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BAM > Anatomy - Temporal and infratemporal fossa > Flashcards

Anatomy - Temporal and infratemporal fossa Flashcards

1
Q

Boundaries of the temporal fossa

A

Superior: temporal lines (superior and inferior)

Anterior: frontal and zygomatic bones

Inferior: continuous w/ infratemporal fossa

lateral: zygomatic arch

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2
Q

why is the pterion clinically important?

A

the anterior branches of the middle meningeal artery lie deep to it; if you fracture it you will kill this artery and get an epidural hematoma

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3
Q

what are the contents of the temporal fossa?

A
  1. temporalis muscle (muscle of mastication)
  2. deep temporal VAN
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4
Q

which bones make up the zygomatic arch?

A
  1. the temporal process of the zygomatic bone
  2. the zygomatic process of the temporal bone
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5
Q

what attaches to the superior temporal line?

A

the temporal fascia

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6
Q

what attaches to the inferior temporal line (and temporal fossa)?

A

the temporalis muscle

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7
Q

what are the boundaries of the infratemporal fossa?

A
  1. lateral - ramus of mandible
  2. medial - lateral pterygoid plate
  3. anterior - maxilla
  4. posterior - tympanic plate, mastoid and styloid processes
  5. superior - inferior surface of the greater wing of the sphenoid
  6. inferior - where medial pterygoid attaches to angle of mandible
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8
Q

what are the contents of the infratemporal fossa?

A
  1. branches of mandibullar division of trigeminal nerve (V3)
  2. branches of maxillary artery (external carotid; terminal branch) and the retromandibular artery
  3. pterygoid plexus of veins
  4. otic ganglion
  5. muscles: lateral and medial ptergoid muscles + inferior part of the temporalis muscle
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9
Q

which muscle attaches to the ptergoid fovea of the condylar process of the mandible?

A

lateral ptergoid muscle

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10
Q

where on the mandible does the medial ptergoid attach?

A

on the medial surface of the ramus

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11
Q

where on the mandible does the masseter muscle attach?

what is its proximal attachment?

what nerve supplies the masseter muscle

A

distal attachment: the angle and the lateral surface of the ramus of the mandible

proximal attachment: inferior border of zygomatic bone

nerve supply: masseteric branch of V3

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12
Q

what attaches to the mylohyoid line on the medial surface of the mandible?

A

the mylohyoid muscle

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13
Q

what takes attachment from the lingula?

A

the sphenomandibular ligament

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14
Q

where does the temporalis muscle attach proximally? distally?

which nerve supplies the temporalis muscle?

A

proximal attachment = floor of temporal fossa

distal attachment = tip and medial

innervation = deep temporal branches of V3

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15
Q

what is the proximal attachment for the lateral ptergoid muscle?

what is its distal attachment? (superior/inferior heads)

what nerve supplies this muscle?

A

proximal attachments: infratemporal surface and crest of the greater wing of the sphenoid + lateral surface of the lataer ptergoid plate

distal attachments (inferior head) - ptergoid fovea

distal attachments (superior head) - joint capsule and articular disc of TMJ

nerve supply - V3

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16
Q

medial ptergoid:

what are the proximal attachments?

what are the distal attachments?

what is its nerve supply?

A

proximal attachments: medial surface of lateral ptergoid plate + pyramidal process of palatine bone (situated at the back part of the nasal cavity between the maxilla and the pterygoid process of the sphenoid) + tuberosity of the maxilla

distal attachments: medial surface of the ramus of hte mandible, near the angle

nerve supply: V3

17
Q

how does the ptergoid plexus anastomose w/ the facial vein?

A

via the deep facial vein

18
Q

how does the ptergoid plexus anastomose w/ the cavernous sinus?

A

via emissary veins

19
Q

the chorda tymapani nerve is a branch of which cranial nerve?

which nerve does the chorda tympani join in the infratemporal fossa?

A
  • the chorda tympani is a branch of the facial nerve (CN VII); it branches when CN VII is in the facial canal
  • chorda tympani crosses the tympanic cavity medial to the handle of the malleus
  • it joins the LINGUAL NERVE (from CN V) carrying tase fibers from the anterior two thirds of the tongue
20
Q

where would you inject anesthetic agent if you wanted to do a mandibullar nerve block?

A

at the foramen ovale of the skull

21
Q

where would you inject anesthetic if you wanted to bock the inferior alveolar nerve?

A

in the mandibular foramen

22
Q

the auricotemporal nerve has a relationship with which branch of the maxillary artery?

A

it is encircled by the middle meningeal artery, which is a branch of the maxillary artery

23
Q

what are the two terminal branches of the external carotid artery?

A

maxillary artery and superficial temporal artery

24
Q

the chorda tympani carries taste fibers from the anterior two thirds of the tongue; what other fibers does it carry?

