Temporal And Infratemporal Fossae

Question 1

Boundaries of the temporal fossa:

1. Anterior
2. Superior and posterior
3. Inferior

Answer 1

1. Zygomatic process of frontal bone and zygomatic bone
2. Temporal lines
3. Zygomatic arch

Question 2

Infratemporal fossa boundaries:

1. Superficial (lateral)
2. Deep (medial)
3. Superior
4. Anterior

Answer 2

1. Ramus of mandible
2. Lateral pterygoid plate
3. Infratemporal surface of greater wing of sphenoid
4. Tuberosity of maxilla

Question 3

How does the infratemporal fossa communicate with the following:

1. Temporal fossa
2. Cranial cavity
3. Orbit
4. Pterygopalatine fossa

Answer 3

1. Through a gap deep to zygomatic arch
2. Through foramen ovale, foramen spinosum, and foramen lacerum
3. Through inferior orbital fissure
4. Through pterygomaxillary fissure

Question 4

Lateral pterygoid

1. Origin
2. Insertion
3. Innervation
4. Action

Answer 4

1. 2 bellies- greater wing of sphenoid and lateral pterygoid plate
2. Articular disc of TMJ, neck of condylar process of mandible
3. CN V3
4. Protrude mandible (bilateral) and side-side motion of mandible (unilateral)

Question 5

Medial pterygoid

1. Origin
2. Insertion
3. Innervation
4. Action

Answer 5

1. Medial surface of lateral pterygoid plate
2. Inside surface of angle of mandible
3. CN V3
4. Elevate/protrude mandible (bilateral); side to side motion of mandible (unilateral)

Question 6

Contents of the infratemporal fossa

1. 2 muscles
2. 2 nerves
3. 1 ganglion
4. 1 artery
5. 1 vein
6. 1 other

Answer 6

1. Lateral and medial pterygoid muscles
2. Mandibular nerve (and branches) and maxillary nerve (and 2 of its branches)
3. Otic ganglion
4. Maxillary artery
5. Pterygoid plexus of veins
6. Chorda tympani

Question 7

TMJ

1. What does it articulate with superiorly and inferiorly
2. What type of joint
3. What divides the joint into upper and lower cavities?

Answer 7

1. Superior-articular tubercle and anterior portion of mandibular fossa of temporal bone
   Inferior- the head (condyloid process) of the mandible
2. Synovial
3. Articular disc

Question 8

Capsule surrounds the TMJ, what are the superior and inferior attachments of the capsule

Answer 8

Superior- articular tubercle and the margins of the mandibular fossa
Inferior- neck of the mandible

Question 9

Relations of the TMJ

1. Anteriorly
2. Posteriorly
3. Laterally
4. Medially

Answer 9

1. Mandibular notch and masseteric nerve and artery
2. Tympanic plate of the external auditory meatus and the glenoid process of the parotid gland
3. The parotid gland (also fascia and skin)
4. Maxillary artery/vein and auriculotemporal nerve

Question 10

Ligaments of the TMJ: lateral temporomandibular ligmament:

1. Strengthens what part of the capsule
2. How do its fibers run (also from where to where)
3. Function of this ligament; to protect what?

Answer 10

1. Lateral aspect of capsule
2. Downward and backward; from the tubercle on the root of the zygoma to the lateral surface of the neck of the mandible
3. Limits movement in a posterior direction; protecting the external auditory meatus

Question 11

Ligaments of the TMJ: sphenomandibular ligament

1. Lies on what side of the joint
2. Attached to what two things?

Answer 11

1. Medial

2. Spine of the sphenoid bone (above) and lingula of the mandibular foramen (below)

Question 12

Ligaments of the TMJ: stylomandibular ligament

1. Location
2. Its a band of what type of fascia
3. Extends from where to where

Answer 12

1. Medial to TMJ
2. Deep cervical
3. Apex of the styloid process to the angle of the mandible

Question 13

Articular disc:

1. Location
2. What is it attached to anteriorly
3. What is the disc attached by, why?

Answer 13

1. On top; circumferentially to the capsule
2. To the tendon of the lateral pterygoid muscle
3. By fibrous bands to the head of the mandible; makes sure the disc moves forward and backward with the head of the mandible during protraction and retraction

