The A To Z Of Bones Of The Skull

The A to Z of Bones of The Skull

Dr A. L. Neill BSc MSc MBBS PhD FACBS [email protected]

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The A to Z of Bones of The Skull

The A to Z of the Bones of the Skull

Introduction After the A to Z of Skeletal Muscles was released to my students (and later my colleagues with the help of Aspen), I received some very valuable feedback from both. From this feedback it became apparent that this format was helpful to all in the health professional field. It was also apparent that there was a need for another pocket reference book of this type on bones and nerves. So as with the other book, I have started with a prototype examining the bones of one of the most complex group in the body, the SKULL. It is hoped that this proves to be as useful as my first A to Z book, and goes on to become a more comprehensive but quick and simple reference for all bones.

Acknowledgement I would like to thank Aspen Pharmacare Australia and particularly Mr Greg Lam CEO and Mr Robert Koster Head of Marketing and Sales for stepping in and giving me their support in this project when it seemed I was not going to be able to complete it, due to lack of resources and time. Students, as always, but particularly today have to sacrifice many things in their pursuit of knowledge. It is hoped that this book will help to make that pathway easier and more enjoyable. As with my other ventures in this A to Z series we want to give knowledge to any who wish to use it.

Dedication To MICKEY 390335, and to stopping pettiness, spite and misinformation wherever it lies. 1

© A. L. Neill

The A to Z of the Bones of the Skull

How to use this book After examining the SKULL as a WHOLE from many view points, identifying individual bones, cavities, impressions and surfaces and including common radiological views, with explanatory diagrams, this book lists all the bones of the skull in ALPHABETICAL order as far as possible. Images of the Skull “in situ” are also included. Features are named using in the most familiar terms and those agreed upon by anatomical nomenclature convention avoiding eponymous terms wherever possible but as with all anatomical studies sometimes several terms are used to name the same feature. Wherever this is common and to save confusion reference is made to each term. Similarly between disciplines such as radiology and osteology as well as anatomy the same view may be described several different ways, so when this is also common and to provide clarity these terms are mentioned. The pages facing each image contain the key/legends to the labels on that diagram. This is to help in the learning of the features and to prevent confusion in the examination of the bones. Numbering commences anew with each diagram. However, with some bones one view is not enough (e.g. Temporal and Sphenoid) to conceptualize all the surfaces and articulations, so these bones are then shown with the same numbering sequentially in an alphabetical way, on each related diagram. Occasionally they are also shown “in situ”, in other words as they lay in the skull. This is particularly the case with the Palatine bones. These bones are hard to see as they are surrounded by other structures and deeply embedded in the head, so several views and rotations of the bone are shown and labelled to see their connections, as well as a view showing how they are placed relative to other bones. © A. L. Neill

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The A to Z of the Bones of the Skull

Capitalization is used to demonstrate the bones involved in several structures including joints of all kinds (e.g. sutures). In other words the parietomastoid suture is listed as ParietoMastoid suture to further remind the reader of the involved bones or bony features involved in the composition of the structure. This helps to further orientate the reader to the structural components of the feature. It is hoped that this will prove a valuable resource for those examining individual bones as in the study of ANATOMY and its many uses such as: archeology, anthropology, chiropractic dentistry, forensics, geology, medicine, orthopaedics, osteology, paleontology, paleobiology, physiotherapy and surgery. It is to be a forerunner of a more complete listing of all bones from A to Z and a more extensive development of other aspects of the skull such as measurement markers, development milestones, individual and ethnic variations “the A to Z of the Skull part II”. Hence any suggestions on format or inclusions will be gratefully received. Thank you Amanda Neill BSc MSc MBBS PhD FACBS

ISBN 1 74138 166 5

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© A. L. Neill

Red spots indicate when there is an articulation or joint between the bones. Please note the hyoid does not articulate with any bones and the mandible articulates at the only synovial joint in the skull- the TMJ -temporomandibular joint. All other joints are secondary cartilagenous bone-fibrocartilage-bone.

The A to Z of the Bones of the Skull

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The A to Z of the Bones of the Skull

Table of contents Introduction Acknowledgement Dedication How to Use this book Table of Articulations of the Skull Common Terms used in Osteology Classification and summary of skull bones

1 1 1 2 4 7 12

The Skull 13-36 External Skull Anterior (norma frontalis) radiology - occipitofrontal (complete) radiology - occipitofrontal (upper aspect) radiology - occipitomental (lower aspect) External Skull Inferior (Base of Skull) (norma basilaris) radiology - submentovertical view (view from below) External Skull Lateral (norma lateralis) radiology - lateral External Skull Posterior (norma occipitalis) External Skull Superior (norma verticularis) Internal Skull Inferior - Skull Cap Internal Skull Superior - Internal Base - cranial fossae Bones of the Skull 37-70

Auditory Ossicles: malleus, incus and stapes enclosed within the Temporal bone Ethmoid bones Anterior & Lateral, Superior, Medial Frontal bone Hyoid bone Lacrimal bones Mandible radiology - Orthopantomogram = OPG (Anterior) radiology - Lateral (with soft tissue) radiology mandibular joint (jaw) open and closed see also TMJ (temporomandibular joint) Maxilla / Maxillae bones Maxillae bones Inferior

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The A to Z of the Bones of the Skull

Nasal bones Occipital External, Internal Palatine bones Parietal External, Internal Sphenoid Anterior, Posterior Sutural / Extrasutural bones - Incus Temporal External, Inferior, Interior Vomer Zygoma

Cavities of the Skull 71-90 Anterior Cranial Fossa Base of the Skull internal Cranial Fossae Anterior, Middle, Posterior Maxillary Sinus Middle Cranial Fossa Nasal cavity Dissected, Lateral, Septum Orbital cavity (Orbital fossa) Anterior radiology obital cavity anterior radiology orbital cavity lateral Posterior Cranial Fossa

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The A to Z of the Bones of the Skull

Common terms in Osteology (the study of bones) (with particular reference to the skull) Ala

A wing, hence a wing-like process as in the Ethmoid bone pl.- alae.

