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NeurocraniumBony case of the Brain and Meninges
ViscerocraniumFacial Skeleton
What does neurocranium contain?brain<br>meninges<br>proxmial cranial nerves<br>casculature of brain&nbsp;
Floor of neurocraniumCranial Base - Basicranium&nbsp;
Calvariaskull cap, flat bones: frontal, parietal, occipital&nbsp;
What bones in neurocranium8 bones<br>4 singular bones: centered on midline (Frontal, Ethmoid, Spenoid, Occipital)<br>2 sets: Temporal, Parietal
Contributing to anterior cranial fossaEthmoid<br>Frontal&nbsp;<br>Lesser wing of sphenoid&nbsp;
Contributing to middle cranial fossa...Sphenoid (greater wing, body)<br>Parietal<br>Temporal (both parts)
Contributing to posterior cranial fossa...Occipital&nbsp;<br>Temporal (Petrous)<br>Parietal
Viscerocranium bones (15)3 singular: Mandible, Ethmoid, Vomer<br>6 paried: Maxilla, Inferior Nasal Concha, Zygomatic, Palatine, Nasal, Lacrimal
Ethmoid Bone components:Crista Galli<br>Cribriform Plate<br>Perpendicular Plate<br>Superior Nasal Concha<br>Middle Nasal Concha&nbsp;<br>Medial Wall of Orbit
Nasal Septum:Perpendicular plate of Ethmoid<br>Vomer
What does the sphenoid articulate with?Occipital<br>Frontal&nbsp;<br>Ethmoid<br>Vomer<br>Parietal<br>Temporal<br>Palatine<br>Zygomatic&nbsp;
Components of Sphenoid2 lesser wings<br>2 greater wings<br>body<br>2 pterygoid processes (medial and lateral, extend from body)
Sella Turcica Components&nbsp;tuberculum sellae<br>dorsum sellae<br>hypophyseal fossa&nbsp;
Where is the sof located?between greater and lesser wings in middle cranial fossa<br>opens anteriorly into the orbit&nbsp;
Foramen Lacerum...convergence of:<br>sphenoid<br>temporal<br>occipital
Optic Canalpasses through lesser wing&nbsp;<br>medial to ant. clinoid process, medial to SOF, lateral to body of sphenoid, loacted in middle cranial fossa<br>communicates with oribit&nbsp;
Foramen rotundumpass through greater wing in middle cranial fossa&nbsp;<br>runs ant/horizontally, opens into pterygopalatine fossa (bony formation between sphenoid, maxilla and palatine bones
Foramen Ovale + Spinosumpassing through greater wing, located in middle cranial fossa<br>opens inferiorly into the infratemporal fossa
Optic Canal transmits&nbsp;Optic Nerve (II)
SOF transmitsOculomotor nerve (III)<br>Trochlear Nerve (IV)<br>trigminal nerve (V,1)<br>abducens nerve (VI)
What consists of the cerebrum?frontal<br>parietal<br>occipital<br>temporal
what makes up the brainstem?midbrain<br>pons<br>medulla oblongata<br>
What does the central Sulcus do?separates frontal lobes from parietal lobes
lateral sulcusinf. to frontal and parietal lobes
Longitundinal cerebral fissureseparates cerebral hemispheres&nbsp;
Cerebrum + Cerebellum : where do they occupy&nbsp;frontal lobes - anterior cranial fossae<br>temporal lobes - lateral aspect of middle cranial fossae<br>occipital lobes - extend posteriorly!!<br>cerebellum - posterior cranial fossae<br>
Brainstem, where does it occupy&nbsp;midbrain - junction of middle and posterior cranial fossae&nbsp;<br>pons - anterior aspect of the posterior cranial fossa<br>medulla oblongata - posterior cranial fossa, continous with spinal cord
Clivusportion of occipital bone that slopes inferior toward the foramen magnum&nbsp;
