Temporal & Infra temporal Fossa Flashcards

1
Q

What are the 2 fossa on the side of the head?

A
  • Temporal
  • Infratemporal Fossa

They are interconnected spaces

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2
Q

what are the boundaries of the two fossa?

A

Soft tissues! Encased

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3
Q

e

The two fossa are related to what musucles?

A

Muscles of mastication

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4
Q

What muscles if lateral to the infratemporal space?

A

Masseter Muscles

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5
Q

What are the 3 muscles of mastication?

A
  • Medial & Lateral Ptergoid Muscles (infratemp fossa)
  • Masseter M.
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6
Q

What are the two parts of the masseter muscles?

A
  • Superficall belly
  • Deep belly
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7
Q

What are the 5 bony landmarks of the two fossa?

A
  • Temporal bone
  • Zygomatic arch
  • Sphenoid bones (greater & lesser wing)
  • Maxilla
  • Mandible
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8
Q

Describe the
* location of the temporal fossa
* shape
* where it stems to where it goes,
* major structures within

A
  • Covers the lateral surface of the skull
  • Fan shaped, thin muscle
  • From Zygomatic process to Supramastoid crestof temporal bone
  • Temporalis Muscle
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9
Q

Explain the function of the temporalis muscles

A
  • **Elevator m. **
  • Muscle of mastication
  • Elevates mandible through closing of jaw
  • Creates posteriorization, brings teeth together and prevents banging of incisors.
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10
Q

What muscles elevates the mandible through closing of jaw?

A

Temporalis Muscle

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11
Q

What is the blood supply of the temporalis muscles?

A
  • Deep temporal artery
  • Middle Temporal artery

Both from temporal Artery from ECA

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12
Q

What 2 nerve branches innervate the temporalis muscles ?

A
  1. Deep Temporal Nerves motor (V3)
  2. Zygomaticotemporal sensory (V2)
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13
Q

What branch of the Mandibular nerve of CN5 provies motor function to the temporalis muscle?

A

Deep Temporal Nerves

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14
Q

What branch off the Zygomatic nerve from the Maxillary V2 CN5 supples sensory inervation to the skin of temple

A

Zygomaticotemporal Branch

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15
Q

Sensory or Motor?

Deep temporal nerve

A

Motor

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16
Q

Sensory or motor?

Zygomatoctemporal?

A

Sensory

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17
Q

What are the two artries supply the temporal fossa

A
  1. Deep tempral Artery
  2. Middle temporal artery
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18
Q

Explain the Deep temporal Artery

A

Come off theMaxillary arteryand branch upward to supply blood to the temporal fossa.

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19
Q

Explaint the middle temporal artery

A

Comes off the Superficial temporal artery (directly off ECA).
* Goes up passes under temporalis muscle into deep surface

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20
Q

In patients with migrains, they often have pulsation of what artery that is visible from the side of the head?

A

Superficial Temporal Artery

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21
Q

Where is the infratemporal fossa located?

What is on either side lateral and medially?

A
  • Inferior to the temporal fossa
  • Ramus of the mandible is Lateral, wall of the pharynx is medial
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22
Q

What bones form the roof of the infratemporal fossa?

A
  • Inferior surface of the greater wing of sphenoid
  • Temporal Bone
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23
Q

What boney landmarks are within the the roof of the infratemporal fossa?

What does it open to superiorly?

A
  • Foramen Ovale (more ant.)
  • Foramen Spinosum
  • Petrotympanic Fissure

Opens superiorly to temporal fossa

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24
Q

Roof of infratemporal fossa

What msucles attaches on the medial & lateral pterygoid plate?

A

The medial and lateral Ptrygoid
muscles of mastication

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25
Q

Roof of infratemporal fossa

What is medial to the infratemporal fossa?

A

The pharynx

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26
Q

What forms the lateral wall of the infratemporal fossa?

Boney & Soft Tissue

A
  • Medial surface of the mandible (ramus)
  • Lateral and Medial Pterygoid muscles.
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27
Q

What forms the medial wall anteriorly of the infratemporal fossa?

A
  • Lateral Plate of the pterygoid Process
  • Ptergomaxillary fissure
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28
Q

allows structures to pass from infratemporal and pterygopalatine fossa

A

Ptergomaxillary fissure

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29
Q

What forms the medial wall posteriorly of the infratemporal fossa?

A
  • Pharynx
  • 2 Muscles of the soft palate
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30
Q

Medial Posterior wall of infratemporal fossa

What are the 2 muscles of the soft pallete?
Function?

A
  1. Tensor palatini muscle
  2. Levator palatini muscle
    Small m. but active role in swollowing major impact on soft pallete
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31
Q

What are the 7 major contents of the infratemporal fossa?

