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MD4001 - Anatomy > The Skull, TMJ and Cervical Spine > Flashcards

The Skull, TMJ and Cervical Spine Flashcards

1
Q

What is the skull?

A
  • Bony skeleton of the head
  • Most complex bony structure in the body
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2
Q

What is housed within the skull?

A

Houses the brain, organs of special sense, upper part of respiratory and gastrointestinal systems

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3
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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4
Q

What are the main types of bones found in the skull?

A
  • Flat and irregular bones
  • Pneumatised bones
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5
Q

How do flat, smooth bones form?

A

intramembrous ossification

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6
Q

How do irregular bones form?

A

endochondral ossification

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7
Q

What are pneumatised bones and what is their function?

A
  • Bones with air spaces (air cells or sinuses) such as frontal, temporal sphenoid and ethmoid
  • WHY? – serve 2 functions in the skull; to reduced weight and add resonance to our voice
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8
Q

What is the skull?

A

cranium, skeleton of the head including the mandible, composed of the neurocranium and viscerocranium with a total of 22 bones in the adult excluding the ossicles of the ear (28 with ossicles)

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9
Q

What is the neurocranium?

A

Bony case of the brain, including the cranial meninges with a dome-like roof (calvaria/skullcap) and a floor (cranial base/basicranium)

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10
Q

What is the viscerocranium?

A

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

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11
Q

What are the bones of the neurocranium?

A

8 bones with 4 being singular midline bones (frontal, ethmoid, sphenoid and occipital) along with 2 sets of bilateral paired bones (temporal and parietal)

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12
Q

What are the bones of the viscerocranium?

A

15 irregular bones with 3 being singular midline bones (ethmoid, vomer and mandible) along with 6 sets of bilateral paired bones (nasal, lacrimal, zygomatic, palatine, maxillae and inferior nasal conchae

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13
Q

What are the main features of the neurocranium?

A
  • External acoustic meatus
  • Styloid and mastoid processes
  • temporal fossa
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14
Q

What are the main features of the viscerocranium?

A
  • Zygomatic arch
  • Mandible
  • Infratemporal fossa
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15
Q

What are the boundaries of the temporal fossa?

A
  • Superior and posterior borders = Superior and inferior temporal lines
  • Anterior border = frontal process of zygomatic bone and zygomatic process of frontal bone
  • Inferior border = infratemporal crest deep tp zygomatic arch
  • Floor = includes pterion
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16
Q

What are the main features of Pterion? And what is its clinical significance?

A
  • H-shaped junction of sutures
  • Frontal, parietal, temporal and greater wing of sphenoid bone
  • Structurally weak (thin) area of the skull
  • Overlies anterior branch of the meningeal artery
  • Vulnerable to injury
  • Trauma can lead to extradural (epidural) haematoma
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17
Q

What is the surface anatomy marking of Pterion?

A

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

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18
Q

What is the Calvaria?

A

4 flat bones (x2 parietal, single frontal and occipital) fused by the coronal sagittal and lambdoid sutures

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19
Q

What are the main features on the internal view of the calavaria?

A
  • Groove for anterior branch of the middle menigeal artery
  • Granular foveolae - ararchnoid granulations that return CSF to the venous system
  • Bregma
  • Groove for superior sagittal sinus - carries venous blood back to the systemic circulation
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20
Q

What is the name for the small islands of bone that may be seen within the cranial suture?

A
  • Known as sutural, accessory or Wormian bones
  • Most commonly observed in the lambdoid

sutures

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21
Q

What is the inion?

A

Craniometric point

In the midline at the boundary between squamous and rough occipital bone

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22
Q

What is the main function of fontanelles and how do they develop?

A

o Moulding of cranial shape during birth
o Post-natal growth of brain
o Corners of frontal and parietal bones fuse by 18 months (anterior fontanelle not palpable)
o Flat bones are separated by fibrous membranes that

fuse in post-natal life (sutures)

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23
Q

What are sutures (functionally and structurally)

A

o Structurally, type of fibrous joint
o Functionally, limited or no movement (synarthrosis)

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24
Q

Name the main features (bones) on an anterior view of the skull

A
  • Frontal bone
  • Glabella
  • Nasion
  • Inferior nasal concha
  • Maxilla
  • Mental foramen (carries CN V3)
  • Infra-orbital foramen (carries CN V2)
  • Supra-orbital foramen (carries CN V1)
  • Nasal bone
  • Zygomatic bone
25
Q

What are the main craniometric points of the skull?

A
  • Lambda
  • Inion
  • Asterion
  • Nasion
  • Glabella
  • Pterion
  • Bregma (where anterior fontanelle closes)
  • Vertex
26
Q

Describe the boundaries of the infratemporal fossa

A

**Space behind maxilla and inferior to skull base

  • Laterally: Ramus of the 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
27
Q

Give the labels of this view of the cranial base

A
28
Q

Give the labels of this view of the cranial base

A
29
Q

Where is the pterygopalatine fossa?

A

Narrow space between pterygoid process of sphenoid and palatine bone

30
Q

What does the pterygopalatine fossa communicate with?

