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week 1 > sievert H&N infratemporal fossa > Flashcards

sievert H&N infratemporal fossa Flashcards

1
Q

what is the only trigeminal branch that has both motor and sensory?

A

V3

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2
Q

types of movements in the TMJ

A

gliding and hinge movements

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3
Q

list the GVEs

A

3 7 9 10

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4
Q

superior border of the infratemporal fossa

two ways to demarcate it

A

zygomatic arch in one sense.
in another sense,the infratemporal fossa is continuous to the temporal fossa, but it demarcated by the infratemporal ridge

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5
Q

what’s the inferior border of the infratemporal fossa?

A

infratemporal fossa is open to the neck….. but bounded somewhat by the inferior pterygoid muscle

so i guess you could say it’s the inferior pterygoid m.

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6
Q

anterior border of the infratemporal fossa

A

maxillary bone

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7
Q

medial border border of the infratemporal fossa

A

lateral pterygoid plate

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8
Q

lateral border of the infratemporal fossa

A

ramus of mandible

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9
Q

lateral border of the infratemporal fossa

A

parts of the temporal bone

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10
Q

body and ramus of mandible

and the angle too

A

body: the c-shaped part of the mandible that supports the teeth
ramus: the vertical extension of the mandible that is continuous w/ the body

angle: the area of the mandible between the body and the ramus. think of the body and ramus as little rectangles

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11
Q

coronoid process and condyle of mandible

A

coronoid process: anterior superior process of mandible

condyle: posterior superior process of mandible

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12
Q

landmark external acoustic meatus: name all the other temporal structures

A

anterior: zygomatic arch (condyle in between z-arch and ext. acoustic canal… but condyle is part of mandible)
inferior: styloid process
posterior: mastoid process

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13
Q

stylomastoid foramen

A

opening between styloid and mastoid…. facial nerve, CN7 passes through here to give off five terminal branches to muscles of facial expression…

not part of infratemporal fossa

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14
Q

location of medial ptyerygoid plate

A

just medial and deep to the lateral pterygoid plate

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15
Q

where do muscles of mastication attach?

A

medial or lateral side of pterygoid plate

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16
Q

body landmarks between the maxilla and the lateral pterygoid plate

A

pterygomaxillary fissure and pterygopalatine fossa

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17
Q

mandibular fossa

A

bony fossa just posterior to the zygomatic arch… serves as a fossa for the condyles of the madible

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18
Q

using styloid as a landmark (even tho it’s temporal), where is the position of the sphenoid bone landmarks of the infratemporal fossa?

A

all sphenoid:

closest to styloid, foramen spinosum, and then foramen ovale is a little bit more anterior and medial to the spinosum.

then you get the medial and lateral pterygoid plates

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19
Q

where does V3 exit the cranial cavity to enter the infratemporal fossa?

A

foramen ovale

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20
Q

middle meningeal artery enters through what foramen?

A

spinosum!

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21
Q

mandibular notch vs foramen

A

notch: the big space between the condyles and the coronoid process
foramen: where the vessels and nerves to the teeth go

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22
Q

TMJ joint cavities

A

superior and inferior joint cavities, separated by a mobile articular disc

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23
Q

TMJ surrounded by what?

A

strong capsule

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24
Q

bony part of the TMJ joint

A

mandibular fossa + articular tubercle (the most posterior protrusion of the zygomatic arch… most anterior bony part of TMJ)

and condyles of course

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25
Q

lateral pterygoid fxn in TMJ

A

attach to condyle and disc.

pull condyle and disc anteriorly

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26
Q

if you open your jaw really wide,

A

it rolls off anteriorly to the articular tubercle

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27
Q

hinge movements of TMJ

A

ELEVATION AND DEPRESSION

happens mainly in lower joint cavity

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28
Q

gliding movements of TMJ

A

protraction and retraction… happens in upper joint cavity

this makes sense coz the disc and the lower joint cavity are being pulled on forward by the lateral pterygoid m.

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29
Q

supporting structures of TMJ

A
  • joint capsule: surrounds whole joint
  • sphenomadibular lig
  • stylomandibular lig

these last two ligs become taught during protraction

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30
Q

TMJ hyaline cartilage

A

surrounds the articular surfaces

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31
Q

synovial membrane of TMJ joint

A

lines the non weightbearing surfaces

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32
Q

what is inside the infratermporal fossa?

A

muscles of mastication
branches of mandibular n.
branches of maxillary art.

