Skull Bones 2012

SKULL BONES
NEUROCRANIM & VISCEROCRANIUM

5. 10. 2012
Kaan Ycel
M.D., Ph.D.
http://yeditepeanatomy1.org
Dr.Kaan Ycel http://yeditepeanatomy1.org Skull bones
http://www.youtube.com/yeditepeanatomy
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The skeleton of the head is the skull. We rather use the ancient Greek term cranium, e.g. the cranial
neres. The skull has 22 !ones, e"cluding the ossicles of the ear. #"cept for the mandi!le, $hich forms the
lo$er %a$, the !ones of the skull are attached to each other !y sutures, are immo!ile, and form the cranium.
The part that is coering the cranial caity and the !rain in it is called neurocranium. The skeleton of the
face is called iscerocranium or facial skeleton. &t is the lo$er part of the cranium.
'ut of the 22 !ones in the skull, ( of them are in the neurocranium. They are:
) 1 *rontal !one+ the !one in the front of the head
) 1 'ccipital !one+ the !one at the !ack of the head
) 2 ,arietal !ones+ paries means $all, and these though !ones are on the lateral sides of the skull.
) 2 Temporal !ones+ temple has t$o meanings time and temple. Time can make more sense for
the temporal !ones, as $here they are the hair !ecomes grey first.
) 1 -phenoid !one in the middle .Greek sph/noeid/s $edge0shaped1
) 1 #thmoid !one again in the middle .&n 2oore3s te"t!ook it is part of the facial skeleton,though1
The skeleton of your face is made up !y the remaining 14 !ones of the cranium.
They are:
) T$o 5asal !ones
) T$o 2a"ill6
) 2andi!le
) T$o 7acrimal !ones
) T$o 8ygomatic !ones
) T$o ,alatines
) T$o &nferior 5asal 9onch6
) :omer
The inferior and anterior parts of the frontal lo!es of the !rain occupy the anterior cranial fossa, the
shallo$est of the three cranial fossae. The fossa is formed !y the frontal !one anteriorly, the ethmoid !one in the
middle, and the !ody and lesser $ings of the sphenoid posteriorly. The !utterfly0shaped middle cranial fossa has
a central part composed of the sella turcica on the !ody of the sphenoid and large, depressed lateral parts on each
side. The !ones forming the lateral parts of the fossa are the greater $ings of the sphenoid and s;uamous parts of
the temporal !ones laterally and the petrous parts of the temporal !ones posteriorly. The posterior cranial fossa,
the largest and deepest of the three cranial fossae is formed mostly !y the occipital !one, !ut the dorsum sellae of
the sphenoid marks its anterior !oundary centrally and the petrous and mastoid parts of the temporal !ones
contri!ute its anterolateral $alls.
-utura is that form of articulation $here the contiguous margins of the !ones are united !y a thin layer of
fi!rous tissue+ it is met $ith only in the skull. The ma%or suturae in the skull are+ coronal, lam!doid, and sagittal
suturues.
&mportant landmarks in the skull are:
<regma: The midline point $here the coronal and sagittal sutures intersect
7am!da: The midline point $here the sagittal and lam!doid sutures intersect.
Gla!ella: The most for$ard pro%ecting point in the midline of the forehead at the leel of the supra0or!ital
ridges and a!oe the nasofrontal suture
,terion: The point of intersection !et$een the frontal, sphenoid, parietal and the temporal !ones
5asion: The point of intersection !et$een the frontonasal suture and the midsagittal plane.
Gnathion: The most anterior and lo$est median point on the !order of the mandi!le
The !ones of the calaria of a ne$!orn infant are separated !y mem!ranous interals. They include the
anterior and posterior fontanelles and the paired sphenoidal and mastoid fontanelles.
The skeleton o the head is the skull. !e rather use the ancient "reek term #cranium$% e.g.
the cranial ner&es. The skull has '' bones% e(cluding the ossicles o the ear. )(cept or the
mandible% which orms the lower *aw% the bones o the skull are attached to each other by sutures%
are immobile% and orm the cranium. Suture is also a term used in surgical practices as #surgical
stitching o a wound$. +ctually suture in anatomy is a type o articulation where two articulation
suraces come together along a line% *ust like you sew them with a needle.
!e can di&ide the cranium into two or three parts. "enerally into two,
-et.s see% there is one part enclosing the brain/ protecting the brain% and there is another
part which makes the skeleton o your ace. The part that is co&ering the cranial ca&ity and the
brain in it is called neurocranium. The skeleton o the ace is called viscerocranium or acial
skeleton. 0t is the lower part o the cranium. 1ere the &iscera means organ% and on your ace there
is a list o organs/ your mouth% your nose% your eyes. The prei( neuro in the term neurocranium
*ust reers to the #ner&e$ telling you that this part o the skeleton o the head co&ers the brain and
meninges 2the membrane co&ering the brain3 within the cranial ca&ity.
+ third part o the skeleton o the head4 The part that co&ers the upper part o the head/
cal&aria 2skullcap3 #kaatas5$ in Turkish might be considered as a third part. 0 you add it into the
neurocranium% then the cranium has two parts. 6k4 So the neurocranium has one roo 2cal&aria3
and one loor/ the base 2base o the skull3 basicranium.
7uestion: which bones make up the neurocranium4 6ut o the '' bones o the cranium% 8
o them belong to the neurocranium. Some o them are paired which means you can ind one on
the right side% and one on the let side% and some o them are single.
1 Frontal bone/ the bone in the ront o the head
1 Occipital bone/ the bone at the back o the head
' Parietal bones/ #paries$ means wall% and these though bones are on the lateral sides o the
skull.
