Theme 4 Flashcards
Infratemporal Fossa & Nose
Infratemporal Fossa
- Boundaries
- Contents
- Boundaries
Superior: Greater wing of sphenoid & Squamous temporal bone
Medial: Lateral Pterygoid
Lateral: Ramus & Coronoid process of mandible
Anterior: Posterior aspect of Maxilla
Posterior: Styloid Process
- Contents:
- Lateral & Medial Pterygoid muscles
- CNV3
- Chorda Tympani of CNVII
- Otic Ganglion
- Maxillary Artery (& branches)
- Maxillary Vein (& branches)
- What muscles of mastication close the jaw?
- What muscle of mastication lower/opens the jaw? How?
- Masseter Temporalis Medial Pterygoid Lateral Pterygoid EXCEPT inferior head
- Inferior head of Lateral Pterygoid by moving the condylar process
Attachments of the Lateral Pterygoid muscle (heads)
Inferior head: lateral aspect of L.P to the neck of Condylar Process
Superior head: L.P & inferior part of Greater Wing of Sphenoid to the Articular Capsule of TMJ & Condylar Process
Attachments of the Medial Pterygoid muscle
Medial aspect of lateral pterygoid plate to medial ramus & angle of the mandible
Temporomandibular Joint (TMJ)
- Attachments
- What surrounds the joint?
- What does the capsule contain?
- What ligament surrounds the capsule ligament? Role?
- Condylar Process to the Mandibular Fossa of the Temporal Bone
- Capsule Ligament - from the temporal bone to the neck of the Condylar Process
- Articular biconcave disc acting as a shock absorbed & forming different compartments
4.
Temporomandibular ligament: lateral thickening of the capsule ligament to prevent displacement
Sphenomandibular- from spine of sphenoid to mandibular foramen
Stylomandibular- from styloid to the angle on inner mandible
Movement of the TMJ
Hinge - Lower compartments (move forwards)
Occurs between condyle and disc
Disc- stationary
Condyle- moves forwards out of the mandibular fossa
Translation - Upper compartment (open/chewing)
Occurs between the disc and the mandibular fossa
The condyle &a disc move together caused by the inferior head of the lateral pterygoid muscle contracting
These combine in functional movements of elevation and depression
Muscles that move the Jaw
Supra-Mandibular Muscles = Muscles of Mastication
Function: mostly closing jaw EXCEPT inf.head of L.PT
Infra-Mandibular Muscles = Supra/Infra-Hyoid muscles
Function: mostly jaw opening
Jaw Opening & Closing cycle
- Rest position with a 5mm freeway space
- Initial opening
- Requires protraction & hinge movements
- Requires inferior head of lateral pterygoid to contract
- Wider opening recruits more muscles to contract (platysma, anterior digastric, suprahyoid)
- Closing reverses the process:
- Masseter, medial pterygoid contract
- Temporalis: closes against resistance
- Superior head of lateral pterygoid locates condyle back into mandibular fossa
Parasympathetic Ganglia of the Head
- What are ganglia?
- Connections of a Parasympathetic Ganglion in the Head
- Small swellings of cell bodies each associated with a division of the CNV
- Each ganglion receives and gives each one
- Parasympathetic Motor Root
- Sympathetic Motor Root: that doesn’t synapse in the head - runs from Superior Cervical Ganglion in neck & hitchhikes along the internal/external carotid
- The sensory root from CN-V (doesn’t synapse)
- Branches of distribution
Otic Ganglion
- Location
- What does it innervate?
- Roots
- infratemporal fossa: Small swelling attached to V3 after it leaves Fo. Ovale
- Innervates Parotid Gland
3.
Parasympathetic (motor) root:
From: lesser petrosal nerve -Preganglionic axons from glossopharyngeal nerve
To: parotid gland in the infratemporal fossa with auriculotemporal nerve
Sympathetic root:
From: middle meningeal artery
To: parotid gland
Sensory root:
From: parotid gland
To: otic ganglion via a branch of auriculotemporal nerve
Branches of distribution:
From ganglion to parotid gland by travelling with the auriculotemporal nerve which leaves V3 under the otic ganglion
Somatic motor root:
From: otic ganglion
To: medial pterygoid & tensor veli palatini
Sympathetic fibers from superior cervical ganglion
Autonomic Nervous System
- Role
- How does it function?
