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The scull: principles of development and structure. The ...

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<strong>The</strong> <strong>scull</strong>: <strong>principles</strong> <strong>of</strong> <strong>development</strong> <strong>and</strong> <strong>structure</strong>.<br />

<strong>The</strong> neurocranium <strong>and</strong> splanchnocranium bones – overview.<br />

Scull <strong>of</strong> the newborn <strong>and</strong> its growth.<br />

MUDr. Veronika Němcová, CSc.


Neurocranium + splanchnocranium<br />

N<br />

L<br />

E<br />

Z<br />

Max<br />

F<br />

S<br />

M<br />

T<br />

P<br />

O


P<br />

O<br />

T (P)<br />

S<br />

Pal<br />

M<br />

Scull<br />

F<br />

N<br />

E<br />

V<br />

Max<br />

neurocranium<br />

capsula encephalica,<br />

capsula ethmoidalis,<br />

capsula optica,<br />

capsula otica<br />

splanchnocranium<br />

(viscerocranium)


Scull in the newborn, in 7 years <strong>and</strong> in adult<br />

proportions<br />

newborn<br />

7 years<br />

neurocranium<br />

splanchnocranium<br />

adult


Desmocranium <strong>and</strong> chondrocranium<br />

• intramenbranous ossification – directly<br />

from the mesenchymal connective tissue<br />

(most <strong>of</strong> the splanchnocranium <strong>and</strong><br />

calvaria)<br />

• enchondral ossification -ossification <strong>of</strong> the<br />

cartilaginous model (mainly bones <strong>of</strong> skull<br />

base)


PRIMITIVE CHONDROCRANIUM<br />

capsula<br />

ethmoidea<br />

branchial<br />

arches I<br />

capsula<br />

optica<br />

capsula<br />

otica<br />

occipital<br />

vertebrae<br />

CARTILAGINOUS CHONDROCRANIUM AND DESMOCRANIUM<br />

II<br />

VI<br />

desmocranium<br />

chondrocranium


Desmocranium <strong>and</strong> chondrocranium in the newborn<br />

os frontale<br />

os ethmoidale<br />

os nasale<br />

maxilla<br />

os lacrimale<br />

os zygomaticum<br />

desmocranium<br />

chondrocranium<br />

m<strong>and</strong>ibula Meckels<br />

cartilage<br />

os temporale -tympanic part<br />

os sphenoidale<br />

malleus<br />

os parietale<br />

squama ossis occipitalis<br />

os occipitale<br />

os temporale squama<br />

styloid process


Desmocranium <strong>and</strong> chondrocranium<br />

N<br />

L<br />

E<br />

Z<br />

Max<br />

F<br />

S<br />

M<br />

pyramis<br />

T<br />

P<br />

O<br />

mastoid process<br />

styloid process


prechordal cartilages<br />

ala orbitalis<br />

hypophysial cartilage<br />

ala temporalis<br />

parachordal<br />

cartilage<br />

periotic<br />

capsule<br />

occipital sclerotoms<br />

chorda dorsalis<br />

(notochord)<br />

Development <strong>of</strong> the <strong>scull</strong> base<br />

6 weeks<br />

Chondrocranium<br />

ethmoid bone<br />

lesser wing<br />

greater wing<br />

body sphenoid<br />

basilar part <strong>of</strong><br />

occipital bone<br />

occipital sclerotoms<br />

pyramis <strong>of</strong><br />

temporale bone


Development <strong>of</strong> the splanchnocranium – from branchial arches<br />

1. branchial arch<br />

incus<br />

stapes<br />

2. branchial arch<br />

styloid process<br />

stylohyoid ligament<br />

3. branchial arch<br />

greater horn <strong>of</strong> the hyoid bone<br />

4. branchial arch<br />

6. branchial arch<br />

lesser horn <strong>of</strong> the hyoid bone<br />

epiglottis<br />

Meckels cartilage


Chondrocranium<br />

Ossification<br />

• os occipitale –basis <strong>and</strong> lateral<br />

parts<br />

• os temporale – pyramis <strong>and</strong><br />

mastoid process<br />

• os sphemnoidale (without<br />

medial lamina <strong>of</strong> pterygoid<br />

process)<br />

• os ethmoidale<br />

• inferior nasal concha<br />

• maleus, incus stapes<br />

• styloid process<br />

• hyoid bone<br />

• Desmocranium<br />

• os occipitale – squama<br />

• os parietale<br />

• os frontale<br />

• os temporale –squama<br />

• os tympanicum<br />

• os nasale<br />

• os lacrimale<br />

• vomer<br />

• medial lamina <strong>of</strong> pterygoid<br />

process<br />

• os palatinum<br />

• os zygomaticum<br />

• maxilla<br />

• m<strong>and</strong>ibula (Meckel cartilage)


