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80 Cards in this Set

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Boundaries of Infratemporal Fossa
-Medial: Lateral pterygoid plate
-Lateral: Ramus & coronoid process of mandible
-Superior: Infratemporal surface of greater wing of sphenoid & squamous part of temporal bone
-Anterior: Posterior wall of maxilla
-Posterior: Styloid process
-Inferior: No Physical boundary
Contents of Infratemporal Fossa
-Lateral/Medial Pterygoid Muscles (mastication)
-Mandibular Division of Trigeminal Nerve (V3)
-Chorda Tympani Branch of Facial Nerve
-Maxillary Artery and Branches
-Maxillary Vein and Branches
-Otic Ganglion (parasympathetic ganglion)
Lateral Pterygoid Muscle Function
-Has inferior and superior heads
-A muscle of mastication
-Protractor (inferior head): Pulls jaw forward
-Elevator (superior head): Raises mandible/jaw
-Only muscle of mastication which can open jaw
Lateral Pterygoid Muscle Attachments
-Posterior: Mandible
-Anterior: Lateral pterygoid plate & roof of infratemporal fossa
Medial Pterygoid Function
-Has superficial and deep heads
-A muscle of mastication
-Elevator of jaw along with masseter
Medial Pterygoid Attachments
-Superior: Lateral pterygoid plate and maxillary tuberosity
-Inferior: Mandible
Mandibular Division of Trigeminal Nerve (V3)
-Exits skull; Foramen ovale
-Divides into anterior and posterior division
-Main trunk of nerve before division provide motor innervation to medial pterygoid, tensor tympani and tensor veli palatini muscles
Anterior Division of V3
Mainly motor innervation (muscles of mastication) except long buccal nerve (sensory)
Anterior Devision of V3; Long Buccal Nerve
Provides sensory innervation to lateral pterygoid muscle and cheek
Posterior Division of V3
Mainly sensory innervation (auriculotemporal nerve, inferior alveolar nerve and lingual nerves) except nerve to mylohyoid (motor)
Posterior Division of V3; Auriculotemporal Nerve
Provides sensory innervation to auricle, external acoustic meatus, outer side of tympanic membrane, skin of temporal region and TMJ
Posterior Division of V3; Inferior Alveolar Nerve
-Enters mandible; Mandibular foramen
-Travels along mandibular canal
-Provides sensory innervation to mandibular teeth (premolar, canine, incisors) and gums.
-Gives off mental nerve emerging through mental foramen & innervating chin and lower lip
Posterior Division of V3; Lingual Nerves
-Provides sensory innervation to the tongue
-Carries fibres from facial nerve (chorda tympani) to provide taste to anterior 2/3rd of tongue
Posterior Division of V3; Nerve to Mylohyoid
-Provides motor innervation to the mylohyoid muscle and anterior belly of digastric muscle
-Comes off the inferior alveolar nerve
Temporomandibular Joint (TMJ)
-Synovial Joint of the jaw
-Articulation between the mandible and temporal bone
-Attached to mandibular glenoid fossa of temporal bone and the mandibular condyle
Components of TMJ
-Articular surfaces
-Capsule
-Articular Disc
-Lateral Pterygoid Muscle
-Ligaments
Articular Surfaces of TMJ
-Diarthrodial (2 surfaces of left and right condyle)
-Cannot move one without the other
-Lined with fibro-cartilage
-Articular surface include head of mandible, articular tubercle of temporal bone & the mandibular fossa
Capsule of TMJ
-Acts as sleeve that goes around joint holding synovial fluid in place
-Thin, loose envelope attached to the mandibular glenoid fossa and articular tubercle (holds mandible head in place)
Articular Disc of TMJ
-Thin oval plate between the mandibular condyle and mandibular glenoid fossa
-Divides the joint cavity into 2 separate compartments
-Has holds present which allow fluid to pass through allowing jaw movement otherwise would stick
Lateral Pterygoid in the TMJ
-Inferior head attaches onto the neck of the mandible
-Superior head attaches to the articular disc and capsule of TMJ
-Lowers the mandible and opens the jaw
-Unilaterally aids mastication
Ligaments of TMJ
-Reinforces joint and can be part of the capsule
-Lateral/temporomandibular ligament
-Stylomandibular ligament
-Sphenomandibular ligament
Lateral/Temporomandibular Ligament
-Thick part of the joint capsule
-Base attached to zygomatic process of temporal bone
and articular tubercle
-Apex attached to lateral side of neck of mandible
-Prevents backward movement of mandible
Stylomandibular Ligament
-Runs from styloid process to angle of mandible
-Becomes taut when mandible protruded
-Separates parotid and submandibular salivary glands
