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Fetal skull
This document describes the fetal skull, its parts, bones, sutures, fontanelles, and diameters. It begins by introducing the fetal skull and its adaptation for birth. The objectives are to describe the regions, bones of the vault, sutures, fontanelles, and diameters of the fetal skull. It then proceeds to describe each of these parts in detail, including labeling diagrams. Key points are that the fetal skull has movable bones, sutures, and fontanelles that allow for molding during birth. The various diameters and circumference are also described as they relate to assessing labor progress and fetal position.
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Fetal skull
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- 2. + INTRODUCTION The fetalhead 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. + OBJECTIVE Describe theregions 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
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- 5. + Comparison ofa 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. + WHAT IS FETALSKULL ? The skull bones encase and protect the brain The fetal skull has 3 major parts and - Vault of cranium ( Roof ) - Face - Base ( Cranium )
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- 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. + FACE Is composed of14 small bones that are also firmly united and non-compressible
- 10. + THE BONES OFTHE VAULT 2 frontal bone 2 parietal bone 1 occipital bone 2 temporal bone
- 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. + 2 PARIETAL BONE Whichlie 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. + 1 OCCIPITAL Whichforms 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. + 2 TEMPORAL BONE On both side of head Forms part of the Vault ( Not significant in obstetrics )
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- 16. + SUTURES Are spacesbetween 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. + Frontal suture Anterior fontanelle Coronalsuture Sagittal suture VIEW FROM TOP OF THE HEAD Lambdoidal suturePosterior fontanelle Coronal suture
- 18. + SUTURES Frontal suture Located betweenthe 2 frontal bones Coronal suture Located between the frontal and parietal bones
- 19. + SUTURES Lamdoidal suture Located betweenthe 2 parietal bones and the occipital bone Sagittal suture Located between the parietal bones divides the skull into left and right halves
- 20. + FONTANELLE A fontanelleis 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. + ANTERIOR FRONTANELLE (BREGMA) POSTERIOR FRONTANELLE (LAMBDA) Large diamond shapeSmall 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
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- 24. + REGION FETAL SKULL Dividedinto 4 region : 1.Occiput region 2.Vertex region 3.Forehead or sinciput region 4.Face
- 25. + REGIONS OF FETALSKULL VERTEX Bounded by postetior fontanelle, the two parietal bones eminences and the anterior fontanelle
- 26. + SINCIPUT Extends fromthe 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 )
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- 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. + Sub-occipitofrontal (SOF) Diameter10cm Measured from below the occipital protuberance to the centre of the frontal suture Attitude : Incomplete felxion Presentation : Vertex
- 31. + Diameter 11.5cm Measured from the occipital protuberance to the root of the nose Attitude : Head extend Presentation : The occipitofrontal (OF)
- 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. + 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. + 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
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- 36. +TRANVERSE DIAMETERS OF FETALSKULL Biparietal diameter Diameter : 9.5cm Is between the two parietal eminence
- 37. + Subparietal diameter Diameter: 9cm Above the parietal eminence to below the opposite eminence
- 38. + Bi-temporal diameter Diameter: 8.2cm The diameter between the two furthest points of the coronal suture at the temples
- 39. + Bi-mastoid diameter Diameter: 7.5cm Between the tips of the mastoid processes
- 40. + CIRCUMFERENCE/ THE PRESENTING AREA Attitudeof the head Circumference Shape of circumference Well flexed 29cm Round Deflexed 34.5 Oval Partial extension 38 Round
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- 43. + CONCLUSION It isimportant 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 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