Lecture 10 = Pterygopalatine Fossa Flashcards
What are the boundaries of the pterygopalatine fossa?
- the infratemporal fossa is the lateral wall
- the opening in the fossa is the nasal cavity - how we get the neurovasculature in the nasal cavity
- it has the main V2 trunk and this is where all of the branches start to diverge
What are the features of the pterygopalatine fossa?
- associated with 7 openings
- “hub” for nn. and aa. supplying the middle face
- pterygopalatine ganglion (CN VII)
- attached to V2 by 2 (short) pterygopalatine nn.
- receives (Vidian) n. pterygoid canal
- composed of both sympathetic and p-symp fibers
- **only p-symp fibers synapse here
What are the 7 foramina of the pterygopalatine fossa?
- sphenopalatine foramen - nasal cavity
- inferior orbital fissure - floor of orbit
- pterygomaxillary fissue - infra temporal fossa
- foramen rotundum - cranial cavity (middle cranial fossa)
- pterygoid canal - cranial cavity (middle cranial fossa)
- palatovaginal canal - nasopharynx
- palatine canal - roof of oral cavity (palate)
- descending palatine canal opens up into the lesser and greater palatine foramen
Where is the pterygomaxillary fissure opening and what goes through it?
- is the lateral opening
- this opening is communicating with the infra temporal fossa
- maxillary a. (it’s 3 branches) and the posterior superior alveolar n. ( go through it
Where is the sphenopalatine foramen opening and what goes through it?
- is the medial opening from the pterygopalatine fossa
- opening communicates with the nasal cavity
- and inferior and anterior to the sphenoid sinus and adjacent to articulation to the sphenoid bone
- sphenopalatine a. (passes thru to enter nasal cavity - gives off post. lat. and post. septal branches) and nasopalatine n. (V2) and posterior lateral nasal nn. (V2) goes through it
What is the sphenopalatine artery supply?
Septal and lateral branches: spehnopalatine branches - supplies septum and lateral wall sphenopalatine a. branches: - posterior septal a. - posterior lateral nasal aa.
What are the general sensory nerves of the nasal cavity?
CN V1: nasociliary n. (motor) - supply some of nasal cavity
CN V2: maxillary n. (sensory) - supply most of nasal cavity - nasopalatine n. and posterior superior lateral nasal nn.
-branches pass thru pterygopalatine ganglion, but don’t synapse there
Where is the foramen rotundum opening and what goes through it?
- main CN V2 trunk - maxillary n. goes through it
- communicates with the middle cranial vault
- is the posteriorsuperior / posterior opening
Where is the inferior orbital fissure and what goes through it?
- is the anterosuperior/superior opening
-located in posterior/inferioir aspect of orbit - communicates with the orbit
-ant/superior exit from pterygopalatine fossa
-Infraorbital and zygomatic nn. (V2) pass thru- infraorbital n. continues thru infraorbital foramen to face
- zygomatic n. sends off 2 branches. in orbit leading to face:
~ zygomaticotemporal n. - exits skull @ temporal fossa just behind the temporal bone
~ zygomaticofacial n. - over the cheek bones
-infraorbital and zygomatic aa. also pass thru
**lacrimal gland requires parasympathetic innervation - so to supply this, needs to follow the path of the V2 branches to get to the lacrimal gland
Where is the pterygoid canal and what goes through it?
- runs post./ant. thru body of sphenoid bone
- this canal connects foramen lacer and PPF and sphenopalantine foramen - also how sympathetic fibers fit into nasal cavity
- communicates with middle cranial
- serves as one posterior opening of pterygopalatine fossa
- transmits Vidian n. of pterygoid canal - have only autonomic components
- transmits pterygoid branch of maxillary a.
- in the Vidian n. have both the parasympathetic and sympathetic - only one type synapses in the ganglion which is the parasympathetic because sympathetic already synapses in the cervical ganglion
- CN 7 gives rise to the greater petrosal nerve with carries pre-synaptic parasympathetic - this traverses the wall of lacerum
Where is the pharyngeal canal and what goes through it?
- found superior/lateral to alae of vomer bone
- ~1 cm ant/med to pterygoid canal
- serves as posterior opening of pterygopalatine fossa
- transmits pharyngeal n (CN V2)
- transmits pharyngeal branch of maxillary a.
- the canal is inferior to the pterygoid canal and is angled obliquely because it has to serve the pharynx so it’s following the pharynx’s wall
Where is the palatine canal and what goes through it?
- runs vertically just lateral to perpendicular plate of palatine bone in the maxilla
- serves as inferior exit of pterygopalatine fossa
- transmits greater and less palatine nn. (CN V2)
- transmits descending palatine a.
- greater and lesser palatine aa.: each runs with n.
- emerge thru greater and lesser palatine foramen
- it communicates with the oral cavity
What are the palatine nn. and aa.?
- transmits greater and lesser palatine n. (CN V2)
- transmits descending palatine a.
- greater and less palatine aa. each runs with n.
- emerger thru greater and less palatine foramen
What are the arteries in the pterygopalatine fossa that supply the middle face?
- infraorbital artery
- sphenopalatine artery
- pharyngeal artery
- artery of pterygoid canal
- maxillary artery in infratemporal fossa
- greater palatine artery
- posterior superior alveolar artery
What are the nerves going through the pterygopalatine ganglion and nasal cavity?
- Cn V1: branchesof anterior ethmoidal n., lateral internal nasal and external nasal
- V2: sphenopalatine foramen
- posterior lateral nasal branches (CN V2) - superior and inferior
- vidian n. of pterygoid canal
- greater and lesser palatine nn. (V2)
** these are the autonomics for all of the nasal cavity and portion of the palate in the oral cavity and the lacrimal gland.
