Skull

We can divide the skull in two major parts:

o Vicerocranium The facial skeleton.
o Cerebrocranium The brain box.
There are two developemental processes in the skull, distinguished
by the way the bones are formed:
o Chondrocranium Enchondral ossification of cartilaginous
models.
o Desmocranium Intermembranous ossification from
mesenchymal stem cells.
There are 22 different bones in the skull. These bones are connected
by cartilage at birth and these cartilaginous models ossifies during
our first years of life. It is important that these flat bones of the
cerebrocranium does not ossify before birth, since the purpose of
these cartilaginous connection is to enable the head structure to
deform while the baby passes through the birth canal.
Important structures for the baby while passing through the birth
canal is the anterior, posterior, sphenoidal and mastoid fontanelles,
respectively the anterior and posterior fontanelles are located
between the parietal bones and the frontal bone in the anterior
region, and the occipital bone in the posterior region. The sphenoidal
fontanelle is between the frontal, parietal, sphenoid and temporal
bone in the anterolateral region, while the mastoid fontanelle is
separating the parietal, occipital and the petrosal part of the
temporal bone in the posterolateral region.
The remnants of these fontanelles form cranial fibrous joints
(syndesmosis) called sutures. We divide the types of sutures in three
major types.
1. Plane suture Suture between two straight lines of bones.
a. An example is the transverse palatine suture which is
between the hard palate of the maxilla and the palatine
bone.
2. Squamos suture Suture between a concave formed bone and
a convex formed bone.
a. An example is the squamos suture between the parietal
bone and the squamos part of the temporal bone.
3. Serrate suture Suture between two uneven bony ends.
a. An example is the coronal suture between the frontal
bone and the parietal bone.
Between the bony part of the skull these are the most important
sutures:
o Coronal suture Between the frontal bone and the two
parietal bones.
o Saggital suture Between the two parietal bones.
o Lambdoid suture Between the parietal bones and the
occipital bone.

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 o Squamos suture Between the parietal bone and the squamos
part of the temporal bone.
o Sphenofrontal suture Between the frontal bone and the
greater wing of the sphenoid bone.
o Sphenoparietal suture Between the parietal bone and the
greater wing of the sphenoid bone.
o Sphenosquamos suture Between the greater wing of the
sphenoid bone and the squamos part of the temporal bone.
o Petrosquamos suture Between the squamos and petrous part
of the temporal bone.
o Occipitomastoid suture Between the occipital bone and the
mastoid part of the temporal bone.
o Parietomastoid suture Between the parietal bone and the
mastoid part of the temporal bone.
o Temporozygomatic suture Between the zygomatic process of
the temporal bone and the temporal process of the zygomatic
bone.
o Frontozygomatic suture Between the zygomatic process of
the frontal bone and the forntal process of the zygomatic
bone.
o Zygomaticomaxillary suture Between the zygomatic bone
and the maxilla.
o Nasomaxillary suture Between the nasal bone and the
maxilla.
o Internasal suture Between the two nasal bones.
o Intermaxillary suture Between the maxilla as a continuous
line from the anterior nasal spine.
o Medial palatine suture Between the two parts of the hard
palate of the maxilla, and between the two parts of the hard
palate of the palatine bone.
o Transverse palatine suture Between the hard palate of the
maxilla and the hard palate of the palatine bone.
o Incicive suture Transverse suture in the hard palate of the
maxilla, near the incicivus canal.
o Spheno-ethmoidal suture Between the ethmoidal bone and
the sphenoid bone in the internal cranial cavity.

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 Viscerocranium:

Important structures of the anterior view of the skull:

Sutures:
1. Frontonasal suture.
2. Frontomaxillary suture.
3. Frontozygomatic suture.
4. Zygomaticomaxillary suture.

Frontal bone:
1. Squamos part of frontal bone.
2. Supraciliary arches.

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 3. Supra-orbital margin.
4. Frontal notch.
5. Supra-orbital foramen.
6. Glabella.
7. Zygomatic process.

Zygomatic bone:
1. Temporal process.
2. Zygomaticofacial foramina.
3. Infra-orbital margin.
4. Frontal process.
5. Temporal fossa.
6. Zygomatic arch.

