CNS Anatomy practical

checklist

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 Skull
I. Norma Frontalis:
1. The supraorbital notch or foramen for supraorbital nerve and vessels.
2. The infraorbital foramen for infraorbital nerve and vessels

II. Norma Lateralis:

1. The pterion (related artery)
2. Attachment of the following muscles:
a. Temporalis: origin from temporal fossa
b. Masseter: origin from lower border and inferior surface of
zygomatic arch
c. Buccinator: origin opposite molar teeth
d. Sternomastoid: insertion from outer surface of mastoid process and
superior nuchal line

III. Norma Verticalis

1. Frontal Bone, Parietal bones and Occipital bone
2. The coronal suture, the sagittal suture, the lambdoid sutures
3. The Bregma (closed anterior fontanelle)
4. The Lambda (closed posterior fontanelle)
5. The emissary foramen in the parietal bones

IV. Norma Occipitalis

1. Squamous part of Occipital bone, Parietal bones & Mastoid part of
Temporal bone
2. The lambdoid sutures and the lambda (posterior fontanelle in infants)
3. The external occipital protuberance
4. The external occipital crest (extend from protuberance to foramen
magnum)
5. The highest nuchal lines
6. The superior nuchal lines
7. The inferior nuchal lines

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 Norma frontalis

The supraorbital notch or foramen

for supraorbital nerve and vessels.

The infraorbital foramen for

infraorbital nerve and vessels

Norma lateralis

Temporalis origin

Masseter origin

Sternomastoid Buccinator origin

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Norma Verticalis
Coronal suture
Frontal
bone
Bregma

Sagittal suture
Parietal Parietal
bone bone

Lambda
Lambdoid suture
Occipital bone

Norma Occipitalis Sagittal suture

Lambdoid suture
Lambda
Parietal bone Parietal bone

Occipital bone

External occipital
protuberance

Inf. Nuchal line

Sup. Nuchal line

External occipital Crest

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 Cranial Cavity:

Skull cap (interior):

1. Sagittal groove: related to superior sagittal sinus
lips provide attachment to falx cerebri
2. Groove for middle meningeal artery
3. Arachnoid granulations (related)

Foramina in cranial cavity:

a. Cribriform plate of ethmoid: transmits olfactory nerves
(Cranial I)
b. Optic canal: transmits optic nerve and ophthalmic artery
(Cranial II)
c. Superior orbital fissure: transmits occulomotor, trochlear,
branches of ophthalmic nerve, abducent (Cranial III, IV, V1)
d. Foramen rotundum: transmits maxillary nerve (Cranial V2)
e. Foramen ovale: transmits mandibular nerve (Cranial V3),
accessory meningeal artery, lesser petrosal nerve
(parasympathetic), emissary vein (MALE)
f. Foramen spinosum: middle meningeal artery, nervus spinosus
g. Internal acoustic meatus: transmits facial and
vestibulocochlear (Cranial VII, VIII)
h. Jugular foramen: transmits glossopharyngeal, vagus,
accessory, internal jugular vein, inferior petrosal sinus
(Cranial IX, X, XI)
i. Hypoglossal canal: transmits hypoglossal nerve (Cranial XII)
j. Foramen magnum: transmits lower part of medulla
oblongata, upper part of spinal cord, spinal root of accessory
nerve, meninges, vertebral arteries, anterior & posterior
spinal arteries,

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Skull Cap (interior)

Sagittal groove
related to superior sagittal sinus

Attachment of falx cerebri

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Cribriform plate
of ethmoid
Olfactory nerves
I

Foramen magnum:
Medulla oblongata,
vertebral arteries

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 Middle meningeal artery

Foramen spinosum

Groove for
middle
meningeal
artery

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 Dural Folds & Sinuses:

Dural folds :
a. Tentorium cerebelli: attached to lips of transverse groove, upper
border of petrous part of temporal bone, posterior and anterior clinoid
process
b. Falx cerebelli: attached to internal occipital crest