Sphenomandibular Ligament
-Runs from spine of sphenoid bone to the lingula of the mandible
-Becomes more prominent and taut when mandible protruded
Innervation of TMJ
-Sensory innervation by auriculotemporal nerve and V3
-No motor innervation as movement is via muscles
Blood Supply of TMJ
-Blood supply by branches of Ext. Carotid artery
-Superficial temporal artery predominately supplies blood to the joint
-Other branches include deep auricular artery, anterior tympanic artery, ascending pharyngeal artery and maxillary artery
Movement of The TMJ
2 movements of the joint which combine causing either elevation or depression;
-Hinge/Rotation
-Translation
Movement of The TMJ; Hinge/Rotational Movement
-Lower compartment
-When open and close mouth
-Occurs between mandibular condyle and articular disc
-Disc remains stationary and condyle moves
Movement of The TMJ; Translation Movement
-Upper compartment
-Protrusion and Retrusion
-Occurs between articular disc and mandibular fossa
-Condyle and disc both move together
Muscles Involved In Jaw Movement
-Supramandibular muscles
-Inframandibular muscles
-Suprahyoid muscles
-Infrahyoid muscles
Muscles Involved In Jaw Movement;Supramandibular Muscles
-Muscles of mastication
-Attached between mandible and skull
-Mainly jaw elevators (close the mouth)
-Small movement eg grinding food
Muscles Involved In Jaw Movement; Muscles of Mastication
-Temporalis
-Lateral Pterygoid
-Masseter
Muscles Involved In Jaw Movement; Inframandibular Muscles
-Suprahyoid and Infrahyoid Muscles
-Move jaw indirectly by moving the hyoid bone down
Muscles Involved In Jaw Movement; Suprahyoid Muscles
Mostly jaw depressors which open the mouth;
-Digastric muscles
-Mylohyoid
-Geniohyoid
-Stylohyoid
Muscles Involved In Jaw Movement; Infrahyoid Muscles
Jaw depressors which open the mouth;
-Sternohyoid
-Sternothyroid
-Thyrohyoid
-Omohyoid
Jaw Opening and Closing Cycle
-Rest Position (5mm freeway space)
-Jaw Opens
-Wider Opening of Jaw
-Jaw Closes
Jaw Opening and Closing Cycle; Opening of Jaw
Jaw opening involves:
-Protraction; pulled forward and dropped under gravity
-Hinge movement
-Requires inferior head of lateral pterygoid and anterior digastric muscle
Jaw Opening and Closing Cycle; Wider Opening of Jaw
-Involves recruitment from more muscles
-Hyoid bone needs to be lowered by inframandibular muscles (suprahyoid and infrahyoid muscles)
Jaw Opening and Closing Cycle; Closing of Jaw
-Closing of jaw reverses the process of opening (relax)
-Contraction of masster, temporalis, medial pterygoid muscles when closing against resistance pulling jaw up and backwards
-Contraction of superior head of lateral pterygoid completes process making sure mandibular condyle positioned correct
Autonomic Nervous System (ANS)
-Controls internal environment
-Connects the CNS to viscera of body
-Motor targets; glands, smooth and cardiac muscle
-Motor Neurons synapse with ganglion (outside CNS)
-2 divisions; Parasympathetic & Sympathetic
Autonomic Nervous System (ANS); Sympathetic
-Fight or Flight
-Thoracolumbar Outflow
-Preganglionic motor neurons in thoracic or lumbar part of spinal cord
-Preganglionic Axons Short (synapse in sympathetic chains)
-Postganglionic Axons Long
Autonomic Nervous System (ANS); Parasympathetic
-Rest and digest
-Craniosacral Outflow
-Preganglionic motor neurons in brain or sacral part of spinal cord
-Preganglionic axons long (synapse in ganglia near targets)
-Postganglionic axons short
Parasympathetic Ganglia of The Head
-Otic Ganglion
-Pterygopalatine Ganglion
-Submandibular Ganglion
-Ciliary Ganglion
Parasympathetic Ganglia of The Head; Otic Ganglion
-Located in infratemporal fossa
-Controls salivation of parotid gland
Parasympathetic Ganglia of The Head;Pterygopalatine Ganglion
-Located in pterygopalatine fossa
-Controls lacrimal glands and glands of nasal cavity
-Makes eyes water and nose run (hayfever)
Parasympathetic Ganglia of The Head; Submandibular Ganglion
-Located on floor of mouth
-Controls salivation of submandibular and sublingual salivary glands
Parasympathetic Ganglia of The Head; Ciliary Ganglion
-Located in orbit
-Controls sphincter pupillae and ciliary muscles
Parasympathetic Ganglia of The Head; Connections in The Head
-Parasympathetic (motor) root; Presynaptic motor fibres terminating at ganglia & synapsing with postsynaptic fibres which go to target organs
-Sympathetic Root; Postsynaptic sympathetic fibres (do not synapse)
-Sensory Root; General sensory fibres (do not synapse)
-Branches of distribution