' Temporal bones/ #temple$ has two meanings #time$ and #temple$. Time can make more
sense or the temporal bones% as where they are the hair becomes grey irst.
1 Sphenoid bone in the middle 2Greek sphnoeids $edge0shaped1
1 Ethmoid bone again in the middle 20n 9oore.s te(tbook it is part o the acial skeleton%though3
http://twitter.com/yeditepeanatomy
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1.SKULL
+s you see only the temporal bones and the parietal bones abo&e them are paried
2bilateral3% and the other our bones are single 2unilateral3 which make the eight bones o the
neurocranium.
The neurocranium has a dome:like roo% the cal&aria 2skullcap3% and a loor or cranial base
2basicranium3. The bones making the cal&aria are primarily lat bones 2rontal% parietal% and
occipital3. The bones contributing to the cranial base are primarily irregular bones with substantial
lat portions 2sphenoidal and temporal3. The ethmoid bone is an irregular bone that makes a
relati&ely minor midline contribution to the neurocranium but is also part o the &iscerocranium.
!atch out, +lthough there is only a minor contribution o the ethmoid bone to the neurocranium% it
is counted under the bones o the neurocranium.
The skeleton o your ace is made up by the remaining 1; bones o the cranium.
They are:
Two <asal bones
Two 9a(ill=
9andible
Two -acrimal bones
Two >ygomatic bones
Two ?alatines
Two 0nerior <asal @onch=
Aomer
The &iscerocranium orms the anterior part o the cranium and consists o the bones surrounding
the mouth 2upper and lower *aws3% nose/nasal ca&ity% and most o the orbits 2eye sockets or orbital
ca&ities3. The &iscerocranium consists o 1; irregular bones: ' singular bones centered on or lying
in the midline 2mandible and &omer3 and B bones occurring as bilateral pairs 2ma(illae/ inerior
nasal conchae/ and Cygomatic% palatine% nasal% and lacrimal bones3.
The ma(illae and mandible house the teethDthat is% they pro&ide the sockets and supporting bone
or the ma(illary and mandibular teeth. The ma(illae contribute the greatest part o the upper acial
skeleton% orming the skeleton o the upper *aw% which is i(ed to the cranial base. The mandible
orms the skeleton o the lower *aw% which is mo&able because it articulates with the cranial base
at the temporomandibular *oints.
Se&eral bones o the cranium 2rontal% temporal% sphenoid% and ethmoid bones3 are
pneumatiCed bones% which contain air spaces 2air cells or large sinuses3% presumably to decrease
their weight. The total &olume o the air spaces in these bones increases with age.
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!hat we ha&e to do now is to see what each bone has: bone markings E ormations. The
inormation on each bone can be presented in two ways. The te(tbooks 29oore.s% "ray.s% and
Snell.s3 present the inormation on cranial bones by talking about the &iews rom anterior% inerior
and lateral aspects. +nother way might be talking about each bone one by one.0 will do it that way.
6n the other hand% 0 will also gi&e you the perspecti&e o #what you see when you look at the
anterior part o the skull or rom an inerior &iew$ at the end. Femember, To remember #repeating$
is the best way, So you will ha&e both the regional 2bones one by one3 perspecti&e and also the
&iews perspecti&e 2that o the te(tbooks3.
Gigure 1. Skull bones 2lateral &iew3
http://images.tutorvista.com/content/locomotion-animals/human-skull-structure.jpeg
2.1. FRONTAL BONE (OS FRONTALE)
Gigure '. Grontal bone
http://www.leaching-!ental.com/img/news/"#$.jpg
The rontal bone consists o two portions:
squama 2etymology: -atin% squama: scale/ squama frontalis3: vertical portion
corresponding with the region o the orehead
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2.BONES OF THE NEUROCRANIUM
The biggest part o the brain 2one third o a brain
hemisphere3/ the rontal lobe mostly resides on the rontal
lobe. The rontal bone orms the orehead. 0t also
contributes to the ormation o two ca&ities/ the orbital
cavity where the eyes are located and the nasal cavity
2the ca&ity inside your nose3.
orbital portion 2rontal orbit/ orbita frontalis3H horizontal partion
enters into the ormation o the roos o the orbital and nasal ca&ities
Gigure I. Grontal bone% sJuamous part
http://&irtual.yosemite.cc.ca.us/rdroual/-ectureK'L<otes/MnitK'L'/chapterNBNa(ialNskeletonNcopyK'LwithK'Ligures.htm
So you should take the rontal bone as two pieces/ one lat surace 2sJuama3 and one
horiContal surace orming the roo o the orbit 2the nest or the eye3. Grom now on% i a cranial
bone has a lat% smooth surace% it will be named as sJuamous part 2*ust like the one in the
occipital bone% back o the head3.
Anterior view
The supra-orbital margin of the frontal bone% the angular boundary between the
sJuamous and the orbital parts% has a supra-orbital foramen or notch in some crania or
passage o the supra:orbital ner&e and &essels. Oust superior to the supra:orbital margin and the
rim o the orbit there is a ridge% the superciliary arch. The prominence o these ridges% deep to
the eyebrows% is generally greater in males. Petween the superciliary arches is a small depression
2glabella3. The superciliary arches e(tend laterally on each side rom the glabella. 0n some
people% frontal eminences are also &isible% gi&ing the cal&aria an almost sJuare appearance.
9edially% the rontal bone pro*ects ineriorly orming a part o the medial rim o the orbit.
-aterally% the zygomatic process of the frontal bone pro*ects ineriorly orming the upper lateral
rim o the orbit. This process articulates with the frontal process of the zygomatic bone.