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33
Q

all muscles of masticaiton are innervated by?

A

CN 5

they come from the first arch

34
Q

masseter
fxn
origin
insertion

A

powerful supericial muscle
helps w/ closure… teeny bit w/ protraction

o: maxillary bone and zygomatic arch
i: mandibular ramus

35
Q

temporalis fxn

A

anterior fibers: closure only

posterior fibers: good retractors. do some closure too

36
Q

masseteric n and art go thru?

what supplies the temporalis tho?

A

mandibular notch

ant. and post. deep temporal nerves

37
Q

lateral pterygoid m.
fxn
o
i

A

fxn: powerful protraction
o: from lateral surface of pterygoid plate
i: condyle and articular disk of TMJ

38
Q

medial pterygoid m.

fxn

o

i

A

Medial pterygoid muscle is similar to the masseter but on the inside of the jaw

o: it arises from the medial surface of the lateral pterygoid plate and part of the fossa between medial and lateral pterygoid plates

inserts on medial border of ramus and angle of mandible

39
Q

sphenomandibular lig relative to muscles

A

runs straight down, in between lateral pterygoid m and medial pterygoid m

40
Q

both pterygoid muscles arise from?

A

lateral pterygoid palte

41
Q

parotid opens through?

A

buccinator

42
Q

buccal branch of CN 5 vs CN 7 in terms of buccinator

A

buccal branch of 5 passes through to give sensory innervation to oral cavity

buccal of 7 innervates the buccinator, as it is a branchiomotor to facial expression

43
Q

three nerves around lateral pterygoid

A

deep: lingual and infeiror alveolar
super
superficial: buccal branch of 5.

44
Q

two immediate branches of the external carotid

A

superficial temporal and the maxillary artery

45
Q

terminal branch of maxillary artery enters through?

A

pterygomaxilalary fissure and heads up to paterygopalatine fossa

46
Q

branches of maxillary artery from origin to terminal part

A
  • -Middle meningeal goes through foramen spinosum
  • -Inferior alveolar artery travels with inferior alveolar nerve through the mandibular foramen to supply the teeth
  • -2 deep temporal arteries travel superiorly and deep to the temporalis muscle (anterior and posterior branches to temporalis muscle)
  • terminal brach that entered the pterygopalatine fossa
47
Q

middle meningeal:

how did it get into skull?
fxn?

A

got in through foramen spinosum!!, which is slightly more lateral than foramen ovale

Middle meningeal artery supplies the dura

can be easily
torn following head trauma to the region of the temporal bone

48
Q

structures near or in fossa that need somatosenosry innervation

A

teeth (we only are about lower law coz maxillary div nerve will go to upper jaw)
tongue
oral cavity
skin anterior to ear

49
Q

tongue innervation

A

general sense: anterior by 5. posterior of tongue by CN 9.

special sense: taste by branhch of seven that jumps on five

50
Q

in the undivided trunk of V3, three branches are motor but one is sensory

A

sensory=meningeal
motor=medial pterygoid, tensor veli palatini, tensor tympani

MMTT

51
Q

in anterior branch of V3, four are motor, but one is sensory

A

sensory=buccal
motor = lateral pterygoid; masseteric n; anterior and deep terporal

BL MAP. big lickin map

52
Q

mostly sensory, but one mixed

A

ALI
auriculotemporal = sensory
lingual = sensory
inferior alveolar = sensory but its branch to the mylohyoid is motor

53
Q

tensory tympani fxn

A

dampen effect of sound on tympanic membrane and inner ear

54
Q

tensory veli palatini fxn

A

open middle ear

55
Q

lingual n fxn

A

carries sensory to 2/3 of tongue from CN 5, but also carries taste from CN7

56
Q

inferior alveolar n fxn

A

Inferior alveolar is gonna supply teeth, but there is a single moddle branch called the mylohyoid nerve that comes off the alveolar—the myohyloid muscle.

57
Q

structural etiology of motor fxn of cn 5

A

motor stuff: motor nucleus of CN 5—> motor root of CN 5 —> short distance —> trigeminal ganglion of CN 5
sensory

58
Q

structural etiology of senosry info of trigeminal nuclues

A
  • discriminative touch, two point discrimination, goes to chief sensory nucleus
  • proprioception goes to mesencephalic nucleus (actually a ganglion)
  • pain and temperature goes to spinal V nucleus
59
Q

location of chief sensory 5 and motor V

A

mid pons

mesenphalic (up on midbrain… proprioception!) and spinal part (on medulla… pain and temp)

60
Q

what’s weird about unconcious proprioception to the CN 5?

