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Incisive foramen
Choanae Foramen ovale Foramen lacerum Foramen spinosum Carotid canal Jugular fossa Mastoid process
Inferior view of the skull showing foramina (Atlas of Human Anatomy, 5th edition, Plate 12)
Clinical Note
Maxillofacial three-dimensional (3-D) displays are very helpful in preoperative planning to correct deformities caused by trauma, tumor, or congenital malformations.
Incisive foramen
Hard palate
Choanae
Foramen ovale
Foramen lacerum
Foramen spinosum
Carotid canal
Mastoid process
Jugular fossa
Cribriform plate
Foramen ovale
Foramen spinosum
Foramen lacerum
Interior of skull showing foramina (Atlas of Human Anatomy, 5th edition, Plate 13)
Clinical Note
The groove for the middle meningeal artery runs along the inner margin of the thinnest part of the lateral skull known as pterion; accordingly, a fracture of this region may result in an extradural hematoma.
Cribriform plate
Foramen ovale
Foramen spinosum
Foramen lacerum
Stylohyoid ligament
Hyoid bone
Lateral view of the skeletal elements of the head and neck (Atlas of Human Anatomy, 5th edition, Plate 15)
Clinical Note
In criminal proceedings, the nding of a fractured hyoid bone is considered to be strong evidence of strangulation.
Styloid process
Mental foramen
Hyoid bone
Axis (C2)
Anterior arch
Anterior view of the axis (C2) (Atlas of Human Anatomy, 5th edition, Plate 19)
Clinical Note
The dens is susceptible to fracture that is classied by the level of the fracture site. The most common fracture occurs at the base of the dens (type II fracture).
Axis (C2)
Anterior arch
Lamina of axis
Zygapophyseal joint
Posterior view of articulated C1-C4 vertebrae (Atlas of Human Anatomy, 5th edition, Plate 19)
Clinical Note
The hangmans fracture consists of bilateral pedicle or pars interarticularis fractures of the axis. Associated with this fracture is anterior subluxation or dislocation of the C2 vertebral body. It results from a severe extension injury, such as from an automobile accident in which the face forcibly strikes the dashboard, or from hanging.
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Dens
Lamina of axis
Zygapophyseal joint
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Cervical Spondylosis
Axis (C2)
Degenerative changes in cervical vertebrae (Atlas of Human Anatomy, 5th edition, Plate 20)
Clinical Note
Degenerative changes of the uncovertebral joints (of Luschka) typically occur with other degenerative changes such as the development of spondylophytes and the loss of intervertebral disk space. These changes reduce the size of the intervertebral foramina (neuroforamina) resulting in radiculopathy and associated pain, paresthesia, and numbness in the corresponding dermatomes. Head and Neck
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Cervical Spondylosis
Axis Normal uncinate process and uncovertebral joint Uncovertebral joint with loss of joint space
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Vertebral artery
C5 transverse process
Lateral view of the cervical spine and vertebral artery (Atlas of Human Anatomy, 5th edition, Plate 22)
Clinical Note
Vertebral artery dissection, a subintimal hematoma, may cause cerebellar or brain infarction; occurrence may be idiopathic or secondary to trauma.
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Vertebral artery
C5 transverse process
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Vertebral artery
Vertebral artery on the posterior arch of the atlas (Atlas of Human Anatomy, 5th edition, Plate 22)
Clinical Note
This is the most tortuous segment of the vertebral artery; increases in tortuosity are associated with atherosclerotic changes.
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Mastoid process
Vertebral artery
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Craniovertebral Ligaments
Alar ligaments
Posterior view of the craniovertebral ligaments after removal of the tectorial membrane (Atlas of Human Anatomy, 5th edition, Plate 23)
Clinical Note
Atlanto-occipital dislocation is a rare traumatic injury that is difcult to diagnose and is frequently missed on initial lateral cervical x-rays. Patients who survive typically have neurologic impairment such as lower cranial neuropathies, unilateral or bilateral weakness, or quadriplegia. Prevertebral soft tissue swelling on a lateral cervical x-ray and craniocervical subarachnoid hemorrhage on an axial CT have been associated with this injury and thus may aid with diagnosis.
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Craniovertebral Ligaments
Alar ligament
Dens
Epiglottis
Dens
Spinal cord
Cerebellum B
A, Oblique coronal CT, cervical spine; B, Axial T2 magnetic resonance (MR) image, cervical spine
The alar ligaments are pencil-thick ligaments that connect the dens to the rim of the foramen magnum, stabilizing the atlanto-occipital relationship. The transverse ligament holds the dens against the anterior arch of the atlas. Superior and inferior bands arise from the transverse ligament forming with it the cruciate ligament.
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Lateral view of the supercial muscles of the neck (Atlas of Human Anatomy, 5th edition, Plate 26)
Clinical Note
Congenital torticollis (wryneck) is typically associated with a birth injury to the sternocleidomastoid muscle that results in a unilateral shortening of the muscle, and the associated rotated and tilted head position.
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Masseter muscle
Mylohyoid muscle
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