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FETAL SKULL
+
INTRODUCTION
 The fetal head is large in relation to the fetal
body compared with the adult
 Adaptation between the sk...
+
OBJECTIVE
 Describe the regions of fetal skull
 Describe the bones that make up the vault
of the fetal skull
 Describ...
+
SKULL
FETAL SKULL ADULT SKULL
+
 Comparison of a baby’s proportions to those of
an adult
 The baby’s head is wider than the shoulders and
one-quarter ...
+
WHAT IS FETAL SKULL ?
 The skull bones encase and protect the
brain
 The fetal skull has 3 major parts and
- Vault of ...
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FETAL SKULL
VAULT
FACE
BASE
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VAULT
Is the large , dome shaped part above an
imaginary line drawn between the orbital
ridges and the nape of the neck
...
+
FACE
Is composed of 14 small bones that are also
firmly united and non-compressible
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THE BONES OF THE VAULT
 2 frontal bone
 2 parietal bone
 1 occipital bone
 2 temporal bone
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2 FRONTAL BONE
 Forms the forehead or sinciput
 The ossification centre of each bone is the
frontal eminence
 The fro...
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2 PARIETAL BONE

Which lie on either side of the skull and
occupy most of the skull
 The ossification centre of each o...
+
1 OCCIPITAL
 Which forms the back of the skull and part of
its base
 Part of it contributes to the base of the skull
a...
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2 TEMPORAL BONE
 On both side of head
 Forms part of the Vault
 ( Not significant in obstetrics )
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SUTURES
 Are spaces between the bones of the skull
 Two or more sutures meet, a fontanelle
 These sutures and fontane...
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Frontal suture
Anterior fontanelle
Coronal suture
Sagittal suture
VIEW FROM TOP OF THE HEAD
Lambdoidal suturePosterior f...
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SUTURES
Frontal suture
Located between the 2 frontal bones
Coronal suture
Located between the frontal and parietal
bones
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SUTURES
Lamdoidal suture
Located between the 2 parietal bones and the
occipital bone
Sagittal suture
Located between the...
+
FONTANELLE
 A fontanelle is a space created by joining of
two or more suture
 6 in number, 2 are of obstetric signific...
+
ANTERIOR
FRONTANELLE
(BREGMA)
POSTERIOR
FRONTANELLE
(LAMBDA)
Large diamond shape Small triangular
shaped
Situated at jun...
+
Posterior fontanelle
Anterior fontanelle
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REGION FETAL SKULL
+
REGION FETAL SKULL
Divided into 4 region :
1.Occiput region
2.Vertex region
3.Forehead or sinciput region
4.Face
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REGIONS OF FETAL SKULL
VERTEX
 Bounded by postetior fontanelle, the two
parietal bones eminences and the anterior
fonta...
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SINCIPUT
 Extends from the anterior fontanelle and the
coronal suture to the orbital ridges
OCCIPUT
 Lies between the ...
+
+
+ANTERIOR POSTERIOR/
LONGITUDINAL
Sub-occipitobregmatic (SOB)
 Diameter ( 9.5 cm)
 Measure from below the occipital
prot...
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Sub-occipitofrontal (SOF)
 Diameter 10cm
 Measured from below the occipital
protuberance to the centre of the frontal
...
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 Diameter 11.5cm
 Measured from the occipital protuberance to
the root of the nose
 Attitude : Head extend
 Presenta...
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 Diameter 13.5
 Measured from the point of the chin to the
highest point on the vertex
 Attitude : Head
 Presentatio...
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The sub-mentovertical (SMV)
 Diameter 11.5cm
 Measured from the point where the chin
joins the neck to the highest poi...
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The sub-mentobregmatic (SMB)
 Diameter 9.5cm
 Measured from the point where the chin
joins the neck to the centre of t...
