Anatomy: Pterygopalatine Fossa Flashcards
Small space that is medial to the infratemporal fossa
Pterygopalatine Fossa
Anterior boundary of the pterygopalatine fossa
Posterior surface of the maxilla
Posterior boundary of the pterygopalatine fossa
Pterygoid process
Superior boundary of the pterygopalatine fossa
Greater wing of the sphenoid
Medial boundary of the pterygopalatine fossa
Perpendicular plate of the palatine bone
Openings into the LATERAL wall of the pterygopalatine fossa
Pterygomaxillary fissure
Openings into the MEDIAL wall of the pterygopalatine fossa
Sphenopalatine foramen
Openings into the ANTERIOR wall of the pterygopalatine fossa
Inferior orbital fissure
Openings into the POSTERIOR wall of the pterygopalatine fossa
Pterygoid canal
Openings into the CEILING of the pterygopalatine fossa
Foramen rotundum (“Skylight” on ceiling)
Openings into the FLOOR of the pterygopalatine fossa
No floor - just a passage to the greater and lesser palatine canals
What nerve passes through the pterygopalatine fossa and what hangs off this nerve?
- V2 (maxillary division of CN 5 = trigeminal nerve)
- the pterygopalatine ganglion hangs from it
Parasympathetic ganglion located in the pterygopalatine fossa
Pterygopalatine ganglion
The three types of fibers that the pterygopalatine ganglion receives.
- Sensory
- Preganglionic parasympathetic fibers
- Postganglionic sympathetic fibers
Where do the SENSORY fibers come from that are received by the pterygopalatine ganglion
From V2 (maxillary division of CN 5 = Trigeminal nerve)
Where do the PREGANGLIONIC PARASYMPATHETIC fibers come from that are received by the pterygopalatine ganglion
From the greater petrosal nerve (branch of VII = facial nerve)
Where do the POSTGANGLIONIC SYMPATHETIC fibers come from that are received by the pterygopalatine ganglion
From the deep petrosal nerve
What kind of fibers does the greater petrosal nerve contain?
Preganglionic parasympathetic fibers
What kind of fibers does the deep petrosal nerve contain?
Postganglionic sympathetic fibers from the superior cervical ganglion
The greater petrosal nerve joins the deep petrosal nerve to form what nerve?
The nerve of the pterygoid canal (aka Vidian’s nerve)
Where does the nerve of the pterygoid canal/Vidian’s nerve terminate?
Pterygopalatine ganglion
What kind of fibers is the nerve of the pterygoid canal/Vidian’s nerve comprised of?
Autonomic fibers: Preganglionic parasympathetic fibers & Postganglionic sympathetic fibers
Where do the preganglionic parasympathetic fibers of the nerve of the pterygoid canal/Vidian’s nerve synapse?
In the pterygopalatine ganglion
What do the postganglionic sympathetic fibers do in the nerve of the pterygoid canal/Vidian’s nerve?
They only pass through the ganglion
Branches from the pterygopalatine ganglion
- Greater palatine nerve
- Lesser palatine nerve
- Nasopalatine nerve
- Posterolateral branches
- Pharyngeal nerve
Where does the maxillary nerve (V2) exit the middle cranial fossa?
Through the foramen rotundum
What kind of fibers does the maxillary (V2) nerve contain?
SENSORY FIBERS ONLY
After exiting the middle cranial fossa, what does the maxillary nerve (V2) immediately do?
Enters the pterygopalatine fossa where it travels in the upper part of the fossa
After traveling through the upper part of the pterygopalatine fossa, what does the maxillary nerve (V2) do?
Enters the orbit through the inferior orbital fissure and changes name
What name does the maxillary nerve (V2) change to after it enters the orbit through the inferior orbital fissure?
Infraorbital nerve
Where does the maxillary (V2) nerve travel?
- Exits middle cranial fossa through foramen rotundum
- Enters pterygopalatine fossa
- Travels in the upper part of the fossa
- Enteres the orbit through the inferior orbital fissure
- Changes name to the infraorbital nerve
- Runs in floor of the orbit
- Exits on the face
Branches of V2 (maxillary division of the trigeminal nerve)
- Intracranial branch
- Ganglionic branch
- Zygomatic nerve
- Zygomaticotemporal nerve*
- Posterior superior alveolar nerve
- Middle superior alveolar nerve
- Anterior superior alveolar nerve
What does the intracranial branch of V2 innervate?
