CRANIUMCRANIUM

THETHE SKULLSKULL

R.R. DrugaDruga InstituteInstitute ofof Anatomy,Anatomy, 2nd2nd andand 1st1st MedicalMedical FacultyFaculty

NEUROCRANIUMNEUROCRANIUM

SPLANCHNOCRANIUMSPLANCHNOCRANIUM

CRANIUM,CRANIUM, THETHE SKULLSKULL II  MostMost highlyhighly modifiedmodified regionregion inin thethe axialaxial skeletonskeleton

 TheThe neurocraniumneurocranium –– developeddeveloped fromfrom aa seriesseries ofof cartilagescartilages ventralventral toto thethe brainbrain (base)(base)  FromFrom mesenchymemesenchyme overover thethe domedome ofof thethe headhead (calvaria(calvaria oror calva)calva)  CranialCranial cavitycavity

 SplanchnocraniumSplanchnocranium –– branchialbranchial apparatusapparatus (cartilaginous(cartilaginous elements)elements) havehave beenbeen replacedreplaced byby overlyingoverlying dermaldermal bonesbones

BranchialBranchial apparatusapparatus

 TheThe mandibularmandibular regionregion andand thethe neckneck areare formedformed byby sixsix pairedpaired branchialbranchial archesarches (cart.(cart. barsbars supportingsupporting thethe gillgill apparatus).apparatus).  InIn thethe tetrapodstetrapods branchialbranchial archesarches werewere modifiedmodified andand persistpersist inin thethe facialfacial (maxilla,(maxilla, mandibula)mandibula) andand neckneck skeletonskeleton (laryngeal(laryngeal cartilages)cartilages)

Derivatives of cartilagines of the branchial arches

1st arch = Meckel cart., mandibula, malleus

2nd arch = Reichert cart., stapes, styloid proc.,stylohyoid lig.

3rd arch = hyoid bone

4th and 6th arch = laryngeal cartil.

CRANIUMCRANIUM IIII

 ComplexComplex ofof skeletalskeletal elements,elements, adaptedadapted toto supportsupport andand containcontain thethe brain,brain, brainbrain vessels,vessels, cranialcranial nervesnerves andand envelopsenvelops  SpecialSpecial sensessenses (eye(eye ball,ball, nasalnasal cavity,cavity, innerinner ear)ear)  IntracranialIntracranial spacesspaces (epidural,(epidural, subdural,subdural, subarachnoideal)subarachnoideal)  CirculatingCirculating cerebrospinalcerebrospinal fluidfluid  x

CRANIUMCRANIUM

 KomplexKomplex kostíkostí axiálníhoaxiálního skeletuskeletu  ObsahujeObsahuje mozek,mozek, mozkovémozkové cévycévy aa obalyobaly  ObsahujeObsahuje očníoční koulikouli aa sluchovýsluchový aparátaparát  ČleníČlení sese nana bazibazi lební,lební, kalvukalvu (calvaria)(calvaria) aa nana obličejovýobličejový skelet.skelet.  ProPro klinickouklinickou medicinumedicinu mámá největšínejvětší významvýznam bazebaze lebnílební aa obličejovýobličejový skeletskelet !!!!

CRANIUMCRANIUM IIIIII

 GeneralGeneral cranialcranial featuresfeatures  BaseBase  CalvariaCalvaria  FacialFacial skeletonskeleton  Spaces,Spaces, cavitiescavities  TheThe skull,skull, consideredconsidered asas aa whole,whole, isis ofof greatergreater practicalpractical importanceimportance thanthan thethe individualindividual bonesbones ofof whichwhich itit isis mademade upup !!!!!!!!!!!! MostMost importantimportant partpart ofof thethe skullskull isis thethe base.base.

Norma lateralis

Norma facialis or Norma frontalis

The orbit

The anterior nasal aperture

The interior of the cranium Basis cranii interna

Norma basalis Basis cranii externa

The anterior, middle and posterior cranial fossa

Basis cranii ! interna Fossae cranii

OS OCCIPITALE

Squamous, basilar and lateral part

Internal aspect Cruciate eminence, 4 fossae

Occipital bone of a newborn child

Posterior aspect

Inferior aspect

OS SPHENOIDALE Body The greater In the base of wings the skull The Resembles a lesser bird with wings wings outstretched The pterygoid processes

Posterior aspect

Chiasmatic sulcus – optic cana Superior Hypophyseal aspect fossa Dorsum sellae Sella turcica Sulcus caroticus

SphenoidSphenoid bonebone –– bodybody

 Cubical,Cubical, containscontains twotwo airair sinusessinuses // septumseptum  AnteriorlyAnteriorly –– ethmoidethmoid bonebone  PosteriorlyPosteriorly –– occipitaloccipital bonebone  SulcusSulcus chiasmatischiasmatis (optic(optic canal)canal)  HypophysealHypophyseal fossafossa ++ DorsumDorsum sellae=sellae= sellasella turcicaturcica (Turkish(Turkish saddle)saddle)

Fissura orbitalis superior : III., IV., VI., V/1, V. orbitalis sup.