Maxilla
1. Infra-orbital margin.
2. Anterior lacrimal crest.
3. Zygomatic process.
4. Infra-orbital foramen. (Leads to the infra-orbital canal, which
exits in the
5. Lower part of the piriform aperture.
6. Canine fossa.
7. Nasal notch.
8. Anterior nasal spine.
9. Alveolar process.
a. Alveolar arch.
b. Dental alveolae.
c. Interalveolar septa.
d. Interradicular septa.

Nasal bone
1. Internasal suture.
2. Upper part of the piriform aperture.

Important structures of mandibula:

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 External view:
1. Body of mandibula.
2. Ramus of madibula.
3. Alveolar part.
4. Alveolar yolks.
5. Mental protuberance.
6. Mental foramen.
7. Oblique line of mandibula.
8. Condylar process/Head of mandibula.
9. Articular surface of condylar process.
10. Coronoid process.
11. Mandibular notch.
12. Mandibular angle.
13. Masseteric tuberosity.
14. Interalveolar septa.

Internal view:
1. Articular surface of the condylar process.

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 2. Pterygoid fovea.
3. Coronoid process.
4. Mandibular notch.
5. Lingula of mandibula.
6. Mandibular foramen (entrance to the mandibular canal, in which
the alveolar arteries run to supplie the teeth).
7. Mylohyoid groove.
8. Mylohyoid line.
9. Submandibular fossa.
10. Alveolar part.
11. Alveolar septa.
12. Pterygoid tuberosity.
13. Mental spine.
14. Sublingual fossa.

Temporomandibular joints:
- Between the articular surface of the condylar process of the
mandible, and the mandibular fossa and articular tubercle of the
temporal bone on each side.
- Synovial joint with fibrocartilage covering the articular surface
instead of hyalin cartilage. Hinge joint.
- Joint capsule is divided completely by a fibrous articular disc. This
articular disc inserts anteriorly in the fibrous capsule which is
united with the infratemporal head of the lateral pterygoid
muscle, and posteriorly the has two insertions:
o Upper part inserts in the posterior portion of the mandibular
fossa and consist of loose fibroelastic tissue.
o Lower part inserts on the posterior margin of the mandibular
head, and consist of strong fibrous tissue.
- Movements: The lower part allows mainly hinge like depression
and elevation. While the upper part of the joint allows protrusion
and retraction of the mandibular head.
- 4 Ligaments reinforceing:
1. Lateral ligament Runs diagonally just lateral to the capsule,
from the articular tubercle to the neck of the mandible.
2. Sphenomanibular ligament Runs medially to the capsule,
from the spine of the sphenoid bone to the mandibular lingula
on the medial side of the ramus.
3. Stylomandibular ligament Passes from the styloid process of
the temporal bone to the posterior margin and the angle of
mandibula.
4. Hyomandibular ligament Runs from the hyoid bone and fuses
with the stylomastoid ligament.

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 Orbital cavity:
- The cavity contains the eyeball, optic nerve, extra-ocular
muscles, lacrimal apparatus, adipose tissue and the nerves and
vessels sypplying these structures.
- The bony orbit are formed by totally seven bones. These bones
form a pyramid shaped cavity with the apex extending in a
posteromedial direction.
- The walls of the pyramid are:
o Superior wall/roof, from anterior to posterior:
a. Orbital plate of the frontal bone anteriorly.
b. Lesser wing of the sphenoid bone posteriorly.
o Medial wall, from anterior to posterior:
a. Frontal process of the maxilla.
b. Lacrimal bone.
c. Orbital plate of the ethmoid bone.
d. Body of sphenoid bone.
o Lateral wall, from anterior to posterior.
a. Zygomatic bone.
b. Greater wing of sphenoid bone.
o Inferior wall/floor, from anterior to posterior:
a. Body of maxilla.
b. Palatine bone.
c. Body of sphenoid bone.

