Internal Carotid Artery and Jugular Foramen

Carotid Canal

Jugular Foramen

Image courtesy of Tabby Kennedy, MD

Coronal Image – Meninges • Supratentorium

– Cerebral hemispheres • Frontal Lobes • Parietal Lobes • Occipital Lobes • Temporal Lobes

• Infratentorium – Cerebellum – Brain Stem

Tentorium

Falx

Image courtesy of Tabby Kennedy, MD

Lateral view – Dural Sinuses

Digital subtraction angiography

Lateral view – Straight Sinus

MR angiography

Frontal view – Dural Sinuses

Digital subtraction angiography

Course of the Internal Carotid Artery: Petrous (C2)

Carotid Canal

Cervical (C1)

Image courtesy of Tabby Kennedy, MD

Course of the Internal Carotid Artery: Petrous (C2)

Carotid Canal

Image courtesy of Tabby Kennedy, MD

Course of the Internal Carotid Artery: Petrous (C2)

Carotid Canal

Image courtesy of Tabby Kennedy, MD

Course of the Internal Carotid Artery: Petrous (C2)

Petrous segment ICA

Lacerum

Image courtesy of Tabby Kennedy, MD

Course of the Internal Carotid Artery: Lacerum (C3)

Image courtesy of Tabby Kennedy, MD

Course of the Internal Carotid Artery: Cavernous (C4)

Cavernous segment ICA

Image courtesy of Tabby Kennedy, MD

Course of the Internal Carotid Artery: Cavernous (C4)

Cavernous segment ICA

Anatomy at a Glance Faiz & Moffat

Image courtesy of Tabby Kennedy, MD

Course of the Internal Carotid Artery: Cavernous (C4)

Image courtesy of Tabby Kennedy, MD

Frontal View - Internal carotid artery

MR angiography

Posterior communicating artery

MR angiography – axial view

Anterior communicating artery

MR angiography – axial view

Terminal Branches Internal Carotid Artery

MR angiography – axial view

Anterior cerebral artery

Middle cerebral artery

Posterior Circulation – Lateral view

Digital subtraction angiography

Frontal view of vertebral artery injection Posterior Circulation – Frontal view

Digital subtraction angiography

Coronal View - Posterior Circulation

Basilar Artery

Posterior Cerebral Arteries

Left Vertebral Artery

Superior Cerebellar Arteries

CN III – not seen, but this is where it travels

Right Vertebral Artery

Foramen of Monro = interventricular foramen

Cerebral aqueduct = aqueduct of midbrain

Neuroanatomy: An Illustrated Colour Text ©2015

Ventricular System

Ventricular System Lateral Ventricles

Ventricular System Interventricular Foramen

Foramen of Monro

Ventricular System 3rd Ventricle

Lateral Ventricles

Ventricular System Aqueduct of midbrain

Cerebral Aqueduct

Ventricular System

Aqueduct of midbrain

Cerebral aqueduct

Ventricular System

Aqueduct of midbrain

Cerebral aqueduct

Ventricular System 4th Ventricle

Anterior Cranial Fossa • Anterior/Inferior: Frontal bone • Medial: Ethmoid bone • Posterior: Body and lesser wings of the sphenoid

Image courtesy of Tabby Kennedy, MD

Olfactory Nerve/ Cribriform Plate

Image courtesy of Tabby Kennedy, MD

Cranial Nerve I: Olfactory Nerve

Nerve fibers located on the nasal septum extend through the cribiform plate and form the olfactory bulb and olfactory tract

Olfactory Bulb Cribriform Plate

Crista Galli

Image courtesy of Tabby Kennedy, MD

Cranial Nerve I: Olfactory Nerve

Image courtesy of Tabby Kennedy, MD

Middle Cranial Fossa • Central: Sella turcica • Anterior: Greater wings of the sphenoid • Lateral: Squamous portion of the temporal bones and parietal bones • Posterior: Petrous parts of the temporal bones

Image courtesy of Tabby Kennedy, MD

Foramina and Apertures Foramina/Aperture Contents

Optic canals Optic nerves (CN II) and ophthalmic arteries

Superior orbital fissure Ophthalmic veins; CN III, IV, ophthalmic nerve (CN V1) and VI

Foramen rotundum Maxillary nerve (CN V2)

Foramen ovale Mandibular nerve (CN V3) and accessory meningeal artery

Foramen spinosum Middle meningeal artery and vein and meningeal branch of CN V3

Foramen lacerum Internal carotid artery passes over foramen, but does not go through it

Image courtesy of Tabby Kennedy, MD

Normal Pituitary and Cavernous Sinus

Image courtesy of Tabby Kennedy, MD

Cranial Nerve II: Optic Nerve

Origin: Globe

Course: Orbit, Optic Canal, Optic Chiasm, Tract, Thalamus

Not a true Cranial Nerve: Extension of the diencephalon

Optic Canal

Optic Nerve

Image courtesy of Tabby Kennedy, MD

Optic Canal Optic Canal Anterior

Clinoid

Image courtesy of Tabby Kennedy, MD

Cranial Nerve III: Oculomotor Nerve

Cerebral Peduncle CN III

Origin: Midbrain Course: •Cistern (passes between posterior cerebral artery and superior cerebellar artery)

•Cavernous sinus

•Superior Orbital Fissure

•Orbit

Exit Skull base: Superior Orbital Fissure

Image courtesy of Tabby Kennedy, MD

Cranial Nerve III: Oculomotor Nerve

CN III

Cavernous Sinus

Origin: Midbrain Course: •Cistern (passes between posterior cerebral artery and superior cerebellar artery)