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Bi-parietal
diameter
9.5CM
Bi-temporal
Diameter
8.2cm
+TRANVERSE DIAMETERS OF
FETAL SKULL
Biparietal diameter
 Diameter : 9.5cm
 Is between the two parietal eminence
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Subparietal diameter
 Diameter : 9cm
 Above the parietal eminence to below the
opposite eminence
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Bi-temporal diameter
 Diameter : 8.2cm
 The diameter between the two furthest
points of the coronal suture at the temp...
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Bi-mastoid diameter
 Diameter : 7.5cm
 Between the tips of the mastoid processes
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CIRCUMFERENCE/
THE PRESENTING AREA
Attitude of the
head
Circumference Shape of
circumference
Well flexed 29cm Round
Defl...
+
+
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CONCLUSION
 It is important for midwife to learn about the
fetal skull by knowing the landmarks will
enable them to est...
+ 44
Marshall J.,& Raynor M. (2014) Myles Textbook For
Midwives. (16th
ed.). London : Elsevier.
Verrals S. (2015) Anatomy ...
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Fetal skull

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Fetal skull

  1. 1. + FETAL SKULL
  2. 2. + INTRODUCTION  The fetal head is large in relation to the fetal body compared with the adult  Adaptation between the skull and the pelvis is necessary to allow the head to pass through the pelvis during labour without complications
  3. 3. + OBJECTIVE  Describe the regions of fetal skull  Describe the bones that make up the vault of the fetal skull  Describe the sutures and fontanelles  Describe the various diameters of the fetal skull and their significance
  4. 4. + SKULL FETAL SKULL ADULT SKULL
  5. 5. +  Comparison of a baby’s proportions to those of an adult  The baby’s head is wider than the shoulders and one-quarter of the total length
  6. 6. + WHAT IS FETAL SKULL ?  The skull bones encase and protect the brain  The fetal skull has 3 major parts and - Vault of cranium ( Roof ) - Face - Base ( Cranium )
  7. 7. + FETAL SKULL VAULT FACE BASE
  8. 8. + VAULT Is the large , dome shaped part above an imaginary line drawn between the orbital ridges and the nape of the neck BASE The base comprises bones that are firmly united to protect the vital centres in the medulla oblongata
  9. 9. + FACE Is composed of 14 small bones that are also firmly united and non-compressible
  10. 10. + THE BONES OF THE VAULT  2 frontal bone  2 parietal bone  1 occipital bone  2 temporal bone
  11. 11. + 2 FRONTAL BONE  Forms the forehead or sinciput  The ossification centre of each bone is the frontal eminence  The frontal bones fuse into a single bone by age 8 years of age.
  12. 12. + 2 PARIETAL BONE  Which lie on either side of the skull and occupy most of the skull  The ossification centre of each of these bones is called the parietal eminence
  13. 13. + 1 OCCIPITAL  Which forms the back of the skull and part of its base  Part of it contributes to the base of the skull as it contains the foramen magnum, which protects the spinal cord as it leaves the skull.  The ossification centre is the occipital protuberance
  14. 14. + 2 TEMPORAL BONE  On both side of head  Forms part of the Vault  ( Not significant in obstetrics )
  15. 15. +
  16. 16. + SUTURES  Are spaces between the bones of the skull  Two or more sutures meet, a fontanelle  These sutures and fontanelle allow for molding of the fetal head during labour
  17. 17. + Frontal suture Anterior fontanelle Coronal suture Sagittal suture VIEW FROM TOP OF THE HEAD Lambdoidal suturePosterior fontanelle Coronal suture
  18. 18. + SUTURES Frontal suture Located between the 2 frontal bones Coronal suture Located between the frontal and parietal bones
