5a. 5. The Sphenoid Bone

(Os Sphenoidale)

The sphenoid bone is situated at the base of the skull in front of the temporals and basilar part of the occipital. It somewhat resembles a bat with its wings extended, and is divided into a median portion or body, two great and two small wings extending outward from the sides of the body, and two pterygoid processes which project from it below. 1 Body (corpus sphenoidale).—The body, more or less cubical in shape, is hollowed out in its interior to form two large cavities, the sphenoidal air sinuses, which are separated from each other by a septum. 2 Surfaces.—The superior surface of the body (Fig. 145) presents in front a prominent spine, the ethmoidal spine, for articulation with the cribriform plate of the ethmoid; behind this is a smooth surface slightly raised in the middle line, and grooved on either side for the olfactory lobes of the brain. This surface is bounded behind by a ridge, which forms the anterior border of a narrow, transverse groove, the chiasmatic groove (optic groove), above and behind which lies the optic chiasma; the groove ends on either side in the optic foramen, which transmits the optic nerve and ophthalmic artery into the orbital cavity. Behind the chiasmatic groove is an elevation, the tuberculum sellæ; and still more posteriorly, a deep depression, the sella turcica, the deepest part of which lodges the hypophysis cerebri and is known as the fossa hypophyseos. The anterior boundary of the sella turcica is completed by two small eminences, one on either side, called the middle clinoid processes, while the posterior boundary is formed by a square-shaped plate of bone, the dorsum sellæ, ending at its superior angles in two tubercles, the posterior clinoid processes, the size and form of which vary considerably in different individuals. The posterior clinoid processes deepen the sella turcica, and give attachment to the tentorium cerebelli. On either side of the dorsum sellæ is a notch for the passage of the abducent nerve, and below the notch a sharp process, the petrosal process, which articulates with the apex of the petrous portion of the temporal bone, and forms the medial boundary of the foramen lacerum. Behind the dorsum sellæ is a shallow depression, the clivus, which slopes obliquely backward, and is continuous with the groove on the basilar portion of the occipital bone; it supports the upper part of the pons. 3

FIG. 145– Sphenoid bone. Upper surface. (See enlarged image)

FIG. 146– Sphenoid bone. Anterior and inferior surfaces. (See enlarged image) The lateral surfaces of the body are united with the great wings and the medial pterygoid plates. Above the attachment of each great wing is a broad groove, curved something like the italic letter f; it lodges the internal carotid artery and the cavernous sinus, and is named the carotid groove. Along the posterior part of the lateral margin of this groove, in the angle between the body and great wing, is a ridge of bone, called the lingula. 4 The posterior surface, quadrilateral in form (Fig. 147), is joined, during infancy and adolescence, to the basilar part of the occipital bone by a plate of cartilage. Between the eighteenth and twenty-fifth years this becomes ossified, ossification commencing above and extending downward. 5 The anterior surface of the body (Fig. 146) presents, in the middle line, a vertical crest, the sphenoidal crest, which articulates with the perpendicular plate of the ethmoid, and forms part of the septum of the nose. On either side of the crest is an irregular opening leading into the corresponding sphenoidal air sinus. These sinuses are two large, irregular cavities hollowed out of the interior of the body of the bone, and separated from one another by a bony septum, which is commonly bent to one or the other side. They vary considerably in form and size, 30 are seldom symmetrical, and are often partially subdivided by irregular bony laminæ. Occasionally, they extend into the basilar part of the occipital nearly as far as the foramen magnum. They begin to be developed before birth, and are of a considerable size by the age of six. They are partially closed, in front and below, by two thin, curved plates of bone, the sphenoidal conchæ (see page 152), leaving in the articulated skull a round opening at the upper part of each sinus by which it communicates with the upper and back part of the nasal cavity and occasionally with the posterior ethmoidal air cells. The lateral margin of the anterior surface is serrated, and articulates with the lamina papyracea of the ethmoid, completing the posterior ethmoidal cells; the lower margin articulates with the orbital process of the palatine bone, and the upper with the orbital plate of the frontal bone. 6