Cranial Nerve Iolfactory nerve<br>- composed of bulb and tract that are in contact with inferior surface of frontal lobe<br>- sense of smell&nbsp;<br>- travels from tract to bulb through cribiform plate of the ethmoid bone
Nasal Cavity: divisons&nbsp;superior 1/3 - olfactory area<br>inferior 2/3 - respiratory area&nbsp;
Cranial Nerve IIOptic Nerve<br>- exits orbit via optic canal to enter middle cranial fossa&nbsp;<br>- two optic nerves join to form optic chiasm before further dividing into optic tracts&nbsp;<br>- sensory for vision&nbsp;
Cranial Nerve III- Motor to 5 extra-ocular muscles (SR, IR, MR, IO, LP) and intra-ocular (sphincter pupillae, cillary muscle)<br>- emerges from midbrain carrying parasympathetic info to the extra-ocular ms<br>- exits cranial cavity and enters orbit via SOF
Cranial Nerve IVTrochlear Nerve<br>- motor nerve to one extra-ocular ms (SO)<br>- emerges from posterior surface of midbrain, relative to pons&nbsp;<br>- passes ant. around brainstem and through cavernous sinus&nbsp;<br>- exits cranial cavity and enters orbit via SOF&nbsp;
Cranial nerve VTrigeminal Nerve<br>- emerges from lateral aspect of the pons, large sensory root + small motor root<br>- motor: muscles of mastication and 4 other small ms<br>- sensory: face; oral, nasal and sinus mucosa; tetth; ant. 2/3 tongue<br>- has 3 divisions<br>- Ophthalmic Nerve (V1) - exits via SOF<br>- Maxillary Nerve (V2) - exits via Foramen rotundum<br>- Mandibular Nerve (V3) - exits via Foramen ovale
Cranial Nerve VIAbducens Nerve&nbsp;<br>- Motor to one extra-ocular eye muslce (LR)<br>- emerges from brainstem between pons and medulla&nbsp;<br>- through cavernous sinus and enters orbit via SOF<br>
points of exit/entry for CN I - VIcribriform plate - CN I<br>Optic Canal - CN II<br>SOF - CN III, IV, V1, VI<br>Foramen rotundum - V2<br>Foramen ovale - V3
Cranial MeningesDura mater (periosteal and meningeal layer)<br>Arachnoid mater (cobweb-like fibres)<br>Pia mater (on surface of brain)<br>Subarachnoid space&nbsp;<br>- role is to protect the brain, form supporting framwork for vasculature and venous sinuses, enclose cerebrospinal fluid within the subarachnoid sapce&nbsp;
Dura MaterPeriosteal layer: lies on inner aspect of the cranium<br>meningeal layer&nbsp;<br>both laters are fused, expect where dural infoldings and sinuses occur<br>- contribute to structure, subarchnoid space and venous sinuses&nbsp;
how are dural infoldings/refections mademeningeal dural layer reflects from the periostel layer to form infoldings which:<br>- compartmentalize the cranial cavity and support parts of the brain<br>- falx cerebri, tentorium cerebelli, falx cerebelli, diaphragma sellae
Falx Cerebrilines in longitudinal cerebral fissure, separting the cerebral hemispheres<br><br><b>anterior bony landmarks</b>: frontal crest of frontal bone and crista galli of ethmoid bone&nbsp;<br><br><b>posterior bony landmarks:&nbsp;</b>internal aspect of occipital protuberance&nbsp;<br><br><br><br>
Tentorium Cerebelli- separates occipital lobes from cerebellum&nbsp;<br>- <b>bony landmarks:&nbsp;</b>clinoid processes of sphenoid, petrous portion of temporal bone, parietal and occipital bones<br>
Falx Cerebelli- lies midsaggital plane, posterior aspect of the posterior cranial fossa<br>- located inf. relative to tentorium cerebelli<br>- partially separates cerebellar hemispheres<br>
