Origin and attachment of lateral pterygoid
Origin
..sup head from inferior surface of greater w of shpenoid
..inf head from lateral surface of lat pterygoid plate
Insertion into
..tmj capsule
..tmj disc
.. pterygoid fovea ie front of neck
Origin and attachment of medial pterygoid
Origin
..superficial head from max tuberosity
..deep head from medial surface of lateral pterygoid plate
Insertion into medial surface of angle of mandible
Origin of temporalis and masseter
-temporalis
..temporal fossa and temporal fascia
-masseter
Superficial from zygomatic bone and deep from inner aspect of zygomatic arch
It’s insertion into lateral aspect of mandibular ramus
Origin of masticatory muscle
The 1st pharyngeal arch
Nerve and blood supply of tmj
-N Auriculotemporal N to masseter A -SUperfacial temporal And maxillary
Lateral mandibular ligament
- attached to articular tubercle and neck of mandible
Depression of mandible is done by
Lateral pterygoid Ant belly of digastric Mylohyoid Geniohyoid Gravity
Branches From the trunk of mandibular N
Nerve to mylohyoid
- Nerve to Medial pterygoid:
supplies 3 muscles:
a. Medial pterygoid b. Tensor palati
c. Tensor tympani
2. Nervus spinosus: sensory to dura. It passes through foramen spinosum.
Mandibular n branches From the anterior division:
- Nerve to masseter
- Deep temporal nerves; to the temporalis
- Pterygoid branches: to the lateral pterygoid.
- Buccal nerve: sensory. It supplies the skin and mucous membrane opposite the buccinator.
Origin and distribution of auriculotemporal
Origin: by 2ools surrounding the middle meningeal artery
Distribution: it carries
A. Sensory fibers to the Scalp
b Auricle External auditory meatus
d. Tympanic membrane
Parotid gland.
- Temporomandibular joint
B. Parasympathetic fibers to the
parotid gland.
Relation of the Mandibular Nerve Branches to the Lateral Pterygoid Muscle
- Above the muscle:
nerve to masseter and deep temporal nerves - Between the two heads: buccal nerve.
- Below the muscle:
inferior alveolar nerve and lingual nerve. - Deep to the muscle: trunk and its branches
and Auriculotemporal nerve
Otic Ganglion
(Parasympathetic Ganglion)
Site: below foramen ovale medial to the mandibular nerve Roots: parasympathetic+ sympathetic nerve to medial pterygoid (no role)
- Parasympathetic: lesser petrosal nerve (from IX nerve)
- Sympathetic: plexus around the middle meningeal artery Branches: to the parotid gland through the auriculotemporal nerve.
To terminal brabches of max n
Infra orbital
And post sup alv
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Course of max n
: it passes in the
Lateral wall of cavernous sinus → foramen rotundum pterygopalatine fossa
pterygomaxillary fissure infratemporal fossa inferior orbital fissue to continue as the infraorbital nerve infraorbital groove infraorbital canal infraorbital foramen.
Branches and Distribution of max
- Meningeal branch: to the dura mater of the middle cranial fossa.
- 2 ganglionic branches: carry sensory fibers to the pterygopalatine ganglion. They also carry parasympathetic fibers from the ganglion to the lacrimal gland.
- Zygomatic nerve: divides into 2 branches:
a. Zygomaticotemporal nerve: supplies the skin of the temple. b. Zygomaticofacial nerve: supplies the skin of the check. - Posterior superior alveolar nerve: to the upper molar teeth and maxillary sinus:
- Middle superior alveolar nerve: from the infraorbital nerve in the infraorbital groove Supplies the upper premolar teeth.
- Anterior superior alveolar nerve: from the infraorbital nerve in the infraorbital canal. Supplies the upper canine & incisor teeth & maxillary sinus
- Three terminal branches of the infraorbital nerve in the face: a. Palpebral branch: to the lower eyelid.
b. Labial branch: to the upper lip.
e. Nasal branch: to the ala and side of the nose
Openings & Communication of the Pterygopalatine Fossa
Posterior: with the cranial cavity and nasopharynx
- Foramen rotundum (with cranial cavity) for the maxillary nerve. 2. Pterygoid canal (with cranial cavity) for nerve of pterygoid canal (Vidian nerve).
