The last lecture Dr.

Rashed talked about the first part of the skull which is the cranial part, he talked about cranial bones and the specific features of each of them. Today we are going to talk about the second part which is the facial bones (the bone that forming the shape of the face), and the other name of them is the vesrocranium (vesro: refer to the face) while the other name of the cranial bones is the neurocranium (neuro: refer to the brain).

Note: The difference between the skull and the cranium is that the
cranium is the skull without the mandible. BEFORE WE START , PLEASE KEEP LOOKING TO THE PICTURE IN THE SLIDE OF THE DR ,COZ IT WILL HELP YOU SO MUCH The bone that contributing to the facial skeleton are 14 in number and most of them are couple bone (one on the right and one on the left) whereas the cranial bones most of them are single bone except the temporal bone & the parietal bone. -the first bone of the facial skeleton is the zygomatic bone ,which we can feel it very easily ,and there is 2 zygomatic bones (right & left ). -the second one is the maxillary bone ,and also we have 2 maxillary bones The difference between the skull and the cranium is that the cranium is the skull without the mandible.(right & left ),they fuses together and form the upper jaw ,however the lower jaw made up of one bone which is the mandible . -the third one it is the nasal bone.

The nasal bone consist of 2 small plates that forming the bridge (roof) of the nose , these bone since they are very prominent and weak bones ; they are the most common bone to be fracture in the skull. -another one that is located a little bit behind the nasal bone called the lacrimal bone (lacrimal: refer to the tears). When we look to these bone we will find a depression or fossa that contain a sacs of connective tissue ,these sac collecting the tears so when it is filled , the tears will be dropped out from the medial aspect of the eye ,that is why we called these bone the lacrimal bone. -the vomer It is triangular shaped and sharped bone, and it is considered very important because it is contributing to the inferior half of the nasal septum. the nasal cavity divided into right and left nasal cavities and these division formed by the septum ,the upper half of the nasal septum is made by the vertical plan of the ethmoid bone however the lower half is made by the vomer. So the vomer is single bone and contributing to the lower half of the nasal septum which divides the nasal cavity into right & left half.

-the palatine bone We cannot see them from the anterior view we have to look from the inferior aspect of the skull because they are contributing to the posterior third of the hard palate.

*between the nasal cavity and the oral cavity there is a separating wall called the palate, so the palate forming the roof of the oral cavity and the floor of the nasal cavity. *the palate made up of different structure, the part that contain the bone is very hard while another part contain muscle (soft tissue) is soft. So we have: 1-hard palate 2- soft palate. *now, the bone of the hard palate: 1- anterior 2 third made by the maxillary bone. 2- Posterior 1 third made by the palatine bone. -in the lateral wall of the nasal cavity there is a small shelves of bone that descending down from there and we refer to them as a conchae (singular : concha) ,those conchae are going down to protect the opening on the lateral wall of the nasal cavity. *there is a species within the bone called paranasal sinuses and those sinuses usually opened into the lateral wall of the nasal cavity and they are protected by bony shelves called the conchae. *on each lateral wall we have 3 shelves (conchae) ;sup,middle,inf. the superior concha in the upper third and covered by the nasal bone. the superior and middle conchae are considered as a part of ethmoid bone. however, the inferior concha in both sides are separate bones , that why they are consider as a part of facial skeleton . So Superior ,middle, inferior conchae locate in the lateral wall of the nasal cavity . Superior part of ethmoid bone

Middle

Inferior

separate bone by itself

-the last bone of the facial skeleton it is the mandible which is form the lower jaw .

Now, in a regional way (not related to these bones) we divide the face into different region:

1-forehead region
the bone that contributing most of the forehead region it is the frontal bone (however the frontal bone also contributing to the cranium and help in covering the brain) 2- beneath the forehead we can find 2 large spaces called

the

orbital cavities

,these cavities are considered very important

because they are containing 2 systems : A) the visual system : consist of the eyeball & ocular muscle (which is moving the eyeball) B) the lacrimal system : consist of the lacrimal glands that release the tears from the upper lateral corner of the orbital cavity ,then the tears goes all over the eyeball to cleans it ,and the usually collect in the lower medial corner of the orbits within a sacs called the lacrimal sacs . NOTE: the orbit doesnt the eyeball, it is just a space in the skull that containing the eyeball and lacrimal glands These orbital cavities are pyramidal in shape and have 4 walls, with its base in front which is opened to allow the eyeball to project anteriorly, and its apex behind. (We will speak about them in details later on ) 3- Nasal

cavity

divided into 2 half right and left by the nasal septum which is made by perpendicular plat of ethmoid and vomer. 4-jaws The upper jaw made by maxillary bone and the lower jaw made by the mandible. So these are the regional parts of the vecero cranium; forehead ,orbit , nasal cavity , jaws . Now we will speak in details about each of them.