0n some adults a metopic suture% a persistent rontal suture or remnant o it% is &isible in
the midline o the glabella% the smooth% slightly depressed area between the superciliary arches.
The estimated pre&alence is 1 in 1Q%LLL li&e births with a I:1 male:emale ratio.
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Gigure ;. Grontal bone 2anterior &iew3
http://www.csuchico.e!u/anth/Mo!ule/%rontal.html
The internal surace o the sJuama rontalis o the rontal bone is conca&e and
presents in the upper part o the middle line a &ertical groo&e% the sagittal sulcus% the edges o
which unite below to orm a ridge% the frontal crest. The rontal crest is a median bony e(tension
o the rontal bone. +t its base is the foramen cecum 2blind hole3 o the rontal bone% which gi&es
passage to &essels during etal de&elopment. asal process is the downward pro*ection o the
nasal part o the rontal bone which terminates as the nasal spine.
Gigure Q. Grontal bone 2inner surace3
http://www.artle&.com/"'(/illus")*.html
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2.2. PARIETAL BONES
The two parietal bones unite and orm the sides and roo o the cranium. )ach bone is
irregularly Juadrilateral in orm. The e(ternal surace is con&e(% smooth% and marked near the
center by an eminence% the parietal eminence 2tuber parietale3. @rossing the middle o the bone
in an arched direction are two cur&ed lines% the superior and inferior temporal lines! The
parietal foramen is a small% inconstant aperture located posteriorly in the parietal bone near the
sagittal suture. ?aired parietal oramina may be present.
Gigure B. ?arietal bone 2lateral &iew3
http://me!ical-!ictionar&.the%ree!ictionar&.com/parietal+one
Gigure R. ?arietal bones 2anterior &iew3
http://a%taph&sio.logspot.com/#'"'/',/ones-o%-skull.html
2.3. TEMPORAL BONES
The temporal bones are situated at the sides and base o the skull. The temporal bone has
the temporal lobe on which is important or a long list o unctions including memory% emotional
memory% hearing. 0t has the canal that goes to the ear.
The temporal bone contributes most o the lower portion o the lateral wall o the cranium.
)ach temporal bone has i&e parts:
13 SJuamous part
'3 Tympanic part
(
I3 9astoid part
;3 ?etrous part
Q3 Styloid process
The squamous part has the appearance o a large lat plate% orms the anterior and superior
parts o the temporal bone% contributes to the lateral wall o the cranium% and articulates anteriorly
with the greater wing of the sphenoid bone at the sphenosquamous suture% and with the
parietal bone superiorly at the squamous suture. The zygomatic process is an anterior bony
pro*ection rom the lower surace o the sJuamous part o the temporal bone that initially pro*ects
laterally and then cur&es anteriorly to articulate with the temporal process o the Cygomatic bone to
orm the zygomatic arch.
The sJuamous part lies *ust lateral to the greater wing o the sphenoid. 0t participates in the
temporomandibular joint. 0t contains the mandibular fossa% which is a conca&ity where the
head o the mandible articulates with the base o the skull. +n important eature o this articulation
is the prominent articular tubercle% which is the downward pro*ection o the anterior border o the
mandibular ossa.
The tympanic part of the temporal bone is immediately below the origin o the Cygomatic
process rom the sJuamous part o the temporal bone. The e"ternal acoustic opening #pore$ is
the entrance to the e(ternal acoustic meatus 2canal3% which leads to the tympanic membrane
2eardrum3. The e(ternal acoustic opening is clearly &isible on the surace o this part.
The mastoid part is the most posterior part o the temporal bone. 0t is continuous with the
sJuamous part o the temporal bone anteriorly% and articulates with the parietal bone superiorly%
and with the occipital bone posteriorly.
6n the lateral edge o the mastoid part lies the cone:shaped mastoid process pro*ecting
rom its inerior surace. The mastoid process is a prominent structure and is the point o
attachment or se&eral muscles. 6n the medial aspect o the mastoid process is the deep mastoid
notch% which is also an attachment point or a muscle.
0mmediately lateral to the basilar part o the occipital bone is the petrous part of the
temporal bone. !edge:shaped in its appearance the petrous part o the temporal bone is
between the greater %ing of the sphenoid anteriorly and the basilar part o the occipital bone
posteriorly. The ape( orms one o the boundaries o the foramen lacerum% an irregular opening
illed in lie with cartilage. ?osterolateral rom the oramen lacerum along the petrous part o the
temporal bone is the large circular opening for the carotid canal.
A
The large opening between the occipital bone and the petrous part o the temporal bone is
the &ugular foramen!This oramen is &ery important as ma*or structures pass through this
oramen. The &ein draining the brain e(its the skull through the *ugular oramen. -ater on% in the
second year you will learn the 1' cranial ner&es. Three o them pass through the *ugular oramen
and go to their destinations e(iting the cranium. +nterosuperior to the *ugular oramen is the
internal acoustic meatus or the passage o two other cranial ner&es. 6ne o them is the ner&e
or the muscles o the ace% and the other is good or the hearing and balance.
The styloid process is needle:shaped bone marking. 0t pro*ects rom the lower border o
the temporal bone anteromedial to the mastoid process. The styloid process is a point o
attachment or numerous muscles and ligaments. The stylomastoid foramen' transmitting the
ner&e or the muscles o the ace lies posterior to the base o the styloid process/ between the
styloid process and the mastoid process.
Gigure 8. Temporal bone
http://me!icinems.logspot.com/#'""/'#/skull-anatom&.html
2.4. SPHENOID BONE
The sphenoid bone is situated at the base o the skull in ront o the temporal bones and
basilar part o the occipital bone. 0t somewhat resembles a bat with its wings e(tended% and is
di&ided into a median portion/ body% two great and two small wings e(tending outward rom the
sides o the body% and two pterygoid processes which pro*ect rom it below.
