Cranium and Facial
Bones
Marilyn Rose
http://www.gomediazine.com/wp-content/images/2008/09/free-skull-photos-preview.jpg
Ground Rules
This room is all we have. We need to find a way to make it work, so we
can do what we're here to do.
1. Absolutely no food or drink consumption in the classroom.
2. No open liquid containers in the classroom. They must be kept
outside.
3. No conversing during lecture.
4. If you can't hear the instructor or another student during lecture or
question and answer, please politely say so.
5. If you're sitting in the back and having difficulty hearing, move to
the front of the classroom next time.
6. Dial down your drama. If you're anxious about this class, find
something constructive to do about it.

8 bones
Occipital
 Temporal Sphenoid
 Ethmoid
 Parietal- vertex
 Frontal
Cranium

http://www.exploringnature.org/graphics/anatomy/skulls_w_text.jpg
http://www.voxel-man.de/3d-navigator/brain_and_skull/images/bs_ct-browser-englisch.jpg
Occipital Protuberance
http://www.theodora.com/anatomy/images/image194.gif
external
internal
http://img.medscape.com/pi/emed/ckb/radiology/336139-389714-1939.jpg
Temporal Bone
Petrous portion
• EAM
Sphenoid Bone
http://img.tfd.com/MosbyMD/thumb/sphenoid_bone.jpg
http://www.eurorad.org/mediafiles/eurorad/0000001070/000002_text.jpg
Level of dorsum sellae=
A square portion of bone on the
body of the sphenoid posterior to
the sella turcica or hypophysial
fossa
http://www.mans.eun.eg/FacMed/arabic/DAW/CourseImages/sag_mri_2za.jpg
http://m.blog.hu/ke/kepalkotas/image/sella.jpg
Ethmoid Bone
http://img.tfd.com/MosbyMD/thumb/ethmoid_bone.jpg
Blunt Traumamost common cause of A deviated
septum
Any impact can potentially detach
perpendicular plate of ethmoid bone
from nasal septum wall, allowing
septum to deviate from one side to
other.
Parietal Bone
http://www.neurographics.org/3/1/2/images/Fig2.jpg
http://www.cyberounds.com/assets/07/90/790/figure1.jpg
Frontal Bone
http://2.bp.blogspot.com/_fBQVVpFhTQs/Sjk7DY4pljI/AAAAAAAAAvE/IYrpGnSa4rU/s
sinus-fx-1.jpg
http://www.face-and-emotion.com/dataface/anatomy/media/frontalbone.jpg
The patient was admitted to the emergency
room for polytrauma with severe
cranioencephalic trauma with fracture and a
depressed fronto-orbital fracture with
external communication
14 Facial Bones
 Nasal
2x
 Lacrimal 2x
 Maxilla 2x
 Palatine
 Zygoma 2x
 Inferior nasal
conchae 2x
 Vomer- Where is
it??
 mandible
http://www.asnr2.org/neurographics/8/2/60/sinusanatomy/axial/apSkull.jpg
Paranasal Sinuses




Ethmoid
Maxillary
Sphenoid
Frontal
http://www.billcasselman.com/paranasal_sinuses_ethmoid_eye_sockets_sphenoid_maxillary.jpg
http://scannermurcia.es/imagenes/estudios/escaner/gallery3.jpg
http://www.szote.u-szeged.hu/radio/szem/fog2a1.gif
Temporomandibular Joint

Hinge of masticaction
http://www.urmc.rochester.edu/smd/Rad/neuroimages/TMJ15.jpg
http://radiopaedia.org/uploads/radio/0000/3817/TMJ_0002_galler
y.jpg
Closed
Open
TMJ
TMJ-@ LPCH

CT-guided imaging at
LPCH for treatment of
juvenile idiopathic
arthritis: The arrow
shows the trajectory of
the needle for
placement of steroid
medication into the
temporomandibular
joint.
Orbit
http://anatomy.uams.edu/anatomyhtml/graphics/rsa2p4.gif
1.
2.
3.
4.
5.
6.
Frontal bone
Ethmoid bone
Palatine bone
Zygomatic bone
Lacrimal bone
Maxillary bone
http://media.photobucket.com/image/anatomy%20of%20eye%20and%20muscles/trimurtulu/Eye.jpg
Orbit

What seven bones make up the orbit?



The posterior obit has a what canal?


frontal, sphenoid, ethmoid (cranium)
Lacrimal, maxillary, palatine and zygomatic (facial)
Optic- optic nerve
A blow-out fracture can cause diplopia, what does that
mean?

Floor of orbit, herniation of orbital contents=
doublevisiondoublevision
http://e-radiography.net/ibase8/Skull/thumbs/Skull_frx_orbit_ct.jpg
Name 5 anatomic structures you can see.
orbit
vertex
Ethmoid
sinus
EAM
TMJ
http://farm4.static.flickr.com/3122/2280819592_7a60701210.jpg
What is wrong?
Rt Frontal bone- axial- orbital contents in maxillary sinus
What level is this?
Petrous Ridge
What are the points at the posterior
aspect?
Internal/External Occipital Protuberance
What is the foreign object? What is now
communicating with the external
environment?
Bullet
Frontal Sinus open
to external
environment.
http://www.firearmsid.com/Feature%20Articles/042002/SkullCT.jpg
What is this bone?
Where is the fracture?
Parietal Bone
Sphenoid
Describe these two views.
Pencil- Nasal cavity, ethmoid,
sphenoid sinus with air/fluid (no
CSF leak)
http://www.powerpak.com/courses/10132/Figure3.jpg
Axial- Air/ Fluid levels in the sinus
http://www.ispub.com/ispub/ijorl/volume_4_number_1_37/pencil_in_the_nose/pencil-fig3.jpg
What is wrong here?
Medulla and Cerebellar tonsils in foramen magnum= Chiari 1 malformation- Spina
Bifida causing herniation of medulla inferior.
CSF is in this space= Normal
http://www.atlaschiro.com/case_studies.htm
Optic Nerve
Frontal Sinus
Sphenoidal
Sinus
Mastoid Air
Cells
Pons
1
2




1 Frontal Sinus
2 Ethmoid Sinus
3 Sphenoid
Sinus
4 Maxillary
Sinus
4
3
2
1
Name the
structures


1 Sphenoid Sinus
2 Cribiform Plate
1
2
2
3



1 Maxillary sinus
2 Frontal sinus
3 Ethmoid sinus
1
1
Before Multiplanar reconstruction the 2 planes used to ACQUIRE
Sinus images were AXIAL and CORONAL planes