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Organisation of head and neck
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Organisation of head and neck

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Questions and Answers

What type of ossification is primarily responsible for the formation of the skull?

  • Metaplastic ossification
  • Intramembranous ossification (correct)
  • Endochondral ossification
  • Appositional ossification

    • Which bones are included in the neurocranium?

  • Frontal, maxilla, zygomatic, sphenoid
  • Frontal, mandible, maxilla
  • Frontal, ethmoidal, nasal, parietal
  • Frontal, occipital, parietal, temporal (correct)

    • What is the primary function of the ethmoid bone?

  • Supports the structure of the jaw
  • Protects the optic nerve
  • Forms the floor of the cranium
  • Contributes to the roof of the nasal cavity (correct)

    • At what stage does the skull's sutures fuse together?

    <p>In adulthood</p> Signup and view all the answers

    What are the bilateral pairs of bones in the neurocranium?

    <p>Temporal and parietal</p> Signup and view all the answers

    The glabella is a part of which bone?

    <p>Frontal bone</p> Signup and view all the answers

    Which bone is found between the two orbital cavities?

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

    Which of the following components make up the roof and floor of the neurocranium?

    <p>Frontal, parietal, and temporal for the roof; frontal, sphenoid, and temporal for the floor</p> Signup and view all the answers

    What structure provides attachment for the falx cerebri?

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

    Which of the following structures is associated with the sphenoid bone?

    <p>Optic canal</p> Signup and view all the answers

    What is the primary function of the foramen rotundum?

    <p>Transmits V2 (maxillary nerve)</p> Signup and view all the answers

    What feature of the temporal bone is associated with the temporomandibular joint (TMJ)?

    <p>Zygomatic process</p> Signup and view all the answers

    Which part of the sphenoid bone houses the pituitary gland?

    <p>Sella turcica</p> Signup and view all the answers

    What is the purpose of the pterygoid hamulus?

    <p>Acts as a pulley for tensor veli palatini</p> Signup and view all the answers

    How does a CSF leak relate to the cribriform plate?

    <p>It causes nasal drip.</p> Signup and view all the answers

    Which structure is formed by the fusion of the medial and lateral sheets of the ethmoidal labyrinth?

    <p>Cribriform plate</p> Signup and view all the answers

    Which anatomical structure separates the middle cranial fossa from the posterior cranial fossa?

    <p>Petrous part of temporal bone</p> Signup and view all the answers

    What is the consequence of trauma at the pterion?

    <p>Extradural haematoma due to meningeal artery damage</p> Signup and view all the answers

    Which cranial foramina is associated with cranial nerve VII?

    <p>Internal acoustic meatus</p> Signup and view all the answers

    Which bones compose the roof of the neurocranium?

    <p>Frontal, two parietal, and occipital bones</p> Signup and view all the answers

    Which structure does the cribriform plate contain, facilitating the passage of sensory information?

    <p>Olfactory nerves (CN I)</p> Signup and view all the answers

    What bones make up the basicranium?

    <p>Frontal, temporal, sphenoid, and occipital bones</p> Signup and view all the answers

    Which process does the zygomatic bone articulate with?

    <p>Frontal, maxillary, and temporal processes</p> Signup and view all the answers

    The jugular foramen is associated with which cranial nerves?

    <p>IX, X, XI</p> Signup and view all the answers

    What forms the temporomandibular joint (TMJ)?

    <p>Head of the condylar process of the mandible and the tubercle of the tympanic part of the temporal bone</p> Signup and view all the answers

    Which nerve supplies the inferior alveolar nerve as it travels through the mandibular canal?

    <p>Mental nerve</p> Signup and view all the answers

    Which of the following muscles is responsible for retracting the jaw?

    <p>Temporalis</p> Signup and view all the answers

    What structure serves as the attachment point for the soft palate at the back of the maxilla?

    <p>Posterior nasal spine</p> Signup and view all the answers

    Which foramen is responsible for supplying the hard palate?

    <p>Greater palatine foramen</p> Signup and view all the answers

    What is the role of the lateral pterygoid muscle?

    <p>Moves the jaw side to side and protracts</p> Signup and view all the answers

    The mylohyoid line is associated with which anatomical feature of the mandible?

    <p>Presence of the mylohyoid groove</p> Signup and view all the answers

    What covers the articular surfaces of the TMJ?

