Pterygopalatine Fossa Flashcards
What Spaces does the pterygopalatine Fossa communicate with?
- Middle Cranial Fossa
- Infratemporal Fossa
- Floor of the orbit
- Lateral Wall of the Nasal Cavity
What is the major site of the distribution for the maxillary n. (V2) and the maxillary a.?
- Pterygopalatine Fossa
Where does all of the blood and nerve supply to the upper teeth come from?
- Maxillary n. (V2)
- Maxillary a. (terminal pt)
Boundaries of Pterygopalatine Fossa:
- Anterior
- Medial
- Posterior
- Roof
Anterior:
- Posterior Surface of Maxilla
Medial:
- Vertical Plate of Palatine Bone
Posterior:
- Sphenoid - Pterygoid Processes
Roof:
- Sphenoid - Greater Wing
What two spaces are connected by foramen rotundum?
- Middle Cranial Fossa
- Pterygopalatine Fossa
Where is the anterior opening to the pterygoid canal?
- Medial and inferior to foramen rotundum
Anterior and posterior openings of the pterygoid canal?
Anterior:
- Pterygopalatine Fossa
Posterior:
- Middle Cranial Fossa ( just anterior and inferior to where carotid enters
What 7 formamina and fissures open into the pterygopalatine fossa?
- Foramen Rotundum
- Pterygoid Canal
- Palatovaginal Canal
- Palatine Canal
- Sphenopalatine Foramen
- Ptergomaxillar Fissure
- Inferior Orbital Fissure
Where does the Palatovaginal canal lead to from the pterygopalatine fossa?
Nasopharynx
Where does the Palatine canal lead to from the pterygopalatine fossa?
Opens inferiorly and spits into greater and lesser palatine foramina
Where does the sphenopalatine foramen lead to from the pterygopalatine fossa
- Lateral Nasal Wall
Where does the pterygomaxillary fissure lead to from the pterygopalatine fossa
Infratemporal Fossa
Where does the Infraorbital Fissure lead to from the pterygopalatine fossa
Floor of the Orbit
What fiber types leave the pterygopalatine ganglion?
- innervation type?
- Nasal
- Palatine
- Pharyngeal
**Maybe orbital, but it was not mentioned in lect
(GVE - symp. and parasymp; GSA)
What do the orbital branches do?
GSA to:
- Orbital wall
- Sphenoid sinus
- ethmoid sinus
What hole must the orbital branches pass through to get to the palatine region?
- Infraorbital Foramen
What holes must the greater and lesser palatine nn. pass through to get to the hard and soft palates?
Palatine Foramen => Greater and lesser palatine foramena
Which of the nasal nn. from the pterygopalatine ganglion travels across the roof of the nasal cavity to supply the medial wall?
- Nasopalatine nerve.
What hole does the pharyngeal n. use to exit the pterygopalatine fossa?
- What does it do?
- Palatovaginal Canal
- Supplies mucosa and glands of the nasopharynx
What are the branches of the zygomatic n.?
- Zygomaticotemporal n.
- Zygomaticofacial n.
How does the posterior superior alveolar n. exit the pterygopalatine fossa?
- Alveolar Formina in the Posterior Maxilla
What nerve gives rise to the middle and anterior superior alveolar nn.?
- Posterior Superior Alveolar n.
Anterior and Middle:
- Infraorbital n.
Posterior:
- Direct branch of V2
What plexuses do the alveolar nn. (Posterior, Middle, Anterior) ultimately become a part of?
- Superior Dental Plexus
What nerves unit to form the nerve of the pterygoid Canal?
- Greater Petrosal n. (CN VII)
- Deep Petrosal n. (=> Int. carotid plexus)
What fiber types are contained in the in the nerve of the pterygoid canal?
GVE:
Parasympathetic PREganglionic - Greater Petrosal n.
Sympathetic POSTganlionic - Deep Petrosal n.
What ganglion is the greater petrosal n. associated with?
- Geniculate Ganglion
**Sensory Ganglion for the Facial n.
What bones make up the Pterygomaxillary Fissure?
- anterior
- posterior
Anterior:
- Posterior Part of Maxilla
Posterior:
- Pterygoid Process of Sphenoid
What is the doorway of the 3rd part of the maxillary artery to enter from the infratemporal fossa?
- Pterygomaxillary Fissure
What innervates most of the nasopharynx?
- Pharyngeal Branch of Maxillary n. (V2)
What is the terminal branch of the maxillary artery?
Sphenopalatine a.
How doe POSTganglionic sympathetic form CNVII reach their target?
- Travel with MAXILLARY (V2) or OPTHALMIC (V1) branches of trigeminal to reach their target
Where does the greater petrosal n. pick up its sympathetic component?
- As it passes the internal carotid and is joined by the deep petrosal n. (sympathetic)
The Greater Petrosal n. carries parasympathetic information to what organs?
***ALL glands above the oral fissure
- All mucous gland in the nasal Cavity
- Salivary Glands in the upper 1/2 of the oral cavity
- Lacrimal gland in the orbit
Where are the postganglionic cell bodies that give rise to the deep petrosal n. located?
- Superior Cervical Sympathetic Ganglion (mostly T1 preganglionics synapsing)
Where do parasympathetic nerves jump off of branches of V2 to ride branches of V1?
