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4001 > 7 Skull and cervical spine: anatomy and imaging > Flashcards

7 Skull and cervical spine: anatomy and imaging Flashcards

1
Q

What does the skull house?

A
  • brain
  • organs of special senses
  • upper part of respiratory and GI system
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2
Q

Where are the restricted movment in the skull?

A
  • mandible at TMJ

- atlanto-occipital joint

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3
Q

Function of skull (4)?

A

1 protects brain, brainstem, cranial nerves and vaculature
2 attachment for muscles
3 framework for head
4 identity as individuals

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4
Q

Types of bones in skull?

A
  • flat and irregular bones

- pneumatised bones

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5
Q

How are flat, smooth bones formed?

A

intramembranous ossification

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6
Q

How are irregualr bones formed?

A

endochondral ossification

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7
Q

What are pneumatised bones? examples?

A
  • bones with air spaces (air cells or sinuses)

- frontal, temporal, sphenoid, ethmoid

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8
Q

Function of pneumatised bones (2)?

A

1 reduce weight

2 add resonance to our voice

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9
Q

What composes the skull?

A
  • neurocranium and viscerocranium

- total of 22 bones in adult

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10
Q

What is neurocranium?

A

bony case of the brain including cranial meninges with a dome-like roof (calvaria) and floor (cranial base)

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11
Q

What is viscerocranium?

A

anterior part of skeleton that consists of bones surrounding the oral cavity, nasal cavity and most of the orbit

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12
Q

Bones of the neurocranium (8)?

A
  • frontal
  • parietal x2
  • occipital
  • sphenoid
  • temporal x2
  • ethmoid
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13
Q

Bones of the viscerocranium (15)?

A
  • (ethmoid)
  • palatine x2
  • lacrimal x2
  • nasal x2
  • zygomatic x2
  • vomer
  • inferior nasal concha x2
  • maxilla x2
  • mandible
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14
Q

Main features of viscerocranium?

A
  • zygomatic arch
  • mandible
  • infratemporal fossa
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15
Q

Main features of neurocranium?

A
  • external acoustic meatus
  • styloid process
  • mastoid process
  • temporal fossa
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16
Q

Borders of temporal fossa?

A
  • superior and posterior: superior + inferior temporal lines
  • anterior: frontal process of zygomatic bone + zygomatic process of temporal bone
  • inferior: infratemporal crest deep to zygomatic arch
  • floor: includes pterion
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17
Q

What is pterion?

A
  • H shaped junction of sutures
  • frontal, parietal, temporal and greater wing of sphenoid bones
  • structurally weak (thin) area of skull
  • overlies anterior branch of middle meningeal artery
  • vulnerable to injury
  • trauma can lead to extradural (epidural) haematoma
  • 4cm superior to mipoint of zygomatic arch + 3cm posterior to frontal process of zygomatic bone
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18
Q

What is calvaria?

A
  • 4 flat bones (2x parietal, single frontal + occipital)

- fused by coronal, sagittal + lambdoid sutures

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19
Q

Function of granular foveolae?

A

arachnoid granulations - return CSF to venous circulation

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20
Q

What are small isalnds of bones that may be seen within a cranial suture called? most common where?

A
  • sutural, accessory or Wormian bones

- most commonly observed in lambdoid sutures

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21
Q

What are sutures?

A
  • structurally: type of fibrous joint

- functionally: limited or no movement (synarthrosis)

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22
Q

What are fontanelles?

A
  • moulding of crnail shape during birth-post-natal growth of brain
  • corners of forntal + parietal bones fuse by 18 months (anterior fontanelle not palpable)
  • flat bones are seperated by fibrous membranes that fuse in post-natal life (sutures)
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23
Q

Divisions of trigeminal nerve (CN V)?

A
  • supra-orbital notch
  • infra-orbital foramen
  • mental foramen
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24
Q

Craniometric points?

A

-naison
-glabella
-pterion
bregma
-vertex
-lambda
-inion
-asterion

25
Q

What are the paranasal sinuses?

A
  • forntal

- maxillary

26
Q

Borders of infratemporal fossa?

A
  • laterally: ramus of mandible
  • medially: lateral pterygoid plate of sphenoid bone
  • anteriorly: posteior aspect of maxilla
  • posterior: tympanic plate, mastoid + styloid processes
  • superiorly: infratemporal crest of sphenoid bone
  • inferiorly: angle of mandible
27
Q

What is anterior cranial fossa?

A
  • frontal, ethmoid + sphenoid bones
  • shallowest part of cranial base
  • occupied by frontal lobes
28
Q

Where do olfactory bulbs (CN I) receive nerve fibres from the nasal cavity?

A

via foramina of cribiform plate (olfaction)

29
Q

What can cribiform plate fractures present wiht?

A

CSF rhinorrhoea

30
Q

What id middle cranial fossa?

