Meriel June C. Mortola SPMC PGI 2011-2012 DORIS Rotation: Jan.

24-31, 2012

The facial bones consist of the following: Zygomatic bones 2 Maxillae 2 Nasal bones 2 Lacrimal bones 2 Vomer 1 Palatine bones 2 Inferior conchae 2 Mandible - 1

Cranial Bones Functions: Site for head muscle attachment Encase brain and particular sense organs Facial Bones Functions: Site for facial muscle attachment Cavities for particular sense organs i. Gustation ii. Olfaction iii. Vision Framework for the face Openings for air and food passage Secure teeth

Suturesconnections (joints) between bones of skull (all bones of the skull except mandible) Cranial bone sutures: Coronal Sagittal Squamous Lamboid Sutures of facial bones are named based on name of bones that are connected

Skull bones top view

Organization of the skull Cranial vault (calvaria; skullcap) a. Forms the superior, lateral and posterior aspects as well as the forehead Cranial base (floor) a. Forms inferior aspect b. Fossaesteps

Cavities a. Cranial i. Brain b. Orbits i. Eyeballs c. Paranasal sinuses i. Nasal cavity d. Middle and inner ear
Openings a. Foramina b. Canals c. Fissures

Bones of the anterior aspect of the skull

Bones of the lateral aspect of skull

Is that part of the central nervous system that lies inside the cranial cavity It is continuous with the spinal cord through the foramen magnum.

Major parts of the brain: Forebrain a. Cerebrum b. Diencephalon Midbrain Hindbrain a. Pons b. Medulla oblongata c. Cerebellum *Brainstem a collective term for the medulla oblongata, pons, and midbrain

Cerebrum Largest part of the brain Consists of 2 cerebral hemispheres

Longitudinal Fissure A deep cleft separating the hemispheres The cerebral cortex is thrown into folds, or gyri, separated by fissures, or sulci. Several of the large sulci conveniently subdivide the surface of each hemisphere into lobes.

Cerebral cortex is divided into 5 bilateral lobes each involving multiple functions * 4 lobes named for overlying cranial bones 1) frontal lobes lie in anterior cranial fossa anterior to central sulcus contains primary motor cortex (precentral gyrus) and language production center (see below) 2) parietal lobes lie posterior to central sulcus just below parietal bones contains primary sensory cortex (postcentral gyrus)

3) temporal lobes lie in middle cranial fossa inferior to parietal lobes and separated by lateral fissure contains primary auditory cortex and language comprehension center (see below)
4) occipital lobes posterior to parietal and temporal lobes, supported by tentorium cerebelli contains primary visual cortex (medial surface) 5) insular lobes "island" of cortex deep to lateral fissure

Diencephalon Is almost completely hidden from the surface of the brain Consists of a dorsal thalamus and a ventral hypothalamus

Midbrain The narrow part of the brain that connects the forebrain to the hindbrain. Contains many nuclei and bundles of ascending and descending nerve fibers.
MIDBRAIN

Medulla oblongata Connects the pons superiorly to the spinal cord inferiorly Serves as a conduit for ascending and descending nerve fibers Pons Situated on the anterior surface of the cerebellum, inferior to the midbrain and superior to the medulla oblongata Contains many nuclei and ascending and descending nerve fibers

Arterial blood supply of brain 2 pair of bilateral arteries (internal carotids and vertebrals) 1) internal carotid - terminal branch of common carotid tortuous route: ascends within carotid canal; runs through cavernous sinus and terminates adjacent to posterior clinoids

Major branches: A) ophthalmic - small; runs within optic nerve to supply internal eye B) anterior cerebral - terminal branch; runs within longitudinal fissure of the cerebrum i) anterior communicating artery connects anterior cerebral artery C) middle cerebral - terminal branch; runs through lateral fissure

2) vertebral a - branch of subclavian; ascends through transverse foramina and enters via foramen magnum; unites with opposite at caudal end of pons to form basilar Major branches: A) posterior inferior cerebellar B) basilar - formed by union of L & R vertebral i) anterior inferior cerebellar ii) superior cerebellar iii) posterior cerebral a) posterior communicating - joins internal carotid

Blood supply to the brain

Circle of Willis an important collateral circulation at the base of the brain formed by : *the basilar artery *the posterior cerebral arteries *the posterior communicating arteries *the anterior cerebral arteries *the anterior communication artery These vessels lie within the subarachnoid space and are a common location for cerebral aneurysms to form.

Veins of the Brain Have no muscular tissue in their thin walls Posess no valves They emerge from the brain and drain into the cranial venous sinuses. The great cerebral vein is formed by the union of the internal cerebral veins and drains into the straight sinus.

The brain has 4 ventricles. Within the cerebral hemispheres are the lateral ventricles, which are connected to each other and to the third ventricle through a pathway called the interventricular foramen (of Monro). The third ventricle lies in the midline, separating deeper brain structures such as the left and right thalami. The third ventricle communicates with the fourth ventricle through the cerebral aqueduct (of Sylvius), which is a long narrow tube.

CSF is produced by the choroid plexuses within the lateral, third, and fourth ventricles of the brain. From the fourth ventricle, CSF flows into the subarachnoid space around both the brain and the spinal cord. From the subarachnoid space, which lines the cerebral hemispheres, CSF is then absorbed into the venous circulatory system. Arachnoid villi are structures within the superior sagittal sinus that release CSF back into the venous system.

CSF FLOW