Temporal, Infratemporal, And Pterygopalatine Fossae

Front 1

Where is the infratemporal fossa located?

Back 1

Inferior to the zygomatic arch. Deep to the ramus of the mandible and the masseter muscle.

Front 2

What attaches to the lingula?

Back 2

Sphenomandibular ligament

Front 3

What muscles protrude the mandible?

Back 3

Lateral pterygoid and medial pterygoid

Front 4

What muscles retract the mandible?

Back 4

Posterior temporalis
Deep masseter
Geniohyoid
Digastric

Front 5

What muscles elevate the mandible?

Back 5

Temporalis
Masseter
Medial pterygoid

Front 6

What muscles depress the mandible?

Back 6

Mostly gravity
Digastric
Geniohyoid
Mylohyoid

Front 7

Where does the greater amount of forward movement occur in the TMJ joint?

Back 7

Upper portion of the joint

Front 8

Where does the hinge movement occur in the TMJ joint?

Back 8

Lower portion of the joint - condylar process and the disc.

Front 9

What occurs when you open your mouth?

Back 9

The condylar process rides up the tubercle of the zygomatic process of the temporal bone.

Front 10

Where does the lateral pterygoid insert?

Back 10

INTO the joint capsule in the region of the articular disc.

Front 11

What does the sphenomandibular ligament attach to?

Back 11

spine of the sphenoid to the lingula of the ramus of the mandible

Front 12

What does the stylomandibular ligament attach to?

Back 12

styloid process of the temporal bone to the angle of the mandible

Front 13

What does the lateral ligament attach to?

Back 13

margin of the articular tubercle to neck of the mandible

Front 14

What is the origin, insertion and action of the masseter muscle?

Back 14

Zygomatic arch and maxillary process of zygomatic bone

Lateral surface of mandible, ramus almost to coronoid process

Elevation of mandible

Front 15

What is innervation and supply to the masseter muscle?

Back 15

Masseteric nerve V3

Masseteric artery (maxillary)

Front 16

What are the boarders of the temporal fossa?

Back 16

Superior border is the superior and inferior temporal lines from the zygomatic process of frontal bone to the supramastoid crest of temporal bone

Lateral boundary is the temporal fascia which covers the temporalis muscle

Anterior limit is the frontal process of zygomatic bone

Inferior margin laterally is the zygomatic arch and medially it is the greater wing of the sphenoid

Front 17

What is in the temporal fossa?

Back 17

Temporalis muscle

Zygomaticotemporal branches of maxillary nerve (V2)

Front 18

What is the origin of the temporalis muscle?

Back 18

Temporal fossa

The anterior fibers are more vertically oriented. The posterior are more horizontal.

The fibers converge and form a tendon that passes deep to the zygomatic arch

Front 19

What is the insertion of the temporalis muscle?

Back 19

Anterior surface of the coronoid process and ramus of mandible

Front 20

What is the action of the temporalis muscle?

Back 20

To translate the head of the mandible from the articular tubercle back into the mandibular fossa.

Lateral translation "side-to-side" chewing.

Front 21

What is the innervation and supply of the temporalis muscle?

Back 21

Deep temporal nerves (V3) from infratemporal fossa to the muscle.

Deep temporal arteries, that follow the same path --> maxillary

Middle temporal artery --> superficial temporal artery

Front 22

What is the roof of the infratemporal fossa?

Back 22

formed by the inferior surfaces of the greater wing of the sphenoid and the temporal bone

Foramen spinosum and ovale open into the roof

Front 23

What is the lateral wall of the infratemporal fossa?

Back 23

medial surface of the ramus of the mandible

Front 24

What is the medial wall of the infratemporal fossa?

Back 24

Lateral plate of the pterygoid process
Tensor veli palatini
Levator veli palatini
pharynx posteriorly

Front 25

What is the anterior wall of the infratemporal fossa?

Back 25

Posterior surface of the maxilla.

Contains aveolar foramen and upper part opens as the inferior orbital fissure into the orbit.

Front 26

What are the openings on the superior surface of the infratemporal fossa?

Back 26

Temporal fossa
Foramen ovale
Foramen spinosum
Petrotympanic fissure

Front 27

What are the openings anteriorly in the infratemporal fossa?

Back 27

Small foramina for posterior superior alveolar BV's and nerves to supply the teeth

Front 28

What are the openings medially in the infratemporal fossa?

Back 28

Pterygomaxillary fissure

Front 29

What goes through the petrotympanic fissure?