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 Important structures in the orbital cavity:
1. Superior-orbital margin.
2. Lesser wing of the sphenoid bone.
3. Optic canal Entrance to the middle cranial fossa.
4. Superior orbital fissure Entrance to the middle cranial fossa.
5. Anterior ethmoid foramina Entrance to the internal cranial
cavity.
6. Posterior ethmoid foramina Entrance to the ethmoidal cells.
7. Posterior crest of the lacrimal bone.
8. Lacrimal groove.
9. Fossa for the lacrimal sac Entrance to the nasolacrimal
canal, which opens into the nasal cavity.
10. Inferior orbital fissure Entrance to the pterygopalatine
fossa.
11. Infra-orbital groove Entrance to the infra-orbital canal,
which opens as the infra orbital foramen on the external
surface of the maxilla.

Pterygopalatine fossa:
- Is an inverted teardrop-shaped space between bones on the
lateral side of the skull, immediately posterior to the maxilla.
- The pterygopalatine fossa communicates via fissures and
foramina in its wall with the:
o Middle cranial fossa.
o Infratemporal fossa.
o Orbit.
o Nasal cavity.

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 o Oropharynx.
o Oral cavity.
- It is the crossing point for the trigeminal nerve, with the
pterygopalatine ganglion.
- The walls of the pterygopalatine fossa are the:
o Anterior wall:
a. Posterior surfce of the maxilla.
o Medial wall:
a. Perpendicular plate (lateral surface) of the palatine
bone.
o Posterior wall and roof:
a. Greater wing of the sphenoid bone (anterior surface of
the pterygoid process).

Important gateways in the pterygopalatine fossa:

o Structures opening on the posterior wall:
1. Foramen rotundum Entrance to the middle cranial fossa.
2. Pterygoid canal Entrance to the middle cranial fossa.
3. Palatovaginal canal Entrance to the nasopharynx.
o Structures opening in the inferior wall:
Pterygomaxillary fissure Entrance to the infratemporal fossa.
Infra-orbital fissure Entrance to the orbital cavity.
1. Greater and lesser palatine foramen Entrance through the
greater/lesser palatine foramen in the roof of the oral cavity
(hard palate of palatine bone).
o Structures opening in the medial wall:
1. Sphenopalatine foramen Entrance to the lateral wall of the
nasal cavity.
o Structures opening in the lateral wall:
1. Pterygomaxillary fissure Opens the pterygopalatine fossa
laterally to connect with the infratemporal fossa.
o Structures opening in the anterior wall:

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 1. Inferior orbital fissure Opening into the floor of the orbital
cavity.

Nasal cavity:
- We have two nasal cavities, divided by the bony nasal septum.
- The nasal cavity opens anteriorly through the piriform aperture,
and posteriorly through the choanae.
- The walls of the nasal cavity are:
o Medial wall, the bony and cartilage part:
a. Bony part of the septum:
a. Perpendicular plate of the ethmoid bone.
b. Perpendicular plate of the vomer bone.
c. Nasal crest of the maxillary and palatine bones.
d. Incisor crest.
b. Cartilage part of the septum:
a. Septal cartilage, with the posterior process and the
major alar cartilage.
o Superior wall/roof, from anterior to posterior:
a. Lateral processes of the septal cartilage.
b. Nasal bone.
c. Nasal spine of the frontal bone.
d. Cribriform plate of the ethmoid bone.
e. Sphenoethmoid recess (connection between the sphenoid
and ethmoid bone).
f. Anterior surface of the sphenoid bone.
g. Ala of the vomer and adjacent sphenoidal process of the
palatine bone.
o Inferior wall/floor, from anterior to posterior:
a. Nasal crest of the maxillary and palatine bones.
b. Horizontal plate of the palatine bone.

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 o Lateral wall, from anterior to posterior:
a. Major/minor alar cartilage, with the lateral process of the
septal cartilage.
b. Frontal process of the maxilla.
c. Ethmoidal labyrinth with the uncinate process.
d. Inferior concha.
e. Perpendicular plate of the palatine bone.
f. Medial pterygoid plate of the sphenoid bone.

