Anatomical Regions: Infratemporal Fossa and Pterygopalatine Fossa Flashcards
Maxillary nerve block
only accessible point along the route of the maxillary nerve is where the nerve passes across the roof of the Pterygopalatine foosoa
- access through a high posterior, superior to the pterygopalatine fossa
- greater palatine approach –> greater palatine foramen is entered with a needle and then followed superiorly to where the canal meets the PPF
- Extraoral approach - needle passed through skin on the face, through the mandibular notch of the mandible and into the PPF
only access point of the maxillary artery for a maxillary nerve block
where the nerve passes across the roof of the ptergopalatine fossa
infratemporal fossa
- general
an irregularly shaped space deep and inferior to the zygomatic arch, deep to the ramus of the mandible, and posterior to the maxilla
it communicates with the temporal fossa through the interval between (deep to) the zygomatic arch and (superficial to) the cranial bones
boundaries to the infratemporal fossa - general
lateral medial anterior posterior superior inferior
lateral border of the infratemporal fossa
ramus of the mandible
medial border of the infratemporal fossa
LATERAL pterygoid plate (vertical projections coming down from the sphenoid bone)
anterior border of infratemporal fossa
posterior aspect of the maxilla
posterior border of the infratemporal fossa
tympanic plate and the mastoid and sytloid processes of the temporal bone
superior border of the infratemporal fossa
inferior (infratemporal) surface of the greater wing of the sphenoid bone
inferior border of the infratemporal fossa
where the medial pterygoid muscle attaches to the mandible near its angle - the medial pterygoid muscle is on the internal surface of the mandible
lateral access into the ITF and what travels here
ramus of the mandible through the mandibular foramen –> inferior alveolar nerve
medial access into the ITF and what travels
lateral pterygoid plate –> pterygomaxillary fissure –> maxillary artery
anterior access into ITF and what travels
posterior aspect of maxilla and the alveolar foramen –> posterior superior alveolar nerve
posterior access to ITF and what travels
Tympanic plate and styloid and mastoid processes of the temporal bone
THERE IS NO DIRECT ACCESS FROM THE POSTERIOR BOUNDARY - so nothing travels
T/F there is no direct access from the posterior aspect of the ITF
TRUE
superior access to ITF and what travels
inferior (infratemporal) surface of the greater wing of the sphenoid bone
foramen spinosum–> middle meningeal artery
foramen ovale –> V3
Petrotympanic fissure –> chorda tympani
inferior access to the ITF and what travels
where the medial pterygoid muscle attaches to the mandible near its angle
NO DIRECT ACCESS - so nothing travels
T/F there is no direct access from the inferior aspect of the ITF
TRUE
muscles associated with ITF
inferior part of the temporalis muscle
lateral and medial pterygoid muscles
vessels associated with the ITF
maxillary artery - first and second divisions
Pterygoid venous plexus
nerve structures associated with ITF
Mandibular nerve and branches
Branches of two CN to join the mandibular nerve in ITF
- CN IX (glossopharyngeal)- lesser petrosal
- CN VII - chorda tympani
Otic ganglion – whih will pass to the parotid gland
location and shape of Pterygopalatine fossa
deep to the infratemporal fossa and an inverted tear drop space
DEEP AND MEDIAL TO INFRATEMPORAL FOSSA
Lateral border of PPF
the pterygomaxillary fissure - which is the MEDAIL BORDER of the ITF (lateral pterygoid plate)
anterior border of PPF
posterior surface of maxilla (same as ITF)
Medial border of PPF
Vertical plate of palatine bone - which forms part of lateral wall of nasal cavity
posterior border of PPF
pterygoid process of sphenoid bone
superior border of PPF
portion of greater wing of the sphenoid bone
inferior border of PPF
pyramidal process of palatine bone
vessels associated with PPF
terminal - 3rd or pterygopalatine part of the maxillary artery and the initial parts of its branches
nerves associated with PPF
maxillary nerve and branches
nerve to pterygoid canal
pterygopalatine ganglion
How many gateways does the PPF have?
Seven
Pterygomaxillary fissure
lateral of PPF and medial of ITF –> so leads to the ITF from the PPF
Inferior orbital fissure
gateway/ opening within the PPF –> between the sphenoid and maxilla –> into orbit
sphenopalatine foramen
gateway to PPF in palatine bone –> to nasal cavity
Palatovaginal canal
gateway in PPF in sphenoid bone –> to nasopharynx
foramen rotundum
Gateway in PPF - in sphenoid bone –> to middle cranial fossa
Pterygoid (vidian) canal
gateway in PPF
in sphenoid bone –> middle cranail fossa
Greater palatine canal
gateway in PPF
in paltine bone –> to oral cavity