    <p>Fibrocartilage</p> Signup and view all the answers

    Which bones are primarily responsible for forming the basicranium?

    <p>Frontal, sphenoid, ethmoid, occipital</p> Signup and view all the answers

    What type of joint forms the suture connections between the bones of the skull?

    <p>Fibrous joint</p> Signup and view all the answers

    Which of the following bones does not contribute to the neurocranium?

    <p>Maxilla</p> Signup and view all the answers

    Which bone is specifically located at the roof of the nasal cavity and between the two orbital cavities?

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

    What is the primary anatomical function of the glabella region of the frontal bone?

    <p>Location for a reflexive response in Parkinson's patients</p> Signup and view all the answers

    Which of the following best describes the composition of the neurocranium?

    <p>Eight distinct bones including four midline and two bilateral pairs</p> Signup and view all the answers

    Which cranial bone contains significant features that are associated with the eye socket?

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

    Which of the following statements is true regarding the bones of the skull?

    <p>The bones of the skull are joined by sutures that become fused in adulthood.</p> Signup and view all the answers

    What anatomical feature serves as an attachment point for the falx cerebri?

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

    During a CSF leak, which structure's damage could result in nasal dripping?

    <p>Cribriform plate</p> Signup and view all the answers

    Which feature is located on the greater wing of the sphenoid bone?

    <p>Foramen rotundum</p> Signup and view all the answers

    What is the function of the pterygoid hamulus?

    <p>Pulley for tensor veli palatini</p> Signup and view all the answers

    Which foramen is responsible for transmitting the middle meningeal vessels?

    <p>Foramen spinosum</p> Signup and view all the answers

    Which anatomical structure divides the anterior cranial fossa from the middle cranial fossa?

    <p>Lesser wing of sphenoid</p> Signup and view all the answers

    What feature is located at the base of the sella turcica?

    <p>Tuberculum sellae</p> Signup and view all the answers

    Which of the following correctly describes the articulation of the zygomatic process?

    <p>Articulates with the zygomatic bone</p> Signup and view all the answers

    What is the significance of the pterion in cranial anatomy?

    <p>It is a common site for extradural hematoma due to underlying arterial structures.</p> Signup and view all the answers

    Which of the following bones does NOT contribute to the formation of the floor of the neurocranium?

    <p>Parietal bone</p> Signup and view all the answers

    What anatomical structures pass through the jugular foramen?

    <p>Glossopharyngeal nerve (CN IX), vagus nerve (CN X), and accessory nerve (CN XI)</p> Signup and view all the answers

    Which cranial foramen is associated with the passage of the internal carotid artery?

    <p>Carotid canal</p> Signup and view all the answers

    The zygomatic bone articulates with which of the following processes?

    <p>Maxillary process</p> Signup and view all the answers

    Which bone forms a crucial part of the boundary between the middle and posterior cranial fossa?

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

    What is the primary anatomical significance of the cribriform plate?

    <p>It supports the olfactory bulbs for the sense of smell.</p> Signup and view all the answers

    Which of the following foramina allows for the passage of the facial nerve?

    <p>Internal acoustic meatus</p> Signup and view all the answers

    What is the primary function of the lingual nerve in relation to the mandibular fossa?

    <p>Supplies sensory innervation to the floor of the mouth</p> Signup and view all the answers

    Which muscles are innervated by the mandibular nerve (V3)?

    <p>Masseter, temporalis, and medial/lateral pterygoid</p> Signup and view all the answers

    Which foramen provides passage for the lesser palatine nerve and vessels?

    <p>Lesser palatine foramen</p> Signup and view all the answers

    What anatomical feature is associated with the mental foramen?

    <p>Allows passage for the mental nerve and vessels</p> Signup and view all the answers

    Where does the temporomandibular joint (TMJ) articulate with the temporal bone?

    <p>Articular tubercle</p> Signup and view all the answers

    What is the role of the greater palatine vessels in relation to the palatine canal?

    <p>To supply the hard palate</p> Signup and view all the answers

    Which anatomical structure does the coronoid process of the mandible primarily serve?

    <p>Attachment of the temporalis muscle</p> Signup and view all the answers

    What is the significance of the articular disc in the temporomandibular joint (TMJ)?

