Pterygopalatine Fossa

Question 1

bony boundaries of pterygomaxillary region

Answer 1

1) maxilla
- anterior
2) sphenoid
- posterior and superior
3) palatine
- medially and inferiorly
4) pterygoid plates
- buttress the face
5) sphenopalatine foramen
6) pterygomaxillary fissure

Question 2

sphenoid bone anatomy

Answer 2

1) foramen rotundum
2) foramen for nerve of pterygoid canal

Question 3

boundaries of pterygopalatine fossa anterior

Answer 3

1) maxillary tuberosity
2) inferior orbital fissure
3) PSA foramen

Question 4

boundaries of pterygopalatine fossa posterior

Answer 4

1) pterygoid process of sphenoid
2) foramen rotundum
3) pterygoid canal

Question 5

lateral boundary of pterygopalatine fossa

Answer 5

1) pterygomaxillary fissure

Question 6

medial boundary of pterygopalatine fossa

Answer 6

1) vertical part of palatine
2) sphenopalatine foramen

Question 7

superior boundary of pterygopalatine fossa

Answer 7

sphenoid bone

Question 8

inferior boundary of pterygopalatine fossa

Answer 8

1) palatine bone
2) palatine canal

Question 9

CN V2 branches

Answer 9

1) meningeal
2) ganglionic
3) zygomatic
- zygomaticofacial and temporal
4) posterior superior alveolar
5) alveolar
- superior alveolar plexus
6) infraorbital
- anterior superior alveolar
- middle superior alveolar
- cutaneous branches (inferior palpebral, lateral nasal, superior labial)

Question 10

pterygo(spheno)palatine ganglion

Answer 10

1) nasopalatine ganglion
2) posterior lateral nasal
3) pharyngeal
4) greater palatine
5) lesser palatine
5) nasopalatine
6) anterior ethmoidal V1

Question 11

preganglionic parasympathetics

Answer 11

1) from superior salivatory nucleus with CN VII
2) but branch off as greater petrosal nerve
3) ONLY PRESYNAPTIC PARASYMPATHETIC

Question 12

postganglionic sympathetics

Answer 12

1) leave internal carotid plexus as the deep petrosal
2) purely sympathetic

Question 13

nerve of the pterygoid canal

Answer 13

1) it is composed of both greater and deep petrosal
2) these supply the minor nasal, palatal, and pharyngeal and lacrima lglands
- also nasal and pharyngeal mucosa

Question 14

sympathetics to the lacrimal gland

Answer 14

1) presynaptic fibers from CN VII
2) postsynaptic parasympathetic fibers from the pterygopalatine ganglion via zygomatic nerve (V2) and communicating branch to gland

Question 15

maxillary artery

Answer 15

1) posterior superior alveolar artery
2) infraorbital artery
3) sphenopalatine (nasopalatine) artery
4) artery of pterygoid canal
5) descending palatine artery

Question 16

posterior superior alveolar artery

Answer 16

1) pulp of molars/premolars
2) mucosa of maxillary sinus
3) vestibular gingiva molar / premolar region

Question 17

infraorbital artery

Answer 17

1) branches
- middle and anterior superior alveolar arteries
- pulp maxillary incisors, canines
- mucosa of anterior wall of maxilla

Question 18

sphenopalatine artery

Answer 18

1) posterior lateral nasal artery
2) septal artery

Question 19

venous drainage

Answer 19

1) vein names and locations correspond to the branches of maxillary artery
2) drain to pterygoid venous plexus

Question 20

nasal cavity relationships

Answer 20

1) inferior
-palate / oral cavity
2) superior
- anterior cranial fossa
2) anterior
- nares / vestibule
4) posterior
- choanae / nasopharynx
5) *rhinitis / rhinorrhea
- inflammation and postnasal drip

Question 21

external nose

Answer 21

1) bones and cartilages
2) bones
- nasal bones
- maxillae (frontal processes
3) cartilages
- septal
- lateral
- greater (major) alar