  19. 19. + SUTURES Lamdoidal suture Located between the 2 parietal bones and the occipital bone Sagittal suture Located between the parietal bones divides the skull into left and right halves
  20. 20. + FONTANELLE  A fontanelle is a space created by joining of two or more suture  6 in number, 2 are of obstetric significance 1. Anterior fontanelle 2. Posterior fontanelle
  21. 21. + ANTERIOR FRONTANELLE (BREGMA) POSTERIOR FRONTANELLE (LAMBDA) Large diamond shape Small triangular shaped Situated at junction of the sagittal , coronal and frontal sutures Situated at the junction of lambdoidal sutures Closed at 18 months Closed at 6 -12 weeks Soft membrane floor Bony floor
  22. 22. + Posterior fontanelle Anterior fontanelle
  23. 23. + REGION FETAL SKULL
  24. 24. + REGION FETAL SKULL Divided into 4 region : 1.Occiput region 2.Vertex region 3.Forehead or sinciput region 4.Face
  25. 25. + REGIONS OF FETAL SKULL VERTEX  Bounded by postetior fontanelle, the two parietal bones eminences and the anterior fontanelle
  26. 26. + SINCIPUT  Extends from the anterior fontanelle and the coronal suture to the orbital ridges OCCIPUT  Lies between the foramen magnum and the posterior fontanelle . The parts below the occipital protuberance (landmark) is known as the sub-occipital region FACE  Extends from the upper ridge of the eye to the nose and mentum ( lower jaw )
  27. 27. +
  28. 28. +
  29. 29. +ANTERIOR POSTERIOR/ LONGITUDINAL Sub-occipitobregmatic (SOB)  Diameter ( 9.5 cm)  Measure from below the occipital protuberance to the centre of the anterior fontanelle or bregma  Attitude : Head is complete flexion  Presentation : Vertex
  30. 30. + Sub-occipitofrontal (SOF)  Diameter 10cm  Measured from below the occipital protuberance to the centre of the frontal suture  Attitude : Incomplete felxion Presentation : Vertex
  31. 31. +  Diameter 11.5cm  Measured from the occipital protuberance to the root of the nose  Attitude : Head extend  Presentation : The occipitofrontal (OF)
  32. 32. +  Diameter 13.5  Measured from the point of the chin to the highest point on the vertex  Attitude : Head  Presentation : Brow The mentovertical (MV)
  33. 33. + The sub-mentovertical (SMV)  Diameter 11.5cm  Measured from the point where the chin joins the neck to the highest point on the vertex  Attitude : Head incompletely extend  Presentation : Face
  34. 34. + The sub-mentobregmatic (SMB)  Diameter 9.5cm  Measured from the point where the chin joins the neck to the centre of the bregma (anterior fontanelle)  Attitude : Head complete extend  Presentation : Face
  35. 35. + Bi-parietal diameter 9.5CM Bi-temporal Diameter 8.2cm
  36. 36. +TRANVERSE DIAMETERS OF FETAL SKULL Biparietal diameter  Diameter : 9.5cm  Is between the two parietal eminence
  37. 37. + Subparietal diameter  Diameter : 9cm  Above the parietal eminence to below the opposite eminence
  38. 38. + Bi-temporal diameter  Diameter : 8.2cm  The diameter between the two furthest points of the coronal suture at the temples
  39. 39. + Bi-mastoid diameter  Diameter : 7.5cm  Between the tips of the mastoid processes
  40. 40. + CIRCUMFERENCE/ THE PRESENTING AREA Attitude of the head Circumference Shape of circumference Well flexed 29cm Round Deflexed 34.5 Oval Partial extension 38 Round
  41. 41. +
  42. 42. +
  43. 43. + CONCLUSION  It is important for midwife to learn about the fetal skull by knowing the landmarks will enable them to estimate the progress of labour.  Midwife also can evaluates the presentation and progression of the fetal skull through these structures.
  44. 44. + 44 Marshall J.,& Raynor M. (2014) Myles Textbook For Midwives. (16th ed.). London : Elsevier. Verrals S. (2015) Anatomy And Physiology Applied To Obstetrics. (3rd ed.). Singapore : Elsevier. Winson N. V., & Mcdonald S. (2014) Illustrated Dictionary Of Midwifery. Edinburgh : Elsevier. REFERENCES

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