The skull is a bony structure that supports the face and also forms a security cavity for the brain. The is made up of numerous bones, which are developed by intramembranous ossification, and also joined through sutures (fibrous joints).

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The skeletal of the skull have the right to be taken into consideration as two groups: those that the cranium (which consists the cranial roof and cranial base) and those the the face.

In this article, us shall look at the anatomy the the skeletal of the skull – your orientation, articulations, and also clinical relevance.


Cranium

The cranium (also well-known as the neurocranium) is formed by the superior aspect of the skull. It encloses and protects the brain, meninges, and also cerebral vasculature.

Anatomically, the cranium have the right to be subdivided right into a roof and a base:

Cranial roof – consisted of of the frontal, occipital and two parietal bones. That is likewise known together the calvarium.Cranial base – consisted of of 6 bones: frontal, sphenoid, ethmoid, occipital, parietal and temporal. This bones articulate through the first cervical vertebra (atlas), the facial bones, and also the mandible (jaw).
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Fig 1 – bones of the calvarium and cranial base.


Clinical Relevance: Cranial Fractures

Fractures of the cranium commonly arise native blunt force or penetrating trauma. When considering cranial fractures, one area that clinical prominence is the pterion – a H-shaped junction in between the temporal, parietal, frontal, and sphenoid bones.

The pterion overlies the middle meningeal artery, and also fractures in this area may injury the vessel. Blood have the right to accumulate in between the skull and also the dura mater, developing an extradural haematoma.


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Fig 2 – Lateral see of the skull, showing the course of the meningeal arteries. Keep in mind the pterion, a weak allude of the skull, wherein the anterior middle meningeal artery is at hazard of damage.


Face

The facial skeleton (also recognized as the viscerocranium) support the soft organization of the face.

It consists of 14 bones, i m sorry fuse to house the orbits of the eyes, the nasal and oral cavities, and also the sinuses. The frontal bone, typically a bone the the calvaria, is sometimes contained as part of the facial skeleton.

The facial bones are:

Zygomatic (2) – develops the cheek skeleton of the face and articulates through the frontal, sphenoid, temporal and also maxilla bones.Lacrimal (2) – the the smallest bones that the face. They kind part the the medial wall of the orbit.Nasal (2) – two slender bones the are located at the leg of the nose.Inferior sleep conchae (2) – located within the nasal cavity, these bones boost the surface area the the sleep cavity, thus increasing the amount of influenced air that can come into contact with the cavity walls.Palatine (2) – positioned at the rear of oral cavity and forms part of the difficult palate.Maxilla (2) – comprises component of the upper jaw and also hard palate.Vomer – develops the posterior element of the sleep septum.
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Fig 3 – Anterior check out of the face, showing some the the bones of the sleep skeleton. The vomer, palatine and also inferior conchae skeletal lie deep within the face.


Clinical Relevance: facial Fractures

Fractures that the facial skeleton are fairly common and most frequently result from roadway traffic collisions, fist fights, and also falls.

The 4 most usual facial fracture varieties are:

Nasal fracture – the most common facial fracture, because of the influential position that the nasal bones in ~ the leg of the nose. There is often far-ranging soft organization swelling and associated epistaxis.Maxillary fracture – connected with high-energy trauma. Fractures influence of maxillary bones space classified making use of the Le fort classification, varying from 1 come 3.Mandibular fracture – frequently bilateral emerging directly in ~ the next of trauma, and indirectly in ~ the contralateral side due to transmitted forces. Clinical features encompass pain in ~ fracture site and also misalignment of the this (malocclusion)Zygomatic arch fracture – associated with trauma come the side of the face. Displaced fractures can damage the nearby infraorbital nerve, bring about ipsilateral paraesthesia of the check, nose, and also lip.
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Fig 4 – 3D repair of a comminuted nasal bone fracture.


Sutures that the Skull

Sutures are a kind of fibrous joint the are distinctive to the skull. They are immovable and also fuse completely around the age of 20.

These joints are important in the paper definition of trauma, as they represent points that potential weakness in the skull. The key sutures in the adult skull are:

Coronal suture – fuses the frontal bone v the two parietal bones.Sagittal suture – fuses both parietal bones to every other.

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Lambdoid suture – fuses the occipital bone come the two parietal bones.

In neonates, the incompletely fused suture joints provide rise to membranous gaps in between the bones, recognized as fontanelles. The two major fontanelles are:

Frontal fontanelle – located at the junction of the coronal and also sagittal suturesOccipital fontanelle – located at the junction the the sagittal and lambdoid sutures