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Neuro 1 Exam > Infratemporal Fossa and Temperomandibular Joint > Flashcards

Infratemporal Fossa and Temperomandibular Joint Flashcards

1
Q

What does the temporal region contain?

A
  1. Temporal fossa, located above the zygomatic arch
  2. Infratemopral fossa, located above the zygomatic arch
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2
Q

Locate the pterygopalatine fossa

on the bone

A
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3
Q

Locate

  1. articular tubercle
  2. Zygomatic bone (zygomatic process is not on SL)
A
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4
Q

locate the

lateral pterygoid plate

pterygoid hamulus

sphenoidal spine

sphenopalatine foramen

Mandibular fossa

A
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5
Q

what are the boundaries of the infratempral fossa?

A
  • Lateral: ramus of mandible
  • Anterior: Maxilla
  • Medial: lateral pterygoid plate
  • Roof: greater wing of the spenoid bone
  • Posterior: tympanic plate, mastoid process and styloid process
  • Inferior: angle of the mandible
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6
Q

What. are the contents of the infratemporal fossa?

A

1. Inferior portion of the temporalis m.

2. Lateral and medial pterygoid muscle

3. Maxillary A

4. Pterygoid venous plexus

5. Nerves:

  • inferior alveolar (V3),
  • Lingual n (V3),
  • Long buccal N. (V3),
  • chorda tympanic (CN VII),
  • otic ganglion
  • Auriculotemporal N.
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7
Q

In the infratemporal fossa, will we be able to see the chorda tympani N?

A

it will be covered by the lateral pterygoid m.

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8
Q

in the infratemporal region, what is important to find?

A

maxillary. A

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9
Q

what does the long buccal N do?

A

Part of V3

Provide sensation to the inner cheek and gum. does NOT innervate. buccinator. m.

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10
Q

where does chorda tympani N arise from in the infratemporal fossa?

actions?

A
  1. Petrotympanic fissue > lingual N -> carries taste to the anterior 2/3 of the tongue and GVE to sublingual and submandibular N.
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11
Q

Where does the inferior alveolar A and N go to in the infratemporal fossa

A

Mandibular foramen

It will have a the mylohyoid N coming off of it.

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12
Q

What tells us that. we bit. our tongue?

A

lingual N. (V3)

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13
Q

Go over maxillary A

A
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14
Q

What veins do we need to identify on the face?

A
  1. Supraorbital V
  2. Superficial temporal V.
  3. Retromandibular V.
  4. Superior opthalamic V
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15
Q

What branches of the mandibular N (V3) should we see in the infratemporal region?

A
  1. Buccal N.
  2. Lingual N.
  3. Mental N.

THOSE THREE ARE SOMATIC SENSORY

  1. Inferior alveolar N, branching into N to the mylohyoid M.
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16
Q
A
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17
Q

If a muscle has the name TENSOR in it, what. innervates it?

A

Trigeminal N (V)

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18
Q

Describe how the anesthesia of a dentician is done through nerve blocks

A

The posterior superior alveolar N is an independent branch off of V2 (maxillary N). The middle and anterior superior alveolar nerves come off of the infraorbital nerve - just like the arteries.

If the dentist wants to pull out the back deeth, anestasize the poterior superior alveolar n.

If he wnts to pull out the side teeth, he will inject in the middle superior alveolar n.

If he wants to pull ut the front tooth, anestasize in the middle of gums, [goes or infraorbital N -> anterior superior alveolar N]/

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19
Q

Where does maxillary. N go through?

A

foramen rotundum

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20
Q

Where does the posterior superior alveolar N go to?

A

maxilla -> maxillary sinus

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21
Q

What nerves will we see in the infratemporal region?

A

Branches of V2 (maxillary N)

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22
Q

What goes through. stylomastoid foramen

A

facial N

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23
Q

What happens if you get a fracture on the neck of the mandible?

what. about the ramus and corpus of the mandible?

A

Neck: damage the. maxillary A.

Ramus: damage the infraalveolar structures

If you hit. the corpus of. the mandible, it is not as bad.

24
Q

What. are the branches of V3. (mandibular N)?

A
  1. Buccal N
  2. Lingual N
  3. Mental N
  4. Inferior alveolar N.
  5. Auriculotemporal N
25
Q

how does the maxillary A run in relation to the lateral pterygoid m.

A

it. can run lateral to it or medial (behind) it.

26
Q

how can maxillary A run in relation to the nerves in the infratemporal fossa

A

medial to buccal abut lateral lingual and inferior alveolar

lateral to inferior alveolar but medial to everything else

medial in front. of mandibular N (V3)

27
Q

The muscles of mastication. are innervated by what?

how do they work?

A

Trigeminal N (V3), which move the mandible. at the TMJ joint

28
Q

what are. the 4 PAIRED muscles of mastication?

A
  1. Temporalis
  2. Masseter
  3. Lateral pterygoid M.
  4. Medial pterygoid M
29
Q

What innervates orbicularis oris m

A

Facial N

Bucciator m and the oribicularis oris muscle are ACCESORY MUSCLES OF MASTICATION

30
Q

how do the lateral pterygoid m and medial pterygoid m act in relation to one another?

