Temporal and Infratemporal Fossas Flashcards

1
Q

What forms the anterior border of the infratemporal fossa?

A

infratemporal surface of maxilla

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2
Q

What forms the posterior boundary of the infratemporal fossa?

A

vertical plane of the styloid process

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3
Q

What forms the superior boundary of the of the infratemporal fossa?

A

infratemporal surface and crest of the greater wing of sphenoid bone

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4
Q

What forms the inferior boundary of the infratemporal fossa?

A

Horizontal plane of the alveolar margin of the mandible

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5
Q

What froms the lateral boundary of the infratemporal fossa?

A

ramus of the mandible

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6
Q

What forms the medial boundary of the infratemporal fossa?

A

lateral pterygoid plate

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7
Q

What structures pass through the pterygomaxillary (PP) fissure?

A

the terminal end of the maxillary artery as it enters PP fossa as well as alveolar branches of the maxillary nerve that travel from the PP fossa to the IT fossa.

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8
Q

What structures pass through the mandibular canal?

A

inferior alveolar nerve, artery and vein

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9
Q

What structures pass through the foramen ovale?

A

OVALE - Otic ganglion, V3, accessory meningeal artery, lesser petrosal, emissary veins

emissary veins connect the cavernous sinus to the Pterygoid plexus in the IT fossa.
The otic ganglion (parasympathetics to parotid gland) is directly beneath the foramen and transmitted through it.

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10
Q

What structures pass through the foramen spinosum?

A

middle meningeal artery and vein

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11
Q

What structures pass through the alveolar canal? What bone is this in?

A

Posterior superior alveolar vessels and nerves through the maxilla

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12
Q

What structures pass through the petrotympanic fissure?

A

chorda tympani from CN VII to provide tase to tongue as well as parasympathetics

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13
Q

Origin/insertion of masseter?

A

origin: zygomatic arch
Insert: lateral angle of mandible

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14
Q

Innervation of masseter?

A

CN V3 Masseteric N.

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15
Q

What are the actions of the masseter?

A

elevate mandible

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16
Q

Origin/insertion of temporalis?

A

origin: temporal fossa and temporal fascia
Insert: coronoid process, ramus of the mandible down to the 3rd molar tooth

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17
Q

Innervation of temporalis muscle?

A

CN V3 Deep temporal N.

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18
Q

What are the actions of temporalis?

A

elevate and retract the mandible

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19
Q

Origin/insertion of the deep head of the medial pterygoid?

A

Origin: medial side of the lateral pterygoid plate and pyramidal process of the palatine bone
Insert: medial angle of the mandible

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20
Q

Origin/insertion of the superficial head of the medial pterygoid?

A

origin: tuberosity and pyramidal process of the palatine bone
insert: medial angle of the mandible

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21
Q

Innervation of the medial pterygoid?

A

N. to the medial pterygoid (CN V3)

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22
Q

What are the actions of both heads of the medial pterygoid

A

elevate and laterally move the mandible

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23
Q

Origin/insertion of the upper head of the lateral pterygoid?

A

origin: roof of the infratemporal fossa
insert: TMJ Disc

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24
Q

Origin/insertion of the lower head of the lateral pterygoid?

A

origin: lateral surface of the lateral pterygoid plate
insert: fovea of the mandible

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25
Q

Innervation of both heads of the lateral pterygoid?

A

N. to the lateral pterygoid form CN V3

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26
Q

What are the actions of both heads of the lateral pterygoid?

A

protrude and laterally move the mandible

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27
Q

What type of cartilage covers the articular surfaces of the bones in the temporomandibular joint?

A

Fibrocartilage. This is highly unusual compared to other synovial joints, which use a layer of hyaline cartilage to cover the articulating surfaces.

28
Q

What separates the TMJ into two parts?

A

a fibrous articular disc

29
Q

What is the primary motion allowed by the lower part of the TMJ?

A

Hinge-like depression and elevation of the mandible

30
Q

What are the primary motions allowed by the upper part of the TMJ?

A

translocation forward (protrusion) onto the articular tubercle and backward (retraction) into the mandibular fossa

31
Q

What are the three extracapsular ligaments of the TMJ?

A

lateral ligament - runs diagonally backward from the articular tubercle to the neck of the mandible (neck of the condylar process)

Sphenomandibular ligament - medial to the TMJ, runs from the spine of the sphenoid bone to the lingula on the medial side of the ramus of the mandible

Stylomandibular ligament - passes from the styloid process to the the posterior margin and angle of the mandible

32
Q

What are all muscles that move the TMJ joint, besides the geniohyoid, innervated by?

A

Branches of the mandibular nerve (CN V3) that originate in the infratemporal fossa.
Geniohyoid is C1 spinal nerve travelling with hypoglossal nerve (CN XII)

33
Q

Describe the relationship between the maxillary artery, the sphenomandibular ligament, and the neck of the mandible.

A

The maxillary artery passes between the sphenomandibular ligament and the neck of the mandible to reach the infratemporal fossa

34
Q

How does the maxillary artery leave the infratemporal fossa and what does it continue into?

A

The maxillary artery passes through the pterygomaxillary fissure to enter the pterygopalatine fossa. It can pass either lateral or medial to the lower head of the lateral pterygoid muscle

35
Q

What separates the three parts of the maxillary artery? Name the branches that come off each part.