A

no true ganglia… remember these enter the mesencephalic nucleus… lots of times this nuclues will communicate w/ motor 5 to do reflexes

61
Q

inferior alveolar n exits the mental foramen to to become?

A

mental nerve!

62
Q

rule of one exception regarding glands

A

all the glands in the head are innervated by CN SEVEN—except for the parotid which is by nine.

63
Q

two types of parasymp that enter ITF?

A

7 for the submandibular + sublingual glands

and 9 for the parotid

64
Q

parasympathetics to the head leave brainstem w/ what cranial nerves?

A

3 7 and 9… ten too but not for head

shortly after exiting w/ cranial nerve, they’ll hitchhike to their targets on a branch of 5

65
Q

brainstem locations of cn 3 7 and 9

A

3 midbrain
7pons
9medulla

66
Q

chorda tympani kinds of fibers

A

-comes from CN 7 and has two kinds of fibers–SVA taste and parasympathetics to submandibular and sublingual glands

67
Q

chorda tympani parasymp course

A

-cn 7 —> travel out of petrotympanic fissure —> jump on back of lingual nerve —> only the parasymp fibers will detour on the SUBMANDIBULAR ganglia to give to the submandibular gland —> then they’ll come back onto the lingual after their little loop around the submandibular ganglion—> then they’ll travel down onto lingual till they reach the sublingual gland —> FIN for the parasymps

68
Q

chorda tympani taste SVA fibers course

A

cn 7 —> travel out of petrotympanic fissure —> jump on back of lingual nerve —> travel straight down to innervate the posterior two thirds of the tongue

69
Q

petrotympanic fissure location

A

crack just posterior to the mandibular fossa

so close to it coz it looks like the condyle of the mandible will crush it.

70
Q

course of chorda tympani through the middle ear

A

under the long limb of incus, over the handle of the malleus, and behind the tympanic membrane

71
Q

where do the taste fibers of CN 7 dump in?

A

not pons….
they go down to the tractus solitarius to the NUCLEUS solitarius in the medulla

also all special visceral will go this way

72
Q

where does cn 7 enter the brainstem?

A

near the pontomedullary junction. remember that pyramids end where pons begin

all the GVA or SVA info will travel down the tractus solitarius to enter the nucleus solitarius

CN 7 doesn’t do any GSA

73
Q

why does branchiomotor nucleus of seven travel strangely?

A

It doesn’t just go into the pons normally.

it hooks over the top of CN 7 and then it does a big ol loop around back to where you’d think it be. branchiomotor nuclues hooking over probably is the cause for the branchiomotor migration

74
Q

course of the CN 7 back to the brain

A

enter temporal bone through internal acoustic meatus

75
Q

what innervates the parotid gland?

A

preganglionic parasymp from the lesser petrosal n (branch of glossopharyngeal, CN 9) will jump onto the V3 part of the trigeminal ganglion and travel down.

the only thing carried by lesser petrosal is preganglionic parasymp.

at otic ganglia, the postganglionic fibers will hitchhike w/ the auriculotemporal n from V3.

SECRETOMOTOR to parotid

76
Q

where does CN IX enter or leave the brainstem?

A

nucleus ambiguus, which is the branchiomotor nucleus for 9 and 10 and 11 if we count it as branchiomotor

77
Q

inferior salivatory nuclues

A

right next to nuclues anbigius. it’s visceromotor and gives rise to the presympathetic preganglionics that eventually will innervate the parotid

remember these come from CN 9

78
Q

superior salivatory nucleus

A

adjacent to the branchiomotor nucleus, and it does the parasympathetics to CN 7

79
Q

what exits over thru the jugular foramen?

A

9 10 and 11

80
Q

course of tympanic n

A

cn 9 —-> exit skull thru jugular foramen —-> enter back into skull thru TYMPANIC CANALICULUS OPENING —> innervate tympanic plexus, providing GSA to middle ear, rests on tympanic promontory

81
Q

route of lesser petrosal in relation to tympanic plexus

A

from tympanic plexus, preganglionic parasympathetic fibers will be given off —-> these will travel on the petrous portion of the temporal bone and then exit through the foramen ovale w/ the V3 and then go to parotid

82
Q

course of auriculotemporal n

A

off posterior div of V3, wraps around middle meningeal artery, and then goes up toward carotid region and then just goes up over temporal n

week 1 (12 decks)

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