FIG. 147– Sphenoid bone. Upper and posterior surfaces. (See enlarged image) The inferior surface presents, in the middle line, a triangular spine, the sphenoidal rostrum, which is continuous with the sphenoidal crest on the anterior surface, and is received in a deep fissure between the alæ of the vomer. On either side of the rostrum is a projecting lamina, the vaginal process, directed medialward from the base of the medial pterygoid plate, with which it will be described. 7 The Great Wings (alæ magnæ).—The great wings, or ali-sphenoids, are two strong processes of bone, which arise from the sides of the body, and are curved upward, lateralward, and backward; the posterior part of each projects as a triangular process which fits into the angle between the squama and the petrous portion of the temporal and presents at its apex a downwardly directed process, the spina angularis (sphenoidal spine). 8 Surfaces.—The superior or cerebral surface of each great wing (Fig. 145) forms part of the middle fossa of the skull; it is deeply concave, and presents depressions for the convolutions of the temporal lobe of the brain. At its anterior and medial part is a circular aperture, the foramen rotundum, for the transmission of the maxillary nerve. Behind and lateral to this is the foramen ovale, for the transmission of the mandibular nerve, the accessory meningeal artery, and sometimes the lesser superficial petrosal nerve. 31 Medial to the foramen ovale, a small aperture, the foramen Vesalii, may occasionally be seen opposite the root of the pterygoid process; it opens below near the scaphoid fossa, and transmits a small vein from the cavernous sinus. Lastly, in the posterior angle, near to and in front of the spine, is a short canal, sometimes double, the foramen spinosum, which transmits the middle meningeal vessels and a recurrent branch from the mandibular nerve. 9 The lateral surface (Fig. 146) is convex, and divided by a transverse ridge, the infratemporal crest, into two portions. The superior or temporal portion, convex from above downward, concave from before backward, forms a part of the temporal fossa, and gives attachment to the Temporalis; the inferior or infratemporal, smaller in size and concave, enters into the formation of the infratemporal fossa, and, together with the infratemporal crest, affords attachment to the Pterygoideus externus. It is pierced by the foramen ovale and foramen spinosum, and at its posterior part is the spina angularis, which is frequently grooved on its medial surface for the chorda tympani nerve. To the spina angularis are attached the sphenomandibular ligament and the Tensor veli palatini. Medial to the anterior extremity of the infratemporal crest is a triangular process which serves to increase the attachment of the Pterygoideus externus; extending downward and medialward from this process on to the front part of the lateral pterygoid plate is a ridge which forms the anterior limit of the infratemporal surface, and, in the articulated skull, the posterior boundary of the pterygomaxillary fissure. 10

