Cavities and spaces of the skull, paranasal sinuses, opening in the

skull bases

MUDr.Veronika Němcová, CSc.

Basis craniiinternaF

Amin

Amaj

T

O

E

Internal surfice of the cranial base

Anterior cranial fossa

Crista galli

Foramen caecum

Cribriform plate

Prechiasmatic groove

Optic canalLesser wing

Anterior clinoid process

Impressionesgyrorum etjugacerebralia

Anterior cranial fossa - repetition

Middle cranial fossaopenings

Foramen rotundum

Foramen venosum

Foramen ovale

Foramen spinosum

Superior orbital fissure

Foramen lacerumHiatus for thelesser petrosalnerve

Hiatus for thegreater petrosalnerve

Middle cranial fossastructures

Hypophysial fossa

Carotid sulcus

Dorsum sellaeTrigeminal impression

Grooves for thelesser andgraeter petrosalnerves

Arcuate eminence

Groove of thesuperior petrosalsinus

Tegmentympani

Middle cranial fossa - repetition

Posterior cranial fossa - openings

Foramenmagnum

hypoglossalcanal

Jugular foramenInternalacusticmeatus

Apertura externaaquaeductusvestibuli

Condylar canal

Posterior cranial fossastructures

Clivus

Cerebellar fossa

Internal occipital crest

Internal occipitalprotuberance

Sulcus sinus transversi

Opening for the emissaryvein from mastoidforamen

Groove of thesigmoid sinus

Subarcuate fossa

Groove of the inferiorpetrosal sinus

Groove of the superior petrosal sinus

Cerebral fossa

n.VIIn.VIII

n.IXn.Xn.XI

n.XII

Sites for passage for nerves in the posterior cranial fossa

Fossa cranii posterior -repetition

Openings in theinternal surface ofcranial base

1-lamina cribrosa2-canalis opticus3-fissura orbitalis superior4-foramen rotundum5-foramen ovale6-foramen spinosum7-foramen lacerum8-hiatus nervi petrosi minoris9-hiatus nervi petrosi majoris10-porus acusticus internus11-foramen jugulare12-canalis nervi hypoglossi13-foramen magnum14-canalis condylaris15-foramen mastoideum

1

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89 10

1112

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15

I. Olfactory nervesII. Optic nerveIII. Oculomotory nerveIV. Trochlear nerveV. Trigeminal 1.Ophthalmic

2.Maxillary3.Mandibular

VI. Abducent nerveVII. Facial nerveVIII. Vestibulocochlear nerveIX. Glossopharyngeal nerveX. VagusXI. Accessory nerveXII. Hypoglossal nerve

Cranial nerves

Basis cranii internaAnterior cranial fossa

Frontal lobes, n.I. a n.II.,falx cerebriorbitocranial canal

Middle cranial fossatemporal lobes, hypophysis cerebri,eye-muscle nerves and V/1, branches of n.V, cavernoussinus, middle meningeal art.,sphenopetrosal synchondrosis

Posterior cranial fossa, brainstem, cerebellum, occipital lobes, grooves ofsinuses, emissary veins, n.VII a n.VIII, endolymphatic duct, nn.IX,X,and XI, spinal cord andn.XI and vertebral art., n.XII

Posterior border of lesser wingsand prechiasmatic sulcus

I

Ophthalmic art.III, IV, VI, V/1

Sup. ophthalmic vein

V/2V/3 Middle

meningealart.

Crista pyramidis, dorsum sellae

II

Greater (from N.VII) and lesser(fromN.IX) petrosal nerves

Ant. meningeal art.

VII, VIII

IX,X,XIVertebral art.

XII

Post. meningeal art.

Int.carotid art.

Sulcussinus sigmoidei

Sulcus sinus petrosisuperioris

Sulcus sinus transversi

Grooves of sinuses

Sulcus sinus petrosi inferioris

n.II

Sup.opthalmic vein

Int. carotid art.n.III

n.Vn.IV.

n.VIn.VII and n.VIII

Falx cerebri

n.IX.,X., IX

n.XII

Vertebral art.r. spinalis n.XI.

Middlemeningeal art.

