SKULL and SCALP

Clinical Anatomy II
Spring
Rutland
Skull and Scalp

Gray’s Fig 8.7A, p. 842

1.Neurocranium
(cranial cavity)
-Calvaria
-Protects brain

2.Facial
Skeleton
(Viscero-
Cranium)
Protects facial region
Parts of skull:
Neurocranium, facial
skeleton, and floor of
cranial cavity: Gilroy Fig 37.1,Gilroy
p. 506Fig 31.1, p. 478
3. Neurocranium
-Cranial Base
(floor of the
cranial cavity)

Cerebellum sits
here
What sits here
Gilroy Fig 37.8, p. 511
Organization of the Skull

Gray’s Fig 8.1, p.838

Moore’s
Can any of you move your
scalp? What ms would Scalp and Face
make your scalp move?
Circle it

Gray’s Fig 8.3, p. 839

How many bones of the cranium?
How many bones of the facial
skeleton?
• Zygomatic
• Lacrimal
• Nasal
• Inferior nasal
conchae
• Palatine
• Maxilla
• Mandible
• Vomer
Moore’s
Bones in the Nasal Septum
Gilroy Fig 37.2, p. 507
 Did you know 7 bones of
the eye orbit?
M________
Z______
F ______
E_______
L________
Sp_______
Palatine

Piriform
aperture:
large
opening
in nasal
region
and
anterior
opening
of nasal
cavity

Purpose
of
glabella?

Gray’s Fig 8.18, p. 813

Which 3 bones form the orbit of the
eye?
Gilroy Fig 37.2, p.
507
Facial Fractures

Gilroy Fig 37.1, p. 507

Soft spots=
fontanelle Skull of newborn

Sharpey’s
fibres bind
sutures
together
 FIND:
Coronal suture
Squamous suture
Lamboid suture
Pterion suture

Which bones do the

coronal suture
connect?

Which bones do the

squamous suture
connect? ______

Sutures are
fibrous bands of
tissue connecting
skull
Gilroy Fig 37.1, p. 506
 Pterion
• Located in the temporal
fossa
• Sutures unite together from
the frontal, parietal,
sphenoid, and temporal
bones
• Fractures of this can be life
threatening
– Middle menigeal vessels
underpterion
– Hard blow to side of head can
frx pterion, lead to epidural
hematoma, and if untreated-
death in few hours.
Name the
body of the
mandible
R____s

What does the

Note this mandibular
foramen- condylar process
nerve exits articulate with?
here T____________

Gray’s Fig 8.19, p. 857

 Lambdoid
suture: small
islands of bone
Suture bones
known as
”wormlike”

What is most
prominent
protuberance of
external
occipital
protuberance?

Mastoid
notch

Inion

Gilroy Fig 37.3, p. 508

Gray’s Fig 8.20, p. 859
• CRANIOSYNTOSIS
• Closing of the cranial bones early
• Normal closure by age 2
Sagittal Suture of the Human Cranium
and the Time of Closing. Int. J.
Morphol.,27(2):469-473, 2009.

Can we really move the suture lines in adults?

Controversy
Sagittal Closes at end of 3rd decade
Or is it that craniosacral therapist may be
moving tissue?
 Lamda:
Bregma:
junction of
Skull Superior: CALVA Junction of
S______ and
S______ &
L_______
C_____
sutures
sutures

What is Calva
made of?
F________
Gilroy Fig 37.4A,
Gray’s Fig 8.21, p. 818 P________ p. 509
O_________
Occipital bone,
basilar part

Gilroy Fig 37.6., p.

510
Gray’s Fig 8.23, p.8 62
Suture Joints

Gray’s Anatomy Fig 5.28, p. 97?

 Scalp
Find this on the cadaver
scalp by cutting a piece of
scalp .Which layer would
allow more fluid to travel?

S – Skin
C – CT (dense)
A – Aponeurosis
L – Loose CT
P – Periosteum (pericranium)
Gray’s Fig 8.67, p.922
 SCALP
1st 3 layers of scalp held tightly
together as one unit. Scalping
injuries usually occur with these 3
layers being torn away.
• Dense CT, if scalp is cut- profuse
bleeding due to 1)vessels tend to
hold vessels open 2)also due to fact
that it is mostly arterial due to
venous pressure low).& 3)Walls of
arteries closely connected to dense
CT so cannot constrict, thus
excessive bleeding in scalp.
• Loose CT- facilitates movement of
scalp over calvaria. Infections can
localize and spread through loose
connective tissue .
• Periosteum: on outer surface of
calvaria. Removable except in areas
where sutures exist.
What would cranial sacral therapists be moving when
doing hands on to the scalp?
Where would arterial
supply be? D ______ Scalp

Gray’s Fig 8.68

p.922
 Scalp
Occipitofrontalis m.
-Frontal belly
-Occipital belly
-Epicranial aponeurosis
-Innervation – Facial n. (CN VII)

Gray’s Fig 8.69, p. 923

Anterior to ears and vertex: Scalp
Supplied by Trigeminal n( V5) Posterior to vertex:
-supratrochlear Innervation
-Supra orbital Lesser occipital n.( ant
-Zygomaticotemporal ramusC2
-auricotemporal -Greater occipital n (post.
Ramus C2)
-3rd occipital n: Posterior
ramus C3

Gray’s Fig 8.70, p. 924

 Cr n.7 supplies facial ms
Cr n.5 supplies sensory of face
Cr n 5: Trigeminal
Scalp laceration
1. Nerve supply/innervation?
2. Concerns?
3. Explain why excessive
bleeding may occur
Virchow’s node from metastatic CA of
stomach
Amazing body