A
  • laterally with infratemporal fossa
  • medially with sphenopalatine foramen to nasal cavity
  • superior to orbit/skull via inferior orbital fissure
  • foramen rotundum = connection to middle cranial fossa
  • foramen lacerum - connects to base of the skull and middle cranial fossa (via Vidian canal)
31
Q

Draw the pathways from the ptergopalatine fossa

A
32
Q

Highlight the main spaces on an internal view of the skull

A
  • anterior cranial fossa
  • middle cranial fossae
  • posterior cranial fossa
33
Q

What are the main features of the anterior cranial fossa

A
  • Frontal, ethmoid and sphenoid bones
  • Shallowest part of cranial base
  • Occupied by frontal lobes
  • Olfactory bulbs (CN I) receive nerve fibres from the nasal cavity via the foramina of the cribriform plate (olfaction)
  • Cribriform plate fractures can present with CSF rhinorrhoea
34
Q

What are the main features of the middle cranial fossae?

A
  • Sphenoid and temporal bones
  • Occupied by temporal lobes
  • The pituitary gland lies in the hypophyseal (pituitary) fossa (deepest part of sella turcica)
  • The pituitary gland is surrounded by 5 clinoid processes and 2 superior projections (dorsum sellae posteriorly and tuberculum sellae anteriorly)
35
Q

What are the main features of the posterior cranial fossa?

A
  • Sphenoid, occipital and temporal bones
  • Occupied by the cerebellum and brainstem
36
Q

What are the main features of the mandible?

A
  • Site for muscle attachments (muscles of mastication)
  • Foramina for passage of neurovascular structures
  • Mandibular teeth within alveolar processes
37
Q

What is the articulation of the temporomandibular joint (TMJ)?

A
  • Glenoid (mandibular) fossa of temporal bone and condylar process of mandible
38
Q

What type of joint is the TMJ?

A
  • Modified hinge (atypical) synovial joint
39
Q

What are the articular surfaces of the TMJ covered in?

A
  • Articular surfaces of bone covered with fibrocartilage (not hyaline cartilage)
  • Fibrocartilaginous articular disc separating the joint into superior and inferior articular cavities
40
Q

What are the ligaments of the TMJ?

A
  • Ligaments
    • 2 extrinsic and 1 intrinsic (lateral)
    • Connect mandible to cranium
  • Sphenomandibular ligament
    • Primary passive support of the mandible
  • Lateral ligament
    • Strengthens TMJ laterally
    • With post-glenoid tubercle prevent posterior dislocation
41
Q

What are the main movements of the mandible?

A
42
Q

When is the TMJ most unstable?

A

during depression as the condylar processes move nateriorly and lie underneath the articular eminences with the mandibular head being vulnerable to anterior dislocation

43
Q

What is the contents of the Cribiform foramina in the cribifrom plate?

A

Axons of olfactory cells in olfactory epithelium that form olfactory nerves

44
Q

What is the contents of the optic canals?

A

Optic nerves (CN II) and opthalmic ateries

45
Q

What is the contents of the superior orbital fissure?

A

Opthalmic veins; opthalmic nerve (CN V1); CN II, IV and VI; and sympathetic fibres

46
Q

What is the contents of foramen rotundum?

A

maxillary nerve CN V2

47
Q

What is the contents of foramen ovale?

A

Mandibular Nerve (CN V3) and accessory menigeal artery

48
Q

What is the contents of foramen spinosum?

A

Middle menigeal artery and vein and menigeal branch of CN V3

49
Q

What is the contents of foramen lacerum?

A

Deep petrosal nerve and some menigeal arterial branches and small veins

50
Q

What is the contents of foramen magnum?

A

medulla and meniges, vertebral arteries, CN XI, dural veins, anterior and posterior spinal arteries

51
Q

What is the contents of the jugular foramen?

A

CN IX, X and XI; superior bulb of internal jugular vein; inferior petrosal and sigmoid sinuses; and menigeal branches of ascending pharyngeal and occipital arteries

52
Q

What is the contents of the hypoglossal canal?

A

Hypoglossal nerve (CN XII)

53
Q

Describe intevertebral joints

A
  • Secondary cartilaginous joint
  • Hyaline cartilage in endplates
  • Intervertebral disc – fibrous
  • Supported by
    • Anterior longitudinal ligament
    • Posterior longitudinal ligament; pierced by vertebral artery; continues cranially as tectorial membrane
54
Q

What are the main spaces of the neck?

A
55
Q

Describe the pretracheal space

A

Between investing layer and pretracheal fascia

Area extends between neck and superior mediastinum

56
Q

What is the ‘true’ retropharyngeal space?

A

Bteween buccopharyngeal fascia and superifical prevertebral fascia (alar fascia)

area extends between base of skull and superior mediastinum

57
Q

What is the danger space in the neck

A

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

58
Q

What are the movements at each level of the neck?

A
    • C0-C1
      • Flexion and extension
      • Lateral flexion
  • C1-C2
    • Rotation
    • Flexion and extension
  • C3-C7
    • Lateral flexion
    • Rotation

MD4001 - Anatomy (6 decks)

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