Pterygopalatine fossa

Question 1

What is the clinical term for hayfever?

Answer 1

allergic rhinitis

Question 2

What are the hay fever symptoms?

Answer 2

• sneezing & stuffy, runny nose
• watery eyes
• allergy to pollen

Question 3

How is hay fever caused?

Answer 3

Allergy to an irritant

Question 4

What happens during hayfever?

Answer 4

Acute inflammation of the nasal mucosa: dilated blood vessels.

Question 5

What causes the secretion of excess mucous (runny/stuff nose) and tear production of lacrimal gland?

Answer 5

The activation of the “ganglion of hayfever” (pterygopalatine ganglion)

Question 6

Where is the pterygopalatine fossa located?

Answer 6

• 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.

Question 7

What sits below the pterygopalatine fossa, and between the pterygoid plate of the sphenoid bone behind and the maxilla anteriorly?

Answer 7

The pterygomaxillary fissure

Question 8

What does the pterygomaxillary fissure open into?

Answer 8

The pterygopalatine fossa.

Question 9

What does the ptergomandibular fossa communicate with?

Answer 9

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)

Question 10

What does the pterygopalatine fossa contain?

Answer 10

1. 1/3 part of the maxillary artery
2. CNVb (maxillary division of the trigeminal nerve)
3. Pterygopalatine ganglion (“ganglion of hay fever”)

Question 11

Where does the first part of the maxillary artery sits ?

Answer 11

Before the lateral pterygoid muscle

Question 12

Where does the second part of the maxillary artery sits ?

Answer 12

Deep to the lateral pterygoid muscle

Question 13

Where does the third part of the maxillary artery sits ?

Answer 13

After/medial to the lateral pterygoid muscle

Question 14

The third part of the maxillary artery gives off the sphenopalatine artery, where does this artery head through and end up?

Answer 14

Travels through the sphenopalatine foramen and ends up in the nasal cavity.

Question 15

The third part of the maxillary artery gives off the descending palatine artery, what does this artery supply?

Answer 15

Supplies palate and nasal cavity

Question 16

The third part of the maxillary artery gives off the posterior, middle and inferior superior alveolar artery, what does these arteries supply

Answer 16

The posterior upper dentition.

Question 17

Where does the infra orbital foramen open out onto?

Answer 17

The face

Question 18

What branches does the infra orbital foramen give off?

Answer 18

It gives off the middle and anterior superior alveolar arteries.

Question 19

What do the middle and anterior superior alveolar arteries?

Answer 19

The middle and anterior upper dentition.

Question 20

What artery supplies the molars?

Answer 20

The posterior superior alveolar artery

Question 21

What artery supplies the anterior dentition?

Answer 21

anterior superior alveolar artery

Question 22

What artery supplies the premolars?

Answer 22

The middle superior alveolar artery

Question 23

What does the third part of the maxillary artery also supply (via infraorbital artery branch) ?

Answer 23

The skin of the face

Question 24

Which arteries supply the palate?

Answer 24

Greater palatine artery: supplies hard palate

Lesser palatine artery: supplies soft palate

Question 25

Which artery supplies the lateral wall of the nasal cavity? Which nerve supplies this lateral wall?

Answer 25

Predominantly supplied by greater and lesser palatine arteries and nerves

Question 26

Which artery supplies the medial wall of the nasal cavity? Which nerve supplies the medial wall of the nasal cavity?

Answer 26

Predominantly supplied by sphenopalatine artery. Supplied by nasopalatine nerve

Question 27

What nerve branch supplies the anterosuperior part of the lateral and medial wall of the nasal cavity?

Answer 27

The anterior ethmoidal branch of nasociliary nerve (CNV1).

Question 28

What nerve branch supplies the posteriosuperior part of the lateral wall of the nasal cavity?

Answer 28

Lateral nasal branches of greater palatine nerve (V2)

Question 29

What nerve branch supplies the posteriosuperior part of the medial wall of the nasal cavity?

Answer 29

Nasopalatine nerve (CNV2)

Question 30

What does the zygomatic branch of the maxillary division of the trigeminal nerve give off?

Answer 30

The zygomaticotemporal and zygomaticofacial branches

Question 31

What nerve does the zygomatic branch have a connecting to?

Answer 31

The lacrimal nerve (V1)

Question 32

What sits within the pterygopalatine fossa?

Answer 32

The pterygopalatine ganglion.

Question 33

Aswell as supplying the premolars and the anterior dentition, what do the middle and anterior superior alveolar nerve also supply?

Answer 33

Supply mucosa of the maxillary sinus and the gingiva associated with the labial and buccal region

Question 34

State the 4 step pathway of the preganglionic sympathetic fibres from the brain.

Answer 34

1. Travel down the spinal cord 2. Exit the spinal cord in T1 spinal nerve 3. Travel superiorly in the sympathetic chain 4. Synapse in the superior cervical sympathetic ganglion.

Question 35

Where do the post synaptic sympathetic fibres then travel to?

Answer 35

The internal carotid nerve.

Question 36

What does the internal carotid nerve do to the post synaptic sympathetic fibres?

Answer 36

Transmits them onto the surface of the internal carotid artery, where they form a plexus.

Question 37

where do the post synaptic sympathetic nerve fibres go after the plexus is formed?

Answer 37

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.

Question 38

What is the parasympathetic nerve supply referred to as?

Answer 38

The craniosacral supply

Question 39

What cranial nerve is related to the nasal cavity?

Answer 39

CNVII

Question 40

What forms the nerve of the pterygoid canal? What does the nerve of the pterygoid canal contain?

Answer 40

Deep petrosal nerve and greater petrosal nerve Pre and post ganglionic parasympathetic fibres

Question 41

What are the roles of the maxillary division of the trigeminal nerve?

Answer 41

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.