Theme 4 Anatomy Flashcards
what are the boundaries of the ITF
Medial- lateral pterygoid plate
Lateral- ramus and coronoid process of mandible
Superior- infratemporal surface of greater wing of sphenoid and squamous part of temporal
Anterior- posterior wall of maxilla
Posterior- styloid process
what are the contents of the ITF
lateral and medial pterygoid muscle v3 v2 chorda tympani maxillary artery & br maxillary vein & br otic ganglion
how many heads does the medial & lateral pterygoid have
2- superficial and deep
2- inferior and superior
what are the attachment of the medial pterygoid
medial aspect of lateral pteryoid plate
maxillary tuberosity superiorly
medial part of ramus
inf border of the angle of mandible
what is the action of the medial pterygoid
elevates mandible (jaw closing cycle)
protrusion of mandible
lateral movements of mandible
(slide movements)
what is the action of the inferior head of the lateral pterygoid
protractor
what is the action of the superior head of the lateral pterygoid
elevate jaw- active in the last part of the jaw closing cycle helping to locate the head of the mandible into the mandibular fossa
what is the function generally of the anterior division of v3
mainly motor to muscles of mastication except for long buccal which is sensory
what is the function generally of the posterior divisions of v3
mainly sensory except for the n to mylohyoid which is motor
what are the posterior divisions of v3
lingual nerve
inferior alveolar
auriculotemporal nerve
nerve to mylohyoid (motor)
wheres are the first 2 parts of the maxillary artery
in infratemporal fossa
where is the 3rd part of the maxillary artery
ptyerygopalatine fossa
what are the br of 1st part of maxillary artery
inf alveolar
middle meningeal
where does the ptyergoid plexus drain
retromandibular vein
which fo does the inf alveolar n enter mandible
mandibular fo
what is the function of the inf alveolar n
sensory innervation to the mandibular teeth
what fo does the inf alveloar exit the skull via and what nerve does it give rise to
mental fo
mental nerve
what does the mental n supply
skin & mucous membrane of the lower lip
what is the function of the lingual nerve
sensory to anterior 2/3 of tongue
what does the chorda typani do
carries taste
innervates sublingual and submandibular glands
how is does the chorda tympani involved in ps innervation to . the submandibular/lingual gland
preganglionic axons travel to the ganglion in the chorda tympani which joins lingual. they synapse in the submandibular ganglion and post ganglionic axons travel to the gland
where are the 2 places of articulation for the TMJ
between the maxillary and mandibular teeth
between mandibular condoyle and temporal bone
outline the anatomy of the TMJ
features of a synovial joint articular surfaces capsule and ligaments articular disc movements of the joints muscles responsible for joint movement nerve and blood supply
what are the contents of the TMJ
mandibular fossa
mandibular condoyle
articular disc
joint capsule
what are the bones involved in the TMJ
condoyle of the mandible & temporal bone
what does the articular capsule do
enclosed joint surfaces like a sleeve
what does the articular disc do
divides joint cavity into 2 compartments that allows translation movements in the upper compartment and hinge in the lower
shock absorber
what is the function of the articular eminence
helps keep joint stable when closed and the head of the mandible must be pulled over it when the jaw is opened more widely
wheres do hinge movements occur
lower compartment between condoyle and disc
disc- stationary
condoyle- moves
where do translation movements occur
upper compartment between disc and mandibular fossa
condoyle & disc move together
what are the muscles of mastication
medial pterygoid
lateral pterygoid
masseter
temporalis
what is the innervation of the medial pteryoid
V3
what is the innervation of the lateral ptyergoid
V3
what are the attachments of the superior head of the lateral pteyrgoid
infratemporal surface of the greater wing of sphenoid to pterygoid fovea and capsule and disc of TMJ
what are the attachments of the inferior head of lateral pterygoid
lateral aspect of lateral pteryoid plate to pterygoid fovea on condylar neck
what are the attachments of the superficial head masseter
zygomatic process of maxilla, and inferior border of anterior two thirds of zygomatic arch, angle of mandible and lower portion of lateral aspect of ramus
what are the attachments of the deep head masseter
inner aspect of zygomatic arch to upper portion of lateral aspect of ramus
what is the action of masetter superficial head
elevation of mandible
what is the action of masetter deep head
retrusion
what is the innervation of masetter
V3
what are the attachment of temporalis
Temporal line to temporal crest
Temporal fossa
Overlying temporal fascia
Coronoid process of the mandible down to retromolar fossa
what is the action of temporalis
Maintains resting position Elevation of mandbile
Ipsilateral excursion Retrusion
what is the innervation of temporalis
v3
how do the infrahyoid muscles assist in jaw opening
stabilise the hyoid bone
how do the suprahyoid muscles assist in jaw opening
the depress the mandible directly or by being attached to the hyoid bone
what muscles does opening jaw require
lateral pterygoid and ant diagastric
wider opening- supra and infra hyoid muscles
what muscles are involved in jaw closing
masseter, medial pterygoid and temporalis (when against resistance)
