Skull and Cranial Bones

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Questions and Answers

If a patient presents with limited mobility in their mandible following a skull fracture, which of the following skull bones is MOST likely to have been affected?

  • Parietal bone
  • Occipital bone
  • Temporal bone (correct)
  • Frontal bone

A forensic anthropologist discovers a skull with a clearly visible sagittal sulcus on the internal surface. Which bone are they MOST likely examining?

  • Parietal Bone (correct)
  • Sphenoid Bone
  • Temporal Bone
  • Occipital Bone

A patient reports a loss of smell following a traumatic injury to the face. Which structure associated with the ethmoid bone is MOST likely damaged?

  • Crista galli
  • Cribriform plate (correct)
  • Perpendicular plate
  • Superior nasal concha

A surgeon is planning an approach to a pituitary tumor via the transsphenoidal route. Which specific part of which bone must the surgeon access to perform this procedure?

<p>Sella turcica of the sphenoid bone (A)</p> Signup and view all the answers

A patient involved in a high-speed motor vehicle collision presents with cerebrospinal fluid (CSF) rhinorrhea (CSF leaking from the nose). Imaging reveals a fracture involving the anterior cranial fossa. Which bone is MOST likely fractured that would directly lead to this condition?

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

During a neurosurgical procedure, a surgeon needs to access the middle cranial fossa. Which of the following landmarks is a critical structure to identify to avoid damaging vital neurovascular structures?

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

A patient presents with numbness in the cheek and upper lip following a fracture involving the maxilla. Which structure is MOST likely involved?

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

A surgeon performs a craniotomy and notes cerebral spinal fluid (CSF) leaking from the surgical site. Which of the following structures is MOST likely disrupted?

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

A dentist is preparing to administer a nerve block to alleviate pain during a dental procedure. To anesthetize the entire lower jaw, which anatomical landmark should the dentist target to inject the anesthetic?

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

During a mastoidectomy, the surgeon identifies the groove for the sigmoid sinus. Which bone are they using as a landmark in this procedure?

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

A patient presents with difficulty in chewing and deviation of the mandible to one side after a traumatic injury. Which of the following muscles, attaching to the coronoid process of the mandible, is MOST likely affected?

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

Which of the following cranial bones houses the structures responsible for both auditory sensation and maintaining equilibrium?

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

Following a blow to the head, a patient exhibits signs of increased intracranial pressure. Given the limited space within the cranial vault, expansion is primarily resisted by what structure?

<p>Fused cranial bones (A)</p> Signup and view all the answers

A patient reports to their doctor that they have lost sensation from the front of the cranium. Based on the sensory distribution, which portion of the skull is MOST likely to be affected by damage?

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

After sustaining a head trauma, a patient experiences a fracture that affects their sense organs. Due to the damage, which portion of the skull is likely to be affected?

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

A newborn presents with a noticeably sunken anterior fontanelle. Which of the following conditions does this clinical finding MOST strongly suggest?

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

A patient is diagnosed with a tumor affecting the hypophyseal fossa. This fossa is a component of which cranial bone?

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

A craniotomy is performed, and the dura mater is inadvertently punctured. To repair the dural tear, the surgeon needs to identify the margins of the bone defect. Which of the following bone features is LEAST likely to be used as a reliable landmark for orientation during the repair?

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

While palpating a newborn's skull, a pediatrician identifies the lambda. Which specific bones are meeting at this location?

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

A physical examination of a patient reveals a prominent glabella. Which of the following best describes the location of this landmark?

<p>The midline elevation on the frontal bone between the superciliary arches (C)</p> Signup and view all the answers

A neurosurgeon is planning a surgical approach that requires precise knowledge of the pterion. Damage to which artery is the MOST significant risk if the pterion is fractured or improperly accessed during surgery?

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

A patient has underdevelopment of the zygomatic bone on both sides of their face. Which set of functions is MOST likely to be affected by this structural abnormality?

<p>Chewing and eye protection (D)</p> Signup and view all the answers

Following a facial fracture, a patient complains of numbness along the upper jaw and cheek. Which bone is MOST likely fractured?

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

Which of the following bones contributes directly to the formation of the hard palate?

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

Following a surgical procedure, a patient develops a complication involving the superior orbital fissure, which is now compressed due to swelling. This fissure is located between the sphenoid and which other bone?

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

What is the MOST likely result if a suture between cranial bone is met by a thin layer of fibrous tissue?

