Bones of the cranium

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Bones of the cranium

ETP Neurological System

ETP Neurological System

Bones of the cranium
Anatomy of the cranial base
Anatomy of the cerebral cortex
Anatomy of the cerebellum
Anatomy of the cranial meninges and dural venous sinuses
Anatomy of the brainstem
Anatomy of the basal ganglia
Anatomy of the white matter tracts
Anatomy clinical correlates: Vertebral canal
Introduction to the cranial nerves
Cranial nerve pathways
Anatomy of the olfactory (CN I) and optic (CN II) nerves
Anatomy of the oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves
Anatomy of the trigeminal nerve (CN V)
Anatomy of the facial nerve (CN VII)
Anatomy of the brachial plexus
Anatomy clinical correlates: Median, ulnar and radial nerves
Vessels and nerves of the gluteal region and posterior thigh
Development of the nervous system
Central nervous system histology
Peripheral nervous system histology
Nervous system anatomy and physiology
Neuron action potential
Cerebral circulation
Blood brain barrier
Cerebrospinal fluid
Cranial nerves
Ascending and descending spinal tracts
Motor cortex
Pyramidal and extrapyramidal tracts
Muscle spindles and golgi tendon organs
Spinal cord reflexes
Sensory receptor function
Somatosensory receptors
Somatosensory pathways
Sympathetic nervous system
Adrenergic receptors
Parasympathetic nervous system
Cholinergic receptors
Enteric nervous system
Body temperature regulation (thermoregulation)
Hunger and satiety
Cerebellum
Basal ganglia: Direct and indirect pathway of movement
Memory
Sleep
Consciousness
Learning
Stress
Language
Emotion
Attention
Spina bifida
Chiari malformation
Dandy-Walker malformation
Syringomyelia
Tethered spinal cord syndrome
Aqueductal stenosis
Septo-optic dysplasia
Cerebral palsy
Spinocerebellar ataxia (NORD)
Transient ischemic attack
Ischemic stroke
Stroke: Clinical
Intracerebral hemorrhage
Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
Saccular aneurysm
Arteriovenous malformation
Broca aphasia
Wernicke aphasia
Wernicke-Korsakoff syndrome
Kluver-Bucy syndrome
Concussion and traumatic brain injury
Shaken baby syndrome
Seizures: Pathology review
Seizures: Clinical
Seizures and epilepsy
Febrile seizure
Early infantile epileptic encephalopathy (NORD)
Headaches: Pathology review
Tension headache
Cluster headache
Migraine
Idiopathic intracranial hypertension
Trigeminal neuralgia
Cavernous sinus thrombosis
Alzheimer disease
Vascular dementia
Frontotemporal dementia
Dementia with Lewy bodies
Creutzfeldt-Jakob disease
Normal pressure hydrocephalus
Torticollis
Essential tremor
Restless legs syndrome
Parkinson disease
Huntington disease
Opsoclonus myoclonus syndrome (NORD)
Multiple sclerosis
Central pontine myelinolysis
Acute disseminated encephalomyelitis
Transverse myelitis
JC virus (Progressive multifocal leukoencephalopathy)
Adult brain tumors
Acoustic neuroma (schwannoma)
Pituitary adenoma
Pediatric brain tumors
Brain herniation
Brown-Sequard Syndrome
Cauda equina syndrome
Treponema pallidum (Syphilis)
Vitamin B12 deficiency
Friedreich ataxia
Neurogenic bladder
Meningitis, encephalitis and brain abscesses: Clinical
Meningitis
Neonatal meningitis
Encephalitis
Brain abscess
Epidural abscess
Sturge-Weber syndrome
Tuberous sclerosis
Neurofibromatosis
von Hippel-Lindau disease
Amyotrophic lateral sclerosis
Spinal muscular atrophy
Poliovirus
Guillain-Barre syndrome
Charcot-Marie-Tooth disease
Bell palsy
Winged scapula
Thoracic outlet syndrome
Carpal tunnel syndrome
Ulnar claw
Erb-Duchenne palsy
Klumpke paralysis
Sciatica
Myasthenia gravis
Lambert-Eaton myasthenic syndrome
Orthostatic hypotension
Horner syndrome
Congenital neurological disorders: Pathology review
Cerebral vascular disease: Pathology review
Traumatic brain injury: Pathology review
Spinal cord disorders: Pathology review
Dementia: Pathology review
Central nervous system infections: Pathology review
Movement disorders: Pathology review
Neuromuscular junction disorders: Pathology review
Demyelinating disorders: Pathology review
Adult brain tumors: Pathology review
Pediatric brain tumors: Pathology review
Neurocutaneous disorders: Pathology review
Cholinomimetics: Direct agonists
Cholinomimetics: Indirect agonists (anticholinesterases)
Muscarinic antagonists
Sympathomimetics: Direct agonists
Sympatholytics: Alpha-2 agonists
Adrenergic antagonists: Presynaptic
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Nonbenzodiazepine anticonvulsants
Migraine medications
General anesthetics
Local anesthetics
Neuromuscular blockers
Anti-parkinson medications
Medications for neurodegenerative diseases
Opioid agonists, mixed agonist-antagonists and partial agonists
Opioid antagonists

Notes

Figure 1: Bones of the cranium A. lateral and B. anterior views.
Figure 2: Anatomy of the maxillary and zygomatic bones, A. anterior and B. lateral views.
Figure 3: Anatomy of the frontal bone, A. lateral, B. anterior, and C. superior views.
Figure 4: Anatomy of the ethmoid bone, A. anterior view and B. lateral view.
Figure 5: Anatomy of the temporal bone, A. lateral view, and B. superior view.
Figure 6: Anatomy of the mandible, A. lateral and B. anterior view.
Figure 7: Anatomy of the calvaria, A. lateral and B. superior view.
Illustrator: Elizabeth Shapiro, MSMI, CMI
Editor: Leah Lebranche
Editor: Andrew Horne

