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AoHNS > Cranium and meninges > Flashcards

Cranium and meninges Flashcards

1
Q

How many bones in skull (excluding ossicles)

A

22

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2
Q

Outline the 3 overall bones

A

Cranium (make up base and vault)
Mandible
Facial skeleton (viscerocranium)

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3
Q

Name the bones of the cranium and the face

A

cranium: frontal (x2), parietal (x2), frontal, occipital, sphenoid, ethmoid
face: maxilla (x2), zygoma (x2), nasal (x2), lacrimal (x2), vomer, inferior conchae (x2), palatine (x2) and mandible

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4
Q

Define suture

A

Fibrous joints permitting little or no movement

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5
Q

T/F: the posterior fontanelle closes before the anterior fontanelle

A

t: anterior fontanelle after 18-24 monts, during first 2-3 months

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6
Q

What happens to the metopic suture

A

aka frontal suture, fuses.

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7
Q

3 sutures- between which bones

A

b/w frontal and parietal bones= coronal
b/w parietal bones= saggital suture
b/w parietal and occipital bones= lambdoid suture

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8
Q

State what the adult remains of the anterior and posterior fontanelle

A

AF- bregma
PF- lambda
used as landmarks in neurosurgery

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9
Q

Where are the lesser and greater wings of the sphenoid bone

A

lesser back of the orbit

greater on the side of the skull

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10
Q

Which bones lie superior and inferior to the greater wing of the sphenoid bone on the side of the skull

A 
superior= frontal 
inferior= temporal
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11
Q

Which bone is found on the medial wall of the orbit

A

lacrimal bone

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12
Q

which bones can be found underneath the eye

A

zygomatic (lat), maxilla (medial)

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13
Q

What passes through the infraorbital foramen, and what bone is this foramen travelling through

A

Through the maxilla: the infraorbital nerve is a branch of the maxillary nerve, which is the 2nd branch of the trigeminal nerve (V2)- provides sensory innervation to cheek

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14
Q

Name of the protrusion in the maxilla in the midline

A

Anterior nasal spine

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15
Q

What nerve passes through the mental formamen

A

The mental nerve (a branch of the inferior alveolar nerve, which is a branch of the mandibular nerve which is a branch of the trigeminal nerve. Sensory innervation to the chin

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16
Q

Where is the vomer

A

In the midline back of the nose

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17
Q

Function and location of inferior nasal conchae

A

Turbinates- lamina of spongey bone projecting into nasal cavity to moisten and slow air as it enters

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18
Q

parts of the ethmoid bone?

A

orbital plate, middle nasal concha and perpendicular plate

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19
Q

The key landmark on the temporal bone?

A

external acoustic meatus

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20
Q

The zygomatic arch involves which 2 bones

A

zygoma and temporal

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21
Q

What is the cranial vault and what is it formed of

A

The space which actually contains the brain: occipital, temporal, frontal, parietal and the greater wings of the sphenoid

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22
Q

Where is the point of weakness within the skull and what is it called?

A

where 4 bones meet: frontal, temporal greater wing of sphenoid and parietal- called the pterion.

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23
Q

What runs behind the pterion?

A

Middle meningeal artery (can be ruptured if fracture –> extradural haematoma causing stroke

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24
Q

What is the occipitomastoid suture

A

Junction between occipital and mastoid process of the temporal bone

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25
Q

Which two bones are found in the top of the mouth. Which is more anterior

A 
palatine bones (x2) and vomer.
Palatine bones more anterior
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26
Q

What bone makes up the majority of the skull base

A

Occipital

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27
Q

Where does the vertetrae articulate with the base of the skull

A

Occipital chondyle

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28
Q

Where does the 7th cranial nerve emerge from the base of the skull

A

Stylomastoid foramen

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29
Q

What makes up the cranial base

A

Fossae (cavities): anterior, middle and posterior

30
Q

What defines the posterior boundary of the anterior cranial fossa

A

Posteriorly and medially it is bounded by the limbus of the sphenoid bone. The limbus is a bony ridge that forms the anterior border of the prechiasmatic sulcus (a groove running between the right and left optic canals).

Posteriorly and laterally it is bounded by the lesser wings of the sphenoid bone (these are two triangular projections of bone that arise from the central sphenoid body).

31
Q

What defines the posterior boundary of the middle cranial fossa

A

the superior border of the petrous part of the temporal bone (stony, solid part)

32
Q

What bones make up the anterior cranial fossa

A

frontal, ethmoid and lesser wing of sphenoid

33
Q

What part of the frontal bone is found in the anterior cranial fossa

A

orbital part

34
Q

Name the raised, horizontal ridge on the ethmoid bone

A

Crista gali

35
Q

Which structures of the ethmoid bone lie lateral to the crista gali- what are their significance

A

cribiform plate- they have foramina through which olfactory neurons pass up from the nose through the base of the skull to synapse onto the olfactory bulb which lies on the inferior side of the frontal lobes

36
Q

Which bones make up the middle cranial fossa

A

greater wing of sphenoid, temporal and a bit of parietal

37
Q

What part of the brain sits in the MCF

A

Temporal lobe

38
Q

What is the sella turcica and what bone is it in

A

Bone housing the pituitary gland- held in the sphenoid bone (asa. hypophsial fossa)

39
Q

State the foramina in the MCF

A

foramen spinosum and foramen ovale and foramen rotundum

40
Q

What passes through the foramen spinosum

A

middle meningeal artery, middle meningeal vein, and the meningeal branch of the mandibular nerve

41
Q

What passes through the foramen ovale

A

motor root of the trigeminal nerve (mandibular branch) and the accessory meningeal artery

