FETAL SKULL

Definition
This is the hardest and biggest part on the fetus. It protects the delicate structures e.g. brain, ventricles and
blood vessels.
Shape
It is oval in shape
Size
It is bigger than the fatal body
Divisions/parts of the fetal skull
Face
This extends from junction of chin and neck to the orbital ridges. It is made up of 14 fused together small bones
which are fully fused together by the time the baby is born.
Base
Extends from junction of chin and neck to foramen magnum (opening through which the spinal cord leaves the
cranium).It has 5 bones which are fused together and forms the floor of the cranium.
Vault
This is the upper dome shaped part. It extends from the orbital ridges to the foramen magnum. It forms the
roof of the cranium. The vault is of much importance in obstetrics because it allows moulding during labour to
make delivery possible. Moulding is made possible by the presence of fontanelles and sutures.
Landmarks of the fetal skull
Face: Extends from junction of chin and neck to the orbital ridges.
Sinciput: extends from orbital ridges (Glabella) to the anterior fontanelle.
Vertex: circular area bordered by the anterior fontanelle, posterior fontanelle and the 2 parrietal eminences.
Occiput: Extends from posterior fontanelle to the foramen magnum.
Base: From foramen magnum to junction of chin and neck.
Bones of the vault
The vault is made of 5 bones
 2 Frontal bones
 2 Parrietal bones
 1 Occipital bone
Frontal bones
These form the forehead (Sinciput).They are roughly square in shape and extend from root of nose posteriorly
to join the parietal bones.
Parrietal bones
These extend from the frontal bones posteriorly to meet the occipital bone
Occipital bone
This forms the back of the head. It is roughly triangular in shape and extends from parietal bones to the
foramen magnum.

DIAGRAM OF THE VAULT BONES

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Development of the vault bones
Bones of the face and base develop from cartilage that is why they are fully ossified by birth. Bones of the vault
develop from membranes. Calcium is laid down at ossification centre found in each bone of the vault during
intra uterine life. These ossification centre are thicker than the whole bone and form prominences on each
individual bone i.e.
 Frontal bosses
 Parrietal eminences
 Occipital protuberance
Ossification spreads out from the ossification centre but by birth there are still some areas which are
membranous between the bones.

Sutures
These are membranous areas found between bones of the vault. There are 4 major sutures which are of
significancy in obstetrics since they are involved in moulding.
Frontal suture: Found between the 2 frontal bones
Saggital suture: found between the 2 parrietal bones
Coronal suture: separates frontal from parrietal bones
Lambdoidal suture: Separates parietal from occipito bone.

Fontanelles
These are membranous areas on the fetal skull where 2 or more sutures meet. There are 2 major fontanelles of
importance in obstetrics i.e. anterior and posterior fontanelles
Anterior fontanelle (Bregma)
This is diamond shaped and bigger than the posterior fontanelle. It has 4 sutures runn9ng into it i.e. 2 coronal
sutures, 1 Saggital suture and 1 frontal suture. This fontanelle is felt when the head is deflexed. It closes at 18
months after birth.
Posterior fontanelle (Lambda)
It is triangular in shape and is felt when the head is well flexed. It has 3 sutures running into it i.e. 2 Lambdoidal
sutures and 1 Saggital suture. It closes at 6 weeks after birth.

DIAGRAM OF SUTURES AND FONTANELLES

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Diameters of the fetal skull
These are measurements taken on the fetal skull by x-ray. They are measured through the skull not over it.
There are 2 types:
 Transverse diameters, measured from side to side
 Longitudinal diameters, measured from front to back.

Transverse diameters
Bi temporal diameter: measured between the 2 furthest ends of the coronal suture. Measures 8.2 cm
Bi parietal diameter: measured between the 2 parrietal eminences. It measures 9.5 cm.

Antero posterior diameters

Some of these diameters arise from the front to the back and their landmark is chin (mentum).All these have
the word mento. Those diameters arising from the back have the Occiput as their landmark so they have the
word occipito in them.
Diameters from the front
 Submento bregmatic : from below the chin to the anterior fontanelle, measures 9.5 cm
 Sub mento vertical: from below the chin to the highest point on the vertex, it measures 11.5 cm
 Mento vertical: from tip of chin to the highest point on the vertex, measures 13.5 cm.
Diameters from the back
 Sub occipito bregmatic: from below the Occiput to the anterior fontanel, measures 9.5 cm
 Sup occipito frontal: from brow the Occiput to the centre of frontal suture, measures 10.5 cm
 Occipito frontal: from the occipito protuberance to the centre of frontal suture, measures 11.5 cm.

DIAGRAMS SHOWING DIAMETERS OF FETAL SKULL