    <p>It divides the joint into two compartments</p> Signup and view all the answers

    Study Notes

    Skull

    • Formed by intramembranous ossification, joined by sutures which fuse in adulthood
    • Composed of neurocranium (brain) and viscerocranium (face)

    Neurocranium

    • Composed of 8 bones : 4 midline (frontal, ethmoidal, sphenoidal, occipital), 2 bilateral pairs (temporal, parietal)
    • Roof/calvarium (frontal, occipital, parietal), floor/basicranium (frontal, sphenoid, ethmoid, occipital, parietal, temporal)
    • Frontal Bone:
      • Glabella tap is used to test for Parkinson's (normal reflex is blinking, but patients with Parkinson's continue to blink)
    • Ethmoid Bone:
      • Forms roof of nasal cavity, between 2 orbital cavities
      • Forms ethmoidal labyrinths which are composed of: lateral sheet (orbital plate) and medial sheet (superior and middle conchae)
      • Labyrinths unite at cribriform plate: holds olfactory nerve (CNI) fibers, crista galli for attachment of falx cerebri, foramen caecum (emissary veins)
      • Perpendicular plate forms part of nasal septum
      • Provides link between cranial & nasal (cribriform plate/foramen caecum) - CSF leak can cause nasal drip
      • Provides link between nasal & orbit - air causing orbital emphysema
    • Sphenoid Bone:
      • Located in middle cranial fossa around back of nasal cavity/orbit/temple
      • Composed of body, greater/lesser wings, pterygoid process
      • Body: Sella turcica (depression) contains hypophyseal fossa (where pituitary gland sits), tuberculum sellae (anterior) and dorsum sellae (posterior), anterior/posterior clinoid processes x2, chiasmatic groove/sulcus formed by optic chiasm
      • Lesser Wing: Forms division between anterior/middle cranial fossa, borders optic canal with body
      • Greater Wing: Foramen rotundum (V2), foramen ovale (V3), foramen spinosum (middle meningeal vessels), spine provides attachment for sphenomandibular l. and tensor veli palatini
      • Pterygoid Processes: Medial pterygoid plate (contains pterygoid hamulus which acts as a pulley for tensor veli palatini and attachment for pterygoidmandibular raphe)
      • Pterygoid Canal: Runs horizontally through root of pterygoid process, opens into pterygopalatine fossa
    • Temporal Bone:
      • Squamous: temporalis muscle, petrotympanic fissure (chorda tympani), zygomatic process articulates with zygomatic bone (contains lateral surface/masseter m., tympanic, external auditory meatus)
      • Styloid Process: Stylomandibular l. of TMJ, styloglossus m., petromastoid
      • Mastoid Process: Sternocleidomastoid, posterior belly of digastric, splenius capitis, mastoid air cells
      • Petrous Part: Inner ear, boundary between middle/posterior cranial fossa
    • Neurocranium Roof: Mainly made up of frontal, 2x parietal, and occipital bones, sutures: coronal, sagittal, lambdoid, bregma (front), lambda (back)
    • Pterion: Point between sphenoid (greater wing), temporal, frontal, parietal bones, anterior division of middle meningeal a. runs under here so trauma can cause extradural haematoma
    • Neurocranium Floor/Basicranium: Made up of frontal, ethmoidal, sphenoid, temporal, parietal, occipital bones
    • Cranial Foramena:
      • Cribriform Plate: CN 1
      • Optic Canal: CN 2, Ophthalmic a.
      • Superior Orbital Fissure: CN 3, 4, 5(1), 6, Sup ophthalmic v.
      • Foramen Rotundum: CN 5(2)
      • Foramen Ovale: CN 5(3)
      • Foramen Spinosum: Middle meningeal a./v.
      • Carotid Canal: Internal carotid a.
      • Internal Acoustic Meatus: CN 7 & 8
      • Jugular Foramen: CN 9, 10 & 11, Inferior petrosal and sigmoid sinus → IJV
      • Hypoglossal Canal: CN 12
      • Foramen Magnum: Medulla oblongata, meninges, vertebral a.