which muscle is involved in the final stages of jaw closing
superior head of lateral pterygoid
what are the ligaments involved in the TMJ
lateral tempormandibular liagment
sphenomandibular
stylomandibular
pterygomandibular raphe
what are the attachments of the lateral temporomandibular ligament
articular tubercle
lateral surface of neck of mandible
what are the attachments of the sphenomandibular ligament
spine of sphenoid bone
lingula of mandible above mandibular fo
what are the attachments of the stylomandibular ligament
syloid process to angle of mandible
what are the attachments of the ptergomandibular raphe
Tip of the hamulus of medial pterygoid plate to posterior end of mylohyoid line
outline jaw opening and closing cycle
- Rest position with a 5mm freeway space
- Opening involves protraction and hinge movements
- Initial opening requires inferior head of lateral pterygoid and anterior digastric
- Wider opening recruits more muscles
- Closing reverses the process, masseter, medial pterygoid, temporalis (when closing against resistance) and superior head of lateral pterygoid (to locate condyle)
where are preganglionic axons in the sympathetic ns
thoracic or lumbar sc
thoracolumbar
where are preganglionic axons in the parasympathetic ns
brain or sacral spinal cord
craniosacral
what are the axons like parasympathetic ns
preganglionic long
post ganglionic short
what are the axons like sympathetic ns
preganglionic short- synapse in sympathetic chains
post ganglionic long
what are the ps ganglion of the head
ciliary
pterygopalatine
otic
submandibular
where do the ps ganglion receive sensory fibres from
v1 v2 or v3
where are post sympathetic fibres from
plexus of the nearest carotid arterial branch
where is the otic ganglion
infratemporal fossa
where is the pterygopalatine ganglion
pterygopalatine fossa
where is the submandibular ganglion
floor of the mouth
where is the ciliary ganglion
orbit
what is the sensory root for the otic ganglion
from parotid gland to otic ganglion via br of the auriocotemporal nerve (br of v3)
what is the parasympathetic root for the otic ganglion
CNIX- lesser petrosal nerve (preganglionic) to
what is the sympathetic root of the otic ganglion
middle meningeal to parotid gland
what are the br of distribution of the otic ganglion
from ganglion to parotid gland via auriculotemporal nerve
what the somatic motor root of the otic ganglion
from otic ganglion to medial pterygoid and tensor veli palitini
what is the sensory root for the submandibular ganglion
lingual nerve (br of v3)
what is the ps root of the submandibular ganglion
CNVII- via chorda tympani and lingual nerves to submandibular and sublingual glands
what is the sympathetic root for the submandibular ganglion
from: ext carotid plexus cia lingual and facial arteries
to: submandibular and sublingual glands
what is the sensory root for the pterygopalatine ganglion
v2 to targets via br od distribution
what is the ps root of the pterygopalatine ganglion
CNVII via pterygoid canal and greater petrosal nerve
what is the sympathetic root of the pterygopalatine ganglion
from int carotid plexus via deep petrosal nerve and nerve of pterygoid canal
what is the sensory root of the ciliary ganglion
v1 ganglionic branches
what is the ps root of the ciliary ganglion
CNIII to motor innervation to sphincter pupillae and ciliary muscles
what is the sympathetic root of the ciliary ganglion
from sympathetic plexus of internal carotid artery and opthalmic arteries
what are the boundaries of the pterygopalatine fossa
post- sphenoid bone
med- palatine bone
ant-maxilla
lat-pterygomaxillary fissure
what are the openings of the pterygopalatine fossa
fo rotundum pterygoid canal sphenopalatine fo palatine canal infraorbital canal inferior orbital fissure pterygomaxillary fissure
what does the fo rotundum transmit
maxillary nerve
what does the sphenopalatine fo transmit
nasopalatine nerve, posterior superior nasal nerves and sphenopalatine artery
what does the palatine canal transmit
greater and lesser palatine nerves
what does the inferior orbital fissure transmit
infraorbital nerves and vessels
what does the pteyrgomaxillary fissure transmit
3rd part of maxillary artery
what are the contents of the pterygopalatine fossa
v2
pterygopalatine ganglion
3rd part of maxillary artery
which division of v is sensory
v1 and v2
which division of v is motor and sensory
v3
through which fo does v3 leave the pterygopalatine fossa
inferior orbital fissure then infraorbital groove
what are the br v2
Greater and lesser palatine Lesser Posterior sup alveolar nerve Zygomatic nerves Infraorbital nerve - Anterior superior alveolar nerve -Middle superior alveolar nerve
what nerves are br arising from the pterygopalatine ganglion
greater and lesser palatine nerve
what are the zygomatic nerves
zygomaticotemporal
zygomaticofacial
what are the br of distribution from the pterygopaltine ganglion
nasopalatine nerve posterior superior nasal nerves greater palatine nerves lesser palatine nerves pharyngeal nerve
what are the branches of . the maxillary artery that accompany the br of the maxillary nerve
Descending palatine (G+L)) Posterior sup alveolar artery Infraorbital artery Artery of pterygoid canal Sphenopalatine artery
which part of the maxillary artery enters the ITF
3rd
what are the main br of the first part of maxillary artery
middle meningeal
inferior alveolar
what do the br of the maxillary nerve supply
pterygopalatie ganglion
What is the path of the nasopalatine nerve ?
