Deep Face and Infratemporal Fossa Flashcards
The temporal region contains the ____ and ____ fossae
Temporal; infratemporal
The _____ fossa is the space found inferior to the zygomatic arch
The ____ fossa is the space found superior to the zygomatic arch
Infratemporal
Temporal
What 5 bones contribute to the temporal fossa?
Temporal bone Sphenoid bone Frontal bone Zygomatic bone Mandible
Boundaries of infratemporal fossa including:
Lateral Anterior Medial Roof Posterior Inferior
Lateral = ramus of mandible
Anterior = maxilla
Medial = lateral pterygoid plate
Roof = sphenoid
Posterior = tympanic plate and mastoid + styloid processes
Inferior = angle of mandible
What is the difference in function between the vertically oriented vs. horizontally oriented fibers of termporalis m?
Vertical fibers occlude the teeth (adduct/close the jaw)
Horizontal fibers pull the jaw posteriorly
What innervates the temporalis m.?
Trigeminal (V3)
The alveolar n. passes through the _____ foramen to supply the teeth
Mandibular
Contents of infratemporal fossa
Temporalis m. Lateral pterygoid m. Medial pterygoid m. Maxillary a. Pterygoid venous plexus
Nervous structures: inferior alveolar n. (V3) Lingual n. (V3) Buccal n. (V3) Chorda tympani (CN VII) Otic ganglion
When blood flow in the jaw is more static during periods of inactivity, yawning occurs using the _____ m., which contracts and expands, pushing on the _____ _____ and assisting with venous drainage
Lateral pterygoid; pterygoid plexus
What n. provides sensation to anterior 2/3 tongue?
Lingual n.
What branches are associated with the mandibular part of the maxillary a?
Deep auricular a. Anterior tympanic a. Inferior alveolar a. Middle meningeal a. Accessory meningeal a.
What does deep auricular a. supply?
External acoustic meatus
External TM
TMJ
What does anterior tympanic a. supply?
Internal TM
What foramen does inferior alveolar a. enter and what does it supply?
Enters mandibular foramen
Supplies mandible, mandibular teeth, chin, and mylohyoid m.
2 branches of inferior alveolar a.
Mylohyoid a.
Mental a.
What foramen does middle meningeal a. enter and what does it supply?
Enters cranium via foramen spinosum
Supplies dura mater of lateral wall, trigeminal ganglion, facial n., geniculate ganglion, tympanic cavity, tensor tympani m.
What foramen does accessory meningeal a. enter and what does it supply?
Enters cranium via foramen ovale
Supplies extracranial muscles of infratemporal fossa, otic ganglion, and sphenoid bone
4 branches of pterygoid part of maxillary a.
Deep temporal a.
Pterygoid branches
Masseteric a.
Buccal a.
What does the deep temporal a. supply
Temporalis m.
What do the pterygoid branches of maxillary a. supply?
Pterygoid m
What does masseteric a. supply?
TMJ
Masseter m.
What does buccal a. supply?
Buccal fat-pad
Buccinator m.
Buccal oral mucosa
Branches of V3
Buccal Lingual Inferior alveolar Auriculotemporal Meningeal
Motor branches: Medial pterygoid Lateral pterygoid Masseteric Deep temporal Mylohyoid
What nerve branch of V2 serves as the communicating branch to the lacrimal nerve (V1)?
Zygomatic n. (Zygomaticotemporal and zygomaticofacial branches)
Maxillary n. exits what foramen of the skull?
Foramen rotundum
What nerve does chorda tympani link onto prior to supplying taste to anterior 2/3 of tongue?
Lingual n.
What 2 variations are seen with maxillary artery in relation to lateral pterygoid?
Maxillary artery runs lateral to lateral pterygoid m.
Maxillary artery runs medial to lateral pterygoid m.
What 3 variations are seen in maxillary artery in relation to nerves?
Maxillary a. runs medial to buccal n. but lateral to the lingual n. and inferior alveolar n.
