A24 - Infra-temporal Fossa and Anaesthetic Anatomy

Question 1

what muscles are contained in the infra-temporal fossa?

Answer 1

• inferior part of temproalis
• medial pteygoid
• lateral pterygoid

Question 2

what nerves are found in the infra-temporal fossa?

Answer 2

• branches of the mandibular nerve (CN V3) auricolotemporal, inferior alveolar, lingual and buccal
• chorda tympani (CN VII)
• otic ganglion

Question 3

what blood vessels are contained in the infra-temporal fossa?

Answer 3

• maxillary artery and branches

- pterygoid venous plexus

Question 4

what is the structure ptyeygoid venous plexus ?

Answer 4

• network of veins that sits in between the temporalis muscle and the lateral pterygoid
• drains venous blood from facial veins into the maxillary vein

Question 5

what is the clinical importance of the ptyeygoid venous plexus ?

Answer 5

• provides a connection between the superficial face and the dural venous sinuses (connected to the cavernous sinus)
• le for fractures may damage this plexus and due to many veins being damaged bleeding will be difficult to stop
• displaces upper 3rd molar can pop into atrium in maxillary sinus or inferiorly onto the infra-temporal fossa damaging the plexus

Question 6

what are the divisions of the maxillary artery?

Answer 6

1st part - before lateral pterygoid

2nd part - associated with the lateral pterygoid

3rd part - after lateral pterygoid

Question 7

what are the main branches of the 1st part of the maxillary artery?

Answer 7

middle meningeal artery

inferior alveolar artery

Question 8

what are the main branches of the 2nd part of the maxillary artery?

Answer 8

deep temporal arteries

buccal artery

Question 9

what are the main branches of the 3rd part of the maxillary artery?

Answer 9

sphenopalatine artery

infra-orbital artery

posterior superior alveolar artery

Question 10

what are the sensory and motor roots of the mandibular nerve?

Answer 10

sensory - ganglion and the branches from the nerve are sensory

motor- this root exits the foramen ovale as a separate root and then will later join together

Question 11

What are the branches and modalities of the anterior division of the mandibular nerve?

Answer 11

deep temporal- motor to temporalis

buccal - sensory to mucosa and skin of cheek

muscular brach - moor to the masseter and later ptyergoid

Question 12

what are the branches and modalities of the posterior division of the mandibular nerve?

Answer 12

auriculotemporal nerve - sensory to the tragus and posterior temple

inferior alveolar - sensory to the lower dental arch and and mandibular labial gingivae

nerve to mylohyoid - motor to mylohyoid and ABD

mental nerve - sensory to lower lip mucosa, gingivae of lower 3-3

lingual nerve - sensory to anterior 2/3 of tongue, floor or moth and mandibular gingiva

Question 13

what is the clinical importance of the infra-temporal fossa?

Answer 13

• muscles involved in movement of mandible
• blood supply to teeth via maxillary artery
• pterygoid plexus is important for infection and bleeding
• mandibular nerve and relationships are important in inferior alveolar nerve block

Question 14

what is the superior boundary of the ITF?

Answer 14

zygomatic arch and the greater wing of sphenoid at the level of the arch

Question 15

what is the inferior boundary of the ITF?

Answer 15

medial pterygoid attaches to the mandible

Question 16

what is the medial boundary of the ITF?

Answer 16

lateral pterygoid plate

Question 17

what is the lateral boundary of the ITF?

Answer 17

medial aspect of the ramus of the mandible

Question 18

what is the anterior boundary of the ITF?

Answer 18

posterior surface of the maxilla

Question 19

what is the posterior boundary of the ITF?

Answer 19

• tympanic plate and mastoid process

Question 20

what is the importance ptyeygoid venous plexus ?

Answer 20

• connections with the superficial face and so important in the spread of infection