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skull base Flashcards

1
Q

What is the skull divided into?

A
  1. Anterior cranial fossae
  2. Middle cranial fossae
  3. Posterior cranial fossae
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2
Q

Where does the frontal lobe of the brain sit?

A

anterior cranial foassae

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3
Q

Where does the cerebellum sit?

A

Posterior cranial fossae

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4
Q

What are the fossae divided by?

A

Ridges

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5
Q

What are the components of the Anterior cranial fossae?

A
  1. Foramen caecum
  2. Crista Galli
  3. Cribrifoirm plate
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6
Q

What is the role of foramen caecum?

A
  1. Transmit emissionary vein

2. Drain nasal cavity into superior sagittal sinus

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7
Q

What is the role of cribriform plate?

A
  1. Transmit sensory nerve fibre from nasal mucosa transmitting smell to olfactory bulb of CN I
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8
Q

What are the components of middle cranial fossae?

A
  1. Optic Canal
  2. Superior Orbital fissure
  3. Foramen Rottundum
  4. Foramen Ovale
  5. Foramen Spinosum
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9
Q

What are the 2 structures that the optic canal transmit?

A
  1. CN II - Optic nerve

2. Opthalmic artery

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10
Q

What is the superior orbital fissure?

A

Transmit structure from cranial cavity to orbit

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11
Q

What are the cranial nerves of superior orbital fissure?

A
  1. CN III - Occulomotor nerve
  2. CN IV - Trochlear nerve
  3. CN VI - Trigeminal
  4. CN VI - Abducens

Superior opthalmic vein

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12
Q

What structure passes through the superior orbital fissure?

A

Superior opthalmic vein

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13
Q

What is the superior orbital fissure?

A

Communication between cavernous sinus and apex of orbit

It is a cleft lying between lesser and greater wings of sphenoid bone

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14
Q

What cranial nerve is found in the foramen Rotundum, and what is the vein called?

A

CN V2 - Trigmeninal

Maxillary nerve

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15
Q

What are the structures found in the Foramen Ovale?

A 
O - Otic Ganglion
V - V3 (Trigeminal)
A - Accessory Meningeal Artery
L - Lesser petrosal nerve
E - Emissary vein
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16
Q

Where is Foramen Spinsosum found and what is it’s role?

A

More lateral to the foramen ovale

Transmits middle meningeal artery

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17
Q

What is the role of Foramen Spinosum?

A

Allows the passage of middle meningeal artery, the middle meningeal vein and meningeal branch of CN V3

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18
Q

What are the 5 bones of normal skull base?

A
  1. Frontal
  2. Ethmoid
  3. Sphenoid
  4. Temporal
  5. Occipital
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19
Q

What does Ethmoid bone form?

A

Part of nasal cavity + orbits

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20
Q

What is the role of Ethmoid bone?

A

Main mechanical support structure of nasal cavity

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21
Q

What does Lesser wing of sphenoid separate?

A

Anterior cranial fossa from middle cranial fossa

It forms the lateral border of optic canal

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22
Q

What do Anterior Cranial Fossa contain?

A
  1. Orbital plate of frontal bone
  2. Ethmoid bone
  3. Lesser Wing of Sphenoid
  4. Frontal Crest
  5. Crista Galli
  6. Foramen caecum
  7. Cribriform plate
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23
Q

What does the middle cranial fossa contain?

A
  1. Sphenoid bone
  2. Squamous temporal
  3. Petrous temporal
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24
Q

What anatomical structures does the middle cranial fossa accomodate?

