The Temporal, Infratemporal And Pterygopalatine Fossae Flashcards
What are the boundaries of the temporal fossa? (On lateral side of skull)
Superiorly and posteriorly by the superior and inferior temporal line.
Anteriorly to the frontal and zygomatic bones
Inferiorly to the zygotes arch
What is the roof of the temporal fossa?
Formed by the thick temporalis fascia that covers the temporalis muscle
The temporal fossa contains, the H-shaped suture at the junction of the frontal, parental, temporal and sphenoid bones. What is this called?
Pterion
What are the contents of the temporal fossa?
Temporalis muscle
Deep temporal nerves/vessels
Auriculotemporal nerve
Superficial temporal vessels
With which fossa does the temporal fossa communicate?
The infratemporal fossa
What are the boundaries of the infratemporal fossa?
Deep to and below the zygomatic arch
Medial to the ramus of the mandible and behind the posterior aspect of the maxilla.
What is the roof of the infratemporal fossa?
By the portion of the sphenoid bone that contains the foramen ovale (V3) and the foramen spinosum (for middle meningeal a) and the mastoid process and stylohoid process of the temporal bone.
What does the infratemporal fossa contain?
A portion of the parotid gland M/L pterygoid muscles (mastication) Maxillary artery Pterygoid venous plexus Motor and sensory branch of V3
The _____ _____ provide surgical approach for the treatment of tumors (e.g. Maxillary sinus), to repair fractures of the skull base, and for the targeted delivery of drugs via the arterial system.
Infratemporal fossa
What are the four primary muscles of mastication?
Medial
Lateral pterygoid
Masseter
Temporalis
In what plane does the lateral pterygoid muscle lie?
Horizontal plane
Where does the superior head of the pterygoid muscle insert?
From the infratemporal surface of the sphenoid bone to the articular capsul
Where does the inferior head of the lateral pterygoid muscle insert?
From the lateral surface of the lateral pterygoid plate to the condylar process of the mandible
What is the origin of the medial pterygoid muscle?
Tuberosity of the Mancilla and the medial surface of the lateral pterygoid plate
What is the insertion of the medial pterygoid muscle?
Inner aspect of the angle of the mandible
Where do both of the pterygoid muscle attach?
Lateral pterygoid plate
Note: they attach at different sides of the plate
From where does the masseter extend?
From the inferior border and medial aspect of the zygomatic arch to the lateral surface of the ramus of the mandible
From where does the temporalis muscle extend?
From the bones of the themporal fossa to the coronoid process and anterior ramus of the mandible
What are the two proceses found on the ramus of the mandible?
Anterior: coronoid process
Posterior: condylar process
What does the notch of the mandible transmit?
The neurovasculr bundle to the muscles
What does the round head of the condylar process articulate with?
The temporal bone at the temporomandbular joint (TMJ)
What nerve passes through the mandíbulas foramen?
The inferior alveolar nerve
The _____ and ______ for a sling around the mandible and, acting in concert with the temporalis muscle, elevate the law and close the mouth.
The masseter and medial pterygoid
What is the primary depressor of the jaw?
The lateral pterygoid
Opening of the mouth if due to the action of the lateral pterygoid with what other muscle?
Hyoid muscles
Protrusion of the mouth is due to what muscles?
Lateral and medial pterygoid muscles
Retrusion of the mouth is done by what muscles?
Posterior fibers of temporalis, the masseter and assisted by the digastric and geniohyoid muscles
What does lateral movement of the mouth?
The temporalis and (contralateral) medial+lateral pterygoid muscles
What forms the tmj?
The condyle of the mandible together with the reticular tubercle and the mandíbulas fossa of the temporal bone
What divide the TMJ into a suprmeniscal and inframeniscal compartments?
A Fibrocartilage bicóncava articular disk
What is the action of the TMJ in the inferior compartment?
The condyle simply rotates on the articular disk
What is the action of the TMJ in the supra compartment?
The condyle and disk slide anterior and posteriorly over the articular tubercle of the temporal bone.
What is the site of delivery for anesthesia for the mandíbulas teeth?
The mandíbulas foramen
Note: when done correctly, the termination of the inferior alveolar nerve, the mental nerve, will result in numbness of the chin
What can result from yawning, excessive contraction of the lateral pterygoid, a blow to the chin when the moist if open, or a fracture of the mandible?
Dislocation of the TMJ
-This is when the condyle passes beyond the apex of the articular tubercle.It is then dislocated and stuck
What nerves can TMJ dislocation damage?
The facial or aurioculotemporal nerves
What is bruxism?
A common problem whereby psychological issues result in excessive grinding of the teeth and/or excessive clenching of the jaw.
Bruxism can damage teeth and dental restorations.
What is the largest terminal branch of the external carotid artery?
The maxillary artery
From where does the maxillary artery originate?
From the ext. carotid behind the neck of the mandible
What is the course of the maxillary artery?
It courses between the ramus of the mandible and the medial pterygoid muscle, then adjacent to the lateral pterygoid muscle and terminates at the entrance of the nasal cavity.
This artery is important for bleeding control during operations and is a portal for selective intra-arterial chemotherapy for the head and neck cancers. What artery is this?
The maxillary artery
What is the general area that the maxillary artery and its 16 branches supply?
The ear and tympanic membrane and the muscles of the temporal and infratemporal fossa.
From what artery do the middle meningeal and accessory middle meningeal arteries come from?
From the maxillary artery
Note: these will cause an epidural hematoma if ruptured
What are the important arteries that come from the maxillary artery?
Middle meningeal (and accessory) Inferior alveolar Buccal Posterior superior alveolar Infraorbital Descending palatine Sphenopalatine Pharyngeal
What does the inferior alveolar artery supply?