The greater and lesser %ings of the sphenoid spread laterally rom the lateral aspects o
the body o the bone. The pterygoid processes% consisting o lateral and medial pterygoid
plates% e(tend ineriorly on each side o the sphenoid rom the *unction o the body and greater
1B
wings. Pterygoid fossa is between the two plates. )ach medial plate o the pterygoid process
ends ineriorly with a hook:like pro*ection% the pterygoid hamulus.
The sphenoidal crests are ormed mostly by the sharp posterior borders o the lesser
wings o the sphenoid bones. The sphenoidal crests end medially in two sharp bony pro*ections%
the anterior clinoid processes.
The sella turcica 2-. Turkish saddle3 is the saddle:like bony ormation on the upper surace
o the body o the sphenoid% which is surrounded by the anterior and posterior clinoid
processes. @linoid means #bedpost%$ and the our processes 2two anterior and two posterior3
surround the hypophysial ossa% the #bed$ o the pituitary gland% like the posts o a our:poster bed.
The sella turcica is composed o three parts:
13 The tuberculum sellae 2horn o saddle3: a &ariable slight to prominent median ele&ation
orming the posterior boundary o the prechiasmatic sulcus and the anterior boundary o the
hypophysial fossa. 0t lies behind the chiasmatic groove. 6n both ends o the tuberculum sellae
are middle clinoid processes.
'3 The hypophysial fossa 2pituitary ossa3: a median depression 2seat o saddle3 in the body o
the sphenoid that accommodates the pituitary gland 2-. hypophysis3.
I3 The dorsum sellae 2back o saddle3: a sJuare plate o bone pro*ecting superiorly rom the
body o the sphenoid. 0t orms the posterior boundary o the sella turcica% and its prominent
superolateral angles make up the posterior clinoid processes.
6n each side o the body o the sphenoid% our oramina perorate the roots o the cerebral
suraces o the greater wings o the sphenoids:
Superior orbital fissure : -ocated between the greater and the lesser wings% it opens
anteriorly into the orbit.
Foramen rotundum #round foramen$ : -ocated posterior to the medial end o the superior
orbital issure.
Foramen ovale #oval foramen$ : + large oramen posterolateral to the oramen rotundum.
Foramen spinosum #spinous foramen$ : -ocated posterolateral to the oramen o&ale.
The foramen lacerum 2lacerated or torn oramen3 is not part o the crescent o oramina.
This ragged oramen lies posterolateral to the hypophysial ossa and is an artiact o a dried
cranium. 0n lie% it is partly closed by a cartilage plate.
Gigure S. Sphenoid bone 2anterior &iew3
http://virtual.&osemite.cc.ca.us/r!roual/-ecture.#'/otes/0nit.#'#/chapter1$1a2ial1skeleton1cop&.#'with.#'%igures.htm
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Gigure 1L. Goramina in the sphenoid bone 2superior &iew3 and other openings
http://me!chrome.com/wp-content/uploa!s/#'""/'*/skull-superior.jpg
2.5. OCCIPITAL BONE
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The occipital bone is situated at the back and lower part o the cranium. 0t is trapeCoid in
shape and cur&ed on itsel. 0t is pierced by a large o&al aperture% the foramen magnum% through
which the cranial ca&ity communicates with the &ertebral canal.
The oramen magnum is the most prominent eature o the cranial base. The ma*or
structures passing through this large oramen:
spinal cord #%here it becomes continuous %ith the medulla oblongata of the brain$
meninges #coverings$ of the brain and spinal cord
vertebral arteries
anterior and posterior spinal arteries
spinal accessory ner&e 2@< T03.
The our parts o the occipital bone are arranged around the oramen magnum:
13 The cur&ed% e(panded plate behind the oramen magnum is named the squama!
'3 The thick% Juadrilateral piece in ront o the oramen is called the basilar part.
I3 6n either side o the oramen is the lateral portion of the occipital bone.
The cranial base is ormed posteriorly by the occipital bone% which articulates with the sphenoid
bone anteriorly.
The e"ternal occipital protuberance% is usually easily palpable in the median plane/
howe&er% occasionally 2especially in emales3 it may not be prominent. The e"ternal occipital
crest descends rom the protuberance toward the oramen magnum.
The superior nuchal line marks the superior limit o the neck. 0t e(tends laterally rom
each side o the protuberance. The inferior nuchal line is less distinct.
6n the lateral parts o the occipital bone are two large protuberances% the occipital
condyles. The cranium articulates with the &ertebral column by the occipital condyles.
The clivus is a shallow depression% incline 2-atin or UslopeU3 behind the dorsum sell= that
slopes obliJuely backward. ?osterior to oramen magnum% the posterior cranial ossa is partly
di&ided by the internal occipital crest into bilateral large conca&e impressions% the cerebellar
fossae. The internal occipital crest ends in the internal occipital protuberance. +ctually% the
internal occipital crest is the lower di&ision o a cross called as cruciate eminence! The cruciate
eminence di&ides the interior surace o the occipital bone into our ossae. The superior two
ossae are triangular and lodge the occipital lobes o the cerebrum 2cerebral ossae3. The inerior
two are Juadrilateral and accommodate the hemispheres o the cerebellum 2cerebellar ossae3.
The internal occipital protuberance is the prominent ele&ation in the centre o the cruciate
eminence.
1=
The hypoglossal canal or the hypoglossal ner&e 2@< T003 is superior to the anterolateral
margin o the oramen magnum.
