The Temporal, Infratemporal And Pterygopalatine Fossae

Question 1

What are the boundaries of the temporal fossa? (On lateral side of skull)

Answer 1

Superiorly and posteriorly by the superior and inferior temporal line.

Anteriorly to the frontal and zygomatic bones

Inferiorly to the zygotes arch

Question 2

What is the roof of the temporal fossa?

Answer 2

Formed by the thick temporalis fascia that covers the temporalis muscle

Question 3

The temporal fossa contains, the H-shaped suture at the junction of the frontal, parental, temporal and sphenoid bones. What is this called?

Answer 3

Pterion

Question 4

What are the contents of the temporal fossa?

Answer 4

Temporalis muscle
Deep temporal nerves/vessels
Auriculotemporal nerve
Superficial temporal vessels

Question 5

With which fossa does the temporal fossa communicate?

Answer 5

The infratemporal fossa

Question 6

What are the boundaries of the infratemporal fossa?

Answer 6

Deep to and below the zygomatic arch

Medial to the ramus of the mandible and behind the posterior aspect of the maxilla.

Question 7

What is the roof of the infratemporal fossa?

Answer 7

By the portion of the sphenoid bone that contains the foramen ovale (V3) and the foramen spinosum (for middle meningeal a) and the mastoid process and stylohoid process of the temporal bone.

Question 8

What does the infratemporal fossa contain?

Answer 8

A portion of the parotid gland
M/L pterygoid muscles (mastication)
Maxillary artery
Pterygoid venous plexus
Motor and sensory branch of V3

Question 9

The _____ _____ provide surgical approach for the treatment of tumors (e.g. Maxillary sinus), to repair fractures of the skull base, and for the targeted delivery of drugs via the arterial system.

Answer 9

Infratemporal fossa

Question 10

What are the four primary muscles of mastication?

Answer 10

Medial
Lateral pterygoid
Masseter
Temporalis

Question 11

In what plane does the lateral pterygoid muscle lie?

Answer 11

Horizontal plane

Question 12

Where does the superior head of the pterygoid muscle insert?

Answer 12

From the infratemporal surface of the sphenoid bone to the articular capsul

Question 13

Where does the inferior head of the lateral pterygoid muscle insert?

Answer 13

From the lateral surface of the lateral pterygoid plate to the condylar process of the mandible

Question 14

What is the origin of the medial pterygoid muscle?

Answer 14

Tuberosity of the Mancilla and the medial surface of the lateral pterygoid plate

Question 15

What is the insertion of the medial pterygoid muscle?

Answer 15

Inner aspect of the angle of the mandible

Question 16

Where do both of the pterygoid muscle attach?

Answer 16

Lateral pterygoid plate

Note: they attach at different sides of the plate

Question 17

From where does the masseter extend?

Answer 17

From the inferior border and medial aspect of the zygomatic arch to the lateral surface of the ramus of the mandible

Question 18

From where does the temporalis muscle extend?

Answer 18

From the bones of the themporal fossa to the coronoid process and anterior ramus of the mandible

Question 19

What are the two proceses found on the ramus of the mandible?

Answer 19

Anterior: coronoid process

Posterior: condylar process

Question 20

What does the notch of the mandible transmit?

Answer 20

The neurovasculr bundle to the muscles

Question 21

What does the round head of the condylar process articulate with?

Answer 21

The temporal bone at the temporomandbular joint (TMJ)

Question 22

What nerve passes through the mandíbulas foramen?

Answer 22

The inferior alveolar nerve

Question 23

The _____ and ______ for a sling around the mandible and, acting in concert with the temporalis muscle, elevate the law and close the mouth.

Answer 23

The masseter and medial pterygoid

Question 24

What is the primary depressor of the jaw?

Answer 24

The lateral pterygoid

Question 25

Opening of the mouth if due to the action of the lateral pterygoid with what other muscle?

Answer 25

Hyoid muscles

Question 26

Protrusion of the mouth is due to what muscles?

Answer 26

Lateral and medial pterygoid muscles

Question 27

Retrusion of the mouth is done by what muscles?

Answer 27

Posterior fibers of temporalis, the masseter and assisted by the digastric and geniohyoid muscles

Question 28

What does lateral movement of the mouth?

Answer 28

The temporalis and (contralateral) medial+lateral pterygoid muscles

Question 29

What forms the tmj?

Answer 29

The condyle of the mandible together with the reticular tubercle and the mandíbulas fossa of the temporal bone

Question 30

What divide the TMJ into a suprmeniscal and inframeniscal compartments?

Answer 30

A Fibrocartilage bicóncava articular disk

Question 31

What is the action of the TMJ in the inferior compartment?