Anterior aspect<br />

L<br />

Z<br />

S<br />

Max<br />

F<br />

M<br />

N<br />

E<br />

INC<br />

V


Openings for trigeminal nerve branches <strong>and</strong> spaces<br />

orbit<br />

pirifom aperture<br />

anterior nasal spine<br />

foramen<br />

supraorbitale<br />

foramen<br />

infraorbitale<br />

foramen<br />

mentale


Norma frontalis<br />

points for measurement<br />

zygion<br />

glabella<br />

nasion<br />

gnathion


Lateral aspect<br />

L<br />

N<br />

Frankfurt plane<br />

Max<br />

Z<br />

F<br />

S<br />

M<br />

T<br />

P<br />

O


opisthocranion<br />

bregma<br />

zygion<br />

gnathion<br />

Norma lateralis<br />

points for measurement<br />

glabella<br />

nasion


Inferior aspect<br />

palatine bone<br />

infreior nasal concha<br />

vomer<br />

styloid<br />

process<br />

mastoid<br />

process<br />

S<br />

O P<br />

Teeth<br />

T<br />

Z<br />

Maxilla<br />

tympanic<br />

bone


Inferior aspect<br />

choana<br />

foramen magnum<br />

Z<br />

M<br />

P<br />

V<br />

O<br />

S<br />

T


Norma basalis<br />

points for measurement<br />

opisthocranion<br />

basion


Calvaria from outside<br />

coronal suture<br />

bregma sagittal suture<br />

parietal foramen for emissary vein<br />

lambdoid suture<br />

lambda


Norma verticalis<br />

points for measurement<br />

euryon<br />

width<br />

glabella lenght<br />

opisthocranion<br />

euryon


Calvaria from inside<br />

sulci arteriae<br />

meningeae mediae<br />

granular foveolae<br />

diploe<br />

frontal sinus<br />

sulcus sinus<br />

sagittalis<br />

superioris<br />

sinus x sinus<br />

air filled cavity x vein between dura mater <strong>and</strong> periosteum or only between dura mater


grooves for<br />

middle<br />

meningeal<br />

artrery<br />

INC<br />

Skull – sagittal section - inner surface<br />

Max<br />

M<br />

F<br />

S<br />

groove - sulcus<br />

P<br />

O<br />

grooves for<br />

sinuses<br />

grooves for branches <strong>of</strong> cranial nerves


N<br />

Skull - midline section - inner surface<br />

E<br />

V<br />

P<br />

F<br />

S<br />

T<br />

P<br />

O


Os sphenoidale<br />

posterior aspect<br />

dorsum sellae<br />

body<br />

lesser wing<br />

pterygoid process<br />

greater wing<br />

(cerebral<br />

orbital<br />

temporal<br />

infratemporal<br />

+sphenomaxilar<br />

surfaces)


Sphenoid bone<br />

anterior aspect - schema<br />

greater wing<br />

lesser wing<br />

pterygoid process<br />

„the pilot sits“ in the<br />

hypophyseal fossa<br />

sphenoid<br />

rostrum<br />

sphenoid sinus<br />

superior<br />

orbital fissure<br />

foramen rotundum<br />

pterygoid canal


ethmoid, frontal,<br />

occipital; parietal,<br />

temporal<br />

Os sphenoidale - placement<br />

right orbit<br />

ethmoid, frontal, zygomatic


Os sphenoidale <strong>and</strong> maxilla, palatine bone <strong>and</strong> vomer<br />

