Lecture 8: Deep Face and Infratemporal Fossa Flashcards
In comparision to the zymgomati arch, where is the temporal and infratemporal fossa found?
Temporal Fossa: Superior to Zymgomatic Arch
Infratemporal Fossa: Inferior to Zymgomatic Arch
What are the boundaries of the infratemporal fossa?
- Roof: Greater Wing of Sphenoid
- Anterior: Maxilla Bone
- Posterior: Tympanic Plate, Mastoid Process, and Styloid Process
- Lateral: Ramus of Mandible
- Medial: Lateral Pterygoid Plate
- Inferior: Angle of Mandible
What are the contents of the infratemporal fossa?
Muscles
- Inferior portion of Temporalis Muscle
- Lateral and Medial Pterygoid Muscles
Vasculature
- Maxillay Artery
- Pterygoid Venous plexus
Nervous Structures
- Inferior Alveolar Nerve of V3: goes to mandible
- Lingual Nerve of V3: sensation of anterior tongue
- Buccal Nerve of V3: sensation to cheek
- Auricolotemporal Nerve of V3: sensation to parotid gland
- Otic Ganglion: parotid gland
- Chorda Tympani of VII: taste of anterior tongue and paraysmpathetic innervation to submandibular and sublingual glands
What are the branches of the mandibular portion of the Maxillary Artery?
- Deep Auricular Artery
- Supplies external acoustic meatus and tympanic membrane and TMJ
- Anterior Tympanic Artery
- Supplies internal tympanic membrane
- Inferior Alveolar Artery: supplies mandible
- Mylohyoid Artery
- Mental Artery
- Middle Meningeal Artery
- Accessory Menigneal Artery
- Supplies extracranial muscles of infratemporal fossa, otic ganglion, and sphenoid bone
What are the branches of the pterygoid portion of the Maxillary Artery?
- Deep Temporal Artery
- Supplies Temporalis Muscle
- Pterygoid Branches
- Supplies Pterygoid Muscle
- Masseteric Artery
- Supplies TMJ and Masseter Muscle
- Buccal Artery
What are all the nerves from of the sensory part of Mandibular Nerve?
- Buccal Nerve
- Lingual Nerve
- Inferior Alveolar
- Dental Nerve
- Incisive Nerve
- Mental Nerve
- Auriculotemporal Nerve
- Meningeal Nerve
What are all the targets of the motor part of Mandibular Nerve?
- Muscles of Mastication
- Temporalis Muslce
- Masseter Muscle
- Lateral Pterygoid Muscles
- Medial Pterygoid Muscles
- Tensor Veli Palatini
- Tensory Tympani
- Deep Temporal Muscle
- Mylohyoid Muscle
- Anterior Belly of Digastric Muscle
What is the function of the buccal N. from the mandibular branch of the trigeminal?
What is the funciton of the buccal branch of the facial nerve?
Buccal nerve from V3 provides sensation to the interior cheek and part of the gums.
The buccal branch of the facial nerve provides motor innervation to the buccinator muscle.
The “tensor” muscles of the face are innervated by which cranial nerve?
Trigeminal N.
What foramen does the inferior alveolar N. enter?
The mandibular foramen
What do the cell bodies of the otic ganglion ultimately serve?
The parotid gland
Less petrosal nerve synapses at ganglion
Where can we find the otic ganglion?
Posterior and inferior to V3 as it exits the foramen ovale
Fracture high on the neck of the mandible can interfere with what structures?
Branches of the Maxillary Artery
Examples: Deep Auricular and Anterior Tympanic
A fracture of the ramus of the mandible can damage what structures?
Inferior Alveolar Artery and Nerve
A fracture of the corpus of the mandible can damage what structures?
Not much
What are the muscles of mastication?
Including Accessory
Main Muscles: Innervated by V3
- Temporalis Muslce
- Masseter Muscle
- Lateral Pterygoid Muscle
- Medial Pterygoid Muscle
Accessory Muscles: Innervated by VII
- Buccinator Muscle
- Orbiculais Oris Muscle
What muscles are responsible for the protraction of the jaw?
Masseter Muscle
Lateral Pterygoid Muscle
Medial Pterygoid Muscle
What muscles are responsible for “retrusion” of the mandible?
Masseter M.
Temporalis M.
What muscles are responsible for elevation of the jaw?
Temporalis Muscle
Masseter Muscle
Medial pterygoid Muscle
What muscles are responsible for depression of the jaw?
Suprahyoid Muscles
Infrahyoid Muscles
Lateral Pterygoid Muscle
What muscles are responsible for lateral movements of the jaw?
Ipsilateral: Temporalis Muslce and Masseter Muscle
Contralateral: Pterygoid Muscles
What muscles open the mandible?
Suprahyoid Muscles
- Geniohyoid Muscle
- Myhlohyoid Muscle
- Stylohyoid Muscle
- Digrastric Muscle
What muscles help with swallowing and stablizing hyoid bone?
Infrahyoid Muscles
- Sternohyoid Muscle
- Sternothyroid Muscle
- Thyrohyoid Muslce
- Omohyoid Muscle
What action do the stylomandibular and sphenomandibular ligament prevent?
Excess anterior protrusion of TMJ
What four ligaments hold the TMJ together?
Joint capsule
Sylomandibular Ligament
Sphenomandibular Ligament
Lateral temporomandibular Ligament
What pulls the articular disc of the TMJ forward during wide jaw opening?
Superior Head of the Lateral Pterygoid Muscle
At what angle is the TMJ dislocated anteriorly?
>15 degrees
What nerves supply the TMJ?
Auriculotemporal Nerve (posterior branch)
Posterior Deep Temporal Nerve
Masseteric Nerve
Where is the injection site for the Anterior Superior Alveolar Nerve?
Just at the exit of the infraorbital foramen.
The infraorbital nerve must be blocked.
Where are the injection sites for the posterior and middle superior alveolar nerve blocks?
By the molars for posterior, and by the premolars for middle.
Where is the injection site for the inferior posterior alveolar nerve?
Just inferior and lateral to the pterygomandibular raphe.
(The pterygomandibular raphe is the junction of the buccinator and the superior pharyngeal constrictor Ms.)
Dental nerve blocks target what nerves?
Anterior and middle superior alveolar nerve
Posterior Superior alveolar nerve
