Where it is
Top of the vertebral column. The cranium encloses the brain; the facial skeleton forms the orbits, nasal cavity and jaws.
What it does
Protects the brain and special sense organs, anchors the muscles of chewing and facial expression, and forms the openings for the airway and digestive tract. Cranial bones are joined by immovable sutures.
Clinical relevance
- In infants the sutures are not fused: the anterior fontanel closes by 12–18 months and the posterior fontanel by about 2 months.
- A bulging fontanel suggests raised intracranial pressure; a sunken fontanel suggests dehydration.
- Basilar skull fractures can cause raccoon eyes, Battle's sign (bruising behind the ear) and clear fluid from the nose or ear (CSF leak).
Nursing focus
- Never insert a nasogastric tube or nasal suction in a suspected basilar skull fracture.
- Test clear drainage from the nose or ear for glucose or a halo sign; report it immediately.