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Anatomy of the base of the skull, the pituitary fossa and the cavernous sinus

Divisions of the fossae


 Anterior vs middle
o Anterior border is the brim of the frontal bone
o posterior border of the anterior cranial fossa: lesser wing sphenoid
o Anterior clinoid processes lie “above” the optic canals
o Lesser wing sphenoid “sits” in the lateral sulcus of the cortex
 Middle vs posterior
o anterior: dorsum sellae (median rectangular plate) and the posterior clinoid
processes (foot of the bed)
o lateral: superior ridge of the petrous temporal bone

Contents of the fossae


 Anterior cranial fossa
o Crista galli
 Expansion of the ethmoid bone
 Attaches the anterior aspect of the falx cerebri (dura)
o Cribiform plate
 Penetrations of the olfactory nerves
o Ethmoidal foraminae
 Anterior and posterior ethmoidal nerves
 Seen from orbit
o Orbital plate of the frontal bone forms most of the floor
 Middle cranial fossa (median)
o 4 clinoid processes – wings of sphenoid, dorsum sellae
o Optical canal and associated groove
o The sella turcica (hypophyseal fossa) – the “turkish saddle”
 Body of the sphenoid bone
 Pituitary gland sits here, covered by dura sella
o Foramen lacerum
 Not a true foramen, nothing traverses it
entirely (things enter and exit via canals
in the the walls of the foramen)
 Apertures for the
 Carotid canal (ICA)
 Pterygoid canal (greater petrosal
nerve)
 Greater petrosal nerve (of CNVII) passes
into foramen lacerum --> pterygoid canal
--> pterygopalatine fossa

o Superior orbital fissure


 III, IV, V1, VI
o Foramen rotundum
 V2 --> pterygopalatine fossa
o Foramen ovale
 V3
 Lesser petrosal nerve --> infratemporal fossa (parasympathetic to otic
ganglion)
o Foramen spinosum
 Middle meningeal --> infratemporal fossa
o Cavernous sinus – see later
 Posterior cranial fossa
o Foramen magnum
 Most inferior portion of the PCF
o Hypoglossal canal
Jugular foramen
 Exit of the hypoglossal nerve, within walls
of foramen magnum
o Jugular foramen
 Exit of vagus, glossopharyngeal, and
accessory nerves
 Figure 8 shape for the formation site of the
IJV (saggital sinus, inferior petrosal sinus)
o Internal auditory meatus
 Exit of facial nerve and vestibulocochlear
nerves
o Clivus
 Basal portion of the occipital bone and the body of the sphenoid
o Internal occipital crest
 Attaches the posterior portion of the falx cerebri

Pituitary gland (middle cranial fossa)


 2 embryological origins
o Oral cavity (pharyngeal tissue)
o Hypothalamus (neural tissue)
 Two outgrowths of each tissue develop
at ~day 42
o Rathke’s pouch (oral)
o Neurohypophyseal bud (neual)
 The outgrowth from the oral cavity
grows towards the neurohypophyeal
bud and by ~day60, loses its connection
to the oral cavity
o Piece of tissue that was part of
the GIT is loosely attached to
the outbud of the developing
hypothalamus
 Therefore the pituitary has the
following strucures
o Anterior lobe – associated with
CNS via vascular connections
o Posterior lobe – associated with
CNS via neural connections
 Bone forms around the bud at ~3
months

Cavernous sinus (middle cranial fossa)


 Lies between 2 layers of dura
 Joined in the midline, allowing passage of venous blood across the midline
o Anterior intercavernouse sinus
o Posterior intercavernous sinus
 BETWEEN the layers
o III, VI, V1, VI (sometimes some V2)
 Note the abducent CNVI lies close to the ICA
o Internal carotid artery
 Heads anteriorly within the cavernous sinus, doubles back on itself to
pierce the dura and branches to supply intracranial branches
o Sympathetic plexii (for structures of the head)
 OUTSIDE the layers (between bone and bony dural surface)
o Middle meningeal artery
o Petrosal nerves (parasympathetics)
 INSIDE both layers (brain side)
o Optic chiasm, optic nerve
o Pituitary gland (intradural structure)
o Temporal lobe of cortex
 Important: pituitary has close association with the ICA, abducent, and venous
drainage of the eye. Things that happen to the pituitary have the potential to affect
structures of the cavernous sinus.
 Image:
o * sphenoidal sinus (air)
o A = pituitary, arrow = infundibulum
o C = optic chiasm
o I = ICA both in the cavernous sinus and intracranial portion

More anterior view (towards anterior clinoid process)


 ICA has branched to form
ophthalmic artery
 Adjacent ophthalmic vein
 Nerves through SOF

Lateral aspect of the cavernous sinus (remove brain surface of dura) and contents of the
middle cranial fossa
Petrosal nerves

Greater petrosal nerve- parasympathetic fibres.


 Branch of the FACIAL nerve (origin: superior salivary nucleus) at the geniculate
nucleis (no synapse)
 Travels below the trigeminal ganglion
 Exits via the foramen laceum (upper aperture)
 Travels through the pterygoid canal into the pterygopalatine fossa
 Synapses on pterygopalatine ganglion (within pterygopalatine ganglion)
 Supplies:
o Lacrimal (tears) – via V2 (hitchike as V2 passes
through the pterygopalatine fossa, then from V2 to
V1 within the orbit)
o Nasal (mucus) – diverge after ganglion to supply
mucosa of concha
o Palatine glands (mucus)– hard and soft palate

Lesser petrosal nerve


 A branch of the GLOSSOPHARYNGEAL nerve, exiting skull through jugular foramen
 Traverses tympanic plexus, travels lateral to the greater petrosal nerve
 Exits via foramen ovale, travels infratemproal fossa to find and...
 Synapses on otic ganglion

 Supplies parotid gland (saliva)