Answer 31

The condyle simply rotates on the articular disk

Question 32

What is the action of the TMJ in the supra compartment?

Answer 32

The condyle and disk slide anterior and posteriorly over the articular tubercle of the temporal bone.

Question 33

What is the site of delivery for anesthesia for the mandíbulas teeth?

Answer 33

The mandíbulas foramen Note: when done correctly, the termination of the inferior alveolar nerve, the mental nerve, will result in numbness of the chin

Question 34

What can result from yawning, excessive contraction of the lateral pterygoid, a blow to the chin when the moist if open, or a fracture of the mandible?

Answer 34

Dislocation of the TMJ -This is when the condyle passes beyond the apex of the articular tubercle.It is then dislocated and stuck

Question 35

What nerves can TMJ dislocation damage?

Answer 35

The facial or aurioculotemporal nerves

Question 36

What is bruxism?

Answer 36

A common problem whereby psychological issues result in excessive grinding of the teeth and/or excessive clenching of the jaw. Bruxism can damage teeth and dental restorations.

Question 37

What is the largest terminal branch of the external carotid artery?

Answer 37

The maxillary artery

Question 38

From where does the maxillary artery originate?

Answer 38

From the ext. carotid behind the neck of the mandible

Question 39

What is the course of the maxillary artery?

Answer 39

It courses between the ramus of the mandible and the medial pterygoid muscle, then adjacent to the lateral pterygoid muscle and terminates at the entrance of the nasal cavity.

Question 40

This artery is important for bleeding control during operations and is a portal for selective intra-arterial chemotherapy for the head and neck cancers. What artery is this?

Answer 40

The maxillary artery

Question 41

What is the general area that the maxillary artery and its 16 branches supply?

Answer 41

The ear and tympanic membrane and the muscles of the temporal and infratemporal fossa.

Question 42

From what artery do the middle meningeal and accessory middle meningeal arteries come from?

Answer 42

From the maxillary artery Note: these will cause an epidural hematoma if ruptured

Question 43

What are the important arteries that come from the maxillary artery?

