Temporal, Infratemporal and Pterygopalatine Fossae Flashcards
Temporal Fossa
Posterior and superior border:
temporal lines
Temporal Fossa
Anterior border:
zygomatic and frontal bones
Temporal Fossa
Lateral border:
zygomatic arch
Temporal Fossa
Inferior border:
infratemporal crest of sphenoid
Temporal Fossa
Floor border:
the 4 bones forming pterion
What are the 4 bones forming pterion?
o Frontal, parietal, temporal, sphenoid (greater wing)
Temporal Fossa
Roof:
temporal fascia
Contents of the temporal fossa:
Upper portion of temporalis muscle
Infratemporal Fossa
Lateral border:
ramus of mandible
Infratemporal Fossa
Medial border:
lateral pterygoid plate
Infratemporal Fossa
Anterior border:
posterior aspect of maxilla
Infratemporal Fossa
Posterior border:
tympanic plate, mastoid process and styloid process of temporal bone
Infratemporal Fossa
Superior border:
inferior surface of greater wing of sphenoid
Infratemporal Fossa
Inferior border:
mandible near its angle where medial pterygoid muscle inserts
What are the contents of the infratemporal Fossa? (6)
- Inferior part of the temporalis muscle
- Lateral and medial pterygoid muscles
- Maxillary artery
- Pterygoid venous plexus
- Mandibular (inferior alveolar br., lingual br., buccal br.) and chorda tympani (from facial n.) nerves
- Otic ganglion
The temporal and infratemporal regions together contain the ___________ joint.
temporomandibular
What are the features of the Maxillary Artery? (2)
- Terminal branch of the external carotid artery
- Divided into 3 parts based on its relation to the lateral pterygoid muscle
What is the course of the maxillary artery in the 1st part of the mandibular?
Horizontal at level of the neck of condylar process of mandible as it runs medially.
What are the branches of the maxillary artery in the 1st part of the mandibular? (5)
1st part - Mandibular
Deep auricular
Distribution: (2)
- external acoustic meatus and external tympanic membrane
- TMJ
1st part - Mandibular
Anterior tympanic
Distribution:
- internal tympanic membrane
1st part - Mandibular
Middle meningeal
Distribution: (4)
Enters foramen spinosum to supply
* Bone and dura mater of lateral wall and calvaria of neurocranium
* Trigeminal and geniculate ganglia
* Facial nerve
* Tympanic cavity and tensor tympani muscle
1st part - Mandibular
Accessory meningeal
Distribution: (3)
Enters foramen ovale and also supplies:
* Muscles of infratemporal fossa
* Sphenoid bone
* Mandibular nerve and otic ganglion
1st part - Mandibular
Inferior alveolar
Distribution:
Descends into mandibular canal to supply:
* Mandible, its teeth, chin and mylohyoid
What is the course of the maxillary artery in the 2nd part - pterygoid?
As it passes lateral pterygoid muscle, it ascends antero-
superiorly, medial to temporalis.
What are the branches of the maxillary artery in the 2nd part- pterygoid? (4)
2nd part - Pterygoid
Masseteric
Distribution:
Traverses mandibular notch to supply:
- TMJ and masseter
2nd part - Pterygoid
Deep temporal
Distribution:
Anterior and posterior branches ascend between temporalis and underlying bone to supply the muscle
2nd part - Pterygoid
Pterygoid
Distribution:
Pterygoid muscle
2nd part - Pterygoid
Buccal
Distribution: (3)
Runs antero-inferiorly with buccal n. to supply
* Buccal fat-pad
* Buccinator
* Buccal oral mucosa
What is the course of the maxillary artery in the 3rd part in the pterygopalatine? (3)
- Passes between heads of lateral pterygoid muscle
- Enters pterygomaxillary fissure
- Enters pterygopalatine fossa
What are the branches of the maxillary artery in the 3rd part in the pterygopalatine? (6)
3rd part - Pterygopalatine
Posterior superior alveolar
Distribution:
Descends on maxilla’s infratemporal surface with branches traversing alveolar canals to supply
* Maxillary teeth, adjacent gingiva and mucous membrane of maxillary sinus
3rd part - Pterygopalatine
Infraorbital
Distribution: (3)
Traverses inferior orbital fissure, infraorbital groove, canal and foramen to supply
* Inferior oblique and rectus muscles, lacrimal sac
* Maxillary canines and incisors and mucous membrane of maxillary sinus
* Skin of infraorbital region of the face
3rd part - Pterygopalatine
Artery of pterygoid canal
Distribution:
Passes posteriorly through pterygoid canal to supply
* Mucosa of upper pharynx, eustachian tube and tympanic cavity
3rd part - Pterygopalatine
Pharyngeal branch
Distribution:
Passes through palatovaginal canal to supply:
* Mucosa of nasal roof, nasopharynx and sphenoidal air sinus
3rd part - Pterygopalatine
Descending palatine artery
Distribution:
Descends into greater palatine canal as it divides into greater and lesser palatine aa. to supply
* Mucosa and glands of hard and soft palate
3rd part - Pterygopalatine
Sphenopalatine artery (terminal branch
of maxillary a.)
