Palet- Pterygopaletine Fossa Flashcards

(66 cards)

1
Q

Explain th Pterygopaletine fossa
(sphenopaletine)

A
  • Inverted pyramidal shape
  • Fat filled
  • On lateral side of skulll
  • Between infratemporal fossa & Nasopharynx
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2
Q

Known as major Neurovascular Crossroadsbetween the orbit – nasal cavity – the infratemporal fossa and the cranial fossa

A

PP fossa!

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3
Q

What is the anterior wall of the PP fossa?

A

Posterior surface of the maxilla

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4
Q

What is the medial wall of the PP fossa?

A

Lateral surface of the paletine bone

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5
Q

What makes the roof/posterior wall of the PP fossa?

A
  • Sphenoid (anterosuperior surface of pterygoid process)
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6
Q

The PP fossa communitcates with what 6 things?

A
  1. Middle cranial fossa
  2. Infratemporal fossa
  3. Floor of the orbit
  4. Lateral wall of the nasal cavity
  5. Oropharynx
  6. Roof of the oral cavity
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7
Q

The PP fossa is a major site for what?

A

Maxillary Nerve (CN5V2) sensory!

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8
Q

The PP fosa is a terminal site for what?

A

Maxillary artery!

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9
Q

What important ganglion is in the PP fossa?

A

Pterygopaletine ganglion

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10
Q

What merges in the PP gnaglion?

A

Merger
* Pre-ganglionc sympathetic fibers from Facial CN7
* Post ganglionic PARAsympathetic fibers
**These join sympathetic fibers from T1 joing branches of V2; sensory **

Oral Facial Pain

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11
Q

The PP fossa is formed by the ?

A

anterosuperior surface of pterygoid process
on the sphenoid bone

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12
Q

What are the 3 foramen in the spehnoid bone?

A
  1. Foramen Rotundum (max V2)
  2. Anterior opening of Pterygoid canal
  3. Foramen Lacerum
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13
Q

How many gateways are in the PP fossa? What do they do?

A

7 formanina & Fissure
1. Foramen rotundum
2. Pterygoind canal
3. Paltovaginal canal
4. Paletine Canal
5. Ptergomaxillary fissure
6. Inferior orbital fissure
7. PP foramen

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14
Q

What exits via formaen rotundum?

A

Maxillary CN5V2 (sensory)

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15
Q

Explain where the maxillary nerve goes once it exits the foramen rotundum

A
  • Passes anteriorly through inferior orbital fissure to become the infra-orbital nerve
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16
Q

Trauma to the infraorbital area results in?

A

Losing sensory, also a source of pain!

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17
Q

What does the infra-orbital nerve (branch from V2) supply?

A

Supplys orbital wall; sphenoidal & ethmoidal sinus

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18
Q

If you have excess mucous in the sphenoidal and ethmoidal sinus, what can this causes?

A

Pressure on the infra-orbital nerve which sends sensory signals back and give us that pain pressure sensation. Sinus pressure!

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19
Q

What exits via the paletine canal?

A

greater & lesser paletine nerves
* Branches off V2

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20
Q

What does the greater paletine nerve innervate?

Branch off V2

A
  • Roof oral cavity
  • Muscosa
  • Glands of hard pallte
  • Lingual Gingiva of incisors
  • give rise to post. nasal nerves of nose
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21
Q

What does the lesser palentine innervate?

branch off V2

A

soft pallate

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22
Q

Where is the greater paletine formaen?

A

Posterior, bilaterally

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23
Q

What does through the sphenopaletine foramen?

A
  • 7 Nasal nerves to nasal cavity
    most go to supply the lateral, some medial wall

branch of V2

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24
Q

WHere does the Nasopaletine n go and exit into the oral cavity?