For. rotundum : V/2 For. ovale : V/3 For. spinosum: a. meningea media

ANTERIOR ASPECT

GreaterGreater wingwing –– 55 surfacessurfaces (facies)(facies)

 CerebralCerebral surfacesurface –– partpart ofof thethe midlemidle cranialcranial fossafossa  OrbitalOrbital surfacesurface –– partpart ofof thethe laterallateral wallwall ofof thethe orbitorbit  TemporalTemporal surfacesurface –– temporaltemporal fossafossa  InfratemporalInfratemporal surface-surface- infratemporalinfratemporal fossafossa  SphenomaxillarSphenomaxillar surface-surface- pterygopalatinepterygopalatine fossafossa

OS TEMPORALE

Parts: Squamous Petromastoid Tympanic (styloid process)

PetrousPetrous partpart ofof thethe temporaltemporal bonebone

 IsIs wedgedwedged betweenbetween thethe sphenoidsphenoid andand occipitaloccipital bonesbones  HasHas aa base,base, anan apex,apex, fourfour surfaces,surfaces, threethree marginsmargins  TheThe anterioranterior (superior)(superior) surfacesurface ((trigeminal impression, arcuate eminence)  TheThe posteriorposterior surfacesurface (the internal acoustic meatus)  TheThe inferiorinferior surfacesurface ((the carotid canal, the jugular fossa)  TheThe ventrobasalventrobasal surfacesurface ((medial wall of the tympanic cavity)

 x

OSOS TEMPORALETEMPORALE –– PARSPARS PETROSA,PETROSA, PYRAMISPYRAMIS

 KlínovitáKlínovitá konfigurace-konfigurace- mezimezi osos sphenoidalesphenoidale aa occipitaleoccipitale  Base,Base, apex,apex, 44 stěnystěny (facies)(facies)  FaciesFacies posteriorposterior (porus(porus acusticusacusticus internus)internus)  FaciesFacies inferiorinferior (canalis(canalis caroticus,caroticus, fossafossa jugularis)jugularis)  FaciesFacies anterioranterior (eminentia(eminentia arcuata,arcuata, impressioimpressio trigeminalis)trigeminalis)  FaciesFacies ventrobasalisventrobasalis (=(= mediálnímediální stěnastěna cavumcavum tympani)tympani)

Temporal bone + pyramis – external aspect

PYRAMIS-internal aspect (facies ant. et post.)

Internal acoustic meatus - n. VII., n.VIII.)

Porus and meatus acusticus internus

Meatus acusticus internus l. dx.

PYRAMIS, FACIES INFERIOR

Carotid canal

Stylomastoid foramen (n. VII.) Jugular foramen Jugular foramen (internal jugular vein, N. IX., X., XI.)

Canaliculus for the tympanic nerve

Facies inferior

Canalis caroticus Foramen jugulare Processus styloideus Foramen Stylomastoideum Processus mastoideus Fossa mandibularis Canaliculus tympanicus

PYRAMIS : FACIES VENTROBASALIS

Medial wall of the tympanic cavity

Mastoid air cells

Celullae mastoideae

Pneumatic type

Stylomastoid foramen.

Canalis n. facialis

Tympanic cavity

Promontory Tympanic nerve – Tympanic plexus

Tympanic cavity, posterior wall

N. VII.

Mastoid antrum Pyramidal (3,5) eminence Chorda tympani

External auditory meatus (1) Tympanic sulcus

PyramidPyramid -- canalscanals andand spacesspaces

 CanalisCanalis nervinervi facialisfacialis –– meatus ac. internus – for. Stylomastoideum (3 parts :ventrolateral, dorsolateral, caudal)  CanalisCanalis caroticuscaroticus –– facies inferior – apex pyramidis  CanaliculusCanaliculus tympanicustympanicus –– fossula petrosa – cavum tympani – sulcus promontorii  CanaliculusCanaliculus chordaechordae tympanitympani –– canalis n. facialis –– cavum tympani – fissura petrotympanica  CanalisCanalis musculotubariusmusculotubarius –– m. tensor tympani, Eustachian tube  LabyrinthusLabyrinthus osseusosseus – vestibulum, canales semicirculares, cochlea

OS FRONTALE, SQUAMA FRONTALIS, PARTES ORBITALES

Desmogenní osifikace ze dvou základů

Inferior aspect

Roof of the orbit

OS FRONTALE, PARTES ORBITALES, PARS NASALIS (Apertura sinus frontalis)

Internal aspect SQUAMA FRONTALIS

OSOS ETHMOIDALEETHMOIDALE

 LaminaLamina cribrosacribrosa (nerve(nerve I.)I.)  LaminaLamina perpendicularisperpendicularis (crista(crista galli)galli)  LabyrithiLabyrithi ethmoidalesethmoidales (cellulae(cellulae ethmoidales)ethmoidales)  LaminaLamina orbitalisorbitalis (papyracea)(papyracea)  ConchaConcha nasalisnasalis mediamedia etet superiorsuperior

Cock´ s comb

Parietal bone

Sulci of the middle meningeal Epidural space artery

Epidural hematoma

OBLIČEJOVÝ SKELET

FACIAL SKELETON

Maxilla 4 plochy 4 surfaces

Tělo + 4 výběžky: Facies : anterior, Body + 4 processes posterior, (proc. orbitalis frontalis, nasalis (the base palatinus, of the hollow zygomaticus pyramidal body) (/apex), alveolaris) Maxillary hiatus is ovelaid by ethmoid Maxillary conchae sinus (25 cm3)

MaxillaMaxilla -- ossificationossification

 TheThe maxillamaxilla ossifiesossifies inin membrane.membrane.  TheThe premaxillapremaxilla (incisive(incisive bone,bone, carryingcarrying incisorincisor teeth)teeth) isis inin mostmost mammalsmammals anan independentindependent bone.bone.