- What branches are involved
- Associated Ganglia
- Parasympathetics ride on ZYGOMATICOTEMPORAL (V2) and hop on the LACRIMAL n. (V1)
- Fibers from Pterygopalatine Ganglia
What do the sympathetic and parasympathetic POST ganglionics that jump onto the the lacrimal n. do?
- Common pathology
- Control tear flow from lacrimal gland
- If a lesion occurs on parasympathetics of VII then patient will have chronic Dry eye
What is the origin of the anterior superior alveolar arteries?
Infraorbital a. => Maxillary a. => ECA = CCA
What frequently forms an elevation in the FLOOR of the sphenoid air sinus?
- Pterygoid Canal
What does the infraorbital n. run in on the floor of the orbit?
- Infraorbital groove
What does the infraorbital n. supply cutaneous innervation to?
- Lower Eyelid
- Lateral Nose
- Upper Lip
- Gingiva
What muscle of facial expression is the infraorbital n. deep to?
- Levator Labii superioris m.
What nn. come together to form the superior dental plexus?
- Anterior, Middle, and Posterior Superior Alveolar nn.
What branch of the 3rd part of the maxillary artery and Maxillary n. (V2) reenters the infratemporal fossa?
- Posterior Superior Alveolar a. and n.
What passes through the Pterygomaxillary fissure?
- maxillary a.
- Posterior Superior Alveolar Branch (=> maxillary a.)
- Posterior Superior Alveolar n. (V2)
What spaces does the pterygopalatine fossa open into via its foramina and fissures?
- Middle Cranial Fossa (rotundum, Pterygoid Canal)
- Nasopharynx (pharyngeal canal)
- Nasal Cavity (sphenopalatine foramen)
- Orbit (orbital fissure)
- Oral Cavity (palatine canal)
- Infratemporal Fossa (Pterygomaxillary fissure)
What two bones make up the pterygoid canal?
- Sphenoid
2. Palatine Bone
What 6 branches come off of the 3rd part of the maxillary a.?
- Phayngeal
- A. of Pterygoid Canal
- Sphenopalatine a.
- Infraorbital a.
- Descending Palatine a.
- Posterior Superior Alveolar a.
What does the artery of the pterygoid canal distribute to?
- Upper Pharynx
- Auditory Tube
What does the Pharyngeal a. distribute to?
- Sphenoid Sinus
- Nasopharyx
- Auditory Tube
What do the middle and anterior superior alveolar arteries branch off from?
- Where do they supply blood?
Branches from Infraorbital artery
Supply:
- Maxillary Sinus
- Incisor Teeth
- Canine Teeth
What two arteries anastomose in the incisive canal?
Greater Palatine
Sphenopalatine
What is the anterior continuation of the maxillary artery?
- Infraorbital artery
T or F: the Maxillary n. has a functional relationship with the Pterygopalatine Ganglion.
False, the relationship is purely anatomical
Describe areas supplied by orbital branches of V2.
Supply:
Oribital Wall
Sphenoid Sinus
Ethmoid Sinus
Describe the passage of the infraorbital n. from the Pterygopalatine Fossa to the Face.
Infraorbital fissure —>
Infraorbital groove —>
Infraorbital Canal —->
Infraorbtial Foramen
What two nerves contribute to the innervation of the maxillary sinus?
- Orbital Branches
2. Posterior Superior Alveolar n.
What are the branches of V2 that pass through the Pterygopalatine Ganglia?
- Palatine n.
- Lateral nasal branches
- Nasopalatine n.
- Pharngeal n.
What nerve gives rise to the anterior and middle alveolar nerves?
- where
Infraorbital n. INSIDE the infraorbital CANAL
What passes through the spenopalatine foramen?
- Posterior Lateral Nasal Branches of V2
- Nasopalatine (V2)
- Sphenopalatine a.
What branch of CN VII has postganglionic that hitchhike on branches of V2?
- ganglia
Greater Petrosal n.
Note: that it also hitchhikes on the lacrimal n. which is a branch of V1
What branch of CN VII is associated with postganglionic that hitchhike on branches of V3?
- ganglia
Chorda Tympani
Besides carrying preganglionic GVE fibers, what fiber type is carried by the Greater Petrosal N.?
Taste information from the soft palate
T or F: branches of maxillary V2 synapse in the pterygopalatine ganglia
FALSE, these just pass through
What fiber types are found in the n. of the pterygoid canal?
Taste
Sympathetic (post gang.)
Parasympathetic (pre gang.)
Special Sensory
T or F: the soft palate is really responsive to sweet taste
True, cell bodies for this are found in the geniculate ganglion
How do SA fibers get to taste buds on the soft palate?
- Greater Petrosal n.
- Though PP ganglion (NO SYNAPSE)
- Leave with Lesser Palatine nn.
What are the Jobs of CN VII?
- BE motor (facial expression)
- GVE:
- Lacrimal (Greater Pet.)
- Submandibular (Chorda Tymp)
- Sublingual (Chorday Tymp)
T or F: In general, parts 1 and 3 of the maxillary a. have branches that travel through bony canals.
True, part two goes to muscle and just travels through soft tissues
What groove the floor of the sphenoid sinus and also travels through the medial pterygoid plate?
N. and A. of the pterygoid canal
If you punctured the infraorbital groove and canal inferiorly, what space would you be in?
Maxillary Sinus
If you punctured the medial wall of the Pterygopalatine fossa where would you be?
Nasal Cavity
If you punctured the anterior wall of the PPF where would you be?
Maxillary Sinus
The infraorbital groove can be found on what bone?
Maxilla