•Cavernous sinus

•Superior Orbital Fissure

•Orbit

Exit Skull base: Superior Orbital Fissure

Image courtesy of Tabby Kennedy, MD

Anterior Clinoid Process Optic Canal

SOF

Superior Orbital Fissure

Superior Orbital Fissure

Image courtesy of Tabby Kennedy, MD

Cranial Nerve IV: Trochlear Nerve Origin: Posterior Midbrain Course: •Posterior origin •Travels anteriorly through cistern •Cavernous sinus •Superior orbital fissure •Orbit Innervation: Superior Oblique Muscle

Image courtesy of Tabby Kennedy, MD

Cranial Nerve V: Trigeminal Nerve Origin: Pons

Course: •Cistern •Trigeminal ganglion

Divides into (3) branches: V1 Ophthalmic , V2 Maxillary , V3 Mandibular

V1 and V2 pass through the cavernous sinus before exiting the skull. V3 does not pass through the cavernous sinus

CN V

Image courtesy of Tabby Kennedy, MD

Optic Canal

Superior Orbital Fissure Anterior Clinoid

Process

Anterior Clinoid Process Optic Canal

SOF

V1:Superior Orbital Fissure

Image courtesy of Tabby Kennedy, MD

V2: Foramen Rotundum

Foramen Rotundum

Image courtesy of Tabby Kennedy, MD

V2: Inferior Orbital Fissure

Image courtesy of Tabby Kennedy, MD

V2: Infraorbital Canal/Foramen

Image courtesy of Tabby Kennedy, MD

V3: Foramen Ovale

Foramen Ovale

Foramen Spinosum

Image courtesy of Tabby Kennedy, MD

V3: Foramen Ovale

Cranial Nerve VI: Abducens Nerve Origin: pontomedullary junction Course: •Cistern •Cavernous sinus •Superior orbital fissure •Orbit Innervation: Lateral rectus muscle

Image courtesy of Tabby Kennedy, MD

Posterior Cranial Fossa • Anterior central: dorsum sellae of the sphenoid • Anterolateral: petrous and mastoid parts of the temporal

bones • Posterior: occipital bone

Image courtesy of Tabby Kennedy, MD

Foramina and Apertures Foramina/Aperture Contents

Foramen magnum Medulla, vertebral arteries, CN XI

Jugular foramen CN IX, X, and XI; internal jugular vein

Hypoglossal canal Hypoglossal nerve (CN XII)

Internal acoustic meatus Facial nerve (CN VII) and vestibulocochlear nerves (CN VIII)

Groove for sigmoid sinus Sigmoid sinus

Image courtesy of Tabby Kennedy, MD

Cranial Nerves VII: Facial Nerve Origin: Pontomedullary junction

Course: 6 Segments

Cisternal Intracanalicular Labyrinthine Tympanic Mastoid Extracranial

Branches: GPN, Chorda Tympani, Stapedius, Muscles of facial expression

Image courtesy of Tabby Kennedy, MD

Internal Auditory Canal (IAC)

Internal Auditory Canal Internal Auditory Canal

Image courtesy of Tabby Kennedy, MD

Cisternal and Intracanalicular Vestibulocochlear Nerve

Sup Vestib Nerve

Inf Vestib Nerve

Facial Nerve

Cochlear Nerve

Image courtesy of Tabby Kennedy, MD

Geniculate Ganglion

Geniculate Ganglion Greater Petrosal Nerve

Tympanic Segment Facial Nerve

Image courtesy of Tabby Kennedy, MD

Tympanic Segment Facial Nerve

Tympanic Segment

Image courtesy of Tabby Kennedy, MD

Mastoid Segment Facial Nerve

Mastoid Segment

Image courtesy of Tabby Kennedy, MD

Mastoid Segment Facial Nerve

Stylomastoid Foramen

Image courtesy of Tabby Kennedy, MD

CN VIII: Vestibulocochlear Nerve Sensory Nerve

Cochlea: Cochlear division (hearing)

Vestibular division (balance): Semicircular canals Course: •Internal Auditory Canal •Cistern •Pontomedullary junction

Image courtesy of Tabby Kennedy, MD

Intracanalicular Facial Nerve Porus Acusticus

Anterior Posterior

Facial Nerve

Cochlear Nerve

Superior Vestibular Nerve

Inferior Vestibular Nerve

IAC

7-up, Coke down

Image courtesy of Tabby Kennedy, MD

Jugular Foramen

Two different appearances of the jugular foramen.

Groove for the sigmoid sinus

Image courtesy of Tabby Kennedy, MD

CN IX: Glossopharyngeal Nerve • Branchial arch 3 • Exits through jugular

foramen • Innervation

– Stylopharyngeus mm – Posterior 1/3 tongue

taste – Gag reflex

Netter’s Correlative Imaging: Neuroanatomy

CN X: Vagus Nerve Exits through jugular foramen Innervation: All muscles of larynx, pharynx and soft palate • Except stylopharyngues (IX) and

tensor veli palatini (V3)

Sensory - Larynx and small portion of pharynx, external ear, posterior cranial fossa meninges Taste buds on epiglottis Viscerosensory thoracic / abdominal organs

Netter’s Correlative Imaging: Neuroanatomy

CN XI: Spinal Accessory Nerve Exits through jugular foramen Innervation: Sternocleidomastoid Trapezius

Netter’s Correlative Imaging: Neuroanatomy

Cranial Nerve XII: Hypoglossal Nerve

Origin: Medulla

Course: Cistern

Exits skull base through hypoglossal canal

Innervation: Muscles of the tongue

Hypoglossal Canal

Image courtesy of Tabby Kennedy, MD