Palate and PPF - SRS

Question 1

What approach is used to remove tumors from the PPF or to ligate the sphenopalatine artery in cases of chronic epistaxis?

Answer 1

Transantral access to PPF:

Upper lip is elevatedf and the maxillary sinus is entered anteriorly to then reach the PPF..

Question 2

What are the general contents of the pterygopalatine fossa?

Answer 2

1. Maxillary artery – third (pterygopalatine) portion
2. Maxillary branch of trigeminal nerve (V2)
3. Pterygopalatine ganglion

Question 3

Identify the following boundaries of the pterygopalatine fossa…

A.Lateral –

B.Superior –

C.Anterior –

D.Medial –

E.Inferior –

F.Posterior –

Answer 3

A.Lateral – pteygomaxillary fissure

B.Superior – greater wing of sphenoid bone

C.Anterior – maxilla

D.Medial – palatine bone

E.Inferior – open via pterygopalatine canal

F.Posterior – pterygoid process of sphenoid bone

Question 4

What are the openings of the pterygopalatine fossa?

(7)

Answer 4

1. Pterygomaxillary fissure
2. Inferior orbital fissure
3. Sphenopalatine foramen
4. pterygopalatine canal
5. Foramen rotundum
6. pterygoid canal
7. pharyngeal canal

Question 5

The pterygomaxillary fissure is lateral to the pterygopalatine fossa, and communicates with the infratemporal fossa. What does it transmit?

Answer 5

1. maxillary a.
2. posterior superior alveolar a.v.n

Question 6

The inferior orbital fissure is anterior to the PPF and communicates with the orbit. What does it transmit?

Answer 6

1. infraorbital a.v.n.;
2. zygomatic a.v.n.
3. (Inferior opthalmic vein also, though not mentioned in Dr. Funk’s notes)

Question 7

The sphenopalatine foramen is medial to the PPF, and communicates with the nasal cavity. What does it transmit?

Answer 7

1. Sphenopalatine a.
2. Nasopalatine n.
3. Posterior superior Lateral nasal n.

Question 8

Foramen rotundum transmits V₂ and communicates with the middle cranial fossa. Where is it in relation to the PPF?

Answer 8

Posterior

Is lateral most of the three posterior openings

Question 9

The pterygoid canal is posterior to the PPF. and the middle of the three posterior openings. It communicates with the middle cranial fossa near foramen lacerum. What does it transmit?

Answer 9

Nerve and artery of the pterygoid canal

Question 10

The pharyngeal canal is posterior to the PPF, and the medial most of the three posterior openings. It passes the pharyngeal n.a.v..

What does it communicate with?

Answer 10

Nasopharynx

Question 11

1.The maxillary artery courses through the infratemporal fossa; its third portion then enters the PPF through the pterygomaxillary fissure. What are the branches of the pterygopalatine portion of the maxillary artery?

Answer 11

1. Posterior Superior Alveolar a.
2. Infraorbital a.
3. Descending palatine a.
4. Artery of the pterygoid canal
5. Pharyngeal a.
6. Sphenopalatine a.

Question 12

What does the posterior superior alveolar a. supply?

Answer 12

1. Maxillary teeth
2. maxillary gingiva
3. Maxillary sinus

Question 13

What does the infraorbital a. supply?

Answer 13

Supplies floor of orbit, maxillary sinus, maxillary teeth, and the skin of the face via the following branches.

Question 14

What are the branches of the infraorbital a. ?

Answer 14

1. Zygomatic artery
2. Middle superior alveolar a.
3. Anterior superior alveolar a.
4. Nasal branches
5. Superior labial branches

Question 15

The descending palatine artery exits the PPF inferiorly via the pterygopalatine canal. What does it supply? By what branches?

Answer 15

1. Supplies the palate, nasal cavity, and palatine tonsil via the following branches:
   a. Greater palatine a.
   b. Lesser palatine a.

Question 16

What does V2 provide GSA to?

Answer 16

1. Middle dermatome of face
2. Nasal Cavity
3. paranasal sinuses
4. maxillary teeth

Question 17

The maxillary nerve distributes parasympathetic innervation from what ganglion?

Answer 17

pterygopalatine ganglion

Question 18

What are the branches of V2?

Answer 18

1. Meningeal branch (to dura of middle cranial fossa)
2. Zygomatic n.
3. Posterior superior alveolar n.
4. Infraorbital n.
5. pterygopalatine nn.
6. Greater palatine n.
7. lesser palatine n.
8. Posterior Superior Lateral nasal n.
9. Pharyngeal n.
10. N of the pterygoid canal
11. nasopalatine n.

Question 19

Where should you inject to anesthetize the nasopalatine nerve?

Answer 19

Near the incisive foramen

Question 20

Where would you inject to anesthetize the greater palatine n?

Answer 20

Greater palatine foramen

Question 21

What fibers does the PPG recieve from the greater petrosal n.?

Answer 21

Preganglionic parasympathetics from VII

Question 22

What fibers does the PPG recieve from the deep petrosal n.?

Question 23

What does the descending palatine artery supply blood to?

Answer 23

1. palate
2. nasal cavity
3. palatine tonsil

Question 24

What does the postertior superior alveolar artery provide blood too?

Answer 24

1. Maxillary teeth
2. gingiva
3. Maxillary sinus

Question 25

What does the infraorbital artery supply blood to?

Answer 25

1. Floor of orbit 2. maxillary sinus 3. maxillary face 4. skin of face

Question 26

What does the pharyngeal a. supply blood to?

Answer 26

1. nasopharynx 2. auditory tube 3. sphenoid sinus

Question 27

What does the artery of the pterygoid canal supply blood to?

Answer 27

1. Nasopharynx 2. Auditory Tube 3. Tympanic Cavity

Question 28

What does the sphenopalatine artery provide blood to?

Answer 28

Nasal cavity