Question 14

Location of the synovial membrane of the TMJ

Answer 14

Lines the capsule in the upper and lower cavities of the joint

Question 15

Nerve supply to TMJ

Answer 15

Auriculotemporal and massesteric branches of the mandibular nerve (V3)

Question 16

Movements of the TMJ

Answer 16

Elevation, depression, protraction, retraction, and rotation (when chewing)

Question 17

1. 3 muscles that depress the mandible

2. 1 muscle that pulls the mandible forward

Answer 17

1. Diagastrics, geniohyoids, and mylohyoids

2. Lateral pterygoids

Question 18

What muscles perform the following movement of the mandible:

1. Elevation (3)
2. Protrusion
3. Retraction

Answer 18

1. Temporalis, masseter, and medial pterygoids
2. Lateral pterygoids (assisted by medial pterygoids)
3. Contraction of posterior fibers of the temporalis

Question 19

How are lateral chewing movements of the mandible performed?

What muscle can do this?

This muscle also moves this way when performing what other motion?

Answer 19

By alternately protruding and retracting the (head of) mandible on each side

Posterior fibers of the temporalis pull the head of mandible backward

Also done in elevation of the mandible

Question 20

TMJ dislocation:

1. What 3 activities can cause it?
2. What is happening when it gets dislocated
3. Symptom
4. What 2 nerves can be damaged
5. Most common type of TMJ dislocation

Answer 20

1. Blow to the side of the face, yawning or taking a large bite
2. Head of mandible slips out of mandibular fossa
3. Patient will be unable to close their mouth
4. Facial and auriculotemporal nerves
5. Anterior (posterior are possible but rare)

Question 21

1. 4 muscles of mastication
2. Derived from?
3. Insert into?
4. Innervation?
5. Act on what joint?

Answer 21

1. Temporalis, massester, lateral and medial pterygoid
2. Mesoderm of 1st branchial arch
3. Ramus of mandible
4. Deep branches of mandibular nerve
5. TMJ

Question 22

Temporalis:

1. Origin
2. Insertion
3. Innervation
4. Action

Answer 22

1. Floor of temporal fossa/deep surface of temporal fascia
2. Coronoid process
3. 2 deep temporal nerves (from anterior division of V3)
4. Elevation of mandible; posterior fibers retract mandible

Question 23

Massester:

1. Origin
2. Insertion
3. Innervation
4. Action
5. Action when both sides work together?
6. Action when both sides act alternatively?

Answer 23

1. Lower border and inner surface of zygomatic arch
2. Lateral surface of ramus of mandible
3. Anterior division of V3
4. Elevation of mandible
5. Protrusion of mandible
6. Side to side movement

Question 24

Lateral pterygoid

1. Origin (of upper and lower head)
2. Insertion
3. Innervation
4. Action

Answer 24

1. Upper- infratemproal surface of greater wing of sphenoid
   Lower- lateral surface of lateral pterygoid plate
2. Pterygoid fovea and capsule/articular disc of TMJ
3. Anterior division of V3
4. Same as masseter

Question 25

Medial pterygoid: 1. Origin (of superficial and deep head) 2. Insertion 3. Innervation 4. Action

Answer 25

1. Superficial-tuberosity of maxilla Deep- medial surface of lateral pterygoid plate 2. Medial surface of ramus and angle of mandible 3. Trunk of mandibular nerve 4. Same as lateral pterygoid/masseter

Question 26

1. So all muscles of mastication elevate the mandible except? 2. All protrude the mandible except? 3. All are innervated by anterior division of V3 except?

Answer 26

1. Lateral pterygoid 2. Temporalis 3. Medial pterygoid

Question 27

Mandibular nerve (V3) has what types of fibers?

Answer 27

Motor and sensory

Question 28

1. Origin of the motor root of V3 2. Origin of the sensory root of V3 3. Both roots emerge from? 4. Where do roots unite? 5. They divide again into?