Alveolus

Air filled bone - tooth socket

Aperture

An opening or space between bones or within a bone.

Areola

Small, open spaces as in the areolar part of the Maxilla.

Articulation

Joint, which is a point of contact b/n 2 opposing bones.

Auditory

Pertaining to hearing, hence, pertaining to the ear.

Axial

Refers to the head and trunk (vertebrae, ribs and sternum) of the body.

Basilar

Relating to the base or bottom of structures

Basiocranium

Bones of the base of the skull

Boss

A smooth round broad eminence - mainly in the Frontal bone female > male

Bregma of

Refers to a junction of more than 2 bones in a joint as in the Bregma the skull, junction between the coronal and sagittal sutures which in the infant is not closed and can be felt pulsating - site of the anterior fontanelle.

Calotte

The calotte consists of the calvaria from which the base has been removed.

Calvaria

The calvaria refers to the cranium without the facial bones attached.

Canal

Tunnel / extended foramen as in the carotid canal at the base of the skull adj,- canular (canicular - small canal)

Caput / Kaput

The head or of a head, adj.- capitate = having a head (c.f.decapitate)

Carotid

To put to sleep; compression of the common or internal carotid artery causes coma. This refers to bony points related to the Carotid vessels

Cavity

An open area or sinus within a bone or formed by two or more bones (adj. cavernous), may be used interchangeably with fossa. Cavity tends to be more enclosed fossa a shallower bowl like space (Orbital fossa-Orbital cavity).

Cavum

A cave.

Cephalic

Pertaining to the head

Clinoid

Like a bed-post, part of a four poster bed so that clinoid process looks like a bed post (generally with other posts) as in the Sphenoid bone.

Clivus

A slope hence in the anterior cranial fossa referring to a slope on the base of the cavity.

Cochlea

A snail hence snail-like shape relating to the Organ of Corti in the ear.

Concha

A shell shaped bone as in the ear or nose (pl. conchae adj. chonchoid) old term for this turbinate.

Condyle

A rounded enlargement or process possessing an articulating surface.

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The A to Z of the Bones of the Skull Cornu

A horn (as in the Hyoid)

Corona

A crown. adj.- coronary, coronoid or coronal; hence a coronal plane is parallel to the main arch of a crown which passes from ear to ear (c.f. coronal suture).

Cranium

The cranium of the skull comprises all of the bones of the skull except for the mandible.

Crest

Prominent sharp thin ridge of bone formed by the attachment of muscles particularly powerful ones eg Temporalis/Sagittal crest

Cribiform / EthmoidA sieve or bone with small sieve-like holes. Cuneate / Cuneus A wedge / wedge-shaped Dens

A tooth hence dentine and dental relating to teeth, denticulate having tooth-like projections adj dentate See odontoid

Depression

A concavity on a surface

Diaphysis

The body of a long bone. In the young this is the region between the growth plates.

Diploë

The cancellous bone between the inner and outer tables of the skull, adj.- diploic.

Eminence

A smooth projection on a bone.

Endocranium

Refers to the interior of the “braincase” adj.- endocranial divided into the 3 major fossae anterior (for the Frontal lobes) middle (containing Temporal lobes) and posterior (for the containment of the Cerebellum).

Epiphysis

The end of a long bone beyond the growth plate or epiphyseal plate. There are 2 epiphyses to each long bone.

Euryon

The ectocranial point of the greatest breadth i.e. the widest point across the skull.

Facet

A face, a small bony surface (occlusal facet on the chewing surfaces of the teeth) seen in planar joints.

Fissure

A narrow slit or gap from cleft.

Fontanelle

A fountain, associated with the palpable pulsation of the brain as in the anterior fontanelle of an infant. These soft spots on the skull are cartilagenous connective tissue coverings “joints” which allow for skull cranial expansion and then become the mould for the bone development and shape joining long the sutural lines, later becoming the Bregma.

Foramen

A natural hole in a bone usually for the transmission of blood vessels and/or nerves.(pl. foramina).

Fornix

An arch

Fossa

A pit, depression, or concavity, on a bone, or formed from several bones as in temporomandibular fossa. Shallower and more like a “bowl” than a cavity

Fovea

A small pit (usually smaller than a fossa)- as in the fovea of the occlusal surface of the molar tooth.

Gallus / Galli

A cock, hence, crista galli, the cock's comb (i e possessive form of gallus).

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The A to Z of the Bones of the Skull Glabella

Most anterior midline point of the Frontal bone - that point between the eyebrows which should be hairless. This is the Latin derivation of this word.

Gnathion

Midline point which is the most inferior point of the Mandible.

Groove

long pit or furrow

Gyrus

A circle, hence a coil of brain cortex.

Hamus

A hook hence the term used for bones which “hook around other bones or where other structures are able to attach by hooking hamulus = a small hook.

Hyoid

U-shaped

Incisura

A notch.

Inter

between

Intra

within

Introitus

An orifice or point of entry to a cavity or space.

Jugum

A bridge between 2 halves of a bone pl.( juga) as in Sphenoid .

Lacerum

Something lacerated, mangled or torn eg foramen lacerum small sharp hole at the base of the skull often ripping tissue in trauma.

Lacrimal

Related to tears and tear drops. (noun lacrima)

Lambda

From the Greek letter a capital 'L' and written as an inverted V. (adj.- lambdoid) and used to name the point of connection between the 3 skull bones Occipital and Temporals.

Lamina

A plate as in the lamina of the vertebra a plate of bone connecting the vertical and transverse spines (pl. laminae)

Linea

A line as in the Nuchal lines of the Occitipum

Locus

A place (c.f. location, locate, dislocate).

