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Unit 1
Skull, meninges, spinal cord
| Term | Definition |
|---|---|
| # bones and attachments? | 22 bones excluding ossicles -> all firmly attached via sutures/immovable xcp temporomandibular joint |
| Details of skull ossification | Cranial vault ossifies in membrane -> frontal, parietal, occipital, squamous temporal bone, skull base ossifies in cartilage around cranial nerves -> foramina |
| Skull sutures | Coronal -> btwn frontal/2 lateral parietal, sagittal -> btwn 2 lateral parietal, lambdoid -> btwn 2 lateral parietal/occipital |
| Which bones form the calvaria of the skull? | Paired temporal/parietal bones, parts of unpaired frontal/sphenoid/occipital bones |
| Which bones form the base of the skull? | Parts of sphenoid/temporal/occipital bones |
| Which bones form the viscerocranium? | Paired nasal/palatine/lacrimal/zygomatic/maxillae/inferior nasal conchae, unpaired vomer |
| What bone is not part of the cranium/viscerocranium? | Mandible |
| Superciliary arches | Frontal -> superior to orbit rim -> more pronounced in men > women |
| Glabella | Frontal -> small depression inbtwn superciliary arches |
| Supraorbital notch | Frontal -> foramen in medial part of superior orbit rim for supraorbital neurovascular bundle (CN Va -> upper eyelid/forehead/scalp sensation) -> in line w/ infraorbital foramen/mental foramen |
| Zygomatic process | Frontal -> forms upper lateral rim of orbit -> articulates w/ zygomatic bone frontal process |
| Zygomaticofacial foramen | Zygomatic -> foramen in lateral surface for zygomaticofacial neurovascular bundle (CN Vb -> pierces orbicularis oculi -> cheek prominence sensation) |
| Frontal process | Zygomatic -> superior projection of superolateral body -> articulates w/ frontal bone zygomatic process |
| Temporal process | Zygomatic -> posterior projection of posterolateral edge -> articulates w/ temporal zygomatic process |
| Crista galli | Ethmoid - perpendicular plate of cribriform plate -> attachment for falx cerebri |
| Perpendicular plate | Ethmoid -> assists in nasal septum formation -> inferior border attachment for septal nasal cartilage |
| Conchae | Ethmoid -> superior conchae -> inferior to sphenoethmoidal recess, Ethmoid -> middle conchae -> grooves for olfactory nerve branches running to superior nasal concha mucus membrane Inferior nasal conchae -> lateral surface forms inferior meatus |
| Sella turcica | Sphenoid -> houses pituitary gland and sphenoidal sinuses in MCF, posterior to tuberculum sellae (ant clinoid process), anterior to dorsum sellae (post clinoid process)/clivus |
| Diaphragma sellae | Sphenoid -> dura mater membrane btwn pituitary gland/sella turcica surface -> central opening for infundibulum connecting pituitary to brain |
| Greater wing | Sphenoid -> lateral projections inferior to lesser wing -> superior surface forms floor of MCF, presents foramen rotundum/ovale/spinosum, lateral surface pierced by foramen ovale/spinosum |
| Lesser wing | Sphenoid -> anterosuperior projections superior to lesser wing -> inferior surface forms upper boundary of SOF |
| Medial pterygoid region | Sphenoid -> attachment for tensor veli palatini in scaphoid fossa -> tendon winds around pterygoid hamulus -> inserts into palatine bone |
| Lateral pterygoid region | Sphenoid -> medial pterygoid muscle (vertical fibres) joins masseter -> insert into inside mandible ramus/angle, lateral pterygoid muscle (horizontal fibres) -> insert into articular disc/fibrous capsule of temporomandibular joint |
| Optic canal | Sphenoid -> MCF -> CN II/ophthalmic artery |
| SOF | Sphenoid -> MCF -> CN III, IV, Va lacrimal/frontal/nasociliary branches, VI, superior ophthalmic vein |
| Foramen rotundum | Sphenoid -> MCF -> CN Vb |
| Foramen lacerum | Sphenoid -> MCF -> greater petrosal nerve, meningeal branch of ascending pharyngeal artery |
| Foramen ovale | Sphenoid -> MCF -> CN Vc, lesser petrosal nerve, accessory meningeal artery |
| Foramen spinosum | Sphenoid -> MCF -> CN Vc meningeal branch, middle meningeal artery |
| IOF | Sphenoid/maxilla -> CN Vb zygomatic/infraorbital branches (pterygopalatine ganglion), inferior ophthalmic vein, infraorbital vessels |
| Infraorbital foramen | Maxilla -> infraorbital neurovascular bundle -> in line w/ supraorbital notch/mental foramen |
| Carotid canal | Temporal -> MCF -> ICA and plexus -> anterior to jugular foramen |
| IAM | Temporal -> PCF -> CN VII, VIII, labyrinthine artery |
| Jugular foramen | Temporal -> PCF -> CN IX, X, XI (cranial), IJV, inferior petrosal sinus, sigmoid sinus |
| Hypoglossal canal | Occipital -> PCF -> CN XII |
| Foramen magnum | Occipital -> PCF -> CN XI (spinal), lowest part of medulla, 3 meninges, vertebral arteries, ant/post spinal arteries |
| Meningeal layer/spaces | Skull -> extradural space -> dura mater -> subdural space -> arachnoid mater -> subarachnoid space -> pia mater |
| Extradural space | Potential space -> dura mater usually firmly attached to skull -> epidural haematoma |
| Dura mater layers | Outer periosteal layer, inner meningeal layer |
| Outer periosteal layer | Dura mater -> firmly attached to skull -> continuous w/ pericranium throughout cranial sutures/foramen |