Answer 28

1. Axons of cells of motor nucleus of trigeminal nerve in pons 2. Peripheral processes of cells of trigeminal ganglion in the middle cranial fossa 3. Both roots emerge separately through foreamen ovale to infratemporal fossa 4. Below foramen ovale 5. Small anterior and large posterior division

Question 29

Relations of the mandibular nerve (V3) 1. Superficial 2. Deep 3. Posterior

Answer 29

1. Lateral pterygoid 2. Otic ganglion 3. Middle meningeal artery

Question 30

1. The trunk of V3 has one motor and one sensory branch what are they? 2. What are the 4 branches from the anterior division of V3? Which are sensory vs motor? 3. What are the 4 branches from the posterior division of V3? Which are sensory vs motor

Answer 30

1. Motor= nerve to medial pterygoid; sensory= meningeal branch (nervus spinosus) 2. Buccal nerve (sensory); masseteric nerve, deep temporal nerves, nerve to lateral pterygoid (motor) 3. Mylohyoid nerve (motor); auriculotemporal nerve, lingual nerve, inferior alveolar nerve (sensory)

Question 31

Nerve to medial pterygoid: ~1. Branch from? 2. Supplies? 3. Gives off 2 branches that pass through where? To supply what other 2 muscles?

Answer 31

1. Trunk of V3 2. Medial pterygoid 3. Otic ganglion (without relay) to supply tensor palati and tensor tympani muscles

Question 32

Masseteric nerve: 1. Motor or sensory branch of ? 2. Course 3. Final destination?

Answer 32

1. Motor branch of anterior division of V3 2. Emerges thru upper border of lateral pterygoid and turns along mandibular notch 3. Reaches masseter

Question 33

Deep temporal nerve: 1. __ branch of? 2. Emerges thru?

Answer 33

1. Motor branch of posterior division | 2. Upper border of lateral pterygoid

Question 34

Meningeal branch (nervus spinosus) 1. __ branch of? 2. Passes through which foramen? 3. Supplies?

Answer 34

1. Sensory branch of the trunk of V3 2. Foramen spinosum 3. Meninges of middle cranial fossa

Question 35

Buccal nerve: 1. __ branch of ? 2. Emerges between? 3. Supplies?

Answer 35

1. Only sensory branch of the anterior division 2. 2 heads of lateral pterygoid 3. Supplies skin and mucus membrane overlying buccinator

Question 36

Auriculotemporal nerve: 1. __ branch of ? 2. Arises ? 3. Runs backward, deep to ? 4. Gives branches to what 4 things? 5. Carries what type of fibers? From where to where?

Answer 36

1. Sensory branch of posterior division 2. From 2 roots encircling middle meningeal artery 3. Neck of mandible 4. Skin of auricle, temple, TMJ, and parotid gland 5. Carries POST-ganglionic PARAsympathetic fibers from otic ganglion to parotid gland

Question 37

Lingual nerve: 1. __ branch of? 2. Emerges from? 3. Joins ? 4. Runs below 3rd molar tooth, why is this dangerous? 5. Connected by 2 roots to what ganglion? 6. Carries general sensations from where?

Answer 37

1. Sensory branch of posterior division 2. Lower border of lateral pterygoid. Then superficial to medial pterygoid 3. Chorda tympani 4. Only covered by mucus membrane 5. Submandibular ganglion 6. From anterior 2/3 of tongue

Question 38

Inferior alveolar nerve: 1. __ branch from ? 2. Emerge behind? 3. Passes through what foramen/canal to supply what? 4. Emerges through what foramen as __ nerve to supply?

Answer 38

1. Sensory branch from posterior division 2. Lingual nerve 3. Mandibular foramen and canal to supply lower teeth 4. Then emerges thru mental foramen as mental nerve to supply skin of lower lip/chin

Question 39

Mylohyoid nerve: 1. __ branch of? 2. Is a branch of what nerve? Location of branching 3. Passes in? 4. Supplies?

Answer 39

1. Only motor branch of posterior division 2. Inferior alveolar nerve just above mandibular foramen 3. Mylohyoid groove of mandible 4. Mylohyoid and anterior belly of digastrics

Question 40

~Relations of lateral pterygoid: 1. Superficial 2. Deep 3. Emerging thru its upper border 4. Emerging thru its lower border 5. Emerging between its 2 heads

Answer 40

1. Temporalis, masseter, ramus of mandible, maxillary artery, buccal nerve 2. Medial pterygoid, mandibular nerve, middle meningeal artery, otic ganglion 3. Deep temporal and massesteric nerves 4. Lingual and inferior alveolar nerves and maxillary artery 5. Buccal nerve, maxillary artery