Back 29

Chorda tympani

Front 30

What is the origin of the medial pterygoid muscle?

Back 30

Deep head arises from the lateral plate of the pterygoid process.

Superficial head arises from the tuberosity of the maxilla and the palatine bone

Front 31

What is the insertion of the medial pterygoid muscle?

Back 31

the 2 muscle heads join to attach to the medial surface of the mandible near the angle

They pass deep to the sphenomandibular ligament

Front 32

What are the muscles of mastication?

Back 32

Temporalis
Masseter
Medial pterygoid
Lateral pterygoid

Front 33

What is the innervation of the medial pterygoid and lateral pterygoids?

Back 33

Nerve to medial pterygoid V3

Nerve to the lateral pterygoid V3

Front 34

What is the origin of the lateral pterygoid muscle?

Back 34

upper head arises from the roof of the infratemporal fossa (sphenoid bone) lateral to foramen ovale and spinosum.

Lower head arises from the lateral surface of the lateral plate of the pterygoid process and passes between the heads of the medial pterygoid muscles

Front 35

What is the insertion of the lateral pterygoid muscle?

Back 35

the fibers converge to the neck of the mandible (pterygoid fovea), and capsule of the TMJ at the articular disc

Front 36

What occurs when lateral and medial pterygoid muscles contract on one side?

Back 36

The chin moves to the opposite side.

Provides the grinding motion needed to chew food with molars.

Front 37

What are the muscles of mastication all innervated by?

Back 37

Branches of V3 mandibular nerve.

Front 38

What is the function of the buccintor muscle?

Back 38

Although the buccinator muscle assists in mastication from the standpoint of holding food between the upper and lower teeth, it is not considered a muscle of mastication.

Additionally, it is not innervated by V3 but instead receives motor innervation by the facial nerve.

Front 39

What does the buccinator branch of V3 do?

Back 39

Sensory nerve that innervates the region of skin overlying the buccinator muscle and mucosa deep to the muscle.

Front 40

Where does the buccal branch of V3 carry motor fibers to occasionally?

Back 40

Temporalis, lateral pterygoid.

Front 41

What is the sensory function of the mandibular nerve?

Back 41

General sensory - teeth and gums of mandible, 2/3 tongue, mucosa on floor of mouth, lower lip, skin over temple and lower face, dura mater

Front 42

What is the motor function of the mandibular nerve?

Back 42

Motor innervation = muscles that move the mandible, tensor tympani, tensor veli palatini

Front 43

Where do all branches of the mandibular nerve originate?

Back 43

Infratemporal fossa

Front 44

What are the branches of the mandibular nerve?

Back 44

Masseteric
Nerve to LP
Nerve to MP --> tensor veli palatini & tensor tympani
Deep temporal
Meningeal
Buccal
Auriculotemporal
Inferior aveolar --> mylohyoid & anterior belly of digastric --> mental
Lingual

Front 45

What two branches of the mandibular nerve arise just distal to the foramen ovale?

Back 45

Meningeal branch and nerve to MP

Front 46

What branch of V3 enters the foramen spinosum?

Back 46

Meningeal branch

Front 47

What V3 branches are from the anterior trunk?

Back 47

Buccal
Masseteric
Deep temporal
Nerve to LP

Front 48

What V3 branches are from the posterior trunk?

Back 48

Auriculotemporal
Lingual
Inferior aveolar

Front 49

What nerve forks around the middle meningeal artery?

Back 49

Auriculotemporal nerve

Front 50

What does the auriculotemporal nerve innervate?

Back 50

Skin of part of the ear and around the ear, temple, external auditory meatus, tympanic membrane, and temporamandibular joint.

Front 51

What does the lingual nerve innervate?

Back 51

Supplies anterior 2/3rds of tongue for general sense. It is joined by the chorda tympani (CN VII) which is responsible for taste to ant. 2/3rds of tongue.

Front 52

What does the inferior aveolar innervate?

Back 52

Enters the mandibular foramen on the inner surface of the mandible. Within the mandibular canal the nerve provides sensory innervation to the lower teeth. At the mental foramen the mental nerve exits and provides sensory innervation to the chin.

Front 53

What does the mylohyoid branch innervate?

Back 53

. Passes along inner surface of the mandible below the mylohyoid line. Provides motor fibers to the mylohyoid and anterior belly of the digastric.

Front 54

What nerves pass deep/medial to the sphenomandibular ligament?

Back 54

Inferior aveolar and lingual nerves

Front 55

What is the path of the lingual nerve?