Question 22

nasal cavity relationships

Answer 22

1) ethmoidal aircells and orbits
2) maxillary sinuses

Question 23

nasalis muscle

Answer 23

1) trasverse compressor and alar dilator portion
- GSE CN VII

Question 24

cutaneous innervation of nasal cavity

Answer 24

1) CN V1-2

Question 25

three major arteries of nasal cavity

Answer 25

1) ophthalmic artery - dorsal and external nasal 2) maxillary artery - infraorbital 3) facial artery - lateral nasal

Question 26

osteology of nasal cavity

Answer 26

1) roof - frontal - nasals - ethmoid - sphenoid 2) floor - hard palate - maxillae (palatal processes; incisive canal) - palatines (horizontal portion)

Question 27

osteology of nasal septum

Answer 27

1) ethmoid 2) septal cartilage 3) vomer 4) puncture - very thin - can puncture through - CSF rhinorrhea 5) surgical approach to pituitary gland - deviated septum (congenital vs deviation)

Question 28

osteology of lateral nasal wall

Answer 28

1) maxilla 2) lacrimal 3) ethmoid (superior and middle conchae) 4) inferior nasal concha 5) palatine - sphenopalatine foramen - palatine canal 6) sphenoid - medial pterygoid plate - hamulus

Question 29

nasal mucosa

Answer 29

1) nasal septum 2) lateral wall - nasal conchae or turbinate - superior / middle / inferior meatus

Question 30

blood supply to nasal cavity

Answer 30

1) ophthalmic artery - anterior ethmoidal and posterior ethmoidal 2) maxillary artery - sphenopalatine - posterior septal / posterior lateral nasal 3) venous drainage - ophthalmic vein - pterygoid plexus 4) CC: epistasis / nosebleed

Question 31

GSA innervation of nasal cavity

Answer 31

1) ophthalmic nerve - CN V1 - anterior ethmoidal - external nasal 2) maxillary nerve - CN V2 - nasopalatine - posterior lateral nasals

Question 32

innervation special sensory to nasal cavity

Answer 32

1) olfactory nerve (CN I)

Question 33

paranasal sinuses

Answer 33

1) frontal, maxillary, ethmoidal, sphenoidal sinuses

Question 34

sinus development

Answer 34

1) pneumatization - nasal mucosa erodes surrounding bones, creating cavities 2) opening = ostium 3) function of sinuses

Question 35

maxillary sinus

Answer 35

1) drainage - maxillary ostium to the semilunar hiatus 2) nerve and blood supply - anterior, middle, and posterior superior alveolar nerves and arteries - venous drainage to pterygoid plexus 3) CC: maxillary sinusitis and drainage - referred pain (to maxillary teeth) - oral-antral fistula - sinus lift (augmentation) surgery

Question 36

sinus drainage into lateral nasal wall

Answer 36

1) frontal and maxillary sinuses - hiatus semilunaris 2) sphenoid sinus - sphenoethmoidal recess 3) posterior ethmoid cells - superior meatus 4) nasolacrimal duct - inferior meatus 5) anterior ethmoidal air cells - ethmoidal bulla

Question 37

frontal sinus

Answer 37

1) location - between the cortical layers of frontal bone, behind superciliary arches 2) drainage - via infundibulum to hiatus semilunaris 3) innervation - supraorbital nerve V1

Question 38

ethmoid air cells

Answer 38

1) location - 3-18 interconnecting compartments (cells) within the ethmoid 2) drainage - posterior cells: superior meatus - anterior and middle cells: middle meatus (bulla and hiatus semilunaris) 3) innervation - anterior and posterior ethmoidal nerves (V1)

Question 39

sphenoidal sinus

Answer 39

1) location - body sphenoid bone 2) relationship - optic chiasm, pituitary fossa, cavernous sinus, internal carotid artery 3) drainage - sphenoethmoidal recess 4) innervation - posterior ethmoidal nerve - V1 and superior pharyngeal nerve V2

Question 40

maxillary sinus

Answer 40

1) location - in body of maxilla 2) posterior - infratemporal fossa - posterior superior alveolar foramina 3) roof - orbit - infraorbital canal 4) anterior - face - anterior superior alveolar canal 5) medial - nasal cavity 6) inferior - upper teeth