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HAE term 2 quiz 4 > pterygopalatine fossa > Flashcards

pterygopalatine fossa Flashcards

1
Q

pterygopalatine fissure

A

narrow space that lies between the tuberosity of the maxilla anteriory and pterygoid process of the sphenoid posteriory
entrance from the infratemporal fossa to the more medial located pterygopalatine fossa

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2
Q

pterygopalatine fossa boundaries (don’t memorize)

A

anterior - maxillary tuberosity
posterior - pterygoid process
medial - perpendicular palate fo the palatine bone
lateral - infratemporal fossa via the pterygomaxiallary fissure
superior - greater wing of the sphenoid and infraorbital fissure
inferior - retropharyngeal space

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3
Q

pterygopalatine fossa contents

A

parasympathetic ptergopalatine ganglin
crossroasds for:
infratemporal fossa - terygomaxiallary fissure
middle cranial fossa - foramen rotundum
base fo skull - pterygoid canal
orbit - inferior orbital fissure
nasal cavity - sphenopalatine foramen
oral cavity (palate) - greater palatine canal
nasopharynx - lesser palatine canal and pharyngeal canal

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4
Q

entrances/exits from pterygopalatine fossa (7)

A 
on lateral wall:
1: pterygomaxillary fissure
on posterior wall: (lateral to medial)
2: foramen rotundum
3: pterygoid canal
on medial wall: (from post to ant)
4: pharyngeal canal
5: sphenopalatine foramen
6: greater palatine canal
on anterior wall:
inferior orbital fissure
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5
Q

sphenopalatine foramen

A

on medial wall of pterygopalatine fossa

formed by a small notch in the upper part of the perpendicular plate of the palatine bone where it joins the sphenoid

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6
Q

maxillary artery

A

supplies most of innermost structures of nasal cavity and mouth
mandibular part
pterygoid part
pterygopalatine part - enters through pterygomaxillary fissure

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7
Q

pterygomaxillary fissure

A

pterygomaxillary part of maxiallary artery enters here

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8
Q

maxillary artery branches and where they go

A

maxillary artery through pterygomaxiallary fissure
posterior superior alveolar artery branches off - leaves through pterygomaxillary fissure
infraorbital artery through inferior orbital fissure
greater palatine artery through greater palatine canal
spenopalatine artery through sphenopalatine foramen
pharyngeal artery through pharyngeal artery
artery of the pterygoid canal through pterygoid canal

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9
Q

posterior superior alveolar artery

A

branch of pterygopalatine part of maxillary
through pterygomaxillary fissure after branches off maxillary artery
enters openings in maxillary tuberosity to supply posterior teeth, maxillary sinus and gums

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10
Q

infraorbital artery

A

branch of pterygopalatine part of maxillary

through infraorbital sepum to supply anterior teeth and gums before terminating on the face

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11
Q

descending palatine artery

A

branch of pterygopalatine part of maxillary
has two branches
greater palatine artery
lesser palatine artery

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12
Q

greater palatine artery

A

branch of pterygopalatine part of maxillary then of descending palatine artery
passes through the greater palatine canal to supply the hard palate

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13
Q

lesser palatine artery

A

branch of pterygopalatine part of maxillary then of the descending palatine artery
passes through the lesser palatine cavity to supply the soft palate

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14
Q

sphenopalatine artery

A

branch of pterygopalatine part of maxillary
passes through sphenopalatine foramen
supplies posterior portions of the nasal cavity
gives off lateral posterior nasal arteries and posterior septal branches

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15
Q

maxillary nerve (V2)

A

entirely sensory
enters pterygopalatine fossa posteriorly through foramen rotundum
branches into
1: zygomatic nerve
2: infraorbital nerve
3: 2 ganglionic branches that are distributed as:
- greater and lesser palatine branches
- posterior superior nasal branches
- pharyngeal branches

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16
Q

foramen rotundum

A

maxillary nerve (V2) enters pterygopalatine fossa through this

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17
Q

zygomatic nerve

A

branch of the maxillary nerve (V2) that branches off in the pterygopalatine fossa

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18
Q

infraorbital nerve

A

continuation of maxillary nerve through pterygopalatine fossa

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19
Q

greater and lesser palatine branches

A

from maxillary nerve and through pterygopalatine ganglion to hard and soft palates

