Head —— 1. Cranial Bones 1.8 Orbit and Neighbo oo) Parietal bore emold bone ca oa Tenporatbone —. thmoicels Superior ob sre eas tomese canto) ein sssleoncha [A Bones ofthe orbits and adjacent cavities The color-coding here isthe same 2s for the bones of the rbit on pp.14~15. These bones se fom portions of the walls of neighboring Cavities. The folowing adjacent structures are ible inthe diagram: + ethmoidcells* + Maxllary sous + Anterior cranial fossa + Frontal sinus + Midale cranial fossa oid cls.” hold bone, perpendicular pte Super vale Super asl conc nero val fssue Corba oor Mae esl conch infer raalconcs Disease processes may originate inthe orbit and spread to these cavities, or originate in ‘these cavities and spread tothe orbit. ig Structures 8 Clinically important relationships between the orbits and surrounding Strctres relbone elaine Neighboring strctre serciioe, theo eine cer oy a ‘Sphenold bone, ™ Eats com | omextny {hurr ilo Boome feeaeiteeel Isoeserte bo) Meaty ede + chmod els von ee eee Important relationship tothe orbit: phenol sinus Middle canal fossa (pic chasm rtutry Covernous sinus Pterygopalatine fossa “The Terminologia Anotomica has dropped the term “ethmold sinus” in favor of "eth: Frontalbone, ort! sure Sphere bone ieserving Opticcana hme bone obi plete trina papyraces) rota src, seater ng 2ygomticbone, ‘bal surce rai cot Meany process ofthe € orbits and neighboring structures {Coronal section trough bath ofits, lewed from the front. The walls separating the orbit from the ethmoid cells (0.3 mm, lamina papyracea) and from the maxlary sinus (0.5mm, orbital loo) are very tin. Thus, both ofthese walls are susceptible to frectures and provide routes for 16 the spread of tumors and inflammatory processes into or out ofthe oF bit. The superior orbital fissure communicates with the middle cranial fossa, ane so several structures that are not pictured here—the sphe- ‘oid Sinus, pituitary gland, and optic chiasm-—are also closely related to the obit.Frontalbone, ygomatie process Gremterwing, temporal suace Temporalbone quimoue part tthmoit ‘bone Spheno- pheno Samus foramen Peryoo. Zygomat paste ‘bone foe ary See deta uberesty in Prengoid aml Preryeid proces, iterate D Close-up view of the left pterygopalatine fossa Lateral view. The pterygopaatine fossa is a crossroads between the ‘middle cranial fossa, ofit, and nose, being traversed by many nerves and vessels that supply these structures. The pterygopalatne fossa is Continuous laterally with the infratemporal forse This diagram shows the lteral approach tothe pterygopaatne fossa through theinfratem- poral oss, whichis utilized in surgical operations on tumors in this e- sion (eg. nasopharyngeal fibroma} Inferior foramen vbtalfasre retunday Sphenopaatine ‘eran Prergoid cn patie cos sengnatne fos F Connections of the lft pterygopalatine fossa with adjacent structures Deal rom D. The contents of the pterygopalatne fossa Include the ptesygopalatine ganglion (see pp. 81, 107), which is an important ganglion inthe parasympatheticnervous system G Structures bordering the pterygopalatine fossa Direction Bordering structure Anterior Maxillary tuberosity Posterior Prerygoid process Medial Perpendiulerpate ofthe palatine bone Lateral Infatemporal fossa (va the pterygo= maxi issue} Superior Creates wing ofthe sphenoid bone junction with the inerr orbital ssure Inferior Retropharyngea space mt — vemurone I ‘cj —~ i surface Palatine bone, ra poral crest process et rs sae femme fone oon SE E Structures adjacent to the right pterygopalatine Inferior view. The arrow indicates the approach to the pterygopala- tine fossa from the skull base, The fssa itself (nat wsibe in this view) 's lateral tothe lateral plate ofthe pterygoid process ofthe sphenoié bone 1H Pathways tothe pterygopalatine fossa Pathways From: ‘Transmitted structures Foremen Middlecranial_— + Maxilrynerve (CN) rotund fossa Prerygoidcanal — skllbase + Greaterpetrosa nerve (edn canal) (inferior (parasympathetic branch surface) of facia neve) + Deep petrosal nerve (sympathetictivers from carota plexus) + Artery of pterygoid canal swith accompanying veins + Nerve of pterygoid anal Greaterpaatine Palate + Greaterpalatine nerve «anal (oramen) + Descending palatine artery + Greater palatine artery Lesserpalatie Palate + Lesser paltine nerves canals + Lessepaltie arteries (terminal branches of descending palatine artery) sphenopalatne _Nasalcavity + Sphenopaatine artery foramen (plus accompanying veins) + Lateral and medial superior pestevior nasal ranches tf thenasopaatine neve (ny) Inferorarbital orbit Inteorital nerve fissure Zygomatic nerve Orbital branches (of CNV) Infor artery (las accompanying veins) + Inferior ophthalmic ein 7