    Viscerocranium

    • Nasal Bone:
    • Vomer:
    • Lacrimal Bone:
    • Zygomatic Bone: Contains maxillary, frontal, and temporal processes where it articulates
      • Zygomaticofacial foramen: contains zygomaticofacial n. and vessels
    • Maxilla:
      • Forms roof of palate
        • Anterior: Incisive canals on either side, greater palatine vessels & nasopalatine nerves travel between oral/nasal cavities
        • Posterior: Posterior nasal spine & posterior margin of horizontal palates, attachment of soft palate
      • Palatine canal: (from pterygopalatine fossa) forms: greater palatine foramen (greater palatine n. & vessels to supply hard palate) and lesser palatine foramen (lesser palatine n. & vessels to supply the soft palate)
    • Mandible:
      • Made up of body and ramus
      • Condylar Process: forms temporomandibular joint (TMJ) with temporal bone
      • Coronoid Process: attachment of temporalis m.
      • Mandibular Foramen: forms mandibular canal that finishes as mental foramen
        • Inferior alveolar n. (from V3) supplies teeth as travels through and turns into the mental n. as it exits to supply the skin of the chin
        • Inferior alveolar vessels also travel through
      • Mylohyoid Line: forms mylohyoid groove, houses lingual n. and n. to mylohyoid
      • Other Bits: Alveolar border (where teeth are), mandibular symphysis (midline, encloses mental protuberance), superior/inferior mental spines, sublingual and submandibular fossa, retromolar triangle, neck of condylar process (lateral pterygoid), lingula (sphenomandibular l)
    • Temporomandibular Joint (TMJ): Synovial joint formed by: head of condylar process (mandible) and tubercle of tympanic part of (temporal bone), ligaments: Lateral, sphenomandibular, stylomandibular, articular surfaces are covered with fibrocartilage and divided into 2 by articular disc

    Muscles of Mastication

    • Masseter, temporalis, medial/lateral pterygoid
    • Develop from 1st pharyngeal arch
    • ALL INNERVATED BY mandibular nerve (V3)
    • All muscles elevate EXCEPT:
      • Lateral Pterygoid: Oriented horizontally onto pterygoid process, moves jaw side to side and protracts
      • Temporalis: (deep temporal n.) also retracts jaw by attaching to condylar process

    Temporal, Infratemporal, Pterygopalatine Fossa

    • Temporal Fossa: Temporalis m., deep temporal n. and artery, middle temporal a.

    Skull

    • Formed by intramembranous ossification
    • Joined by sutures (fibrous joints) that fuse in adulthood
    • Divided into neurocranium (houses the brain) and viscerocranium (the face)

    Neurocranium

    • Composed of 8 bones: 4 midline (frontal, ethmoid, sphenoid, occipital) and 2 bilateral pairs (temporal, parietal)
    • Roof/calvarium: frontal, occipital, parietal
    • Floor/basicranium: frontal, sphenoid, ethmoid, occipital, parietal, temporal

    Frontal Bone

    • Glabella tap: normal reflex is blinking, but in Parkinson’s patients they continue to blink.

    Ethmoid Bone

    • Forms part of the roof of the nasal cavity and lies between the two orbital cavities.
    • Forms ethmoidal labyrinths, which are composed of two sheets:
      • Lateral sheet (orbital plate)
      • Medial sheet (superior and middle conchae)
    • Labyrinths unite at the cribriform plate, which has holes for the olfactory nerve fibers and the crista galli, for attachment of the falx cerebri (dura mater).
    • Provides a link between:
      • Cranial and nasal (cribriform plate/foramen caecum) - CSF leak causes nasal drip
      • Nasal and orbit - air can cause orbital emphysema

    Sphenoid Bone

    • Located in the middle cranial fossa around the back of the nasal cavity, orbit, and temple.
    • Composed of a body, greater/lesser wings, and pterygoid process.
    • Body:
      • Sella turcica (depression) contains the hypophyseal fossa, where the pituitary gland sits, bound by the tuberculum sellae (anterior) and dorsum sellae (posterior).
      • Anterior/posterior clinoid processes x2
      • Formed by the optic chiasm
    • Lesser wing:
      • Forms the division between anterior and middle cranial fossa.
      • Borders the optic canal with the body
    • Greater wing:
      • Foramen rotundum (V2)
      • Foramen ovale (V3)
      • Foramen spinosum (middle meningeal vessels)
      • Spine provides attachment for the sphenomandibular ligament and tensor veli palatini.
    • Pterygoid processes:
      • Medial pterygoid plate (contains the pterygoid hamulus, which acts as a pulley for tensor veli palatini and attachment for the pterygoidmandibular raphe)
      • Lateral pterygoid plate (attachment for the medial/lateral pterygoid muscles)
      • Pterygoid canal (runs horizontally through the root of the pterygoid process, opening into the pterygopalatine fossa)

