Rad Anat PGC CT COURSE Abuja

PGC- CT COURSE
ABUJA-2024
SECTIONAL ANATOMY OF THE

HEAD AND NECK
by
Mohammed ABBA,
B. Rad (UNIMAID), MSc. (BUK), PhD (UNIZIK)
Senior Lecturer, Department of Medical Radiography,
Bayero University Kano
Chief. Radiographer (Honourary), Department of
Radiology, Aminu Kano TeachiNg Hospital Kano
6th May, 2024

OUTLINE
• Head
• Bones of the skull and cranium
• Sections of the Brain
• Cortical & sub-cortical structures (at
various levels e.g Basal Ganglia)
• Intra-cerebral Cavities
• Ventricular System and Cisterns
• Cranial Nerves*
• Orbital and auditory Canal 2
HEAD & NECK -SKELETON
• Forms the top part of the skeletal section of the axial skeleton and
continues with the vertebral column joining at C1.
• Is made of:
• Skull,
• Hyoid Bone
• Auditory Ossicles
• Cervical Spine
• Skull is further subdivided into
• Cranial bones (8 bones: 1 frontal, 2 parietal, 1 Occipital, 2 temporal, 1 sphenoid, 1
• ethmoid))
• Facial Bones (14: 2 zygomatic, 2 maxillary, 2 palatine, 2 nasal, 2 lacrimal, 2 inferior
conchae, 1 vomer, 1 mandible)
3
4
5
Cerebral Hemispheres
• Cortical greymatter
• White matter- Projection,Association&
Commissuralfibers
• Basalganglia
• Thalamus
• Hypothalamus
• Pituitary gland
• Limbic lobe- Cingulate, hippocampus, splenial &
parahippocampal gyri,fornix*
Basalganglia
Subcortical grey matter

Internal Capsule
Corpus Calosum
Large midline mass of commissural fibers which

connects corresponding areas of both hemispheres
(10cm long & progressively thicker towards
posteriorly)
4 parts of corpuscallosum
Ventricular System
LateralVentricles
Cerebellum
Cisterns
• LargeCSFfilled Subarachnoidspacesat certain
placeswithinthecranialcavity
• Actsasthe cushion around the medullaand
other brainstructures
• Havethe density of CSF
Suprasellar Cistern
• Suprasellar cistern comprises interpeduncular
cistern posteriorly, crural and ambient cistern
posterolaterally, sylvian cistern anterolaterally and
chiasmatic cisternanteriorly
• It looks like aStarof DavidorPentagon.The

corners of the pentagon are made of
interhemispheric fissure anteriorly, sylvian
fissure anterolaterally, ambient cisterns
postlaterally
SectionalAnatomy
REVIEW- BASIC CONCEPTS
HOUNSFIELD UNIT
25
HOUNSFIELD UNIT
CT-IMAGE ORIENTATION
27
REFERENCE LANDMARK: TENTORIUM
28
INFRA-
TENTORIAL
CUTS/ BRAIN
SUPRA-
TENTORIAL
CUTS/ BRAIN
Axial sections
• Infratentorial Cuts: • SupratentorialCuts:

Below the fourth ventricle Third Ventricular Level
Level of the fourthventricle
Low Ventricular Level
Above the fourthventricle
Mid-ventricular Level
Above theVentricles
Posterior Fossa
• Outlined by Clivus, Petrousbone andoccipital
bone. Superiorly-Tentoriumcerebelli
• Divided by 4th ventricle into anterior &
posterior compartments:
Ant (1/3rd) Brainstem
Post (2/3rd)Cerebellum
LEVEL OF POST. FOSSA
Below the Fourth ventricle level
• Medulla
• Cerebellartonsils
• Cerebellarhemispheres
• Cisterna magna
• Vertebral arteries
• Baseof the skull structures (foramina ifwide
window setting)
• Orbital contents
34
Fourth Ventricular Level
• 4th Ventricle with choroidplexus (maj.landmark)

• Lowerpons
• BasilarArtery
• Middle cerebellarpeduncles
• PrepontineCistern
• CPAcistern
• CisternaMagna
• Orbit(eyeball+ lens)
• ±TrigeminalN.
INFRATENTORIAL ANAT. @ LEVEL
OF 4th VENTRICLE
36
Above the Fourth Ventricle Level
• Midline vermis
• Mesencephalon
• Temporallobes
• Sylvianfissure
• Frontal lobe
• Suprasellar cistern containing ICA, infundibulum,
optic chiasma, mammillary bodies, top of basilar
artery
@ the Tentorial Hiatus
39
• Amegdala
• Hippocampus
• Sup. Vermis
• Quadrigeminal Cistern
Cnt’d @ Level of tentorial hiatus
• Interpendencular
Cistern
• Suprasellar Cistern
• Mammillary Bodies
• Cerebral Aqueduct
• Sup. Vermis
• Optic Tract
• Circle of Wills
SUPRATENTIAL CUTS;
above tentorial Hiatus: BASAL GANGLIA
Landmarks:
• 3rd Ventricle (midline)
• Frontal horn of lateral Ventricle
• Occipital horn of lateral Ventricle
Third Ventricular level
• Third ventricle- in themidline
• Inferior parts of frontallobes
• Sylvianfissure
• Insular cortex
• Internal capsule
• Externalcapsule
• Putamen andglobus pallidus
Phy
sio
calc
ifica
tion
s
Mid-High ventricular level
• Superior extension of Sylvianfissure