A
  • sphenoid + temporal bones

- occupied by temporal lobes

31
Q

Where does pituitary gland lie? Surrounded by?

A
  • lies in hypophyseal (pituitary) fossa (deepest part of sella turcica)
  • surrounded by 4 clinoid proceses + 2 superior projections (dorsum sellae post. and tuberculum sellae ant.)
32
Q

What is posteiror crnial fossa?

A
  • sphenoid, occipital + temporal bones

- occupied by cerebellum + brainstem

33
Q

What is mandible?

A
  • site for muscle attachemnts (muscles of mastication)
  • foramina for passage of neurovascular strucutres
  • mandibular teeth within alveolar processes
34
Q

What is the temporomandibular joint (TMJ)?

A
  • glenoid (mandibular) fossa of temporal bone and condylar process of mandible
  • modified hinge (atypical) synovial joint
  • articular surfaces of bones covered with fibrocartilage
  • fibrocartilaginous articular disc separating the joint into superior and inferior articular cavities
  • intrisically ‘unstable’ joint
  • anterior dislocation most common
35
Q

TMJ ligaments?

A
  • 2 extrinsic (spehnomandibular + stylomandibular) and 1 intrinsic (lateral)
  • connect mandible to cranium
36
Q

What is sphenomandibular ligament?

A

primary passive support of mandible

37
Q

What is lateral ligament?

A
  • strengthens TMJ laterally

- with postglenoid tubercle prevent posterior dilocation

38
Q

Muscles involved in protrustion of mandible?

A
  • lateral pterygoid

- assisted by medial pterygoid

39
Q

Muscles invovled in retraction of mandible?

A
  • posteior fibres of temporalis
  • deep part of masseter
  • geniohyoid
  • digastric
40
Q

Muscles involved in elevation of mandible?

A
  • temporalis
  • masseter
  • medial pterygoid
41
Q

Muscles/ forces involved in depression of mandible?

A
  • gravity
  • digastric
  • geniohyoid
  • mylohyoid
42
Q

Movement which causes protrusion and retraction of mandible?

A

Gliding movements between temporal bone and articular disc (superior cavity)

43
Q

Movement which causes elevation and depression of mandible?

A

Hinge and rotational movements between head of mandible and articular disc (inferior cavity)

44
Q

When is the TMJ most unstable?

A

during depression as the condylar processes move anteriorly and lie underneath the articular eminences wiht the mandibular head being vulnerabel to anteror dislocation into the infratemporal fossa

45
Q

Name the foramina of cranial fossae?

A

anteior cranial fossa:
-cribiform foramina in cribiform plate

middle cranial fossa:

  • optic canals
  • superior orbital fissure
  • foramen rotundum
  • foramen ovale
  • foramen spinosum
  • foramen lacerum

posteiror cranial fossa:

  • foramen magnum
  • jugular foramen
  • hypoglossal canal
46
Q

Contents of cribiform foramna in cribiform plate?

A

axons of olfactory cells in olfactory epithelium that form olfactory nerves

47
Q

Contents of optic canals?

A
  • optic nerves (CN II)

- opthalmic arteries

48
Q

Contents of superior orbital fissure?

A
  • opthalmic veins
  • opthalmic nerves (CN V)
  • CN III, IV, VI
  • sympathetic fibres
49
Q

Contents of foramen rotundum?

A

maxillary nerve (CN V2)

50
Q

Contents of foramen ovale?

A
  • mandibular nerve (CN V3)

- accessory meningeal artery

51
Q

Contents of foramen spinosum?

A
  • middle meningeal artery and vein

- meningeal branch of CN V3

52
Q

Contents of foramen lacerum?

A
  • deep petrosal nerve

- some meningeal arterial branche and small veins

53
Q

Contents of foramen magnum?

A
  • medulla and meninges
  • vertebral arteries
  • CN XI
  • dural veins
  • anterior and posterior spinal arteries
54
Q

Contents of jugular foramen?

A
  • CN IX, X and XI
  • superior bulb of internal jugular vein
  • infeiror petrosal and sigmoid sinuses
  • meningeal branches of ascending pharyngeal and occipital arteries
55
Q

Contents of hypoglossal canal?

A

hypoglossal nerve (CN XII)

56
Q

What are the atypical bones in cervical vertebra?

A

C1, C2

57
Q

Where do movements occur?

A

C0-C1: flexion + extension; lateral felxion
C1-C2: rotation; flexion + extension
C3-C7: lateral flexion; rotation

58
Q

What is the pre-vertebral fascia?

A
  • allows gliding
  • extends down to T3
  • covers:
    (a) floor of posterior triangle
    (b) cervical and brachial plexus
    (c) 3rd part subclavian artery
59
Q

Where do vertebral vessels enter?

A

-enter foramen transversarium:

  • C7: vein
  • C6: artery

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