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SA head and neck > S2) Osteology and Radiology of the Skull and Cervical Spine > Flashcards

S2) Osteology and Radiology of the Skull and Cervical Spine Flashcards

1
Q

Identify the following structures on an X-Ray of the cervical vertebrae:

  • C1-C7 vertebrae
  • Vertebral body
  • Spinous processes
  • Facet joints
  • Lamina
  • Pedicle
A
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2
Q

Identify the types of osteological features of skull bones

A
  • Fossae: shallow depressions
  • Canal: bony tunnel
  • Foramina: round holes
  • Fissures: narrow slits
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3
Q

The bones of the skull can be broadly divided into two groups.

Identify them

A
  • Neurocranium (8 bones) - encompasses the brain
  • Viscerocranium (14 bones) - forms the facial skeleton
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4
Q

Describe the function and components of the neurocranium

A
  • Function: encase and protect the brain
  • Components:

I. Calvaria

II. Cranial floor

III. Cranial cavity

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5
Q

Describe the development of the neurocranium

A
  • Calvaria begin as membranes i.e. intramembranous ossification (skull cap)
  • Cranial floor begin as cartilage i.e. endochondral ossification (base)
  • quite a few ares remain membranous
  • all the bones are very flat
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6
Q

Describe the function and components of the viscerocranium

A
  • Contents: facial skeleton and the jaw
  • Function: surrounds oral cavity, pharynx and upper respiratory passages
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7
Q

Describe the development of the viscerocranium

A
  • Bones begin as membranes or cartilage and ossify
  • Most structures develop from the pharyngeal arches (1&2)
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8
Q

Why are there foramina, fissures and canals in the neurocranium?

A
  • To allow the neurocranium to communicate with other structures of the head and neck
  • To allow passage of blood vessels and cranial nerves
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9
Q

Three ‘bowl‐shaped’ depressions form the cranial floor.

Identify them and describe their osteological features

A

Anterior, middle and posterior cranial fossae – each fossae has series of foramina, fissures and/or canals

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10
Q

What is the significance of the trilaminar arrangement of the bones of cavaria?

A

Confers protective strength without adding significant weight

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11
Q

What are sutures?

A

Sutures are fibrous joints which are found at intersections between bones

– all found between the 22 individual bones that form the skull

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12
Q

Identify the names of the most important sutures

A
  • coronal - run between frontal and parietal bone
  • sagittal - between two paired pariatal bone
  • lamboid - intersection between occipital bine and two parietal bone
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13
Q

Describe the features of the bones forming a suture joint

A

Edges of bones forming suture joint are ‘serrated’ to prevent slippage and movement

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14
Q

Describe the development of suture joints

A
  • Growth at sutures stops around puberty
  • Then are gradually obliterated from inside → outside
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15
Q

What are fontanelles?

A

Fontanelles are large areas of unossified membranous gaps between flat bones of calvaria

  • anterior
  • posterior
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16
Q

What is the function of fontanelles?

A
  • Allow for alteration of the skull size and shape during childbirth
  • Permit growth of infant brain
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17
Q

When do the fontanelles fuse?

A

Fontanelles fuse in early infancy:

  • Anterior: ~18 months ‐ 2 years
  • Posterior: ~1 ‐ 3 months
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18
Q

What is the early fusion of fontanelles called?

A

Craniosyntosis is the early fusion of fontanelles and sutures so brain can’t grow to max size

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19
Q

Why is the anterior fontanelle clinically useful when examining babies?

A

Inspection and gentle palpation of anterior fontanelle can be used to assess intracranial pressure and state of hydration

  • high pressure → bulge
  • dehydrated → sunken
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20
Q

What is required to fracture a skull?

Why are the incidence in skull fractures varied?

A
  • Significant trauma and force required to fracture skull due to trilaminar arrangement of skull
  • Thickness of cranial bones varies, resistance to fracture therefore varies
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21
Q

What is the main concern with regards to skull fractures?

A

Skull fractures are associated with higher incidence of intracranial pathology (injury to brain, blood vessels, cranial nerves) and neurological deficits

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22
Q

Can one still have an intracranial injury without a skull fracture?

How do we confirm this?

A

Yes, CT scanning should be performed in all patients with known or suspected skull fractures to identify any intracranial injuries

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23
Q

Identify and describe the three main fracture types

A
  • Linear fractures: fracture passes full thickness of skull, fairly straight, involve no bone displacement
  • Depressed fractures: fragment is displaced inwards towards the brain

– Comminuted: multiple fractures can be depressed or not

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24
Q

What are fractures involving the cranial base called?