Gigure 11. 6ccipital bone 2inner surace3
2.6. ETHMOID BONE
"k% ethmos, sie&e siter% eidos, orm
The etmoid bone is e(ceedingly light and spongy% and cubical in shape/ it is situated at the
anterior part o the base o the cranium% between the two orbits% at the roo o the nose% and
contributes to each o these ca&ities. 0t consists o our parts: a horiContal or cribriform plate%
orming part o the base o the cranium/ a perpendicular plate% constituting part o the nasal
septum/ and two lateral ethmoidal labyrinths. The crista galli 2-. crest o the cock3 is a thick%
median ridge o bone posterior to the oramen cecum 2rontal bone3% which pro*ects superiorly rom
the ethmoid. 6n each side o the ridge called crista galli% located in the rontal bone% is the sie&e:
like cribriform plate of the ethmoid. 0ts numerous tiny oramina transmit the olactory ner&es 2@<
03 rom the olactory areas o the nasal ca&ities to the olactory bulbs o the brain% which lie on this
plate.
Gigure 1'. )thmoid Pone
http://me!ical-!ictionar&.the%ree!ictionar&.com/ethmoi!+one
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Gigure 1I. )thmoid bone.s location in the skull
http://www.!avi!!arling.in%o/images/ethmoi!1one.jpg

3.1. ANTERIOR CRANIAL FOSSA
The inerior and anterior parts o the rontal lobes o the brain occupy the anterior cranial
ossa% the shallowest o the three cranial ossae. The ossa is ormed by the rontal bone
anteriorly% the ethmoid bone in the middle% and the body and lesser wings o the sphenoid
posteriorly. The greater part o the ossa is ormed by the orbital parts o the rontal bone% which
support the rontal lobes o the brain and orm the roos o the orbits. This surace shows sinuous
impressions 2brain markings3 o the orbital gyri 2ridges3 o the rontal lobes.
3.2. MIDDLE CRANIAL FOSSA
The butterly:shaped middle cranial ossa has a central part composed o the sella turcica
on the body o the sphenoid and large% depressed lateral parts on each side. The middle cranial
ossa is posteroinerior to the anterior cranial ossa% separated rom it by the sharp sphenoidal
crests laterally. The bones orming the lateral parts o the ossa are the greater wings o the
sphenoid and sJuamous parts o the temporal bones laterally and the petrous parts o the
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3.CRANIAL FOSSAE
temporal bones posteriorly. The lateral parts o the middle cranial ossa support the temporal lobes
o the brain. The boundary between the middle and the posterior cranial ossae is the superior
border o the petrous part o the temporal bone laterally and a lat plate o bone% the dorsum sellae
o the sphenoid% medially.
3.3. POSTERIOR CRANIAL FOSSA
The posterior cranial ossa% the largest and deepest o the three cranial ossae% lodges the
cerebellum% pons% and medulla oblongata. The posterior cranial ossa is ormed mostly by the
occipital bone% but the dorsum sellae o the sphenoid marks its anterior boundary centrally and the
petrous and mastoid parts o the temporal bones contribute its anterolateral #walls.$ ?osterior to
oramen magnum% the posterior cranial ossa is partly di&ided by the internal occipital crest into
bilateral large conca&e impressions% the cerebellar ossae.
Gigure 1;. @ranial ossae
http://tmjc.com.ne.kr/tmj/in%o/!rin%o/images/tm$-$.jpg
4.1. NASAL BONES
The nasal bones are two small oblong bones% &arying in siCe and orm in dierent
indi&iduals/ they are placed side by side at the middle and upper part o the ace% and orm% by
their *unction% #the bridge$ o the nose. )ach has two suraces and our borders.
Gigure 1Q. <asal bone and other acial bones
http://uploa!.wikime!ia.org/wikipe!ia/commons/thum/(/((/3llu1%acial1ones.jpg/#*'p2-3llu1%acial1ones.jpg
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4.BONES OF THE VISCEROCRANIUM
4.2. MAXILL (UPPER A!)
The ma(illae are the largest bones o the ace% e(cepting the mandible% and orm% by their
union% the whole o the upper *aw. )ach assists in orming the boundaries o three ca&ities: the
roo o the mouth% the loor and lateral wall o the nose and the loor o the orbit. 0t has two issures%
the inferior orbital and pterygoma"illary fissures!
)ach bone consists o a body and our processesDzygomatic' frontal' alveolar' and
palatine. The ma(illae orm the upper *aw/ their al&eolar processes include the tooth sockets
2al&eoli3 and constitute the supporting bone or the ma(illary teeth. The two ma(illae are united at
the interma"illary suture in the median plane. The ma(illae surround most o the piriform
aperture and orm the inra:orbital margins medially. They ha&e a broad connection with the
Cygomatic bones laterally and an infraorbital foramen inerior to each orbit or passage o the
inra:orbital ner&e and &essels.
Gigure 1B. 9a(illa
http://www.proertenc&clopae!ia.com/41M563--5.78M
4.3. MANDIBLE (LO!ER A!)
1@
The mandible is the largest and strongest bone of the face% ser&es or the reception o
the lower teeth. 0t is a M:shaped bone with an al&eolar process that supports the mandibular teeth.
(entoalveolar syndesmosis #gomphosis or socket$ is a ibrous *oint in which a peglike process
its into a socket articulation between the root o the tooth and the al&eolar process o the *aw
2mandile or ma(illa3.
The mandible consists o a head' a cur&ed% horiContal portion% the body% and two
perpendicular portions% the rami 2sing. ramus% which means branch3. The two rami o the
mandible unite with the ends o the body nearly at right angles. Oust below the head o the
mandible% is the neck of the mandible.
