8. Infratemporal Fossa and Temporomandibular Joint Flashcards

1
Q

What does the temporal region contain?

A

temporal and infratemporal fossae

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2
Q

Where are the (1) temporal fossa and (2) infratemporal fossa found?

A
  1. superior to to zygomatic arch
  2. inferior to the zygomatic arch
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3
Q

bones of the infratemporal fossa

A
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4
Q

boundaries of the infratemporal fossa

A
  • lateral = ramus of mandible
  • anterior = maxilla
  • medial = lateral pterygoid plate
  • roof = sphenoid (greater wing)
  • posterior = tympanic plate & mastoid and styloid process
  • inferior = angle of mandible
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5
Q

contents of the infratemporal fossa

A
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6
Q

supplies external acoustic meatus, external tympanic membrane, and TMJ

A

deep auricular artery

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7
Q

supplies internal TM

A

anterior tympanic artery

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8
Q

enters madibular foramen and supplies mandible, mandibular teeth, chin, and mylohyoid m.

A

branches of inferior alveolar a.

[mylohyoid artery and mental artery]

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9
Q

enters cranium via foramen spinosum and supplies dura mater of lateral wlal, trigeminal ganglion, facial nerve, and geniculate ganglion, tympanic caity, and tensory tympani m.

A

middle meningeal artery

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10
Q

enters cranium via foramen ovale and supplies extracranial muscles of infratempora fossa, otic ganglion, and sphenoid bone

A

accessory meningeal artery

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11
Q

supplies temporalis m.

A

deep temporal artery

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12
Q

supplies pterygoid m.

A

pterygoid branches of maxillary artery

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13
Q

supplies TMJ and masseter muscle

A

masseteric artery

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14
Q

supplies bucca fat-pad, buccinator, and buccal oral mucosa

A

buccal artery

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15
Q

arteries from the mandibular part of the maxillary artery

A
  • deep auricular artery
  • anterior tympanic artery
  • inferior alveolar artery
  • middle meningeal artery
  • accessory meningeal artery
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16
Q

arteries from the pterygoid part of the maxillary artery

A
  • deep temporal artery
  • pterygoid branches
  • masseteric artery
  • buccal artery
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17
Q

What nerve does the buccal artery run with?

A

buccal nerve

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18
Q

branches of mandibular division of trigeminal nerve (V3)

A
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19
Q

branches of maxillary division of trigeminal n. (V2)

A
20
Q

Infratemporal fossa: relational anatomy

A
21
Q

Infratemporal fossa: relational neurology

A
22
Q

Fracture at the neck of the mandible can damage what structures?

A

V3 and otic ganglion

23
Q

Fracture at the ramus of the mandible can damage what structures?

A

inferior alveolar vessels/artery

24
Q

Fracture at the corpus can damage what structures?

A

inferior alveolar vessels/arteries

25
Q

variations in location of the maxillary artery in relation to other structures

A
  • in relation to lateral pterygoid m.
    • max a. can run lateral to muscle
    • max a. can run medial to muscle
  • in relation to nerves
    • medial to buccal nerve (but lateral to lingual n. & inferior alveolar n.)
    • medial to buccal and lingual n. (lateral to inferior alveolar n.)
    • medial to mandibular n. (V3)
26
Q

muscles of mastication & innervation

A
  • temporalis m.
  • masseter m.
  • lateral pterygoid m.
  • medial pterygoid m

[innervated by trigeminal n.]

27
Q

muscles of mastication involved in movement at what joint?

A

TMJ

28
Q

temporalis m. (superficial head)

A
  • origin: temporal fascia
  • insertion: cornoid process of mandible
  • innervation: deep temporal n. (CN V3)
  • action:
    • vertical fibers: elevate mandible
    • horizontal: retract mandle
    • unilateral: lateral movement of mandible
29
Q

temporalis m. (deep head)

A
  • origin: temporal fossa
  • insertion: cornoid process of mandible
  • innervation: deep temporal n. (CN V3)
  • action:
    • vertical fibers: elevate mandible
    • horizontal: retract mandle
    • unilateral: lateral movement of mandible
30
Q

lateral pterygoid (superior/upper head)

A
  • origin: greater wing of sphenoid bone
  • insertion: mandible
  • innervation: lateral pterygoid n.
  • action:
    • bilateral: protrudes mandible and opens mouth
    • unilateral: alternating actions, along with ipsilateral medial pterygoid; side-to-side movement necessary for grinding
31
Q

lateral pterygoid (inferior/lower head)

A
  • origin: lateral pterygoid plate
  • insertion: mandible
  • innervation: lateral pterygoid n.
  • action:
    • bilateral: protrudes mandible and opens mouth
    • unilateral: alternating actions, along with ipsilateral medial pterygoid; side-to-side movement necessary for grinding
32
Q

What opens the mandible?

A
33
Q

elevation of the mandible

A
  • temporalis m.
  • masseter m.
  • medial pterygoids m.
34
Q

depression of the mandible

A
  • lateral pterygoids m.
  • suprahyoid m.
  • infrahyoid mm.
35
Q

protrusion of the mandible

A
  • lateral pterygoids
  • masseter m.
  • medial pterygoids
36
Q

retrusion of the mandible

A
  • temporalis m.
  • masseter m.
37
Q

lateral movements of the mandible

A
  • ipsilateral temporalis m. and masseter m.
  • contralateral pterygoids
38
Q

What nerve runs close to the TMJ capsule?

A

facial n.

39
Q

jaw dislocation

A

excessive contraction of the lateral pterygoids may cause heads of mandible to dislocate anteriorly (anterior to articular tubercles)

appearance: mandible depressed & person unabe to close his/her mouth

*close proximity: facial nerve and auriculotemporal nerve

[if damage to auriculotemporal nerve, laxity and instability of the TMJ]

40
Q

innervation of TMJ

A
41
Q

medial pterygoid (superficial/external head)

A
  • origin: maxilla and palatine bone
  • insertion pterygoid rugosity on medial surface of mandibular angle
  • innervation: medial pterygoid n.
  • action: see below
42
Q

medial pterygoid m. (deep/internal head)

A
  • origin: medial surface of lateral pterygoid plate and pterygoid fossa
  • insertion: pterygoid rugosity on medial surface of mandibualr angle
  • innervation: medial pterygoid n.
  • action: see below
43
Q

mandibular nerve block

A

inject near the mandibular nerve (infratemporal fossa)

anesthesize: CN branches - auriculotemporal n., inferior alveolar n., lingual n., buccal
* alternative*: pass needle through mandibular nothc of the ramus of the mandible into infratemporal fossa

44
Q

inferior alveolar nerve block

A

inject around mandibular foramen (opening into mandibular canal)

anesthesizes inferior alveolar n. (CN V3)

*also anesthesize:; all mandibular teeth to the median plane, skin and mucus membrane of lower lip labial alveolar mucosa and gingiva, chin (mental n.)

45
Q

possible problem with inferior alveolar nerve block

A

injection of anesthetic into parotid gland or medial pterygoid muscle

causes inability to open mouth (pterygoid trismus)