Temporal, Infratemporal and Pterygopalatine Fossae Flashcards by Motheo Moledi

Temporal Fossa
Posterior and superior border:

temporal lines

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Temporal Fossa
Anterior border:

zygomatic and frontal bones

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Temporal Fossa
Lateral border:

zygomatic arch

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Temporal Fossa
Inferior border:

infratemporal crest of sphenoid

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Temporal Fossa
Floor border:

the 4 bones forming pterion

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What are the 4 bones forming pterion?

o Frontal, parietal, temporal, sphenoid (greater wing)

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Temporal Fossa
Roof:

temporal fascia

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Contents of the temporal fossa:

Upper portion of temporalis muscle

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Infratemporal Fossa
Lateral border:

ramus of mandible

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Infratemporal Fossa
Medial border:

lateral pterygoid plate

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Infratemporal Fossa
Anterior border:

posterior aspect of maxilla

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Infratemporal Fossa
Posterior border:

tympanic plate, mastoid process and styloid process of temporal bone

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Infratemporal Fossa
Superior border:

inferior surface of greater wing of sphenoid

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Infratemporal Fossa
Inferior border:

mandible near its angle where medial pterygoid muscle inserts

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What are the contents of the infratemporal Fossa? (6)

Inferior part of the temporalis muscle
Lateral and medial pterygoid muscles
Maxillary artery
Pterygoid venous plexus
Mandibular (inferior alveolar br., lingual br., buccal br.) and chorda tympani (from facial n.) nerves
Otic ganglion

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The temporal and infratemporal regions together contain the ___________ joint.

temporomandibular

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What are the features of the Maxillary Artery? (2)

Terminal branch of the external carotid artery
Divided into 3 parts based on its relation to the lateral pterygoid muscle

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What is the course of the maxillary artery in the 1st part of the mandibular?

Horizontal at level of the neck of condylar process of mandible as it runs medially.

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What are the branches of the maxillary artery in the 1st part of the mandibular? (5)

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1st part - Mandibular
Deep auricular
Distribution: (2)

external acoustic meatus and external tympanic membrane
TMJ

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1st part - Mandibular
Anterior tympanic
Distribution:

internal tympanic membrane

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1st part - Mandibular
Middle meningeal
Distribution: (4)

Enters foramen spinosum to supply
* Bone and dura mater of lateral wall and calvaria of neurocranium
* Trigeminal and geniculate ganglia
* Facial nerve
* Tympanic cavity and tensor tympani muscle

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1st part - Mandibular
Accessory meningeal
Distribution: (3)

Enters foramen ovale and also supplies:
* Muscles of infratemporal fossa
* Sphenoid bone
* Mandibular nerve and otic ganglion

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1st part - Mandibular
Inferior alveolar
Distribution:

Descends into mandibular canal to supply:
* Mandible, its teeth, chin and mylohyoid

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What is the course of the maxillary artery in the 2nd part - pterygoid?

As it passes lateral pterygoid muscle, it ascends antero- superiorly, medial to temporalis.

What are the branches of the maxillary artery in the 2nd part- pterygoid? (4)

2nd part - Pterygoid Masseteric Distribution:

Traverses mandibular notch to supply: * TMJ and masseter

2nd part - Pterygoid Deep temporal Distribution:

Anterior and posterior branches ascend between temporalis and underlying bone to supply the muscle

2nd part - Pterygoid Pterygoid Distribution:

Pterygoid muscle

2nd part - Pterygoid Buccal Distribution: (3)

Runs antero-inferiorly with buccal n. to supply * Buccal fat-pad * Buccinator * Buccal oral mucosa

What is the course of the maxillary artery in the 3rd part in the pterygopalatine? (3)

- Passes between heads of lateral pterygoid muscle - Enters pterygomaxillary fissure - Enters pterygopalatine fossa

What are the branches of the maxillary artery in the 3rd part in the pterygopalatine? (6)

3rd part - Pterygopalatine Posterior superior alveolar Distribution:

Descends on maxilla’s infratemporal surface with branches traversing alveolar canals to supply * Maxillary teeth, adjacent gingiva and mucous membrane of maxillary sinus

3rd part - Pterygopalatine Infraorbital Distribution: (3)

Traverses inferior orbital fissure, infraorbital groove, canal and foramen to supply * Inferior oblique and rectus muscles, lacrimal sac * Maxillary canines and incisors and mucous membrane of maxillary sinus * Skin of infraorbital region of the face

3rd part - Pterygopalatine Artery of pterygoid canal Distribution:

Passes posteriorly through pterygoid canal to supply * Mucosa of upper pharynx, eustachian tube and tympanic cavity

3rd part - Pterygopalatine Pharyngeal branch Distribution:

Passes through palatovaginal canal to supply: * Mucosa of nasal roof, nasopharynx and sphenoidal air sinus

3rd part - Pterygopalatine Descending palatine artery Distribution:

Descends into greater palatine canal as it divides into greater and lesser palatine aa. to supply * Mucosa and glands of hard and soft palate

3rd part - Pterygopalatine Sphenopalatine artery (terminal branch of maxillary a.) Distribution: (2)

Traverses sphenopalatine foramen to supply * Walls and septum of nasal cavity and all paranasal sinuses * Anterior-most palate

What are the somatic sensory branches of the mandibular nerve? (5)

Somatic sensory branches Meningeal branch Structures innervated:

Dura mater

Somatic sensory branches Buccal nerve Structures innervated:

Skin over the buccal region of the face 2nd and 3rd molars

Somatic sensory branches Auriculotemporal nerve Structures innervated:

Auricle and temporal region and TMJ

Somatic sensory branches Lingual nerve (anastomoses with chorda tympani in infratemporal fossa) Structures innervated: (2)

Anterior 2 thirds of tongue Floor of the mouth

Inferior alveolar nerve, sub-branches:

Inferior dental plexus Mental nerve

Inferior dental plexus Structures innervated:

All mandibular teeth

Mental nerve Innervation: (3)

Skin and mucous membrane of lower lip Skin of the chin Vestibular gingiva of the mandibular incisors

Somatic motor branches: (4)

1 Masseteric nerve 2 Deep temporal nerves 3 Nerves to medial and lateral pterygoid 4 Nerve to mylohyoid

What are the structures innervated by the somatic motor branches?