The orbital surface of the great wing (Fig. 146), smooth, and quadrilateral in shape, is directed forward and medialward and forms the posterior part of the lateral wall of the orbit. Its upper serrated edge articulates with the orbital plate of the frontal. Its inferior rounded border forms the postero-lateral boundary of the inferior orbital fissure. Its medial sharp margin forms the lower boundary of the superior orbital fissure and has projecting from about its center a little tubercle which gives attachment to the inferior head of the Rectus lateralis oculi; at the upper part of this margin is a notch for the transmission of a recurrent branch of the lacrimal artery. Its lateral margin is serrated and articulates with the zygomatic bone. Below the medial end of the superior orbital fissure is a grooved surface, which forms the posterior wall of the pterygopalatine fossa, and is pierced by the foramen rotundum. 11 Margin (Fig. 145).—Commencing from behind, that portion of the circumference of the great wing which extends from the body to the spine is irregular. Its medial half forms the anterior boundary of the foramen lacerum, and presents the posterior aperture of the pterygoid canal for the passage of the corresponding nerve and artery. Its lateral half articulates, by means of a synchondrosis, with the petrous portion of the temporal, and between the two bones on the under surface of the skull, is a furrow, the sulcus tubæ, for the lodgement of the cartilaginous part of the auditory tube. In front of the spine the circumference presents a concave, serrated edge, bevelled at the expense of the inner table below, and of the outer table above, for articulation with the temporal squama. At the tip of the great wing is a triangular portion, bevelled at the expense of the internal surface, for articulation with the sphenoidal angle of the parietal bone; this region is named the pterion. Medial to this is a triangular, serrated surface, for articulation with the frontal bone; this surface is continuous medially with the sharp edge, which forms the lower boundary of the superior orbital fissure, and laterally with the serrated margin for articulation with the zygomatic bone. 12 The Small Wings (alæ parvæ).—The small wings or orbito-sphenoids are two thin triangular plates, which arise from the upper and anterior parts of the body, and, projecting lateralward, end in sharp points (Fig. 145). 13 Surfaces.—The superior surface of each is flat, and supports part of the frontal lobe of the brain. The inferior surface forms the back part of the roof of the orbit, and the upper boundary of the superior orbital fissure. This fissure is of a triangular form, and leads from the cavity of the cranium into that of the orbit: it is bounded medially by the body; above, by the small wing; below, by the medial margin of the orbital surface of the great wing; and is completed laterally by the frontal bone. It transmits the oculomotor, trochlear, and abducent nerves, the three branches of the ophthalmic division of the trigeminal nerve, some filaments from the cavernous plexus of the sympathetic, the orbital branch of the middle meningeal artery, a recurrent branch from the lacrimal artery to the dura mater, and the ophthalmic vein. 14 Borders.—The anterior border is serrated for articulation with the frontal bone. The posterior border, smooth and rounded, is received into the lateral fissure of the brain; the medial end of this border forms the anterior clinoid process, which gives attachment to the tentorium cerebelli; it is sometimes joined to the middle clinoid process by a spicule of bone, and when this occurs the termination of the groove for the internal carotid artery is converted into a foramen (carotico-clinoid). The small wing is connected to the body by two roots, the upper thin and flat, the lower thick and triangular; between the two roots is the optic foramen, for the transmission of the optic nerve and ophthalmic artery. 15 Pterygoid Processes (processus pterygoidei).—The pterygoid processes, one on either side, descend perpendicularly from the regions where the body and great wings unite. Each process consists of a medial and a lateral plate, the upper parts of which are fused anteriorly; a vertical sulcus, the pterygopalatine groove, descends on the front of the line of fusion. The plates are separated below by an angular cleft, the pterygoid fissure, the margins of which are rough for articulation with the pyramidal process of the palatine bone. The two plates diverge behind and enclose between them a V-shaped fossa, the pterygoid fossa, which contains the Pterygoideus internus and Tensor veli palatini. Above this fossa is a small, oval, shallow depression, the scaphoid fossa, which gives origin to the Tensor veli palatini. The anterior surface of the pterygoid process is broad and triangular near its root, where it forms the posterior wall of the pterygopalatine fossa and presents the anterior orifice of the pterygoid canal. 16 Lateral Pterygoid Plate.—The lateral pterygoid plate is broad, thin, and everted; its lateral surface forms part of the medial wall of the infratemporal fossa, and gives attachment to the Pterygoideus externus; its medial surface forms part of the pterygoid fossa, and gives attachment to the Pterygoideus internus. 17 Medial Pterygoid Plate.—The medial pterygoid plate is narrower and longer than the lateral; it curves lateralward at its lower extremity into a hook-like process, the pterygoid hamulus, around which the tendon of the Tensor veli palatini glides. The lateral surface of this plate forms part of the pterygoid fossa, the medial surface constitutes the lateral boundary of the choana or posterior aperture of the corresponding nasal cavity. Superiorly the medial plate is prolonged on to the under surface of the body as a thin lamina, named the vaginal process, which articulates in front with the sphenoidal process of the palatine and behind this with the ala of the vomer. The angular prominence between the posterior margin of the vaginal process and the medial border of the scaphoid fossa is named the pterygoid tubercle, and immediately above this is the posterior opening of the pterygoid canal. On the under surface of the vaginal process is a furrow, which is converted into a canal by the sphenoidal process of the palatine bone, for the transmission of the pharyngeal branch of the internal maxillary artery and the pharyngeal nerve from the sphenopalatine ganglion. The pharyngeal aponeurosis is attached to the entire length of the posterior edge of the medial plate, and the Constrictor pharyngis superior takes origin from its lower third. Projecting backward from near the middle of the posterior edge of this plate is an angular process, the processus tubarius, which supports the pharyngeal end of the auditory tube. The anterior margin of the plate articulates with the posterior border of the vertical part of the palatine bone. 18 The Sphenoidal Conchæ (conchæ sphenoidales; sphenoidal turbinated processes).—The sphenoidal conchæ are two thin, curved plates, situated at the anterior and lower part of the body of the sphenoid. An aperture of variable size exists in the anterior wall of each, and through this the sphenoidal sinus opens into the nasal cavity. Each is irregular in form, and tapers to a point behind, being broader and thinner in front. Its upper surface is concave, and looks toward the cavity of the sinus; its under surface is convex, and forms part of the roof of the corresponding nasal cavity. Each bone articulates in front with the ethmoid, laterally with the palatine; its pointed posterior extremity is placed above the vomer, and is received between the root of the pterygoid process laterally and the rostrum of the sphenoid medially. A small portion of the sphenoidal concha sometimes enters into the formation of the medial wall of the orbit, between the lamina papyracea of the ethmoid in front, the orbital plate of the palatine below, and the frontal bone above. 19 Ossification.—Until the seventh or eighth month of fetal life the body of the sphenoid consists of two parts, viz., one in front of the tuberculum sellæ, the presphenoid, with which the small wings are continuous; the other, comprising the sella turcica and dorsum sellæ, the postsphenoid, with which are associated the great wings, and pterygoid processes. The greater part of the bone is ossified in cartilage. There are fourteen centers in all, six for the presphenoid and eight for the postsphenoid. 20