Dural venous sinuses:

a. Sphenoparietal sinus: related to posterior border of lesser wing of
sphenoid
b. Cavernous sinus: related to sides of sphenoid body
c. Superior petrosal sinus: related to superior border of petrous part of
temporal bone
d. Inferior petrosal sinus: related to petro-occipital fissure
e. Transverse sinus: related to transverse groove
f. Sigmoid sinus: related in groove for sigmoid sinus as a continuation of
transverse sinus
g. Occipital sinus: related to internal occipital crest and lips of foramen
magnus
h. Basilar venous plexus: related to clivus

3. Groove for middle meningeal vessel: extending from foramen spinosum

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 Norma basalis Externa

Anterior Part
➢ Palatine processes of maxillary bone
➢ Horizontal plates of palatine bones
➢ Alveolar arch
➢ Incisive fossa & foramina
➢ Maxillary tuberosity (gives attachment to superficial head of medial pterygoid)
➢ Posterior nasal spine
➢ Greater & lesser palatine foramina (transmit greater & lesser palatine nerves & vessels)

Middle Part
➢ Posterior nasal openings
➢ Pterygoid process
❖ Lateral pterygoid plate (origin of lower head of lateral pterygoid laterally & deep
head of medial pterygoid medially)
➢ Greater wing of sphenoid
❖ Infratemporal crest (origin of upper head of lateral pterygoid)
❖ Spine of sphenoid (gives attachment to sphenomandibular ligament)
❖ Foramen ovale (transmits ..….)
❖ Foramen spinosum (transmits …..)

Posterior Part
➢ Foramen lacerum (transmits emissary vein between cavernous sinus and pterygoid
plexus of veins)
➢ Carotid canal: transmits the internal carotid artery and sympathetic plexus around it.
➢ Jugular foramen: transmits ……
➢ Stylomastoid foramen: transmits facial nerve.
➢ Occipital condyles: articulate with the atlas to form atlanto-occipital joint.
➢ Anterior condylar foramen: transmits ……
➢ Foramen magnum: transmits …….

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 Mandible

1. Mandibular condyle:
a. Attachment of capsule of temporomandibular joint
b. Lateral pterygoid muscle: insertion into condylar (pterygoid) fovea
c. Structures related to neck of mandible: maxillary artery,
auriculotemporal nerve

2. Coronoid process:
a. Temporalis muscle : inserted into all aspects of coronoid process
except lateral surface insertion extends to third molar tooth

3. Ramus of mandible:
a. Masseter : insertion into lateral surface of ramus
b. Medial pterygoid muscle: insertion in medial surface of mandibular angle
c. Mandibular canal: for inferior alveolar nerve and vessels

4. Body of mandible:
a. Buccinator : insertion on outer surface of body as a line below the molars
b. Mylohyoid muscle: origin from mylohyoid line.
c. Anterior belly of digastric: from digastric fossa
d. Mental foramen: for mental nerve and vessels

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 Attachment of capsule of TMJ

Maxillary artery and

auriculotemporal
Mandibular canal for inf. Alveolar nerve related to neck
nerve and vessels

Mydial pterygoid insertion

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lateral pterygoid
insertion
Temporalis

Mental foramen for

mental nerve and
vessels
Buccinator
origin

Mylohyoid muscle origin

Anterior belly of digastric

origin

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 Cervical Vertebrae
1. Typical cervical vertebra:
Vertebral body: small, kidney shaped, with raised lips
Transverse process: shows Foramen Transversarium (for vertebral artery) +
anterior and posterior tubercles
Spine: short, bifid (for ligamentum nuchae)
Foramen transversarium: transmits vertebral artery

2. 1st Cervical vertebra (Atlas):

