MSMS 5500 The Skull- Features and Foramina.pdf

7/29/24 Surgeries involving the face and skull require deep knowledge of the anatomy...

7/29/24 Surgeries involving the face and skull require deep knowledge of the anatomy The Skull Features and Foram ina Cranial Nerves 1 2 The Axial Skeleton Question If the opening in the left image (CT of the cranial cavity) is fractured, the patient would have which of the following symptoms? A. can’t close his/her eye on the right B. can’t move his/her mandible C. Unable to move his/her right eye to the left D. has trouble with his/her vision 3 4 Anatomy of Skeletal Elements What Covers the Cranium? Bone Markings include: SCALP Projections Depressions SCALP is an acronym … Fissures S= Skin with hair (at least in m ost people!) Foram ina C= Dense connective tissue contains arteries Canals (m eatuses) (scalp lacerations bleed profusely) A= Aponeurosis: consists of the frontalis m uscle L= Loose connective tissue P= Periosteum : bone 5 6 1  7/29/24 Neurocranium and Viscerocranium Structures of the Skull (Articulations) 7 8 Neurocranium Viscerocranium Neurocranium Neurocranium Bones of the cranium Coronal Coronal Viscerocranium Bones of the suture suture cranium Squamous Facial Bones Squamous suture suture Lambdoid Lambdoid suture suture 9 10 Bones of the Neurocranium and Viscerocranium Bones of the neurocranium (8) 1. 1 ethmoid bone 2. 1 frontal bone Bones of the viscerocranium (8) Neurocranium 3. 1 occipital bone 1. Inferior nasal concha (2) 4. 2 parietal PEST of 6 2. Lacrimal bones (2) 5. 1 sphenoid 3. Mandible Auditory ossicles 6. 2 temporal 4. Maxilla (2) 5. Nasal bones (2) V.A.I.N. M M P.L.Z 6. Palatine bones (2) 7. Vomer 8. Zygomatic bones (2) 11 12 2  7/29/24 Identify the Bone 1 Identify the Bone 2 13 14 Identify the Bone 3 Identify the Bone 4 15 16 Identify the Bone 5 Bones of the Neurocranium 17 18 3  7/29/24 The Skull: Posterior View Pterion Weakest part of the skull Middle meningeal artery runs underneath the pterion 19 20 Bones of the Face: Lacrimal Epidural Hematoma Bone Radiograph of an epidural hematoma- buildup of blood between the dura and skull- typically as a result of injury to the middle meningeal artery Palatine bone- also part of the viscerocranium not shown here 21 22 Bones of the Face: Maxilla Bones of the Face: Mandible Palatine bone- also part of the viscerocranium not shown here Palatine bone- also part of the viscerocranium not shown here 23 24 4  7/29/24 Bones of the Face: Sphenoid Bones of the Face: Nasal Bone, Bone Zygomatic Bone, Vomer Bone Palatine bone- also part of the viscerocranium not shown here Palatine bone- also part of the viscerocranium not shown here 25 26 Bones of the Face: Inferior Nasal Concha Now let’s look at some of the bones that have foramina and various features in more detail Palatine bone- also part of the viscerocranium not shown here 27 28 Middle and Superior Nasal The Ethmoid Bone Conchae Part of the Ethmoid bone The ethmoid bone ( a neurocranium bone) 29 30 5  7/29/24 Identify the Opening: Sphenoid The Sphenoid Bone- Bone 1 Neurocranium Five Important openings of the sphenoid bone 1. O ptic canal 2. Superior orbital fissures 3. Foram en rotundum 4. Foram en ovale 5. Foram en spinosum 31 32 Identify the Opening: Optic Identify the Opening: Sphenoid Foramen Bone 2 33 34 Identify the Opening: Superior Identify the Opening: Sphenoid Orbital Fissure Bone 3 35 36 6  7/29/24 Identify the Opening: Foramen Identify the Opening: Sphenoid Rotundum Bone 4 37 38 Identify the Opening: Foramen Ovale and Foramen Spinosum The Temporal Bone 1 39 40 The Temporal Bone 2 The Temporal Bone 3 41 42 7  7/29/24 The Temporal Bone 4 The Temporal Bone 5 43 44 Questions Vomer What does the word ‘innervate’ mean? What does sensory (afferent) mean? What does motor (efferent) mean? 45 46 Dartmouth: Lateral Skull Dartmouth: AP Skull 47 48 8  7/29/24 Mandible: Mandibular Condyle Mandible: Coronoid Process 49 50 Mandible: Mandibular Foramen Mandible: Mental Foramen 51 52 Superior View of the Skull: Foramina Identification Anterior Cranial Fossa 53 54 9  7/29/24 Superior View of the Skull: Superior View of the Skull: Middle Cranial Fossa Posterior Cranial Fossa 55 56 Superior View of the Skull: Superior View of the Skull: Identification 1 Identification 2 57 58 Superior View of the Skull: Superior View of the Skull: Identification 3 Identification 4 59 60 10  7/29/24 Inferior Aspect of the Skull Carotid Canal and Foramen Lacerum 61 62 Identify the Sinus 1 Identify the Sinus 2 63 64 Identify the Area Identify the Sinus 65 66 11  7/29/24 Cranial Nerves and The Cranial nerves III-XII originate Foramina Through Which They from the brainstem Travel 67 68 Brainstem Locations of the Cranial Nerves The twelve cranial nerves- These nerves innervate the face, head and neck. Cranial nerves III-XII arise from the brainstem and take one of the holes of the cranial fossae to reach various parts of the head and neck. CN III and IV- arise from the midbrain CN V- arises from the pons VI, VII and VIII- arise from pontomedullary junction CN IX-XII- arise from the medulla 69 12