9 Infratemporal Fossa and Pterygopalatine Fossa Flashcards
A patient with rheumatoid arthritis of her tempromandibular joint has severe ear pain. Which nerve is responsible for conducting the facial pain?
The auriculotemporal nerve is a posterior branch of the mandibular division of the trigeminal nerve. It encircles the middle meningeal artery and courses medially to the TMJ and then ascends up near the auricle.
Since the auriculotemporal supplies the TMJ and skin of the external auditory canal, pain from the joint can be referred to the ear.
A patient damaged their greater petrosal nerve. Which symptom would be seen?
The greater petrosal nerve carries PS fibers that are involved in the innervation of the lacrimal gland as well as the mucosal glands of the nose, palate and pharynx. An injury to the right greater petrosal nerve would decrease lacrimal secretions for the right eye.
A patient has acute inflammation of the TMJ due to arthritis. Which muscle would be affected by this inflammation?
Part of the lateral pterygoid muscle has its insertion on the articular disc within the TMJ and would be most affected
A patient has an aneurysm of the basilar artery close the cavernous sinus. An anterior approach to the sella turcica through the nasal cavity is performed. Through which route will the surgeon gain access to the cranial cavity?
The sphenoidal sinus provides the most direct access to the pituitary gland, which is situated directly above the sinus.
A physician diagnoses a lesion at the neural cell bodies of the preganglionic axons of the fibers that terminate in the pterygopalatine ganglion. Which structure contains the neural cell bodies of the pregang. axons?
The neural cell bodies are located in the superior salivatory nucleus and synapse in the pterygopalatine ganglion.
It is located in the pons.
Which muscle is the most important in jaw protrusion and depressing the mandible?
The lateral pterygoid muscle is a muscle of mastication innervated by V3.
CT examination shows severe trauma to the articular disc and fracture of the neck of the mandible in a patient. This could result in injury to a muscle that developed from which embryonic structure?
The lateral pterygoid muscle attaches to the articular disc and capsule of the TMJ. The muscles of mastication, including the lateral pterygoid, are derived from the 1st pharyngeal arch mesenchyme.
The 2nd arch forms the muscles of facial expression.
A patient complains of sinusitis. During examination, a physician taps the area slightly superior the midportion of the patient’s eyebrows and this elicits pain. Which anatomic area is the physician most likely examining?
The frontal sinuses are located in the frontal bone above the orbital margin.
The maxillary sinus in the cheek region is within the maxillary bone.
The ethmoid sinus is located between the nose and the eye.
A patient compalins of numbness ot the right side of the lower jaw and inside of the cheek. Examination reveals loss of sensation over the scalp in the posterior temporal region and skin over the anterior auricle. There was weak lateral deviation of the mandible to the right. CT scan showed a mass in the medial temporal fossa. What other function is affected?
The infratemporal fossa is inf. to the temporal fossa and between the ramus of the mandibe laterally and the wall of the pharynx medially. The contests include the temporalis, masseter and lateral + medial pterygoid muscles. Nerves passing through the fossa include the mandibular, inf. alveolar, lingual, buccal and chorda tympani.
A patient had a displaced fracture of the floor of the middle cranial fossa involving the pterygoid canal. Which describes the fiber types that are affected in this injury?
Coursing throught the pterygoid canal (aka Vidian canal) are the presynaptic PS fibers from the facial nerve via the greater petrsoal n. (which goes to synpase in the PT ganglion) and postganglionic sympathetic fibers from the deep petrosal nerve.