42
Q

What passes through foramen rotundum

A

maxillary branch of the trigeminal nerve

43
Q

The clivus is part of what bone

A

Occipital bone

44
Q

What happens in foramen magnum

A

Brainstem becomes continuous with spinal cord

45
Q

Where does the oculomotor nerve emerge

A

between the 2 cerebral peduncles in the brainstem

46
Q

Which cranial nerve emerges from the pons

A

trigeminal nerve

47
Q

Which cranial nerve emerges most medially on the ponto-medullary junction

A

Abducent

48
Q

Wha cranial nerve emerges lateral to the abducent on the pontomedullary junction

A

facial

49
Q

Wha cranial nerve emerges lateral to the facial on the pontomedullary junction

A

vestibulocochlear

50
Q

Pyramids are found on the dorsal surface of the brainstem t/f

A

F- they are on the anterior surface: they extend to the corticospinal tracts (from the ventral white matter of the spinal cord- carries voluntary motor fibres)

51
Q

Where does the hypoglossal nerve emerge

A

b/w junction of pyramids and olives

52
Q

State where each cranial nerve originates

A

midbrain: oculomotor (ant b/w peduncles) and trochlear (post)
Pons: trigeminal
pontomedullary junction: abducent, facial and vestibulocochlear (med–> lat)
medulla: glossopharyngeal, vagus and accessory
(spinal cord: b/w medulla and olive= hypoglossal)

53
Q

Important foramina of anterior cranial fossa (or border with middle cranial fossa really)

A

optic canal (most anteriorly): optic nerve through back of orbit through orbit canal

54
Q

Important foramina of medial cranial fossa in sphenoid bone

A

Superior orbital fissure-4 cranial nerves innervating extrinsic muscles of eye pass through, sympathetic fibres and ophthalmic veins
Foramen rotundum- maxillary nerve (V2)
Foramen ovale- mandibular nerve (V3) and accessory meningeal artery
Foramen spinosum- middle meningeal artery and vein and meningeal branch of mandibular nerve (V3)

55
Q

Which structures (processes) surround the sella turcica and what is their function

A

clinoid processes (2 superior and inferior) which serve as attachment points for tentorium cerebelli

56
Q

Foramina in the MCF in the temporal bone

A

Hiatus of the greater petrosal nerve – transmits the greater petrosal nerve (a branch of the facial nerve), and the petrosal branch of the middle meningeal artery.

Hiatus of the lesser petrosal nerve – transmits the lesser petrosal nerve (a branch of the glossopharyngeal nerve).

Carotid canal – located posteriorly and medially to the foramen ovale. This is traversed by the internal carotid artery, which ascends into the cranium to supply the brain with blood. The deep petrosal nerve also passes through this canal.

57
Q

Foramina in the temporal bone in the PCF

A

internal acoustic meatus:in the posterior aspect of the petrous part of the temporal bone. It transmits the facial nerve (CN VII), vestibulocochlear nerve (CN VIII) and labyrinthine artery.

58
Q

Foramina in the occiipital bone in the PCF

A

Foramen magnum- transmits the medulla of the brain, meninges, vertebral arteries, spinal accessory nerve (ascending), dural veins and anterior and posterior spinal arteries. Anteriorly an incline, known as the clivus, connects the foramen magnum with the dorsum sellae.

Jugular foramina: Located either side of the foramen magnum. Each transmits the glossopharyngeal nerve, vagus nerve, spinal accessory nerve (descending), internal jugular vein, inferior petrosal sinus, sigmoid sinus and meningeal branches of the ascending pharyngeal and occipital arteries

Hypoglossal canal: on anterolateral margin of foramen magnum, carries hypoglossal nerve

59
Q

Blood supply to the meninges

A

From the middle meningeal artery, which is a branch of the maxillary artery, which is a branch of the external carotid artery (passes through foramen spinosum

60
Q

State 2 layers of dura mater

A

periosteal and meningeal

61
Q

Difference between dura mater in skull and vertebral canal

A

It is adherent to the skull but not to the vertebral canal due to spinal epidural space

62
Q

Superior sagittal sinus drains where

A

through back of brain into the confluence of sinuses

63
Q

Between which layers is the venous sinus formed

A

Periosteal and meningeal layer of the dura mater

64
Q

Name of the dura that separates 2 hemispheres

A

falx cerebri

65
Q

Name of dura separating cerebellum

A

falx cerebelli (so occipital lobe sits above the cranial fossa, above the tentorium, and cerebellum sits below)

66
Q

What is the tentorial notch

A

Entrance to the posterior cranial fossa- above this you have cortices, below it you have cerebellum and brainstem

67
Q

Where can brain tissue herniate?

A

underneath falx cerebri (subfalcine herniatin)
under the tentorium (transtentorial herniation= between brain and posterior cranial fossa- some of the temporal lobe can herniate)
tonsil of the cerebellum through the foramen magnum (tonsillar herniation)

68
Q

Outline venous drainage of the brain

A

Superior sagittal sinus (superior border of falx) drains to confluence
Inferior sagittal sinus is inferior border of falx drains into straight sinus which drains into confluence
Great cerebral vein drains directily from brain into straight sinus

Transerse sinus –> sigmoid sinus –> internal jugular veins

69
Q

Where does transverse sinus lie

A

below the falx cerebelli

70
Q

Where does cavernous sinus lie

A

sitting on either side of the body of sphenoid bone in the cranial base. In middle cranial fossa

71
Q

Which structures run through cavernous sinus

A

internal carotid arterires (abducent is assicated with this here), and also oculomotor, trochlear, opthalmic (V1) and maxillary (V2) run through the wall of the cavenous sinus.

AoHNS (8 decks)

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