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OBJECTIVES

OBJECTIVES. Skull, Sinus and Orbit anatomy Vascular anatomy Neck anatomy Clinical cases. SKULL ANATOMY. SINUSES PA view Nasal Septum Frontal Sinus Maxillary Sinus Ethmoid Sinus Inferior Turbinate Superior orbital fissure. 2. 6. 4. 3. 1.

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OBJECTIVES

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  1. OBJECTIVES • Skull, Sinus and Orbit anatomy • Vascular anatomy • Neck anatomy • Clinical cases

  2. SKULL ANATOMY

  3. SINUSES PA view Nasal Septum Frontal Sinus Maxillary Sinus Ethmoid Sinus Inferior Turbinate Superior orbital fissure 2 6 4 3 1 5

  4. 1- Superior orbital fissure 2- Inferior orbital foramen 3- Mental foramen 1 2 1 2 3 Fissures and foramen have nerves that show on lab practicals. 3

  5. OPTIC CANAL

  6. AP WATERS VIEW SINUSES 1. Frontal sinus 2. Zygomatic-Frontal Suture 3. Maxillary Sinus 4. Inferior orbital margin 1 2 3 4 This view is angled to project the maxillary sinuses free of the petrous ridge.

  7. Note the opacified right maxillary sinus with fluid layering dependently indicating sinusitis

  8. WHAT RECTUS MUSCLE CAN BE INJURED BY EYE TRAUMA? • Superior • Inferior • Medial • Lateral

  9. ORBITAL FLOOR FRACTURE Arrow points to bone fragment displaced into orbit. The inferior rectus muscle can become entrapped in fracture

  10. CT FACIAL CORONAL SCAN CT scans redemonstrate fracture and edema at site.

  11. 1. Frontal Sinus 2. Maxillary Sinus 3. Ethmoid Sinus 4. Sphenoid Sinus 1 3 2 4 LATERAL SINUS & SKULL

  12. Middle meningeal artery

  13. EPIDURAL HEMATOMA FRACTURE Cause: Laceration of the meningeal artery adjacent to inner table.

  14. Normal skull Sella

  15. CAROTID CANAL JUGULAR FORAMEN CT SKULL BASE

  16. PINNA MANDIBULAR CONDYLE MASTOID AIR CELLS CT SKULL BASE

  17. SKULL BASE FRACTURE

  18. “RACCOON EYES” Periorbital ecchymosis is a sign of a basal skull fracture. Blood tracks along the periosteum and can collect in soft tissues of the orbital lid.

  19. ZYGOMATIC ARCH EXTERNAL AUDITORY CANAL CT SKULL BASE

  20. FORAMEN OVALE PETROUS CAROTID CANAL FORAMEN SPINOSUM CLIVUS CT SKULL BASE

  21. CAROTID CANAL OSSICLES IAC INTERNAL AUDITORY CANAL CT SKULL BASE

  22. Acoustic neuroma is a slow growing tumor that develops on the 8th cranial nerve. Symptoms include unilateral loss of hearing, Tinnitus-ringing in ears. dizziness and vertigo.

  23. SINUS AND ORBIT ANATOMY

  24. SINUSES PA view Frontal Sinus Maxillary Sinus Ethmoid Sinus 1 3 2

  25. AP WATERS VIEW • SINUSES • Frontal sinus • 2. Zygomatic-Frontal Suture • 3. Maxillary sinus • 4. Inferior orbital margin 1 2 3 4 This view is angled to project the maxillary sinuses free of the petrous ridge.

  26. 1. Frontal Sinus 2. Maxillary Sinus 3. Ethmoid Sinus 4. Sphenoid Sinus 5. Sella Turcica 1 3 5 4 2 LATERAL SINUS & SKULL

  27. CT- SINUS AXIAL VIEW 1 1. Frontal Sinus Scans start superiorly and are shown going inferiorly

  28. CT SINUS AXIAL SCAN normal Note the destroyed posterior wall of the left frontal sinus due to bacterial invasion.

  29. CT- SINUS AXIAL VIEW 1 1. Ethmoid sinus 2. Sphenoid sinus 3. Carotid canal 2 3

  30. CT- SINUS AXIAL VIEW 1 • Maxillary sinus • Med. & Lat. Pterygoid plate • Nasopharynx • Nasal septum • Inferior turbinate 4 5 2 3

  31. CT- SINUS Coronal sections extending from anterior to posterior 2 • Fronto-nasal suture • Frontal sinus • Nasal bones 1 3

  32. CT- SINUS CORONAL VIEW 1 3 1. Ethmoid sinus 2. Maxillary sinus 3. Middle turbinate

  33. CT- SINUS CORONAL VIEW Maxillary sinus

  34. CT- SINUS CORONAL VIEW 3 1 • Sphenoid sinus • Hard palette • Anterior clinoid 2

  35. CT ORBIT AXIAL SCAN • Retro orbital fat • Medial rectus • Lens • Lateral rectus • Optic nerve 2 4 1 3 5

  36. AXIAL SCAN Optic nerves CORONAL SCAN Chiasm MR SCAN

  37. In Biblical liturature who showed a knowledge of cranial nerve anatomy? • Moses • Noah • David • Goliath

  38. Normal Sella Mass Compare the normal with the enlarged pituitary adenoma. The mass impinges on the optic chiasm to create the visual disturbance.

  39. NECK ANATOMY

  40. 3 • LATERAL NECK • Hard palate • Soft palate • Nasopharynx • Oropharynx • Epiglottis 1 2 4 5

  41. AIRWAY • Calcified tracheal cartilage rings • Hyoid bone • Epiglottis • Thyroid cartilage • Cricoid cartilage 3 2 5 4 1 LATERAL VIEW OF NECK

  42. 3 • AIRWAY • Calcified tracheal cartilage rings • Hyoid bone • Epiglottis • Thyroid cartilage • Cricoid cartilage 2 5 4 1 LATERAL VIEW OF NECK

  43. Where do you insert the tube at an emergency tracheostomy? Cricothyroid membrane

  44. LATERAL VIEW OF NECK

  45. LT MAXILLARY SINUSES SCAN LEVEL ZYGOMA ZYGOMA SPHENOID SINUS Sections from the skull base extending inferiorly through the neck.

  46. MANDIBULAR CONDYLE LT MAXILLA SCAN LEVEL EXTERNAL AUDITORY MEATUS NASOPHARYNX MASTOIDS

  47. MANDIBLE LT MASSETER MUSCLE MASSETER MUSCLE SCAN LEVEL PTERYGOID MUSCLES PAROTID GLAND

  48. LT SCAN LEVEL SUBMANDIBULAR GLAND EPIGLOTTIS STERNOCLEIDOMASTOID MUSCLE SUBCUTANEOUS FAT

  49. LT HYOID BONE SCAN LEVEL VALLECULA PYRIFORM SINUS JUGULAR VEIN JUGULAR VEIN COMMON CAROTID ARTERIES

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