PPF and Palate

Question 1

What is transantral access to the PPF? When would this be utilized?

Answer 1

Elevation of the upper lip to enter the maxillary sinus anteriorly to allow access to the PPF.

This procedure would be utilized in excising tumors in the PPF or ligating the sphenopalatine a. in cases of severe epistaxis.

Question 2

Ptrerygomaxillary fissure opens to where? Transmits which structures?

Answer 2

Opens laterally to the infratemporal fossa. Transmits the maxillary a. and posterior superior alveolar n.a.v.

Question 3

Infraorbital fissure opens to where? Transmits which structures?

Answer 3

Opens to anteriorly to the orbit. Transmits infraorbital n.a.v., zygomatic n.a.v., and inferior ophthalmic v.

Question 4

Sphenopalatine foramen opens to where? Transmits which structures?

Answer 4

Opens medially to the nasal cavity. Transmits sphenopalatine a, nasopalatine n., and posterior superior lateral nasal n.

Question 5

Pterygopalatine canal opens to where? Transmits which structures?

Answer 5

Opens inferiorly to the palate and oral cavity. Transmits the descending palatine a. and greater/lesser palatine nn.

Question 6

Pterygoid canal opens to where? Transmits which structures?

Answer 6

Opens posteriorly to the middle cranial fossa via foramen lacerum. Transmits the A. and N. of the pterygoid canal.

Question 7

Pharyngeal canal opens to where? Transmits which structures?

Answer 7

Opens posteriorly to the nasopharynx. Transmits pharyngeal n.a.v.

Question 8

Name the 6 branches of the Maxillary a. in the PPF.

Answer 8

Infraorbital, posterior superior alveolar, descending palatine, sphenopalatine, pharyngeal, and a. of pterygoid canal.

Question 9

What are the branches, course, and area of vascularization for the infraorbital a?

Answer 9

Branches - zygomatic, superior labial, nasal, anterior/middle superior alveolar.

Course - exits PPF through infraorbital fissure to travel through the infraorbital canal to the infraorbital foramen

Supplies - floor of orbit, maxillary teeth/sinus, face.

Question 10

What are the branches, course, and area of vascularization for the descending palatine a?

Answer 10

Branches - greater and lesser palatine aa.

Course - exits PPF through PP canal to the palate

Supplies - the palate, nasal cavity, and palatine tonsil

Question 11

What is the course and area of vascularization of the artery of the pterygoid canal?

Answer 11

Course - exits PPF through the pterygoid canal

Supplies - nasopharynx, auditory tube, and tympanic cavity

Question 12

What is the course and area of vascularization of the pharyngeal artery?

Answer 12

Course - exits PPF via the pharyngeal canal to pass near the sphenoid sinus

Supplies - sphenoid sinus, nasopharynx, and auditory tube

Question 13

What are the eleven branches of the maxillary n. (V2)?

Answer 13

Meningeal, zygomatic, posterior superior alveolar, infraorbital, pterygopalatine, greater/lesser palatine, posterior superior lateral nasal, nasopalatine, n. to pterygoid canal, and pharyngeal nn.

Question 14

What is the course and innervation of meningeal n.(V2)?

Answer 14

Branches from maxillary n. before exiting the middle cranial fossa to innervate the dura of the middle cranial fossa.

Question 15

What is the course and innervation of zygomatic n. (V2)? How does it provide autonomic innervation to the lacrimal gland?

Answer 15

Enter the infraorbital canal to branch into the zygomaticotemporal and zygomaticofacial nn. Innervates aspects of the face.

Sends a communicating branch to the lacrimal n. (V1) to allow autonomic innervation of the lacrimal gland.

Question 16

What is the course and innervation of posterior superior alveolar n. (V2)?

Answer 16

Enters the maxilla posteriorly through an unnamed foramen to innervate the maxillary gingiva, teeth, and sinus.

Question 17

What is the course and innervation of infraorbital n. (V2)? What are it’s 5 branches?

Answer 17

Courses through the infraorbital canal to provide innervation to the floor of orbit, maxillary sinus/teeth, and skin of face.

Branches - anterior/middle superior alveolar, superior labial, external nasal, and inferior palpebral nn.

Question 18

What is the course and innervation of the pterygopalatine nn. (V2)?

Answer 18

Suspends the PPG and carreis autonomic fibers to and from the PPG.

Question 19

What is the course and innervation of the greater palatine n. (V2)?

Answer 19

Course through the PP canal to innervate the hard palate and nasal cavity. Innervates the nasal cavity via the posterior inferior lateral nasal n. which enters through some unnamed foramen.

Question 20

What is the course and innervation of lesser palatine n. (V2)?

Answer 20

Courses through the PP canal to innervate the soft palate and the tonsilar bed.

Question 21

What is the course and innervation of posterior superior lateral nasal n. (V2)?

Answer 21

Enters the nasal cavity through the sphenopaltine foramen. Innervates the superior posterior portion of the nasal cavity wall.

Question 22

What is the course and innervation of pharyngeal n.?

Answer 22

Innervates the nasopharynx via the pharyngeal canal. Also innervates the sphenoid sinus because it passes adjacent to this space.

Question 23

What is the course and innervation of n. of pterygoid canal (V2)?

Answer 23

Supplies autonomics to the PPG.

Question 24

What is the course and innervation of nasopalatine n. (V2)?

Answer 24

Enters the nasal cavity via the sphenopalatine foramen to innervate the majority of the nasal septum. Also innervates anterior hard palate via the incisive canal.

Question 25

Where would nasopalatine and greater palatine nerve blocks be administered?

Answer 25

At the incisive canal and greater palatine foramen, respectively.

Question 26

Which bones form the hard palate?

Answer 26

The palatine processes of the maxillary bone and the palatine bones.

Question 27

Which foramen are found in the hard palate?

Answer 27

Incisive canal and greater/lesser palatine foramen.

Question 28

Which structures are found in the tonsillar bed?

Answer 28

Superior/middle pharyngeal contrictor mm., hyoglossus m., CN IX, and tonsillar vessels

Question 29

What are the five arteries which supply blood to the palatine tonsil?

Answer 29

Facial, ascending pharyngeal, lesser palatine, ascending palatine, and dorsal lingual aa.

Question 30

What is the venous drainage of the palatine tonsil?

Answer 30

Pharyngeal and tonsillar plexus of vv.

Question 31

What is the innervation and action of the palatoglossus?

Answer 31

Innervated by CN X. Functions to pull the tongue and soft palate together in swallowing.

Question 32

What is the innervation and action of the palatopharyngeus m. ?

Answer 32

Innervated by CN X. Functions in swallowing.

Question 33

What is the innervation and action of the musculus uvulae?

Answer 33

Innervated by CN X. Elevates and shortens the uvula.

Question 34

What is the innervation and action of the tensor veli palatini?

Answer 34

Innervated by CN V3. Tenses palate during chewing and swallowing. Opens the auditory tube in swallowing and yawning.

Question 35

What is the innervation and action of the levator veli palatini?

Answer 35

Innervated by CN X. Elevates the palate agains the pharynx to prevent food from entering the nasopharynx.

Question 36

What manifestation in the palate would paralysis of CN X present with?

Answer 36

Faucial pillars and palate would sag. Uvula would point towards the unaffected side.

Note: Tensor veli palatini would be unaffected.

Question 37

What 3 arteries supply blood to the palate?

Answer 37

Facial via ascending palatine, greater/lesser palatine aa.

Question 38

What provides the venous drainage of the palate?

Answer 38

Pterygoid venous plexus