A

First part - between the neck of the mandible and the sphenomandibular ligament. Gives off the middle meningeal, inferior alveolar, deep auricular, anterior tympanic, and accessory meningeal arteries.

Second part - related to the lateral pterygoid muscle (either medial or lateral to it). Gives off the deep temporal, masseteric, buccal and pterygoid branches, which follow the mandibular nerve CN V3)

Third part - in the PP fossa

36
Q

What type of hematoma would form from damage to the middle meningeal artery?

A

The middle meningeal artery travels in the periosteal layer of the dura matter. A leak here would separate the dura from the bone, causing a extradural hematoma.

37
Q

What two major veins does the pterygoid plexus drain into?

A

Posteriorly - retromandibular vein

Anteriorly - facial vein

38
Q

How can infections or anesthesia in the teeth and mandible spread to the brain?

A

The pterygoid plexus drains blood from this region and has connections to the cavernous sinus via emissary veins that pass through the foramen ovale, sphenoid foramen, and foramen lacerum. This is why its especially important to not provide anesthesia to the teeth or jaw under pressure.

39
Q

What branchiomeric arch are the muscles of mastication derived from? What nerve is associated with that?

A

1st arch. Trigeminal nerve. (for mastication muscles, specifically mandibular branch, CN V3)

40
Q

What muscles would be affected by a lesion in CN V3?

A

MAST-MATT: targets of mandibular branch.
MAST = mastication: Temporalis, masseter, lat and med pterygoids
MATT = Mylohyoid AnteriorDigastric Tensor tympani, Tensor veli palatini

41
Q

What nerve is deeply embedded in the attachment of the temporalis muscle along the anterior edge of the ramus of the mandible?

A

Buccal sensory n.

42
Q

What passes through the gap in between the two heads of the lateral pterygoid?

A

Maxillary artery

43
Q

What foramen does middle meningeal artery pass through to reach the cranial cavity?

A

foramen spinosum

44
Q

What are the branches of the 1st part of the maxillary artery, in order?

A

Deep auricular a., anterior tympanic, middle meningeal, accessory meningeal, inferior alveolar

45
Q

What are the branches of the 2nd part of the maxillary artery in order?

A

masseteric, posterior deep temporal, internal and external pteryoid arteries, Anterior deep temporal a, buccal artery

46
Q

What forms a loop around the middle meningeal artery?

A

auriculotemporal nerve.

47
Q

What is the parent branch of the mental artery?

A

inferior alveolar artery

48
Q

Before the inferior alveolar artery enters the mandibular foramen, it gives off a small branch. What is this?

A

artery to mylohyoid

49
Q

Describe the usually relationship between maxillary artery, the mandible, and the lateral pterygoid.

A

Maxillary is usually deep to mandible, then superficial to the lower head of lateral pterygoid, then dives deep between the gap between the two heads

50
Q

What two veins combine to form the retromandibular vein?

A

maxillary vein and superficial temporal vein

51
Q

What two veins combine to form external jugular?

A

retromandibular and posterior auricular veins

52
Q

What main vessel does facial vein drain into?

A

internal jugular vein

53
Q

What main vessel does the maxillary vein drain into?

A

retromandibular –> external jugular vein

54
Q

When mandibular nerve enters infratemporal fosssa, it has two general divisions: Anterior and posterior. What does each division carry?

A

Anterior: BE motor with one exception (buccal sensory nerve to skin and mucosa on cheek as well as buccal gingiva)

Posterior: GSA sensory with one exception (nerve to mylohyoid and ant. digastric off inferior alveolar)

55
Q

Name the branches of the mandibular nerve from posterior/lateral to anteromedial.

A

Allan Iverson Loves Basketball

Auriculotemporal, inferior alveolar, lingual, buccal

56
Q

Where do the postganglionic cell bodies that provide motor innervation to the parotid gland reside and what nerve carries them?

A

otic ganglion. Lesser petrosal nerve (CN IX) synapses in otic ganglion then joins auriculotemporal (V3) to carry parasympathetics to parotid gland

57
Q

What bone is the foramen spinosum in? Is it lateral or medial to the foramen ovale?

A

sphenoid bone. Lateral

58
Q

Which muscle lies deeper: lateral or medial pterygoid?

A

Medial pterygoid. Medial is deeper dipshit

59
Q

Which of the pterygoid muscles “points towards the eyes”?

A

Medial pterygoid, parallel to the masseter’s fibers

60
Q

Is stylomandibular ligament medial or lateral to the TMJ? Where does it attach to the mandible?

A

Medial. Runs from the styloid process to the posterior margin of the ramus of the mandible

61
Q

What ligament attaches to the articular tubercle of the TMJ?

A

lateral ligament

62
Q

What is the parent branch of the superficial temporal artery?

A

Comes directly off external carotid.

63
Q

What two branches of the maxillary artery supply the area in and around the ear?

A

deep auricular and tympanic arteries

64
Q

What fibres does the the auriculotemporal nerve have? (not carry)

A

GSA of CN V3 (parasympathetic postganglionics of CN IX travel with it to the parotid gland)

65
Q

A patient has numbness to the skin directly anterior to the ear, what terminal nerve branch has likely been damaged?

A

auriculotemporal nerve, a branch of CN V3

66
Q

What are the muscles of mastication?

A

Masseter, medial pterygoid, lateral pterygoid, temporalis

*Note buccinator is not a muscle of mastication. It is a facial expression muscle

67
Q

What innervates the buccinator?

A

CN VII (facial nerve)