Diaphragma Sellae- suspended between clinoid processes<br>- forms partial roof over hypophyseal fossa, covering pituitary gland&nbsp;
Dural Venous Sinusesendothelial-lined spaces within the dura, between periosteal and meningeal layers<br><br>principal venous channels of the brian; vein from surface of brain and diploe empty into these sinuses, on route to the internal jugular vein&nbsp;
Arachnoid Granulationsvisible as outward bulges of the dura mater<br><br>- prolongations of arachnoid mater that protude through the menigeal layer of dura into the venous sinuses<br>- allow CSF to exit into venous system (BAD)
Superior Sagittal Sinus- lies in superior border of the falx cerbri&nbsp;<br>- starts at crista galli; ends near the itnernal occipital protuberance at confluence of sinuses&nbsp;<br>
Inferior Sagittal Sinus- lines in inferior border of the falx cerebri<br>-drains into straight sinus&nbsp;
Straight Sinus- runs along the line of attachment of the falx cerebri and the tentorium cerebelli<br>- joins the confluence of sinuses&nbsp;
occipital sinus- lies in posterior border of the falx cerebelli&nbsp;<br>- ends superiorly at the confluence of sinuses&nbsp;<br>- associated with cerebellum
transverse sinuses- run laterally from the confluence in posterior margin of tentorium cerebelli; cont. with the sigmoid sinus&nbsp;
sigmoid sinuses-cont. of transverse sinus<br>- S-shaped course<br>- after passing the juglar foramina, will continue as the internal jugular vein&nbsp;
Cavernous Sinus- located bilaterally on sides of sella turcica on the body of sphenoid bone<br>- CN 3,4,6 Pass through<br>
Confluence of Sinuses- cont. with transverse sinus<br>receives venous blood from:<br><b>S</b>uperior Sagittal Sinus<br><b>O</b>ccipital Sinus<br>Straight Sinus
Internal Carotid Arteries- arise in neck from common carotid arteries (cervical part)<br>- ascend vertically in neck to cranial base (cervical part)<br>- pass through the external opening of the carotid canal and internal opening of the carotid canal, within petrous portion of temporal (petrous part)
Path of internal carotid artery in cavernous sinus- ICA exits petrous portion and enters cranial cavity&nbsp;<br>- ascend to posterior clinoid process<br>- travels anterior, along the lateral aspect of the body of the sphenoid<br>- curves up on the medial side of the ant. clinoid process<br>- pierces dura mater; cavernous part ends and cerebral part begins!
Vertebral Arteries- arise from subclavian arteries<br>- ascend vertically in neck, passing through the transverse formaina of cervical vertebrae (C6-C1)<br>- enters cranial cavity via foramen magnum&nbsp;<br>- meet at midline to form Basilar Artery
Anterior communicating artery- connects both anterior cerebral arteries
Internal carotid arteries provide:- middle cerebral and anterior cerebral arteries
Posterior communicating arteries:- small communicating arteries that provide a link between posterior cerebral arteries and internal carotid arteries
Basilar Arteries provide:- posterior cerebral a<br>- branches to brainsteam<br>- superior cerebellar a.<br>- anterior inferior cerebellar a.<br>
Vertebral arteries provide:- posterior inferior cerebellar a.<br>- converge to form basilar a.