enters the nasal cavity through sphenopalatine Fo.
Passes along the roof of the nasal cavity
descends to the roof of the oral cavity
passes through the incisive Fo to the hard palate
What does the nasopalatine nerve innervate
?
the maxillary anterior teeth
What are the functions of the nose ?
ventilation olfactory filtration of the air drainage of secretions from the paranasal air sinuses and the nasolacrimal duct
What is the external nose pierced by ?
2 nasal apertures
What type of epithelium lines the nasal cavity ?
respiratory pseudostratified ciliated epithelium
What separates the nasal cavity from the anterior cranial fossa ?
the cribriform plate
What is lateral to the lateral wall of the nose ?
ethmoidal air cells
What is lateral to the lower half of the nasal wall ?
The maxillary air sinus
What separates the nasal cavity from the oral cavity?
the hard palate
What makes up the hard palate ?
palatine process of the maxilla
horizontal plane of the palatine bone
What do the nostrils lead to anteriorly ?
The vestibule
What makes the roof of the nasal cavity ?
sphenoid bone
cribriform plate
nasal spine of the frontal bone
of what bone is the cribriform plate a part of ?
the ethmoid bone
What are the conchae ?
3 scroll like elevations from the lateral wall of the nose
The superior and middle conchae are extensions of which bone ?
the ethmoid bone
What do the conchae overly ?
meati
What is the space above the superior concha ?
the sphenoethmoidal recess
What is the nasal septum made of ?
perpendicular plate of the ethmoid bone and the
vomer (post)
What do secretions from nasal mucosa drain through ?
ostia
What is hiatus semilunaris ?
a curved depression in the middle meatus
What is bulla ethmoidalis ?
a swelling superior to the hiatus semilunaris
Which sinus is the biggest ?
maxillary
What is the roof of the maxillary sinus ?
floor of the orbit
What is the floor of the maxillary sinus ?
the palatine process of maxilla
Why can sinusitis manifest as toothache ?
maxillary air sinus and teeth have a common nerve supply
What does the maxillary air sinus drain into ?
hiatus semilunaris and the middle meatus
Where is the ostium of the maxillary air sinus ?
high up in the medial wall of the nose
Where is the frontal sinus ?L
Lies in the frontal bone and behind the supercilairy arches
What does the frontal sinus drain into ?
hiatus semilunaris
middle meatus
What is superior to the sphenoidal air sinus ?
the pituitary fossa
What does the sphenoidal air sinus drain into ?
sphenoethmoidal recess
Where are the ostia of the sphenoidal air sinus ?
in the body of the sphenoid
What are the types of ethmoidal air cells ?
anterior
middle
posterior
Where do the anterior ethmoidal air cells drain into ?
middle meatus - hiatus semilunaris
Where do the posterior ethmoidal air cells drain into ?
superior meatus
Where do the middle ethmoidal air cells drain into ?
middle meatus
What are the articular surfaces of the TMJ and the disc made of ?
fibrocartilage
What are the structures related to the deep surface of the parotid gland ?
styloid process and stylopharyngeus , styloglossus and stylohyoid.
