Fetal Skull

AREAS OF SKULL
Vertex : It is a quadrangular area bounded anteriorly by the bregma and

coronal sutures behind by the lambda and lambdoid sutures and laterally
by lines passing through the parietal eminences.
• Brow : It is an area bounded on one side by the anterior fontanel and
coronal sutures and on the other side by the root of the nose and
supraorbital ridges of either side.
• Face : It is an area bounded on one side by root of the nose and supraorbital ridges and on the other, by the
junction of the floor of the mouth with neck.
• Sinciput is the area lying in front of the anterior fontanel and corresponds to the area of brow and the occiput
is limited to the occipital bone.

Bones of fetal skull
• Frontal bone
• Forms the forehead
• In the fetus frontal bone is in two halves, which fuse in to a single
bone after the age of 8 years
Two parietal bones
• Lie on either side of the skull and occupy most of the skull
Occipital bone
• Forms the back of the skull and part of its base
• It joins with the cervical vertebrae
Two temporal bones
• One on each side of the head, closest to the ear.

SUTURES:
• The sagittal or longitudinal suture lies between two parietal bones.
• The coronal sutures run between parietal and frontal bones on either side.
• The frontal suture lies between two frontal bones.
• The lambdoid sutures separate the occipital bone and the two parietal bones
Importance:
(1) It permits gliding movement of one bone over the other during molding of
the head, a phenomenon of significance while the head passes through the
pelvis during labor.
(2) Digital palpation of sagittal suture during internal examination in labor
gives an idea of the manner of engagement of the head, degree of internal
rotation of the head and degree of molding of the head.
FONTANELS:
Wide gap in the suture line is called fontanel.
Of the many fontanels (6 in number), two are of obstetric significance:
(1)Anterior fontanel or bregma
(2)Posterior fontanel or lambda.
Anterior fontanel
Also known as bregma
It is formed by joining of the four sutures in the midplane.
The sutures are anteriorly frontal, posteriorly sagittal
and on either side, coronal.
The shape is like a diamond.
Its anteroposterior and transverse diameters
measure approximately 3 cm each.
The floor is formed by a membrane and it becomes ossified 18 months after birth.
It becomes pathological, if it fails to ossify even after 24 months.

Importance:
• Its palpation through internal examination denotes the degree of flexion of

the head.
• It facilitates molding of the head.
• As it remains membranous long after birth, it helps in accommodating the

marked brain growth; the brain becoming almost double its size during the
first year of life.
• Palpation of the floor reflects intracranial status—depressed in dehydration,
elevated in raised intracranial tension.
• Collection of blood and exchange transfusion, on rare occasion, can be
performed through it via the superior longitudinal sinus.
• Cerebrospinal fluid can be drawn, although rarely, through the angle of the
anterior fontanel from the lateral ventricle.

Posterior fontanel:
Also known as lamda
• It is formed by junction of three suture lines — sagittal suture anteriorly and

lambdoid suture on either side.
• It is triangular in shape and measures about 1.2 × 1.2 cm (1/2" × 1/2").
• Its floor is membranous but becomes bony at term.
• It denotes the position of the head in relation to maternal pelvis.

MOLDING:
It is the alteration of the shape of the fore-coming head while passing through the resistant
birth passage during labor. During normal delivery, an alteration of 4 mm in skull diameter
commonly occurs.
• Molding disappears within few hours after birth.
• Grading: There are three gradings.
• Grade-1—the bones touching but not overlapping,
• Grade-2— overlapping but easily separated and
• Grade-3—fixed overlapping.
Importance:
• Slight molding is inevitable and beneficial. It enables the head to pass more
easily, through the birth canal.
• Extreme molding as met in disproportion may produce severe intracranial

disturbance in the form of tearing of tentorium cerebelli or subdural
hemorrhage.
• Shape of the molding can be a useful information about the position of the
head occupied in the pelvis.

Fetal Skull

Uploaded by

Copyright:

Available Formats

Fetal Skull

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Fetal Skull

Uploaded by

Copyright:

Available Formats

AREAS OF SKULL

Vertex : It is a quadrangular area bounded anteriorly by the bregma and

junction of the floor of the mouth with neck.

is limited to the occipital bone.

• Forms the back of the skull and part of its base

• It joins with the cervical vertebrae

Two temporal bones

• One on each side of the head, closest to the ear.

• The sagittal or longitudinal suture lies between two parietal bones.

• The frontal suture lies between two frontal bones.

Also known as bregma

It is formed by joining of the four sutures in the midplane.

The sutures are anteriorly frontal, posteriorly sagittal

and on either side, coronal.

The shape is like a diamond.

Its anteroposterior and transverse diameters

measure approximately 3 cm each.

It becomes pathological, if it fails to ossify even after 24 months.

• Its palpation through internal examination denotes the degree of flexion of

• It facilitates molding of the head.

• As it remains membranous long after birth, it helps in accommodating the

elevated in raised intracranial tension.

• Collection of blood and exchange transfusion, on rare occasion, can be

performed through it via the superior longitudinal sinus.

anterior fontanel from the lateral ventricle.

Also known as lamda

• It is formed by junction of three suture lines — sagittal suture anteriorly and

• It is triangular in shape and measures about 1.2 × 1.2 cm (1/2" × 1/2").

• Its floor is membranous but becomes bony at term.

• It denotes the position of the head in relation to maternal pelvis.

• Grading: There are three gradings.

• Grade-1—the bones touching but not overlapping,

• Grade-2— overlapping but easily separated and

• Extreme molding as met in disproportion may produce severe intracranial

You might also like