Magnum

Large pl magna

Malleus

Hammer (as in the ear ossicle)

Mandible

From the verb to chew, hence, the movable lower jaw; adj.- mandibular.

Mastoid

A breast or teat shape - mastoid process of the Temporal bone.

Maxilla

The jaw-bone; now used only for the upper jaw; adj.- maxillary.

Meatus

A short passage; adj.- meatal as in external acoustic meatus connecting the outer ear with the middle ear.

Mental

Relating to the chin (mentum = chin not mens = mind).

Metaphysis

The slightly expanded end of the shaft of a bone.

Nasion

Midline point where the Nasal and Frontal bones meet .

Neurocranium

The neurocranium refers only to the braincase of the skull.

Notch

An indentation in the margin of a structure.

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The A to Z of the Bones of the Skull The nape or back of the neck adj.- nuchal. The prominent convexity of the back of the head Occipitum = Occipital bone adj.- occipital

Occulus

An eye

Odontoid

relating to teeth, toothlike see Dens

Opisthion

Midline point at the posterior margin of the Foramen Magnum

Orbit

A circle; the name given to the bony socket in which the eyeball rotates; adj - orbital.

Orifice

An opening.

Os

A bone adj osseus

Ossicle

A small bone as in the ear ossicles: stapes (stirrup), incus (anvil) and malleus (hammer).

Ostium

A door, an opening, an orifice.

Otic

Pertaining to the ear

Ovale

Oval shaped

Palate

A roof adj.- palatal or platatine.

Parietal

Pertaining to the outer wall of a cavity from paries, a wall.

Parotid

Pertaining to a region beside or near the ear

Pars

A part of

Pecten

A comb.

Petrous

Pertaining to a rock / rocky / stoney adj.- petrosal

Process

A general term describing any marked projection or prominence as in the mandibular process.

Prominens

A projection

Prosthion

Midline point of the maxilla alveolar bone which is most anterior

Pterion

A wing; the region where the tip of the greater wing of the sphenoid meets or is close to the parietal, separating the frontal from the squamous region of the temporal bone. (TERY- on) Alternatively the region where these 4 bones meet.

Pterygoid

Wing shaped

Recess

A secluded area or pocket; a small cavity set apart from a main cavity.

Rectus

straight - erect

Rhinion

Midline point of the free end of the Nasal bones where they join with the Nasal cartilages

Ridge

elevated bony growth often roughened.

Rotundum

Round

Sagittal

An arrow, the sagittal suture is notched posteriorly, making it look like an arrow by the lambdoid sutures.

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BONES OF THE SKULL

Nucha Occiput

The A to Z of the Bones of the Skull Sella

A saddle; adj.- sellar, sella turcica = Turkish saddle.

Sesamoid

grainlike

Sigmoid

S-shaped, from the letter Sigma which is S in Greek.

Sinus

A space usually within a bone lined with mucous membrane, such as the frontal and maxillary sinuses in the head, (also, a modified BV usually vein with an enlarged lumen for blood storage and containing no or little muscle in its wall). Sinuses may contain air, venous or arterial blood, lymph or serous fluid depending upon location and health of the subject adj.- sinusoid.

Skull

The skull refers to all of the bones that comprise the head.

Spheno

A wedge i.e. the Sphenoid is the bone which wedges in the base of the skull between the unpaired frontal and occipital bones adj.- sphenoid .

Spine

A thorn adj.- spinous descriptive of a sharp, slender process/protrusion.

Splanchocranium The splanchocranium refers to the facial bones of the skull. Sulcus

long wide groove often due to a BV indentation

Suture

The saw-like edge of a cranial bone that serves as joint between bones of the skull.

Stylos

An instrument for writing hence adj.- styloid a pencil-like structure.

Symphysis

A joint or a growth

Tectum

A roof.

Tegmen

A covering.

Temporal

Refers to time and the fact that grey hair (marking the passage of time) often appears first at the site of the temporal bone.

Tentorium

A tent.

Trabecula

A “little” beam i.e. supporting structure or strut pl. trabeculae

Tubercle

A small process or bump, an eminence..

Tuberculum

A very small prominence, process or bump.

Tuberosity

A large rounded process or eminence, a swelling or large rough prominence often associated with a tendon or ligament attachment.

Turbinate

A child’s spinning top, hence shaped like a top. An old term for the nasal conchae.

Tympanum

A drum pl. tympani

Uncus

A hook adj.- uncinate.

Vagina

A sheath; hence, invagination is the acquisition of a sheath by pushing inwards into a structure, and evagination is similar but produced by pushing outwards adj.- vaginal.

Zygoma

A yoke , hence, the bone joining the maxillary, frontal, temporal & sphenoid bones adj.- zygomatic.

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The A to Z of the Bones of the Skull

Classification and Summary of Skull bones Flat bones

Thin flattened and usually curved bones. Most Skull bones.

Irregular bones Various shapes not easily classified Sphenoid Long bone

Longer than wide 2 ends epiphysis and a central diaphysis. Growth mainly lengthwise. Most limb bones.

Pneumatic bone/Alveolar bone Bones filled with air to lighten their weight Maxilla, Frontal, Mandible and bones with “sinuses” Sesamoid bone Bones completely surrounded by soft tissue w/o joints Hyoid Short bone

Roughly cubic in shape. Most wrist and ankle bones; many of the bones at the base of the skull.

Sutural bone

“Wormian” bone small bones which occur within the skull sutures sometimes called extra-sutural if the main part of the bone is outside of the suture. Generally they are unnamed although the Incus is the name given to the large extra-sutural bone when present.