OSSAOSSA PALATINA PALATINA

Orbital process (3) Sphenoidal process (5) Sphenopalatine incisure

MANDIBULA Corpus – CORPUS + Alveolar process RAMUS – Condylar process Each half (articular ossifies from a surface) single centre in membrane Coronoid ovelying the process Meckel (temporalis m.) cartilage

Sublingual fossa Submandibular fossa

Mandibular canal

Ramus in line with the body Age changes in the mandible

Following the loss of teeth the alveolar part is absorbed

THE THE NASAL ORBITAL CAVITY CAVITY

CAVITAS ORBITA NASI OSSEA

Piriform aperture – Choanae

Facies lateralis

CAVUM CAVUM NASI NASI

MEATUS THE NASAL NASI : CAVITY, inferior FRONTAL SECTION medius superior

SINUS PARANASALES

Frontal Maxillary Ethmoidal Sphenoidal

THE ORBIT ORBITA

THE ORBIT, MEDIAL WALL ORBITA, FACIES MEDIALIS

Temporal fossa FOSSA InfratemporalTEMPORALIS, fossa INFRATEMPO RALIS

Pterygomandibular Infratemporal fissure fossa : Lamina lateralis proc. Pterygoidei and maxilla – mandibular ramus

FOSSA PTERYGOPALATINA Pterygomandibular fissura

Rotundum Upper wall : maxillary surface of Pterygoid canal the greater wings Sphenopalatine for.

Inferior orbital Medial wall: fissure palatine bone Greater palatine canal

Anterior wall : maxilla

Posterior wall : pterygoid process

FOSSAE CRANII

Anterior Middle Posterior

Lebka novorozence Skull in a new-born 6 fontanellae

Facial part small (rudimentary condition of the mandible and maxillae) Ossification is Paranasal

incomplete sinuses - absent Anterior fontanelle BREGMA

Posterior fontanelle

TheThe skullskull duringduring thethe birthbirth

 TheThe skullskull isis alteredaltered inin shapeshape  TheThe skullskull isis compressedcompressed andand elongatedelongated  BonesBones ofof cranialcranial vaultvault (calva)(calva) overlapoverlap toto aa smallsmall extentextent (fontanellae(fontanellae !!)!!)  TheseThese changeschanges disappeardisappear withinwithin aa weekweek

 x

KonfiguraceKonfigurace lebkylebky připři poroduporodu

 LebkaLebka jeje komprimovánakomprimována (mediolaterálně)(mediolaterálně)  ElongaceElongace lebkylebky  KostiKosti kalvykalvy sese podsouvajípodsouvají (fontanely)(fontanely)  VV průběhuprůběhu několikaněkolika dnůdnů sese konfiguracekonfigurace lebkylebky vracívrací kk nornálunornálu

CRANIOMETRY

Frankfurt plane Frankfurtská horizontála gnathion

CRANIOMETRYCRANIOMETRY II

 CranialCranial heightheight == bregmabregma –– basionbasion == VýškaVýška lebkylebky

 CranialCranial breadthbreadth == euryoneuryon –– euryoneuryon == ŠířkaŠířka lebkylebky

 CranialCranial lengthlength == glabellaglabella -- occipitaloccipital pointpoint == DélkaDélka lebkylebky

 FacialFacial heightheight == nasionnasion –– gnathiongnathion == VýškaVýška obličejeobličeje

 FacialFacial breadthbreadth == zygionzygion -- zygionzygion == ŠířkaŠířka obličejeobličeje

CRANIOMETRY CRANIAL INDEX Š x 100/ d do 75 dolicho- 75 – 80 meso- Breadth x 100/ 80 a více brachy - length

Up to 75 dolichocephalic

75 – 80 mesocephalic

80 – 85 brachycephalic

Female : wall thinner, superciliary arches, tuberosities and mastoid Sexual differences processes less prominent, air sinuses smaller, tubera frontalia at parietalia +

ReferencesReferences ::

 R.R. ČihákČihák :: AnatomieAnatomie 1,1, AvicenumAvicenum  M.M. Grim,Grim, R.R. DrugaDruga etet al.:al.: ZákladyZáklady anatomie.anatomie. GalenGalen 20012001  GrayGray ´s´s Anatomy,Anatomy, LongmanLongman 19731973  P.P. KopfKopf –– MaierMaier :: AtlasAtlas ofof HumanHuman Anatomy,Anatomy, Karger,Karger, 19901990

KONEC LEBKY