• Most superior portion of frontalhorns
• Corpuscallosum
• Caudatenucleus
• Occipital horns
Above the Ventricular level
• Frontal and parietal lobes
• Small portion of occipitallobe
• Central sulcusin mid portion of scan–deeper
sulcus
• Preand post central gyri
• Interhemispheric fissure withfalx
CTA
Thank You
MOHAMMED ABBA
SECTIONAL ANATOMY OF NECK
OUTLINE
• Neck
• Vertebra
• Cervical Compartments
• Cervical Spaces
• Structures of the neck
• Vascular Supply
CERVICAL VERTEBRA
• 7 in no.
• Smallest distinguished by the presence
of T. foramina
• C1 and C2 specialized
• Great amount of movement (flexion &
extension; rotation)
• C3-C7 classical C. vertebra (body,
pedicles, laminae, spinous process &
facet joints)
• C7 (typical/atypical) (2 reasons)
CT OF CERVICAL VERTEBRA
Contents of the Neck
Cervical Compartment
• Has complex anatomy with numerous muscular structures
associated with each other.
• Advent of cross sectional imaging helped in dividing it into

fascial compartment with distinct anatomic structures.
• Fascial compartments gives rise to potential spaces.
• Significance of compartmentalization is:

• Lesion (masses) localization
• Differential Diagnosis
• Pattern of spread of disease
• Guided biopsy/FNAC
Cervical Compartment- fascial layers
• Compartments oriented in a
vertical direction
• The 4 “V”s
• 1 Visceral Compartment
• Thyroid gland, trachea,
oesophagus
• 2 Vascular Compartments
• CCA +ICA, IJV, CN-X, deep
cervical lymph nodes
• 1 Vertebral Compartment
• Muscles, spinal cord
Cervical Compartment- fascial layers
• Superficial fasciae
• Courses anterior
neck like a collar
• Encloses platysma
M., Sup. Lymph
nodes (LN), Subcut.
vessels & fat
Deep fascial layers
• Deep fascia has 3 layers
• Superficial/investing layer
• SCM & trapezius muscle
• Middle/Visceral/Pre-tracheal layer
• Encloses structures in the visceral compartment
• Carotid sheath
• Deep/ prevertebral layer

• Vertebra, spinal cord & associated vertebral muscles
Deep Superficial fascial layers
Encloses:
• Sternocleidomastoid
muscle.
• Trapezius muscle
• Asso. spaces
Deep pre-tracheal layer
Encloses:
• Thyroid glands x2
• Trachea
• Oesophagus
• Asso. spaces
Deep prevertebral layer
Encloses:
• C. Vertebra
• Spinal Cord
• Asso. Vertebral Muscles
• Asso. spaces
NECK SPACES
• Between fascial layers in the neck are spaces that may
provide a conduit for spread of infection from the neck to the
mediastinum
• Their knowledge is essential for
• Lesion localization
• Pattern of spread
• Differential Diagnosis
• Guided biopsy/FNAC
TRIANGLES OF THE NECK
SPACES WITHIN THE ANTERIOR NECK
TRIANGLE
MOST IMPORTANT
• Peritonsillar space
• Parapharyngeal space
• Retropaharyngeal space
• Danger space
• Prevertebral space
• Submandibular space
• Sublingual space
• Masticator space
PERITONSILLAR SPACE
Bounded
• Ant= tonsillar pillar anteriorly
• Post= tonsillar pillar post
• Med= palatine tonsil capsule
• Lat= Sup. Pharyngeal constrictor
• Comprises loose areola connective

tissue
• Communicates with the
parapharyngeal space
PARAPHARYNGEAL SPACE
Bounded:
• Sup =base of skull
• Inf= Hyoid Bone
• Lat= parotid gland
Contains:
• Fat & LN
• Muscles
• Deep lobe of parotid gland
• ICA, IJV, CN IX-XII
Communicates with the Submandibular,

peritonsillar, retropharyngeal & sublingual
spaces
RETROPHARYNGEAL SPACE
Lies post to the pharynx

Bounded
Ant= middle cervical fascia
Post =Alar div of deep cervical fascia
Lat= carotid sheath
Sup=skull base
Inf= mediastinum
Contains: maj. Loose areola connective tissue, LN,

