Arnab Rana. Last updated 27th November The Skull Base. Arnab Rana. Background. Skull base foramina. Skull base bones. Self learning exercise

Transcription

1 Last updated 27th November 2017

2 Table of contents

3 Aberdeen MBChB learning guide links Year 2 Systems II (Part 1) ENT Pg 24

4 Aberdeen MBChB learning guide links Year 2 Systems II (Part 1) ENT Pg 24 Understand briefly the various structures that go to form the base of the skull

5 Aberdeen MBChB learning guide links Year 2 Systems II (Part 1) ENT Pg 24 Understand briefly the various structures that go to form the base of the skull Describe the internal auditory meatus and its contents

6 Aberdeen MBChB learning guide links Year 2 Systems II (Part 1) ENT Pg 24 Understand briefly the various structures that go to form the base of the skull Describe the internal auditory meatus and its contents Year 2 Systems II (Part 1) Neuro

7 Aberdeen MBChB learning guide links Year 2 Systems II (Part 1) ENT Pg 24 Understand briefly the various structures that go to form the base of the skull Describe the internal auditory meatus and its contents Year 2 Systems II (Part 1) Neuro Disorders of cranial nerves lecture

8 Aberdeen MBChB learning guide links Year 2 Systems II (Part 1) ENT Pg 24 Understand briefly the various structures that go to form the base of the skull Describe the internal auditory meatus and its contents Year 2 Systems II (Part 1) Neuro Disorders of cranial nerves lecture Pg 44 Describe the anatomy and function of the 12 cranial nerves

9 Aberdeen MBChB learning guide links Year 2 Systems II (Part 1) ENT Pg 24 Understand briefly the various structures that go to form the base of the skull Describe the internal auditory meatus and its contents Year 2 Systems II (Part 1) Neuro Disorders of cranial nerves lecture Pg 44 Describe the anatomy and function of the 12 cranial nerves Pg 48 Describe the dural coverings of the brain and opening of the skull

10 Scope There is an enormous amount which could be learned about the skull base

11 Scope There is an enormous amount which could be learned about the skull base In the following slides I will mention some things which I think would help medical students pass exams

12 Scope There is an enormous amount which could be learned about the skull base In the following slides I will mention some things which I think would help medical students pass exams First, I will show you an intricately-labelled diagram which I stumbled across on the internet

13 Scope There is an enormous amount which could be learned about the skull base In the following slides I will mention some things which I think would help medical students pass exams First, I will show you an intricately-labelled diagram which I stumbled across on the internet Please don t learn it, it is only for amusement!

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15 Limitations Limitations of the models I have put 3D models in the online PDFs for my other 3D tutorials. Unfortunately, the skull base model is too complicated for conversion, therefore only the text notes are available online.

16 What are the openings of the skull? Selected list page 1 One foramen magnum cervicomedullary junction, two vertebral arteries important for all nervous functions under the head

17 What are the openings of the skull? Selected list page 1 One foramen magnum cervicomedullary junction, two vertebral arteries important for all nervous functions under the head Two optic canals optic nerve II for vision

18 What are the openings of the skull? Selected list page 1 One foramen magnum cervicomedullary junction, two vertebral arteries important for all nervous functions under the head Two optic canals optic nerve II for vision Two ovalia mandibular branch of trigeminal nerve V3 needle entry point for trigeminal nerve anaesthesia

19 What are the openings of the skull? Selected list page 1 One foramen magnum cervicomedullary junction, two vertebral arteries important for all nervous functions under the head Two optic canals optic nerve II for vision Two ovalia mandibular branch of trigeminal nerve V3 needle entry point for trigeminal nerve anaesthesia Two rotunda maxillary branch of trigeminal nerve V2 numb patch on face after trauma

