External Occipital Protuberance
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- Wilfrid Summers
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1 Osteology Exterior Skull Frontal Bone Glabella Superciliary Arch Supraorbital Notch/Foramen Nasion (junction w/ Nasal bone) Frontal/Metopic Suture (usually absent in adult, b/w ossification centers of frontal bone) Nasal Bone Anterior Nasal Aperture (formed w/ maxillae) Zygomatic Bone Frontal Process Temporal Process Zygomatic Arch Maxilla Frontal Process Infraorbital Foramen Anterior Nasal Spine Alveolar Process Nasal Septum Mastoid Process Zygomatic Process (forms the zygomatic arch) External Acoustic Meatus Mandible Alveolar Process Ramus Coronoid Process Mandibular Notch Condylar Process Head (Condyle) Neck Angle Body Mental Foramen Mental Protuberance Inferior Border Parietal Bone Occipital Bone External Occipital Protuberance Sutures Lambdoid (b/w occipital & parietal bones) Squamosal (b/w parietal & temporal bones) Coronal (b/w frontal & parietal bones) Sagittal (b/w two parietal bones on the midline) Pterion ( H junction b/w frontal, parietal, sphenoid, & temporal bones) Calvaria (skullcap, formed by parts of frontal, parietal, & occipital bones) Coronal, Sagittal Suture, & Lambdoid Sutures Bregma (meeting of coronal & sagittal sutures) Lamdba (meeting of sagittal & lambdoid sutures) Groove for the Superior Sagittal Sinus Granular Foveolae Grooves for the Branches of the Middle Meningeal Artery Layers: Outer Lamina Diploë (spongy bone b/w inner & outer lamina) Inner Lamina Atlas Posterior Atlanto-occipital Membrane (connects atlas w/ occipital b) Vertebral Canal Orbit (4-sided pyramid) Orbital Margin (base, formed by maxillary, frontal, & zygomatic bones) Supraorbital Margin Infraorbital Margin Optic Canal (tip of pyramid) Periorbita (periosteum that lines bones of the orbit, continuous w/ dura mater at optic canal & superior orbital fissure) Lateral Walls of the Orbit (at 90 to each other) Medial Wall of the Orbit (related to ethmoid air cells) Ethmoid Bone Anterior Ethmoid Foramina Posterior Ethmoid Foramina Ethmoid Air Cells Lamina Papyracea (part of the ethmoid bone that forms the MW) Roof of the Orbit (related to the anterior cranial fossa) Floor of the Orbit (related to the maxillary sinus) Frontal Bone Supraorbital Notch/Foramen Orbital Part & Surface 1/5
2 Lacrimal Fossa Frontal Sinus Lacrimal Bone Posterior Lacrimal Crest Lacrimal Groove Maxilla Anterior Lacrimal Crest Infraorbital Groove Superior orbital fissure Inferior Orbital Fissure (gap b/w maxilla & greater wing of the sphenoid) Internal Skull Anterior Cranial Fossa Ethmoid Bone Cribiform Plate (floor of cranial cavity) Crista Galli (midline of cribiform plate) Jugum Lesser wing Sphenoidal crest (separate ant & mid cranial fossae, w/ limbus) Sphenoidal limbus (ridge post border of jugum, ant border of prechiasmatic sulcus) Orbital Part of the Frontal Bone forms the Roof of the Orbit Middle Cranial Fossa Squamous Part Petrous Part Superior Border/Petrous Ridge (separate mid & post cranial fossae, w/ dorsum sellae) Foramen Lacerum (formed from TB + greater wing of sphenoid) Optic canal & Superior orbital fissure Anterior clinoid process Greater Wing Hypophyseal fossa Posterior clinoid process Foramen rotundum Foramen ovale Foramen spinosum (Mid meningeal artery runs through FS) Dorsum Sellae (ridge post border of hypophyseal fossa) Posterior Cranial Fossa Groove for the Sigmoid Sinus Internal Acoustic Meatus Occipital Bone Internal Occipital Protuberance Foramen Magnum Jugular Foramen Hypoglossal Canal Groove for the Superior Sagittal Sinus Grooves for the Transverse Sinus Grooves for the Sigmoid Sinus Fossae for the Cerebellum Fossae for the Occipital Poles of the Cerebral Hemispheres Clivus Surface Anatomy/Layers Vertex Nasal Bones Alveolar Process & Angle of the Maxilla Mental Protuberance of the mandible Zygomatic Bone & Zygomatic Arch Superficial Fascia of the Face Buccal Fat Pad (ant to parotid gland) Parotid Gland Parotid Duct (crosses lat surf of masseter m ~2 cm inf to zygomatic arch, turns ant to masseter m, pierces buccinator m, & drains into oral cavity) Submandibular Gland (part) The Scalp: Skin Connective Tissue (dense, contains vessels & nerves) Aponeurosis, Epicranial (connects occipitalis & frontalis m) Loose Connective Tissue (allows movement of scalp) Pericranium 2/5