pterygomaxillary fissure<br />

lateral aspect<br />

perpendicular plate<br />

<strong>of</strong> the palatine bone<br />

lateral wall <strong>of</strong> the nasal cavity<br />

vomer<br />

nasal septum


Os sphenoidale –<br />

inferior aspect<br />

Os palatinum<br />

Vomer


Os sphenoidale openings <strong>and</strong> grooves<br />

aspect from superoposterior left side<br />

sulcus prechiasmaticus<br />

superior orbital fissure<br />

turkish saddle<br />

optic canal<br />

canalis<br />

pterygoideus<br />

fossa hypophysialis<br />

sulcus caroticus<br />

foramen<br />

rotundum<br />

foramen<br />

spinosum<br />

foramen ovale


dorsum sellae<br />

Sella turcica<br />

(turkish saddle)<br />

hypohysial<br />

fossa<br />

anterior clinoid process<br />

sphenoid sinus


Os temporale- lateral aspect<br />

zygomatic bone<br />

graeter wing <strong>of</strong> sphenoid<br />

parietal bone<br />

temporale bone - squama<br />

occipital bone


Os temporale inferior aspect - parts<br />

zygomatic process<br />

tympanic part<br />

mastoid process<br />

squamous part<br />

petrosal part (pyramis)<br />

styloid process


Os temporale -superior aspect<br />

anterior <strong>and</strong> posterior wallgrooves<br />

<strong>of</strong> sinuses, nerves <strong>and</strong><br />

middle meningeal artery<br />

os petrosum – pyramis, inside are:<br />

1) bony labyrinth<br />

2) canalis caroticus<br />

3) canalis nervi facialis<br />

4) canalis musculotubarius<br />

5) canaliculus cochlea<br />

6) aquaeductus vestibuli<br />

7) canaliculus tympanicus (for branch <strong>of</strong> IX.n)<br />

8) canaliculus chordae tympani (from VII.n)<br />

9) canaliculus mastoideus (for external branch<br />

<strong>of</strong> X.n.)<br />

squama


Position <strong>of</strong> the inner ear in petrosal bone<br />

cochlea<br />

canales<br />

semicirculares<br />

(ant., post., lat.)<br />

n.vestibulocochlearis


Os temporale labyrinthus osseus<br />

1-squama<br />

2-porus acusticus int.<br />

n.VII +VIII)<br />

3-sulcus sinus sigmoidei<br />

4-apex pyramidis<br />

5-semicircular canals


Os temporale cochlea<br />

cochlea<br />

impressio n.trigemini<br />

squama ossis<br />

temporalis<br />

antrum<br />

mastoideum


Fossa cranii posterior<br />

meatus acusticus internus<br />

(n.VII. a n.VIII.)<br />

sulcus sinus petrosi<br />

inferioris<br />

foramen jugulare<br />

(n.IX., X., a XI.)<br />

canalis nervi hypoglossi<br />

Os petrosum (pyramis) - posterior wall<br />

fossa subarcuata<br />

apertura externa<br />

aquaeductus vestibuli<br />

sulcus sinus sigmoidei


Os petrosum (pyramis) - posterior wall<br />

sulcus<br />

meatus acusticus<br />

internus<br />

sinus<br />

petrosi apertura externa aquaeductus vestibuli<br />

nerves VII,VIII superioris<br />

semicircularendolymphatetic<br />

cochlea canals sac<br />

sulcus sinus<br />

petrosi inferioris<br />

incisura jugularis<br />

(jugular notch)<br />

sulcus sinus sigmoidei<br />

nerves IX,X,XI.


Fundus meatus acustici interni – nerves VII. <strong>and</strong> VIII.<br />

right pyramis posterior aspect<br />

crista transversa<br />

A<br />

area n. facialis<br />

facial nerve –n.VII.<br />

cochlear nerve<br />

area<br />

vestibularis<br />

superior<br />

P<br />

area<br />

vestibularis<br />

inferior


Canalis nervi facialis<br />

1) anterolateraly<br />

2) posterolateraly<br />

3) caudaly<br />

internal acoustic<br />

meatus<br />

facial nerve (VII.n)<br />

cochlear nerve<br />

vestibular nerve<br />

greater<br />

petrosal nerve<br />

stylomastoid foramen


Important openings<br />

on the inferior wall<br />

<strong>of</strong> petrosal bone<br />

canaliculus mastoideus<br />

(ramus auricularis n.vagi)<br />

tympanomastoid fissure<br />

(ramus auricularis n.vagi)<br />

mastoid foramen<br />

(emissary vein)<br />

stylomastoid foramen<br />

(facial nerve – VII.n)<br />

petrotympanic fissure<br />

(chorda tympani)<br />

carotid canal<br />

internal carotid artery<br />

fossula petrosa<br />

(tympanic nerve)<br />

opening <strong>of</strong><br />

canaliculus cochleae<br />

jugular fossa<br />

(internal<br />

jugular vein)


