Week 7: temporal & infra-temporal region, TMJ, MoM

Question 1

osteology of the mandible - key components

Answer 1

condylar process/ condyle
coronoid process (head and neck)
mandibular notch
neck
ramus
angle
body

Question 2

how does the mandible articulate with the skull

Answer 2

via the mandibular fossa of the temporal bone

Question 3

what forms the TMJ

Answer 3

Mandibular fossa of temporal bone
condylar process of mandible
articular disc

Question 4

what type of joint is the TMJ

Answer 4

Modified hinge (atypical) synovial joint
- has joint capsule

Question 5

what type of cartilage is in the TMJ

Answer 5

Articular surfaces of bone covered with fibrocartilage (not hyaline cartilage)

Question 6

what 3 ligaments connect the mandible to the temporal bone

Answer 6

2 extrinsic
- sphenomandibular (connects to the lingula)
- stylomandibular ligaments (connects to angle)

1 intrinsic (joint and capsule) - lateral ligament

Question 7

what muscles are involved in the DEPRESSION of the mandible

Answer 7

lateral pterygoid
supra + infrahyoid muscles

Question 8

what muscles are involved in the ELEVATION of the mandible

Answer 8

temporalis
masseter
medial pterygoid

Question 9

what muscles are involved in the PROTRUSION of the mandible

Answer 9

lateral pterygoid
medial pterygoid
masseter

Question 10

what muscles are involved in the RETRUSION of the mandible

Answer 10

temporalis

Question 11

what muscles are involved in the LATERAL MOVEMENTS of the mandible

Answer 11

Temporalis of same side
pterygoids of opposite side
masseter

Question 12

what are the muscles of mastication

Answer 12

temporal
medial and lateral pterygoid
masseter

Question 13

MoM are derived from which embryonic arch

Answer 13

1st pharyngeal arch

Question 14

what nerves supplies the MoM

Answer 14

Trigeminal nerve mandibular division (CNV3)

Question 15

temporalis origin and insertion, innervation

Answer 15

O: temporal fossa

I: medial surface of coronoid process of mandible + anterior border of ramus of mandible

deep temporal nerves from anterior trunk of CN V3

Question 16

masseter origin and insertion, innervation

Answer 16

O: zygomatic arch

I: angle & lateral surface of ramus of mandible

masseteric nerve from anterior trunk of CN V3

Question 17

medial pterygoid origin and insertion, innervation

Answer 17

O:
deep head -medial surface of lateral pterygoid plate
superficial head - the pyramidal process of the palatine bone

I: medial surface of the ramus & angle of mandible

medial pterygoid branch from main trunk of CN V3

Question 18

lateral pterygoid origin and insertion, innervation

Answer 18

O:
upper head - infratemporal surface of greater wing of sphenoid bone
lower head - lateral surface of lateral pterygoid plate

I: onto the articular disc and fibrous capsule of the TMJ

lateral pterygoid & buccal nerve from anterior trunk of CN V3

Question 19

boundaries of the temporal fossa

Answer 19

Superior & posterior borders - Superior & inferior temporallines

Anterior border - Frontalprocess of zygomatic bone &zygomatic process of frontalbone

Inferior border - Infratemporalcrest deep to zygomatic arch

Floor - frontal, parietal, temporal & greater wing of sphenoid bone.Includespterion

Question 20

boundaries of the infratemporal fossa

Answer 20

Laterally: Ramus of the mandible
Medially: Lateral pterygoid plate of sphenoid bone
Anteriorly: Posterior aspect of maxilla
Posteriorly: Tympanic plate, mastoid & styloid processes
Superiorly: Infratemporal crest of sphenoid bone
Inferiorly: Angle of the mandible

Question 21

contents of the temporal fossa

Answer 21

Muscles - temporalis + fascia

Vessles - superficial, middle & deep temporal arteries and veins

Nerves -
deep temporal nerves
zygomaticotemporal nerves (CNV2)
auriculotemporal nerve (from CNV3)
temporal branch of facial nerve (CNVII)

Question 22

contents of the infratemporal fossa

Answer 22

Muscles: inferior part of the temporalis muscle;lateral and medial pterygoid muscles

Blood vessels: maxillary artery; pterygoid venous plexus

Nerves: mandibular, inferior alveolar, lingual, buccal, and chorda tympani nerves & oticganglion

Question 23

contents of the pterygopalatine fossa

Answer 23

maxillary nerve [V2]
pterygopalatine ganglion
terminal part of the maxillary artery
veins, as well as their associated branches.

Question 24

describe origin + branches of CNV3 (mandibular branch of trigeminal)

Answer 24

Arises from trigeminal ganglion in middle cranial fossa
exits foramen ovale

Branches:
Auriculotemporal n.
Inferior alveloar n.
Lingual nerve
Buccal nerve

Question 25

what is the significance of the Auriculotemporal nerve (branch of CNV3)

Answer 25

encircles the middle meningeal artery and divides into numerous branches

the largest of which passes posteriorly and medial to the neck of the mandible to supply sensory fibers to the auricle and temporal region

Question 26

course and distribution of inferior alveolar nerve (CNV3)

Answer 26

branches to innervate mylohyoid muslce (mylohyoid nerve)

then enters mandibular foramen & passes through mandibular canal, forming inferior dental plexus

branch of the dental plexus
= mental nerve, passes through the mental foramen and supplies the skin of the lower lip + the chin, and the vestibular gingiva of the mandibular incisor teeth.

mental and incisive nerve = terminal branches

Question 27

what does the lingual nerve supply

Answer 27

Sensory to anterior 2/3rds of tongue,floor of mouth, lingual gingivae​

Passes medial and inferior to 3rdmolar tooth​
Joined by chorda tympani nerve withininfratemporal fossa

Question 28

3 parts of the Maxillary artery

Answer 28

mandibular
pterygoid
pterygopalatine parts

Question 29

Important maxillary arteries (out of the 7/15)

Answer 29

Middle meningeal
inferior alveolar
anterior and posterior deep temporal
masseteric
buccal
superior alveolar

Question 30

pterygoid venous plexus is located where?

Answer 30

The infratemporal fossa

Question 31

what does the pterygoid venous plexus drain

Answer 31

deep structures of the head
- palate, nasal cavity, paranasal sinuses, nasopharynx, auditory tube and deep parts of the scalp in the temporal region.