- The lateral wall of each nasal cavity are made irregular by the
three turbinate bones, the concha nasales, and the underlying
ethmoidal cells.
- The superior and middle concha belonges to the ethmoid bone,
while the inferior concha is a seperate bone of the skull.
o Superior concha:
a. Behind the superior concha lies the spheno-ethmoidal
recess, into which the sphenoidal sinus opens. The
sphenopalatine foramen lies in the lateral wall of the
recess (connection to the pterygopalatine fossa).
b. The openings to the posterior ethmoidal cells can be seen
in the superior nasal meatus.
o Middle concha:
a. Behind the middle concha is the middle nasal meatus, here
lies the uncinate process, which partly covers the maxillary
hiatus, which connects the maxillary sinus with the nasal
cavity.
b. Superior to the uncinate process, in the middle nasal
meatus, is the ethmoidal bulla. Above and under the bulla,
the anterior and middle ethmoidal cells open into the
middle nasal meatus.
c. Between the ethmoidal bulla and the uncinate process is
the ethmoidal infundibulum, which the frontal sinus, the

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 maxillary sinus and the anterior ethmoidal cells are
connected with the nasal cavity.
o Inferior concha:
a. The nasal opening of the nasolacrimal canal lies in the
inferior nasal meatus.

Cerebrocranium:

The calvaria:
- The calvaria is the vault of the cranium.
- It contains the frontal bone, parietal bones, and the occipital bone.
- Structure of the flat bones of the heads are:
a. A compact external table (lamina externa), which is covered
with the pericranium.
b. A compact inner table (lamina interna), which is covered with
the endocranium or dura mater.
c. The diple, which is a spongy layer in between.
o The main structures in the internal calvaria are:
1. Frontal crest.
2. Groove for saggital sinus.
3. Frontal angle.
4. Groove for the middle meningeal arteries.
5. Granular foveolae, is small caveings in the bone, caused by the
compression of the arachnoid mater.
6. Frontal angle, where sutures meet.
7. Occipital angle, where sutures meet.
8. Parietal foramina.
o On the external surface of the calvaria we find:
1. The coronal suture.
2. Saggital suture.
3. Occipital suture.
4. Superior and inferior temporal lines.
5. Parietal foramina.
6. Frontal eminence of the frontal bone.

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 The external base of the skull:
- The anterior part of the external base is a part of the
viscerocranium.
- The posterior part are called the neural part.
- The most important structures of the external base of the cranium
is:
1. Incisive fossa.
2. Incisive suture.
3. Medial palatine suture.
4. Transverse palatine suture.
5. Hard palate of the maxilla.
6. Hard palate (horizontal plate) of the palatine bone.
7. Alveolar arch.
8. Posterior nasal spine.
9. Pyramide process.
10. Greater and lesser palatine foramina.
11. Pterygoid process, with the:
a. Lateral plate.
b. Medial plate.
c. Pterygoid fossa.
d. Pterygoid canal.
e. Scaphoid fossa.
f. Hamulus pterygoideus.
12. Vomer bone.
13. Choanae
14. Alveolar part of the maxilla.
15. Intratemporal crest.
16. Sphenoid spine.
17. Basilar part of the occipital bone, with the:
a. Pharyngeal tubercle.
18. Foramen lacerum.
19. Foramen ovale.

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 20. Foramen spinosum.
21. Carotid canal.
22. Petrosal fossa, is between the carotid canal and the
jugular foramen.
23. Canalis musculotubarius.
24. Petrosal fossula, opening for the tymphanic nerve is
between the carotid canal and the jugular foramen.
25. Jugular foramen.
26. Jugular notch.
27. Sphenopetrosal fissure.
28. Thympanic part of the temporal bone.
29. Anulus tympanicus.
30. Pterotympanic fissure (in the mandibular fossa).
31. Mandibular fossa.
32. Articular tubercle.
33. Styloid process.
34. Stylomastoid foramen.
35. External acoustic meatus.
36. Mastoid process.
37. Mastoid notch.
38. Groove for occipital arteries
39. Mastoid foramen.
40. Occipital condyles.
41. Condylar foramen, is the opening for:
a. Condylar canal which leads to the hypoglossal canal.
42. Condylar fossa.
43. Foramen magnum.
44. Hypoglossal canal.
45. External occipital crest.
46. External occipital protuberance.
47. Superior and inferior nunchal lines.