Forehead

-made by: frontal bone -there is very important intersection usually used by the orthodontics called the nasion. So, the nasion: it is the intersection between the 2 nasal bones and frontal bone. another thing is that the metopic suture which is NOT always present .during development and growth of the skull ,the frontal bone made up of 2 half (right and left) and the center of calcification start from there ( that is mean we have 2 centers of calcification right one &left one). So during these calcification and formation of frontal bone ,the right & left half usually continue to calcify until they reach the midline , now, these midline will not calcify it will remain as a connective tissue suture called the frontal suture ( during the infancy and childhood). This suture is considered very important because it is allow for the expansion of the skull, l2no as the child growth up, the skull will also grow. So to allow for larger growth of the skull we keep this suture there. (that is mean as the skull growth posteriorly will also grow anteriorly by these suture in both side ) that is why we have the frontal suture. So the frontal suture normally will be present, and it is appear at birth and still until childhood (usually close at the age of 6 years). b5te9ar the frontal suture located in the median plane and in immature skull also it is usually fuses in early childhood and become one bone which the frontal bone. However , if the frontal suture doesnt close at the age of 6 years and continue to adulthood in some people we dont refer to it as the frontal suture ( because now it is NOT normal ) so it is called the

metopic suture . (y3ne metopic suture : it is the frontal suture but after the age of 6 years ) **ALL human have frontal suture until the age of 6 years . **SOME few percent after the age of 6 years, the frontal suture doesnt close ,so now it is called the metopic suture . -NOW , if we dont have frontal suture before the age of 6 years , y3ne if the frontal suture close at birth ( the 2 half already fuses ) , in these case there will be no much expansion of the skull aneriorly so the skull will grow in other sides but anteriorly doesnt and because of that the shape of the skull in the infant will become triangular ( very sharp anteriorly ) in these case we refer to it triangulocephally . ** so , the trianglocephaly happed because of what??? Premature closure of frontal suture usually during infancy .

The orbital cavity

-there is no base of the orbital cavity anteriorly to allow the eyeball to project from there ( FROM THE BOOK : about one sixth of the eye is exposed ; the remainder is protected by the walls of the orbit ). the apex of the orbital cavity located posteriorly and called the optic canal (foramen) which is allow the optic nerve and ophthalmic artery to pass through it. between the apex and base we have 4 walls (roof,floor,medial wall,laterl wall). ** Each wall made up of 2 bones except the medial wall made up of 4 bones.

**the roof is made up of the frontal bone and lesser wing of sphenoid bone. **the lateral wall is made up of zygomatic bone and greater wing of sphenoid bone. **the floor is made up of maxillary bone and posteriorly the palatine bone. ** is made up of frontal process of maxilla, lacrimal bone, ethmoid bone, the body of sphenoid bone. NOTE: the nasal bone doesnt contributing to the medial wall; it is just contributing to the bridge of the nose. QU: all the following bones contributing to the medial wall of the orbit EXCEPT: 1)sphenoid bone 2)palatine bone 3)ethmoid bone ANSWER : the palatine bone QU: in which part of the orbit dose the lesser wing of sphenoid contributing there : 1)roof 2)floor 3)medial wall 4) lateral wall ANSWER: the roof

-the orbital cavity contain the eyeball and lacrimal apparatus and there is also 2 fissures ( species) :

1) the superior orbital fissure :located between the roof & the lateral wall ( located posteriorly between the greater and lesser wing of the sphenoid bone ) 2) the inferior orbital fissure: located between the floor & the lateral wall ( located posteriorly between the maxilla and the greater wing of the sphenoid ) . Those fissures very important because they allow the orbit to communicate with other areas -the superior one: communicates the orbit with the cranial cavity (middle cranial fossa) because there is very important veins & nerves( the trochlear, oculomotor nerve) will pass through these fissure , the nerves come from the brain and then pass through sup.orbital fissure and supply the ocular muscle which is the muscle that allow you to move your eye (sup , inf ,,,, etc ). The inferior one : communicates the orbit with the infratemporal fossa which is considered very important area especially to the persons who get specialized in dental occupation ( FROM THE BOOK: because these fissure transmits the maxillary nerve and its zygomatic branch , the inferior ophthalmic vein, and the sympathetic nerves ).

NASAL CAVITY :)
location : Inf: to the ant cranial cavity sup:to the oral cavity FROM THE BOOK
Walls of the nasal cavity : Each half of the nasal cavity has a floor , roof , lateral wall , medial or septal wall .

Floor : the palatine process of the maxilla and the horizontal plate of the palatine bone . Roof : the roof is narrow and is formed anteriorly beneath the bridge of the nose bb the nasal and frontal bones , in the middle by the cribriform plate of the ethmoid ,located beneath the anterior cranial fossa , and posteriorly by the downward sloping body of the sphenoid . Lateral Wall : the lateral wall has 3 projection of the bone called superior,middle,inferior conchae * the space below each conchae called meatus

The nasal cavity is divided into right and left halves by Nasal septum the septum is made up of the septal cartilage , the vertical palate of the ethmoid bone , and the vomer .