    Temporal Bone

    • Squamous: temporalis muscle, petrotympanic fissure (chorda tympani)
    • Zygomatic process: articulates with the zygomatic bone
    • Lateral surface: masseter muscle, tympanic
    • External auditory meatus (ear)
    • Articulates with the head of the mandible to form the temporomandibular joint (TMJ)
    • Styloid Process: stylohyoid ligament of TMJ, styloglossus muscle
    • Petromastoid: mastoid process (sternocleidomastoid, posterior belly of digastric, splenius capitis), mastoid air cells
    • Petrous part: inner ear and boundaries between the middle/posterior cranial fossa

    Neurocranium: Roof

    • Primarily made up of the frontal, parietal x2, and occipital bones.
    • Sutures: coronal, sagittal, lambdoid
    • Bregma (front), lambda (back)
    • Pterion: a point where the sphenoid (greater wing), temporal, frontal, and parietal bones meet, the anterior division of the middle meningeal artery runs under here, so trauma can cause an extradural hematoma.

    Neurocranium: Floor/Basicranium

    • Made up of the frontal, ethmoid, sphenoid, temporal, parietal, and occipital bones.
    • Divided into three fossae: anterior, middle, and posterior cranial fossa
      • Lesser wing of the sphenoid
      • Petrous part of the temporal bone
    • Contains cranial foramina

    Cranial Foramena

    • Foramen | CN | Others
    • Cribriform Plate | I
    • Optic canal | II | Ophthalmic artery
    • Superior orbital fissure | III, IV, V(1), VI | Superior ophthalmic vein
    • Foramen rotundum | V(2)
    • Foramen ovale | V(3)
    • Foramen spinosum | | Middle meningeal artery/vein
    • Carotid canal | | Internal carotid artery
    • Internal acoustic meatus | VII, VIII
    • Jugular foramen | IX, X, XI | Inferior Petrosal Sinus and Sigmoid Sinus → Internal Jugular Vein
    • Hypoglossal canal | XII
    • Foramen magnum | | Medulla oblongata, meninges, vertebral artery

    Viscerocranium

    • Bones | Key Features
    • Nasal |
    • Vomer |
    • Lacrimal |
    • Zygomatic | Zygomaticofacial foramen - zygomaticofacial nerve and vessels
    • Maxilla | Forms the roof of the palate, incisive canals, posterior nasal spine, palatine canal
    • Mandible | Body, ramus, condylar process, coronoid process, mandibular foramen, mylohyoid line, alveolar border, mandibular symphysis, sublingual and submandibular fossa

    Mandible

    • Important Parts
      • Body
      • Ramus
      • Condylar process - forms temporomandibular joint (TMJ)
      • Coronoid process - attachment of temporalis muscle
      • Mandibular foramen - forms the mandibular canal (inferior alveolar nerve supplies teeth and turns into the mental nerve as it exits to supply the skin of the chin), inferior alveolar vessels also travel through.
      • Mylohyoid line - forms mylohyoid groove (lingual nerve, nerve to mylohyoid)
    • Other Bits
      • Alveolar border = where teeth are
      • Mandibular symphysis = midline, encloses the mental protuberance
      • Superior/inferior mental spines on the inside of the chin
      • Sublingual and submandibular fossa
      • Retromolar triangle
      • Neck of condylar process - lateral pterygoid
      • Lingula - sphenomandibular ligament

    Temporomandibular Joint (TMJ)

    • Synovial joint
    • Formed by: head of condylar process (mandible) and tubercle of the tympanic part of the temporal bone.
    • Ligaments: lateral, sphenomandibular, stylomandibular.
    • Articular surfaces covered with fibrocartilage and divided into two by the articular disc.

    Muscles of Mastication

    • Masseter, temporalis, medial/lateral pterygoid
    • Develop from the first pharyngeal arch
    • All are innervated by the mandibular nerve (V3)
    • All muscles elevate the mandible EXCEPT:
      • Lateral pterygoid (oriented horizontally onto the pterygoid process) which moves the jaw side to side and protracts.
      • Temporalis muscle (deep temporal nerve) also retracts the jaw by attaching to the condylar process

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