There are:

22 paired skull bones including the ear ossicles / not including the teeth. 5 single bones mainly on the base of the skull 1 mandible 1 hyoid variable sutural and extra-sutural bones (generally between 3-5)

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The A to Z of the Bones of the Skull

External Skull Anterior THE SKULL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

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Frontal bone Fronto-Nasal suture Inter-Nasal suture Nasal bone, Lacrimal bone Supra-Orbital foramen Spheno-Parietal suture Spheno-Frontal suture Spheno-Squamosal suture Zygoma Zygomatico-Maxillary suture Infra-orbital foramen Middle Nasal concha - turbinate (from Ethmoid bone) Inferior nasal concha - turbinate (from Ethmoid bone) Vomer Mandible Mental foramen Inter-Maxillary suture Maxilla Ethmoid bone (Orbital plate) Inferior Orbital fissure Temporo-Zygomatic suture Superior Orbital suture Fronto-Zygomatic suture Greater wing of the Sphenoid Coronal suture - Fronto-Parietal suture Lesser wing of the Sphenoid Optic foramen Metopic suture (rare) Fronto-Fronto suture Glabella

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The A to Z of the Bones of the Skull

THE SKULL

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The A to Z of the Bones of the Skull

External Skull Anterior THE SKULL

radiology occipitofrontal 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

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Sagittal suture Lamboid suture (view to the posterior) meeting at the Bregma Frontal sinus Lesser wing of the Sphenoid Supraorbital fissure Greater wing of the Sphenoid Fronto-Zygomatic suture Petrous ridge Anterior clinoid process Floor of the hypophyseal fossa + upper apex of nasal cavity adjacent to nasal sinuses Lateral pterygoid plate Base of the skull - floor of posterior cranial cavity Foramen rotundum Mastoid process Upper central incisor tooth Mandible

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The A to Z of the Bones of the Skull

THE SKULL

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The A to Z of the Bones of the Skull

THE SKULL

External Skull Anterior upper and lower views in detail radiology occipitofrontal (upper) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

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Frontal sinus Ethmoid sinus Maxillary sinus Foramen rotundum Supraorbital fissure Anterior clinoid process Posterior clinoid process Petrous ridge Floor of the hypophyseal fossa + upper apex of nasal cavity adjacent to nasal sinuses Crista galli Frontal process of zygoma Middle concha - turbinate Inferior concha - turbinate Lateral border of Greater wing of sphenoid Greater wing of sphenoid Lesser wing of sphenoid Hard palate Infraorbital foramen Zygomaticofacial foramen Coronoid process of the mandible Soft tissue of lower lid Pterygoid plates of the sphenoid

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The A to Z of the Bones of the Skull

THE SKULL

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The A to Z of the Bones of the Skull

THE SKULL

External Skull Anterior upper and lower views in detail radiology occipitomental (lower) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

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Frontal sinus Ethmoid sinus Maxillary sinus Foramen rotundum Supraorbital fissure Anterior clinoid process Posterior clinoid process Petrous ridge Floor of the hypophyseal fossa + upper apex of nasal cavity adjacent to nasal sinuses Crista galli Frontal process of zygoma Middle concha - turbinate Inferior concha - turbinate Lateral border of Greater wing of sphenoid Greater wing of sphenoid Lesser wing of sphenoid Hard palate Infraorbital foramen Zygomaticofacial foramen Coronoid process of the mandible Soft tissue of lower lid Pterygoid plates of the sphenoid

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The A to Z of the Bones of the Skull

THE SKULL

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The A to Z of the Bones of the Skull

External Skull Inferior THE SKULL

Base of Skull 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 21

Incisive fossa - Alveolare Medial Pterygoid plate and Hamulus (ethmoid) Posterior Nasal aperture Pterygoid plate (ethmoid) Lateral Pterygoid plate (ethmoid) Zygomatic arch Mandibular fossa External Auditory meatus Styloid process Mastoid process Parieto - Mastoid suture Occipito - Mastoid suture Foramen magnum External Occipital proturberance Sagittal suture - Parieto - Parieto suture Lambda Lambda suture Superior nuchal line (Occipital) Inferior nuchal line (Occipital) Occipital condyle Jugular foramen (fossa) Stylo-Mastoid foramen Carotid foramen - Carotid canal Foramen spinosum Foramen lacerum-Basilar suture Greater Palatine foramen Horizontal plate of Palatine Palatine process of the Maxilla Foramen ovale Alveolon © A. L. Neill

The A to Z of the Bones of the Skull

THE SKULL

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The A to Z of the Bones of the Skull

External Skull Inferior THE SKULL

radiology submentovertical view 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27

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Nasal septum (vomer and perpendicular plate of the ethmoid) Posterior border of vomer Maxillary sinus Ethmoid sinus Greater palatine foramen Lesser palatine foramen Sphenoid sinus Posterior orbital margin - greater wing of the sphenoid Posterior boundary of the maxillary sinus Zygomatic arch Lesser wing of the sphenoid Head of mandible condyloid process Foramen ovalae Foramen spinosum Spine of the sphenoid Foramen lacerum Clivus - base of the occipital and sphenoid bones Eustachian tube - (pharyngotympanic tube) Carotid canal Jugular foramen Stylomastoid foramen Anterior arch of the atlas (C1) Odontoid process of axis (C2) Occipital condyles Foramen magnum Canaliculus for tympanic nerve Inner and outer tables of the skull - Diploe

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THE SKULL

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The A to Z of the Bones of the Skull

External Skull Lateral THE SKULL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

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Frontal bone - Temporal ridges for attachment of Temporalis Bregma - Coronal suture Parietal bone Parieto-Temporal suture Lambda - Occipito-Parietal suture Occipital bone - Occipitum Occipito-Mastoid suture Porion - upper margin of external auditory meatus Mastoid process Temporal bone Styloid process Zygomatic arch Ramus of the Mandible Body of the Mandible Gnathion Maxilla Zygoma Prosthion Rhinion Nasal bone Lacrimal bone Nasion Glabella Frontal bone Greater wing of the Sphenoid

