum.

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What Structures are found within the cranial cavity?

A cavity containing the brain, meninges, proximal parts of cranial nerves.

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What is the cause of Depressed Skull Fractures?

A bony fragment is depressed below the normal skull convexity.

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What are depressed skull fractures able to cause?

Secondary arterial and venous damage with hematoma formation.

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Study Notes

  • The head is mainly the skull, enclosing the brain and meninges within the cranial cavity.
  • Special senses, such as sight and hearing, reside within skull bones or their bounded cavities.

Introduction to the Skull

  • The skull serves as the skeleton of the head.
  • It has two parts: the cranium/brain box and the facial skeleton.
  • The cranium has two subdivisions: the vault (calvaria) and the base of the skull.
  • There are 22 bones in the skull.

Bones of the Cranium

  • There is one frontal bone.
  • There are two parietal bones.
  • There is one occipital bone.
  • There are two temporal bones.
  • There is one sphenoid bone.
  • There is one ethmoid bone.

Facial Bones

  • There are two zygomatic bones.
  • There are two maxillae.
  • There are two nasal bones.
  • There are two lacrimal bones
  • There is one vomer.
  • There are two palatine bones.
  • There are two inferior conchae.
  • There is one mandible.
  • The sphenoid bone has a shape that somewhat resembles a butterfly or bat with its wings extended.
  • The ethmoid bone is unpaired and exists between the two orbits.
  • The mandible is the largest, strongest, and lowest bone in the human facial skeleton and is the only movable bone of the skull.
  • The largest and only mobile bone of the skull is the mandible.
  • The mandible has two parts: the body and two rami.
  • The horizontal part of the mandible forms the anterior, and it has two surfaces and borders.
  • Each ramus is the vertical, posterior portion with two surfaces and four borders.
  • The maxilla is a paired bone in the upper jaw that supports the orbits, consisting of a pyramidal body and four processes (zygomatic, frontal, alveolar, palatine).
  • Each palatine bone is composed of two plates and sits between processes of the right or left maxilla bone and the single sphenoid bone.
  • The vomer is located in the midline and forms the inferior part of the nasal septum, articulating with the sphenoid, ethmoid and palatine bones.
  • Nasal bones are rectangular bones that form the bridge of the nose.
  • The nasal bones articulate superiorly with the frontal bone, posteriorly with the ethmoid and frontal process of maxilla and medially with each other.
  • The hyoid bone is a horseshoe-shaped bone in the anterior midline of the neck between the chin and thyroid cartilage.

The Cranial Cavity

  • The cranial cavity is the space within the cranium containing the brain, meninges, cranial nerves, blood vessels, and venous sinuses.
  • The cranial cavity has a roof, a dome-shaped protector of the brain's superior aspect, and a floor divided into fossae.
  • The roof has the frontal bone anteriorly, the paired parietal bones in the middle, and the occipital bone posteriorly.
  • The floor has anterior, middle, and posterior cranial fossae.
  • The anterior cranial fossa contains frontal lobes.
  • The middle cranial fossa contains temporal lobes.
  • The posterior cranial fossa contains the cerebellum.
  • The anterior cranial fossa is separated from the middle cranial fossa by the lesser wing of the sphenoid bone.
  • The middle cranial fossa is separated from the posterior cranial fossa by the petrous part of the temporal bone.

Applied Anatomy

  • Fractures of the cranium can lead to extradural hematomas with clinical significance.
  • Clinically significant skull fractures include depressed, compound, and pterion fractures.
  • Depressed skull fractures involve a bony fragment depressed below the normal skull convexity.
  • Secondary arterial and venous damage with hematoma formation may result from depressed skull fractures.
  • Primary brain injury may result from depressed fractures.
  • Compound fractures are fractures with a breach of skin that may allow infection to enter.
  • Compound fractures are typically associated with scalp lacerations and are usually treated with antibiotics.
  • The Pterion is the skull's weakest lateral section where the frontal, parietal, greater wing of the sphenoid, and temporal bones meet.
  • The middle meningeal artery can be found deep to the pterion.
  • Fracture at the pterion can rupture the middle meningeal artery.
  • Rupture of the middle meningeal artery is extremely dangerous because it can produce a significant extradural hematoma, and cause possible death.
  • Other fractures can occur in the anterior, middle and posterior cranial fossae.
  • Fractures can also occur in the nasal bones, zygomatic arch, and mandible.

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