pterygopalatine fossa and palate Flashcards
transantral acess to PPF
via maxillary sinus
upper lip elevated and maxillary sinus entered ant
can remove tumors from PPF or ligate a sphenopalatine aa for chornic epistaxis
general contents of PPF
maxillary a- 3rd portion
maxillary br of V2
pterygopalatine ganglion
boundaries of PPF
lat- pterygomaxillary fissure sup- greater wing of sphenoid ant- maxilla med- palatine bone inf- open via pterygopalatine canal pot- pterygoid process sphenoid
openings of PPF
pterygomaxillary fissure inf orbital fissure sphenopalatine foramen pterygopalatine canal foramen rotundum pterygoid canal pharyngeal canal
pterygomaxillary fissure
lateral
communicates w/infratemporal fossa
transmits maxillary a, post superior alveolar a,v,n
inf orbital fissure
ant
communicates w/orbit
transmits infraorbital a,v,n zygomatic a,v,n and inferior ophthalmic v
sphenopalatine foramen
medial
communicates w/nasal cavity
transmits sphenopalatine a, nasopalatine n, post sup lat nsal n
pterygopalatine canal
inf
communicates w/palate and oral cavity
transmits descending palatine a, greater and lesser palatine nn
foramen rotundum
post
lat- most of the 3 post openings
communicates w/middle cranial fossa
transmits V2
pterygoid canal
post
middle of 3 post openings
communicates w/middle cranial fossa near foramen lacerum
transmits n and a of pterygoid canal
pharyngeal canal
post
medial- most of the 3 post openings
communicates w/nasopharynx
transmits pharyngeal a,v,n
brr of pterygopalatine portion of maxillary a
post sup alveolar a infraorbital a descending palatine a a of pterygoid canal pharyngeal a sphenopalatine a
post sup alveolar a
enters un-named foramen on maxillary bone
supplies maxillary teeth, gingiva, and maxillary sinus
infraoribital a
exits PPF ant via inf orbital fissure
courses in infraorbital canal
exits via infraorbital foramen
supplies floor of orbit, maxillary sinus, maxillary teeth, and skin of face
brr of infraorbital a
zygomatic a
middle sup alveolar a
nasal brr
sup labial brr
descending palatine a
exits PPF inf via pterygopalatine canal
supplies palate, nasal cavity, and palatine tonsil via greater and lesser palatine aa
a of pterygoid canal
exits PPF post via pterygoid canal
supplies nasopharynx, auditory tube, and tympanic cavity
pharyngeal a
exits PPF post via pharyngeal canal
pharyngeal canal courses thru medial wall of sphenoid into nasopharynx
supplies nasopharynx, sphenoid sinus, and auditory tube
sphenopalatine a
exits PPF medially via sphenopalatine foramen
supplies nasal cavity
V2
exits via foramen rotundum to enter PPF
GSA to middle dermatome, nasal cavity, paranasal sinuses, maxillary teeth
distributes parasympathetics from pterygopalatine ganglion
brr of V2
meningeal br sygomatic n post sup alveolar n infraorbital n pterygopalatine nn greater palatine lesser palatine post sup lat nasal n pharyngeal n n of pterygoid canal nasopalatine n
meningeal br of V2
to dura of middle cranial fossa
zygomatic
exits PPF ant via inf orbital fissure
course thru floor and lat wall orbit divides into
zygomaticofacial
zygomaticotemporal
zygomaticotemporal
gives rise to communicating br btwn lacrimal n of V1
route for autonomics to lacrimal gland
post sup alveolar n
enters un-named foramen on maxillary bone
supplies maxillary teeth gingiva and sinus
infraorbital n
exits PPF ant via inf orbital fissure
coures thru infraorbital canal and exits infraorbital foramen
supplies floor of orbit, maxillary sinus, maxillary teeth, skin of face
brr of infraorbital n
middle and ant sup alveolar nn
inf palpebral nn
external nasal brr
sup labial brr
pterygopalatine nn
suspend the pterygopalatine ganglion to V2
carry parasympathetic nn to pterygopalatine ganglion
greater palatine n
exits PPF inf via pterygopalatine canal to oral cavity
supplies hard palate
also supplies nasal cavity via post inf lateral nasal n
lesser palatine