- Pharyngeal canal (with nasopharynx) for pharyngeal n of pterygopalatine ganglion. Medial: sphenopalatine foramen with the nose, it transmits the nasopalatine nerve.
Lateral: Pterygomaxillary fissure with the infratemporal fossa. Superior: inferior orbital fissure (with the floor of the orbit) transmitting the following:
- Infraorbital nerve and vessels.
- Zygomatic nerve.
- Vein connecting the inferior ophthalmic vein with the pterygoid venous plexus:
Inferior: greater and lesser palatine canals and foramina (with the oral cavity), which transmit the greater and lesser palatine nerves and vessels
Roots of sphenopalatine ganglion
:
- Sensory root: ganglionic branches from the maxillary nerve. They pass through the
ganglion to the nose, palate and pharynx. 2. Parasympathetic: greater superficial petrosal nerve from the facial nerve. 3. Sympathetic: deep petrosal nerve from the plexus around the internal carotid
artery. The greater petrosal nerve unites with the deep petrosal nerve to form nerve of pterygoid canal (Vidian nerve). The greater petrosal nerve relays in the pterygopalatine ganglion while the sympathetic fibers of the deep petrosal nerve don’t relay.
Branches of sphenopalatine ganglion:
to the lacrimal, nasal and palatine glands
2 palatine (greater & lesser). 2 nasal (nasopalatine & lateral nasal), pharyngeal & orbital
- Greater palatine nerve: passes through the greater palatine canal and foramen to supply the palatine glands in the hard palate.
- Lesser palatine nerve: passes through the lesser palatine canal and foramen to supply
the palatine glands in the soft palate.
- Nasopalatine nerve: passes through the sphenopalatine foramen to supply the nasal glands in the nasal septum. It then passes through the incisive canal and fossa to supply the glands in the hard palate.
- Lateral nasal nerves: to the lateral wall of the nasal cavity (to the nasal glands)!
- Orbital branches: pass through the inferior orbital fissure to supply the orbital wall and
the sphenoidal and ethmoidal sinuses.
- Pharyngeal nerve: passes through the pharyngeal (palatovaginal) canal to supply the mucosa and glands of the nasopharynx.
- Secretomotor fibers to the lacrimal gland: enter the maxillary nerve zygomatic nerve zygomaticotemporal nerve lacrimal nerve to reach lacrimal gland.
Where does the division of the 2 terminal branches of external carotid occur
Inside parotid
First Part of max A
: mandibular part 5 branches
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- Deep auricular artery: to the tympanic membrane and external auditory meatus.
- Anterior tympanic artery: to the tympanic membrane and middle ear.
- Middle meningeal artery: to the dura of the middle cranial fossa.
- Accessory meningeal artery: to the dura of
the middle cranial fossa.
- Inferior alveolar artery: to the lower teeth, chin & lower lip.
Second Part of max A
: pterygoid part, 4 branches
Dolly & Monika Play Basketball (to muscles)
- Deep temporal arteries: to temporalis.
- Masseteric artery: to masseter.
- Pterygoid arteries: to pterygoid muscles.
- Buccal artery: to the buccinator.
Third Part of max A
: sphenopalatine part, 6 branches
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- Posterior superior alveolar artery: to the upper molar & premolar teeth.
- Infraorbital artery: to the face and the upper canine and incisor teeth.
- Pharyngeal artery: to the pharynx.
- Artery of pterygoid canal: to the pharynx.
- Sphenopalatine artery: to the nasal cavity.
- Greater palatine artery: to the palate. It gives the lesser palatine artery.
Course of max artery
Course: divided into 3 parts by lower head of the lateral pterygoid
First part: medial to the neck of the mandible below the lower head. Second part: superficial to the lower head. Third part: between the 2 heads the pterygo- Am
maxillary fissure pterygopalatine fossa
Origin and termination of maxillary A
:
Maxillary Artery
81
One of the 2 terminal branches of the external carotid artery behind the neck of the mandible inside the parotid gland.
Terminatin: in the pterygopalatine fossa as the sphenopalatine artery.