<p>Immovable articulation promoting strong structure. (B)</p> Signup and view all the answers

Which of the following bones does NOT form a boundary of the nasal cavity?

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

If a patient experiences head trauma and present with a leak in cerebral spine, which bone forming cranial fossa is compromised?

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

In a patient exhibiting pronounced prognathism (protruding lower jaw), which of the following bones is MOST likely to show abnormal development?

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

A trauma surgeon is treating a patient with a Le Fort fracture, which involves separation of the facial bones from the cranial base. Which set of bones is MOST likely affected?

<p>Maxilla and palatine bones (A)</p> Signup and view all the answers

A patient presents with an inability to move their jaw after a fight with another person. Damage to which of structure is most likely?

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

During a surgical approach to the infratemporal fossa, a surgeon needs to retract the mandible. Which of the following features of the mandible is a key attachment site for muscles that control mandibular movement and must be carefully considered during retraction?

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

During a surgical procedure, a structure is found to run close between the inner ear canal and the jugular foramen. Which skull bone is this running through?

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

A patient has their nasal septum pierced. This results in the separation of nasal cavity caused by a bone. Which structure is most affect with this septum?

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

A patient presents with anosmia (loss of smell) subsequent to mild head trauma, but CT scans show no obvious fractures. Which of the following mechanisms is MOST likely responsible for their loss of smell?

<p>Shearing of olfactory nerve fibers as they pass through the cribriform plate. (C)</p> Signup and view all the answers

A patient reports that their nose has lost the ability to effectively deliver scents. Which bone of the face is most likely impacted?

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

A patient reports excessive nosebleeds and is found to have a deviated septum. Which bone is MOST likely displaced to cause the septal deviation?

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

A patient must have a tumor in the cranium removed. Which of the following bones forms the roof protecting this region of the skull?

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

A patient exhibits signs of damage to the squamous portion of the temporal bone. Which of the following functions would be MOST likely affected?

<p>Articulation of the mandible. (A)</p> Signup and view all the answers

During the removal of a brain tumor, a surgeon inadvertently damages the cribriform plate. Which of the following complications is MOST likely to arise postoperatively?

<p>Loss of smell. (D)</p> Signup and view all the answers

A patient presents with trigeminal neuralgia resulting from compression within the skull. Which of the following cranial bones is MOST likely involved in housing the affected trigeminal ganglion?

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

A surgeon encountering the foramen spinosum during a cranial procedure should be aware of the potential risk to which of the following structures?

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

A pediatric patient is diagnosed with craniosynostosis affecting the coronal suture. Which of the following outcomes is MOST likely if this condition is left untreated?

<p>Restricted frontal lobe development. (B)</p> Signup and view all the answers

A patient exhibits signs of increased intracranial pressure due to a lesion near the foramen magnum. Dysfunction of which structure is MOST likely contributing directly to these signs?

<p>Medulla oblongata. (A)</p> Signup and view all the answers

A patient complains of decreased sensation in the upper cheek and lateral nose following trauma to the face. Which foramen is MOST likely involved?

<p>Infraorbital foramen. (B)</p> Signup and view all the answers

A surgeon is repairing a fracture involving the anterior cranial fossa and needs to ensure a watertight seal to prevent CSF leakage. Which anatomical feature, associated with the frontal bone, is critical to address during this repair?

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

A patient presents with vision loss resulting from compression of the optic nerve. A lesion in which part of the sphenoid bone is MOST likely responsible for this?

<p>Lesser wing. (A)</p> Signup and view all the answers

Following a motor vehicle accident, a patient is diagnosed with a basilar skull fracture. Injury to which structure within the occipital bone poses the GREATEST risk of respiratory and cardiovascular instability?

<p>Foramen magnum. (D)</p> Signup and view all the answers

A surgeon is planning a procedure that requires access through the sphenopalatine foramen. Which of the following bones would need to be carefully considered and potentially manipulated during this approach?

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

A patient presents with conductive hearing loss following a head injury. Damage to which specific part of the temporal bone is MOST likely responsible for this condition?

<p>Petrous part. (C)</p> Signup and view all the answers

A patient is involved in a high-speed motor vehicle collision. Imaging reveals a fracture involving the squamous part of the temporal bone, extending into the middle cranial fossa. Which of the following is the MOST immediate and life-threatening risk associated with this type of fracture?