3 Vasculature Angular Artery (becomes facial a at lat side of the nose) Facial Artery (crosses inf border of mandible at ant edge of masseter m deep only to skin & platysma m) Superior Labial Artery Inferior Labial Artery Facial Vein (post to & less tortuous than, but runs w/ facial a) Mental Artery & Vein (goes through mental foramen w/ mental n) Vertebral Artery Middle Meningeal Artery (supplies dura mater & adjacent calvaria; ant branch crosses inner surface of pterion) Internal Carotid Artery (passes through carotid canal) Ophthalmic artery Dural Venous Sinuses Confluence of Sinuses Superior Sagittal Sinus (runs from crista gali to the CoS) Lateral Venous Lacunae (lat expansions of the SSS) Arachnoid Granulations Bridging Veins (short, connects SSS to cerebral v) Cerebral Veins (in arachnoid mater) Straight Sinus (in line of junction of falx cerebri & tentori cerebelli) Inferior Sagittal Sinus (drains into SS near tentori cerebelli) Great Cerebral Vein Left & Right Transverse Sinuses (carries blood to the sigmoid sinus) (L & R) Sigmoid sinuses (takes blood from TS to jugular foramen) Internal Jugular Vein (becomes at external surface of JF) Sphenoparietal Sinus (runs along the sphenoidal crest) Cavernous Sinus Superior Opthalmic Vein inner angle & communicates w/ angular vein, corresponds to opthalmic artery, passes b/w heads of lat rectus m, through sup orbital fissure, & into cavernous sinus) Lat wall from sup to inf: Oculomotor n, trochlear n, opthalmic n (V1), maxillary n (V2) Int carotid Artery, abducent n immediately lat to ICA Superior Petrosal Sinus Inferior Petrosal Sinus Basilar Plexus The Eye Supra & infraorbital margin Eyelashes/Cilia Palpebral Fissure/Rima (opening of eyelid) Eyelid Tarsal Plate (structural support in eyelid) Orbital Septum (CT from the orbital margin (periosteum) to the tarsal plate, separates the superficial fascia of the face from the contents of the orbit) Lacrimal Gland (drains into superior conjunctival fornix via 6-10 ducts) Lacrimal Fossa Medial & Lateral Palpebral Commissures Medial Angle of the Eye Lacrimal Caruncle Lacrimal Lake Lacrimal Papilla Lacrimal Puncta Lateral Angles of the Eye Sclera (whitish post 5/6 of exterior coat of eyeball) Cornea (transparent ant 1/6 of exterior coat of eyeball) Iris Pupil Margin of the Eyelid Conjunctiva Bulbar Conjunctiva Palpebral Conjunctiva Superior & Inferior Conjunctival Fornices (where the bulbar & palpebral conjunctiva become continuous) Conjunctival Sac (potential space between the two conjunctiva) Apex of the orbit Sup Orbital Fissure Frontal n, Lacrimal n, Trochlear n, Sup Ophthalmic v Common tendinous ring: nasociliary n, inf & sup divisions of oculomotor n, abducens n Optic Canal Optic n & ophthalmic a Extraocular muscles 3/5
4 Musculature Occipitalfrontalis Muscle Frontalis Muscle/Frontal Belly Inf attach: skin of forehead & eyebrows Sup attach: epicranial aponeurosis Occipitalis Muscle/Occipital Belly Inf attach: occipital bone Sup attach: epicranial aponeurosis Common innerv: facial n Temporalis Muscle Platysma Muscle Inf attach: Superficial fascia of upper thorax Sup attach: inf border of mandible, skin of the cheek, & angle of mouth Masseter Muscle (muscle of mastication) Orbicularis Oculi Muscle Orbital Part (surrounds orbital margin) (used in tight closure of eyelid) Palpebral Part (in eyelids covering tarsal plate) (used in blinking) Med attach: med orbital margin, med palpebral ligament, lacrimal bone) Lat attach: skin around orbital margin Innerv: temporal & zygomatic branches of facial nerve Around the mouth Levator Labii Superioris Muscle (elevates upper lip) Sup attach: maxilla right below orbital margin Inf attach: upper lip Zygomaticus Major Muscle (draws angle of the mouth sup & post) Lat attach: zygomatic arch Med attach: angle of the mouth Orbicularis Oris Muscle (sphincter of the mouth) Lat attach: angle of the mouth Med attach: maxilla, mandible, skin Buccinator Muscle (pierced by buccal branches of facial nerve, buccal nerve, & parotid duct) (presses cheek against molar teeth, helps chew) Prox attach: pterygomandibular raphe, lat surfaces of alveolar processes of maxilla & mandible Dist attach: angle of the mouth Depressor Anguli Oris Muscle Inf attach: mandible Sup attach: angle of the mouth