Dura mater in the middle cranial fossa
What do the ganglionic branches contain and do?
- Contain mostly sensory fibers (plus a few postganglionic parasympathetic fibers)
- Connect V2 with the pterygopalatine ganglion
What does the zygomatic nerve of V2 do and what does it supply?
- Divides into the zygomaticotemporal and zygomaticofacial nerves
- Supplies skin over temporal region and cheek
What branch of fibers does the zygomaticotemporal nerve of V5 contain and what’s it destined for?
- Has a branch that contains postganglionic parasympathetic fibers
- Destined for the lacrimal gland
What is the fiber compensation of the nerve of the pterygoid canal/Vidian’s nerve?
- Preganglionic parasympathetic fibers (from greater petrosal nerve)
- Postganglionic sympathetic fibers (from deep petrosal nerve which is from the superior cervical ganglion)
What does the POSTERIOR SUPERIOR ALVEOLAR NERVE of V2 supply?
- Maxillary molar teeth
- Mucosa of maxillary sinus
What does the MIDDLE SUPERIOR ALVEOLAR NERVE of V5 supply?
- Maxillary premolars
- Mucosa of maxillary sinus
What does the ANTERIOR SUPERIOR ALVEOLAR NERVE of V2 supply?
- Maxillary incisors and canine teeth
- Mucosa of maxillary sinus
What is the one thing that all superior alveolar nerves of V2 supply?
Mucosa of maxillary sinus
What is the third part of the maxillary artery?
Pterygopalatine Part (third part)
Where does the pterygopalatine part of the maxillary artery travel?
- Maxillary artery leaves the infratemporal fossa
- Enters pterygopalatine fossa through the pterygomaxillary fissure
- Branches follow those of V2 and the pterygopalatine ganglion
Branches of the pterygopalatine part of the maxillary artery
- Posterior superior alveolar artery
- Infraorbital artery
- Descending palatine artery
- Pharyngeal artery
- Artery of the pterygoid canal
- Sphenopalatine artery
What does the POSTERIOR SUPERIOR ALVEOLAR ARTERY of the pterygopalatine part of the maxillary artery supply?
- Maxillary molar and premolars teeth
- Mucosa of the maxillary sinus
What does the INFRAORBITAL ARTERY of the pterygopalatine part of the maxillary artery accompany, and what are it’s branches?
- Accompanies the infraorbital nerve; emerges on the face
- Branches:
- -Anterior superior alveolar artery
- -Terminal branches
What does the ANTERIOR SUPERIOR ALVEOLAR ARTERY of the infraorbital artery of the pterygopalatine part of the maxillary artery supply?
- Maxillary incisor and canine teeth
- Mucosa of maxillary sinus
What do the TERMINAL BRANCHES of the infraorbital artery of the pterygopalatine part of the maxillary artery supply?
Structures on the face
What does the DESCENDING PALATINE ARTERY of the pterygopalatine part of the maxillary artery divide into and supply?
-Divides into the greater and lesser palatine arteries to hard and soft palate
Where does the PHARYNGEAL ARTERY of the pterygopalatine part of the maxillary artery pass through, and what does it supply?
- Passes through the (palatovaginal)?? canal with a branch of the pterygopalatine ganglion
- Supplies the mucosa of the nasopharynx and sphenoid sinus
What does the ARTERY OF THE PTERYGOID CANAL of the pterygopalatine part of the maxillary artery supply?
Supplies the walls and contents of the pterygoid canal and mucosa of the nasopharynx, auditory tube, and tympanic cavity
**Accompanies the nerve; “Little artery that does a big job”
Where does the SPHENOPALATINE ARTERY of the pterygopalatine part of the maxillary artery enter, and what are it’s branches?
- Enters the nasal cavity through the sphenopalatine foramen (located in the medial wall)
- Branches:
- -Posterolateral nasal branches
- -Posterior septal branches
What do the POSTEROLATERAL NASAL BRANCHES of the sphenopalatine artery of the pterygopalatine part of the maxillary artery supply?
Supplies posterior part of lateral wall of nasal cavity
What do the POSTERIOR SEPTAL BRANCHES of the sphenopalatine artery of the pterygopalatine part of the maxillary artery supply?
Supplies mucosa of the posterior part of the nasal septum