FIG. 148– Sphenoid bone at birth. Posterior aspect. (See enlarged image) Presphenoid.—About the ninth week of fetal life an ossific center appears for each of the small wings (orbitosphenoids) just lateral to the optic foramen; shortly afterward two nuclei appear in the presphenoid part of the body. The sphenoidal conchæ are each developed from a center which makes its appearance about the fifth month; 32 at birth they consist of small triangular laminæ, and it is not until the third year that they become hollowed out and coneshaped; about the fourth year they fuse with the labyrinths of the ethmoid, and between the ninth and twelfth years they unite with the sphenoid. 21 Postsphenoid.—The first ossific nuclei are those for the great wings (ali-sphenoids) 33. One makes its appearance in each wing between the foramen rotundum and foramen ovale about the eighth week. The orbital plate and that part of the sphenoid which is found in the temporal fossa, as well as the lateral pterygoid plate, are ossified in membrane (Fawcett) 34. Soon after, the centers for the postsphenoid part of the body appear, one on either side of the sella turcica, and become blended together about the middle of fetal life. Each medial pterygoid plate (with the exception of its hamulus) is ossified in membrane, and its center probably appears about the ninth or tenth week; the hamulus becomes chondrified during the third month, and almost at once undergoes ossification (Fawcett). 35 The medial joins the lateral pterygoid plate about the sixth month. About the fourth month a center appears for each lingula and speedily joins the rest of the bone. 22 The presphenoid is united to the postsphenoid about the eighth month, and at birth the bone is in three pieces (Fig. 148): a central, consisting of the body and small wings, and two lateral, each comprising a great wing and pterygoid process. In the first year after birth the great wings and body unite, and the small wings extend inward above the anterior part of the body, and, meeting with each other in the middle line, form an elevated smooth surface, termed the jugum sphenoidale. By the twenty-fifth year the sphenoid and occipital are completely fused. Between the pre- and postsphenoid there are occasionally seen the remains of a canal, the canalis cranio-pharyngeus, through which, in early fetal life, the hypophyseal diverticulum of the buccal ectoderm is transmitted. 23 The sphenoidal sinuses are present as minute cavities at the time of birth (Onodi), but do not attain their full size until after puberty. 24 Intrinsic Ligaments of the Sphenoid.—The more important of these are: the pterygospinous, stretching between the spina angularis and the lateral pterygoid plate (see cervical fascia); the interclinoid, a fibrous process joining the anterior to the posterior clinoid process; and the caroticoclinoid, connecting the anterior to the middle clinoid process. These ligaments occasionally ossify. 25 Articulations.—The sphenoid articulates with twelve bones: four single, the vomer, ethmoid, frontal, and occipital; and four paired, the parietal, temporal, zygomatic, and palatine. 36 26

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