*route of infection skull base + mediastinum
DANGER
SPACE
Lies post to the retropharyngeal
space
Extends from the skull base to
the mediastinum (just above
mediastinum)
Bounded
• Post= prevertebral fascia
• Lat= T. process of vertebra
infection (bacterial+ viral)

spreads to thorax very quick
SUB-MANDIBULAR
SPACE
Bounded:
Ant.= ant. Belly of digastric muscle
Post= post. Belly of digastric muscle
Med+Sup= mylohoid muscle
Lat.=platysma M
Inf.=hyoid bone
Contains:
Submandibular gland, LN, hypoglossal N.,
fascial vessels
Communicates with parapharyngeal

+sublingual spaces
SUBLINGUAL
SPACE
Bounded
Sup= floor of the mouth
Inf= mylohyoid M
Ant+lat.= mandible
Post=hyoid bone
Med.= extrinsic M of the tongue
Communicates with the

submandibular +parapharyngeal
spaces
MASTICATOR
SPACE
Bounded:
Med= fascia medial to pterygoid M
Lat=Mandibular Ramus
Sup=Base of skull
Inf=lower border of mandible
Ant=pterygomandibulat raphe
Post=parotid gland
Divided by the sup. Deep fascia into masseteric

& pterygoid spaces
Contains muscles of mastication, ramus + post
part of mandible, inf. Alveolar N, ECA
Communicates with parapharyngeal,

submandibular & sublingual spaces
ARTERIAL SUPPLY
• Subclavian A,
• Branch of brachiocephalic A. on the right side while
• left side a direct branch from aorta
SECTIONAL ANATOMY THE THORAX
AND SPINE
Sections are arranged to match the CT sections (as if looking at the top )
Sections were selected from the Visible Human Projectwww.nlm.nih.gov/research/visible/visible_human.html

Sections are arranged to match the CT sections (as if looking at the top )
Sections were selected from the Visible Human
Projectwww.nlm.nih.gov/research/visible/visible_human.html
Contents
• Thorax
▪ Cross-sectional anatomy of the thorax
▪ Thoracic cavity
▪ Contents of the thoracic cavity
• Spine
▪ Vertebrae
▪ Intervertebral disc
▪ Spinal cord
Skeletal Anatomy of the Thorax
• Ribs
• Typical rib has a head, neck,
tubercle and shaft.
• Sternum
• Manibrum, body and
xiphoid process of the
sternum.
• Vertebrae
• 12 in number
Thoracic cavity
• Made up of;
-The thoracic skeleton
-Intercostal muscles
-Pleural lining
-The diaphragm
Contents of thoracic cavity
• Lungs
• Mediastinum
Thymus, air way, oesophagus.
aortic arch and it branches
SVC and its tributaries
The heart
LUNGS
T2
T2/T3
T3/T4
T3/T4
T4/T5
T4/T5
T5/T6
T5
T8
T8/T9
Lungs
Oesophagus and Airway
• 4 chambered structure
• Supplied by coronary arteries.
Vertebral column
• There are 33 vertebrae
7 cervical
12 thoracic
5 lumbar
5 sacral (fused)
4 coccygeal (fused)
• Spinal cord extend from
medullar to conus
medullaris
Typical vertebrae
• Vertebral body anteriorly
• Neural arch posteriorly
• Adjacent vertebral body form
neural exit.
Disc element
• Consist of annulus fibroses and nucleus polposus.
Terminal cord and internal structure of the
cord
CT ANATOMY OF THE ABDOMEN
CT ANATOMY OF THE ABDOMEN
OUTLINE
• Sound Knowledge of the abdomen
• Region & Quadrant
• Visceral distribution
• Vascular Course
• Landmarks
HIGHESTTOMOGRAPHICSECTIONOF
ABDOMEN-T8
T9
T10
T12
T12/L1 L2
L2
L3
L4
L4/L5
L5
L5/S1 S2
Reconstructed
CoronalImages
Reconstructed
CoronalImages
Reconstructed
CoronalImages
Reconstructed
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PGC- CT COURSE

SECTIONAL ANATOMY OF THE

6th May, 2024

Subcortical grey matter

Large midline mass of commissural fibers which

• It looks like aStarof DavidorPentagon.The

• Infratentorial Cuts: • SupratentorialCuts:

• 4th Ventricle with choroidplexus (maj.landmark)

• Superior extension of Sylvianfissure

• Advent of cross sectional imaging helped in dividing it into

• Significance of compartmentalization is:

• Deep/ prevertebral layer

• Comprises loose areola connective

Communicates with the Submandibular,

Lies post to the pharynx

Contains: maj. Loose areola connective tissue, LN,

infection (bacterial+ viral)

Communicates with parapharyngeal

Communicates with the

Divided by the sup. Deep fascia into masseteric

Communicates with parapharyngeal,

Sections were selected from the Visible Human Projectwww.nlm.nih.gov/research/visible/visible_human.html

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