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MD4001 Anatomy > Skull and cervical spine: anatomy and imaging > Flashcards

Skull and cervical spine: anatomy and imaging Flashcards

1
Q

What are the main functions of the skull?

A
  • Protects the brain, brainstem, cranial nerves and vasculature
  • Provides attachment for muscles
  • Provides a framework for the head
  • Gives us our identity as individuals
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2
Q

What are the bones like in the skull?

A
  • Flat and irregular

- Pneumatised (air spaces within bones)

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3
Q

What is the neurocranium?

A
  • Bony base of the brain including cranial meninges with a dome-like roof (calvaria/skullcap) and a floor (cranial base/basicranium)
  • In contact with parts of the brain
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4
Q

What is the viscerocranium?

A

Anterior part of the cranium that consits of bones surrounding the oral cavity, nasal cavity and most of the orbit

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5
Q

WHat are the bones of the neurocranium?

A

Formed by 8 bones

  • Frontal
  • Parietal x2
  • Occipital
  • Sphenoid
  • Temporal x2
  • Ethmoid
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6
Q

What are the bones of the viscerocranium?

A

Composed of 15 irregular bones

  • Ethmoid
  • Palatine x2
  • Lacrimal x2
  • Nasal x2
  • Zygomatic x2
  • Vomer
  • Inferior nasal concha x2
  • Maxilla x2
  • Mandible
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7
Q

What bone is in both the viscero and neurocranium?

A

Ethmoid bone

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8
Q

What is the zygomatic arch formed by?

A

Zygomatic process of temporal bone and temporal process of zygomatic bone

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9
Q

What make up the temporal fossa?

A
  • Superior and inferior temporal lines
  • Supramastoid crest of temporal bone
  • Zygomatic arch
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10
Q

Where does the temporalis muscle originate?

A

Inferior temporal line

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11
Q

Where does the temporal facia attach?

A

Superior temporal line

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12
Q

Where does the temporalis muscle insert?

A
  • Pass deep to zygomatic arch and insert on coronoid process of mandible
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13
Q

What is the Pterion?

A
  • Important craniometric area
  • H shaped junction of sutures where frontal, parietal, temporal and greater wing of sphenoid bone articulate
  • Underneath temporalis muscle
  • Bones are thin, structurally weak
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14
Q

What artery is vulnerable to injury in the Pterion?

A

Anterior branch of the middle meningeal artery

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15
Q

Where is the Pterion (surface anatomy)?

A

4cm superior to midpoint of zygomatic arch and 3cm posterior to frontal process of

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16
Q

What is the calvarium?

A

Top of neurocranium

  • Formed by 4 flat bones
  • Parietalx2, Occipital, Frontal
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17
Q

What suture connects the 2 parietal bones?

A

Sagittal suture

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18
Q

What suture connects the frontal bone to the 2 parietal bones?

A

Coronal suture

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19
Q

What suture connects the 2 parietal bones to the occipital bone?

A

Lamboid suture

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20
Q

What is the bregma?

A

On the calvarium where the coronal suture is intersected perpendicularly by the sagittal suture. Where ant. fontanelle was located

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21
Q

What is the purpose of the groove in sagittal suture?

A

For the sagittal sinus - carries venous blood to systemic circulation

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22
Q

What is the purpose of the granular foveolae?

A

Inside are arachnoid granulations

- function is to absorb CSF from the subarachnoid space and pass it on to the superior sagittal sinus

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23
Q

What is the lambda?

A

Midline bony landmark where the lambdoid sutures and sagittal suture meet, between the occipital and two parietal bones

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24
Q

What is the boundry between the squamous and the nuchal part of the occipital bone called?

A

Superior nuchal line

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25
Q

WHy is the nuchal part of the occipital bone rough?

A

For attachment of deep neck muscles and superficial back muscles

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26
Q

Where is the inion located?

A
  • Tip of the external occipital protuberance

- Midpoint of superior nuchal line

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27
Q

What are sutures?

A

Types of fibrous joints - do not move (or limited) (synarthrosis)

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28
Q

What are the soft spots on the cranium called?

A
  • Anterior fontanelle

- Posterior fontanelle

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29
Q

When does the anterior fontanelle fuse?

A

18 months

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30
Q

What is the suture between the 2 frontal bones which eventually fuse together called?

A

Metopic suture

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31
Q

What do unfused sutures allow for?

A

Brain to grow without being compressed

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32
Q

When does the posterior fontanelle fuse?

A

6-9 months after birth

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33
Q

What happens to the bones of the neurocranium during birth?

A

They go over each other

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34
Q

The impression on the anterior fontanelle is useful for what reason?

A

no bone to protect brain - this protects instead (if depressed infant may be malnourished)

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35
Q

What will make the anterior fontanelle buldge?

A

Increased intracranial pressure

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36
Q

What are the 3 divisions of the trigeminal nerve?