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 The internal surface of the cranial base:
- Is subdivided in three fossae:
o Anterior cranial fossa.
o Middle cranial fossa.
o Posterior cranial fossa.
- The following bones form the inner surface of the skull:
i. Ethmoid bone.
ii. Frontal bone.
iii. Sphenoid bone.
iv. Temporal bones.
v. Occipital bone.
vi. Parietal bones.

The anterior cranial fossa.

- Borders:
o Anterior border:
i. The frontal bone.
o Inferior border:
i. The orbital plate of the frontal bone.
o Posterior border:
i. The lesser wing of the sphenoidal bone.
Important structures in the anterior cranial fossa:
1. Frontal crest, with the groove for the saggital sinus.
2. Ethmoid bone with the:
a. Foramen ceacum.
b. Crista galli, with its alar processes.
c. Cribriform plate, with foramina cribrosa to the nasal cavity.

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 3. Digitate impressions.
4. Jugum sphenoidale.
5. Lesser wing of sphenoid bone.
6. Anterior clinoid processes.
7. Sphenoethmoidal suture.

The middle cranial fossa:

- Borders:
o Anterior border:
i. Lesser wing of sphenoidal bone.
o Lateral border:
i. Temporal bone.
o Inferior border/floor:
i. Greater wing of sphenoidal bone, and petrosal part of
temporal bone.
o Posterior border:
i. Groove for the superior petrosal sinus.
- Important structures of the middle cranial fossa:
1. Sphenosquamos suture.
2. Greater wing of sphenoid bone.
3. Squamos part of temporal bone.
4. Optic canal.
5. Prechiasmatic groove.
6. Sella turcica, with the following structures:
a. Hypophysial fossa
b. Tuberculum sellae.
c. Dorsum sellae.
7. Posterior clinoid process.
8. Foramen rotundum.
9. Superior orbital fissure.
10. Sphenoidal lingula
11. Foramen ovale.
12. Foramen spinosum.
13. Foramen lacerum.

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 14. Groove for carotid artery.
15. Carotid canal.
16. Groove for middle meningeal arteries.
17. Hiatus and groove for greater petrosal nerve.
18. Hiatus and groove for lesser petrosal nerve.
19. Arcuate eminence, is produced by the semicircular canal.
20. Tegmen tymphani, plate that separate the cranial cavity from
the tymphanic cavity.

21. Groove for superior petrosal sinus.

22. Trigeminal impression.

The posterior cranial fossa.

- Borders:
o Anterior border:
i. Groove for superior petrosal sinus, and anterior part of
clivus.
o Inferior and posterior border:
i. Occipital bone.
Important structures in the posterior cranial fossa.
1. Clivus.
2. Groove for the inferior petrosal sinus.
3. Petro-occipital suture.
4. Internal acoustic meatus.
5. Subarcuate fossa, on the medial side of the pyramid.
6. Opening of the cochlear canaliculus, just anterior to the
subarcuate fossa.

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 7. Opening of the vestibular aqueduct, just posterior to the
subarcuate fossa.
8. Jugular foramen.
9. Intrajugular process.
10. Jugular fossa.
11. Groove for the sigmoid sinus.
12. Foramen magnum.
13. Hypoglossal canal.
14. Groove for transverse sinus.
15. Internal occipital crest.
16. Internal occipital protuberance.

Facial canal:
- Its the z-shaped canal running through the temporal bone, from
the internal acoustic meatus to the stylomastoid foramen.
- It is approx 3 cm long in humans, making it the longes osseous
nervous canal in the body.
- It contains the facial nerve, and the facial canal commences at
the internal auditory meatus with the horizontal part, which
passes at first anteriorly (medial crus of facial canal) then turns
posteriorly at the geniculum of the facial canal to pass medial to
the tympanic cavity (lateral crus of facial canal); finally, it turns
downward (descending part of facial canal) to reach the
stylomastoid foramen.
- It gives off the greater petrosal nerve at the geniculate ganglion,
the nerve to the stapedius muscle in the inner ear and the chorda
tymphani (is one of three nerves involved with the tasting in
the tongue.

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Fredrik Femtehjell Friberg