Sigmoid sinus

Transverse sinusSup. sagittal sinus

confluens of sinuses

infundibulumhypophysae

Repetition

Tentorium of thecerebellum Vertebral art.

Middlemeningeal art.

Int. carotid art.

Cavernoussinus

Nasal cavity and paranasal sinuses

Sphenoid sinus

Posterior ethmoidal cells

Frontal sinus

Anterior ethmoidal cells

Nasolacrimal duct

Maxillary sinus

Paranasal sinuses - development

Piriformaperture

Frontal sinus

Anteriorly

Middle nasalmeatus

Superior nasalmeatus

Inferior nasalmeatus

Choana

Posteriorly

Nasal septum:

perpendicular plate ofethmoid

vomer

Cavum nasi osseum

Roof:nasal bone

frontal bone

Cribriform plate ofethmoid

sphenoid(body)

Floor:palatine process of maxillahorizontal plate of palatine bone

Lateral wall of the nasal cavity

Frontal process and body of maxilla

Lacrimal bone

Ethmoid

Inferior nasalconchaPerpendicular plate ofpalatine bone

Medial lamina ofpterygoid process

Bony nasal cavity - repetition

sphenopalatine foramen

Palatum durum

Os incisivum

Processus palatinusmaxillae

Lamina horizontalisossis palatini

Foramen incisivum(nervus nasopalatinus)

F

Z

M

Vomer

Frontal section through the maxillary sinus(schema)

Ant. cranial fossa

Frontal sinus

Orbit

Maxillarysinus

Semilunar hiatus

Ant.ethmoid cells

Post.ethmoid cells

Frontální řez přes sinus maxillaris

3

2

8

4

5

6

1

Frontal section through themaxillary sinus

X-ray picture of the skullAP projection

4

2

3

8

Sinusitis

X-ray picture ofparanasal sinuses(Waters projection)

Frontal sinus

Maxillary sinus

Sphenoid sinus

RTG Waters projection - sinusitis

Pansinusitis after tsunami

Normal CT of paranasal sinuses on the same levels

Fossahypophysialis Sinus sphenoidalis

Sinus maxillaris

X-raypicture ofthe skulllateralprojection

Sinus frontalis

Infratemporal fossa

Content:Pterygoid musclesPterygoid plexusMaxillary arteryBranches of the mandibular nerveOtic ganglion Buccal adipose body

Borders:Sup.: infratemporal crestAnt.: maxillary tuberosityLat.: ramus of the mandibleMed.: lateral plate of the pterygoidprocess

Infratemporal fossaopenings

Mandibular nerve(oval foramen)

Middle meningeal art(spinous foramen)

Inf.ophthalmic vein(inf. orbital fissure)

Inf. alveolar nerve(mandibular canal)

Mylohyoid nerve(mylohyoid groove)

Infratemporal fossarepetition

Pterygoidmuscles

Otic ganglion

Maxillary artery

Branches ofmandibularnerve

M

L

N.lingualis

N.alveolaris inf.

Corpus adiposum

N.mandibularis

Arcus zygomaticusVomer

Sinus sphenoidalisin oval foramen

Processus pterygoideus

Frontal section through thetemporal and infratemporal region

Frontal section through thetemporal and infratemporal regionrepetition

Plexus pterygoideus

V.jugularis externa

V.jugularis interna

V.temporalis spf.

Vv.diploicae

V.angularis

V.facialis

V.retromandibularis

Pterygoid plexus in the infratemporal fossa

Maxillary artery in the infratemporal fossa

N.auriculotemporalis

N.VII(stylomastoidforamen)

N.alveolaris inf.

R.mylohyoideus

N.lingualis

N.buccalis

Nerves in the infratemporal fossa – branches of mandibular nerve (V/3)

Pterygopalatine fossa – deepest part of the infratemporal fossa

Pterygopalatine fossa

Pterygopalatinefossa

Orbit

Nasalcavity

Oral cavity

Middle cranial fossa

Externalsurface ofcranial baseBorders:

