OSTEOLOGY OF THE

HEAD

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 SKULL
• Cranium
(Neocranium)
• Face
(Viscerocranium)

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 CRANIUM
Anatomically subdivided into
 Calvarium (roof)
 Cranial base (base)

Comprised of 8 bones
2 paired 4 unpaired
Parietal bone Frontal bone
Temporal bone Sphenoid bone
Ethmoid bone
Occipital bone 3
Calvarium

Cranial base

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 FACIAL SKELETON
 Support soft tissues of the face
 Determine facial appearance

 Consists of;

6 paired bones 2 unpaired bones

Zygomatic Vomer
Lacrimal Mandible
Nasal
Inferior nasal conchae
Palatine
Maxilla 7
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 SUTURES OF THE SKULL
 Type of fibrous joint unique to the skull
 Immovable and fuse completely around the age of 20

 Main sutures in adulthood include;

Coronal suture- frontal + 2 parietal bones

Sagittal suture- both parietal bones
Lambdoid suture- occipital + 2 parietal bones
Squamous suture- parietal + temporal bones

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 Sagittal suture
Lambda

Bregma

Lambdoid suture
Coronal suture

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Other minor sutures include
 Frontonasal suture
 Frontozygomatic suture
 Zygomaticomaxillary suture
 Intermaxillary suture
 Metopic suture
 Sphenofrontal suture
 Sphenoparietal suture
 Sphenosquamosal suture
 Occipitomastoid suture

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 Frontonasal
suture

Frontozygomatic Intermaxillary
suture suture

Zygomaticomaxillary
suture
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Squamous suture

Sphenofrontal
suture
Spheno-
squamosal
suture
Sphenoparietal
suture

Temporo-
zygomatic
Occipitomastoid suture
suture

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 FONTANELLES
 Often referred to as ‘soft spots’
 One of the most prominent anatomical features of the
newborn’s skull
 Membranous gaps between bones formed by incompletely
fused suture joints
 They facilitate the movement and moulding of the cranium
through the birth canal during labour
 They also allow for rapid postnatal growth and development of
the brain
 There are 6 fontanelles
 Anterior fontanelle
 Posterior fontanelle
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 Paired Mastoid fontanelle
 Paired Sphenoid fontanelle
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Anterior fontanelle
 The largest of the 6 and diamond-shaped

 Forms through the juxtaposition of the frontal bone and the

parietal bones
 Average closure time ranges from 13 to 24 months

 Studies have shown that infants of African descent have

larger anterior fontanelles
 Studies have also shown that the anterior fontanelles of male
infants close sooner compared to female infants
 In addition to being the largest, the anterior fontanelle is also
the most important clinically
 This structure offers insight into the newborn’s state of
health, especially hydration and intracranial pressure
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Posterior fontanelle
 Triangular in shape

 Forms through the juxtaposition of the parietal bones

and occipital bone
 Completely closes within about 6-8 weeks after birth

 Often the delayed closure of the posterior fontanelle

is associated with hydrocephalus or congenital
hypothyroidism

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Mastoid fontanelle
 Also called posterolateral fontanelle

 Paired structure that forms from the juxtaposition of the

temporal, parietal and occipital bones
 They close anywhere from 6-18 months of age

Sphenoid fontanelle
 Also known as the anterolateral fontanelle

 Paired structure that forms from the juxtaposition of the

sphenoid, parietal, temporal and frontal bone
 Closure occurs at approximately the 6th month mark after
birth
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JUNCTIONS OF CRANIAL SUTURES
 Lambda
intersection of the lambdoid and sagittal sutures.
 Bregma:
intersection of the sagittal and coronal sutures.
 Pterion:
a craniometric point at the junction of the frontal,
parietal, and temporal bones and the great wing of the
sphenoid bone.

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 JUNCTIONS OF CRANIAL SUTURES
 Asterion:
a craniometric point at the junction of the parietal, occipital,
and temporal(mastoid part) bones.
 Nasion:
a point on the middle of the nasofrontal suture (intersection of
the frontal and two nasal bones).
 Inion:
 most prominent point of the external occipital protuberance,
which is used as a fixed point in craniometry.