The body o mandible is arbitrarily di&ided into two parts: the lower part is the base o
mandible/
the upper part is the al&eolar part o mandible. 'n the superior part o the ramus a condylar and
coronoid process e(tend upward. The condylar process is in&ol&ed in articulation o the mandible
with the temporal bone% and the coronoid process is the point o attachment or the temporalis
muscle. The head o the mandible enters the ossa mandibularis in the temporal bone when it
comes to the temporomandibular *oint.
)andibular notch is a deep conca&ity between the condylar and coronoid processes.
0nerior to the second premolar teeth are the mental foramina or the mental ner&es and &essels.
@ontinuing past this oramen is a ridge 2oblique line3 passing rom the ront o the ramus onto the
body o mandible. The obliJue line is a point o attachment or muscles that depress the lower lip.
The incisive canal is a continuation orward o the mandibular canal beyond the mental oramen
and below the incisor teeth.
The mental protuberance% orming the prominence o the chin% is a triangular bony ele&ation
inerior to the mandibular symphysis 2-. symphysis menti3% the osseous union where the hal&es o
the inantile mandible use. Oust lateral to the mental protuberance% on either side% are slightly
more pronounced bumps 2mental tubercles3.
I"#$%&'% (&$)
9edial to the condylar process is the pterygoid fossa. )andibular foramen lies inerior to this
ossa. *ingula is a tongue:like bony process o&er the mandibular oramen. The internal surace o
the body bears an obliJue ridge% the mylohyoid line% which begins a short distance below the last
molar tooth as a prominent crest. Pelow the mylohyoid line is a conca&e area% termed the
submandibular fossa% which lodges the submandibular sali&ary gland. Funning orward rom the
ramus into the submandibular ossa is the shallow mylohyoid groove which ades out anteriorly.
0mmediately abo&e the line is the shallow sublingual fossa or the sali&ary gland o the same
name. The inerior border o the body is marked% a little to each side o the midline% by the small%
1(
roughened digastric fossa or attachment o the anterior belly o the digastric muscle. The
digastric ossa is on either on either side o the symphysis menti.
Gigure 'I. 9andible 2-at.% mandibula3
http://%acial%ractures.logspot.com
4.4. LACRIMAL BONE
The lacrimale bone is the smallest and most ragile bone o the ace is situated at the ront part o
the medial wall o the orbit.
Gigure 1R. -acrimal bone
http://www.upstate.e!u/c!/e!ucation/grossanat/hnskullantl.shtml
4.5. *+,OMATIC BONES
cheek bones !"#"r bones
The Cygomatic bones are Juadrilateral bones. The Cygomatic bones orm the prominence o
the cheeks% and that is why we also call them as #the cheek bones$. They are located on the
ma(illae on each side and inerolateral sides o the orbits. The walls% loor and much o the inra:
orbital margins o the orbits are ormed by the Cygomatic bones.
1A
+ small zygomaticofacial foramen pierces the lateral aspect o each bone. The Cygomatic
bones articulate with the rontal% sphenoid% and temporal bones and the ma(illae.
Gigure 18. >ygomatic bone.s location in the skull Gigure 1S. >ygomatic bone
http://me!ical-!ictionar&.the%ree!ictionar&.com/9&gomatic+one http://www.upstate.e!u/c!/e!ucation/grossanat/hnskullant9#.shtml

4.6. PALATINE BONE
The palatine bone is situated at the back part o the nasal ca&ity between the ma(illa and
the pterygoid process o the sphenoid. 0t contributes to the walls o three ca&ities: the loor and
lateral wall o the nasal ca&ity% the roo o the mouth% and the loor o the orbit. 0t has one
horizontal plate% and a vertical #perpendicular$ plate. 0t also three prolongations/ orbital'
ma"illary #pyramidal$ and sphenoidal processes.
The hard palate 2bony palate3 is ormed by the palatine processes o the ma(illae anteriorly
and the horiContal plates o the palatine bones posteriorly. The ree posterior border o the hard
palate pro*ects posteriorly in the median plane as the posterior nasal spine. ?osterior to the
central incisor teeth is the incisive foramen% in the midline o the bony palate where blood &essels
and ner&es pass.
Superior to the posterior edge o the palate are two large openings: the choanae 2posterior
nasal apertures3% which are separated rom each other by the vomer 2-. plowshare3% a lat
unpaired bone o trapeCoidal shape that orms a ma*or part o the bony nasal septum.
Gigure 'L. ?alatine bone
http://me!ical-!ictionar&.the%ree!ictionar&.com/os+palatinum
2B
Gigure '1. 1ard palate
http://www.gla.ac.uk/ils/0:/cal/anatom&/cle%tpalate/%inal/har!p,(*.htm
4.-. INFERIOR NASAL CONCHA
Conch" N"s"#is In$erior% In$erior &'rbin"te( )one
The inerior nasal concha e(tends horiContally along the lateral wall o the nasal ca&ity. The
anterior and middle nasal conchae are not separate bones but parts o the ethmoid bone.
Gigure ''. 0nerior nasal concha
http://www.cnlp.ac.th/5natom&/page/apichat/one/page/in%erior-concha.html
4... VOMER
Aomer is a small bone in the midline% resting on the sphenoid bone. 0t contributes to the
ormation o the bony nasal septum separating the two choanae.
Gigure ';. Aomer
http://www.ask.com/wiki/;omer
21
Sutura is that orm o articulation where the contiguous margins o the bones are united by a thin
layer o ibrous tissue/ it is met with only in the skull.
