Pterygopalatine Fossa Flashcards
Components of the bony part of the nose:
Nasal bones
Front process of maxilla
Nasal part of frontal bone and nasal spine
Bony part of the nasal septum
Cartilaginous component of the nose:
2 lateral cartilage
2 alar cartilage
Septal cartilage
All the nasal cavity is lined with …. Except for …
Nasal mucosa
Vestibule of the nose
Nasal mucosa is connected to..
Periosteum of the bony parts of the nasal cavity and the perichondrum of the nasal cartilage
Olfactory area
Olfactory area has specialized nasal mucosa that contains the peripheral nerve ending from CNI for olfaction
*Borders of the nasal cavity:
Roof: frontal, ethmoid and sphenoid bones
Floor: Palatine process of maxilla, horizontal plate of palatine bone
Medial wall: nasal septum (perpendicular plate of ethmoid, vomer, septal cartilage, nasal crests of the maxillary and palatine bones
Lateral wall: superior, middle and inferior nasal conchae
4 passages of the nasal cavity:
What openings do they have?
Spheno-ethmoidal recess (forms the opening of the sphenoid sinus)
Superior nasal meatus (forms the opening of the ethmoidal sinus)
Middle nasal meatus (forms opening of frontal sinus and maxillary sinus)
Inferior nasal sinus (forms opening of nasolacrimal duct)
Draw the 4 nasal cavity passages and their associated openings
Refer to drawings
What is the major arterial supply to the nasal cavity?
Branches of the Maxillary A. (particularly the Sphenopalatine A. Also, Anterior and Posterior ethmoidal As., Greater Palatine A.)
Branches from the Facial A. (Superior Labial A. and Lateral Nasal branches )
Draw the arteries of the nasal cavity
Refer to drawings
*Maxillary sinus (largest):
Drains where …
Blood supply?
Innervation?
Drains via the maxillary ostium into middle meatus
Superior alveolar branches of Maxillary A and the Greater Palatine A.
Superior Alveolar Nerve branches (V2)
*Ethmoid Sinus (located in ethmoid air cells between orbits) :
Drains?
Blood supply?
Innervation?
Anterior and middle ethmoidal cells drain into middle meatus while Posterior Ethmoidal cells drain into superior meatus Ethmoidal A. (from the ophthalmic A.) Nasociliary nerve (CN V1)
Sphenoid sinus (divided by the boy part of nasal septum):
Drains?
Blood supply?
Innervation?
Via spheno-ethmoidal recess
Posterior ethmoidal A.
Posterior ethmoidal N. (CN V1)
Frontal sinus (located between the tables of frontal bone)
Drains?
Blood supply?
Innervation?
Via frontonasal duct into semilunar hiatus of middle meatus
Supraorbital A. and Anterior Ethmoidal As.
Supraorbital N. (CN V1)
Where is the Pterygopalatine Fossa?
Found inferior to the apex of the orbit
*Borders of the Pterygopalatine Fossa:
Anterior: Maxillary tuberosity
Posterior: Pterygoid process of sphenoid
Medial: Perpendicular plate of palatine bone
Lateral: Opens into infratemporal fossa via the pterygomaxillary fissure
Roof: Greater wing of the sphenoid
Floor: pyramidal process of the palatine bone
What are the openings of the pterygopalatine fossa?
Superior: Opens into inferior orbital fissure
Inferior: closed except for the palatine foramen
Fissures of the Pterygopalatine Fossa:
Inferior Orbital fissure
Pterygomaxillary fissure
Foramina of the pterygopalatine fossa:
Spheno-palatine foramen
Foramen rotundum
Canals of the pterygopalatine fossa:
Pharyngeal canal
Vidian canal
Pterygopalatine canal
What are the contents of the Pterygoid (vidian) canal?
Greater petrosal N. (CN VII) and the Deep Petrosal N. to form the N. of the Pterygopalatine canal and terminates at the Pterygopalatine ganglion
Draw the openings of the pterygopalatine fossa and what passes through it (Table 32.8)
Refer to drawings
*What are the contents of the Pterygopalatine fossa?
Maxillary N. (CN V2)
Pterygopalatine ganglion
3rd part of the maxillary artery
Pathway of the parasympathetic fibers to the lacrimal nerve from the pterygopalatine ganglion (from the greater petrosal N.)
Maxillary N (V2) > Zygomaticotemporal N. > communicating branch conveys the parasympathetic fibers to the lacrimal N.
Parasympathetic pathways in the pterygopalatine fossa
Greater petrosal N. (branch of CN VII) > joins the deep petrosal N. to from the N. of the pterygoid canal > supplies the pterygopalatine ganglion > conveys parasympathetic innervation to the lacrimal n. > lacrimal gland to produce tears
Sympathetic pathways in the pterygopalatine fossa
Deep petrosal nerve branches out of the internal carotid plexus > supplies the superior cervical ganglion > conveys postsynaptic sympathetic fibers that join the maxillary n via the pterygopalatine ganglion (but they do not synapse here). Jump on arteries and nerves to get places
Draw the parasympathetic pathway in the pterygopalatine fossa
Refer to drawings
Draw the sympathetic pathway in the pterygopalatine fossa
Refer to drawings
Draw the innervations of the pterygopalatine fossa
REfer to drawings
Mandibular part of the maxillary a:
What do these vessels supply?
Inferior alveolar a.
Anterior tympanic a.
Deep auricular a.
Middle meningeal a.
- mandible, teeth, gingiva
- tympanic cavity
- TMJ, external auditory canal
- Calvaria, dura, anterior and middle cranial fossae
Pterygoid part of the maxillary a.
What do these vessels supply?
Masseteric A.
Deep temporal A.
Pterygoid branches
Buccal A.
Masseter M.
Temporalis M.
Pterygoid M.
Buccal mucosa
Pterygopalatine part of the maxillary a.
What do these vessels supply?
Greater palatine A. (from descending palatine a.)
Lesser Palatine A. (from descending palatine a.)
Posterior superior alveolar a.
Infraorbital a.
Lateral posterior nasal A. (from sphenopalatine a.)
Posterior septal branches (from sphenopalatine a.)
- hard palate
- soft palate, palatine tonsil, pharyngeal wall
- Maxillary molars, maxillary sinus, gingiva
- Maxillary alveoli
- Lateral wall of nasal cavity, choanea
- Nasal septum
Draw the arteries of the pterygopalatine fossa
Refer to drawings
Venous drainage in the nasal cavities drains to…
sphenopalatine, facial and ophthalmic veins