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20
Q

posterior superior nasal branches and nasopalatine nerve

A

from maxillary nerve and through pterygopalatine ganglion to nasal cavity

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21
Q

pharyngeal branches

A

from maxillary nerve to pterygopalatine ganglion to upper pharynx
supply general sensory fibers to their respective regions

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22
Q

pterygopalatine ganglion

A

largest of 4 parasympathetic ganglia in the head
lies within pterygopalatine fossa
attached to maxillary nerve
from nerve of the pterygoid canal, receives:
preganglionic parasympathetic fibers from greater petrosal nerve
postganglionic sympathetic fibers from the deep petrosal nerve

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23
Q

nerve of the pterygoid canal

A

brings to the pterygopalatine ganglion:
preganglionic parasympathetic fibers from greater petrosal nerve
postganglionic sympathetic fibers from the deep petrosal nerve

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24
Q

greater petrosal nerve

A

source of preganglionic parasympathetic fibers to the pterygoid ganglion via nerve of the pterygoid canal
synapse in ganglion
attach themselves to branches of maxillary nerve that distribute them to the minor salivary glands of the hard and soft palate, small glands of the nasal cavity and the upper pharynx
secretomotor function to these glands

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25
Q

deep petrosal nerve

A

source of postgangionic sympathetic fibers to pterygoid ganglion via nerve of the petrosal canal
pass through ganglion without change
travel with branches of maxillary nerve to their destinations

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26
Q

major branches of maxillary nerve

A 
zygomatic nerve
infraorbital nerve
ganglionic branches
greater and lesser palatine branches
posterior and superior nasal branches
nasopalatine
pharyngeal branches
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27
Q

lacrimal gland innervation

A

postganglionic parasympathetic fibers pass into the main trunk of maxillary via ganglionic branches
ultimately supplies secretomotor fibers to lacrimal gland
travel from main trunk along zygomatic and zygomaticotemporal branches then cross to lacrimal branch of opthalmic nerve (V1)
terminate as secretomotor fibers to the lacrimal gland

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28
Q

supporting skeleton of external nose

A

osseus part

cartilagenous part

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29
Q

osseus part of external nose

A

two nasal bones of the bridge articulate with the frontal bone at the root of the nose and the frontal process of the maxillae

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30
Q

cartilaginous part of the external nose

A

midline septal cartilage extends bilaterally as the lateral nasal cartilages
two u-shaped alar cartilages at the apex of the nose maintain patency of the nares

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31
Q

septal cartilage

A

part of cartilaginous part of external nose
midline
extends bilaterally as the lateral nasal cartilages

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32
Q

alar cartilages

A

part of cartilages of external nose
u-shaped
maintains patency of nares

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33
Q

components of nasal cavites

A

each has vestibule and a nasal fossa

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34
Q

nasal vestibule

A

component of nasal cavities

lined by skin and has virbrissae

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35
Q

vibrissae

A

coarse hairs that trap and remove particles of dust

in vestibule of nasal cavities

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36
Q

nasal fossae

A

part of nasal cavity

each has a large respiratory area and an olfactory area

37
Q

respiratory area of nasal cavity

A

part of nasal fossae
has mucous membrane of pseudostratified columnar ciliated epithelium
highly vascular
contains abundant mucous and serous glands
purpose: humidify and warm incoming air
creates sticky surface that traps and filters particulate matter
cilia that sweep secretions and debris posteriorly into the nasopharynx

38
Q

olfactory mucous membrane

A

in roof of upper portion of both the medial and lateral nasal walls of the fossae
less well vascularlized
nonciliated epithelium
modified olfactory nerve cells form nerve fibers that traverse the cribriform plate of the ethmoid bone to synapse in olfactory bulb

39
Q

movement of air during respiration

A

during quiet respiration: air circulates around mucosal lining primarily along inferior and middle conchae of lateral nasal walls
sniffing: creates eddies - send air toward roof and olfactory mucosa

40
Q

borders of nasal cavities

A

inferior: separated from oral cavity by hard palate = palatine portions of maxillae and horizontal plates of the palatine bones
superior: separated from anterior cranial fossa by frontal, cribriform plate of the ethmoid and sphenoid bones
lateral: series of bones (see other card)
medially: separated by nasal septum
posterior: vomer
superior: perpendicular plate of ethmoid bone
anterior: septal cartilage