5.1. CORONAL SUTURE
?arietal bones articulate with the rontal bone in their ront% orming the coronal suture.
5.2. LAMBDOID SUTURE
?arietal bones articulate with the occipital in their behind% orming the lambdoid suture.
5.3 .SA,ITTAL SUTURE
?arietal bone articulates with its the opposite side% orming the sagittal suture. Aerte(% the most
superior point o the cal&aria% is near the midpoint o the sagittal suture.
The coronal suture separates the rontal and parietal bones% the sagittal suture separates the
parietal bones% and the lambdoid suture separates the parietal and temporal bones rom the
occipital bone.
Gigure 'B. Suturae
http://uploa!.wikime!ia.org/wikipe!ia/commons/thum/'/'!/7uman1skull1si!e1suturas.svg/*#<p2-7uman1skull1si!e1suturas.svg.png
22
5.SUTURA
Pregma: The midline point where the coronal and sagittal sutures intersect
-ambda: The midline point where the sagittal and lambdoid sutures intersect.
"labella: The most orward pro*ecting point in the midline o the orehead at the le&el o the
supra:orbital ridges and abo&e the nasorontal suture
?terion: The point o intersection between the rontal% sphenoid% parietal and the temporal
bones
<asion: The point o intersection between the rontonasal suture and the midsagittal plane.
"nathion: The most anterior and lowest median point on the border o the mandible.
Gigure 'R. -andmarks o the skull
http://chesto%ooks.com/health/anatom&/7uman-=o!&->onstruction/>raniocereral-8opograph&.html
2=
-. FONTANELLES
6. IMPORTANT
LANDMARKS
The bones o the cal&aria o a newborn inant are separated by membranous inter&als.
They include the anterior and posterior ontanelles and the paired sphenoidal and mastoid
ontanelles. ?alpation o the ontanelles during inancy% especially the anterior and posterior ones%
enables physicians to determine the:
V ?rogress o growth o the rontal and parietal bones.
V Degree o hydration o an inant 2a depressed ontanelle indicates dehydration3.
V -e&el o intracranial pressure 2a bulging ontanelle indicates increased pressure on the
brain3.
The anterior fontanelle% the largest one% is diamond or star shaped/ it is bounded by the hal&es o
the rontal bone anteriorly and the parietal bones posteriorly. Thus it is located at the *unction o
the sagittal% coronal% and rontal sutures% the uture site o bregma. Py 18 months o age% the
surrounding bones ha&e used and the anterior ontanelle is no longer clinically palpable.
The posterior fontanelle is triangular and bounded by the parietal bones anteriorly and the
occipital bone posteriorly. 0t is located at the *unction o the lambdoid and sagittal sutures% the
uture site o lambda. The posterior ontanelle begins to close during the irst ew months ater
birth/ and by the end o the 1st year% it is small and no longer clinically palpable.
The sphenoidal and mastoid ontanelles use during inancy and are less important clinically than
the midline ontanelles.
The resilience o the cranial bones o inants allows them to resist orces that would produce
ractures in adults. The ibrous sutures o the cal&aria also permit the cranium to enlarge during
inancy and childhood. The increase in the siCe o the cal&aria is greatest during the irst ' years%
the period o most rapid brain de&elopment. The cal&aria normally increases in capacity or 1Q:1B
years. +ter this% the cal&aria usually increases slightly in siCe or I:; years as a result o bone
thickening.
Gigure '8. Gontanelles
http://me!ical-!ictionar&.the%ree!ictionar&.com/%ontanelle
24
HEAD INURIES
1ead in*uries are a ma*or cause o death and disability. The complications o head in*uries include
hemorrhage% inection% and in*ury to the brain and cranial ner&es.
FRACTURES OF THE CRANIAL FOSSAE
0n ractures o the anterior cranial ossa% the cribriorm plate o the ethmoid bone may be damaged.
Gractures o the middle cranial ossa are common% because this is the weakest part o the base o
the skull. +natomically% this weakness is caused by the presence o numerous oramina and
canals in this region/ the ca&ities o the middle ear and the sphenoidal air sinuses are particularly
&ulnerable.
2>
CLINICAL ANATOM+
How the bones are located in the skull?
Which bones/anatomical features do you see in each view
(anterior, lateral, posterior,superior views)?
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6%5"&39)
Gigure 'S. +nterior &iew o the skull
http://img.me!scape.com/pi/eme!/ck/clinical1proce!ures/?)<#(,-?)*<'"-#).jpg
2?
The anterior &iew o the skull includes the orehead superiorly% and% ineriorly%
the orbits% the nasal region% the part o the ace between the orbit and the upper *aw%
the upper *aw% and the lower *aw. Geatures o the anterior or acial 2rontal3 aspect o the
cranium are the rontal and Cygomatic bones% orbits% nasal region% ma(illae% and mandible.
8he %rontal one, speci%icall& its s@uamous A%latB part, %orms the skeleton o% the %orehea!,
articulating in%eriorl& with the nasal an! 9&gomatic ones.
8he 9&gomatic ones Acheek ones, malar onesB, %orming the prominences o% the cheeks,
lie on the in%erolateral si!es o% the orits an! rest on the ma2illae. 8he anterolateral rims, walls,
%loor, an! much o% the in%ra-orital margins o% the orits are %orme! & these @ua!rilateral ones.
8he 9&gomatic ones articulate with the %rontal, sphenoi!, an! temporal ones an! the ma2illae.
3n%erior to the nasal ones is the pear-shape! piri%orm aperture, the anterior nasal opening
in the cranium. 8he on& nasal septum can e oserve! through this aperture, !ivi!ing the nasal
cavit& into right an! le%t parts. Cn the lateral wall o% each nasal cavit& are curve! on& plates, the
nasal conchae.