20 What are the openings of the skull? Selected list page 1 One foramen magnum cervicomedullary junction, two vertebral arteries important for all nervous functions under the head Two optic canals optic nerve II for vision Two ovalia mandibular branch of trigeminal nerve V3 needle entry point for trigeminal nerve anaesthesia Two rotunda maxillary branch of trigeminal nerve V2 numb patch on face after trauma Two jugular sigmoid sinuses go through this to become the two internal jugular veins the main venous outflow tracts for blood from the brain

21 What are the openings of the skull? Selected list page 2 The cribriform plate many small holes for the olfactory receptor neurones anosmia after trauma)

22 What are the openings of the skull? Selected list page 2 The cribriform plate many small holes for the olfactory receptor neurones anosmia after trauma) Two superior orbital fissures oculomotor III, trochlear IV, ophthalmic V1 and abducens VI pupil dilatation, drooping eyelid, eye movement syndrome and forehead sensation

23 What are the openings of the skull? Selected list page 2 The cribriform plate many small holes for the olfactory receptor neurones anosmia after trauma) Two superior orbital fissures oculomotor III, trochlear IV, ophthalmic V1 and abducens VI pupil dilatation, drooping eyelid, eye movement syndrome and forehead sensation Two internal auditory meatii facial VII and vestibulocochlear VIII unilateral sensorineural deafness in vestibular schwannoma)

24 What are the openings of the skull? Selected list page 2 The cribriform plate many small holes for the olfactory receptor neurones anosmia after trauma) Two superior orbital fissures oculomotor III, trochlear IV, ophthalmic V1 and abducens VI pupil dilatation, drooping eyelid, eye movement syndrome and forehead sensation Two internal auditory meatii facial VII and vestibulocochlear VIII unilateral sensorineural deafness in vestibular schwannoma) Two stylomastoid facial nerves VII

25 What are the openings of the skull? Selected list page 2 The cribriform plate many small holes for the olfactory receptor neurones anosmia after trauma) Two superior orbital fissures oculomotor III, trochlear IV, ophthalmic V1 and abducens VI pupil dilatation, drooping eyelid, eye movement syndrome and forehead sensation Two internal auditory meatii facial VII and vestibulocochlear VIII unilateral sensorineural deafness in vestibular schwannoma) Two stylomastoid facial nerves VII Two carotid canals internal carotid artery

26 What are the openings of the skull? Selected list page 2 The cribriform plate many small holes for the olfactory receptor neurones anosmia after trauma) Two superior orbital fissures oculomotor III, trochlear IV, ophthalmic V1 and abducens VI pupil dilatation, drooping eyelid, eye movement syndrome and forehead sensation Two internal auditory meatii facial VII and vestibulocochlear VIII unilateral sensorineural deafness in vestibular schwannoma) Two stylomastoid facial nerves VII Two carotid canals internal carotid artery Two spinosa middle meningeal artery artery may be damaged further up, deep to the pteryon

27 What are contents of the interal auditory canal? Facial nerve VII

28 What are contents of the interal auditory canal? Facial nerve VII Vestibulocochlear nerve VIII

29 What structures form the skull base? Bones Occipital bone

30 What structures form the skull base? Bones Occipital bone Temporal bone

31 What structures form the skull base? Bones Occipital bone Temporal bone Sphenoid bone

32 What structures form the skull base? Bones Occipital bone Temporal bone Sphenoid bone Frontal bone

33 What structures form the skull base? Bones Occipital bone Temporal bone Sphenoid bone Frontal bone Ethmoid bone

34 What structures form the skull base? Bones Occipital bone Temporal bone Sphenoid bone Frontal bone Ethmoid bone Maxillary and palatine if viewed from below

35 Picture from

36 More detailed picture from Clemente Zoom for detail

37 Name the channels for as many of the following nerves as you can

38 Acknowledgement of references / sources AO Foundation Surgery reference https: //www2.aofoundation.org/wps/portal/surgery My favourite anatomy book. Carmine D Clemente. Anatomy: A Regional Atlas of the Human Body (third edition). Baltimore Munich: Urban & Schwarzenberg, Encyclopedia Britannica Dr H Jastrow s webpage workshop//skullbase.html

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