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 HEAD AND NECK

lntermaxillary suture
lncisive foramen (nasopalatine nerves)
lnterpalatine suture
Palatine process (bony palate)

Zygomatic arch
Medial and lateral

É
pterygoid plates
Greater palatine foramen (anterior
palatine nerve)
Foramen lacerum
(nerve of pterygoid canal)
lnferior orbital fissure (zygomatic and
Mandibular fossa infraorbital nerves)

Sulcus tubae Les$er palatine foramen

(middle and posterior palatine nerves)
Petrotympanic fissure
Pharyngeal tubercle Foramen ovale (mandibular and
lesser petrosal nerves)
Carotid canal (internal
Styloid process
carotid artery)

Mastoid process Stylomastoid foramen (Vll nerve)

Foramen spinosum and sPine of

Jugular foramen (lX, X, Xl and sphenoid (middle meningeal artery)
internal jugular vein)
Occipital condyle
Hypoglossal canal (Xll nerve)
Foramen magnum (spinal cord with
Posterior condylar canal
meninges,anterior and Posterior
Superior nuchal line spinal arteries, vertebral arteries.
spinal roots of Xl nerves)
External occipital crest
lnferior nuchal line
External occipital protuberance
(a)

lnfratemporal crest Posterior margin of inferior

orbital fissure

Continuous with pterygoid process

(medial surface)
Foramen spinosum
(middle meningeal
artery)
Foramen ovale (mandibular nerve,
acce$sory meningeal artery lesset
Articulates with petrosal nerve and emissarY vein)
squamous temporal
Sulcus tubae
Auriculotemporal nerve

Spine of sphenoid Peirous part of temPoral bone

Chorda tympani
nerve
.Y
o
zo Figs 1.1i a and (a) Norma basalis showing passage of main nerves and arteries, and (b) infratemporal surface of greater wing
b:
tt
of sphenoid seen from below
(E
!,
G'
o 7 The posterior border of the hard palate is free and Middle Porl of Normo Bosolis
presents theposterior nasal spine in the median plane. The middle part extends from the posterior border of
c 8 The palatine crest is a curved ridge near the posterior the hard pilate to the arbitrary transverse line
.9
C) border. It begins behind the greater palatine foramen passing thiough the anterior margin of the foramen
ao and runs medially (Fig. 1.12). maSnum.

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 INTRODUCTION AND OSTEOLOGY

b. The terminal part of the nasopalatine neroe from 11 The structures passing through the for amen lacerum :
the nose to the palate (Fig. 1.11a). During life the lower part of the foramen is filled
2 The greater palatine foramen transmits: with cartilage, and no significant structure passes
a. The grenter palatine aessels. through the whole length of the canal, except for
b. The anterior pnlatine nerT)e, both of which run the meningeal branch of the ascending pharyngeal
forwards in the groove that passes forwards from artery and an emissary vein from the cavernous
the foramen (see Fig. 15.14). sinus.
3 The lesser palatine foramina transmit the middle and However, the upper part of the foramen is
posterior palatine neraes. traversed by the internal carotid artery with venous
4 The palatinoaaginal cannl transmits: and sympathetic plexuses around it. In the anterior
a. A pharyngeal branch from the pterygopalatine part of the foramen, the greater petrosal nerae lunites
-

ganglion (see Fig. 15.1.4). with the deep petrosal neroe to form the nerae of the
b. A small pharyngealbranch of the maxillary artery. pterygoid canal (Yidian's nerve) which leaves the
5 The aomerooaginal canal (if patent) transmits foramen by entering the pterygoid canal in the
branches of the pharyngeal branch from pterygo- anterior wall of the foramen lacerum (Fig. 1.15).
palatine ganglion and vessels. 12 The medial end of the p etrotympanicfissure transmits
6 T}ee foramen oaale transmits (mnemonic-MAlE) the chorda tympani nerve, anterior ligament of
a. The mandibular nerae (Fi1.1,.1,1) malleus and the anterior tympanic artery (Fig.
b. The accessory meningeal artery. 1.11a).
c. The lesser petrosal neruse L3 The foramen magnum (Fig. 1.16) transmits the
d. An emissaty aein connecting the cavernous sinus
following
with the pterygoid plexus of veins.
e. Anterior trunk of middle meningeal vein Through the narrow anterior part
(occasionally). "
7 Tlaeforamen spinosumtransmits the middle meningeal
a. Apical ligament of dens.
b. Vertical band of cruciate ligament. CAM
mmmm
artery (Fig. f .i1a) the meningeal branch of the c. Membrana tectoria.
mandibular nerve or nervus spinosus, and the
posterior trunk of the middle meningeal vein.
Through wider posterior part
a. Lowest part of medulla oblongata. → PMO
8 The emissary sphenoidalforamen (foramen of Vesalius) b Three meninges.
transmits anemissary aein connecting the cavernous
Through the subarachnoid space pass:

→
sinus with the pterygoid plexus of veins.
9 \Mhen present the canaliculus innominatus transmils a. Spinal accessory nerves.
the lesser petrosal nerve, (in place of foramen ovale). b. Vertebral arteries.
L0 The carotid canal transmits the internal carotid artery, c. Sympathetic plexus around the vertebral arteries.
and the oenous and sympathetic plexuses around the
artery (Fig. 1.11a).
d. Posterior spinal arteries.
e. Anterior spinal artery. Vasu
Anterior Posterior

lnternal carotid artery and

sympathetic plexus

Greater petrosal nerve Deep petrosal nerve

(from sympathetic
plexus)
Pterygoid process
Petrous temporal .Y
o
Nerve of pterygoid canal
in pterygoid canal zo
E
tr
G
Emissary vein
tt(E
Meningeal branch of o
ascending pharyngeal
Pterygoid plexus of veins artery
C
Cartilage filling lower .9
end of foramen lacerum ()
Fig. 1.15: Structures related to the foramen lacerum ao

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 HEAD AND NEOK

in it. Tympanohyal before birth and stylohyal after week near the mental foramen. The upper half of
birth. ramus ossifies in cartilage. Ossification spreads in
Sphenoid: It ossifies in two parts: condylar and coronoid processes above the level of
whichlies in front of tuberculum
Presphenoidal part the mandibular foramen.
sellae and lesser wings ossifies from six centres in lnferior nasal concha; It ossifies in cartilage. One
cartilage: Two for body of sphenoid during ninth centre appears during fifth month in the lower border
week; two for the two lesser wings during ninth of the cartilaginous nasal capsule.
week; two for the two sphenoidal conchae during Palatine: One centre appears during eighth week
fifth month. in perpendicular plate. It ossifies in membrane.
Postsphenoidal part consisting of posterior part of Lacrimal: It ossifies in membrane. One centre
body, greater wings and pterygoid processes ossifies appears during twelfth week.
from eight centres: Nasal: It also ossifies in membrane from one
Two centres for two greater wings during eighth centre which appears during third month of intra-
week forming the root only; two for postsphenoidal uterine life.
part of body during fourth month; two centres appear
Vomer: It ossifies in membrane. Two centres
for the two pterygoid hamulus during third month
appear during eighth week on either side of midline.
of foetal life. These six centres appear in cartilage.
These fuse by twelfth week.
Two centres for medial pterygoid plates appear
during ninth week and the remaining portion of the Zygomatic: It ossifies in membrane by one centre
greater wings and lateral plates ossify in membrane which appears during eighth week.
from the centres for the root of greater wing only. Maxilla: It also ossifies in membrane by three
Ethmoid: It ossifies in cartilage. Three centres centres. One for main body which appears during
appear in cartilaginous nasal capsule. One centre sixth week above canine fossa.
appears in perpendicular plate during first year of Two centres appear for premaxilla during seventh
life. Two centres one for each labyrinth appear week and fuse soon.
between fourth and fifth months of intrauterine life. Various foramina of anterior, middle and
Mandible: Each half of the body is ossified in posterior cranial fossae and other foramina with their
membrane by one centre which appears during sixth contents are shown in Table L.5.