A

Lateral pterygoid miscle has a superior and inferior head.

Medial pterygoid will hug (wrap around) lateral

31
Q

What does the masseter m look like?

A

1. Has a superficial head

2. Has a deep head

32
Q

overal axn of pterygoid muscles

A
  1. Lateral opens mouth, protrudes and helps to move side to side.
  2. Medial will close mouth, protrude mandible and helps move side to side
33
Q

What opens our mandible?

A
  1. Stabilize the hyoid inferiorly. If not, it will raise the larynx when we swallow.
  2. Digastric m, geniohyiod m, mylohyoid m, stylohyoid m
  3. Sternohyoid m, sternothyroid m, thyrohyoid m, omohyoid m will anchor the jaw in place that we. can pull down on the hyoid bone -> open jaw -> move trachea inferiorly
34
Q

Whtat. ms help to elevate. (close) our mandible

A
  1. Temporalis
  2. Masseter.
  3. Medial pterygoids
35
Q

What helps to depress (open) our mandible?

A
  1. Lateral pterygoids
  2. Suprahyoid muscles
  3. Infrahyoid muscles.
36
Q

What helps to protrude our mandible?

A
  1. LAteral pterygoids
  2. Masseter. m
  3. Medial pterygoids
37
Q

What helps to retract our mandible?

A
  1. Temporalis m.
  2. Masseter M
38
Q

What helps. to laterally. move our mandible?

A
  1. Ipsilateral temporalis and masetter m
  2. Contralateral. pterygoids.
39
Q

what L stabilize TMJ joint

A

1. Lateral (temporo-mandibular) L

2. Stylomandibular L

40
Q

what kind of joint is the TMJ joint

41
Q

What L limit the movement anterior dislocation of TMJ

A

1. Sphenomandibular L

2. Stylomandibular L

42
Q

What allows free movement of the TMJ?

A

articular disk, which has superior head and inferior head of lateral pterygoid attached to it

43
Q

What keeps the gleniod in the middle of the disk as it slides posteriorly. and anterioly?

A

Posterior and anterior bands of articular disc

44
Q

Describe TMJ during GAPE

A
  1. the first 15 degrees, the condylar process rotates in the joint.
  2. Once we exceed 15 degrees, we dislocate the joint anteriorly (articular disk pops out) onto the ridge of the mandibular fossa. Articular disc moves onto the articular eminence because thr lateral pterygoid pulls it forward. If it keeps moving it forward, the disk stays there. and the condyle goes back. ->. TMJ!!!
45
Q

What innervates the TMJ?

A

Branches of the mandibular N (V3)

1. Auriculotemporal N

2. Posterior deep temporal N

3. Masseteric N

46
Q

what is the most common type of TMJ dislocation

A

anterior dislocation.

HEad of the mandible can go into the temporal fossa from the mandibular fossa

47
Q

how to reposition TMJ?

A

stick fingers in mouth and slide the jaw rearward

48
Q

Anesthetic agents are commonly administered by injection to block pain during dental procedures. CN ____ is important..

A

5

because it is the sensory nerve of the head, serving the teeth and mucosa of the oral cavity. Because the superior alveolar nerves (branches of CN V2) are not accessible, the maxillary teeth are locally anesthetized by injecting the agent into the tissues surrounding the roots of the teeth and allowing the solution to infiltrate the tissue to reach the terminal (dental) nerve branches that enter the root. By contrast, the inferior alveolar nerve (CNV3) is readily accessible and is probably anesthetized more frequentlythan any other nerve

49
Q

An inferior alveolar nerve block anesthetizes the inferior alveolar nerve, a branch of CN

50
Q

how to do a inferior alveolar n block

A

In mouth

go anterior to the pterygomandibular raphe (between the buccinator and superior pharyngeal constructor m) -> where you will hit the inferior alveolar N.

vein. When this nerve block is successful, all mandibular teeth (lower teeth) are anesthetized to the median plane

51
Q

in inferior alvolar N block what is also taken out (anesthasized?

A

. The skin and

mucous membrane of the lower lip, the labial alveolar

mucosa and gingivae, and the skin of the chin are also anesthetized

because they are supplied by the mental nerve, a

branch of the inferior alveolar nerve

52
Q

Sometimes during yawning or taking a large bite (above 15 degrees),

excessive contraction of the __________ may

cause the heads of the mandible to dislocate ______

A

lateral pterygoids

anterioly

mandible remains depressed and person cannot close their. mouth

53
Q

Because of the close relationship of the ____ and _______to the TMJ, care must be taken during surgical to prevent damage to them

A

facial and auriculotemporal

54
Q

where do we inject. to take out posterior superior alveolar N

A

next to second molar

55
Q

How do we take out the front teeth?

A

The anterior teeth can only be anesthetized via a block of the infraorbital nerve as it comes out of the infraorbital foramen. This is a deep injection.

Whill also take up upper lip and front teeth

Neuro 1 Exam (24 decks)

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