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THE SKULL

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The A to Z of the Bones of the Skull

External Skull Lateral / oblique THE SKULL

radiology 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

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Coronal suture Impression for Middle meningeal artery Lambdoid suture Wormian bone - Extrasutural bone Styloid process Posterior wall of Nasopharynx Clivus - (base of Sphenoid and Occiptal bones) Hypophyseal fossa Sphenoid sinus Greater wing of the Sphenoid Posterior Air cells in the Ethmoid - Ethmoid sinus Anterior Air cells in the Ethmoid - Ethmoid sinus Frontal sinus Zygoma - frontal process Maxilla - malar process Zygoma - Arch Posterior border of the Maxillary sinus Hard palate - Palatine bone Alveolar bone in Maxilla Pterygoid plates Soft tissue of Soft Palate and Uvula Mandibular canal Head of Mandible Coronoid process of Mandible

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THE SKULL

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The A to Z of the Bones of the Skull

External Skull Posterior THE SKULL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

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Sagittal sinus Parietal foramen Lambda Pareito - Occipital suture Occipital bone Lambdoid suture Superior nuchal line Highest nuchal line Superior nuchal line Mastoid process External Occitipal protruberance Inferior nuchal groove Superior nuchal groove Sutural bones - Inca Euyron Parietal bone

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The A to Z of the Bones of the Skull

THE SKULL

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The A to Z of the Bones of the Skull

External Skull Superior THE SKULL

1 2 3 4 5 6 7 8 9

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Occipital bone Lambdoid suture - Occipito-Parieto suture Parietal eminence - Euryon Frontal bone Bregma Coronal suture Parietal bone Sagittal suture Lambda

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THE SKULL

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The A to Z of the Bones of the Skull

Internal Skull Inferior THE SKULL

Skull cap 1 2 3 4 5 6 7 8 9 10 11 12 13 14

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Lambda Lambdoid suture Parietal foramen Diploe Bregma Coronal suture Frontal crest and Diploe - inner and outer tables of the skull bone Frontal bone Depressions for arachnoid granulations Grooves for middle meningeal vessels Parietal bone Sagittal suture Groove for superior sagittal sinus Occipital bone

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THE SKULL

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The A to Z of the Bones of the Skull

Internal Skull Inferior THE SKULL

Internal base – Cranial fossa

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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Cribiform plate Frontal sinus Crista Galli Orbital plate of Frontal bone Jugum of Sphenoid Optic canal Lesser wing of the Sphenoid bone Anterior Clinoid process Foramen rotundum Foramen lacerum Foramen ovale Foramen spinosum Dorsum sellae Internal acoustic meatus Jugular foramen Foramen magnum

A B C

POSTERIOR FOSSA MIDDLE FOSSA ANTERIOR FOSSA

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THE SKULL

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The A to Z of the Bones of the Skull

Ethmoid bones Anterior / Lateral / Medial / Superior Description - Light spongy bone the size and shape of an ice cube, located between the 2 orbital cavities. 1 2 3 BONES OF THE SKULL

4 5 6 7 8 9 10 11 12

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Ethmoidal labyrinth containing air cells (part of the Ethmoid sinus) continuous with the Sphenoid sinus Crista Galli Orbital plate of Ethmoid bone (part of the Orbital cavity) Middle Nasal concha Jugum of Sphenoid - Jugum Sphenoidale (Bridge connecting the 2 wings of the Sphenoid bone) Perpendicular plate of the Palatine bone Uncinate process Ala (of Crista Galli) Anterior groove (on the Ethmoid) Posterior groove (on the Ethmoid) Cribiform plate (entrance for the Olfactory nerve) Vomer

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Anterior

Lateral

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Medial

Superior

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Frontal bones Anterior / Lateral / Inferior Description - Unpaired largest and very robust anterior bone forming the forehead - horizontal section forming the roof of the orbit. 1 2 3 4

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Frontal tuberosity - Frontal bossing Superciliary arch Supraorbital margin and notch Nasal spine - medial to articulation with Lacrimal bones Superior and inferior temporal lines Superior Orbital plate - pars orbitalis Frontal and Ethmoid air cells - Frontal sinus Posterior Ethmoidal foramen Anterior Ethmoidal foramen Zygomatic process Supra - Orbital notch or foramen Lacrimal fossa Metopic suture - frontal suture, Glabella Frontal squama Ethmoidal notch

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Hyoid bone Description - Small U-shaped bone. Attached to the styloid processes via ligaments, this bone has no articulations and is not normally broken in normal trauma. It may be broken in hanging and strangulation. Body of hyoid Greater horn (cornu) Lesser horn (cornu)

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1 2 3

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Mandible Lateral / Posterior Description - The lower jaw bone joins the skull via a single paired joint the temporomandibular joint (TMJ) via the condyles and a cartilaginous plate in the Temporal fossa. Primary function - mastication.

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Mandibular notch Pterygoid fovea Head of Mandible - Condyle - Condylar process Neck of Mandible Posterior border of ramus of mandible Ramus - Vertical ramus Angle of mandible Oblique line Inferior border Body - Horizontal ramus Base Mental foramen Mental tubercle - Gnathion Mental protuberance Alveolar bone surrounding teeth Anterior border of ramus Coronoid process - Endocoronial ridge Mandibular foramen Lingula Superior and inferior mental spines Digastric fossa Mylohyoid line Mylohyoid groove Extramolar sulcus Infradentale

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The A to Z of the Bones of the Skull

Mandible Anterior radiology orthopantomogram = OPG Used to show mandibular fractures and an overview of sinuses and complete dentition

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Central incisor Lateral incisor Canine First premolar Second premolar First molar Second molar Pulp chamber Coronoid process Head of mandible Zygoma Maxillary sinus Anterior nasal spine of maxilla Vomer (nasal septum) Sites for the third molar Hard palate

