Skull and the cervical spine Flashcards

1
Q

Where in the skull is there movement?

A
  • Mandible at the temporomandibular joint

* Atlanto-occipital joint

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2
Q

What are the functions of the skull?

A
  • Protects the brain, brainstem, vasculature and cranial nerves
  • Provides attachment for the muscles
  • Provides a framework for the brain
  • Gives us our identity
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3
Q

How are smooth flat bones formed?

A

Intramembranous ossification

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4
Q

How are irregular bones formed?

A

Endochondral ossification

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5
Q

What are pneumatised bones?

A
  • Bones with air spaces

* Frontal, temporal, sphenoid and ethmoid bones

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6
Q

What are the functions of pneumatised bones?

A
  • To reduce weight

* Add resonance to our voice

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7
Q

What makes up the neurocranium?

A
  • bony case of the brain
  • Cranial meninges with a dome live roof and a floor (cranial base)
  • occipital bones, frontal, temporal, parietal, sphenoid, ethmoid bones
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8
Q

What makes up the viscerocranium?

A
  • Anterior part of the cranium
  • Bones surrounding the oral cavity, nasal cavity and most of the orbit
  • Ethmoid, palatine bones, vomer, nasal bones, zygomatic bones, maxilla, mandible, lacrimal, inferior nasal concha, palatine
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9
Q

What is the temporal fossa bound by?

A
  • Zygomatic process of the frontal bone
  • Frontal process of the zygomatic bone
  • Superior temporal line
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10
Q

What is the superior temporal line?

A
  • line on the side of the skull, on the parietal and frontal bone
  • point of attachment of temporal fascia
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11
Q

What is the inferior temporal line?

A

Point of attachment for the temporalis muscle (muscle of mastication)

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12
Q

What is the pterion?

A
  • H shaped point where the 4 bones articulate

* Parietal, frontal, temporal and zygomatic bones

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13
Q

What is the surface anatomy of the pterion?

A

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

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14
Q

What is a risk at the pterion?

A
  • Deep to the pterion is the middle meningeal artery

* Risk of epidural haemorrhage

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15
Q

Where does CSF return to the venous circulation?

A

Via arachnoid granulations at the granular fovelae

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16
Q

What is the superior nuchal line?

A

• Point of attachment for deep neck and back muscles

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17
Q

What are wormion bones?

A
  • Small bones within a suture
  • Sutural/accessory bones
  • Most commonly seen in the lambdoid suture
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18
Q

What are the functions of the fontanelles

A
  • Allow moulding of the cranium during birth

* Allows post natal growth of the brain

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19
Q

What type of joint are sutures?

A
  • Type of fibrous joint

* Synarthrosis - no, or limited movement

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20
Q

Depressed fontanelle

A

Depressed if the baby is dehydrated or malnourished

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21
Q

Bulging fontanelle

A

Raised intracranial pressure

22
Q

What is the anterior opening of the nasal canal?

A

Piriform aperture

23
Q

What passes through the supra-orbital notch?

A

Ophthalmic nerve

24
Q

What passes through the info-orbital foramen?

A

Maxillary

25
Q

What passes through the mental foramen?

A

Mandibular nerve

26
Q

What does the superior orbital fissure transmit?

A
  • Lacrimal nerve
  • Frontal nerve
  • Trochlear nerve
  • Superior ophthalmic vein
  • Nasociliary nerve
  • Oculomotor nerve
  • Abducens nerve
27
Q

What does the inferior orbital fissure transmit?

A
  • Zygomatic branch of the maxillary nerve
  • Infraorbital nerve
  • Inferior ophthalmic nerve
  • Sympathetic nerve
28
Q

What are the boundaries of the infratemporal fossa?

A
  • Laterally: ramus of the mandible
  • Medially: lateral pterygoid plate of the sphenoid bone
  • Anteriorly: Posterior aspect of the maxilla
  • Posteriorly: tympanic plate, mastoid and styloid processes
  • Superiorly: Infratemporal crest of sphenoid bone
  • Inferiorly: angle of the mandible
29
Q

What is the pterygopalatine fossa?

A

A slit like space between the palatine and sphenoid bone

30
Q

What can cribriform plate fractures present with?

A

CSF rhinorrhoea

31
Q

Where does the pituitary gland lie?

A

In the hypophyseal fossa

32
Q

What surrounds the pituitary gland?

A
  • 4 clinoid processes

* 2 superior projections (dorsum sell posteriorly and the tubercular sell anteriorly)

33
Q

What is within the alveolar process?

A

• Mandibular teeth

34
Q

What type of joint is the temporomandibular joint?

A

• Modified hinge (Atypical) synovial joint

35
Q

What makes up the temporomandibular joint?

A
  • Glenoid (mandibular) fossa of temporal bone and condylar process of the mandible
  • Articular surfaces of the bone are covered in fibrocartilage
36
Q

What does the fibrocartilaginous articular diss separate the temporomandibular joint into?

A
  • Superior articular cavity

* Inferior articular cavity

37
Q

What is the most common dislocation of the temporomandibular joint?

A

Anterior

38
Q

What ligaments connect the cranium to the mandible

A
Extrinsic: 
• Sphenomandibular 
• Stylomandibular 
Intrinsic: 
• Lateral ligament
39
Q

Sphenomandibular ligament

A

Primary passive support of the mandible

40
Q

Lateral ligament

A
  • Strengthens the TMJ laterally, with the postglenoid tubercle
  • Prevents posterior dislocation
41
Q

What are the movements of the mandible?

A
  • Flexion
  • Extension
  • Protraction
  • Retraction
  • Elevation
  • Depression
  • Rotational movements
42
Q

Which muscles are involved in the protrusion of the mandible?

A

Lateral pterygoid assisted by the medial pterygoid

43
Q

Which muscles are involved in the retraction of the mandible?

A
  • Posterior fibres of temporalis
  • Deep part of masseter
  • Geniohyoid
  • Digastric
44
Q

Which muscles are involved in the elevation of the mandible?

A
  • Temporalis
  • Masseter
  • Medial pterygoid
45
Q

Which muscles are involved in the depression of the mandible?

A

• Digastric
• Geniohyoid
• Mylohyoid
Main depressor is gravity

46
Q

During which movement is the temporomandibular joint most unstable? Why?

A
  • During depression
  • The condylar processes move anteriorly and lie under the articular eminences with the mandibular head being vulnerable to anterior dislocation into the infratemporal fossa
47
Q

What is the movement of the Atlanto-occipital joint?

A

Flexion and extension

48
Q

What are the articular surfaces of the atlanto-occipital joint?

A

Occipital condyle and superior articular facets of the atlas

49
Q

What forms the median and lateral atlantoaxial joint?

A

Dens of the axis and an osteoligamentous ring of the atlans anteriorly and transverse ligament posteriorly
• Pivot joint

50
Q

Pretracheal space

A
  • Between investing layer and pretracheal fascia

* Area extends between the neck and superior mediastinum

51
Q

True retropharyngeal space

A
  • Between the buccopharyngeal fascia and superficial prevertebral (alar) fascia
  • Extends between the base of the skull and the superior mediastinum
52
Q

Alar space

A
  • Within the prevertebral layer (alar fascia and deep prevertebral layer)
  • Area extends from the base of the skull through posterior mediastinum to the diaphragm