upper parts of the carotid sheath
which 2 muscles attach to the lateral pterygoid plate
medial and lateral pterygoid muscle
small part of buccinator
of which larger nerve is the lingual nerve a branch
v3
what muscle attaches to the angle of the mandible
medial pterygoid
which muscle attaches to the outer surface of the mandible
masseter
which muscle attaches to the infratemporal surface of the greater wing of sphenoid
superior head of the lateral pterygoid
what muscle attaches to the digastric fossa
anterior belly of digastric
does the anterior digastric muscle have an affect of the tempromandibular joint
yes it actively opens the joint
what is the innervation of the anterior digastric
v3
of which larger artery is the inferior alveolar artery a branch
maxillary
which bone is the mandibular fossa apart of
temporal
where is the squamotympanic fissure
lies in the temporal bone
what are the attachments of the articular disc within the cavity of the TMJ
capsule of the joint
squamotympanic fissure and neck of mandible
what is the function of the inferior alveolar nerve
sensory innervation to the mandibular teeth via its mental branch to the mucous membrane of the lip
name the bones that form the floor of the nasal cavity
palatine bone (horizontal plate) palatine process of maxilla
what does the specialised olfactory epithelium of the nasal cavity do
detect odours
what does the ciliated epithelium of the nasal cavity do
filter air
what do meatus do
increase SA to warm and moisten incoming air
what are the attachments of the articular disc within the cavity of the TMJ
capsule of the joint
squamotympanic fissure and neck of mandible
what is the function of the inferior alveolar nerve
sensory innervation to the mandibular teeth via its mental branch to the mucous membrane of the lip
name the bones that form the floor of the nasal cavity
palatine bone (horizontal plate) palatine process of maxilla
what does the specialised olfactory epithelium of the nasal cavity do
detect odours
what does the ciliated epithelium of the nasal cavity do
filter air
what do meatus do
increase SA to warm and moisten incoming air
what lines the nasal cavity within the sphenoethmoidal recess
olfactory epithelium
what is the remainder of the nasal cavity lined with
ciliated columnar respiratory epithelium
what nerves pass through the ethmoid bone
olfactory nerves
what structures do the olfactory nerves innervate
olfactory epithelium
what type of epithelium lines the maxillary sinus
ciliated columnar respiratory type epithelium
- What is the clinical importance of the maxillary sinus
Infection spread- roots of molar teeth project into the maxillary sinus. Also danger when extracting teeth creating and oral-antral fistula or the extracted tooth ending up in the sinus. Maxialla relationships with surrounding bones provides routes for further spreads of infection to the orbit and interior of the skull
what does the infraorbital canal transmit
infraorbital nerves and vessels
what does the pterygoid canal transmit
nerve of pterygoid canal
Define the three parts of the maxillary artery
The first part form its origin from the external carotid artery to the inferior border of the lateral pterygoid
Second part- passing either superficial or deep to the lateral pterygoid muscle
Third part- pterygopalatine fossa
How does this explain why your nose runs when you cry
The nasolacrimal duct drains tears from the eye
Where does the maxillary sinus drain
Hiatus semilunaris within the middle meatus
List the structures that drain into the space inferior to the middle concha
Frontal sinus, anterior and middle ethmoidal air cells and the maxillary sinus
Which nerve provides most of the sensory innervation for the nasal septum?
Nasopalatine nerve
Small contribution from anterior ethmoidal nerve
how does the nasopalatine nerve reach the nasal septum
sphenopalatine fo
Name the structure that drains into the inferior meatus
Nasolacrimal duct
List the relationships of the maxillary sinus.
The maxillary sinus is located inferior to the orbit and lateral to the nasal cavities.
Its floor is related to the alveolar process of the maxilla.
The roots of the maxillary teeth project into the sinus, especially in the case of the posterior teeth where there may be only a thin covering of bone over the root.
The ethmoid bone and air sinus are located supero-medial. Along the roof of the sinus is located the infraorbital canal.
What nerve follows a similar course to the wire located in the infraorbital canal
V2 – passes out of fo rotundum into pterygopalatine fossa
what bones form the lateral wall of the nose
inferior concha
maxilla
ethmoid bone- superior and middle concha
Name the parts of the ethmoid bone
Crista galli, cribriform plat, perpendicular plate and body (with its ethmoidal air sinuses, superior and middle conchae
List the bones that form the roof of the nasal cavity has anteriorly, posteriorly and in its intermediate part.
Frontal bone, cribriform plate of ethmoid and sphenoid
What structures drain into the middle meatus
The frontal air sinus, the anterior and middle ethmoidal air sinuses and the maxillary air sinus
List the relationships of the maxillary sinus.
The maxillary sinus is located inferior to the orbit and lateral to the nasal cavities. Its floor is related to the alveolar process of the maxilla. The roots of the maxillary teeth project into the sinus, especially in the case of the posterior teeth where there may be only a thin covering of bone over the root. The ethmoid bone and air sinus are located supero-medial. Along the roof of the sinus is located the infraorbital canal.
What is the sensory innervation of the lateral wall of the nose
Antero-superior
Anterior ethmoidal nerves (V1)
Postero-superior
Posterior superior alveolar (V2)
Antero-inferior
Anterior superior alveolar nerves (V2)
Postero-inferior
Greater palatine nerves (v2)
Name the branches of the pterygopalatine ganglia that provide a sensory innervation to the maxillary teeth and their supporting structures
Nasopalatine and greater palatine nerves