A

it carries presynaptic parasympathetic secretomotor nerve fibers (for the submandibular and sublingual glands)

don’t forget that the chorda tympani joins the lingual nerve in the infratemporal fossa

25
Q

V2 is the maxillary division of trigeminal nerve. through which foramen does this nerve exit the skull?

through where does this nerve exit the face? what is it called once it exits?

A
  • the maxillary nerve (V2) exits the skull via foramen rotundum
  • it exits the face via the infraorbital foramen
  • it is called the infraorbital nerve once it is in the face
26
Q

how does the mandibular nerve (V3) exit the skull?

once it exits, it splits into an anterior and posterio trunk. which trunk is smaller/bigger? what are the branches of these trunks?

A
  • the mandibular nerve exits the skull via the foramen ovale
  • the anterior trunk is the smaller of the two trunks. its branches are:
    • long buccal nerve (sensory fiber to mucosa oof cheeks)
    • deep temporal nerves (to temporalis muscle)
    • masseteric nerve (to masseter)
    • ptergoid nerves (to medial/laterl ptergoids)
  • the posterior trunk is larger. its branches are:
    • auricotemporal nerve
    • lingual nerve
    • inferior alveolar nerve
    • nerve to mylohyoid
27
Q

what does the auricotemporal nerve supply?

A
  • it supplies sensory fibers to the auricule and temporal regions
  • it supplies articular fibers to TMJ
  • it supplies parasympathetic seretomotor fibers to parotid gland

*Secretomotor refers to the capacity of a structure (often a nerve) to induce a gland to secrete a substance (usually mucus or serous).

28
Q

the nerve to mylohyoid supplies the mylohyoid muscle plus one other muscle. what is the other muscle?

A

the anterior belly of the digastric

29
Q

where is the otic ganglion located?

A

the otic ganglion (a parasympathetic ganglion) is located:

  • within the infratemporal fossa
  • inferior to the foramen ovale
  • medial to the mandibular division of V3
  • posterior to the pterygoid muscle
30
Q

the otic ganglion is a parasympathetic ganglion.

where do the fibers that synapse on it arise from?

how are these fibers carried to the ganglion?

A
  • preganglionic fibers arise from inferior salivary nucleus of the medulla
  • fibers are carried via the lesser petrosal nerve (arises from tympanic plexus of CN IX - glossopharyngeal - exits via foramen ovale)
31
Q

the otic ganglion is a parasympathetic ganlgion.

it contains the cell bodies of post-ganglionic cells. the fibers of these cells are carried to the parotid gland via which nerve?

A

post-ganglionic fibers are carried to the parotid gland via the auricotemporal never (branch of V3)

these fibers have secretomotor functions

32
Q

sympathetic fibers pass through the otic ganglion but don’t synapse there.

  • why?
  • where do these fibers come from?
  • are they presynpatic or post synaptic?
  • where do they go?
A
  • sympathetic fibers synapse in sympathetic ganglion, so they would not synapse in the otic ganglion, which is a parasympathetic ganglion
  • these fibers are derived from the superior cervical ganglion (a sympathetic ganglion)
  • they are post-synaptic fibers
  • they are going to the blood vessels of the parotid gland (remember that blood vessels are under sympathetic control only)
33
Q

the superior and inferior compartmnet of the TMJ are responsible for different actions.

  • what are they?
  • what separates the two compartments?
A
  • the superior compartment is responsible for gliding movements of protrusion and retrusion
  • the inferior compartment is responsible for hinge movements of depression and elevation
  • the articular disc divides the two compartments
34
Q

the TMJ is a modified hindge type of synovial joint

what is the intrinsic ligament of the joint?

what are the extrinsic ligaments of the joint?

A
  • intrinsic ligament - lateral ligament (thickening of joint capsule)
  • extrinsic ligament - sphenomandibular ligament (spine of sphenoid to lingula)
  • extrinsic ligament - stylomandibular ligament (thickening of fibrous capsule of parotid gland; extends from styloid process to angle of mandible)
35
Q

what is the most common dislocation of TMJ? why?

A
  • anterior dislocation is most common
  • this is b/c postglenoid tubercle and lateral ligament provide stronger support posteriorly
  • anterior dislocation occurs when the heads of condyles of mandible pass anterior to the articular tubercles
36
Q

which muscles are responsible for elevation of the TMJ?

which muscles are responsible for depression?

which muscles are responsible for protrusion?

which muscles are responsible for retrusion?

which muscles control lateral movement?

A
  1. elevation = temporalis, masseter, medial pterygoid
  2. depression = lateral pterygoid, suprahyoids, infrahyoids
  3. protrusion = pterygoids, masseter
  4. retrusion = temporalis, masseter
  5. latearl movements = temporalis (of same side), pterygoids (of opposite side), masseter
37
Q

what are the two nerevs associated with TMJ?

A
  1. facial nerve - overlies the joint
  2. articular branches of auricotemporal nerve (branch of V3) - enters hte posterior part of joint

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