Ant. - maxillaPost. – pterygoid processMed.- perpendicular plate

of palatine boneLat.-pterygomaxillary

fissureSup.- greater wing of

sphenoidInf. – foramen palatinum

majus

Maxilla

Pterygoid process

Inferior orbital fissure Sphenopalatine foramen

Pterygoid canalForamen rotundum

Greater palatine canal

Pterygopalatine fossa lateral aspect -schema

MaxillaPtPr

IOFI SPF

PCFR

V/2 somatosensory

Greater petrosal nerve (VII)parasympathetic

Lesser petrosal nerve(plexus a.carotis int.)sympathetic

GPC

Pterygopalatine fossa schema - nerves

Pterygopalatine ganglion

Pterygopalatine fossa lateral aspect - nerves

MaxillaPtPr

IOF SPF

PC

FR

V/2

Infraorbital nerve

Zygomatic nerve

nn.pterygopalatini

Palatine nerves (greater and lesser)

Nasal branches

Greater petrosal nerve (VII)parasympathetic

Lesser petrosal nerve(plexus a.carotis int.)sympathetic

somatosensory

Pterygopalatine ganglion

communicating branch to zygomatic nerve(for lacrimal gland)

Fossa pterygopalatina schema– branches of maxillary artery

M

Post. sup. alveolar art.

Ant. sup. alveolar art.

Sphenopalatine art-Rr. nasales post.lat.+septi

Descendingpalatine art.

Greater and lesser palatine art.

Infraorbital art.

A.canalis pterygoidei

Fossa pterygopalatina schema – nerves and arteries

M

Ant. sup. alveolarnerves and art.

Sphenopalatine art.

Nasalbranches

A.palatina descendens

Infraorbital nerve and art.

A.canalis pterygoidei

Zygomatic nerve Maxillary nerve

Greater petrosal nerve Lesser petrosal nerve

Pterygopalatineganglion

Post. sup. alveolarnerves and art.

Greater and lesser palatine nerves and art.

Pterygopalatine fossa medial aspekt lamina perpendicularis ossis palatini removed

Pterygoid canal

Greater palatine canal

Incisive canal

M

L

E

F

LW

Z

Orbital cavity

P

GW

Optic canal

Infraorbital foramen

Inferior orbital fissure

Superior orbital fissure

Zygomaticofacialforamen

Supraorbital foramen

Frontal notch

Ant.and post. ethmoid foramen

Trochlear fovea

Fossa for lacrimal gland

Fossa for lacrimal sac

Orbital cavity – openings and fossas

Orbital cavity – sites for passage

Anteriorcranialfossa

Middle cranial fossa

Infratemporal andpterygopalatine fossa

Orbitocranial canal

Orbitoethmoid canal

Nasolacrimal canal

lacrimalfrontal

n.IV

Infraorbital nerve and art.

Zygomatic nerve

Inf. ophthalmic vein

Anulus tendineus communis

nasociliary

n.III

n.VI

ant. et post.ethmoidalnerves andart.

Supraorbital

Supratrochlear

n.IIOphthalmic art.

Orbital cavity arteries and nerves

Superior ophthalmic vein

Orbital cavity repetition

lacrimal nerve from V/1

frontal nerve from V/1

nasociliary nerve -from V/1 and ophthalmic art.

trochleary nerve(IV)

n. abducens (VI)

optic nerve(II)

oculomotory (III)

Nerves in the superior part of the orbite

Nasopalatine nerve

Greater palatine nerve and art.

Mandibular nerve

Middle meningeal art.

Greater and lesserpetrosal nerve

Internal carotid art.

Facial nerve

n.IX.,X., IXInt. Jugular vein

n.XIIemissarium mastoideum

emissarium condylarer.spinalis n.XI

Vertebral art

Basis cranii externa-sites for passage for vessels and nerves

Basis cranii externarepetition

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1-incisive canal2-greater palatine foramen3-inf.orbital fissure4-foramen ovale5-foramen spinosum6-mastoid process7-stylomastoid foramen8-carotid canal9-jugular foramen10-foramen magnum11-condylar canal12-occipital condyle13-mastoid notch14-foramen lacerum15-vomer16-lateral plate of pterygoidprocess

Basis cranii externarepetition

Sources

• Čihák, Anatomie 1• Gray, Anatomy• Petrovický a spol., Anatomie 1• Sobotta , Atlas anatomie člověka• http://anat.lf1.cuni.cz/muzeum/kranio.html• Personal archive