pterygopalatine foss Flashcards
where is pterygopalatine fossa located
on lateral side of skull between the infra temporal fossa and nasopharynx
the ptergyopalatine fossa is known as
major neuromuscular crossroads between the orbit, nasal cavity, the infra temporal fossa, and cranial fossa
walls of PP fossa
anterior wall- posterior surface maxilla
medial wall- lateral surface palatine bone
roof/posterior wall- from sphenoid (anterosuperior surface of pterygoid process)
PP fossa communicates with
middle cranial fossa, infratemporal fossa, floor of orbit, lateral wall of nasal cavity, oropharynx, roof of oral cavity
PP fossa is the major site for
the maxillary nerve V2
PP fossa is the terminal site for
the maxillary artery
PP fossa contains what ganglion
pterygopalatine
the pterygopalatine ganglion is a merger of
preganglionic parasympathetic fibers from facial nerve (VII) and postganglionic parasympathetic fibers
preganglionic parasympathetic fibers from facial n. (VII) and postganglionic parasympathetic fibers join
sympathetic fibers from T1 join branches of V2
PP fossa is formed by
anterosuperior surface of pterygoid process
two large foramen of PP fossa on sphenoid bone
foramen rotundum and anterior opening of pterygoid canal
how many foramina and fissures as apertures are seen within the PP fossa and what are they
7
sphenopalatine foramen- nasal cavity
inferior orbital fissure- floor of orbit
pterygomaxillary fissure- 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)
To remember the seven foramina of the pterygopalatine fossa, you can use a mnemonic or memory technique. Here’s a simple mnemonic that may help you recall them:
“A Tiny Man Saw Three Fat Rats”
Here’s what each word in the mnemonic represents:
A (Anterior): This refers to the anterior opening of the pterygopalatine fossa, which is the pterygomaxillary fissure.
Tiny (Temporal): This represents the temporal (or lateral) side of the fossa, which has the foramen rotundum.
Man (Maxillary): This stands for the maxillary (or superior) side, which contains the greater palatine foramen.
Saw (Sphenopalatine): This represents the sphenopalatine foramen, which is a crucial foramen in this region.
Three (Teres): This refers to the terygoid canal (also known as the pterygoid or Vidian canal).
Fat (Foramina): This reminds you that there are multiple foramina, so you need to keep them in mind.
Rats (Rotundum): This refers to the foramen rotundum again, reinforcing the second foramen.
what nerve goes through the foramen rotundum
maxillary nerve V2 (sensory)
maxillary nerve passes where and supplies what
passes anteriorly- passes through the inferior orbital fissure as infraorbital nerve
supplies orbital wall- sphenoidal and ethmoidal sinuses
what nerves go through the palatine canal
from V2 the greater and lesser palatine nerves
greater palatine nerve
roof of oral cavity, innervates mucosa, glands of hard palate, gingiva to incisors, gives rise to posterior nasal nerves to nose
lesser palatine
soft palate?
