Initial Viewing of the Skull Illustrated Anatomy of the Head and Neck Third Edition Margaret J. Fehrenbach and Susan W. Herring Elsevier, 2007 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. NOTE It is easier to study the skull by first looking at its various views: the superior, anterior, lateral, and inferior views. 2 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Superior View of the Skull When the skull is viewed from above, four cranial bones are visible. At the front of the skull is the single frontal bone. At the sides are the paired parietal bones. At the back of the skull is the single occipital bone. Figure 3-1 3 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. SUTURES ON SUPERIOR VIEW The suture extending across the skull, between the frontal and parietal bones, is the coronal suture. A second suture, the sagittal suture, extends from the front to the back of the skull, between the paired parietal bones. The third suture, located between the single occipital bone and the paired parietal bones, is the lambdoidal suture. Figure 3-2 4 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Anterior View of the Skull When the skull is viewed from the front, certain bones of the skull (or portions of these bones) are visible. These bones include the single frontal, ethmoid, vomer, and sphenoid bones and the mandible, and also the paired lacrimal, nasal, inferior nasal conchal, zygomatic, and maxillary bones. Figure 3-3 5 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Facial Bones on Anterior View The facial bones visible on the anterior view of the skull include the lacrimal bone, nasal bone, vomer, inferior nasal concha, zygomatic bone, maxilla, and mandible. Figure 3-4 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. 6 Orbit and Associated Structures The orbit contains and protects the eyeballs. The larger orbital walls are composed of the orbital plates of the frontal bone (roof or superior wall), ethmoid bone (greatest portion of medial wall), and lacrimal bone (at the anterior medial corner of the orbit) and the orbital surfaces of the maxilla (floor or inferior wall) and zygomatic bone (anterior portion of the lateral wall). The orbital surface of the greater wing of the sphenoid bone is also included (the posterior portion of the lateral wall). Figure 3-5 7 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Orbit and Associated Structures The orbital apex is composed of the lesser wing of the sphenoid bone (forming the base) and the palatine bone (a small inferior portion). The opening in the orbital apex is the optic canal, which lies between the two roots of the lesser wing of the sphenoid bone. The second cranial or optic nerve passes through the optic canal to reach the eyeball. The ophthalmic artery also extends through the canal to reach the eye. Figure 3-6 8 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Orbit and Associated Structures Lateral to the optic canal is the superior orbital fissure, between the greater and lesser wings of the sphenoid bone. Like the optic canal, the superior orbital fissure connects the orbit with the cranial cavity. The third cranial or oculomotor nerve, the fourth cranial or trochlear nerve, the sixth cranial or abducent nerve, and the ophthalmic nerve (from the fifth cranial or trigeminal nerve) and vein travel through this fissure. Figure 3-7 9 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Orbit and Associated Structures The inferior orbital fissure can be seen between the greater wing of the sphenoid bone and the maxilla. The inferior orbital fissure connects the orbit with the infratemporal and pterygopalatine fossae. The infraorbital and zygomatic nerves, branches of the maxillary nerve, and infraorbital artery enter the orbit through this fissure. The inferior ophthalmic vein travels through this fissure to join the pterygoid plexus of veins. Figure 3-7 10 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Nasal Cavity and Associated Structures The nasal cavity can also be viewed from the anterior aspect. The nasion, a midpoint landmark, is located at the junction of the frontal and nasal bones. The anterior opening of the nasal cavity, the piriform aperture, is large and triangular. The bridge of the nose is formed from the paired nasal bones. The lateral boundaries of the nasal cavity are formed by the maxillae. Figure 3-8 11 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Nasal Cavity and Associated Structures Each lateral wall of the nasal cavity has three projecting structures that extend inward from the maxilla, which are called the nasal conchae. Figure 3-8 12 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Nasal Cavity and Associated Structures The vertical partition of the nasal cavity, the nasal septum, divides the nasal cavity into two portions. Anteriorly, the nasal septum is formed by both the nasal septal cartilage inferiorly and the perpendicular plate of the ethmoid bone superiorly. The posterior portions of the nasal septum are formed by the vomer. Figure 3-9 13 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. External Lateral View of the Skull When viewed from the side, the external skull shows both cranial bones and facial bones. A division between the cranial bones and facial bones can be reinforced by making an imaginary diagonal line that passes downward and backward from the supraorbital ridge of the frontal bone to the tip of the mastoid process of the temporal bone. Figure 3-10 14 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. External Lateral View of the Skull On the lateral external surface of the skull are two separate parallel ridges or temporal lines, crossing both the frontal and parietal bones. The superior ridge is the superior temporal line. The inferior ridge or inferior temporal line is the superior boundary of the temporal fossa and where the temporalis muscle attaches. Figure 3-11 15 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Cranial Bones on External Lateral View From the lateral view, the cranium is easily seen, which includes the cranial bones: the occipital , frontal, parietal, temporal, sphenoid, and ethmoid bones. Figure 3-12 16 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Cranial Bones on External Lateral View Also present on the lateral view of the cranium are the coronal suture, an articulation between the frontal and parietal bones, and the lambdoidal suture, an articulation between the parietal and occipital bones. Also present is the squamosal suture, between the temporal and parietal bones. Figure 3-12 17 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fossae on External Lateral View The temporal fossa is formed by several bones of the skull and contains the body of the temporalis muscle. Inferior to the temporal fossa is the infratemporal fossa. Deep to the infratemporal fossa and harder to see is the pterygopalatine fossa. Figure 3-13 18 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Zygomatic Arch and TMJ on External Lateral View The zygomatic arch is formed by the union of the broad temporal process of the zygomatic bone and the slender zygomatic process of the temporal bone. The suture between these two bones is the temporozygomatic suture. The zygomatic arch