Bones contributing to the orbit- frontal<br>- zygomatic<br>- maxilla<br>- Lacrimal<br>- Ethmoid<br>- Sphenoid&nbsp;<br>- palatine (floor of orbit)
Location of common tendinous ringsurrounds optic canal and portion of the SOF
Under the frontal bone from superior vieweyeball<br>extra-ocular muscles<br>neurovascular strucues<br>lacimal gland<br>oribital fat
Controlling Eyeball movementsuperior rectus<br>inferior rectus<br>medial rectus<br>lateral rectus<br><br>inferior oblique<br>superior oblique&nbsp;
Elevating superior eyelid:levator palpebrae Superioris
Superior Rectus:Origin: Common Tendinous Ring<br><br>Insertion: Sclera - Anterior to equator of the eyeball<br><br>Innervation: Oculomotor Nerve
Inferior rectusorigin: common tendinous ring<br><br>insertion: sclera - ant. to equator of eyeball<br><br>innveration: oculomotor nerve&nbsp;
Medial Rectusorigin: common tendinous ring<br><br>insertion: sclera - ant. to equator of eyeball<br><br>innveration: oculomotor nerve
Lateral RectusOrigin: common tendinous ring<br><br>Insertion: sclera - ant. to equator of eyeball<br><br>innervation: Abducens nerve&nbsp;
Superior ObliqueOrigin: Body of sphenoid bone<br><br>insertion: sclera - posterior to equator of eyeball<br><br>innervation: Trochlear nerve&nbsp;
Trochlea/Tendinous Pulleyattaches to frontal bone<br><br>redirects superior oblique backwards to its insertion&nbsp;<br><br>located on the ant/medial aspect
Inferior Obliqueorigin: oribital surface of maxilla (anterior aspect of orbit)<br><br>insertion: sclera - post. to equator of eyeball<br><br>innervation: oculomotor nerve
Levator Palpebrae SuperiorisOrigin: lesser wing of sphenoid<br><br>Insertion: superior eyelid<br><br>innveration: oculomotor nerve
ALL NERVES INNERVATED BY OCULOMOTOR EXPECT FOR:SO - trochlear (CN4)<br>LR - abducent (CN6)
Does trochlear nerve pass through common tendinous ring?NO
abducent nerve travels with internal carotid artery&nbsp;
What is the zygomatic arch composed of?Temporal process of zygomatic bone<br>Zygomatic process of temporal bone
temporomandibular join (TMJ)articuation between mandibular fossa (temporal) and head of condyloid process of mandible&nbsp;<br><br>movements:<br>elevation (close mouth)<br>depression (open mouth)<br>protrusion (protrude chin - move chin ant.)<br>retrusion (retrude chin)<br>lateral movements (grinding and chewing)
"<img src=""paste-59eceaae3d7677e11712e022c7a5d602a6d2fa9c.jpg"">"TMJ
"<img src=""paste-6e1be14c053d3f576cfa76e3878e92c791060e7e.jpg"">"temporal fossa
Temporal Fossa- depressed area on side of skull<br>- occupied primarily by upper portion of temporalis ms<br>- superior to the infratemporal fossa
Infratemporal Fossa Wallsmedial wall: lateral pterygoid plate<br><br>anterior wall: posterior aspect of the maxilla<br><br>posterior wall: mastoid and styloid processes of temporal bone<br><br>lateral wall: ramus of mandible&nbsp;<br><br>roof: inf. surface of greater wing and squamous portion of temporal&nbsp;
How do nerves gain access to the infratemporal fossa?foramen ovale<br>- the route through which the nerves that innervate the muscles of mastication gain access to the fossa
Trigeminal Nerve Divisions:ophthalmic nerve (V1) - Sensory;SOF<br>maxillary nerve (V2) - Sensory;Foramen rotundum<br>mandibular nerve (V3) - Motor and Sensory;Foramen Ovale
muscles of masticationall innervated by mandibular division<br><br>all originate on external aspect of cranium and insert on mandible<br><br>masseter<br>temporalis<br>lateral pterygoid ms (superior and inferior head)<br>medial pterygoid ms (superifical and deep heads)&nbsp;
"<img src=""paste-ff23a4d69d652f4533e77bf43faefcc150743af3.jpg""><img src=""paste-275410d38716b6d9e6e50073f009c8c15c8e39bc.jpg"">""<img src=""paste-a8af6381ce292e49ba9a05dbf9089521ac3d15f8.jpg""><br><br>condyloid: assocaited w head and neck, inserts onto TMJ"