No body, No Spine, transverse process has No Tubercles
Identify the following special features:
Anterior arch:
Short, shows Anterior Tubercle
Its posterior surface shows articular facet articulates with odontoid process of axis
in median atlanto-axial joint
Posterior arch:
Long, shows Posterior Tubercle
Upper surface shows groove for vertebral artery and 1st cervical nerve
Superior articular facet: large and kidney shaped (for atlanto-occipital joint)
Transverse process: long
Foramen transversarium: transmits vertebral artery
3. 2nd Cervical vertebra (axis):
Body:
Shows upward process; the odontoid process (dens), its apex provides attachment
to apical ligament
Anterior surface of dens shows articular facet for median atlanto-axial joint
Spine: thick, strong, bifid

4. 7th cervical vertebra:

Spine: long, non bifid
Foramen transversarium: transmits accessory vertebral vein only.
✓ Please Identify the following:
❑ The ligaments attached to atlas and axis.
❑ The joints between the skull, atlas and axis.

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Typical Cervical vertebra

Foramen Transversarium
(for vertebral artery)

Bifid spine
(for ligamentum nuchae)

7th Cervical vertebra

Foramen transversarium:
transmits accessory vertebral
vein only

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 First Cervical vertebra: Atlas

kidney shaped Articular facet

related to occipital condyles
(for atlanto-occipital joint)
articular facet articulates with
odontoid process of axis in
median atlanto-axial joint

Second Cervical vertebra: Axis

Apex of dens
attachment of
apical ligament
articular facet
for median atlanto-axial
joint related to articular
facet of atlas

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 Brain
I. Superolateral surface
• The frontal pole, the temporal pole and the occipital pole
Identify the major sulci dividing the superolateral surface into 4 lobes:
a. The central sulcus; notice its extension on the medial surface
b. The lateral (Sylvian) sulcus with its anterior ramus, ascending
ramus and posterior ramus
c. The parieto-occipital sulcus and preoccipital notch

Identify the four lobes represented in this view: frontal, parietal,

temporal and occipital:
1.The frontal lobe:
Identify the following sulci and gyri
a. The precentral sulcus & gyrus
b. Superior & inferior frontal sulci
c. Sup., middle & inferior frontal gyri
d. Pars orbitalis, triangularis & opercularis

2.The parietal lobe:

Identify the following sulci and gyri
a. The postcentral sulcus & gyrus
b. Intraparietal sulcus
c. Sup. & inf. Parietal lobules

3.The temporal lobe:

Identify the following sulci and gyri
a. The superior & inferior temporal sulci
b. The superior, middle & inferior temporal gyri

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II . Medial surface
1. Parts of corpus callosum: rostrum, genu, body and splenium
2. Fornix
3. lateral ventricle
4. Septum pellucidum
5. Thalamus
6. Cingulate gyrus
7. Central sulcus
8. Parietoocciptal sulcus
9. Cuneus , precuneus
10. Medial frontal gyrus
11. Paracentral lobule

III. Inferior surface

1. The temporal pole
The orbital surface showing:
1. The olfactory sulcus, tract & bulb
2. The gyrus rectus
3. H-shaped orbital sulcus
4. Four orbital gyri (anterior, posterior, medial and lateral)
The tentorial surface showing:
1. The collateral sulcus
2. The rhinal sulcus
3. The occipito-temporal sulcus
4. The parahippocampal gyrus and the uncus
5. The medial and lateral occipito-temporal gyri

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 Central Sulcus

Parieto occipital
sulcus

Occipital pole
Frontal pole

Temporal pole Preoccipital

Lateral sulcus notch

Precentral Sulcus
Postcentral Sulcus

Superior temporal sulcus

Inferior temporal sulcus

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 Olfactory sulcus

H Shaped Orbital
sulcus

Occipitotemporal
sulcus

Collateral
sulcus

Orbital gyri
1
3
Gyrus rectus
2
4

Lateral
occipitotemporal

Uncus
Medial
occipitotemporal

Parahippocampal
gyrus

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 Central sulcus
Paracentral lobule Body
Medial frontal gyrus precuneus
Parietoocciptal
Cingulate
sulcus
gyrus
Genu
Cuneus