<p>Epidural hematoma. (A)</p> Signup and view all the answers

Following a complex surgical procedure involving the temporal bone, a patient exhibits dysarthria (difficulty speaking) and dysphagia (difficulty swallowing). Injury to which structure within the temporal bone is MOST likely responsible for these deficits?

<p>Internal acoustic meatus. (B)</p> Signup and view all the answers

A patient presents with a fracture involving the pterion. Which set of bones are involved at this structure?

<p>Frontal, parietal, temporal and sphenoid (D)</p> Signup and view all the answers

A patient is diagnosed with a rare condition characterized by the absence of the nasal bones. What is the MOST likely functional consequence of this anatomical variation?

<p>Compromised structural protection of the nasal cavity (B)</p> Signup and view all the answers

A patient with a suspected skull base infection displays inflammation extending from the middle ear to the internal aspect of the petrous temporal bone. Which subsequent complication represents the GREATEST threat to neurological function?

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

A patient reports to a physician after a traumatic injury that resulted in a nasal septum injury. Which of the following facial structures is most likely affected?

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

During a rhinoplasty, a surgeon must carefully elevate the periosteum from the lateral aspects of the bony nasal aperture to reshape the nasal bridge. Which bone is the surgeon primarily addressing in this maneuver?

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

A patient reports diplopia (double vision) and is found to have entrapment of the inferior rectus muscle following a 'blowout' fracture of the orbit. Which of the following bones is MOST likely fractured?

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

During a surgical procedure, a pathology is found related to the zygomaticotemporal branch. Which bone is this associated with?

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

A patient presents with difficulty in chewing and is diagnosed with a fracture involving the coronoid process of the mandible. Which of the following muscles, directly attaching to this process, is MOST likely affected?

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

A patient complains of numbness from the frontal area to the anterior nasal spine. Dysfunction within which bone is most likely?

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

Fractures to which of the following sections of bone will most likely disrupt olfactory nerves?

<p>The cribriform plate of the ethmoid bone. (D)</p> Signup and view all the answers

Within the squama of the frontal bone, which groove runs vertically, housing the superior sagittal sinus?

<p>Groove for the superior sagittal sinus. (D)</p> Signup and view all the answers

If a patient exhibits a fracture causing functional limitations with sight and eye movement, which bone is MOST likely the source of the injury?

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

A patient reports a recent traumatic event that has impacted their ability to form the top of their nose. Which bone needs to be inspected for damage?

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

In the event the occipital bone is fractured in a way that harms vision, which suture is most likely involved?

<p>Lambdoid suture. (A)</p> Signup and view all the answers

A patient is undergoing a procedure to receive the placement for dental implants. Which area needs to be inspected prior to the procedure?

<p>Alveolar processes of the maxillae. (A)</p> Signup and view all the answers

Given the vulnerability of cranial nerves, what is a primary consideration when addressing fractures involving the ethmoid bone?

<p>Proximity to the optic nerve and olfactory nerves. (D)</p> Signup and view all the answers

A patient has just undergone a reconstructive surgery that included parts that involve the bone within the nasal septum. Which bone is of most concern?

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

The brain is well protected and is covered by a protective structure containing the frontal bone and parietal bone. What is this called?

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

Following a severe head trauma, a patient is unable to abduct their right eye (CN VI palsy). Which bone is MOST likely to be fractured, leading to compression of the nerve within the cavernous sinus?

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

What specific anatomical landmark on the temporal bone is crucial for maintaining balance?

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

A patient experienced an injury that damaged the superior orbital fissure. This is located between the sphenoid and what other bone?

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

What specific feature on the internal surface of the occipital bone is MOST directly involved in dividing the cerebrum and the cerebellum?

<p>The lower fossae. (D)</p> Signup and view all the answers

The coronoid is an important structure of the:

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

A patient suffers damage to the anterior cranial fossa. Dysfunction within which bone is most likely the primary source of the trauma?

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

A doctor explains to a family that their child is delayed in one of the bone junctions of the head. Which option can the doctor be referring to?

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

During the review of symptoms, a patient reports difficulty swallowing. Which bone may the doctor investigate further?

<p>Occipital Bone. (A)</p> Signup and view all the answers

Flashcards

Vertebral column

The skull sits atop this structure.

Sutures

Joints that immovably articulate flattened, irregular skull bones.

Neurocranium

The bony structure protecting the brain.

