1. Name all those holes in the base of the skull and tell us what goes through each.

Cranial
fossa

Bone

Foramina

Vessels

Nerves

supraorbital
foramen

supraorbital artery,
supraorbital nerve
supraorbital vein

frontal

anterior
cranial
fossa

foramen cecum

emissary veins to
superior sagittal
sinus

ethmoid

foramina of
cribriform plate

olfactory nerve bundles

(I)

ethmoid

anterior
cranial
fossa

anterior
ethmoidal
foramen

anterior ethmoidal
artery
anterior ethmoidal
vein

anterior ethmoidal
nerve

ethmoid

anterior
cranial
fossa

posterior
ethmoidal
foramen

posterior ethmoidal
posterior ethmoidal
artery
posterior ethmoidal nerve
vein

sphenoid

optic canal

ophthalmic artery

sphenoid

middle
cranial
fossa

superior orbital
fissure

oculomotor nerve (III)

superior
trochlear nerve (IV)
ophthalmic vein
lacrimal, frontal and
inferior ophthalmic nasociliary branches of
vein
ophthalmic nerve (V 1 )
abducent nerve (VI)

sphenoid

middle
cranial
fossa

foramen
rotundum

maxillary nerve (V 2 )

incisive
foramen/incisive
canals

sphenopalatine
artery

nasopalatine nerve(V2)

palatine

greater palatine
foramen

greater palatine
artery
greater palatine
vein

greater palatine nerve

palatine
and
maxilla

lesser palatine
foramina

lesser palatine
lesser palatine nerve
artery
lesser palatine vein

inferior orbital
fissure

inferior ophthalmic zygomatic nerve and

veins
infraorbital nerve of
infraorbital artery maxillary nerve (V 2 )

frontal

maxilla

sphenoid
and
maxilla

optic nerve (II)

infraorbital vein

orbital branches of
pterygopalatine
ganglion

maxilla

infraorbital
foramen

infraorbital artery
infraorbital vein

infraorbital nerve

sphenoid

middle
cranial
fossa

foramen ovale

accessory
meningeal artery

mandibular nerve (V 3 )
lesser petrosal nerve
(occasionally)

sphenoid

middle
cranial
fossa

foramen
spinosum

middle meningeal
artery

meningeal branch of
the mandibular nerve
(V 3 )

sphenoid

middle
cranial
fossa

internal carotid
foramen lacerum artery, artery of
pterygoid canal

temporal

middle
cranial
fossa

internal acoustic
meatus

facial nerve (VII),

labyrinthine artery vestibulocochlear nerve
(VIII)

temporal

posterior
cranial
fossa

jugular foramen

inferior petrosal
sinus, sigmoid
sinus

occipital

posterior
cranial
fossa

hypoglossal canal -

hypoglossal nerve (XII)

occipital

posterior
cranial
fossa

anterior and
posterior spinal
foramen magnum
arteries, vertebral
arteries

medulla oblongata

temporal

posterior
cranial
fossa

stylomastoid
foramen

nerve of pterygoid
canal

glossopharyngeal nerve
(IX), vagus nerve (X),
accessory nerve (XI)

stylomastoid artery facial nerve

2. Review the boundaries of anterior, middle and posterior cranial fossa.

Anterior cranial fossa: Anterior limit is the posterior wall of the frontal sinus. The
anterior clinoid processes and the planum sphenoidale, which forms the roof of the
sphenoid sinus, mark the posterior limit. The frontal bone forms the lateral boundaries.
The frontal bone houses the supraorbital foramina, which, along with the frontal sinuses,
form 2 important surgical landmarks during approaches involving the anterior skull base.
Middle cranial fossa: The greater wing of the sphenoid helps form the anterior limit of
the middle skull base. The posterior limit is the clivus. The greater wing of the sphenoid
forms the lateral limit as it extends laterally and upward from the sphenoid body to meet
the squamous portion of the temporal bone and the anteroinferior portion of the parietal
bone. The greater wing of the sphenoid forms the anterior floor of the fossa. The anterior
aspect of the petrous temporal bone forms the posterior floor of the middle cranial fossa.
The body of the sphenoid makes up the central portion of the middle fossa and houses the
sella turcica.
Posterior cranial fossa: The posterior skull base consists of primarily the occipital bone,
with contributions from the sphenoid and temporal bones. The basal portion of the
occipital bone (the basiocciput) and the basisphenoid form the anterior portion of the

posterior skull base. These 2 regions combine to form the midline clivus. The posterior
surface of the petrous temporal bone and the lateral aspect of the occipital bone form the
lateral wall. The occipital bone also fuses with the mastoid portion of the temporal bone
to form the occipitomastoid suture. The petrous portion of the temporal bone and the
greater wings of the sphenoid bone are particularly important for identifying structures.
The overlying tentorium cerebelli separates the cerebellum from the cerebral hemispheres
above, whereas the occipital bone form the lateral walls and floor.
3. List the contents of the superior and inferior orbital fissures.
Superior orbital fissure:

superior and inferior divisions of oculomotor nerve (III)

trochlear nerve (IV)
lacrimal, frontal and nasociliary branches of ophthalmic nerve (V 1 )
abducens nerve (VI)
superior and inferior divisions of ophthalmic vein. Inferior division also passes
through the inferior orbital fissure.
sympathetic fibers from cavernous plexus

The nerves passing through the fissure can be remembered with the mnemonic, "Live
Frankly To See Absolutely No Insult" - for Lacrimal, Frontal, Trochlear, Superior
Division of Oculomotor, Abducens, Nasociliary and Inferior Division of Oculomotor
nerve.
It is divided into 3 parts from lateral to medial:
Lateral Part transmits: lacrimal nerve, frontal nerve, trochlear nerve, meningeal branch of
lacrimal artery, anastomotic branch of middle meningeal artery which anastomoses with
recurrent branch of the lacrimal artery
Middle Part transmits: Upper and lower divisions of the oculomotor nerve, nasociliary
nerve between the two divisions of oculomotor nerve and abducent nerve
Medial Part transmits: Superior ophthalmic vein and sympathetic nerves from the plexus
around internal carotid artery
Inferior orbital fissure:
infraorbital nerve (a branch of V2),
infraorbital artery (a branch of the third part of the maxillary artery)
Anatomy of the left orbital apex, highlighting the extraocular muscle origins and the
contents of the superior orbital fissure. Key: LPS, levator muscle; SR, superior
rectus; LR, lateral rectus; IR, inferior rectus; MR, medial rectus; SO, superior
oblique; SOV, superior ophthalmic vein; III sup , superior division of oculomotor nerve;
III inf , inferior division of oculomotor nerve; IOF, inferior orbital fissure.