exits PPF inf via pterygopalatine canal to oral cavity
supplies soft palate and tonsillar bed
post sup lat nasal n
exits PPF medially via sphenopalatine foramen to enter nasal cavity
supply lat wall of nasal cavity
pharyngeal n
exits PPF post via pharyngeal canal to nasopharynx
supplies nasopharynx
n of pterygoid canal
enter PPF post pterygoid canal
autonomics to PPG
nasopalatine n
exits PPF via sphenopalatine foramen to nasal cavities
supplies nasal cavit
passes thru incisive foramen to supply an hard palate
nasopalatine n block
injected near incisive canal
greater palatine n block
near greater palatine foramen
pterygopalatine ganglion
suspended form V2 by pterygopalatine nn
cell bodes of postganglionic parasympathetics
preganglionics from VII via greater petrosal
postganglionics from deep petrosal n
autonomics of n of pterygoid canal
preganglionci parasympathetics
postganglionic sympathetics fto PPG
composed of greater petrosal n and deep petrosal n
autonomics greater petrosal n
preganglionics in salivatory nucleus -> VII -> greater petrosal n -> n of pterygoid canal -> PPG -> V2
autonomics deep petrosal n
preganglionics T1-4 -> symp chain -> sup cervical ganglion -> internal carotid n -> deep petrosal n -> n of pterygoid canal -> thru PPG (do not synapse) -> V2
autonomics to lacrimal glans
postganglionic parasympathetics & sympathetics with zygomatic (V2) and lacrimal V1 from PPG
autonomics mucous secreting glands of head
brr of V2 from PPG
palate
consists of hard and soft
forms boundary btwn oral and nasal cavities
nasal surface covered w/respirator mucosa
oral surface covered w/typical oral mucosa
hard palate
ant 2/3s
palatine processes of maxillary bones and horizontal plate of palatine bones
foramina of hard palate
incisive foramen
greater and lesser palatine formen
incisive foramen
nasopalatine n and greater palatine a
greater palatine formen
greater palatine a, v, n
lesser palatine foramen
lesser palatine a, v, n
mucosa of hard palate
palatine glands- mucous secreting
transverse palatine folds
palatine raphe
too painful for injection, inject int sup gingiva mucosa
soft palate
post 1/3 of tongue
mobile assists w/swallowing
palatine aponeurosis and mucosa w/palatine glands
ends in uvulua
soft palate and swallowing
presses against tongue to hold food in oral cavity
presses against roof of pahrynx to prevent food from passing into nasal cavity
fauces
passage from oral cavity into pharynx
sup- palate
inf- base of tongue
lat- faucial pillars
faucial pillars
palatoglossal arch
palatopharyngeal arch
isthmus of fauces (btwn pillars)
palatine tonsillar bed
btwn palatoglossal and palatopharyngeal folds sup and middle constrictor hypoglossus glossopharyngeal tonsillar vessels
palatine tonsil aa
facial a palatine br of ascending pharyngeal ascending palatine dorsal lingual lesser palatine
palatine tonsil vv
tonsilar plexus
pharyngeal plexus
palatoglossus
soft palate via palatine aponeurosis
tongue
X
pulls tongue and soft palate together when swallowing
palatopharyngeus
soft palate via palatine aponeurosis
thyroid cartilage
X
swallowing
musculus uvulae
soft palate via palatine aponeurosis
uvula
X
shortens and elevates uvula
tensor veli palatini
-lateral cartilaginous auditory tube, membranous auditory tube, medial pterygoid plate, scaphoid fossa, spine of sphenoid
- palatine aponeurosis via tendon passing inf to pterygoid hamulus
V3
tenses palate, mastication, swallowing, opens auditory tube
levator veli palatini
medial side cartilaginous auditory tube, petrous portion temporal bone
passes in gap 1 to attach to palatine apneurosis
X
elevate palate, pull against roof of pharynx
paralysis of X
soft palate and faucial pillars sag, uvula deviate to unaffected side
aa of palate
maxillary a (3rd portion):
-greater and lesser palatine aa
facial a:
-ascending palatine a
vv of palate
pterygoid plexus of vv -> maxillary v
sensory of palate
nasopalatine, greater and lesser palatine all V2