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Masseter"Origin: Zygomatic bone and arch<br><br>Insertion: ramus of mandible: angle and lateral surface&nbsp;<br><br>Action: elevate and protrude mandible<br><br>Innervation: muscular branches of the mandibular divison of the trigeminal nerve<br><br>Superifical and Deep heads<br><img src=""paste-a8e09e01f401b4f0b061fbfe9c64ee32c6197ade.jpg"">"
TemporalisOrigin: Temporal fossa<br><br>Insertion: Coronoid process of mandible (Apex and medial surface)<br><br>Action: elevate and retract<br><br>innervation: musclar branches of CNIV3
Lateral Pterygoid Muscle (travels posterior)"Superior head Origin: Greater wing of Sphenoid Bone<br><br>Inferior Head origin: lateral surface of lateral pterygoid plate<br><br>Insertion: region of TMJ; neck of condyloid process of mandible<br><br>Acting together: protrude; Alone and Alt.: side to side movement<br><br><img src=""paste-b5dab42205b57331df0b05924bb549e980d3c9a8.jpg"">"
Medial pterygoid muscle (travels inf.)"Deep head Origin: medial surface of lateral pterygoid plate<br><br>Superficial head Origin: tuberosity of maxilla<br><br>Insertion: medial surface of mandible&nbsp;<br><br>Acting Together: elevate and protrude mandible; Acting Along and Alt.: produce a grinding motion<br><br><img src=""paste-c9914e27d5a3e9f3d3be34ba4e4b17e37a49c7b9.jpg"">"
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Muscular sling formed by...medial pterygoid and masseter muscles
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Sensations that the mandibular division of the Trigeminal Nerve provides:side of head<br>skin of face over mandible&nbsp;<br>lower lip<br>mandibular teeth<br>temporomandibular joint (TMJ)<br>Mucosa of mouth (lining of the mouth)<br>Anterior 2/3 of tongue&nbsp;
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Braches of mandibular division of trigeminal nerve (CNV3)Muscular branches: massete, tempoarlis, medial/lateral pterygoids<br><br>Auriculotemporal nerve: travels posterior (sensation back from side of head)<br><br>Buccal Nerve: cheek region<br><br>Lingual Nerve: ant. 2/3 of tongue (anterior and medial to Inf. alveolar)<br><br>mental nerve: lower lip<br><br>inferior alveolar nerve: gives inferior dental plexus
Sensations that arise from ophthalmic division of trigeminal nerve (CNV1)scalp<br>skin of forehead<br>superior eyelid<br>cornea (to globe of eye)<br>nose<br>mucosa of nasal cavity and sinuses&nbsp;
Sensations that arise of maxillary division of trigeminal nerve (CNV2)Skin of face over maxilla&nbsp;<br>inferior eyelid<br>upper lip<br>maxillary teeth<br>mucosa of nose<br>maxillary sinuses<br>palate
Distal branches of trigeminal nerve and where they exitOphthalmic Nerve (V1) : SOF to supra-orbital foramen<br>Maxillary Nerve (V2): F. rotundum to infra-orbital formen<br>Mandibular Nerve (V3): F. Ovale to mental formen&nbsp;
Nerves assocaited with the orbitCN 2 - optic nerve (via optic canal)<br>CN 3 - oculomotor nerve (via SOF)<br>CN 4 - trochlear nerve (Via SOF)<br>CN V1 - ophthalmic nerve (via SOF)<br>CN 6 - adbucens nerve (Via SOF)
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Branches of the ophthalmic division (CNv1)lacrimal nerve<br>frontal nerve --- branches into supra-trochelar N, and supra-orbital nerve<br>nasociliary nerve -- branches into posterior ethomidal, anterior ethmoidal (gives external nasal n), and infra-trochlear n
Branches in OrbitFrontal N<br>Lacrimal N<br>Nasociliary N&nbsp;
Through common tendinous ringOptic N<br>oculomtor N<br>abducens N<br>nasociliary N
nerves that DON'T pass through common tendinous ringFrontal N<br>Lacrimal N<br>Trochlear N<br><br>these are visible from superifical/superior view of orbit<br>does still pass through SOF
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Maxillary Division branchesinfra-orbital nerve (gives ant/middle/post. superior alveolar nerves)<br>zygomatic nerve (travels up lateral wall of orbit and gives two branches)<br>- zygomatico-temporal N and zygomatico-facial N<br><br>
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pneumatized bones- have air sapces/cells/large sinuses therefore less weight<br>ethmoid<br>frontal<br>sphenoid<br>temporal