8he ma2illae %orm the upper jawD their alveolar processes inclu!e the tooth sockets AalveoliB
an! constitute the supporting one %or the ma2illar& teeth. 8he two ma2illae are unite! at the
2@
interma2illar& suture in the me!ian plane. 8he ma2illae surroun! most o% the piri%orm aperture an!
%orm the in%ra-orital margins me!iall&. 8he& have a roa! connection with the 9&gomatic ones
laterall& an! an in%raorital %oramen in%erior to each orit %or passage o% the in%ra-orital nerve an!
vessels.
8he man!ile is a 0-shape! one with an alveolar process that supports the man!iular
teeth. 3t consists o% a hori9ontal part, the o!&, an! a vertical part, the ramus. 3n%erior to the
secon! premolar teeth are the mental %oramina %or the mental nerves an! vessels. 8he mental
protuerance, %orming the prominence o% the chin, is a triangular on& elevation in%erior to the
man!iular s&mph&sis A-. s&mph&sis mentiB, the osseous union where the halves o% the in%antile
man!ile %use.
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Gigure IL. Skull% lateral &iew
http://www.arthursclipart.org/me!ical/skeletal/skull.#'lateral.#'view.gi%
8he lateral aspect o% the cranium is %orme! & oth the neurocranium an! the viscerocranium .8he
main %eatures o% the neurocranial part are the e2ternal acoustic opening, an! the mastoi! process
o% the temporal one. 8he main %eatures o% the viscerocranial part are the 9&gomatic arch, an!
lateral aspects o% the ma2illa an! man!ile.
8he 9&gomatic arch is %orme! & the union o% the temporal process o% the 9&gomatic one an! the
9&gomatic process o% the temporal one.
8he e2ternal acoustic opening AporeB is the entrance to the e2ternal acoustic meatus AcanalB,
which lea!s to the t&mpanic memrane Aear!rumB. 8he mastoi! process o% the temporal one is
2(
posteroin%erior to the e2ternal acoustic opening. 5nterome!ial to the mastoi! process is the st&loi!
process o% the temporal one, a slen!er nee!le-like, pointe! projection.
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Gigure IL. Skull% posterior &iew
http://www.in%ovisual.in%o/')/'"$1en.html
8he posterior or occipital aspect o% the cranium is compose! o% the occiput A-. ack o% hea!, the
conve2 posterior protuerance o% the s@uamous part o% the occipital oneB, parts o% the parietal
ones, an! mastoi! parts o% the temporal ones. 8he e2ternal occipital protuerance, is usuall&
easil& palpale in the me!ian planeD however, occasionall& Aespeciall& in %emalesB it ma& e
inconspicuous. 5 craniometric point !e%ine! & the tip o% the e2ternal protuerance is the inion AE.
nape o% neckB. 8he e2ternal occipital crest !escen!s %rom the protuerance towar! the %oramen
magnum, the large opening in the asal part o% the occipital one. 8he superior nuchal line,
marking the superior limit o% the neck, e2ten!s laterall& %rom each si!e o% the protueranceD the
in%erior nuchal line is less !istinct. 3n the center o% the occiput, lam!a in!icates the junction o% the
sagittal an! the lam!oi! sutures . -am!a can sometimes e %elt as a !epression. Cne or more
sutural ones Aaccessor& onesB ma& e locate! at lam!a or near the mastoi! process.
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Gigure I1. Skull bones% superior &iew
http://www.ecomehealth&now.com/images/organs/ones/skull1ones1top1view.png
2A
8he superior AverticalB aspect o% the cranium, usuall& somewhat oval in %orm, roa!ens
posterolaterall& at the parietal eminences. 3n some people, %rontal eminences are also visile,
giving the calvaria an almost s@uare appearance.
8he coronal suture separates the %rontal an! parietal ones, the sagittal suture separates the
parietal ones, an! the lam!oi! suture separates the parietal an! temporal ones %rom the
occipital one. =regma is the craniometric lan!mark %orme! & the intersection o% the sagittal an!
coronal sutures. ;erte2, the most superior point o% the calvaria, is near the mi!point o% the sagittal
suture.
8he parietal %oramen is a small, inconstant aperture locate! posteriorl& in the parietal one near
the sagittal sutureD paire! parietal %oramina ma& e present.
CRANIAL BASE (BASE OF THE SKULL: BASICRANIUM: KAFA TABANI)
The cranial base 2basicranium3 is the inerior portion o the neurocranium 2loor o the cranial
ca&ity3 and &iscerocranium minus the mandible. The e(ternal surace o the cranial base eatures
the al&eolar arch o the ma(illae 2the ree border o the al&eolar processes surrounding and
supporting the ma(illary teeth3/ the palatine processes o the ma(illae/ and the palatine% sphenoid%
&omer% temporal% and occipital bones. The hard palate is a part o the e(ternal surace o the
cranial base.
The internal surace o the cranial base 2-. basis cranii interna3 has three large depressions that lie
at dierent le&els: the anterior% middle% and posterior cranial ossae% which orm the bowl:shaped
loor o the cranial ca&ity. The anterior cranial ossa is at the highest le&el% and the posterior cranial
ossa is at the lowest le&el.
Gigure I'. @ranial base
https://www#.ao%oun!ation.org/5CFile:erver:urger&/M&PortalFilesGFilePathH/:urger&/en/1img/surger&/'"-Diagnosis/,)/:kull-ase/,)1:=-
D1i*#'1-.gi%
=B
=1

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NEUROCRANIM & VISCEROCRANIUM

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