What is the clinical term for hayfever?
allergic rhinitis
What are the hay fever symptoms?
- sneezing & stuffy, runny nose
- watery eyes
- allergy to pollen
How is hay fever caused?
Allergy to an irritant
What happens during hayfever?
Acute inflammation of the nasal mucosa: dilated blood vessels.
What causes the secretion of excess mucous (runny/stuff nose) and tear production of lacrimal gland?
The activation of the “ganglion of hayfever” (pterygopalatine ganglion)
Where is the pterygopalatine fossa located?
- Beneath the apex of the orbital cone
- Anterior to the pterygoid process
- Posterior to the maxilla
- Medial to the infra-temporal bone
- Lateral to the poster-superior part of the lateral wall of the nasal cavity.
What sits below the pterygopalatine fossa, and between the pterygoid plate of the sphenoid bone behind and the maxilla anteriorly?
The pterygomaxillary fissure
What does the pterygomaxillary fissure open into?
The pterygopalatine fossa.
What does the ptergomandibular fossa communicate with?
Other multiple areas of the skull;
- the orbit : via inferior orbital fissure (anteriorly)
- the middle cranial fossa: via foramen rotunda & pterygoid canal (posteriorly)
- the infra temporal fossa: via pterygomaxillary fissure (laterally)
- the nasal cavity: via sphenopalatine foramen (medially)
What does the pterygopalatine fossa contain?
- 1/3 part of the maxillary artery
- CNVb (maxillary division of the trigeminal nerve)
- Pterygopalatine ganglion (“ganglion of hay fever”)
Where does the first part of the maxillary artery sits ?
Before the lateral pterygoid muscle
Where does the second part of the maxillary artery sits ?
Deep to the lateral pterygoid muscle
Where does the third part of the maxillary artery sits ?
After/medial to the lateral pterygoid muscle
The third part of the maxillary artery gives off the sphenopalatine artery, where does this artery head through and end up?
Travels through the sphenopalatine foramen and ends up in the nasal cavity.
The third part of the maxillary artery gives off the descending palatine artery, what does this artery supply?
Supplies palate and nasal cavity
The third part of the maxillary artery gives off the posterior, middle and inferior superior alveolar artery, what does these arteries supply
The posterior upper dentition.
Where does the infra orbital foramen open out onto?
The face
What branches does the infra orbital foramen give off?
It gives off the middle and anterior superior alveolar arteries.
What do the middle and anterior superior alveolar arteries?
The middle and anterior upper dentition.
What artery supplies the molars?
The posterior superior alveolar artery
What artery supplies the anterior dentition?
anterior superior alveolar artery
What artery supplies the premolars?
The middle superior alveolar artery
What does the third part of the maxillary artery also supply (via infraorbital artery branch) ?
The skin of the face
Which arteries supply the palate?
Greater palatine artery: supplies hard palate
Lesser palatine artery: supplies soft palate
Which artery supplies the lateral wall of the nasal cavity?
Which nerve supplies this lateral wall?
Predominantly supplied by greater and lesser palatine arteries and nerves
Which artery supplies the medial wall of the nasal cavity?
Which nerve supplies the medial wall of the nasal cavity?
Predominantly supplied by sphenopalatine artery.
Supplied by nasopalatine nerve
What nerve branch supplies the anterosuperior part of the lateral and medial wall of the nasal cavity?
The anterior ethmoidal branch of nasociliary nerve (CNV1).
What nerve branch supplies the posteriosuperior part of the lateral wall of the nasal cavity?
Lateral nasal branches of greater palatine nerve (V2)
What nerve branch supplies the posteriosuperior part of the medial wall of the nasal cavity?
Nasopalatine nerve (CNV2)
What does the zygomatic branch of the maxillary division of the trigeminal nerve give off?
The zygomaticotemporal and zygomaticofacial branches
What nerve does the zygomatic branch have a connecting to?
The lacrimal nerve (V1)
What sits within the pterygopalatine fossa?
The pterygopalatine ganglion.
Aswell as supplying the premolars and the anterior dentition, what do the middle and anterior superior alveolar nerve also supply?
Supply mucosa of the maxillary sinus and the gingiva associated with the labial and buccal region
State the 4 step pathway of the preganglionic sympathetic fibres from the brain.
- Travel down the spinal cord
- Exit the spinal cord in T1 spinal nerve
- Travel superiorly in the sympathetic chain
- Synapse in the superior cervical sympathetic ganglion.
Where do the post synaptic sympathetic fibres then travel to?
The internal carotid nerve.
What does the internal carotid nerve do to the post synaptic sympathetic fibres?
Transmits them onto the surface of the internal carotid artery, where they form a plexus.
where do the post synaptic sympathetic nerve fibres go after the plexus is formed?
Travel from plexus through deep petrosal nerve. This nerve then passes through the pterygoid canal, passing through the pterygoid ganglion to then distribute its branches.
What is the parasympathetic nerve supply referred to as?
The craniosacral supply
What cranial nerve is related to the nasal cavity?
CNVII
What forms the nerve of the pterygoid canal?
What does the nerve of the pterygoid canal contain?
Deep petrosal nerve and greater petrosal nerve
Pre and post ganglionic parasympathetic fibres
What are the roles of the maxillary division of the trigeminal nerve?
Relays general sensation from;
- midface skin
- maxillary teeth and gingivae
- mucosa of maxillary sinus
- walls of the nasal cavity
- hard and soft palate
Distributes sympathetic and parasympathetic secret-motor fibres from pterygopalatine ganglion to:
- lacrimal gland
- mucous glands of nasal cavity
- minor salivary glands of the palate.