A
  1. Pituitary gland

2. Temporal lobes of the cerebral cortex

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25
What are examples of openings in the middle cranial fossa?
1. Optic canal 2. Superior orbital fissure 3. Foramen rotundum 4. Foramen ovale 5. Foramen spinosum 6. Foramen lacerum 7. Carotid canal
26
What is the role of foramen lacerum in middle cranial fossa?
Transmits artery and nerve of pterygoid canal
27
What is the sphenoid bone?
1. Mid-section of the skull base | 2. Anterior wall of middle cranial fossa
28
What are important for identifying structures?
1. The petrous portion of the temporal bone | 2. Greater wings of sphenoid bone
29
What are 3 distinct areas of occipital bone of posterior fossa?
1. Basiocciput 2. Condylar 3. Squamous
30
What are the apertures of occipital bone of posterior cranial fossa?
1. Foramen magnum 2. Posterior condylar canal 3. Hypoglossal canal
31
What is the petrous part of temporal bone?
Pyramid-shaped and is wedged in at the base of skull between sphenoid and occipital bone
32
What is temporal bone?
Bone located bilaterally on either side of the skull Part of the cranium part of the middle cranial fossa
33
What are the components of the posterior cranial fossa?
1. Internal acoustic meatus 2. Jugular foramen 3. Hypoglossal canal 4. Foramen magnum
34
Internal acoustic meatus of PCF?
Transmits 2 cranial nerve CNVII - facial CN VIII - Vestibulocochlear nerve
35
Jugular foramen of the PCF?
cavity formed by the petrous part of temporal bone anteriorly and occipital bone posteriorly
36
What is the main function of jugular foramen?
Act as a conduit for essential structures to pass through CN 9-11 Internal jugular vein
37
Hypoglossal canal of PCF
CN 12 - Hypoglossal nerve
38
Foramen magnum of PCF
Spinal root CN X1 (spinal accessory) Anterior and posterior spinal arteries Spinal cord - medulla oblongata Vertebral arteries
39
What are the 4 parts of the temporal bone?
1. Petrous 2. Mastoid 3. Tympanic 4. Squamous part
40
Petrous Carotid Canal
A passage within petrous temporal bone and transmits internal carotid artery and sympathic plexus
41
What is foramen lacerum?
Triangular-shaped hole in the base of the skull located between sphenoid bone, the apex of the petrous part of temporal bone and basilar part of occipital bone
42
Internal auditory canal
A canal within the petrous part of the temporal bone of skull between posterior cranial fossa and inner ear
43
What are the components of the midline of sphenoid bone?
1. sulcus chiasmaticus 2. Tuberculum sella 3. Sella Turcica 4. Dorsum Sellae
44
What are the components of paramedian of sphenoid bone?
1. Optic canal 2. Anterior clinoid process 3. Superior orbital fissure 4. Foramen rotundum 5. Foramen vesalius 6. Foramen ovale 7. Formane spinosum
45
What does the pterygoid process contain?
1. Pterygopalatine fossa | 2. Infratemporal fossa
46
What is Pterygopalatine fossa?
pyramidal space located inferior to the orbital apex and posterior to the maxillary sinus
47
What is the function of pterygopalatine fossa?
communicates with the infratemporal fossa via the pterygomaxillary fissure
48
What are the compontents of greater wing of sphenoid?
1. Inferior orbital fissure 2. Pterygopalatine fossa 3. Nasal cavity 4. Vividian canal 5. F. Ovale V3 6. F. Spinosum
49
What are used to image the skull base?
1. CT | 2. MRI
50
What are the characteristic of CT
``` Planes : Axial & Coronal Thin slices : <3mm Algorithm : bone & soft tissue Windows : wide bone / narrow soft tissue MDCT: Reformats in multiple planes IV Contrast : ? CTA / CTV IT Contrast : Cisternography ```
51
What are the characteristic of MRI?
``` Planes : Axial / Coronal / Sagittal Thin slices : <3mm Sequences : T2 FSE T1 pre; T1 fat sat post C +/- MRA/MRV ```
52
What are the skull base pathology?
Most tumours are benign -m but can be fatal due to site
53
What are the presentation for skull base pathology?
1. Neurovascular 2. Compression 3. Brain invasion
54
Skull Base pathology
Difficult to access surgically | Often require combined Neuro / ENT surgeon
55
What are the lesions from below?
1. Inflammatory 2. Benign tumour 3. Malignant tumour
56
What are examples of inflammatory lesion?
1. Osteomyelitis from sinus 2. Otitis externa 3. Facial abscess 4. Aggressive sinonasal polyposis
57
What are examples of Benign tumour?
1. Nasal: Juvenile angiofibroma, inverting papilloma, dermoid sinus osteoma
58
What are examples of malignant tumour?
NP Carcinoma, NH Lymphoma, Esthaesioneuroblastoma, SCC (perineural spread), parotid malignancies
59
What are examples of lesions that are intrinsic to skull base?
1. Pseudomass 2. Congenital 3. Inflammatory 4. Trauma 5. Benign Tumour 6. Malignant Tumour 7. Metabolic/Dysplastic
60
What are examples of Pseudomass?
1. Jugular bulb complex flpw | 2. Petrous apex air cell fluid
61
What is an example of congenital lesion?
Primary cholesteatoma
62
What is an example of inflammatory lesion intrinsic to skull base?
Apical petrositis, mucocele, cholesterol granuloma
63
Trauma
Fracture +/- dural tear
64
Benign tumour
Paraganglioma (glomus) tumour, nerve sheath tumour, meningioma, chordoma, benign primary bone tumour
65
Malignant Tumour
Metastasis, NH Lymphoma / Leukaemia, Myeloma, malignant primary bone tumour
66
Metabolic / Dysplastic
Fibrous dysplasia, Paget’s, Anaemias, Histiocytosis X
67
What are examples of lesions from above?
1. Congenital 2. Vascular lesion 3. Benign tumour 4. Malignant tumour
68
Congenital lesion
1. Cephalocele (meningocele/encephalocele | 2. Arachnoid cyst
69
Vascular lesion
1. Carotid aneurysm | 2. Dural AVF
70
Benign tumour (above lesion)
1. Meningioma 2. Nerve sheath tumour 3. Dermoid 4. Pituitary tumour 5. Rathe's cleft cyst
71
Malignant tumour (above lesion)
Primary brain tumour | Dural metastasis

C1 Modules (20 decks)

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