Splanchnocranium

Facial bones protecting sense organs.

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Frontal bone

Bone forming the forehead and upper eye sockets.

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Squama of frontal bone

The flat or vertical and main portion of the frontal bone.

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Parietal bone

Forms sides and roof of the cranium

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Occipital bone

The postero-inferior part of the cranium with a large opening.

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Foramen magnum

Large aperture in the occipital bone.

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Sphenoid bone

Bone resembling a bat at the skull's base.

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Sella turcica

A saddle-shaped depression on the internal surface of the sphenoid bone.

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Hypophysial fossa

The part of the sella turcica that lodges the hypophysis.

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Temporal bone

Bones situated at the sides and base of the skull

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Ethmoid bone

Bone at the anterior cranium base, roof of the nose.

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Cribriform plate

Portion forming the anterior part of the base of the cranium.

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Vomer

Thin and triangular bone between nasal cavities

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Mandible (lower jaw)

Largest, strongest facial bone receiving lower teeth.

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Body of the Madible

The curved anterior portion of the mandible.

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Mandible

The landmark, largest and strongest bone of the face, serves for the reception of the lower teeth.

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Maxillae

Bones forming the upper jaw.

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Palatine process

Forms Part of the floor of the nose and the roof of the mouth (palate).

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Palatine bone

A bone contributes to walls of nasal cavities.

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Zygomatic bone

Facial bone forming the cheek prominence and part of the orbit

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Nasal bone

Facial bone located on the dorsum of the nose.

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Lacrimal bone

Facial bone on the anteromedial wall of the orbit

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Suture

Articulation uniting contiguous bone margins with fibrous tissue.

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Coronal suture

Suture articulating parietal bones with frontal bone.

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Lambdoidal suture

Suture articulating parietal bones with occipital bone.

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Sagittal suture

Suture articulating parietal bones on opposite sides.

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Squamosal suture

Junction between temporal and parietal bones.

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Occipitomastoid suture

Junction between the occipital and temporal bones.

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Sphenosquamosal suture

Junction between temporal and sphenoid bones.

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Cranial fossae

Openings within the skull.

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Bregma

Midline point where coronal and sagittal sutures intersect.

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Lambda

midline point where the sagittal and lambdoidal sutures intersect

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Glabella

Slight elevation in the midline of the forehead

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Pterion

Intersection between frontal, sphenoid, parietal, temporal bones

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Nasion

Point of intersection between frontonasal suture and midsagittal plane

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Gnathion

Most anterior, lowest median point on the mandible border.

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Anterior fontanelle

Junction between frontal and parietal bones in newborns.

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Posterior fontanelle

Junction between occipital and parietal bones in newborns.

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Study Notes

Skull and Individual Cranial Bones

  • The skull is supported on the summit of the vertebral column.
  • It is composed of flattened or irregular bones that immovably articulate with joints called sutures.
  • The mandible is the only exception.

Skull Divisions

  • The skull is divisible into the neurocranium and splanchnocranium.
  • The neurocranium lodges and protects the brain.
  • The splanchnocranium protects sense organs

Bones of the Face (Splanchnocranium)

  • The skeleton of the face consists of the following bones:
  • Two nasal bones
  • Two maxillae
  • Two zygomatic bones
  • Two palatine bones
  • Two inferior nasal conchae
  • One vomer
  • Two lacrimal bones
  • One mandible

Neurocranium Bones

  • The neurocranium consists of eight bones:
  • Occipital bone
  • Two parietal bones
  • Frontal bone
  • Two temporal bones
  • Sphenoid bone
  • Ethmoid bone

Parietal Bone

  • The parietal bones form the sides and roof of the cranium.
  • Each bone is irregularly quadrilateral in form.
  • Each has two surfaces, four borders, and four angles.

Frontal Bone

  • It is located on the anterior-superior part of the skull.
  • It has two portions:
    • The flat vertical portion called the squama corresponds to the forehead.
    • The orbital or horizontal portion contributes to the formation of the roof of the orbit.

Occipital Bone

  • Situated at the postero-inferior part of the cranium.
  • Bears a large oval aperture called the foramen magnum.
  • The cranial cavity communicates with the vertebral canal through it.
  • The internal surface is deeply concave and divided into two fossae
  • The upper fossae lodge the brain (cerebrum).
  • The lower fossae accommodate the cerebellum.
  • On inferior surface are the condyles for articulation with the atlas (the first cervical vertebrae).