A

Basilar skull fractures

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25
Q

What are basilar skull fractures associated with?

A

Basilar fractures are associated with cranial nerve injuries

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26
Q

What is the pterion?

A

The pterion is the thinnest area of the skull (part of the temporal bone)

meeting point of 4 bones - parietal, frontal, greater wing of sphenoid, squamous part of temporal bone

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27
Q

Why are injuries to the side of the head associated with intracranial haemorrhages?

A
  • Pterion is associated with middle meningeal artery
  • Blows to side of head can fracture bone in area of pterion and injure blood vessel lying immediately below
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28
Q

Identify 3 other bones which are commonly fractured/injured

A
  • Nasal bones
  • Zygomatic bone and arch
  • Mandible
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29
Q

Identify 5 distinct clinical features associated with basilar skull fractures

A
  • Raccoon eyes – bruising around both eyes (periorbital ecchymoses)
  • Battle’s sign – bruising over the mastoid process
  • Haemotympanum – blood behind eardrum
  • CSF rhinorrhea – cerebrospinal fluid leaking from nose
  • CSF otorrhea – cerebrospinal fluid leaking from ear
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30
Q

Identify the frontal bone

A
  • grows as left and right frontal bone and then fuses together
  • forms the roof of the orbit → orbital plates
  • part of the anterior cranial fossa and forms the boundary of the anterior cranial fossa
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31
Q

Identify the parietal bone

A
  • flat bone
  • paired we have a left and a right
  • damage to this bone can cause damage to the ear
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32
Q

Identify the occipital bone

A
  • occipital condoles which meet with the first cervicle vertebra
  • from behind has the external occipital protuberance and superior nucheal line causing the arcs
  • hole → foramen magnum where the brainstem continues as the spinal chord
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33
Q

Identify the sphenoid bone

A
  • you can only see the greater wing of the sphenoid when looking at the skull
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34
Q

Identify the temporal bone

A
  • has a flat part forming vault of skull
35
Q

Identify the maxilla bone

A
36
Q

Identify the mandible bone

A
37
Q

Identify the zygoma bone

A
38
Q

Identify the nasal bones

A
39
Q

Identify the ethmoid bone

A
  • forms top of nasal cavity
  • it has lots of air filled cavities (numeratised)
  • perpendicular plate splits the nasal cavity in half
    *
40
Q

Identify the lacrimal bone

A
41
Q

Identify the following osteological landmarks on the skull below:

  • Ethmoid bone
  • Infraorbital ridge
  • Infraorbital foramen
  • Middle nasal concha
  • Inferior nasal concha
A
42
Q

Identify the following osteological landmarks on the skull below:

  • Supraorbital ridge
  • Lacrimal fossa
  • Nasal bone
  • Supraorbital foramen
  • Orbital plate
A
43
Q

Identify the following osteological landmarks on the skull below:

  • Superior orbital fissure
  • Perpendicular plate
  • Zygoma
  • Vomer
A
44
Q

Identify the following osteological landmarks on the skull below:

  • Maxilla
  • Alveolar process
  • Mandible
  • Mental foramen
  • Mental protuberance
A
45
Q

Identify the following osteological landmarks on the skull below:

  • Condyloid process
  • Ramus
  • Zygomatic process of temporal bone
A
46
Q

Identify the following osteological landmarks on the skull below:

  • Styloid process
  • Mastoid process
  • Petrous part
  • Squamous part
  • Superior nuchal line
A
47
Q

Identify the following osteological landmarks on the skull below:

  • External auditory meatus
  • Head of mandible
  • Body of sphenoid
  • Articular fossa for mandible
  • Lacrimal bone
A
48
Q

Identify the following osteological landmarks on the skull below:

  • Frontal process of maxilla
  • Zygomatic arch
  • Zygomatic process of maxilla
  • Coronoid process
A
49
Q

Identify the following sutures on the skull below:

  • Bregma
  • Lambda
  • Coronal suture
A
  • bregma is in between sagittal and coronal suture
  • intersection between sagittal and lambdoid suture is lambda
  • in fetal skull these remain membranous to allow for bone growth
50
Q

Identify the following osteological landmarks on the skull below:

  • Sagittal suture
  • Superior temporal line
  • External occipital protuberance
A
51
Q

Identify the mandibular foramen on the skull bone below

A
52
Q

Identify the following osteological landmarks on the skull below:

  • Crista galli
  • Cribiform plate
  • Anterior clinoid process
  • Posterior clinoid process
  • Foramen lacerum
A
53
Q

Identify the following osteological landmarks on the skull below:

  • Cribiform foramina
  • Optic canal
  • Hypophyseal fossa
  • Lesser wing of sphenoid
  • Greater wing of sphenoid
A
54
Q

Identify the following osteological landmarks on the skull below:

  • Foramen rotundum
  • Internal acoustic meatus
  • Hypoglossal canal
  • Petrous part
A
55
Q

Identify the following osteological landmarks on the skull below:

  • Superior nuchal line
  • Hypoglossal canal
  • Articular condyles for atlas (C1)
  • Foramen ovale
  • Temporal fossa
A
56
Q

Identify the following osteological landmarks on the skull below:

  • Lateral pterygoid plate
  • Medial pterygoid plate
  • Palatine process
  • Base of sphenoid bone
  • Clivus
A
57
Q

Label structures A, B, C and D in the image below

A
  • A – Foramen rotundum
  • B – Foramen ovale
  • C – Internal acoustic meatus
  • D – Jugular foramen
58
Q

Label structures E, F and G in the image below

A
  • E – Foramen lacerum
  • F – Foramen spinosum
  • G – Carotid canal
59
Q

bones of the calvaria

A

These bones all form the calvaria:

  • parietal
  • frontal
  • occipital

all of these are flat with a curved surface

  • all provide protection
In a CT you will see white inner and outer layer and a black inner filling
60
Q

periosteum

A
  • wrap themselves over the bones of the skull
  • The middle meningeal artery runs between the periosteum and bone → if it starts to bleed then it forms an extradural haemorrhage
  • it starts to strip the periosteal layers off the bone but once it reaches the sutures it stops peeling away
60
Q

periosteum

A
  • wrap themselves over the bones of the skull
  • The middle meningeal artery runs between the periosteum and inner table of bone → if it starts to bleed then it forms an extradural haemorrhage
  • it starts to strip the periosteal layers off the bone but once it reaches the sutures it stops peeling away
61
Q

What is the role of the petrous part of the temporal bone

A

houses the structures of the middle and inner ear

62
Q

bones forming the anterior cranial floor

A
  • frontal bone (anterior)
  • ethmoid bone (in the middle of the frontal bone
  • posterior part of fossa is made up of the lesser wing of the sphenoid bone
63
Q

bones forming the middle cranial floor

A
  • sphenoid bone - greater wings
  • sella turnica
    *
64
Q

bones forming the posterior cranial fossa

A
  • temporal bone
  • occipital bone
65
Q

when fracture involving skull what type of imagining would you use

A
  • CT
66
Q

If someone had an injury involving the facial part what type of imagining would you use

A
  • xray
67
Q

what bones that make up the facial part of the head are most likely to be fractured?

A
  • nasal bones
  • zygomatic arch and bone
  • mandible
68
Q

temporomandibular joint and its innervation

A
  • synovial hung type joint
  • can get TMJ pain, dislocation and arthritis
  • innervated by auriculotemporal nerve (branch of the mandibular division of the trigeminal nerve)
69
Q

anatomy of the TMJ

A
  • temporalis muscle inserts into the coronoid process
  • have inferior and superior joint capsule
70
Q

how is the TMJ stabilised

A
  • joint capsule around the joint
  • extra capsular ligaments
71
Q

role of the inferior and superior joint capsule of the TMJ

A
  • inferior → rotation of the head
  • superior → gliding forward and protraction
72
Q

muscles involved in moving the mandible:

  1. elevation
  2. depression
  3. protrusion
  4. retraction
  5. grinding
A
73
Q

dislocation of the TMJ can be caused due to:

A
  1. facial trauma (yawning)
  2. jaw locks due to anterior dislocation of the articular tubercle
  3. contraction of muscle around joint can keep it in a locked position
74
Q

superior orbital fissure

A

transmits lots of nerves

75
Q

which area transmits the optic nerve ?

A

optic canal

76
Q

which are transmits maxillary division of the trigeminal nerve?

A

foramen rotundum

77
Q

which area transmits the mandibular division of the trigeminal nerve

A

foramen ovale

78
Q

Which area is filled with cartilage

A

foramen lacerum

  • the internal carotid artery traverses over the top of it during its course, just as it exits the carotid canal
79
Q

what is the name of the structure that transmits the middle meningeal artery

A

foramen spinosum

80
Q

what area transmits the internal carotid artery

A

carotid canal

81
Q

what vessel is a continuation of the sigmoid sinus

A

internal jugular vein

82
Q

what is the role of the concha in the ethmoid bone?

A
  • it makes air flow into the nose turbulent so that there is more time for the air to be humidified

SA head and neck (18 decks)

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