Answer 43

``` Middle meningeal (and accessory) Inferior alveolar Buccal Posterior superior alveolar Infraorbital Descending palatine Sphenopalatine Pharyngeal ```

Question 44

What does the inferior alveolar artery supply?

Answer 44

The mandibular teeth

Question 45

What does the Buccal artery supply?

Answer 45

The check

Question 46

What does the posterior superior alveolar artery supply?

Answer 46

Posterior teeth of the maxilla

Question 47

Where does the infraorbital artery course through?

Answer 47

The infraorbital groove beneath the eye Note: fractures

Question 48

What does the descending palatine artery supply?

Answer 48

The oral region

Question 49

What ones the sphenopalatine artery supply?

Answer 49

The nasal cavity, paransal sinuses, palate and roof of the pharynx

Question 50

Through where do the sphenopalatine artery, the terminal branch of the maxillary artery, pass though to the nasal cavity?

Answer 50

The sphenopalatine foramen Note: in danger during surgery to this area

Question 51

The infratemporal fossa is continuous medically with?

Answer 51

The small pterygopalatine fossa

Question 52

What structure is located between the pterygoid process of the greater wing of the sphenoid and the maxilla?

Answer 52

Small pterygopalatine fossa

Question 53

What is the medial border of the small pterygopalatine fossa?

Answer 53

Perpendicular plate of the palatine bone

Question 54

The posterior will of the pterygopalatine fossa is formed by the _____ , contains 3 foramina.

Answer 54

Pterygoid process of the greater wing of the sphenoid bone

Question 55

What are the 3 foramina of the posterior wall of the pterygoidpalatine fossa

Answer 55

Pterygoid (Vidian) canal Foramen rotundum Palatovaginal canal

Question 56

What does the palatovaginal canal contain that is within the pterygopalatine fossa?

Answer 56

Vessels that communicate with the pharynx

Question 57

What structure contains preganglionic parasympathetic axons and postganglionic axons destined for the pterygopalatine ganglion?

Answer 57

The pterygoid (vidian) canal

Question 58

What do the greater and lessor palatine canals transmit to the oral cavity?

Answer 58

The palatine neurovascular bundle

Question 59

At the base of the pterygopalatine fossa are the __________ that form the junction between the alveolar process of the maxilla, the palatine bone and the pterygoid process.

Answer 59

Greater and lessor palatine canals

Question 60

On the medial wall of the pterygopalatine fossa what foramen opens into the nasal cavity?

Answer 60

Sphenopalatine foramen

Question 61

The pterygopalatine fossa is open laterally to the infratemporal fossa through the _____________.

Answer 61

Pterygomaxillary fissure

Question 62

The pterygopalatine fossa communicates with the middle cranial fossa via?

Answer 62

The foramen rotundamente and pterygoid canal

Question 63

The pterygopalatine fossa communicate with the infratemporal fossa via the?

Answer 63

Pterygomaxillary fissure

Question 64

The pterygopalatine fossa communicate with orbit via the?

Answer 64

Inferior orbital fissure

Question 65

The pterygopalatine fossa communicates with the nasal cavity via the?

Answer 65

Sphenopalatine foramen

Question 66

The pterygopalatine fossa communicates with the oral cavity via the?

Answer 66

Palatine canal

Question 67

The pterygopalatine fossa communicates with the pharynx via the?

Answer 67

Pterygovaginal canal

Question 68

What fossa contains V2 of the trigeminal, the pterygopalatine ganglion and its branches, and the maxillary artery and its branches.

Answer 68

The pterygopalatine fossa

Question 69

In the pterygopalatine fossa the arteries enter _______ and the nerves enter _________.

Answer 69

Laterally Posteriorly

Question 70

Axons from the pterygopalatine ganglion leave as the _______ for parasympathetic nerves.

Answer 70

Greater petrosal nerve

Question 71

Sympathetic neurons form a plexus on the internal carotid artery and ________ leaves to join preganglionic parasympathetic axons in the greater petrosal nerve.

Answer 71

Deep petrosal nerve

Question 72

The deep petrosal nerve and the greater petrosal nerve forms the?

Answer 72

The nerve of the vidian canal

Question 73

What is the hay fever ganglion?

Answer 73

Pterygopalatine ganglion Note: because of its role in tearing and mucous secretion

Question 74

From what nerve is the pterygopaltine ganglion suspended?

Answer 74

The maxillary nerve

Question 75

What does the maxillary nerve innervate?

Answer 75

The deep face

Question 76

What is the path of the maxillary nerve?

Answer 76

Enters the pterygopalatine fossa through the foramen rotunda, exits through the inferior orbital fissure, and terminates as the infraorbital nerve.

Question 77

What is the nerve that the maxillary receives sensation from the maxillary teeth?

Answer 77

The superior alveolar nerve

Question 78

These branches are from what nerve that are within the pterygopalatine fossa? 1. Communicating branches to the pterygopalatine ganglion 2. A branch that exits via the sphenopalatine foramen 3. Palatine nerves 4. Zygomatic nerve

Answer 78

The maxillary nerve (V2)

Question 79

Palatine nerve pass though the greater and lesser palatine foramen to receive sensations from what location.

Answer 79

The hard and soft palate (respectively)

Question 80

What does the zygomatic nerve split into?

Answer 80

Zigomaticofacial Zigomaticotemporal

Question 81

An infection in the region of the nose can reach the cavernous sinus with the potential to cause meningitis. That is why it's called a _________.

Answer 81

Danger area

Question 82

The veins of the infratemporal fossa can direct blood to what plexus? (Within the fossa)

Answer 82

Pterygoid plexus

Question 83

What plexus surround the lateral pterygoid muscle and communicates with the cavernous sinus, ophthalmic veins and facial vein.

Answer 83

Pterygoid plexus Note: it also has channels to the IJV and EJV

Question 84

Damage to what plexus during surgery within the infratemporal fossa can lead to serious bleeding?

Answer 84

Pterygoid plexus

Question 85

A hematoma (pool of blood outside a vessel) is a complication from an improperly placed ______ nerve block. (Within the infratemporal fossa)

Answer 85

Posterior alveolar

Question 86

What is the primary nerve of the infratemporal fossa?

Answer 86

The mandibular division of trigeminal

Question 87

The ___ ganglion resides in a pouch of dura in Mekel's cave in the middle cranial fossa.

Answer 87

Trigeminal

Question 88

Where is the trigeminal ganglion located?

Answer 88

Meckels cave

Question 89

Where is meckels cave located?

Answer 89

Middle cranial fossa

Question 90

When the mandibular division of trigeminal enters the foramen ovale, into what fossa does it enter?

Answer 90

Infratemporal

Question 91

What are the primary sensory branches of the mandibular nerve?

Answer 91

Auriculotemporal Inferior alveolar Lingual Buccal

Question 92

What is the sensation of the auriculotemporal nerve?

Answer 92

From the skin in the region of the ear

Question 93

From what part of the body does the inferior alveolar nerve sense?

Answer 93

From the mandibular teeth

Question 94

Where does the lingual nerve receive sensation from?

Answer 94

The terror 2/3 of the tongue

Question 95

From where does the Buccal nerve receive sensation?

Answer 95

The cheek