Lecture 1

Anatomy of the skull

The bone of the skull can be divided into those of the cranium and
those of the face. The upper part of the cranium is called the valut or
calvaria and the base of the skull is the lowest part of the cranium.
Skull contains 22 bones all of them are non-movable except the
mandible. These bones joint together by fibrous joints called sutures.
The bones of the skull are irregular and flat. The valut of the skull
develops by intramembranous ossification whereas the base of the
skull by endochondral ossification. The main function of the bones of
the skull is to protect the brain. Bones of the skull can be divided into
pairs and unpairs.
Bones forming the cranium:
Frontal bone. 1
Parietal bone. 2
Occipital bone. 1
Temporal bone. 2
Sphenoid bone. 1
Ethmoid bone. 1
Facial bones:
Zygomatic bones. 2
Maxillae. 2
Nasal bones. 2
Lacrimal bones. 2
Vomer. 1
Palatine bones. 2
Inferior conchae. 2
Mandible. 1
Skull can be studied as aspects, frontal, superior, lateral, inferior or
base of the skull and posterior aspect. Interior of the skull is called
cranial cavity. The cranial cavity can be divided into: anterior , middle
and posterior cranial fossae. The largest fossa is the posterior cranial
fossa which contains foramen magnum. Each fossa has roof, floor and
boundaries.
 The aspect of the skull contains bones, sutures, processes and
forameni . Bones of the skull may contain parts e.g temporal bone
has different parts: squamous part, mastoid, mastoid process,
tympanic plate, styloid process and petrous part.

General questions:
- How many bones in the skull?
- How can the bones of the skull divide?
- Which type of the bone forming the skull?
- What are the pairs and un-pairs bones of the skull?
- Define with example ( foramen, fossa, notch and suture).
- How does the calvaria develop?
- What is the function of the skull bones?

Q/ Frontal aspect of skull:

- Enumerate the bones that can be seen in this aspect.
- Enumerate the foramina that can be seen in this aspect.
- Enumerate the cavities that can be seen in this aspect.
- Which bone forming the forehead?
- Which bone referring as the cheek bone?
- Which process of the maxilla can be seen in this aspect?
- Describe the anatomical position of mental foramen?

Q/ lateral aspect:
- Enumerate the bones that can be seen in this aspect?
- Enumerate the bones forming the pterion?
- Zygomatic arch separates between two fossae, what are these
fossae?
- What are the parts of temporal bone that can be seen in this
aspect?

Q/ posterior aspect:
- What is/ are the bone that can be seen in this aspect?
- What is the name of the protuberance in this region?
- What are the superior and inferior nuchal lines?
Q/ superior aspect:
- What are the bones forming the vault of the skull?
- What are the suture that can be seen in this region ?
- What are the forameni that can be seen in this region?

Q/ Inferior aspect:
- What are the bones that can be seen in this region?
- What are the parts of sphenoid bone that can be seen in this
aspect?
- What are the forameni that can be seen in this aspect?
- What are the fossa that can be seen in this aspect?
- What are the bones forming hard palate?
- What are the forameni that can be seen in the hard palate?
- Enumerate the structure passing through these forameni?
- What are the parts of the occipital bone that can be seen in this
aspect?

Q/ Internal of the skull or cranial cavity:

- What are the bones forming floor of the anterior cranial fossa?
- What are the boundaries of the anterior cranial fossa?
- What are the bones forming the floor of middle cranial fossa?
- What are the boundaries of the middle cranial fossa?
- What are the forameni that can be seen in the middle cranial
fossa?
- What is/are the bones forming floor of posterior cranial fossa?
- What are the boundaries of posterior cranial fossa?
- What are the forameni that can be seen in this fossa?
- What is the name of the protuberance and lines can be seen in
this region?
- What is the largest cranial fossa?
- What is the weakest cranial fossa? And why?
- What is the largest forame in the cranial cavity and where is
situated? What is the structure passing through?
 Q/ Mandible:
- What are the parts of the mandible?
- What are the processes of the mandible?
- Which part of the mandible articulating with temporal bone to
form temporomandibular joint?
- What are the forameni seen in the mandible?
- Enumerate the structures passing through these forameni?

Facial bones
Nasal bone: has two surfaces and four borders. These two bones meet
in the midline forming bridge of the nose.
Maxillary bone: the largest bone among skull bones after the mandible.
These two bones are meeting in the midline and forming the upper jaw.
It has four surfaces: anterior, posterior or infratemporal surface, medial
or nasal, and superior or orbital surface. It has four processes: frontal,
zygomatic, alveolar and palatine. It shares in the formation of floor of
the nasal cavity, floor of the orbit and roof of the oral cavity.
Zygomatic bone: the cheek bone, it has two surfaces and four processes:
frontosphenoidal, maxillary, orbital and temporal. There are two
foramina in the external surface of the zygoma: zygomatico facial and
zygomaticotemporal foramen. This bone shared in the formation of the
orbit and facing two fossae: temporal and infratemporal fossa.
Lacrimal bone: small and fragile bone forming part of the medial wall of
the orbit.
Palatine bone: it has perpendicular and horizontal plates and three
processes: orbital, lacrimal and pyramidal. It shares in the formation of
hard palate , nasal cavity and floor of the orbit. There are two foramen
present in the horizontal plate of palatine bone that forming the hard
palate greater and lesser forameni.
Vomer bone: single bone situated in the midline and shared in the
formation of the nasal septum.
Inferior concha: a bony projection found in the lateral wall of the nasal
cavity. It is the largest concha among other conchae. The space below
this concha is called inferior meatus which contains the opening of
nasolacrimal duct. This concha increases the surface area of the nasal
cavity.
Mandible: has two surfaces internal and external and two processes:
cornoid and condylar process. The mandible consists of two halves
meeting in the midline in the symphesis menti. Details can be read in
Snell anatomy.

