Fig. 2. Cranio-cerebral Topography. 1, 1, Reid’s base-line; 2, 2, A line parallel to the above at the level of the supra-orbital margin; 3, The middle meningeal artery; 4, The anterior branch; 5, 5, 5, The three sites for trephining; 6, The posterior branch; 7, The site for trephining; 8, The point for trephining to reach the descending horn of the lateral ventricle; 9, The lateral sinus; 10, The inion; 11, The mastoid process; 12, Macewen’s suprameatal triangle; 12a, The mastoid antrum; 12b, The facial nerve; 13, The suprameatal and supramastoid crests; 14, 14, The temporal crest; 15, The temporal fossa; 16, The external angular frontal process; 17, The tendo-oculi attachment; 18, The lachrymal groove. (Reproduced, by the permission of Mr. H. K. Lewis, from the author’s work on ‘Landmarks and Surface-markings’.)
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The infratentorial region.
The cerebellum lies wholly beneath the tentorium cerebelli, and it is obvious that, in operations carried out over this portion of the brain, the surgeon is limited in his field of exposure, above by the line of the lateral sinus, and on either side by the posterior border of the mastoid process. The division between the halves of the cerebellum may be represented by a line drawn vertically downwards from the external occipital protuberance to the nuchal region. This line also represents the surface-marking of the occipital sinus and falx cerebelli.
The supratentorial region.
Brief allusion must be made to certain landmarks that aid in the representation of structures situated in this region:—
(a) The external angular frontal process.
The suture between the external angular frontal process and the corresponding process of the malar bone lies immediately above the central point of the outer border of the orbital cavity.