1/7 nasal nerve brances of V2

A
  • Down nasal septum into oral cavity via incisive foramen adj to incisors.
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25
What goes through the **Palatovaginal Canal?**
Chains from below.
26
Explain **zygomatic nerve** | Branch off V2
**Branch off V2** * Supplies mucosa & glands of nasopharynx * Divides into zygomatico- temporal & facial
27
Explain the **zygomaticotemporal** branch of zygomatic n
Goes up and supplies skin over temple
28
Explain the **zygomaticofacial** branch of zygomatic n
Supply adjacent skin of zygomatic bone
29
What stems from the **Pterygopaletine fisure?** | (infratemporal fossa)
**Posterior Superior Alveolar Nerve** | branch off V2
30
What does the **Posterior Superior Alveolar nerve do & supply**? | branch off V2
* Joings with superior dental plexus inferior to max sinus * Supplies innervation to: 1. molar teeth 2. buccal gingiva 3. max sinus
30
What goes through the inferior orbital fissure?
Inferior orbital nerve | Continuation of V2
31
Explain the infra-orbital n. Location and branches
* lies in **infra-orbital groove,** exit via infraorbital canal * Branches are **middle & anterior superior alveolar nerves**
32
What do the middle & anterior superior branches off the infra-orbital canal do?
join superior alveolar plexus **supplies maxillary teeth**
33
# Infra-orbital nerve What does the **middle superior alveolar** nerve supply?
Maxiillary sinus
34
What does the **anterior superior alveolar** nerve supply?
Small **nasal branch into nasal floor & walls**
35
What branchesdoes the end of the **infra-orbital nerve** divide into? (3). Supply what?
1. Nasal (skin over nose + nasal septum) 2. Palpebral (lower skin of eyelids) 3. Superior labial (cheek, upper lip, oral mucosa)
36
What innervates the maxillary teeth?
* **Post** superior alveolar (branch off V2) * **Anterior & middle** superior alveolar (branch off infraorbital)
37
What provides blood supply to maxillary teeth?
**3 Branches off Maxillary Artery** 1. Posterior 2. Middle 3. Anterior **Alveolar arteries**
38
What innervates mandibular teeth?
Inferior alveolar nerve (V3 branch, sensory + motor)
39
What is blood supply of the mandibular teeth?
**Inferior alveolar artery** off maxillary artery
40
What is located in the pterygoid canal?
**Nerve to the pterygoid Canal** Formed by Joining of: * *greater petrossa* (branch from CN7) * *deep petrosal *(branch from internal carotid plexus) **pre ganglionic para sympathetic** & **post ganglion sympathtic fibers**
41
Explain the Greater Petrossal nerve
**Branch from CN7** * Pre-ganglionic Parasympathetic innervation * Joins with deep petrosal to form nerve to pterygoid canal
42
What does the **parasympathetic innervation** of the **greater petrosal nerve** go?
* mucous glands of nasal cavity * salivary glands in upper half of oral cavity * lacrimal gland in orbit * taste from soft palate
43
Explain the Deep Petrossal nerve
Brnach from **internal carotid plexus** * Post-ganglionic sympathetic fibers for blood vessles * Joins with Greater petrosal to form to pterygoid canal
44
Where does the deep petrosal nerve orignate from?
**Superior cervical sympathetic ganglion** that gives off the **internal carotid plexus then deep petrosal **
45
Explain **Pterygopaletine Ganglion** (PP ganglion)
* Largest of **4 parasympathetic ganglion in head** * Merging of nerve fibers CN7 and V2 * Located directly back though nose
46
What are the 3 branches off of the PP ganglion continued off V2?
1. Orbital Branch 2. Nasopaletine Branch 3. Pharyngeal branch
47
What does a pterygopalatine ganglion block do?
Helps **manage oral facial pain & headache**. * Block using a sphenocath through nose allows for direct injection into the nose.
48
How do you **Relieves trigeminal autonomic cephalalgias** such as * cluster headache * migraine * chronic paroxysmal hemicrania (CPH) * certain neuralgias
Pterygopaletin ganglion block via injection of anesthetic!
49
What does the PP ganglion contain (3 types of nerve fibers)
1. Parasympathetic 2. Sympathetic 3. Somatosensory **Help block sinus related pain & superfical nerve pain**
50
What innervates the lacrimal gland?
* Zygomaticotemporal; autonomic nerve * General sensory branch off opthalmic Nerve V1
51
Explain maxillary artery and 6 branches
**primary arterial distribution from ECA** 1. Post Sup Alveolar 2. Greater paletine 3. Infra-orbital 4. Pharyngeal 5. Artery of pterygoid canal 6. Spheno paletine artery
52
# Maxillary artery branch supplies blood **molars / premolars** – **adjacent gingivae and maxillary sinus**
Posterior Superior Alveolar Artery
53
# Maxillary artery branch Supplies blood to **structures around the orbital floor**
Infra-orbital artery
54
# Maxillary artery branch Supplies **blood to incisors canines and maxillary sinus**
Anterior Superior Alveolar Artery
55
# Maxillary artery branch Through **palatine canal** becomes lesser palatine branch: supplies: * **soft palate** – continues to greater palatine foramen to supply hard palate – to a**nterior septum of nose**
Greater Paletine Artery
56
# Maxillary artery branch **supplies blood ** * posterior aspect of roof of nasal cavity * Sphenoidal sinus * pharygotympanic tube
Pharyngeal branch
57
# Maxillary artery branch **Terminal branch of maxillary artery** Supplies: * Lateral wall of nasal cavity * Paranasal sinues (septum)
Sphenopaletine branch
58
# Maxillary Artery branch at **pterygoid canal ** * supplies surrounding tissues * fills foramen lacerum * terminates in mucosa of nasopharynx
Artery of pterygoid canal
59
All veins in the PP fossa pass ____ through PP ____ to from the ____ in the infratemporal fossa
All veins in the PP fossa pass **laterall** through **PP fissure** to from the **pterygoid plexus** in the infratemporal fossa
60
How does the **pterygoid plexus** communitcate witht the cavernous sinus?
Emmissary veins that comme off the pterygoid plexus and go up into the cavernous sinus
61
What 2 veins join befroe foing to pterygoid plexus?
Facial + Deep Facial
62
Where does the pterygoid plexus mainly drain into via what??
**External jugular** via the **retromandibular vein **
63
Where is the pterygoid plexus located
Infratemporal fossa; between temporalis m. & lateral pterygoid m.
64
Whre does the external jugular vein drain into?
Subclavian vein
65
Where does the cavernous sinus drain?
The brains dura