A

V1- Opthalmic (sensory)
V2 - Maxillary (sensory)
V3 - Mandibular (sensory + motor)

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37
Q

What is the piriform aperture?

A

Anterior opening of the nasal cavity (looks like a pear)

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38
Q

What does the opthalmic nerve pass through?

A

Supra-orbital notch (foramen)

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39
Q

What does the maxillary nerve pass through?

A

Infra-orbital foramen

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40
Q

What does the mandibular nerve pass through?

A

Mental foramen

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41
Q

Where is the glabella?

A

Area between the eyebrows

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42
Q

Where is the nasion?

A

Point where frontal and nasal bones unite

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43
Q

What travels through the superior orbital fissure?

A
  • Lacrimal nerve
  • Frontal nerve
  • Trochlear nerve
  • Superior opthalmic vein
  • Nasociliary nerve
  • Oculomotor nerve
  • Abducens nerve
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44
Q

What does the superior orbital fissure connect?

A

The orbit to the middle cranial fossa

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45
Q

What travels through the inferior orbital fissure?

A
  • Zygomatic branch of maxillary nerve
  • Infraorbital nerve
  • Inferior opthalmic vein
  • Sympathetic nerves
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46
Q

What does the inferior orbital fissure connect?

A

Orbit to pterygopalatine fossa

47
Q

Where is the vertex located?

A

Highest most point of the skull

48
Q

What is the asterion?

A

Where occipital, parietal and temporal bones unite/join

49
Q

What is the choana?

A

Posterior opening of the nasal cavity

50
Q

What is the sphenoid bone said to resemble?

A

a bat with the legs representing the pterygoid process

51
Q

Where does the internal carotid artery enter the cranium?

A

External opening of carotid canal (on temporal bone)

52
Q

What is the jugular foramen formed by?

A

Articulation of the temporal and occipital bones

53
Q

What foramen does the spinal cord pass through?

A

Foramen magnum

54
Q

What does the Hypoglossal nerve travel through?

A

Hypoglossal canal

55
Q

What does the middle meningeal artery enter into the cranial cavity through?

A

Foramen spinosum

56
Q

What nerve passes through the foramen ovale?

A

Mandibular

57
Q

What pases through the foramen lacerum?

A

Artery of pterygoid canal, the nerve of pterygoid canal and some venous drainage

58
Q

What are the boundries of the infratemporal fossa?

A
  • Laterally: Ramus of mandible
  • Medially: Lateral pterygoid plate of sphenoid bone
  • Anteriorly: Posterior aspect of maxilla
  • Posteriorly: Tympanic plate, mastoid and styloid processes
  • Superiorly: Infratemporal crest of sphenoid bone
  • Inferiorly: Angle of the mandible
59
Q

WHat is the boundry between the infratemporal and temporal fossa?

A

Zygomatic arch

60
Q

What is the pterygopalatine fossa?

A

Narrow space between the pterygoid process of the sphenoid and the palatine bone

61
Q

What is the connection/door between pterygopalatine fossa and infratemporal fossa called?

A

Pterygomaxillary fissure

62
Q

What does the sphenopalatine foramen connect?

A

Pterygopalatine fossa with nasal cavity

63
Q

What does the inferior orbital fissure connect?

A

Pterygopalatine fossa with orbit

64
Q

What does the foramen rotundum connect?

A

Pterygopalatine fossa with middle cranial fossa

65
Q

What are the 3 fossae of the cranial base?

A
  • Anterior middle and posterior cranial fossa
66
Q

What is the border between the anterior and middle cranial fossa called?

A

Sphenoid crest

67
Q

What is the border between the middle and posterior cranial fossa called?

A

Superior border of the petrous temporal bone

68
Q

What bones form the anterior cranial fossa?

A

Frontal, ethmoid and sphenoid bones

69
Q

Where do the olfactory bulbs receive fibres from?

A

The nasal cavity via the foramina of the cribriform plate (olfaction)

70
Q

What can cribiform plate fractures result in?

A

CSF rhinorrhoea

71
Q

What is the middle cranial fossa formed by?

A

Sphenoid and temporal bones and occupied by temporal lobes of the brain

72
Q

Where is the pituitary gland located?

A

Hypophyseal fossa

73
Q

What is immediately anterior to the hypophyseal fossa?

A

Chiasmatic sulcus (where optic chiasm is located)

74
Q

What is the posterior cranial fossa formed by?

A
  • Sphenoid
  • Occipital
  • Temporal bones
75
Q

What occupies the posterior cranial fossa?

A
  • Cerebellum inferiorly (cerebellar fossa)

- Occipital lobes (cerebral fossa)

76
Q

What does the brainstem lie against in the posterior cranial fossa?

A

Clivus

77
Q

What exit/enter through the internal acoustic meatus (part of posterior cranial fossa)?

A

Vestibulocochlear + fascial nerve

78
Q

What passes through the mandibular foramen?