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Foramina/apertures
ANTERIOR CRANIAL FOSSA
Groove for superior sagittal sinus Superior sagittal sinus
Foramen caecum Emissary vein to superior sagittal sinus from upper part of nose
Anterior ethmoidal foramen Anterior ethmoidal nerve and vessels
Foramina of cribiform plate Olfactory nerve rootlets
Posterior ethmoidal foramen Posterior ethmoidal vessels
MIDDLE CRANIAL FOSSA
Optic canal Optic nerve and ophthalmic artery
Superior orbital fissure:
. Lateral part Lacrimal and frontal nerues, (branches of ophthalmic nerve); trochlear nerue; superior
ophthalmic vein; meningeal branch of lacrimal artery; anastomotic branch of middle
meningeal artery, which anastomoses with recurrent branch of lacrimal artery.
l. .
o Middle part Upper and lower divisions of oculomotor nerue (CN lll), nasociliary nerue, abducent
o
z nerue (CN Vl)
E
tr
. Medial part lnferior ophthalmic vein; sympathetic nerve from plexus around internal carotld artery.
(E
Foramen rotundum Maxillary nerve (CN V2)
ItG
o Foramen ovale Mandibular nerve (CN V3); accessory meningeal artery; lesser petrosal nerve;
I emissary vein connecting cavernous sinus with pterygoid plexus (male)
C Foramen spinosum Middle meningeal artery and vein, meningeal branch of mandibular nerve (CN V3)
o
o Emissary sphenoidal foramen Emissary vein connecting cavernous sinus with pterygoid plexus of veins
o
U) (Contd...)

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 INTRODUCTION AND OSTEOLOGY

Foramina/apertures Contents
Foramen lacerum During life, the foramen is filled with cartilage
No significant structure passes through it; internal carotid artery and nerve plexus pass
across its superior end; nerve to pterygoid canal passes through its anterior wall;
meningeal branch of ascending pharyngeal artery and emissary vein pass through it.
Carotid canal lnternal carotid artery and nerve plexus (sympathetic)
Groove for lesser petrosal nerve Lesser petrosal nerve
Groove for greater petrosal nerve Greater petrosal nerve
POSTERIOR CRANIAL FOSSA
Foramen magnum Lowest part of medulla oblongata and three meninges; vertebral arteries; spinal roots
of CN Xl; anterior and posterior spinal afieries; apical ligament; vertical band of cruciate
ligament and membrana tectoria.
Jugular foramen CN lX; X; Xl; inferior petrosal and sigmoid sinuses; meningeal branches of ascending
pharyngeal and occipital arteries.
Hypoglossal canal/anterior condylar canal CN XII
Internal acoustic meatus CN Vll; Vlll and labyrinthine vessels
External opening of vestibular aqueduct Endolymphatic duct
Posterior condylar canal Emissary vein connecting sigmoid sinus with the suboccipital venous plexus
Mastoid foramen Mastoid emissary vein and meningeal branch of occipital artery
OTHER FORAMINA
External acoustic meatus Air waves
External nasal foramen External nasal nerve
Greater palatine foramen Greater palatine vessels; anterior palatine nerve
lncisive canal Greater palatine vessels; terminal part of nasopalatine nerve
lnferior orbital fissure Zygomatic nerve; orbital branches of pterygopalatine ganglion; infraorbital nerve and
vessels
lnfraorbital foramen lnfraorbital nerve and vessels
Lesser palatine foramen Middle and posterior palatine nerves
Mandibular foramen/canal lnferior alveolar nerve and vessels
Mandibular notch Masseteric nerve and vessels
Mastoid canaliculus Auricular branch of vagus nerve
Mental foramen Mental nerve and vessels
Palatinovaginal canal Pharyngeal branch from pterygopalatine ganglion; pharyngeal branch of maxillary
artery
Parietal foramen Emissary vein from scalp to superior sagittal sinus
Petrotympanic fissure Chorda tympanic nerve and anterior tympanic artery.
Pterygoid canal Nerve to pterygoid canal and vessels
Pterygomaxillary f issure Maxillary nerve
Pterygopalatine fossa Pterygopalatine ganglion
Stylomastoid foramen Facial nerve; stylomastoid branch of posterior auricular artery.
xo
Supraorbital foramen Supraorbital nerve and vessels zo
Tympanic canaliculus Tympanic branch of glossopharyngeal nerve t,c
(5
Tympanomastoid fissure Auricular branch of vagus nerve !,(E
Vomerovaginal canal Branch of pharyngeal nerve and vessels o
Zygomatic foramen Zygomatic nerve
C
Zygomaticofacial foramen Zygomaticofacial nerve .9
()
Zygomaticotemporal foramen Zygomaticotemporal nerve
ao

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