41
Q

nasal septum

A

separates nasal cavities from each other

42
Q

vomer

A

forms posterior part of the nasal cavities

43
Q

perpendicular plate of the ethmoid bone

A

forms superior boarder of nasal cavities

44
Q

lateral bones of nasal cavity (don’t memorize)

A 
maxilla
lacrimal bone
ethmoid bone
inferior nasal concha
palatine bone (vertical plate)
sphenoid bone (medial pterygoid plate)
45
Q

conchae

A 
tubercles
3
curved shelf-like extensions
project into nasal cavity
superior and middle part of ethmoid bone
inferior concha is an independent bone
46
Q

superior and middle conchae

A

ethmoid bone

47
Q

inferior conchae

A

independent bone

48
Q

meatuses

A

air passageways underneath each of the concha

49
Q

sphenoethmoidal recess

A

superior and posterior to the superior concha

50
Q

conchae and meatusese purpose

A

increase surface area and prevent laminar flow

provide greater contact between the inspired air and mucosal surfaces in order to filter, warm, and humidify the air

51
Q

posterior nasal apertures

A

where nasal cavities open into nasopharynx

at the choanae

52
Q

paranasal sinuses

A 
four bilaterally paired sinuses
air-filled evaginations of the respiratory part of the nasal cavity 
named for bones which they invade:
frontal
ethmoid
maxillary
sphenoid
all sinuses lined by respiratory epithelium
53
Q

ostia

A

open into lateral walls of the nasal cavity allowing drainage of mucous and equilibration of air

54
Q

frontal sinuses

A

located in the vertical portion of the frontal bone

contain frontalnasal duct

55
Q

frontal nasal duct

A

in upright position, drains inferiorly by gravity into the middle meatus
part of frontal sinuses

56
Q

ethmoid sinuses

A

honeycomb of small separate air cells within the thin-walled ethmoid labyrinth
lies between the medial wall of the orbit and the upper lateral wall of the nasal cavity
sub-grouped based on location of air cells or ostia
separated from the orbit by the thin-walled lamina papyracea of the ethmoid bone

57
Q

sub-groups of ethmoid sinuses

A
  • anterior ethmoid cells open into middle meatus
  • middle ethmoid cells open into middle meatus on or above the ethmoidal bulla
  • posterior ethmoid cells drain into the superior meatus
58
Q

lamina papyracea

A

of the ethmoid bone
separates ethmoid sinus from orbit
infections can spread readily to cause orbital cellulites

59
Q

maxillary sinuses

A
  • in body of maxilla, largest paranasal air sinus
  • drainage occurs through the ostium located on teh most superior part of the medial wall into the middle meatus - drainage non-gravity dependent and so poor
  • roots of teeth may erupt into these
60
Q

sphenoid sinuses

A
  • located in the body of the sphenoid bone posterior to upper part of the nasal cavities
  • related to the pituitary gland, optic chasm, cavernous sinus and carotid artery
  • drainage occurs into the sphenoethmoidal recess by ciliary action only - gravity drainage is poor - ostium on the anterior wall of the sinus is well above the floor
61
Q

nasal meatuses

A

paranasal sinuses and tears drain into the nasal fossae

1: inferior nasal meatus
2: middle nasal meatus
3: superior nasal meatus
4: sphenoethmoidal recess

62
Q

inferior nasal meatus

A

one of the nasal meatuses where paranasal sinus secretions and tears drain into the nasal fossae
contains nasolacrimal duct

63
Q

nasolacrimal duct

A

in inferior nasal meatus

drains into the anterior portion of this meatus

64
Q

sphenoethmoidal recess

A

one of the nasal meatuses where paranasal sinus secretions and tears drain into the nasal fossae
spheniod sinus drains here

65
Q

superior nasal meatus

A

one of the nasal meatuses where paranasal sinus secretions and tears drain into the nasal fossae
posterior ethmoid cells drain here

66
Q

middle nasal meatus

A

one of the nasal meatuses where paranasal sinus secretions and tears drain into the nasal fossae
frontal recess - frontonasal duct and anterior ethmoid cells drain here
ethmoid bulla - bulging middle ethmoidal air cells and their ostia
uncinate process - a sharp ridge of bone below the ethmoid bulla
semilunar hiatus - opening between teh ethmoid bulla above and uncinate process below leading into a groove - maxillary sinus drains here