Muscles of mastication

Otic Ganglion Location:

Located in the infratemporal fossa inferior to foramen ovale

Otic Ganglion: Medial to...

Medial to mandibular nerve

Otic Ganglion: Posterior to...

Posterior to medial pterygoid muscle

Otic Ganglion: Presynaptic parasympathetic fibres of _____ _____ (CN IX)

glossopharyngeal nerve

Otic Ganglion: * _______ in the otic ganglion * Postsynaptic parasympathetic fibres pass from the ganglion to the parotid gland through _________ nerve

Synapse auriculotemporal

Pterygopalatine Fossa Relative position: Medial to...

Medial to infratemporal fossa

Pterygopalatine Fossa Relative position: Lateral to...

Lateral to the back of the nose

Pterygopalatine Fossa Relative position: Inferior to...

Inferior to the apex of the orbit

Pterygopalatine Fossa Boundaries * Posterior-

Posterior- pterygoid process of sphenoid

Pterygopalatine Fossa Boundaries * Anterior-

Anterior- rounded posteromedial aspect of maxilla

Pterygopalatine Fossa Boundaries Medial-

Medial- perpendicular plate of palatine

Pterygopalatine Fossa Boundaries Lateral-

Lateral- pterygomaxillary fissure

Pterygopalatine Fossa Boundaries Roof-

Roof- medial continuation of infratemporal crest of greater wing of sphenoid

Pterygopalatine Fossa Boundaries Floor-

Floor- pyramidal process of palatine

Posterior communications: (3)

1. Foramen rotundum to middle cranial fossa 2. Pterygoid canal to middle cranial fossa via foramen lacerum 3. Palatovaginal/Pharyngeal canal to nasopharynx

Lateral communication:

4. Pterygomaxillary fissure to infratemporal fossa

Medial communication:

5. Sphenopalatine foramen to nasal cavity

Anterior communication:

6. Inferior orbital fissure to floor of orbit

Inferior communications: (2)

7. Greater palatine canal to mucosa of hard palate 8. Lesser palatine canal to mucosa of soft palate

Pterygopalatine Fossa contents: (2)

* Pterygopalatine (3rd) part of maxillary artery * Maxillary nerve (CN V2) and pterygopalatine ganglion

Communication: Foramen rotundum Artery - Nerve -

- Maxillary nerve

Communication: Pterygoid canal Artery - Nerve -

Artery of pterygoid canal Nerve of pterygoid canal

Communication: Palatovaginal/pharyngeal canal Artery - Nerve -

Pharyngeal artery Pharyngeal nerve

Communication: Pterygomaxillary fissure Artery - Nerve -

Maxillary artery Posterior superior alveolar nerves

Communication: Sphenopalatine foramen Artery - Nerve -

Sphenopalatine artery Lateral nasal nerve

Communication: Inferior orbital fissure Artery - Nerve -

Infraorbital artery Infraorbital nerve and zygomatic nerve

Communication: Greater palatine canal Artery - Nerve -

Greater palatine artery Greater palatine nerve

Communication: Lesser palatine canal Artery - Nerve -

Lesser palatine artery Lesser palatine nerve

Branch of maxillary nerve: Meningeal branch Structures innervated (sensory innervation only):

Dura mater of anterior middle cranial fossa

What are the 3 branches of the Zygomatic nerve?

Zygomaticofacial Structures innervated (sensory innervation only):

Anterior cheek

Zygomaticotemporal Structures innervated (sensory innervation only):

Skin of the temple

Communicating br. to lacrimal n. Structures innervated (sensory innervation only):

Lacrimal gland

Branch of the 4. Ganglionic branches to ______________ ganglion.

pterygopalatine

Branch of maxillary nerve: Posterior superior alveolar Structures innervated (sensory innervation only):

Molar teeth and maxillary sinus

What are the 5 branches of the Infraorbital nerve?

Middle superior alveolar Structures innervated (sensory innervation only):

Maxillary premolars and molars

Anterior superior alveolar Structures innervated (sensory innervation only):

Maxillary incisors and canines

Superior labial Structures innervated (sensory innervation only):

Upper lip

Inferior palpebral Structures innervated (sensory innervation only):

Conjunctiva of inferior eyelid

External nasal Structures innervated (sensory innervation only):

Skin of lateral external nose

Branch of maxillary nerve: Greater palatine nerve Structures innervated (sensory innervation only):

Hard palate

Branch of maxillary nerve: Lesser palatine nerve Structures innervated (sensory innervation only):

Soft palate and palatine tonsils

Branch of maxillary nerve: Posterior lateral nasal nerves Structures innervated (sensory innervation only):

Lateral wall of nasal cavity

Branch of maxillary nerve: Nasopalatine nerve Structures innervated (sensory innervation only):

Anterior part of hard palate and nasal septum

Branch of maxillary nerve: Pharyngeal nerve Structures innervated (sensory innervation only):

Nasal part of the pharynx