Common innerv: zygomatic, buccal, & mandibular branches of facial n Semispinalis Capitis Muscle Sup attach: Occipital Bone Splenius Capitus Muscle Sup attach: Occipital Bone Extraocular Muscles Levator Palpebrae Muscle (raises upper eyelid) Origin: apex of the orbit Insert: tarsal plate of upper eyelid Superior Oblique Muscle (depresses, abducts, & med rotates) Origin: lesser wing of sphenoid bone, hooks around trochlea Inferior Oblique Muscle (elevates, abducts, & lat rotates) Origin: med ant portion of orbital floor Superior Rectus Muscle (elevates & adducts) Lateral Rectus Muscle (2 heads) (abducts) Inferior Rectus Muscle (depresses & adducts) Medial Rectus Muscle (adducts) Common origin of rectus m: Common Tendinous Ring (surrounds optic canal & part of the sup orbital fissure) Common insert of rectus & oblique m: eyeball 4/5
5 Neurology Cranial Nerves Olfactory Nerve (CN I) Olfactory Bulbs (rest on cribiform plates) Optic Nerve (CN II) Ciliary Ganglion Short Ciliary Nerves (to post eyeball) Oculomotor Nerve (CN III) (goes over petrous ridge & ant in lat wall of cavernous sinus) Superior Division (innerv sup rectus m & levator palpebrae m) Inferior Division (innerv med rectus m, inf rectus m, & inf oblique m) Trochlear Nerve (CN IV) (runs ant in lat wall of cavernous sinus inf to oculomotor n, in orbit runs med to frontal n, goes through sup orbital fissure to sup oblique m) Trigeminal Nerve (CN V) (sensory S, crosses petrous ridge) Trigeminal Ganglion Opthalmic Division (V1) (from TG ant in lat wall of cavernous sinus inf to trochlear n to skin of forehead, upper eyelids, & nose) Supraorbital Nerve (goes through supraorbital notch/foramen) Nasociliary Nerve (crosses sup to optic nerve) Long Ciliary Nerves (to post part of eyeball) Anterior Ethmoid Nerve (through ant ethmoid foramen) Frontal Nerve (to supraorbital margin, sup to extraocular m) Supraorbital Nerve Supratrochlear Nerve Lacrimal Nerve (lat to frontal nerve, goes through sup orbital fissure along lat wall of the orbit to the lacrimal gland) Maxillary Division (V2) (goes through foramen rotundum to skin of lower eyelid, cheek, & upper lip) Infraorbital Nerve (goes through infraorbital foramen & deep to levator labii m; to inf eyelid, side of nose, upper lip) Mandibular Division (V3) (goes through foramen ovale to skin of lower face & bit of side of the head) Buccal Nerve (emerges from deep to masseter m, to mucosa & skin of cheek) Mental Nerve (through mental foramen, to lower lip & chin) Abducens Nerve (CN VI) (enters dura mater over clivus, goes ant cavernous sinus lat to internal carotid a) (innerv lat rectus m) Facial Nerve (CN VII) (motor to muscles of facial expression, goes through internal acoustic meatus) Parotid Plexus (formed by the nerve branches within parotid gland) Temporal Branch (crosses zygomatic arch) Zygomatic Branch (crosses zygomatic bone) Buccal Branches (crosses superficial surf of masseter m) Mandibular Branch (parallels inf border of mandible) Cervical Branch (crosses angle of manbible to enter neck) Vestibulocochlear Nerve (CN VIII) (through internal acoustic meatus) Glossopharyngeal Nerve (CN IX) (goes through jugular foramen) Vagus Nerve (CN X) (goes through jugular foramen) Accessory Nerve (CN XI) (comes up through foramen magnum & goes through jugular foramen) Hypoglossal Nerve (CN XII) (goes through hypoglossal canal) Cervical Spinal Nerves 2 & 3 Meninges (from superficial to deep) Dura Mater Periosteal Layer Meningeal Layer (creates infoldings that incompletely partition the cranial cavity) Falx Cerebri (Cerebral Falx) (attached to crista galli, tentori cerebelli, & calvaria on 2 sides of sup sagittal sinus) Tentori Cerebelli (Cerebellar Tentorium) (attached to clinoid processes, sup border of petrous portion of the temporal bone, occipital bone on both sides of the groove for the transverse sinus; separate cerebral hemispheres & cerebellum) Tentorial Incisure/Notch Falx Cerebelli (Cerebellar Falx) (attached to occipital bone inf to tentori cerebelli in midline) Sellar Diaphragm (covers hypophyseal fossa, stalk of pituitary passes through it) Dural venous sinuses Arachnoid Mater Arachnoid Granulations (return CSF to the venous system) Subarachnoid Space Pia Mater Brain Frontal Lobe Stalk of the Pituitary Gland 5/5
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