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Mandible Lateral radiology Showing relationship to surrounding soft tissue

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Head of mandible – Condylar process Neck of the Mandible Hard Palate Soft Palate Anterior notch of the Atlas (C1) Odontoid process of the Axis (C2) – Dens Posterior aspect of the tongue Retropharyngeal sac Epiglottis Vallecula - fold anterior to epiglottis Hyoid bone

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Mandibular joint Temporo-Mandibular joint (TMJ) Lateral radiology Open - upper Shut - lower

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Head of mandible – Condylar process Neck of the Mandible Coronoid process Zygomatic arch External auditory meatus + Handle of the malleus Articular cubicle Tympanic plate Mastoid process Groove for posterior belly of Digastric muscle Mandibular fossa Greater wing of the sphenoid (basal surface) Lesser wing of the sphenoid

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Maxilla / Maxillae Bones Anterior / Lateral / Medial Description - Paired bones which form the dominant portion of the face and hold the upper teeth. The “overgrowth” of the maxilla is often the reason for orthodontic treatment.

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Frontal process Medial Orbital surface Infra-Orbital margin Zygomatic process Infra-Orbital foramen Nasal notch Nasal crest Anterior nasal spine Alveolar bone around teeth Tuberosity Infra-Temporal surface Orbital surface Palatine process Ethmoid crest Middle meatus Conchal crest Anterior Nasal spine premaxillary suture is here - fuses with completed jaw growth Incisive canal supported by the canine jugun Greater Palatine canal - groove Articulating surface - with Palatine bones Maxillary hiatus continues with the sinus Nasal Lacrimal process Alveolus -bone containing tooth root Canine jugun Inferior meatus © A. L. Neill

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Maxilla / Maxillae Bones Inferior

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Incisive fossa Median Palatine suture (Inter-Maxillary suture) Groove for greater Palatine vessels Palatine process of the Maxilla Greater Palatine foramen Palato-Maxillary suture Inter-Palatine suture Inferior Orbital fissure Lesser Palatine foramen Posterior Nasal spine Foramen spinosum Foramen ovale Carotid canal Foramen lacerum Occipital condyle Foramen magnum Palato-vaginal canal Pharyngeal tubercle Ala of Vomer Medial Pterygoid plate Lateral Pterygoid plate Infratemporal crest of Sphenoid Zygomatic arch Pyramidal process of the Palatine bone Maxillary tuberosity Left Third Molar tooth LM3 Left Second molar tooth - LM2 Left First molar tooth LM1 Left Second premolar tooth - LP2 Left First premolar tooth - LP1 Left Canine tooth LC1 Left Second incisor tooth - LI2 Left First incisor tooth LI1 © A. L. Neill

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Nasal Bones External (rotated 180 degrees to show) Internal (below) also see the Nasal Cavity to see the Nasal bones in situ Description - Small thin rectangular paired bones below the Glabella, the inferior edges form the top margin of the nasal aperture. Inferior nasal conchae - small snail shaped fragile bones extending along the lateral walls of the nasal cavity on top of the palatines. BONES OF THE SKULL

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Articulation surface with Frontal bone and Lacrimal bone Articuation surface with the Maxilla External surface Notch for external nasal nerve Foramen for Veins / Venous foramen Articulation with other nasal bone (here - Right nasal bone) Internal surface Groove for anterior Ethmoidal nerve

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Occipital bone External / internal Description - Large bowl like bone with a hole at the inferoposterior portion of the skull. Articulates with vertebral column C1 and C2.

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Superior angle Highest nuchal line Superior nuchal line Inferior nuchal line Mastoid margin Jugular process Condylar fossa Occipital condyle Foramen magnum Hypoglossal canal Condylar canal Lateral surface Lateral angle External / Internal Occipital crest Squamous surface External / Internal Occipital protuberance Lamboid margin Groove for superior sagittal sinus Cerebral fossa Groove for transverse sinus Attachment for Tentorium Cerebelli Groove for superior sigmoid sinus Jugluar notch Jugular tubercle Attachments for Falx Cerebri Opisthion Basion Occipital sulcus - Sagittal sinus © A. L. Neill

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Palatine bones (Left) Anterior / Lateral / Medial / Posterior / Sagittal Description - Delicate paired small bones L-shaped bones forming the palate and the floor of the nasal cavity.

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Perpendicular plate - vertical plate Palato-Maxillary suture Maxilla Orbital process Spheno-Papalatine notch Spenoidal process - Pterygo-Palatine canal Horizontal plane Pyramidal process - Posterior nasal spine Palatine bone Sphenoidal process Maxillary process Ethmoidal crest Greater Palatine groove Conchal crest

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Sagittal

Anterior

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Medial

Posterior

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Parietal bone (Left) External / Internal 1 2 3 4 5 6 BONES OF THE SKULL

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Superior Temporal line Parietal eminence Articulation with the Occipital bone (Lambdoid suture) Articulation with the Temporal bone (Mastoid) Parieto-Mastoid suture Articulation with the Temporal (Squamous) Temporo-Parietal suture Articulation with the Sphenoid (Greater wing) Spheno-Parietal suture Articulation with the Frontal bone Coronal suture Inferior Temporal line Groove for superior sagittal sinus Frontal angle Sphenoidal angle Groove for frontal branch of Middle Meningeal vessels Groove for parietal branch of Middle Meningeal vessels Mastoid angle Groove for sigmoid sinus Occipital angle Articulation between Parietal bones Sagittal suture Arachnoid granulations - Granular fovea Groove for transverse sinus

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The A to Z of the Bones of the Skull

Sphenoid Anterior / Posterior Description: A single wedge-shaped bone consisting of four parts: the central body; the lateral greater wings, the medial lesser wings and the lower Pterygoid plates. The bone looks like a bat in flight and is the centre piece of the skull.