Walls<br />

Middle ear cavity (cavum tympani)<br />

Lat.- membranous wall<br />

(drum)<br />

Sup.- tegmental wall – tegmen tympani<br />

post. mastoid wall<br />

ant. - carotic wall<br />

Inf.- jugular wall – jugular vein<br />

Med.- labyrinthic wall<br />

(inner ear)


Section -<br />

anterobasal wall<br />

<strong>of</strong> petrosal bone<br />

– medial wall <strong>of</strong><br />

the middle ear<br />

cavity<br />

Mastoid<br />

aer cells<br />

n. stapedius<br />

Mastoid<br />

antrum<br />

chorda<br />

tympani<br />

Epitympanic<br />

recess<br />

Facial canal<br />

Tympanic nerve<br />

(from IX.n)


Tympanic cavity – schematic frontal section<br />

Paries labyrinthicus – anterobasal wall <strong>of</strong> petrosal bone<br />

Recessus<br />

epitympanicus<br />

Membrana<br />

tympani<br />

chorda tympani<br />

Fossa cranii media<br />

M<br />

I<br />

S<br />

Bulbus v. jugularis int.<br />

Canalis semicircularis<br />

lateralis<br />

N. facialis<br />

Fenestra ovalis -<br />

vestbuli<br />

Promontorium – 1.<br />

convolution <strong>of</strong><br />

cochlea<br />

Fenestra rotunda -<br />

cochleae


Os ethmoidale<br />

posterior<br />

aspect<br />

bulla<br />

ethmoidale air cells ethmoidalis<br />

(cellulae ethmoidales)<br />

processus uncinatus<br />

concha nasalis media<br />

crista galli<br />

cribriform plate<br />

orbital plate<br />

perpendicular plate


frontal process<br />

zygomatic process<br />

corpus maxillae<br />

(body)<br />

Maxilla<br />

tuber maxillae<br />

alveolar process


praemaxilla<br />

(os incisivum)<br />

Maxilla<br />

palatine process


Maxilla<br />

maxillary sinus


M<strong>and</strong>ible lateral aspect<br />

alveolar<br />

process<br />

mental<br />

protuberance<br />

coronoid process<br />

m<strong>and</strong>ibular notch<br />

corpus m<strong>and</strong>ibulae<br />

condylar<br />

process<br />

ramus<br />

m<strong>and</strong>ibulae


M<strong>and</strong>ible<br />

anterolateral view<br />

pterygoid<br />

tuberosity<br />

m<strong>and</strong>ibular foramen<br />

masseteric<br />

tuberosity<br />

mental foramen<br />

pterygoid fossa


sublingual fossa<br />

mylohyoid line<br />

subm<strong>and</strong>ibular fossa<br />

m<strong>and</strong>ibular foramen<br />

mylohyoid groove


M<strong>and</strong>ible <strong>of</strong> Karel IV.<br />

Post traumatic changes A-C<br />

Correction <strong>of</strong> the occlusion


Skull <strong>of</strong> a newborn<br />

Lenght 11 cm<br />

Circumference 34 cm<br />

Fonticulus anterior<br />

it closes in 2-3 years


Lenght 11 cm<br />

Circumference 34 cm<br />

fontanellae = fonticuli cranii<br />

Fontanella major<br />

(it closes in 2. or 3.year)<br />

Fontanella minor<br />

(it closes in 3.month)