what nerve goes through sphenopalatine canal
nasal nerves (7) enter nasal cavity
nasal nerves
most go to supply the lateral wall, others medial wall
nasopalatine nerve passes down
nasal septum via incisive canal to oral cavity adjacent to incisor teeth
what nerves goes through the palatogingival canal
Zygomatic nerve off pterygopalatine ganglion
zygomatic nerve
supplies mucosa and glands of nasopharynx
divides into Zygomaticotemporal branch and Zygomaticofacial branch
two branches of zygomatic nerve and what they supply
Zygomaticotemporal- supplies skin over temple
Zygomaticofacial- supply adjacent skin
what nerve goes through pterygomaxillary fissure
posterior superior alveolar nerve
posterior superior alveolar nerve
originate from V2, joins the superior dental plexus inferior to maxillary sinus, supplies molar teeth, buccal gingiva
also involved with maxillary sinus
what goes through infraorbital fissure
infraorbital nerve
infraorbital nerve- where is lies/exits, branches
continuation of V2
lies in infraorbital groove, exits through infraorbital canal
branches- middle and anterior superior alveolar nerves, join superior alveolar plexus (supplies maxillary teeth)
middle superior alveolar nerve
supplies maxillary sinus
anterior superior alveolar nerve
small branch of nasal, to area of nasal floor and walls
infraorbital nerve divides into
nasal (to skin over nose and part of nasal septum)
palpebral (to skin of lower eyelid)
superior labial branches (to cheek, upper lip, and related oral mucosa)
innervation and blood supply of maxillary teeth
posterior superior alveolar- branch of maxillary V2
anterior and middle superior alveolar- branch of infraorbital
branches of maxillary artery (posterior- middle and anterior alveolar artery)
innervation and blood supply of mandibular teeth
inferior alveolar nerve from V3
inferior alveolar artery off maxillary artery
the nerve of the pterygoid canal is formed by
greater petrosal from CN VII (facial) and deep petrosal (branch of internal carotid plexus)
nerve to pterygoid canal carries
preganglionic parasympathetic and postganglion sympathetic fibers
greater petrosal nerve
from geniculate ganglion of CN VII
parasympathetic innervation to mucous glands of nasal cavity, salivary glands in upper half of oral cavity, lacrimal gland in orbit
also for taste from soft palate
deep petrosal nerve
carries postganglionic sympathetic fibers for blood vessels
deep petrosal nerve originates in and joins
superior cervical sympathetic ganglion, merges with ganglionic fibers from T1
joins greater petrosal
pterygopalatine ganglion
largest of 4 sympathetic ganglia in head
from CN VII (facial) carried by greater petrosal and nerve of pterygoid canal
join V2 fibers
what nerves continue off of CN V2
orbital, palatine, nasal, pharyngeal??? slide 24
sphenopalatine ganglion block is often involved in
management of orofacial pain and headache
sphenopalatine ganglion block relieves
trigeminal autonomic cephalagias such as cluster headache, migraine, chronic paroxysmal hemicrania, and certain neuralgias
sphenopalatine ganglion has what kind of fibers
parasympathetic, sympathetic, and somatosensory nerve fibers
what supplies sensation to lacrimal gland
off Zygomaticotemporal branch of the zygomatic nerve- forms special autonomic nerve
general sensory branch off ophthalmic nerve (V1)
arterial supply
most of nasal cavity, roof of oral cavity, all maxillary teeth, also contribute to supply of sinuses- floor of orbit and oropharynx
major blood supply of PP fossa
maxillary artery off ECA
branches of maxillary artery
posterior superior alveolar
greater palatine
infraorbital
pharyngeal
artery of pterygoid canal
sphenopalatine artery
posterior superior alveolar artery
supplies molars/molars, adjacent gingiva and maxillary sinus
infraorbital artery
structures around orbital floor
anterior superior alveolar artery
incisors, canines, maxillary sinus
greater palatine artery through palatine canal become what and supplies what
lesser palatine branch, supplies soft palate, continues to greater palatine foramen to supply hard palate, to anterior septum of nose
pharyngeal branch maxillary artery
supplies posterior aspect of roof of nasal cavity, sphenoidal sinus and pharyngotympanic tube
sphenopalatine artery
terminal branch of maxillary artery, supplies lateral wall of nasal cavity and paranasal sinuses (posterior septal branches supply nasal septum then join greater palatine artery
artery of pterygoid canal
at pterygoid canal supplies surrounding tissues, fills foramen lacerum, terminates in mucosa of nasopharynx
all veins of PP fossa join in what and pass what
join in pterygopalatine fossa and pass laterally into PP fossa, pass through PP fissure to form pterygoid plexus in ITF
pterygoid plexus travels with
branches of maxillary artery
what vein bypasses PP fossa
infraorbital vein
emissary veins connecting pterygoid plexus drain to
cavernous sinus
pterygoid plexus mainly drains into
external jugular vein
pterygoid plexus exists between
temporalis and lateral pterygoid muscles
path from pterygoid plexus
external jugular to subclavian
cavernous sinus is brain’s
dura
