The cranium (skull) is the skeletal structure of the head that supports the face and protects the brain. It is subdivided into the facial bones and the brain case, or cranial vault. The facial bones underlie the facial structures, form the nasal cavity, enclose the eyeballs, and support the teeth of the upper and lower jaws. The rounded brain case surrounds and protects the brain and houses the middle and inner ear structures.
In adults, the skull consists of 22 individual bones, 21 of which are immobile and united into a single unit. The 22nd bone is the mandible (lower jaw), which is the only moveable bone of the skull.
The anterior skull consists of the facial bones and provides the bony support for the eyes and structures of the face. This view of the skull is dominated by the openings of the orbits and the nasal cavity. Also seen are the upper and lower jaws, with their respective teeth.
The orbit is the bony socket that houses the eyeball and muscles that move the eyeball or open the upper eyelid. The upper margin of the anterior orbit is the supraorbital margin. Located near the midpoint of the supraorbital margin is a small opening called the supraorbital foramen. This provides for passage of a sensory nerve to the skin of the forehead. Below the orbit is the infraorbital foramen, which is the point of emergence for a sensory nerve that supplies the anterior face below the orbit.
Inside the nasal area of the skull, the nasal cavity is divided into halves by the nasal septum. The upper portion of the nasal septum is formed by the perpendicular plate of the ethmoid bone and the lower portion is the vomer bone. Each side of the nasal cavity is triangular in shape, with a broad inferior space that narrows superiorly. When looking into the nasal cavity from the front of the skull, two bony plates are seen projecting from each lateral wall. The larger of these is the inferior nasal concha, an independent bone of the skull. Located just above the inferior concha is the middle nasal concha, which is part of the ethmoid bone. A third bony plate, also part of the ethmoid bone, is the superior nasal concha. It is much smaller and out of sight, above the middle concha. The superior nasal concha is located just lateral to the perpendicular plate, in the upper nasal cavity.
A view of the lateral skull is dominated by the large, rounded brain case above and the upper and lower jaws with their teeth below. Separating these areas is the bridge of bone called the zygomatic arch. The zygomatic arch is the bony arch on the side of skull that spans from the area of the cheek to just above the ear canal. It is formed by the junction of two bony processes: a short anterior component, the temporal process of the zygomatic bone (the cheekbone) and a longer posterior portion, the zygomatic process of the temporal bone, extending forward from the temporal bone. Thus the temporal process (anteriorly) and the zygomatic process (posteriorly) join together, like the two ends of a drawbridge, to form the zygomatic arch. One of the major muscles that pulls the mandible upward during biting and chewing arises from the zygomatic arch.
On the lateral side of the brain case, above the level of the zygomatic arch, is a shallow space called the temporal fossa. Below the level of the zygomatic arch and deep to the vertical portion of the mandible is another space called the infratemporal fossa. Both the temporal fossa and infratemporal fossa contain muscles that act on the mandible during chewing.
A suture is an immobile joint between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the bones of the brain case are not straight, but instead follow irregular, tightly twisting paths. These twisting lines serve to tightly interlock the adjacent bones, thus adding strength to the skull for brain protection.
The two suture lines seen on the top of the skull are the coronal and sagittal sutures. The coronal sutureruns from side to side across the skull, within the coronal plane of section. It joins the frontal bone to the right and left parietal bones. The sagittal suture extends posteriorly from the coronal suture, running along the midline at the top of the skull in the sagittal plane of section. It unites the right and left parietal bones. On the posterior skull, the sagittal suture terminates by joining the lambdoid suture. The lambdoid suture extends downward and laterally to either side away from its junction with the sagittal suture. The lambdoid suture joins the occipital bone to the right and left parietal and temporal bones. This suture is named for its upside-down "V" shape, which resembles the capital letter version of the Greek letter lambda (Λ). The squamous suture is located on the lateral skull. It unites the squamous portion of the temporal bone with the parietal bone. At the intersection of four bones is the pterion, a small, capital-H-shaped suture line region that unites the frontal bone, parietal bone, squamous portion of the temporal bone, and greater wing of the sphenoid bone. It is the weakest part of the skull. The pterion is located approximately two finger widths above the zygomatic arch and a thumb’s width posterior to the upward portion of the zygomatic bone.
The paranasal sinuses are named for the skull bone that each occupies. The frontal sinus is located just above the eyebrows, within the frontal bone. This irregular space may be divided at the midline into bilateral spaces, or these may be fused into a single sinus space. The frontal sinus is the most anterior of the paranasal sinuses. The largest sinus is the maxillary sinus. These are paired and located within the right and left maxillary bones, where they occupy the area just below the orbits. The maxillary sinuses are most commonly involved during sinus infections. Because their connection to the nasal cavity is located high on their medial wall, they are difficult to drain. The sphenoid sinus is a single, midline sinus. It is located within the body of the sphenoid bone, just anterior and inferior to the sella turcica, thus making it the most posterior of the paranasal sinuses. The lateral aspects of the ethmoid bone contain multiple small spaces separated by very thin bony walls. Each of these spaces is called an ethmoid air cell. These are located on both sides of the ethmoid bone, between the upper nasal cavity and medial orbit, just behind the superior nasal conchae.