What is the structure formed by two nasal bones?

- Enumerate the surfaces of maxillary bone?
- Enumerate the processes of maxillary bone?
- How does maxillary bone shared in the formation of orbital cavity,
nasal cavity and oral cavity?
- What is the name of the fossa situated lateral to canine
eminence?
- What is the structure formed by meeting of two maxillary
notches?
- What are the bones forming hard palate?
- What are the processes of palatine bone?
- Enumerate the processes of zygomatic bone?
- Enumerate the surfaces of zygomatic bone and mention the
foramen in each surface?
- What is the name of the groove in the lacrimal bone?
- What is the structure that vomer bone shared in the formation?
- How does ethmoid bone shared in the formation of anterior
cranial fossa?

Nasal cavity:
The nasal cavity is a pear shaped cavity. It has medial wall or nasal
septum, lateral wall, floor and roof. The medial wall is formed by vomer,
nasal cartilage and perpendicular plate of ethmoidal bone. The lateral
wall is formed by frontal process of maxilla, lacrimal, ethmoidal, palatine
, inferior concha and medial plate of ptyregoid process. The roof: the
nasal bone anteriorly, cribriformplate of ethmoid in the middle and
slope of body of sphenoid posteriorly. The floor is formed by hard
palate. There are three bony projections in the lateral wall of the nasal
cavity: superior, middle and inferior conchae. The space below each of
these concha is called meatus, there are three meatus: superior, middle
and inferior meatus.
- What are the bones forming the roof of the nasal cavity?
- What are the bones forming the floor of the nasal cavity?
- What are the bones forming lateral wall?
 - What are the bones shared in the formation of medial wall of
nasal cavity?
- What is the nasal concha and what is the name of the space below
each concha?
- Which conchae belong to ethmoid bone?
- Which concha is the largest one?
- What is the importance of nasal concha?
- What is the nasal vestibule?
- Discuss the innervation of the nasal cavity?
- Discuss the blood supply of the nasal cavity?

Paranasal sinuses:
These are four air sinuses located around the nasal cavity. These are air-
filled spaces lined by mucous membrane. The maxillary sinus is
pyramidal in shape situated in the body of the maxilla. It is considered as
the largest air sinus. It has a base directed medially toward the nasal
cavity and apex laterally toward zygomatic bone. In addition, it has four
surfaces: anterior, posterior, superior and inferior. The roof or superior
surface is formed by the floor of the orbit and the base is the alveolar
process. The maxillary sinus opens at the middle meatus in the area
called hiatus semilunaris. The floor of the maxillary sinus associated with
the apices of the upper molars and sometimes premolars and rarely
upper canine. The infection of theses sinuses is called sinusitis.
Opening of paranasal sinuses:
Sphenoidal sinus: in the sphenoethmoidal recess.
Posterior ethmoidal air cells: superior meatus.
Anterior and middle ethmoidal, frontal and maxillary sinus: middle
meatus.
Nasolacrimal duct: inferior concha.

- Define paranasal sinuses?

- What are the functions of paranasal sinuses?
- Enumerate the paranasal sinuses?
- How can the air cells of ethmoid bone be divide?
- Mention the position of the opening of each paranasal sinuses?
- How does the sinus appear in the radiograph?
- What is the clinical significant of maxillary sinus in relation to
dentistry?
- Where is the apex and base of maxillary sinus situated?
- Why the pain of maxillary sinus referred to upper molar teeth?
 - What are the innervation and blood supply of maxillary sinus?

Muscle of facial expression:

These are group of muscles developed from the 2nd pharyngeal arch and
innervated by facial nerve (the seventh cranial nerve). Some of these
muscles controlling the opening of the mouth, nostrils and eyes and
working as a sphincter or a dilator. These muscles are distinguished from
other muscles by their bony origin and skin or facial insertion.

- What is the feature that distinguish these muscles from other

muscles of the human body?
- What is the nerve supplying these muscles?
- What is the origin and insertion of occiptofrontalis muscle?
- What are the parts of orbicularis occuli?
- What is the origin and insertion of corregator supercilly?
- What are the muscles elevating the upper lip?
- What are the muscles elevating the angle of the mouth?
- What are the muscles depressing the lower lip?
- What are the muscles depressing the angle of the mouth?
- What is the sphincter of the opening of oral cavity?
- What is the origin and insertion of buccinators muscle?
- Describe the shape of buccinators muscle? What is the function of
this muscle?
- What is the name of the muscle attach to mental protuberance?
- What is the modiolus?
- What is the origin and insertion of platysma muscle?
- Mention the branch of facial nerve supplying each muscle?