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Articulation with Left Temporal bone Orbital surface Infratemporal crest Body of the Sphenoid Openings for sphenoidal sinuses Lesser Wing Squamosal suture - Articulation with Right Temporal bone Superior orbital fissure Foramen rotundum Pterygoid canal Rostrum Vaginal process Medial Pterygoid plate Pterygoid hamulus Pterygoid notch Lateral Pterygoid plate Pterygoid process Sphenoid spine Cerebral surface of the Greater Wing Anterior Clinoid process Posterior Clinoid process Dorsum Sellae Scaphoid fossa Occipital surface

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Temporal bone (Left) External / Inferior / Internal

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Description - Paired bones which are involved in both the wall and the base of the skull. They contain the auditory ossicles and form the only joint with the mandible. 1 2 3 4 5 6 7 8 9 0 hole) 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 65 suture

Suprameatal triangle Groove for middle Temporal artery Parietal notch Squamo-Mastoid suture Mastoid area Mastoid process Sheath of Styloid process Styloid process Tympanic part l External Acoustic meatus / anterior border (bony ear Tympanosquamosal (squamotympanic) fissure Mandibular fossa Zygomatic process Articular tubercle Postglenoid tubercle Squamous part - Squama Stylomastoid foramen Mastoid notch - Digastric groove Occipital groove Jugular surface Jugular fossa Canaliculus (opening) for Tympanic nerve Petrous part Carotid canal Edge of Tegmen Tympani Groove for the Middle Meningeal vessels Groove for the superior Petrosal sinus Articulation with the greater wing of the Sphenoid Spheno-Temporal suture Zygomatic process Groove for the Middle Meningeal vessels Internal Acoustic meatus Articulates with the Occipital bone Aqueduct of the Vestibule Mastoid foramen Groove for sigmoid sinus - Sigmoid sulcus Arcuate eminence Articulates with the parietal bone - Temporoparietal © A. L. Neill

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The A to Z of the Bones of the Skull

Vomer Lateral / Posterior / in situ Description - A single small narrow frail plough-shaped midline bone. Deviation of this bone may obstruct the nasal airways. 1 2

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Ala (Alae) Articulation with Maxillae and Palatine Maxillovomer suture / palatinovomer suture Groove for the nasopalantine nerves and vessels Articulation with nasal cartilages Articulation with Sphenoid bone Articulation with the Ethmoid plate Perpendicular plate of the Ethmoid Body of Vomer Maxillae areolar bone Medial pterygoid plate Frontal bone Sphenoid sinus Anterior of nasal bones Frontal sinus

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lateral

Posterior BONES OF THE SKULL

in situ

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Zygoma Antero-Lateral / Postero-Medial Description - Paired cheek bones which form the prominent corners of the face under the orbital rim.

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Frontal process Zygomatico-Facial formina Articulation with the Frontal bone Articulation with the Sphenoid Zygomatico-Orbital foramina Articulation with Maxilla Zyomatico-Temporal foramina Temporal process Maxillary process Orbital surface

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Anterior Cranial Fossa Superior view from the top 1 2 3 4 5 6 7 8 9 10

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Frontal sinus Frontal crest Foramen Caecum Cranionasal exit of the anterior ethmoidal nerve Slit for the process of the dura mater Anterior Ethmoidal groove Concealed entry for the anterior Ethmoidal nerve Posterior Ethmoidal groove Concealed entry for the posterior Ethmoidal nerve Jugam Sphenoidale Optic canals Anterior Clinoid process Fronto-Sphenoid suture Lesser wing of the Sphenoid Vascular foramen Diploe Orbital plate of the Frontal bone Crista Galli

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Maxillary Sinus (Left) Sagittal

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Frontal sinus Anterior Ethmoidal foramen Orbital plate of Ethmoid Posterior Ethmoidal foramen Lesser wing of the Sphenoid Pterygo-Maxillary fissure Perpendicular plate of the Palatine Alveolar processes of the Maxilla Maxillary Sinus - opened Inferior concha, Maxillary process Anterior Nnasal spine Uncinate process of the Ethmoid Nasal bone Lacrimo-Maxillary suture Supra-Orbital foramen Frontal bone

Description: Maxilla - sinuses within this bone -particularly around the teeth may cause toothache, complicate endodontic (root canal) treatment; or act as a conduit for tooth/nasal/other infection to enter the blood stream.

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Middle Cranial Fossa (Left) Superior view from the top Greater wing of the Sphenoid Superior Orbital fissure Middle Clinoid process Optic canal Anterior Clinoid process Hypophysial fossa Posterior Clinoid process Dorsum Sellae Foramen lacerum Trigeminal impression Foramen rotundum Groove for superior petrosal sinus Groove for greater petrosal nerve Diploe Arcuate eminence Tegmen typani Temporal bone Groove for the Parietal branch of the middle Meningeal vessels

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Nasal Cavity - dissected to show Right nasal cavity and inferior nasal conchae Para - Sagittal section of Right Nasal cavity looking in through the Right side of the nose to show sinuses around the area 1 2 3 4 5 6 7 8 9 10

Semilunar hiatus Ethmoid bulla Air cells of Ethmoid sinus Sphenoidal sinuses Spheno-Palatine foramen Perpendicular plate of the palatine Inferior nasal concha and meatus Opening of the maxillary sinus Uncinate process of Ethmoid bone Right Frontal sinus

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Note middle and superior nasal conchae have been dissected and removed.