A

Branch of mandibular nerve supplying the lower teeth gums

79
Q

What is the only synovial moveable joint in the skull?

A

Temporomandibular joint (hinge joint)

80
Q

What are the articular surfaces of the mandible bone covered by?

A

fibrocartilage (not hyaline)

81
Q

What seperates the temporomandibular joint into superior and inferior articular cavities?

A

Fibrocartilaginous articular disc

82
Q

What is the most common form of dislocation of the temporomandibular joint?

A

Anterior

83
Q

What are the ligaments of the temporomandibular joint?

A
  • Sphenomandibular ligament (extrinsic)
  • Stylomandibular ligament (extrinsic)
  • Lateral ligament (intrinsic)
84
Q

In what cavity of the TMJ does the mandible retract and protrude?

A

Superior cavity

85
Q

In what cavity of the TMJ does the mandible elevate and depress?

A

Inferior cavity

86
Q

What is C1 called?

A

Atlas

87
Q

What is unique about the atlas?

A
  • No body
  • No spinous process just tubercle
  • 2 lateral masses with articular surfaces superiorly and inferiorly
88
Q

What is unique about the axis (C2)?

A
  • Has a dens (articulates on the articular facet on C1)

- 2 lateral masses

89
Q

What is unique to the cervical vertebra?

A

Bifid spinous process

90
Q

What do Occipital condyles articulate with?

A

Superior articular surfaces on the lateral masses of the atlas

91
Q

Describe the intervertebral joints

A
  • Secondary cartilaginous
  • Hyaline cartilage on endplates
  • Intervertebral disc - fibrous
92
Q

What are the intervertebral joints supported by?

A
  • Anterior longitudinal ligament

- Posterior longitudinal ligament; pierced by vertebral artery; continues cranially as tectorial membrane

93
Q

Where does the nucleus pulposus herniate?

A

Posterolaterally (due to presence of ligaments)

- touches spinal nerves

94
Q

What is another name for the facet joints?

A

Zygapophysial joints

95
Q

Describe the facet joints?

A
  • Synovial joint
  • Between superior and inferior articular processes
  • Hyaline cartilage
  • Supported by ligamentum flavum
96
Q

What ligaments stabilise the atlanto-axial joint?

A
  • Apical ligament
  • Alar ligament
  • Transverse ligament of atlas (cruciform)
97
Q

What is the ligamentum nuchae?

A
  • Superior and posterior extension of the supraspinous ligament (fascial like)
  • Covers C1 to C6
98
Q

What is the most superior spinous process the supraspinous ligament reaches?

A

C7

99
Q

What are the 4 compartments of the neck?

A
  • Visceral compartment
  • 2x vascular compartments
  • Vertebral compartment
100
Q

What are the fascia which divide the compartments of the neck?

A
  • Superficial facia
  • Investing fascia
  • Pretracheal fascia
    Buccopharyngeal fascia
  • Prevertebral fascia
  • Carotid sheath
101
Q

What does the investing fascia cover?

A
  • Sternoclydomastoid
  • Trapezius
  • Supra and infra hyoid muscles
102
Q

What does the pretracheal fascia cover?

A
  • Oesophagus
  • Trachea
  • Thyroid and parathyroid gland
103
Q

What part of the pretracheal fasicia is called buccopharyngeal fascia?

A

Posterior part

104
Q

What does the prevertebral fascia surround?

A
  • Vertebral column plus spinal nerves pre and post vertebral muscles
105
Q

Where does the prevertebral fascia extend from?

A

Base of the skull to the superior mediastinum (T3)

106
Q

What is the danger space?

A

The alar space - within prevertebral layer (alar fascia anf deep prevertebral layer) area extends from base of skull though posterior mediastinum to diaphragm

107
Q

What is the true retropharyngeal space?

A

Between bucopharyngeal fascia and superficial prevertebral fascia (alar fascia); area extends between base of skull and superior mediastinum. Pharynx infection can spread through this to post. mediastinum

108
Q

What is the pretracheal space?

A

Between investing layer and pretracheal fascia; area extends between neck and superior mediastinum

109
Q

What 2 spaces are indistinguishible in healthy people?

A

True retropharyngeal and danger/alar space

110
Q

What do vertebral vessels travel in up the neck?

A

Foramen transversarium (found on transverse process)

111
Q

What cervical vertebra does the vertebral artery not travel through?

A

C7

112
Q

What cervical vertebra does the vertebral vein not pass through?

A

C6

113
Q

What should you see on an adequate cervical x-ray?

A

All 7 cervical vertebrae and the occipital bone

114
Q

What is the curve like on the cervical spine?

A

Lordotic curve (-43deg arc)

  • You should be able to draw a line from:
  • Ant + Post vertebral bodies
  • Lamina junctional line
  • Posterior tip of spinous processes

MD4001 Anatomy (7 decks)

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