Ethmoid Bone :
composed of 2 plates one horizontal and the other is perpendicular or vertical . the horizontal one is cribriform Why ?! to allow olfactory nerve fibers pass from the carnial cavity to the nasal cavity

Crista Galli : sharp upword projection of the ethmoid bone ( when the 2 perpendicular plates join together above the horizontal plate )

NOTE :
when you look to the nasal cavity you cant see the superior conchae because its covered by the nasal bone . To continue the shape of the Ethmoid bone 2 small wings (shells) become attached to the lateral side of the horizontal plate which called superior and middle conchae .

MAXILLA :
Maxilla is the bone of the upper jaw made of Body and 2 Ramus Body : pyramidal in shape with 4 processes or long elevations 1- Zygomatic process of Maxilla : going laterally to the zygomatic bone 2- Frontal process : project superiorly to the frontal bone 3- Alveolar process : projecting inferiorly and have a sockets and contain the root of the teeth ( upper teeth) 4- palatine process : projecting posteriorly and form the anterior 2/3 of the hard palate .

Qu : How many Maxillary bone in the upper jaw ? 2 bones the 2 Alveolar processes
both Alveolar processes ( right and left one ) form what we called upper Dental arch But in the lower jaw which made one bony partmandible have one Alveolar process connecting superiorly .

Maxillary Processes Also in the Maxilla we can find 2 IMPORTANT Foramina : 1- InfraOrbital f : located in the body of the Maxilla just beneath the Orbit ,very Important structures ( InfraOrbital nerve and blood vessel ) passes from within the Maxilla (posteriorly) to the Face to provide blood and nerve supply to the area below the Orbit . Infraorbital nerve is terminal branch of the Maxillary nerve that supply the teeth 2- Incisive Foramen : behind the central incisors between the palatine processes ,allowing very important nerve to pass (INCISIVE NERVE ) Terminal branch of Nasopalatine nerve which also come from Maxillary nerve . * Incisive nerve supply primary palate ( the region of the palate that contain a transverse palatine folds

Maxillary Air sinus is the largest air sinuses in the skull

In Addition to these processes the body of the Maxilla is empty inside Why?! To
reduce the weight of the skull and for other function we will mention it in the AIR SINUSes

NOTE : the nerve that supply the lower teeth called Lower Mental nerve OR Inferior alveolar nerve this nerve pass within a foramina in the ramus of the Mandible at the level of the second premolar it give a branch which passes through Mental foramina ( in the body of the Mandible) to give sensation to the Chin area > So what is the important features that found in the body of the MANDIBLE ?! 1- mental foramina 2-alveolar process

RAMUS :
features of the ramus : * Mandibular Notch On the superior border and 2 elevations one ANTERIOR and the Other posterior ,the anterior one CALLED Coronoid process because it like a (crown ) very important WHY ?! one of the Mastication Muscle (Temporalis Muscle) in the temporal bone go downward laterally to inserted onto the coronoid process of the mandible the Contraction of the temporal muscle elevates the mandible. *Condylar process : located posteriorly and have a Condyle ( smooth rounded bony surface) form TM joint.

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MANDIBLE :
the bone of the lower jaw have a ( u ) shape body and 2 superior ramus . * because the body is horizontal and the ramus is vertical the area between them called Angle and it easily palpated .

TM JOINT : THE ONLY MOVABLE JOINT IN THE SKULL . NECK : narrowing of the condylar process the HEAD OF THE MANDIBLE = CONDYLE THE NECK OF THE MANDIBLE = THE NECK OF THE CONDYLAR PROCESS .

The mandible considered as the largest and strongest facial bone but its the second facial bone to be fracture ! Why ? * only movable bone in the skull . PARANASAL SINUSES : DEF : air containing spaces within the cranial bones fun : 1. Reduce the weight of the skull 2. Voice modification 3. Insulation effect prevent the loss of the heat from the nasal cavity .

In addition each ramus of the Mandible have Mandibular foramina this foramina is very important because the dental nerve which supply the teeth and give a branch to Mental nerve pass through this foramina * this foramina protected by a small bony elevation called lingual

Paranasal sinuses : 1. Maxillary sinuses : the tooth root on the upper jaw very sensitive to the cold air
that come from the environment to the nasal cavity So to prevent heat lose Maxillary sinuses during exhalation will be filled with wormed air so when cold air come from outside the sinuses is already filled with air , the cold air continue to the RES ( THE cold air will not reach the dental root ) 2. Frontal sinuses : located in frontal bone ,above the orbit , middle meatus * smaller than maxillary 3. Sphenoid sinuses : in the body of the sphenoid under the sella tucica . * smaller than frontal 4 . ethomidal air cells :group of many small spaces not large to called sinuses anterior . middle , posterior groups

From wiki : Sinusitis is inflammation of the paranasal sinuses, which may be due to infection, allergy, or autoimmune issues. Most cases are due to a viral infection and resolve over the course of 10 days.

All of the sinuses open to the nasal cavity except ?! the 5th one ( Mastoid air cells) *mastoid process easily palpated behind the ear , part of the temporal bone. * open into middle ear

Please forgive us if you find any mistake Heba Radaideh , Haya Momani GOOD LUCK
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