Distribution: (2)
Traverses sphenopalatine foramen to supply
* Walls and septum of nasal cavity and all paranasal sinuses
* Anterior-most palate
What are the somatic sensory branches of the mandibular nerve? (5)
Somatic sensory branches
Meningeal branch
Structures innervated:
Dura mater
Somatic sensory branches
Buccal nerve
Structures innervated:
Skin over the buccal region of the face
2nd and 3rd molars
Somatic sensory branches
Auriculotemporal nerve
Structures innervated:
Auricle and temporal region and TMJ
Somatic sensory branches
Lingual nerve (anastomoses with chorda tympani in infratemporal fossa)
Structures innervated: (2)
Anterior 2 thirds of tongue
Floor of the mouth
Inferior alveolar nerve, sub-branches:
Inferior dental plexus
Mental nerve
Inferior dental plexus
Structures innervated:
All mandibular teeth
Mental nerve
Innervation: (3)
Skin and mucous membrane of lower lip
Skin of the chin
Vestibular gingiva of the mandibular incisors
Somatic motor branches: (4)
1 Masseteric nerve
2 Deep temporal nerves
3 Nerves to medial and lateral pterygoid
4 Nerve to mylohyoid
What are the structures innervated by the somatic motor branches?
Muscles of mastication
Otic Ganglion
Location:
Located in the infratemporal fossa inferior to foramen ovale
Otic Ganglion:
Medial to…
Medial to mandibular nerve
Otic Ganglion:
Posterior to…
Posterior to medial pterygoid muscle
Otic Ganglion:
Presynaptic parasympathetic fibres of _____ _____ (CN IX)
glossopharyngeal nerve
Otic Ganglion:
* _______ in the otic ganglion
* Postsynaptic parasympathetic fibres pass from the ganglion to the parotid gland through _________ nerve
Synapse
auriculotemporal
Pterygopalatine Fossa
Relative position:
Medial to…
Medial to infratemporal fossa
Pterygopalatine Fossa
Relative position:
Lateral to…
Lateral to the back of the nose
Pterygopalatine Fossa
Relative position:
Inferior to…
Inferior to the apex of the orbit
Pterygopalatine Fossa
Boundaries
* Posterior-
Posterior- pterygoid process of sphenoid
Pterygopalatine Fossa
Boundaries
* Anterior-
Anterior- rounded posteromedial aspect of maxilla
Pterygopalatine Fossa
Boundaries
Medial-
Medial- perpendicular plate of palatine
Pterygopalatine Fossa
Boundaries
Lateral-
Lateral- pterygomaxillary fissure
Pterygopalatine Fossa
Boundaries
Roof-
Roof- medial continuation of infratemporal crest of greater wing of sphenoid
Pterygopalatine Fossa
Boundaries
Floor-
Floor- pyramidal process of palatine
Posterior communications: (3)
- Foramen rotundum to middle cranial fossa
- Pterygoid canal to middle cranial fossa via foramen lacerum
- Palatovaginal/Pharyngeal canal to nasopharynx
Lateral communication:
- Pterygomaxillary fissure to infratemporal fossa
Medial communication:
- Sphenopalatine foramen to nasal cavity
Anterior communication:
- Inferior orbital fissure to floor of orbit
Inferior communications: (2)
- Greater palatine canal to mucosa of hard palate
- Lesser palatine canal to mucosa of soft palate
Pterygopalatine Fossa contents: (2)
- Pterygopalatine (3rd) part of maxillary artery
- Maxillary nerve (CN V2) and pterygopalatine ganglion
Communication:
Foramen rotundum
Artery -
Nerve -
- Maxillary nerve
Communication:
Pterygoid canal
Artery -
Nerve -
Artery of pterygoid canal
Nerve of pterygoid canal
Communication:
Palatovaginal/pharyngeal canal
Artery -
Nerve -
Pharyngeal artery
Pharyngeal nerve
Communication:
Pterygomaxillary fissure
Artery -
Nerve -
Maxillary artery
Posterior superior alveolar nerves
Communication:
Sphenopalatine foramen
Artery -
Nerve -
Sphenopalatine artery
Lateral nasal nerve
Communication:
Inferior orbital fissure
Artery -
Nerve -
Infraorbital artery
Infraorbital nerve and zygomatic nerve
Communication:
Greater palatine canal
Artery -
Nerve -
Greater palatine artery
Greater palatine nerve
Communication:
Lesser palatine canal
Artery -
Nerve -
Lesser palatine artery
Lesser palatine nerve
Branch of maxillary nerve:
Meningeal branch
Structures innervated (sensory innervation only):
Dura mater of anterior middle cranial fossa
What are the 3 branches of the Zygomatic nerve?
Zygomaticofacial
Structures innervated (sensory innervation only):
Anterior cheek
Zygomaticotemporal
Structures innervated (sensory innervation only):
Skin of the temple
Communicating br. to lacrimal n.
Structures innervated (sensory innervation only):
Lacrimal gland
Branch of the 4. Ganglionic branches to ______________ ganglion.
pterygopalatine
Branch of maxillary nerve:
Posterior superior alveolar
Structures innervated (sensory innervation only):
Molar teeth and maxillary sinus
What are the 5 branches of the Infraorbital nerve?
Middle superior alveolar
Structures innervated (sensory innervation only):
Maxillary premolars and molars
Anterior superior alveolar
Structures innervated (sensory innervation only):
Maxillary incisors and canines
Superior labial
Structures innervated (sensory innervation only):
Upper lip
Inferior palpebral
Structures innervated (sensory innervation only):
Conjunctiva of inferior eyelid
External nasal
Structures innervated (sensory innervation only):
Skin of lateral external nose
Branch of maxillary nerve:
Greater palatine nerve
Structures innervated (sensory innervation only):
Hard palate
Branch of maxillary nerve:
Lesser palatine nerve
Structures innervated (sensory innervation only):
Soft palate and palatine tonsils
Branch of maxillary nerve:
Posterior lateral nasal nerves
Structures innervated (sensory innervation only):
Lateral wall of nasal cavity
Branch of maxillary nerve:
Nasopalatine nerve
Structures innervated (sensory innervation only):
Anterior part of hard palate and nasal septum
Branch of maxillary nerve:
Pharyngeal nerve
Structures innervated (sensory innervation only):
Nasal part of the pharynx