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1. MMS - Skull and Cranial Nerves (1).pptx - Skull and...

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Skull and Cranial NervesAnthony Pappas, Ph.D.LECOM Bradenton – MMS
Learning ObjectivesUnderstand the anatomy of the bonescomprising the skull – viscerocranium andneurocraniumUnderstand the 12 cranial nerves, the type ofinformation each nerve carries and theirrelationship to the skull.Be able to predict cranial nerve lesions basedon symptoms
The Human SkullMost bones of the skull are joinedby interlocking fibrous suturesTemporomandibular joint (TMJ)is a synovial jointSphenoid and occipital bonesbecome united by hyalinecartilage (synchondrosis)mandibletemporal bonesutures
The Human SkullSutures form the fibrous jointsconnecting the bones of the skullObliteration of the sutures beginsinternally (30 - 40 yr) and endsexternally (~50 yr)
Sutures – Lateral viewcoronallambdoidsquamoussphenoparietalparietomastoidoccipitomastoid
Sutures – Posterior viewlambdoidsagittaloccipitomastoid
Sutures – Superior viewlambdoidcoronalsagittal
Craniometric pointsBregma – intersection betweenthe coronal and sagittal suturesLambda – intersection betweenthe sagittal and lambdoid suturesPterion – intersection betweenthe frontal, parietal, sphenoid andtemporal bonesFSTP
Clinical Note – Epidural hematomaFracture of the pterion can causea life-threatening intra-cranialhemorrhage calledepiduralhematoma.The bleed is due to rupture of theanterior branch of the middlemeningeal arteryBlood pools within the epiduralspace (i.e., between dura andcalvaria) causing a dangerousincrease in intra-cranial pressure
Clinical Note – Epidural hematomaFracture of the pterion can causea life-threatening intra-cranialhemorrhage calledepiduralhematoma.The bleed is due to rupture of theanterior branch of the middlemeningeal arteryBlood pools within the epiduralspace (i.e., between dura andcalvaria) causing a dangerousincrease in intra-cranial pressure
Fetal and infant skullSome fibrous membranesbetween skull bones do not ossifyuntilafter birth creating distinctfontanelles (anterior andposterior).The delayed ossification permitssome skull deformation at birthand accommodates the rapidgrowth of the brain
Anterior and Posterior Fontanelles
Clinical Note – Palpation of fontanellesPalpation of the fontanelles is usefulfor monitoring the growth of thefrontal and parietal bones.Dehydrated infants will havedepressed fontanellesBulging fontanelles indicatesincreased intra-cranial pressure
Clinical Note – Premature closure of the sutures(craniosynostosis)Absent or narrow anteriorfontanellePremature closure of thecoronal or lambdoid sutureunilaterallyPremature closure ofcoronal suture bilaterally
Neurocranium vs Viscerocranium
Neurocranium vs ViscerocraniumThe viscerocranium provides theskeleton of the faceBones – 2 lacrimal, 2 nasal, 2maxillae, 2 zygomatic, 2 palatine,2 inferior nasal conchae, a singlemandible and a single vomerContains the orbits, nasalcavities, upper and lower jaws

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Term
Fall
Professor
N/A
Tags
Facial nerve, trigeminal nerve

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