A
  1. Sphenomandibular ligament
  2. Medial and Lateral Pterygoid muscles
  3. Maxillary artery
  4. Mandibular nerve (V3)
  5. Branches of Facial nerve (VII)
  6. Glossopharyngeal Nerve (IX)
  7. Pterygoid plexus of veins
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32
Q

Explain the Sphenomandibular Ligament

A

1 of 5 ligaments that supports mandible
* Extracapsular for TMJ
* From spine of sphenoid to lingula near foramin on mandible

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33
Q

What ligament prevents the mandible from over opening?

A

Sphenomandibular ligament

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34
Q

When a patient has hypermobility of the mandible what may be affected?

A

A ligament (5) , ex. spehnomandibular ligament, that is not supoorting the mandible correctly

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35
Q

Why is the sphenomadibular ligament extra important?

A

2 functions
Restricts mandible im opening motion AND side to side motion.

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36
Q

Explain the medial and lateral pterygoid muscles

A

Both muscles are the soft tissue boundry form the infratemporal fossa.

37
Q

What does it mean to be extracapusular for TMJ

A

Outside of the fiborous capsul that encases the TMJ

38
Q

Where does the Inferior alveolar nerve branch off V3 enter the mandible?

A

Lingula

39
Q

Explain the Lateral Pterygoid Muscles

A

2 Heads that both insert in the TMJ
* Lower head
* Upper head
Both come from the pterygoid plate posterior to insert at TMJ

40
Q

Surron ds the condyle of the mandible

A

Capsule

41
Q

Explain the Medial Pterygoid Muscle

A

2 Heads
* Superifical head
* Ddeep head
Both come from the pterygoid plate posterior to insert at the medial boarder of the mandbile

42
Q

Explain the maxillary artery in the infratemporal fossa

A

Largest branch off the ECA

43
Q

Where does the maxillary artery supply blood?

A
  • Nasal Cavity
  • Roof & lateral wall of oral cavity
  • Dura mater
  • all teeth
44
Q

What Branches does the first part of maxillary artery give off?

A
  • Middle meningial branch
  • Inferior alveolar
45
Q

What Branches does the second part of maxillary artery give off?

A
  • Deep temporal
  • Masseteric
  • Buccal
  • ptergoid branches
46
Q

Explain the Mandibular Nerve (V3) in the infratemporal fossa

A
  • Enters the infratemporal fossa via the foramen ovale
  • Provides motor and sensory
47
Q

What are the 4 main anterior trunk branches of the mandibular nerve V3?

Sensory or motor?

A
  1. Buccal branch (sensory)
  2. Masseteric Branch (motor)
  3. Deep temporal (motor)
  4. Nerve to lateral ptergoid
48
Q

Anterior Trunk Mandibular V3

Explain the Buccal branch.
What kind of innervation? Located where?

A

mostly sensory
* Goes down to innervate sensory to oral. mucasa and buccal gingiva of lower molars.
* Some motor to the lateral pterygoid
* Moves through tendon of temporalis m. and contiues to the cheek.
* Lateral to the buccinator m.

49
Q

Anterior Trunk Mandibular V3

Explain the Masenteric Nerve Branch

A

Supplys motor to the muscles of mastication
* Masseter muscles
* Passes over the lateral pterygoid through the mandibular notch

medial and lateral pterygoid m.

50
Q

Anterior Trunk Mandibular V3

Explain the Deep Temporal Branch

A

Provides motor innervation
* Temporalis muscles via infratemporal crest via temporal fossa
* Goes up

51
Q

Anterior Trunk Mandibular V3

Explaint he Nerve to Lateral pterygoid branch

A

Goes into deep surface lateral pterygoid m.
* Sources from Anterior trunk or its buccal branch
* Partial motor, some sensory

52
Q

WHat does the tendon of the temporalis muscles do?

A

Comes down off temporalis m. and inserts in the coronoid process of the mandible.

53
Q

Anesthesia called “Long buccal” anesthetizes what?

A

The buccal branch of V3

54
Q

What muscles has no boney insertionor orgin? Contiguous with superior cosntrisctor muscles of the pharynx

A

Buccinator M.

55
Q

Nerve branches of the posterior trunk provide what kind of innervation?

A

Sensory!

* Auriculotemporal
* Lingual
* Inferior alveolar

56
Q

What are the 3 branches off the posterior trunk in the infratemporal fossa

A
  1. Auriculotemporal
  2. Lingual
  3. Inferior alveolar
57
Q

Posterior Trunk Mandibular V3

Explain the auricolotemporal nerve

A

sensory
* through foramen spinosum
* Passes around and up the TMJ
* Sensory for external & middle ear + large area of temple

58
Q

Where does the auriculotemporal nerve provide innervation to?

A

sensory
* large area over temple
* External ear; ext. auditory meatus
* Tympanic membrane
* Extracapsular Inv. of TMJ

59
Q

Explain innervation of TMJ

A

All extracapsular innervation, no internal innervation.

60
Q

Explain ganglionic fibers of the auriculotemporal nerve

A

Post-ganglionic parasympathetic nerves (lesser petrosal) from glossalpharyngeal CN9 to parotid gland.

