4 Osteology and Radiographic Appearance of the Skull Flashcards

1
Q

The neurocranium is made up of 8 bones and its function if to encase and protect the brain. Name the 3 major components of the neurocranium?

A
  1. Calvaria (‘skull cap’ or ‘vault’)
  2. Cranial floor (base)
  3. Cranial cavity
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2
Q

How do the bones of the neurocranium develop?

(Hint: vault bones vs floor/base bones)

A

Vault bones: intramembranous ossification (begin as membranes)

Floor/base bone: endochodrial ossification (begin as cartilage)

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3
Q

The viscerocranium is made up of 14 bones. What do the majority of these bones develop from?

A

Pharyngeal arches

(more detail–> session 5)

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4
Q

Label the coloured bones in the following image:

A
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5
Q

Label the bones on this diagram:

A
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6
Q

Which bone is highlighted in this image?

A

Occipital bone

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7
Q

Name the suture on this image:

A

(like crown)

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8
Q

Fill in the missing labels in the following image:

A
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9
Q

Where on this image did the fontanelles used to be?

A

At bregma and lambda

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10
Q

What are fontanelles? What is their purpose (2)?

A

Large areas- unossified membranous gaps between flat bones on calvaria

Purpose:

  • Allow movement to enable birth
  • Allow development of brain
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11
Q

When do the anterior and posterior fontanelles fuse?

A

Anterior: 18-24 months

Posterior: 1-3 months

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12
Q

What is craniosynostosis?

A

Early fusion of fontanelles and sutures

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13
Q

Why might the anterior fontanelle be useful when examining newborns and infants?

(taken in context of how infant appears)

A

Fontanelle= slightly convex in shape (healthy)

Can be used to asses:

  • Intracranial pressure
  • State of hydration
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14
Q

Describe the trilaminar arrangement of the bone of the Calvaria (in cross section). Why is this important?

A
  1. Outer table (compact bone)
  2. Diploe (spongy bone)
  3. Inner table (compact bone)

Importance:

Protective strength without adding significant weight

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15
Q

Look at the following image showing a bleed from the middle menigeal artery. Why has the bleed not spread any further?

A

Middle meningeal artery runs between periosteum and inner table

(Periosteum ‘shrink wrapped’ every invidual bone of skull)

Blood strips away periosteum from inner table

…but at sutures= too strongly adhered- periosteum doesn’t pull away

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16
Q

Name the 3 ‘bowl shaped’ depressions that form the cranial floor:

A

Anterior, middle and posterior cranial fossae

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17
Q

What is the name of the bone highlighted in green:

A

Ethmoid bone

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18
Q

Name the bone that forms most of the floor of the anterior cranial fossa:

A

Frontal bone (+ethmoid bone)

Frontal bone also forms roof of orbits

19
Q

What structure sits in the sella turcica?

A

Pituitary

20
Q

What is the name of the bone highlighted in green?

A

Sphenoid bone

21
Q

Label the parts of the temporal bone:

A
22
Q

What structures can be found within the petrous part of the temporal bone?

A

Middle and inner ear structures

23
Q

Label the parts of the occipital bone:

A
24
Q

Skull fractures of the cranial vault can be linear or comminuted. What’s the difference between these 2?

A
  • Linear= fairly straight, no bone displacement
  • Comminuted= multiple fracture lines
    • Can be depressed or non-depressed
25
Q

What is the pterion?

A

Region where the frontal, parietal, temporal, and sphenoid bones join together

26
Q

Why is the Pterion clinically significant?

A
  • Thinnest area of skull- easy to fracture
  • Underlying blood vessel: middle meningeal (anterior branch)
27
Q

What do we call fractures through the base of the skull?

A

Basilar fractures (rarer than cranial vault fractures)

28
Q

A patient presents with bilateral bruising of the eyes and a basilar skull fracture is suspected. Where is this fracture likely to be?

A

Anterior cranial fossa

29
Q

A patient presents with blood coming out of their ear and a Hemotympanum (see image). A basilar skull fracture is suspected. Where is this fracture likely to be?

A

Petrous part of temporal bone

(Batter’s sign also suggestive of fracture of petrous bone)

30
Q

Fill in the missing labels:

A
31
Q

Out of the facial bones shown in this image, which ones are most likely to get fractured?

A
  • Nasal
  • Zygomatic (and zygomatic arch- see image)
  • Mandible
32
Q

Where is the fracture in this following x-ray? What has fractured?

A
33
Q

If a fracture of the mandible is found on an x-ray, what should you always look for?

A

A second fracture- usually fractures in 2 places

34
Q

Describe the temporomandibular joint.

A

Articulation between temporal bone and mandible

Synovial hinge-type joint (divided into 2 synovial cavities by fibrocartilaginous disc)

(Dislocation can be caused by yawning)

35
Q

If a patient complains of pain in the ear, but ear examination is normal, what should be considered?

A

TMJ disorder

36
Q

The TMJ is innervated by the auricotemporal nerve. What is this nerve a branch of?

A

Mandibular division of trigeminal (Vc)

37
Q

Describe the movement of the TMJ.

A

Depression of mandible:

  1. Hinge- rotational- action
  2. Gliding forward action
38
Q

What happens if the condyle slips in front of the articular tubercle? How can this occur?

A

Dislocation of TMJ

Due to:

  • Facial trauma
  • Yawning

Jaw locked in open position

39
Q

What is Le Fort classification? (Type I, II, III)

A

Way of classifying injuries to misface- depending on plane of injury and bones involved

40
Q

How does an adult skull differ from a fetal skull?

A
41
Q

What is a jefferson fracture (aka burst fracture)? What is the likely mechanism of injury?

A
42
Q

How can you obtain an AP x-ray of C1 and C2 (usually obscured by mandible).

A
43
Q

How might the fontanelles be used to assess the wellbeing of a new born?

A