Septum
pellucidum Splenium
Fornix

Rostrum

Thalamus

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 central sulcus
Paracentral lobule
Cingulate sulcus Precuneus
Cingulate gyrus
Medial frontal gyrus
Parieto-
occiptal sulcus
Body of corpus
callosum
Genu of corpus Cuneus
callosum

rostrum of corpus
callosum splenium of corpus
callosum

Fornix

lateral ventricle

Thalamus

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 Paracentral lobule
central sulcus

Cingulate gyrus Precuneus

Body of corpus
callosum
Medial frontal gyrus
Parieto-
occiptal sulcus
Genu of corpus
callosum Cuneus

rostrum of corpus
splenium of corpus
callosum
callosum

Thalamus

Fornix

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 Horizontal section of Brain

1. Anterior horn of lateral ventricle

2. Posterior horn of lateral ventricle
3. Forceps minor
4. Forceps major
5. Caudate nucleus
6. Lentiform nucleus (putamen & globus pallidus)
7. Thalamus
8. Anterior and posterior limb of internal capsule
9. Insula
10. External capsule, colostrum & extreme capsule

Anterior horn of
lateral ventricle Forceps
minor

Ant. Limb of
Caudate internal
capsule
Genu of internal
Insula capsule

Putamen Post. Limb of

internal
Globua capsule
pallidus
Thalamus

Posterior
horn of
lateral
Forceps major
ventricle

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Anterior horn of lateral ventricle

Forceps minor

Caudate
internal
Insula capsule

Lentiform

Thalamus

Forceps major

Posterior horn of lateral ventricle

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 Blood Supply of Brain

1. Circle of Willis
2. Carotid system
3. Vertebrobasilar system
4. Middle cerebral artery
5. Anterior cerebral artery
6. Posterior cerebral artery
7. Cortical blood supply by the above-mentioned arteries

Post. Cerebral A.

Sup. Cerebellar A.

Pontine branches

Basilar A.

Ant. Inf. Cerebellar

A. (AICA)

Post. Inf. Cerebellar A.

Ant. Spinal A.

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 Ant. communicating

Ant. cerebral A. Ant. cerebral A.

ICA ICA
Post.
Post.
communicating
communicating

Post. Cerebral A.

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Middle cerebral A. Ant. cerebral A.

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 Ventricular System
➢ Lateral ventricle (with horns)
➢ Interventricular foramen of Monro
➢ Third Ventricle (with recesses)
➢ Cerebral aqueduct of Sylvius
➢ Fourth ventricle
➢ Central canal

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 Brainstem
I . Ventral surface
features Cranial nerves

Mid brain 1-cerebral peduncles Oculomotor

Trochlear
Pons 1-Basilar groove for basilar artery Trigeminal (2 roots)
2-MCP Abducent
Facial (2 roots)
Vestibulocochlear
Medulla Glossopharyngeal
Pyramid – olive - ICP vagus
Cranialaccessory
Hypoglossal

The interpeduncular fossa:

Identify boundaries:
• The optic chiasma
• The optic tracts
• The cerebral peduncles
Identify contents:
• Tuber cinereum
• Mammillary bodies
• Posterior perforated substance
• Oculomotor nerve

➢ Arteries on the ventral surface of brainstem

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 II . Dorsal surface
Midbrain:
1. Superior colliculus
2. Inferior colliculus
3. Pineal gland

Pons:
1. Median sulcus
2. Medial eminence
3. Facial colliculus
4. Vestibular area
5. Sulcus limitans

Medulla:
1. Hypoglossal trigon
2. Vestibular trigon
3. Vagal trigone
4. Gracile tubercle-tract
5. Cuneate tubercle -tract

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 Pineal gland Superior colliculus
inferior colliculus