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SPHENOID BONE
 Butterfly-shaped bone located in the cranium
 Consists of;
Body
Paired greater and lesser wings
Two pterygoid processes

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 ETHMOID BONE
 Small unpaired bone located in the midline of the
anterior cranium
 It is situated at the roof of the nasal cavity and between
the 2 orbital cavities
 The term ‘ethmoid’ originates from the Greek ‘ethmos’
meaning sieve which is reflected in its lightweight,
spongy structure
 It is made up of 3 parts
 Cribriform plate
 Perpendicular plate
 Ethmoidal labyrinth
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TEMPORAL BONE
 It contributes to the lower lateral walls of the
skull
 It contains the middle and inner portions of the
ear
 It is comprised of 5 parts
Squamous part (squama temporalis)
Tympanic parts
Petromastoid parts
Zygomatic process
Styloid process
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INTERNAL SURFACE OF CRANIAL
BASE

 Has 3 depressions that lie at different levels

Anterior cranial fossa
Middle cranial fossa
Posterior cranial fossa

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CRANIAL FORAMINAS
Anterior cranial fossa
 Foramen caecum

nasal emissary vein

 Cribriform foramina in cribriform plate

axons of olfactory cells

 Anterior and posterior ethmoidal foramina

vessels and nerves with same names

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Middle cranial fossa
 Optic canals

optic nerves (CN II)

ophthalmic arteries
 Superior orbital fissure

ophthalmic veins
ophthalmic nerve (CN V1)
occulomotor nerve (CN III)
trochlear nerve (CN IV)
abducens nerve (CN VI)
 Foramen rotundum
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maxillary nerve (CN V2)
 Foramen ovale
mandibular nerve (CN V3)
accessory meningeal artery
 Foramen spinosum

middle meningeal artery and vein

meningeal branch of CN V3
 Foramen lacerum

deep petrosal nerve

internal carotid artery
 Groove or hiatus of greater petrosal nerve

greater petrosal nerve

petrosal branch of middle meningeal artery 35
Posterior cranial fossa
 Foramen magnum
medulla and meninges, vertebral arteries,
accessory nerve (CN XI), dural veins, ant
&post spinal arteries
 Jugular foramen
glossopharyngeal nerve (CN IX), vagus nerve (CN

X), inferior petrosal and sigmoid sinuses

 Hypoglossal canal
hypoglossal nerve (CN XII)
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 Internal Acousticmeatus
facial nerve (CN VII)
vestibulocochlear nerve (CN VIII)
 Condylar canal

emissary veins
 Mastoid foramen

mastoid emissary vein from sigmoid sinus

meningeal branch of occipital artery

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APPLIED ANATOMY
Cranial fractures
 Depressed fracture
Fracture of the bone with depression of the bone
inwards
Occur as a result of a direct blow, causing skull
indentations, with possible underlying brain injury
 Linear fracture
A simple break in the bone, traversing its full
thickness
Most common type of cranial fracture
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 Basal skull fracture
Affects the base of the skull
Characteristically present with bruising behind
the ears or bruising around the eyes
 Diastatic fracture
Fracturethat occurs along a suture line, causing a
widening of the suture
Most often seen in children

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APPLIED ANATOMY
Transsphenoidal surgery
 The sphenoid bone shares a close anatomical
relationship with the pituitary gland
 The pituitary can be accessed surgically by passing
instruments through the sphenoid bone and sinus
 This type of surgery is know as endoscopic trans-
sphenoidal surgery (ETSS), and is the usual treatment
of choice for pituitary adenomas
 It allows for the surgical management of pituitary
pathology without the need for a more extensive
craniotomy 41
 APPLIED ANATOMY
CSF Rhinorrhoea
 A fracture of the cribriform plate may allow
communication between the nasal cavity and the
CNS
 Consequently, CSF can enter the nasal cavity
and drain out from the nose
 This manifests clinically as a clear watery
discharge from one side of the nose, called CSF
Rhinorrhoea
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 MANDIBLE
U shaped bone
 Has 2 parts

Horizontal body
Vertical ramus
Body Ramus
Main body condyloid process
Alveolar process head, neck
coronoid process
 Has 2 foramina
mandibular foramen 43
mental foramen
mandibular
notch

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angle
 Lingula

Mylohyoid
groove

Mylohyoid line

Mental spines
Digastric fossa
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 A
B
F

C
D

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 A

B
F

E H

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 2

3
1 A
4

5
B

C
6 48
 C
D

J
I

B
F 49

H G
 A

B C

E D

F G

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