67
Q

frontal recess

A

part of middle nasal meatus

frontonasal duct and anterior ethmoid cells drain here

68
Q

ethmoid bulla

A

part of middle nasal meatus

bulging middle ethmoidal air cells and their ostia

69
Q

uncinate process

A

part of middle nasal meatus

a sharp ridge of bone below the ethmoid bulla

70
Q

semilunar hiatus

A

part of middle nasal meatus
opening between the ethmoid bulla above and uncinate process below leading into a groove
maxillary sinus drains here

71
Q

arteries to nasal cavities

A 
external carotid system
     - maxillary
               - sphenopalatine artery
               - greater palatine artery (terminal portion)
     - facial artery
internal carotid system
     - opthalmic artery
          - ethmoidal branches
                - anterior ethmoidal
                - posterior ethmoidal
72
Q

opthalmic artery

A 
branch of the internal carotid 
ethmoidal branches
     - anterior
     - posterior
supply blood to roof of superior medial and lateral walls of both nasal cavities and frontal and ethmoidal sinuses
73
Q

facial artery

A

branch of external carotid

superior labial branch of the facial artery supplies the very antero-inferior portion of the nasal cavity

74
Q

maxillary artery

A

sphenopalatine branch and greater palatine artery

75
Q

sphenopalatine artery

A

branch of maxillary artery
enters nasal cavity through sphenopalatine foramen
main blood supply to the nasal mucosa - to conchae and meatuses of lateral wall and posteroinferior portion of the nasal septum

76
Q

greater palatine artery

A

branch of maxillary artery
passes down the palatine canal and exits the greater palatine foramen
travels anteriorly on the oral surface of the hard palate
passes through the incisive foramen and canal to enter the nasal cavity and anastomose with a septal branch of the sphenopalatine artery on the anterior portion of the septum

77
Q

little’s area/kiesselbach’s plexus

A

regin in anterioinferior part of the nasal septum wehre 4 arteries anastomose to form a vascular plexus
arteries:
1: anterior ethmoidal (from opthalmic)
2: sphenopalatine artery (from maxillary)
3: greater palatine artery (from maxillary)
4: septal branch of superior labial artery (from facial)
common site for nose bleed

78
Q

venous drainage of nasal cavity

A

extensive submucosal cavernous plexuses especially dense over inferior and middle concha and posterior nasal septum
to warm and humidify inspired air, every 6 hours there’s a cyclical fluctuation of venous engagement - veins of one nasal cavity become engorged, other side becomes decongested
opthalimic vein
maxillary vein
facial vein

79
Q

opthalmic vein

A

ethmoidal veins drain here

drains into cavernous sinus

80
Q

maxillary vein

A

remainder of venous drainage is via sphenopalatine vein to pterygoid plexus in infratemporal fossa (mandibular vein - retromandibular vein)

81
Q

facial vein

A

drains into internal jugular vein

82
Q

lymphatic drainage of nasal cavity

A

submandibular

deep cervical

83
Q

submandibular lymph nodes

A

drain anterior region of the nose plus frontal, anterior ethmoidal and maxillary sinuses

84
Q

deep cervical lymph nodes

A

receive lymph directly or via retropharyngeal nodes

85
Q

retropharyngeal lymph nodes

A

drain into deep cervical nodes
receive lymph from posterior region of the nasal cavity including posterior ethmoidal cells, sphenoid sinuses and nasopharynx

86
Q

nerves to nasal cavity

A 
olfactory nerves (CN1)
ordinary sensation:
     - opthalmic (V1)
          - nasociliary nerve
                - anterior ethmoidal nerve
                      - nasal branches
                            - internal
                            - external
     - maxillary (V2)
autonomic nerves 
    - sympathetic
    - parasymptathetic
87
Q

olfactory nerve

A

CNI
perception of smell
nerve fibers from the olfactory mucosa pass through the cribriform plate to synapse in the olfactory bulb

88
Q

maxillary nerve

A

through foramen rotundum to pterygopalatine fossa
supplies posteroinferior portion of nasal cavity
lateral - to posterior superior lateral nasal branches
medial - posterior superior medial nasal branches, nasopalatine nerve

HAE term 2 quiz 4 (6 decks)

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