1. Head & Neck – Lecture 2 د. حيدر جليل الأعسم
The Skull II
Head & Neck – Lecture 2
د. حيدر جليل الأعسم

2. The Cranial Cavity Vault Sutures: (Coronal, Sagittal & Lambdoid)
-Impressions:
arachnoid granulations, middle meningeal aa., and superior sagittal sinus.

3. The Cranial Cavity The Base of skull 1- Anterior Cranial fossa
2- Middle Cranial fossa
3- Posterior Cranial fossa
We should know for each fossa:
Formed by? bones
Boundaries? walls
Contents?
Main Features? foramina

4. Anterior Cranial Fossa
Formed by: orbital plates of the frontal bone, cribriform plate of the ethmoid, lesser wing of sphenoid & anterior part of body of sphenoid.
Boundaries: inner surface of the frontal bone, lesser wings of the sphenoid on the sides and groove for the optic chiasma.
Contains: the frontal lobes of the brain
Main features:
Foramen cecum (emissary vein)
Crista Galli (attachment of the falx cerebri)
Cribriform plate (olfactory bulbs and the olfactory nerves)
Anterior clinoid processes (attachment of tentorium cerebelli)

5. Middle Cranial Fossa Formed by: median part- body of sphenoid bone
Lateral concavities - greater wing of sphenoid, squamous and petrous parts of temporal bone.
Boundaries: Ant. lesser wing of sphenoid
Post. upper border of petrous part of temporal bone
Lat. greater wing of sphenoid, parietal bone and squamous part of temporal bone.
Contains: the temporal lobes of the brain.

6. Middle Cranial Fossa
Features: (7 foramina, median part, petrous part of temporal bone)
1- Optic Canal: (ophthalmic a. & optic nerve) ―→ to the orbit.
2- Superior orbital fissure: (superior ophthalmic vein, lacrimal, frontal, nasocilliary, Abducent, Oclomotor & Trochlear nerves) ―→ to the orbital cavity.
3- Foramen rotundum: (maxillary branch of Trigeminal (V) nerve) ―→ to the pterygo-palatine fossa.
4- Foramen ovale: (mandibular branch (sensory & motor) of trigeminal (V) nerve & the lesser petrosal nerve) ―→ to the infratemporal fossa.

7. Middle Cranial Fossa
Features: (7 foramina, median part, petrous part of temporal bone)
5- Foramen spinosum: (middle meningeal artery)
6- Foramen lacerum:
Upper opening (Open - Internal Carotid Artery)
Lower opening (Closed – cartilage & fibrous tissue)
7- Carotid Canal: (Internal Carotid Artery).

8. Middle Cranial Fossa
Features: (7 foramina, median part, petrous part of temporal bone)
The petrous part of temporal bone:
Medial groove for greater petrosal nerves
Lateral groove for Lesser petrosal nerve
Arcuate eminence: (semicircular canal in inner ear)
Tegmen tympani: (roof mastoid antrum, tympanic cavity and auditory tube)

9. Middle Cranial Fossa
Features: (7 foramina, median part, petrous part of temporal bone)
The Median part of Middle Cranial Fossa: (body of the sphenoid)
Sulcus Chiasmatis: a groove for optic chiasma.
Tuberculum sellae: (with middle clinoid processes)
Sella Turcica (Turkish saddle): a depression for the pituitary gland.
Dorsum Sellae: (with posterior clinoid process)

10. Posterior Cranial Fossa
Formed by: Occipital bone, Mastoid part & post. half of petrous temporal bone.
Boundaries: superior border of petrous part of temporal bone & internal surface of occipital bone.
Contains: cerebellum, midbrain, pons and medulla oblongata.
Main features: (Roof, 4 Foramina, 4 sinus grooves)
Roof: by a fold of dura called tentorium cerebelli that is attached to the upper border to the petrous part of temporal bone.

11. Posterior Cranial Fossa
Foramina:
1- Foramen Magnum: (Medulla Oblongata, Vertebral arteries and ascending roots of accessary cranial nerve).
2- Hypoglossal canal: (Hypoglossal nerve)
3- Jugular foramen: (Inferior petrosal sinus, cranial nerves 9, 10 & 11 and sigmoid sinus).
4- Internal acoustic canal : (Vestibulo-cochlear nerve & Facial nerve)

12. Posterior Cranial Fossa
Sinus grooves: these are deep impressions for the venous sinuses which are:
1- Superior Petrosal sinus on upper border of petrous part of temporal bone.
2- Inferior Petrosal sinus on lower border of petrous part of temporal bone.
3- Sigmoid sinus which is S shaped on mastoid and petrous parts of temporal bone.
4- Transverse sinus on each side of internal occipital protuberance. 

13. 1- Cervical Vertebrae (Spines)
Bones of the Neck
1- Cervical Vertebrae (Spines)
2- Hyoid bone:

14. Cervical Spines They are 7 cervical vertebrae
Unique transverse foramen in the transverse processes (vertebral vein and vertebral artery) 
There are:
3 Atypical (C1,C2 & C7)
4 typical (C3-C6)
All have transverse processes

15. Typical Cervical Spine
Features: 1- The vertebral body is small and longer from side to side than anteroposteriorly; the superior surface is concave, and the inferior surface is convex. 2- The vertebral foramen is triangular. 3- The superior facets of the articular processes are directed superoposteriorly, and the inferior facets are directed inferoposteriorly. 4- The spinous processes are short and bifid. 5- The transverse process has anterior and posterior tubercles and in between a groove for spinal nerve.

16. Atypical Cervical Spine – C1
C1 vertebra (Atlas):
Ring-like shape
Encloses the odontoid process of C2 & Spinal cord with meninges
No Spinous process No Body
Has two lateral masses connected by anterior and posterior arches.
It has concave superior articular facets (Kidney shaped) to receive the occipital condyles.

17. Atypical Cervical Spine – C2
C2 vertebra (Axis):
The strongest cervical vertebra.
Has two large, flat surfaces, the superior articular facets
Has tooth-like dens (odontoid process).
Both dens and the spinal cord are encircled by the atlas. The dens lies anterior to the spinal cord and separated by the transverse ligament of the atlas.
It has a large bifid spinous process that can be felt deep in the nuchal groove.

18. Atypical Cervical Spine – C7
C7 vertebra:
It has long spinous process, which is not bifid.
Its transverse processes are large and directed downward which allow differentiation from T1 Spine that has upward directed transverse process.

19. Hyoid Bone
It is a U-shaped bone that lies in the anterior part of the neck level of the C3)
It is suspended by muscles that connect it to:
Mandible by mylohyoid, genohyoid &digastric muscles
Styloid processes by stylohyoid muscle and ligament
Thyroid cartilage by thyrohyoid muscle
Manubrium by sternohyoid muscle
Scapulae by omohyoid muscle
The hyoid does not articulate with any other bone.
The hyoid consists of a body, greater and lesser horns.
Functionally, the hyoid serves as an attachment for anterior neck muscles and a prop to keep the airway open.

20. Good Luck