Otic Ganglion; Parasympathetic (Motor) Root
-From lesser petrosal nerve (preganglionic axons from glossopharyngeal nerve (IX)
-To parotid gland
Otic Ganglion; Sympathetic Root
-From middle meningeal artery
-To parotid gland
Otic Ganglion; Sensory Root
-From parotid gland
-To otic ganglion via branch of auriculotemporal nerve
Otic Ganglion; Branches of Distribution
-From ganglion
-To parotid gland (via auriculotemporal nerve)
Otic Ganglion; Somatic Motor Root
-From otic ganglion
-To medial pterygoid and tensor veli palatini
Boundaries of Pterygopalatine Fossa
-Posterior; Sphenoid bone (pterygoid process)
-Medial; Palatine bone (perpendicular plate)
-Anterior; Maxilla (posterior aspect)
-Lateral; Pterygomaxillary fissue
Content of Pterygopalatine Fossa
-V2 of Trigeminal Nerve (Maxillary division)
-Pterygopalatine ganglion
-3rd part of the maxillary artery
Maxillary Division of Trigeminal Nerve (V2)
-Transmitted through foramen rotundum
-Exits infraorbital foramen (via inferior orbital fissure and infraorbital groove)
-Passes along floor of orbit (roof of maxilla)
Maxillary Division of Trigeminal Nerve (V2); Branches
-Zygomatic Nerves
-Infraorbital Nerve
-Posterior Superior Alveolar Nerve
-Anterior Superior Alveolar Nerve
-Middle Superior Alveolar Nerve
Zianists Interfere Partially As Mackems
Maxillary Division of Trigeminal Nerve (V2); Superior Alveolar Nerves
Supply upper dentition
Pterygopalatine Ganglion; Parasympathetic (Motor) Root
-From nerve of pterygoid canal
-To pterygopalatine ganglion
-Postganglionic axons then go to palatine, nasal & pharyngeal mucous glands and lacrimal glands
Pterygopalatine Ganglion; Sympathetic Root
-From deep petrosal nerve via nerve of pterygoid canal
-To pterygopalatine ganglion targets
Pterygopalatine Ganglion; Sensory Root
-From maxillary nerve
-To targets via branches of distribution
Pterygopalatine Ganglion; Branches of Distribution
Branches innervate structures of teeth eg gingiva
-Nasopalatine nerve
-Posterior superior nasal nerve
-Greater palatine nerve
-Lesser palatine nerves
-Pharyngeal nerve
Maxillary Artery
Accompanies maxillary nerve with the following branches:
-Posterior Superior Alveolar
-Infraorbital
-Descending palatine
-Sphenopalatine
-Artery of pterygoid canal
Functions of The Nose
-Ventilation
-Olfactory
-Speech
-Drainage
Functions of The Nose; Ventilation
Filters, warms and humidifies air protecting the ciliated epithelium
Functions of The Nose; Olfactory
Roof of nose involved in sense of smell
Functions of The Nose; Speech
-Soft palate diverts air through nose
-Resonating chamber with presence of paranasal air sinus to produce sound
Functions of The Nose; Drainage
Removal of secretions of lungs via nose
The External Nose
-Projects from face
-Pierced by 2 nasal apertures
-Nasal septum divides cavity and supports external nose
The External Nose; Nasal Septum
-Skeleton bony and cartilaginous
Composed of:
-Ethmoid bone
-Vomer bone
-Septal Cartilage
The External Nose; Crista Galli
-Median ridge of bone that projects from cribriform plates of ethmoid bone
-Olfactory bulbs lie on either side
The External Nose; Bridge of Nose
-Only bony part
-Nasal bone & parts of maxillary/frontal bones made of elastic cartilage (bends if hit)
Paranasal Sinuses
-Air filled extensions of nasal cavities
-Located in adjacent bones to nasal cavity
-Growth is post natal and important in determining face shape/size
-Growth dependant on air flowing past it in nose
4 Paranasal Sinuses
-Maxillary
-Frontal
-Sphenoidal
-Ethmoidal
Maxillary Air Sinus
-Largest sinus; pyramidal in shape
-Drains into hiatus semilunaris (2/3rd up wall)
-Infection can lead to tooth ache as affects sensory innervation of maxillary teeth
Maxillary Air Sinus; Boundaries
-Medial wall: Part of lateral wall of nose
-Roof: Floor of orbit
-Floor: Palatine process of maxilla
-Opening: High on medial wall (small)
Frontal Air Sinus
-Lies in frontal bone above and behind superciliary arches (eyebrows)
-May extend over orbit
-Drains into middle meatus
Sphenoidal Air Sinus
-Lies in body of sphenoid
-Varies in size
-Drains into sphenoethmoidal recess
-Related to pituitary gland, nerves and vessels in cranium
Ethmoidal Air Sinuses
-Occupies lateral parts of ethmoid bone
-Contains number of separate air cells
-Drains into middle and superior meati
-Closely related to orbit & base of skull
Paranasal Sinuses; Innervation
-Maxillary sinus; V2 (infraorbital and superior alveolar nerves)
Frontal Sinus; V1 Supraorbital
-Sphenoidal Sinus; V1 Ethmoidal
-Ethmoidal Sinus; V1 Ethmoidal