| Inner meningeal layer | Dura mater -> reflected to form 4 septa/dural folds -> falx cerebri, tentorium cerebelli, falx cerebelli, diaphragma sellae |
| Falx cerebri | Dura mater -> separates 2 cerebral hemispheres, ant attachments to frontal crest (frontal), crista galli (ethmoid), post attachments to tentorium cerebelli |
| Tentorium cerebelli | Dura mater -> separates cerebellum/post cerebral hemispheres, post attachments to transverse sinus grooves, lateral attachments to superior border of petrous temporal bone, midline oval opening (tentorial notch) for midbrain |
| Falx cerebelli substance/function/attachments | Dura mater -> separates 2 cerebellar hemispheres -> sup attachment to midline tentorium cerebelli, post attachment to internal occipital crest |
| Dura mater cranial/spinal | 2 lamellae in cranium (outer periosteal/inner meningeal), 1 layer in spine (meningeal) |
| Subdural space | Anatomically non-existent -> cerebral vein bleeding -> subdural haematoma |
| Arachnoid mater | Thin avascular membrane entering longitudinal fissure |
| Cranial arachnoid mater | Thicker than spinal arachnoid, thin trabeculae cross subarachnoid space -> continuous w/ pia mater -> keep brain suspended in skull |
| Spinal arachnoid mater | Expands at level of conus medullaris -> lumbar cistern from L1-S2 -> contains cauda equina (L2-Co) -> site of lumbar puncture |
| Subarachnoid space | Enlarges into cisterns -> contains CSF produced by choroid plexus in brain ventricles -> returns to venous system via arachnoid villi -> superior sagittal sinus -> circle of Willis aneurysm (post/ant communicating) -> subarachnoid haemorrhage |
| Pia mater | Thin delicate highly vascularised membrane |
| Pia mater cranial/spinal | Cranial -> thinner than spinal, loosely attached to brain, spinal -> follows ventral median fissure of spinal cord |
| Occipital condyles | Articulate w/ superior facets of C1 (atlas) vertebra |
| Odontoid process | Superior projection of C2 (axis) -> dens |
| Cruciate ligament | Attachest atlas body to occipital condyle/foramen magnum -> merges w/ atlas transverse ligament to form dorsal cross |
| Lumbar puncture layers | Skin, subcutaneous layer, back muscles, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space |
| Ligaments of spinal cord | Anterior/posterior longitudinal ligament, ligamenta flava, supraspinatus ligament, ligamentum nuchae, interspinous ligament |
| Anterior longitudinal ligament location/function | Anterolateral surfaces of vertebral bodies/IV discs -> occipital/anterior foramen magnum/anterior C1 tubercle -> anterior surface of upper sacrum -> prevents spine hyperextension |
| Posterior longitudinal ligament location/function | Posterior surfaces of vertebral bodies w/in vertebral canal -> tectorial membrane -> sacrum -> narrower/weaker than ant ligament -> resists vertebral column hyperflexion and prevents IV disc nucleus pulposus posterior herniation |
| Ligamentum flava location/function | Broad ligaments connecting adjacent vertebral arch laminae -> posterior surface of vertebral canal -> yellow elastic tissue -> resist laminae separation during flexion, aids extension of vertebral column back to erect posture |
| Interspinous ligaments location | Connect adjacent vertebral spinous processes -> blends w/ ligamentum flava ventrally and supraspinous ligament dorsally |
| Supraspinous ligament location/function | Connects tips of spinous processes from C7 -> sacrum -> continuous superiorly w/ cervical nuchal ligament -> prevents separation of spinous processes during flexion, resists hyperflexion |
| Nuchal ligament location/function | Triangular fibroelastic band from external occipital protuberance/posterior foramen magnum/posterior C1 tubercle -> tip of C7 spinous process (merge w/ supraspinous ligament) -> resists neck flexion |
| Intertransverse ligaments location/function | Connect adjacent vertebral transverse processes -> limit lateral flexion |
| Atlas transverse ligament location/function | Atlas medial tubercles -> odontoid process/dens posterior articular facet -> merges w/ cruciate ligament to form dorsal cross |
| Dens | Superior projection of C2 (axis) -> odontoid process |
| Alar ligament location/function | Posterolateral dens -> lateral foramen magnum -> resist excessive head rotation |
| Tectorial membrane | Superior continuation of posterior longitudinal ligament -> C2 body -> through foramen magnum to blend w/ cranial dura mater on central floor of cranial cavity |
| Denticulate ligament | Lateral projections of pia mater -> anchor spinal cord to dura mater bilaterally -> 21 denticulate ligaments each side -> below foramen magnum -> btwn T12/L1 |
| How many spinal cord nerve roots? | 31 pairs of spinal nerves/roots from 33 vertebrae |
| Spinal cord length | Foramen magnum -> L1 lower border as conus medullaris |
| What is filum terminale? | Pia mater stalk that attaches conus medullaris (end of spinal cord - L1) to end of dursal sac (S2) |
| What is cauda equina? | Carries roots of spinal nerves L2 - Co to exit at respective intervertebral foramina |
| Where is child lumbar puncture? | In line w/ L3 as child spinal cord ends at L3 (vertebral column grows longitudinally into adulthood whereas spinal cord stops at age 4) |
Created by:
vykleung
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