Transcript

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The cranium, or skull, is the bony structure that protects the structures found inside our head, and it’s divided into two parts: the viscerocranium and the neurocranium. Viscera- refers to the organs within the body cavities, so the viscerocranium is the lower and anterior part of the skull that forms the orbits, the nasal cavities, and the oral cavities; in other words, the facial skeleton. Neuro-, on the other hand, refers to the nervous system, so the neurocranium, also called the cranial cavity, is the superior and posterior part of the skull that houses the brain, and its membranous coverings - the cranial meninges - and also blood vessels and the proximal parts of the cranial nerves

Let’s look at the viscerocranium first, which is actually made up of 15 bones! Only three of them are unpaired bones, and they sit on the midline: the mandible, ethmoid, and vomer; then there are six pairs of paired, symmetrical bones: the maxillae, the inferior nasal conchae, as well as the zygomatic, palatine, nasal, and lacrimal bones. Most of these bones articulate with each other by fibrous - or immovable - joints; except for the mandible, which articulates only with the temporal bones by a synovial - or movable - joint. 

Next, the neurocranium is made up of eight bones: the frontal, ethmoid, sphenoid, and occipital bones, which are singular and placed in the midline; then two temporal and two parietal bones, which are bilaterally paired. All these bones articulate by fibrous joints. In addition, the neurocranium can be further divided into the calvaria - or skullcap - and the cranial base, which would be like the roof and the floor of the neurocranium, respectively. The cranial base is where the foramen magnum is found, where the spinal cord is continuous with the brain. 

Alright, so let’s get started with the bones of the viscerocranium. If you get face to face with a skull, you'll see the most bones of the viscerocranium. The maxillary bones occupy most of the surface. On each side there are the zygomatic bones, which form the skeleton of the cheek. Medial to the superior part of the maxillary bones, there's the nasal bones, and laterally there's the lacrimal bones. Now, if you look inside the piriform aperture, which is the opening to the nasal cavity, you can see the nasal septum formed by the ethmoid bone superiorly, and the vomer inferiorly. You can also see the middle nasal conchae, which are also part of the ethmoid bone; and the inferior nasal conchae, which are their own separate bones. The most inferior bone of the face is the mandible. The only bones you won't see from this view, are the palatine bones, which are behind the maxillary bones.

Let's begin with the maxillary bones. These are two big irregular bones placed in the middle part of the face that form the upper jaw and help form the boundaries of the orbits, the nasal cavity, and the mouth. They articulate with one another on the midline, at the intermaxillary suture. The inferior border of each bone is called the alveolar process; that consists of a number of cavities, or alveoli, for the upper or maxillary teeth. The anterior border of both bones together form the piriform or nasal aperture. The superior border helps form the lower orbital margin, and the posterior border articulates with the sphenoid to help form the infratemporal fossa. Laterally, the maxilla articulates with the zygomatic bones, and anterior to this articulation and inferior to each orbit there’s the infraorbital foramina, through which the infraorbital nerve and vessels pass. Superior and anteriorly, the maxilla frontal process articulates with the nasal, frontal, and lacrimal bones.

Moving on to the zygomatic bones, these are two quadrilateral bones situated inferior and lateral to the orbits, so they’re also called malar or cheekbones. In the center, they have a small opening called the zygomaticofacial foramen, through which the zygomaticofacial vessels and nerves pass in order to reach the cheeks, and make us blush when complimented. The zygomatic bones articulate with other bones of the facial skeleton through four processes: the frontal process, which articulates superiorly with the frontal bone; the orbital process, which articulates with the maxillary and sphenoid bone to form the floor of the orbit and also forms the lateral and inferior rims of the orbit; the maxillary process, which articulates inferiorly with the maxillary bone; and the temporal process, which articulates with the temporal bone to form the zygomatic arch, and contributes the inferior boundary of the temporal fossa.

Okay now, moving forward to the unpaired bones, let's take a look at the mandible. It's the bone that forms the lower jaw and results from the union of two bones in the midline at the mandibular symphysis. The mandible consists of two parts: the body, which is horizontal, and a vertical ramus on each side. The angle where each ramus joins the body is called the angle of the mandible, where part of the masseter muscle inserts. The body of the mandible presents the mental protuberance, which defines the shape of our chin. A bit lateral and posterior to the mental protuberance, there’s the mental foramen, a hole through which the mental vessels and nerve pass. The superior border of the body is called the alveolar process that supports the mandibular teeth. The superior border of each ramus has a coronoid process anteriorly, which is thin and triangular, with the mandibular notch posterior to it. The mandibular notch is a concave depression that separates the coronoid process from the condyloid process posterior to it, which is thick and round-shaped, and articulates with the mandibular fossa of the temporal bone to form the temporomandibular joint

Sources

  1. "Human Anatomy & Physiology, 11th edition" Pearson (2018)
  2. "Costanzo Physiology, 7th edition" Elsevier (2021)
  3. "Moore’s Clinically Oriented Anatomy, 9th edition" Wolters Kluwer (2023)
  4. "Primary Intraosseous Cavernous Hemangioma of the Cranium: A Systematic Review of the Literature" World Neurosurg (2022)
  5. "Headache or facial pain attributed to disorder of the cranium, eyes, ears, nose, sinuses, teeth, mouth, or other facial structure" Headache and Migraine in Practice (2022)