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33 Cards in this Set
- Front
- Back
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Infratemporal fossa boundaries |
Superiorly - surface of greater wing of sphenoid Medially - lateral surface of lateral pterygoid plate of sphenoid bone Laterally - ramus and coronoid process of mandible Communicates with orbit via the inferior orbital fissure and with the pterygopalatine fossa via the pterygopalatine fissure/foramen |
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Ligaments of the TMJ (temporomandibular joint) |
Temporomandibular ligament: Reinforces joint on lateral surface. Strong, covered by parotid gland and prevents excessive movement in posterior direction by protecting external auditory meatus
Sphenomandibular ligament: Flat, thin band from spine of sphenoid to lingula of mandible. Lies on medial side of TMJ. Derivative of first pharyngeal arch
Stylomandibular ligament: From the styloid process to the ramus of mandible above the angle. Separates parotid from submandibular gland. Thickened band of deep cervical fascia |
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Muscles of Mastication (and innervation) |
Important muscles supplied by the mandibular division of the trigeminal nerve (V3)
1. Temporalis 2. Masseter 3. Medial Pterygoid 4. Lateral Pterygoid |
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Temporalis actions and attachments |
O: from floor of temporal fossa I: into coronoid process and anterior border of ramus
Elevates and retracts the mandible |
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Masseter actions and attachments |
O: superficial and deep head from inferior surface of zygomatic arch I: medial surface of the mandible near its angle
Elevates the mandible
Crossed superficially by the transverse facial artery, parotid duct, and buccal branch of CN VII (facial nerve) |
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Lateral Pterygoid actions and attachments |
O: Upper head; arises from from infratemporal surface of greater wing of sphenoid bone Lower head; lateral surface of lateral pterygoid plate I: Attaches to the neck of the mandible and the articular disc
Protracts and depresses mandible Deviates mandible to the contralateral side with concomitant action of medial pterygoid, producing a grinding movement |
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Medial Pterygoid actions and attachments |
O: Superficial head, arises from the tuberosity of the maxilla Deep head, arises from the medial surface of the lateral pterygoid plate I: Attaches to the medial surface of the angle of the mandible
Protracts and elevates the mandible |
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Mandible Elevation (close mouth) |
Temporal, masseter, and medial pterygoid |
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Mandible Depression (open mouth) |
Lateral pterygoid and suprahyoid and infrahyoid muscles |
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Mandible protrusion (protrude chin) |
Lateral pterygoid, masseter, and medial pterygoid |
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Mandible retrusion (retrude chin) |
Temporal (posterior oblique and near horizontal fibers) and masseter |
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Lateral movements (grinding and chewing) |
Temporal of same side, pterygoids of opposite side, and masseter |
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Maxillary Artery |
Larger of 2 terminal branches of external carotid artery, which arises behind neck of mandible
Lies superficial (or sometimes deep) to lateral pterygoid muscle; runs in infratemporal fossa towards pterygomaxillary fissure
Divided into 3 parts: 1st = Mandibular -- deep to or embedded in the substance of the parotid gland 2nd = Pterygoid 3rd = Pterygopalatine to the fossa |
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Smiling muscle |
Zygomaticus |
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Frowning muscle |
Depressor anguli oris |
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Kissing muscle |
Orbicularis oris |
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Raising eyebrows |
Occipitofrontalis |
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Fish face |
Buccinator |
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Pterygoid Venous Plexus |
Lateral to maxillary artery and pterygoid muscle; receives tributaries corresponding to maxillary artery
Coalesces to form maxillary vein that joins superficial temporal vein, which then becomes retromandibular vein
Plexus also communicates w/ facial vein and cavernous sinus
Important factor in focal demyelination of CN V2 |
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After exiting foramen ovale, mandibular nerve (V3) has an undivided motor and sensory trunk (2-3 mm), which immediately divides into ant/post divisions. Before the division, the undivided trunk gives rise to... |
1) Meningeal branch - to dura of middle cranial fossa; passes w/ middle meningeal a. through foramen spinosum
2) Nerve to the medial pterygoid muscle (SVE); closely associated w/ otic ganglion
3) Nerve to the tensor tympani muscle
4) Nerve to the tensor veli palatini muscle (can also arise from nerve to medial pterygoid) |
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Tensor veli palatini : attachments and actions |
O: scaphoid fossa of medial pterygoid plate I: palatine aponeurosis
A: elevates the palate during swallowing |
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Tensor tympani: attachments and actions |
O: Auditory tube and greater wing of sphenoid I: Handle of the malleus A: Pulls handle medially and tenses tympanic membrane to reduce amplitude of its oscillations |
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Anterior division of mandibular nerve |
1) Deep temporal nerves 2) Masseteric nerve 3) Nerve to lateral pterygoid muscle 4) Buccal nerve - only sensory nerve of anterior division which supplies skin and mucosa over most of cheek and gingiva; penetrates buccinator muscle, but not part of its motor supply |
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Posterior division of mandibular nerve |
1) Auriculotemporal nerve 2) Lingual nerve 3) Inferior alveolar nerve 4) Nerve to the mylohyoideus and anterior belly of the digastric; a branch of inferior alveolar; only motor nerve of the posterior division |
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Lingual nerve |
General sensory to anterior 2/3 of tongue
Pain, temperature, touch |
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Chorda tympani - CN VII |
SVA (taste to anterior 2/3 of tongue) |
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Temporomandibular joint |
Gliding synovial joint separated by a fibrocartilagenous disc on the articular surfaces
Slight opening of jaw = hinge action
Jaw widely opened = hinge and sliding movement combined |
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Concavoconvex Articular Disc |
Fibrocartilage that separates the joint cavity into an upper and lower compartment, each lined by separate synovial membranes
Disc attaches to margins of joint capsule, anteriorly to lateral pterygoid muscle and head of mandible |
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Movements that occur in superior cavity/compartment of TMJ |
gliding movements of protrusion and retrusion (translation) |
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Movements that occur in inferior cavity/compartment of TMJ |
hinge movements of depression and elevation, and rotational or pivoting movements |
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Anterior Dislocation of TMJ |
Large bites or yawning - excessive contraction of the lateral pterygoids produce an anterior dislocation (jaw "locked" open) |
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Middle Meningeal Artery |
Ascends deep to lateral pterygoid and passes between the 2 roots of the auriculotemporal nerve; enters cranium through foramen spinosum
Divides into ant/post branches and supplies skull and dura mater
Damages by fractures of temporal bone produce epidural hematoma |
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Cause and results of epidural hematoma |
Caused by damage to middle meningeal artery from temporal bone fracture
Results: Herniation of temporal lobe under tentorium cerebelli Herniation of cerebellar tonsil Compression of oculomotor nerve (III) leading to ipsilateral pupil dilation and 3rd cranial nerve muscle palsy Compression of corticospinal and associated pathways, resulting in contralateral hemiparesis, deep tendon hyperreflexia, and Babinski sign |