The mandibular teeth
What does the Buccal artery supply?
The check
What does the posterior superior alveolar artery supply?
Posterior teeth of the maxilla
Where does the infraorbital artery course through?
The infraorbital groove beneath the eye
Note: fractures
What does the descending palatine artery supply?
The oral region
What ones the sphenopalatine artery supply?
The nasal cavity, paransal sinuses, palate and roof of the pharynx
Through where do the sphenopalatine artery, the terminal branch of the maxillary artery, pass though to the nasal cavity?
The sphenopalatine foramen
Note: in danger during surgery to this area
The infratemporal fossa is continuous medically with?
The small pterygopalatine fossa
What structure is located between the pterygoid process of the greater wing of the sphenoid and the maxilla?
Small pterygopalatine fossa
What is the medial border of the small pterygopalatine fossa?
Perpendicular plate of the palatine bone
The posterior will of the pterygopalatine fossa is formed by the _____ , contains 3 foramina.
Pterygoid process of the greater wing of the sphenoid bone
What are the 3 foramina of the posterior wall of the pterygoidpalatine fossa
Pterygoid (Vidian) canal
Foramen rotundum
Palatovaginal canal
What does the palatovaginal canal contain that is within the pterygopalatine fossa?
Vessels that communicate with the pharynx
What structure contains preganglionic parasympathetic axons and postganglionic axons destined for the pterygopalatine ganglion?
The pterygoid (vidian) canal
What do the greater and lessor palatine canals transmit to the oral cavity?
The palatine neurovascular bundle
At the base of the pterygopalatine fossa are the __________ that form the junction between the alveolar process of the maxilla, the palatine bone and the pterygoid process.
Greater and lessor palatine canals
On the medial wall of the pterygopalatine fossa what foramen opens into the nasal cavity?
Sphenopalatine foramen
The pterygopalatine fossa is open laterally to the infratemporal fossa through the _____________.
Pterygomaxillary fissure
The pterygopalatine fossa communicates with the middle cranial fossa via?
The foramen rotundamente and pterygoid canal
The pterygopalatine fossa communicate with the infratemporal fossa via the?
Pterygomaxillary fissure
The pterygopalatine fossa communicate with orbit via the?
Inferior orbital fissure
The pterygopalatine fossa communicates with the nasal cavity via the?
Sphenopalatine foramen
The pterygopalatine fossa communicates with the oral cavity via the?
Palatine canal
The pterygopalatine fossa communicates with the pharynx via the?
Pterygovaginal canal
What fossa contains V2 of the trigeminal, the pterygopalatine ganglion and its branches, and the maxillary artery and its branches.
The pterygopalatine fossa
In the pterygopalatine fossa the arteries enter _______ and the nerves enter _________.
Laterally
Posteriorly
Axons from the pterygopalatine ganglion leave as the _______ for parasympathetic nerves.
Greater petrosal nerve
Sympathetic neurons form a plexus on the internal carotid artery and ________ leaves to join preganglionic parasympathetic axons in the greater petrosal nerve.
Deep petrosal nerve
The deep petrosal nerve and the greater petrosal nerve forms the?
The nerve of the vidian canal
What is the hay fever ganglion?
Pterygopalatine ganglion
Note: because of its role in tearing and mucous secretion
From what nerve is the pterygopaltine ganglion suspended?
The maxillary nerve
What does the maxillary nerve innervate?
The deep face
What is the path of the maxillary nerve?
Enters the pterygopalatine fossa through the foramen rotunda, exits through the inferior orbital fissure, and terminates as the infraorbital nerve.
What is the nerve that the maxillary receives sensation from the maxillary teeth?
The superior alveolar nerve
These branches are from what nerve that are within the pterygopalatine fossa?
- Communicating branches to the pterygopalatine ganglion
- A branch that exits via the sphenopalatine foramen
- Palatine nerves
- Zygomatic nerve
The maxillary nerve (V2)
Palatine nerve pass though the greater and lesser palatine foramen to receive sensations from what location.
The hard and soft palate (respectively)
What does the zygomatic nerve split into?
Zigomaticofacial
Zigomaticotemporal
An infection in the region of the nose can reach the cavernous sinus with the potential to cause meningitis. That is why it’s called a _________.
Danger area
The veins of the infratemporal fossa can direct blood to what plexus? (Within the fossa)
Pterygoid plexus
What plexus surround the lateral pterygoid muscle and communicates with the cavernous sinus, ophthalmic veins and facial vein.
Pterygoid plexus
Note: it also has channels to the IJV and EJV
Damage to what plexus during surgery within the infratemporal fossa can lead to serious bleeding?
Pterygoid plexus
A hematoma (pool of blood outside a vessel) is a complication from an improperly placed ______ nerve block. (Within the infratemporal fossa)
Posterior alveolar
What is the primary nerve of the infratemporal fossa?
The mandibular division of trigeminal
The ___ ganglion resides in a pouch of dura in Mekel’s cave in the middle cranial fossa.
Trigeminal
Where is the trigeminal ganglion located?
Meckels cave
Where is meckels cave located?
Middle cranial fossa
When the mandibular division of trigeminal enters the foramen ovale, into what fossa does it enter?
Infratemporal
What are the primary sensory branches of the mandibular nerve?
Auriculotemporal
Inferior alveolar
Lingual
Buccal
What is the sensation of the auriculotemporal nerve?
From the skin in the region of the ear
From what part of the body does the inferior alveolar nerve sense?
From the mandibular teeth
Where does the lingual nerve receive sensation from?
The terror 2/3 of the tongue
From where does the Buccal nerve receive sensation?
The cheek