Medial Trochlear nerve

eminence sulcus limitans

SCP
MCP
ICP

2 1
Facial colliculus
3
5
4

1-Hypoglossal trigone Vestibular area

2-Vestibular trigone
3-Vagal trigone
4-Gracile tubercle-tract
5-Cuneate tubercle -tract

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 Cerebellum
1. The 2 cerebellar notches (anterior and posterior)
2. The 2 cerebellar hemispheres (right &left)
3. Cerebellar Tonsils
4. Vermis
5. Primary fissure
6. Horizontal fissure
7. 3 lobes (anterior, posterior and flocculo-nodular lobe).

ant. Cerebellar notch

Primary Superior surface

fissure

Posterolateral fissure
Tonsil

Inferior surface

Post. Cerebellar notch

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Superior surface

Anterior lobe

Posterior lobe

Inferior surface
Flocculonodular lobe

Posterior lobe

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 Spinal Cord
1. Dorsal horn
2. Ventral horn
3. Anterior median fissure
4. Posterior median sulcus
5. Central canal
6. Dorsal root
7. Dorsal root ganglion
8. Ventral root
9. Spinal verve
10.Dorsal ramus
11.Ventral ramus

Posterior median sulcus

Dorsal horn
Central canal
Ventral horn
Anterior median fissure
Dorsal root
Dorsal root
ganglion Dorsal ramus

Ventral root Ventral ramus

Spinal verve

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 Face and scalp

1. Occipitofrontalis (& its nerve supply)

2. Orbicularis oculi (orbital part and palpebral part) (& its nerve supply)
3. Orbicularis oris (& its nerve supply)
4. Buccinator (& its nerve supply)
5. Facial artery (& its branches)
6. Facial vein
7. Facial nerve (& its branches)
8. Masseter (attachment, nerve supply & action)
9. Temporalis (attachment, nerve supply & action)

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Post. auricular ➢ Occipital bellies
Temporal
➢ Frontalis
➢ Orbicularis oculi

Zygomatic
➢ Orbicularis oculi

Buccal
➢ Buccinator
➢ Orbicularis oris
➢ Muscles of upper lip

Mandibular
➢ Muscles of lower lip

Cervical
➢ Platysma

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 Neck Triangles
Posterior triangle
1. The sternomastoid muscle (attachment & nerve supply)
2. External jugular vein (beginning, end & tributaries)
3. Cutaneous branches of cervical plexus
4. The trunks of brachial plexus
5. Muscles of floor
6. Subclavian artery & vein

Anterior Triangle
1. The anterior and posterior bellies of digastric & stylohyoid (& their
nerve supply)
2. The superior and inferior bellies of omohyoid (& their nerve supply)
3. The mylohyoid
4. The submandibular gland
5. Facial artery & vein
6. The hypoglossal, vagus & spinal accessory nerves
7. The sternohyoid, the sternothyroid and the thyrohyoid (& their nerve
supply)
8. Carotid arteries (& branches of external carotid artery)
9. Internal jugular vein

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 Infratemporal &
Pterygopalatine Fossae

➢Temporalis muscle (attachment, nerve supply & action)

➢Masseter muscle (attachment, nerve supply & action)
➢Medial pterygoid muscle (attachment, nerve supply & action)
➢Lateral pterygoid muscle (attachment, nerve supply & action)
➢Mandibular nerve(with its branches)
➢Maxillary nerve (with its branches)
➢Maxillary artery (with its branches)
➢Pterygoid venous plexus

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 Congenital Anomalies

Congenital malformations of clefts

Preauricular sinus Branchial cyst

Congenital malformations of Face

Oblique facial cleft Macrostomia Microstomia

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 Congenital malformations of the spinal cord

Rachischisis

Spina bifida occulta Meningocele

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Congenital malformations of the brain

Cranial Meningiocele

Anencephaly

Microcephaly
Hydrocephalus

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