Maxillary a. runs lateral to inferior alveolar n. and medial to the buccal and lingual nn.
Maxillary a. runs medial to the mandibular n. (V3)
What nerve provides motor innervation to the muscles of mastication?
Trigeminal = V3
What are the 4 paired muscles of mastication?
Temporalis m.
Masseter m.
Lateral pterygoid m.
Medial pterygoid m.
Action of masseter m.
Elevates mandible (closes jaw)
Also assists in protraction, retraction, and side-to-side motion
Insertion point of temporalis m.
Coronoid process of mandible
What group of muscles (besides the muscles of mastication) assist with opening the mandible?
Suprahyoid muscles, provided that the hyoid bone is fixed in place by infrahyoid mm.
Actions of lateral pterygoid m. (Bilateral and unilateral)
Bilateral: protrudes mandible (pulls articular disc forward) and OPENS mouth
Unilateral: alternating actions, along with ipsilateral medial pterygoid, result in side-to-side movements necessary for grinding
Actions of medial pterygoid m. (bilateral and unilateral)
Bilateral: elevation of mandible (closes jaw); also acts with lateral pterygoid to assist in protrusion of mandible
Unilateral: acts with ipsilateral lateral pterygoid m. to protrude mandible and produce medial movement toward the opposite side. Alternating actions between right and left sides result in side to side movements
Which neck muscles assist in opening the mandible?
Digastric m.
Geniohyoid m.
Mylohyoid m.
Stylohyoid m.
Which neck muscles are responsible for “fixing” the hyoid in place so that the suprahyoid mm. can assist with opening the mandible?
Sternohyoid m.
Sternothyroid m.
Thyrohyoid m.
Omohyoid m.
Which muscles of mastication elevate the mandible (close the jaw)?
Temporalis m.
Masseter m.
Medial pterygoids
Which muscles of mastication depress the mandible (open the mouth)?
Lateral pterygoids
Suprahyoid mm.
Infrahyoid mm.
Which muscles of mastication protrude the mandible?
Lateral pterygoids
Masseter m.
Medial pterygoids
Which muscles of mastication retrude the mandible?
Temporalis m.
Masseter m.
Which muscles of mastication provide lateral movements?
Ipsilateral temporalis and masseter + contralateral pterygoids
Ligaments that provide stability at TMJ
Lateral (temporomandibular) ligament
Stylomandibular ligament
What 2 ligaments limit inferior excursion at the TMJ?
Sphenomandibular ligament
Stylomandibular ligament
The TMJ exists where the head of the mandible articulates with the _____ fossa with an ____ ____ between
Mandibular fossa; articular disk
What specific muscle attaches to the articular disc of the TMJ?
Superior head of lateral pterygoid m.
The mandibular fossa is a depression between the anterior _____ _____ and posterior _________ _______
Articular tubercle; postglenoid tubercle
What happens to the TMJ when the jaw is opened?
Stays in position up to about 15 degrees of gape
Past 15 degrees, the TMJ essentially dislocates, sliding anteriorly and dropping the glenoid down onto the anterior articular process
When injured, the TMJ can be very painful. This is due to sensory innervation from what nerves?
Auriculotemporal n.
Posterior deep temporal n.
Masseteric n.
[these are branches of mandibular n. V3]
What bony structure makes posterior dislocation of the TMJ difficult?
Tympanic plate
What nerve(s) would you anesthetize to perform a dental procedure on the lower teeth?
Inferior alveolar n. — this is the only nerve you would need to block in order to operate on lower teeth
Injection site for anesthetizing inferior alveolar n.
Between coronoid notch and pterygomandibular raphe
Some upper dental procedures are anesthetized using a ________ n. block, which is a branch of trigeminal V2
Superior labial n.
Injection site for upper central and lateral incisor teeth
Incisive fossa/foramen
Injection site for upper canines through 2nd premolars
Palatine process of maxilla
Injection site for upper molars
Horizontal plate of palatine bone