Fonticulus minor<br />

Tuber<br />

parietale<br />

Fonticulus major<br />

Tuber<br />

frontale<br />

Tuber


Sutura metopica<br />

Fonticulus major<br />

Symphysis menti Angulus m<strong>and</strong>ibulae


Fonticulus<br />

sphenoidalis<br />

Sutura<br />

mendosa<br />

Fonticulus<br />

angulus m<strong>and</strong>ibulae<br />

Anulus tympanicus mastoideus


Synchondrosis sphenooccipitalis<br />

Symphysis menti<br />

Synchondrosis<br />

intraoccipitalis<br />

anterior<br />

Fonticulus<br />

mastoideus<br />

Synchondrosis<br />

intraoccipitalis<br />

posterior


Craniosynostoses<br />

premature<br />

closure <strong>of</strong> cranial<br />

sutures<br />

trigonocephaly<br />

tuber frontale<br />

sutura coronalis<br />

tuber parietale<br />

brachycephaly<br />

sutura lambdoidea<br />

anterior<br />

plagiocephaly<br />

sutura metopica<br />

fonticulus anterior<br />

sutura sagittalis<br />

fonticulus posterior<br />

posterior plagiocephaly<br />

dolichocephaly<br />

(scaphocephaly)


Skull <strong>of</strong> a newborn<br />

Big neurocranium<br />

Small splanchnocranium<br />

Prominent tubera frontalia et parietalia (centers <strong>of</strong> ossification)<br />

Fonticuli cranii<br />

Possible movement among bones <strong>of</strong> the calvaria<br />

Paranasal sinuses are not fully developed<br />

Os frontale divided by a suture<br />

Suture between maxilla <strong>and</strong> premaxilla<br />

Symphysis menti<br />

Angle <strong>of</strong> m<strong>and</strong>ible -150-160 degree<br />

Os tympanicum – anulus tympanicus


X-ray skull <strong>of</strong> a newborn


Lenticular left parietal calvarial mass-like lesion with<br />

peripheral sclerosis/calcification <strong>and</strong> central lucency.<br />

<strong>The</strong> lesion does not cross suture lines<br />

Subperiosteal cephalohematoma.


Cranial nerves !!!<br />

• I. nn. olfactorii<br />

• II. n. opticus<br />

• III. n. oculomotorius<br />

• IV. n. trochlearis<br />

• V. n. trigeminus 1.ophthalmicus<br />

• 2.maxillaris<br />

• 3.m<strong>and</strong>ibularis<br />

• VI. n. abducens<br />

• VII. n. facialis<br />

• VIII. n. vestibulocochlearis<br />

• IX. n. glossopharyngeus<br />

• X. n. vagus<br />

• XI. n. accessorius<br />

• XII. n. hypoglossus


Development<br />

<strong>of</strong> the face<br />

1- maxillary process<br />

2-m<strong>and</strong>ibular process<br />

3-second branchial arch<br />

3<br />

2<br />

1


Development<br />

<strong>of</strong> the face<br />

1-maxillary process<br />

2- m<strong>and</strong>ibular process<br />

3-medial nasal process<br />

4-lateral nasal process<br />

stadium 12<br />

I<br />

II<br />

stadium 13<br />

1<br />

1<br />

2<br />

3<br />

stadium 15<br />

2<br />

4<br />

3


prominentia<br />

nas<strong>of</strong>rontalis<br />

oropharyngeal<br />

membrane<br />

Development <strong>of</strong> the face<br />

4 weeks<br />

6 weeks<br />

maxillar<br />

process<br />

5 weeks<br />

7 weeks<br />

internasal<br />

groove<br />

5,5 weeks<br />

9 weeks


Development <strong>of</strong> palate <strong>and</strong> nasal septum <strong>and</strong> nose<br />

medial nasal process<br />

lateral nasal<br />

process<br />

maxillar<br />

process<br />

primary palate<br />

nasal septum<br />

palatine process<br />

internasal groove


Meckel<br />

cartilage<br />

Development <strong>of</strong> the palatine processes<br />

palatine<br />

process<br />

nasal septum<br />

tongue<br />

palatine process


Sources<br />

• Čihák, Anatomie 1<br />

• Gray, Anatomy<br />

• Petrovický a spol., Anatomie 1<br />

• Sobotta , Atlas anatomie člověka<br />

• Ten Donkelaar, Lohmann en Moorman, Klinische<br />

Anatomie en Embryologie<br />

• Thieme, Atlas <strong>of</strong> Anatomy<br />

• http://anat.lf1.cuni.cz/muzeum/kranio.html<br />

• Personal archiv

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