61
Q

Where does the auricolotemporal nerve run to the ext. auditory meatus?

A

Petrotympanic Fissure

62
Q

What occurs if the TMJ is compresses up and down into the fossa?

A

The auriculotemporal nerve will be compressed and will result in pain.

63
Q

Posterior Trunk Mandibular V3

Explain the lingual nerve

A

sensory
* Anterior 2/3 tongue
* Oral mucosa floor of mouth
* lingual gingiva around lower teeth

64
Q

Injury to the lingual nerve results in what?

A

Lose taste& sensation! No longer innervating 2/3rd of tongue

65
Q

Posterior Trunk Mandibular V3

Where does the lingual nerve enter the oral cavity at?

A

Posterior attachment of mylohyoid and superior constrictor of the pharynx.

66
Q

Posterior Trunk Mandibular V3

Where does the lingual nerve enter the tongue at?

A

Lateral surface of hyoglossus muscles (of tongue)

67
Q

Posterior Trunk Mandibular V3

Explain the location of the lingual nerve

(in the oral cavity)

A

Inferior to the lower 3rd molars, easily palpated and easily traumatized

68
Q

What nerve can be damaged in 3rd molar surgery through anesthezia or trauma of extraction?

A

Lingual nerve

69
Q

Posterior Trunk Mandibular V3

What is the motor branche of the inferior alveolar nerve?

A

Motor branch to mylohyoid and anterior digastric

70
Q

Posterior Trunk Mandibular V3

Explain the inferior alveolar nerve

A

Major sensory to lower oral cavity
* one motor branch to myohyloid and anterior diagstric prior to entering canal
* 2 branches incisive nerve & mental nerve

71
Q

Posterior Trunk Mandibular V3

What are the two sensory branches of the inferior alveolar nerve?

A
  1. Incisive branch
  2. Mental branch
72
Q

Posterior Trunk Mandibular V3

Where does the inferior alveolar nerve run?

A

Between the spehnomandibilar ligament & ramus of the mandible, enters canal via mandibular foramen

Same path as artery

73
Q

What provides innervation of posterior digastric?

A

Facial CN7

74
Q

Posterior Trunk Mandibular V3

What are 2 nerve prior to the branching of the posterior trunk?

A
  1. Meningial branch
  2. Nerve to medial pterygoid
75
Q

Where does the meningial branch of the posterior trunk go and what does it innervate?

A
  • goes up into the skull via the foramen spinosum
  • Innervates sensory to the dura mater and Mastoid (attachment point for SCM)
76
Q

Where does the Nerve to medial pterygoid of the posterior trunk go and what does it innervate?

A

Branches to tensor veli palatini & tensor Tympani muscles

77
Q

What other 2 nerves innervate the infratemporal fossa?

A
  1. Chorda Tymplani (branch of CN7)
  2. Lesser Petrosal (branch of CN9)
    both join with branches of V3 in the infratemporal fossa
78
Q

Explain the Chorda Tympani

A

parasympathetic innervation
* Salivary glands
* Taste at anterior 2/3 of tongue
* Inner ear and TMJ (petrotympanic fissure)

79
Q

Explain the lesser Petrosal Nevre

A

parasympathetic fibers to the parotid gland
* Branch of Glossopharyngeal CN9

80
Q

Where does the pterygoid plexus of veins reside?

A

Between the pterygoids (bone), lateral pterygoid m. and the temporalis muscles.

deep

81
Q

What drains into the pterygoing plexus?

A

Facial Vein + Deep facial veins, which then drain into the External Jugular Vein

82
Q

Where is the deep facial vein and what does it do?

A

It is anterior to the zygomatic process and flows under it, going posterior to joing with the facial vein drain into the ptergoid plexus.

83
Q

Where is the facial vein and what does it do?

A

It is superficial to the masseter muscle, going up on the face, joins with deep facial vein and drains into pterygoid plexus.

84
Q

What is the significance of the pterygoid plexus

A

Holds significant amount of blood, acts as a lymphatic system for the nasal cavity, and drains into the EJV.

85
Q

Why can the pterygoid plexus be problematic?

A
  • Infection can spread into this area via emissary veins (small) and go into cavernous sinus.. bad
  • Lack of valves can allow anesthetic to backflow into the cranial cavity..
86
Q

The pterygoing plexus drains what areas?

A

drains!
* Areas asscoated with the maxillary artery
* Nasal Cavity
* Oral cavity (all teeth)
* Muscles of the infratemporal fossa
* Nasopharynx

87
Q

Explain the mastoid process

A
  • At the base of the skull
  • Area of attachment for SCM, Posterior digastric, etc.
  • Has air cells (sinunses)
88
Q

Why can the air cells of the mastoid process cause issues?

A

Middile ear iinfection can spread into air cells (mastoiditis), and fill them up, causing
* Pain
* Discomfort
* Swelling