- Divisions
- Controls internal enviroment
- Two neurons connect CNS to motor targets (smooth muscle, cardiac muscle & glands)
3.
Parasympathetic:
- Rest & digest
- Craniosacral Outflow
- Preganglionic axons are long therefore they synapse in ganglia near the targets
- Postganglionic axons are short
Sympathetic:
- Fight or flight
- Thoracolumbar outflow (T1-L3)
- Preganglionic axons are short therefore they synapse in sympathetic chains
- Postganglionic axons are long
Pterygopalatine Fossa
- Location
- Boundries
- Content
- Inside the pterygomaxillary fissure between the posterior maxilla & the lateral pterygoid plate
2.
Posterior wall: sphenoid bone (pterygoid process)
Medial wall: palatine (perpendicular plate)
Anterior wall: maxilla (posterior aspect)
Lateral wall: pterygomaxillary fissure
3.
- V2 from Fo. Rotundum to Inferior Orbital Fissure
- Pterygopalatine Ganglion
- 3rd part of Maxillary Artery
Openings of Pterygopalatine Fossa
Foramen Rotundum (V2): Posterior Wall
Pterygoid Canal: Opening for Greater & Deep Petrosals
Sphenopalatine Fo: Nasopalatine enters to Septum
Palatine Canals
Infraorbital Canal: orbital fissure leading to infraorbital Fo.
Inferior Orbital Fissure: Zygomatic branch enters here = Zygomaticofacial & Zygomaticotemporal via Zygomatic Fo.
Pterygoid Fissure
Pterygopalatine Ganglion
- Location
- Roots
- Branches of V2 at Pterygopalatine Fossa
https://www.youtube.com/watch?v=v2261IPz3W8
- Pterygopalatine Fossa: Small swelling attached to V2 as it leaves Fo. Rotundum
Largely innervated by the greater petrosal nerve (a branch of the facial nerve)
2.
Parasympathetic (motor) Root
From: nerve of pterygoid canal (pre-ganglionic axons from facial nerve)
(greater & deep petrosals of CN-VII)
To: pterygopalatine ganglion then postganglionic axons (zygomatic branch) to palatine, nasal & pharyngeal mucous glands and lacrimal glands
Sympathetic Root
From: deep petrosal nerve via n of pterygoid canal
To: pterygopalatine ganglion targets
Sensory Root
From: maxillary nerve (CN-V2)
To: targets via branches of distribution
3.
- Nasopalatine nerve: enters sphenopalatine foramen and then enters septum to travel forward to maxilla (innervates palate)
- Posterior superior nasal nerves: branches off just before infraorbital canal
- Greater & Lesser Palatine nerve: branch into foramen in palatine bone
- Pharyngeal nerve
Maxillary Artery
How many parts of the Maxillary artery are there?
Where is each part located?
What are the branches of each part?
passes over & behind the lateral pterygoid before entering pterygopalatine fossa. Has three parts
First part: just before lateral pterygoid
- Middle meningeal artery
- Inferior alveolar artery
Second part: passes over lateral pterygoid
Supplies muscles of mastication
Third part: after crossing lateral pterygoid
enters from infratemporal fossa
Branches accompany those of the maxillary nerve-
- Posterior superior alveolar artery
- Infraorbital artery
- Descending palatine artery
- Sphenopalatine artery
- Artery of pterygoid canal
- What are the 4 Paranasal Sinuses?
- What is there innervation?
- Where does each sinus drain into?
Air filled extensions of nasal activities
1.
- Maxillary - Drains into hiatus semilunaris
- Frontal - Drains into middle meatus via frontonasal duct
- Sphenoid - Drains into sphenoethmoidal recess above superior conchae
- Ethmoidal - Drain into middle meatus to the bulla ethmoidalis which is deep & superior meatus
- Innervated by CN-V
- Frontal: Supraorbital (V1)
- Ethmoid & sphenoid: Ethmoidal (V2)
- Maxillary: Superior alveolar & infraorbital (V2)