Sphenoid Bone

  • It is situated at the base of the skull in front of the temporals and the occipital.
  • Resembles a bat, with a body in the middle and wings on the sides.
  • Two pterygoid processes arise from the body extending inferiorly.
  • On the internal surface of the body is a deep depression called the sella turcica
  • The deepest part of sella turcica lodges the hypophysis which is known as the hypophysial fossa

Temporal Bone

  • Situated at the sides and base of the skull.
  • Contains the organ of hearing and the organ of equilibrium.
  • It has three major parts: squamous part, petrous part, and mastoid process.

Ethmoid Bone

  • It is situated at the anterior part of the base of the cranium, at the roof of the nose.
  • The horizontal part or cribriform plate forms the anterior part of the base of the cranium and is perforated by foramina for the passage of olfactory nerves.
  • The perpendicular plate constitutes part of the nasal septum.
  • The superior and middle nasal conchae are its downward extensions on the sides of the septum.

Vomer

  • It is located in between the two nasal cavities.
  • It is thin and roughly triangular in shape.
  • The vomer contributes to the lower part of the nasal septum.

Mandible (Lower Jaw)

  • The mandible is the largest and strongest bone of the face, and serves for the reception of the lower teeth.
  • It has a curved, horizontal portion called the body, and two perpendicular portions, the rami.
  • The superior border of the body is hollowed into cavities for the reception of the teeth.
  • These cavities are sixteen in number.
  • The condyle of the rami presents an articular surface for articulation with the temporal bone.

Maxilla

  • Two maxillae unite to form the upper jaw.
  • Each assists in forming the boundaries of three cavities; the roof of the mouth, the floor and lateral wall of the nose, and the floor of the orbit.
  • The body is pyramidal in shape, contains a large cavity, the maxillary sinus.
  • The palatine process forms a considerable part of the floor of the nose and the roof of the mouth (palate)

Palatine Bone

  • Situated at the posterior part of the nasal cavity, between the maxilla and the sphenoid.
  • It contributes to the walls of two cavities:
  • The floor and lateral wall of the nasal cavity
  • The roof of the mouth (palate)

Zygomatic Bone

  • Situated on the lateral part of the face
  • It forms the prominence of the cheek, part of the lateral wall and floor of the orbit.

Nasal Bone

  • Located on the dorsum of the nose.

Lacrimal Bone

  • Located on the anteromedial wall of the orbit.

Sutures

  • A suture is a form of articulation where the contiguous margins of bones are united by a thin layer of fibrous tissue.
  • It appears only in the skull.
  • Coronal Suture: Parietal bones articulate with the frontal bone in their front, forming the coronal suture.
  • Lambdoidal Suture: Parietal bones articulate with the occipital behind, forming the lambdoidal suture.
  • Sagittal Suture: Parietal bones articulate with each other on the opposite side, forming the sagittal suture.
  • Squamosal Suture: Between the temporal and parietal bones.
  • Occipitomastoid Suture: Between the occipital and temporal bones.
  • Sphenosquamosal Suture: Between the temporal and sphenoid bones.

Cranial Fossae

  • Anterior cranial fossa
  • Middle cranial fossa
  • Posterior cranial fossa

Important Landmarks

  • Bregma: The midline point where the coronal and sagittal sutures intersect.
  • Lambda: The midline point where the sagittal and lambdoidal sutures intersect.
  • Glabella: The slight elevation in the midline of the forehead, between the superciliary arches and above the nasofrontal suture.
  • Pterion: The point of intersection between the frontal, sphenoid, parietal, and temporal bones.
  • Nasion: The point of intersection between the frontonasal suture and the midsagittal plane.
  • Gnathion: The most anterior and lowest median point on the border of the mandible.

Fontanelles

  • The junction between the frontal bone and the two parietal bones is called the bregma.
  • In a newborn, as ossification is incomplete, this region can be felt as a soft spot called the anterior fontanelle.
  • The anterior fontanelle is the biggest fontanelle.
  • By palpating the anterior fontanelle, it is possible to follow the development of bones and hydration status of the infant.
  • A sunken fontanelle indicates dehydration.
  • A tense and bulging fontanelle indicates increased intracranial pressure.
  • The junction between the occipital bone and the two parietal bones is called the lambda.
  • Also palpable as a soft spot in a newborn and called the posterior fontanelle.

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