Description: inferior nasal conchae - small paired frail bones extending along the lateral walls of the nasal cavity. Involved in olfaction, humidification. Highly vascularized and when the soft tissue surrounding this is swollen, it may cause nasal obstruction and sinuses. Please note when "picking one's nose" the finger never reaches the nasal conchae, stopping just short of this area. 77

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Nasal Cavity dissected to show lateral wall of right nasal cavity Sagittal section of Lateral Right nasal cavity looking in to the lateral side of the right side of the nose Middle concha Middle concha meatus Superior concha Superior concha meatus Sphenoid sinus Medial Pterygoid plate Spheno-Palatine foramen Perpendicular plate of Palatine bone Palato-Maxillary suture Incisive fossa and canal Inferior concha and meatus Maxilla Lacrimal bone Nasal bone Right Frontal sinus Left Frontal sinus

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Nasal Cavity dissected to show medial wall of the nasal cavity Sagittal section of Nasal cavity looking in to the medial wall of the nose in front of the right nasal cavity Right Frontal sinus Crista Galli Left Sphenoidal sinus Right Sphenoidal sinus Vomer Pterygoid hamulus Maxilla Anterior Nasal spine Inferior concha Perpendicular plate of the Ethmoid Nasal bone Nasal spine of the Frontal bone Left Frontal sinus

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Orbital Cavity / Fossa (Left) Anterior view from the front

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Lesser wing of the Sphenoid Optic foramen Anterior and Posterior Ethmoidal foramina Lacrimal bone Nasal bone Orbital plate of the Ethmoid bone Orbital plate of the Maxilla Infraorbital foramen Infraorbital groove Zygoma Inferior Orbital fissure Foramina for Zygomatic branch of the Facial nerve Orbital surface of the Zygoma Greater wing of the Sphenoid Superior Orbital fissure Orbital plate of the Frontal bone Supra-Orbital margin Supra-Orbital foramen

Eyeball and muscles all sit in this cavity with the Optic nerve entering from the posterior part of the cavity through the Orbital foramen.

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Orbital cavity Inferoanterior radiology (also Orbital fossa Optic cavity Optic foramen) Frontal sinus Foramen ovale Infraorbital foramen Foramen rotundum Hard palate –floor of nasal cavity Maxillary antrum Lateral wall of maxillary antrum Zygomatic arch Sphenoid sinus Soft tissue of nose and lower lid

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Optic Cavity Lateral / oblique radiology Optic foramen Supraorbital ridge Sphenoid ridge Frontal bone Sphenoid sinus (note clear no fluid lines as with sinusitis) Anterior clinoid process Posterior clinoid process Frontal process of zygoma Zygomatic arch Lateral border of greater wing of the sphenoid

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Posterior Cranial Fossa Superior view from the top Dorsum sellae Groove for inferior Petrosal sinus Groove for superior Petrosal sinus Internal Acoustic meatus Concealed crevice for Endolymphatic sac Mastoid emissary foramen Occipito-Mastoid suture Diploe Lambdoid suture Groove for transverse sinus Fossa for Right Occipital lobe of the Cerebrum Fossa for Right Cerebellar hemisphere Internal Occipital proturberance Internal Occipital crest Groove for sigmoid sinus Foramen magnum Hypoglossal canal Jugular formamen Clivus: Basi-Occipital Clivus: Basi-Sphenoid Posterior Clinoid process

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Biography and Aim of the A to Z and Dr Amanda Neill Dr Amanda Neill has a medical degree with specializations and research in the areas of Histology, Pathology, and Anatomy and Forensic medicine, with a separate specialization (MSc in renal glomerular disease). After teaching for many years at university of Sydney and completing her PhD on “the immunopathology of cerebral malaria” Amanda developed the only accredited RCAGP continuing education course on anatomy. Developing courses on the anatomy of the Back (Back to the Back) and the Head and Neck the PG program for Dental graduates and writing a number of manuals, booklets and programs for medical, dental, nursing and other health students. Qualifying as a GMP (Graduate medical program) facilitator she has seen and been involved in the transition form the classic medical course to the GMP and the integration and amalgamation of the classic preclinical and clinical medical subjects to the total self directed computer content based course. Moving to Macquarie University, she brought and developed her anatomy and histology program from scratch, conceptualizing and developing the virtual anatomy laboratory using her Flagship grant. This massive project is still in development. Despite modern computer developments and because of her diverse teaching, research and medical background Amanda knows the value of learning the fundamental building blocks the A to Z of health and medicine in order to write and know the whole medical book. She is passionate about developing accessible and wide reaching medical and educational programs for all levels: the student, the postgraduate, the health and medical professional. Particularly in anatomy and its branches after all we are all ANATOMY!! Looking for collaboration in her projects Amanda developed links with the NSW Department of Forensic medicine, the University of Sydney, the Coroner’s court, the Royal colleges of Anaethetists and Biomedical scientists (of which she is currently the secretary) and commercial sponsors such as Aspen. So anatomy@mac has spread and involved students from all the university divisions and the all walks of life. Always looking to improve accessibility and application of knowledge and skills (such as Anatomy in Action and morphing@mac Art Anatomy exhibitions) and schools science projects Amanda and Aspen are collaborating on a series of A to Z pocket references to be used as handy guides and aids for all those interested in health and medicine, particularly the busy medical practitioner. We want these to be a guide and a help for you and want your help and feedback in order to make the manuals and the accompanying websites a benefit for you. You can be a part of this project too. Write to us And Of course if you want to get a HEAD do Amanda’s A to Z. 91

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WHAT is WRONG with this ??!!!

write to us for the answer. E-mail: [email protected]

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94

For Bronchitis, Sinusitis and Otitis Media.

For skin and soft tissue infections and ...urinary tract infections

TAZAC

for

REFLUX

(nizatidine)

Dr. A. L. NEILL BSc MSc MBBS PhD FACBS

[email protected] www.amandasatoz.com 0414248747 Contact www.aspenpharma.com.au for login and passwords for the complete A to Z and the AspenAtlas online.

Aspen Pharmacare Australia Pty Ltd 34-36 Chandos Street, St Leonards NSW 2065 ABN 51 096 236 985