serves as the origin for the masseter muscle. Figure 3-14 19 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Zygomatic Arch and TMJ on External Lateral View The temporomandibular joint is a movable articulation between the temporal bone and the mandible. Figure 3-14 20 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Inferior View of the External Surface of the Skull Most of the structures of the inferior aspect of the skull surface are more easily viewed on the skull model if the mandible is temporarily removed. The maxillary, zygomatic, vomer, temporal, sphenoid, occipital, and palatine bones are visible on this inferior view of the skull’s external surface. Figure 3-15 21 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Hard Palate and Associated Structures At the anterior portion of the skull’s inferior aspect is the hard palate, bordered by the alveolar process of the maxilla with its maxillary teeth. The hard palate is formed by the two palatine processes of the maxillae and the two horizontal plates of the palatine bones. Figure 3-16 22 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Hard Palate and Associated Structures Two sutures are present on the hard palate. One suture is the median palatine suture, a midline articulation between the two palatine processes of the maxillae anteriorly and the two horizontal plates of the palatine bones posteriorly. The other suture is the transverse palatine suture, an articulation between the two palatine processes of the maxillae and the two horizontal plates of the palatine bones. Figure 3-16 23 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Hard Palate and Associated Structures The hard palate forms the floor of the nasal cavity, as well as the roof of the mouth. The posterior edge of the hard palate forms the inferior border of the posterior nasal apertures or choanae. The superior border of each aperture is formed by the vomer and the sphenoid bone. The posterior edge of the vomer forms the medial border of the posterior nasal apertures. The posterior nasal apertures are the posterior openings of the nasal cavity. Figure 3-16 24 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Hard Palate and Associated Structures Near the superior border of each posterior nasal aperture is the pterygoid canal. The pterygoid canal extends to open into the pterygopalatine fossa and carries the pterygoid nerve and blood vessels. Figure 3-16 25 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Middle Portion of the External Skull Surface The lateral borders of the posterior nasal apertures are formed on each side by the pterygoid process of the sphenoid bone. Each pterygoid process consists of a medial pterygoid plate and a lateral pterygoid plate. Figure 3-17 26 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Middle Portion of the External Skull Surface The depression between the medial and lateral plates is called the pterygoid fossa. At the inferior portion of the medial plate of the pterygoid process is the hamulus. Figure 3-17 27 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Foramina of the External Skull Surface The larger anterior oval opening on the sphenoid bone is the foramen ovale, through which the mandibular division of the fifth cranial or trigeminal nerve. Figure 3-18 28 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Foramina of the External Skull Surface The smaller and more posterior opening is the foramen spinosum, which carries the middle meningeal artery into the cranial cavity. The foramen spinosum receives its name from the nearby spine of the sphenoid bone, which is at the posterior extremity of the sphenoid bone. Figure 3-18 29 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Foramina of the External Skull Surface Also on the external surface of the skull is the large foramen lacerum. Posterolateral to the foramen lacerum is an opening in the petrous portion of the temporal bone, the carotid canal. The carotid canal carries the internal carotid artery and sympathetic carotid plexus. Figure 3-18 30 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Foramina of the External Skull Surface A bony projection, the styloid process, is visible lateral and posterior to the carotid canal. Immediately posterior to the styloid process is the stylomastoid foramen, an opening through which the seventh cranial or facial nerve exits from the skull to the face. Figure 3-18 31 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Foramina of the External Skull Surface The jugular foramen, just medial to the styloid process, is more easily seen if the skull model is tilted to one side. The jugular foramen is the opening through which pass the internal jugular vein and three cranial nerves: the ninth cranial (glossopharyngeal) nerve, tenth cranial (vagus) nerve, and eleventh cranial (accessory) nerve. Figure 3-18 32 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Foramina of the External Skull Surface The largest opening on the inferior view is the foramen magnum of the occipital bone, through which pass the spinal cord, vertebral arteries, and eleventh cranial or accessory nerve. Figure 3-18 33 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Superior View of the Internal Surface of the Skull The internal surface of the skull is viewed by carefully removing the top half of the skull model. The frontal, ethmoid, sphenoid, temporal, occipital, and parietal bones are visible from this view of the internal surface of the skull. Superior orbital fissure Foramen lacerum Figure 3-19 34 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Foramina of the Internal Skull Surface Also present are the inside openings of the optic canal, superior orbital fissure, foramen ovale, foramen spinosum, carotid canal, jugular foramen, and foramen magnum. The perforated cribriform plate, with foramina for the first cranial or olafactory nerve, and the foramen rotundum, for the maxillary division of the fifth cranial or trigeminal nerve, are also seen from this view. Superior orbital fissure Foramen lacerum Figure 3-19 35 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Foramina of the Internal Skull Surface Also present are the hypoglossal canal, for the twelfth cranial or hypoglossal nerve, and the internal acoustic meatus, for the seventh cranial or facial nerve and the eighth cranial or vestibulocochlear nerve. Superior orbital fissure Foramen lacerum Figure 3-19 36 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-22 37 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-23 38 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-26 39 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-30 40 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-31 41 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-32 42 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-44 43 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-45 44 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-48 45 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-51 46 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-52 47 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-54 48 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Fig 3-60 49 Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.