Back 55

Medial to sphenomandibular lig --> oral cavity --> medial surface of mandible inferior to last tooth --> under tongue

Front 56

What nerve does the submandibular ganglion hang from?

Back 56

The lingual nerve

Front 57

Where do the lesser nerves decend into the infratemporal fossa from?

Back 57

Through foramen ovale with V3

Front 58

The otic ganglion is _________ to the V3 branch.

Back 58

Medial

Front 59

What are the three parts of the maxillary artery?

Back 59

1: Middle meningeal, inferior aveolar, deep auricular, anterior tympanic, accessory meningeal

2: Deep temporal, masseteric, buccal, pterygoid branches

3: enters pterygopalatine fossa --> infraorbital, posterior superior aveolar, greater palatine, sphenopalatine, pharyngeal, pterygoid canal a.

Front 60

Where does the maxillary artery arise?

Back 60

Within the parotid gland

Front 61

Through what two structures does the maxillary artery pass?

Back 61

Mandible and the sphenomandibular ligament

Front 62

What are the contents of the infratemporal fossa?

Back 62

Mandibular nerve (V3)
Lesser petrosal nerve and Otic ganglion
Chorda tympani nerve
Pterygoid plexus of veins
Medial and lateral pterygoid muscles
Maxillary artery
Sphenomandibular ligament

Front 63

What is the path of drainage of the infratemporal fossa?

Back 63

Deep facial --> emissary
Facial --> retromandibular vein
Superficial temporal --> Maxillary and branches --> emissary veins

Emissary veins --> pterygoid plexus --> inferior opthalmic vein --> cavernous sinus --> external and internal jugular veins

Front 64

What is special about the veins in the pterygoid plexus?

Back 64

They have no valves.

Infection of the orbit or infratemporal fossa can enter cranial cavity!

Front 65

What are the boundaries of the pterygopalatine fossa?

Back 65

Anterior wall is formed by the posterior surface of the maxilla
Medial wall is formed by the lateral surface of the palatine bone
Posterior wall and roof are formed by parts of the sphenoid bone

Front 66

What are the openings into the pterygopalatine fossa?

Back 66

Inferior orbital fissure
Sphenopalatine foramen
Palatovaginal canal
Foramen rotundum
Pterygoid canal
Palatine canal

Front 67

What is in the inferior orbital fissure and where does it connect?

Back 67

Inferior orbital fissue – inferior opthmalic vein, infraorbital, zygomatic, and orbital branches from V2

Floor of orbit

Front 68

What is in the sphenopalatine foramen and where does it connect?

Back 68

Sphenopalatine foramen – nasal nerves

Nasal cavity

Front 69

What is in the palatovaginal canal and where does it connect?

Back 69

Palatovaginal – pharyngeal nerves

Nasopharynx

Front 70

What is in the foramen rotundum and where does it connect?

Back 70

Rotundum – maxillary nerve

Front 71

What is in the pterygoid canal and where does it connect?

Back 71

Pterygoid canal – nerve of the pterygoid canal

Cranial cavity (middle fossa)

Front 72

What is in the palatine canal and where does it connect?

Back 72

Palatine canal – palatine nerves

Roof of oral cavity (palate)

Front 73

What is in the aveolar foramen?

Back 73

Posterior superior aveolar nerve

Front 74

Where does the lacrimal gland get its innervation from?

Back 74

Pterygopalatine ganglion

Front 75

What are the two sets of nerves that emerge from the sphenopalatine foramen?

Back 75

Posterior superior lateral nasal nerves
Posterior inferior lateral nasal nerves --> both to nasal conchae

Nasopalatine nerve --> nasal septum

Front 76

Where does the maxillary artery branch off of the external carotid?

Back 76

The neck of the mandible

Front 77

What is the orientation of the maxillary artery in the pterygopalatine fossa?

Back 77

passes forward through the infratemporal fossa and then enters the pterygopalatine fossa through the pterygoymaxillary fissure. It lies anterior to the pterygopalatine ganglion

Front 78

What are the branches of the maxillary artery?

Back 78

Infraorbital artery --> anterior alveolar artery
Posterior superior alveolar
Greater palatine --> lesser palatine artery
Sphenopalatine
Pharyngeal artery
Artery of the pterygoid canal

Front 79

What is the course of the infraorbital artery?

Back 79

Travels with infraorbital nerve through the inferior orbital fissure - gives rise to the anterior alveolar artery that supplies the maxillary teeth

Front 80

What is the course of the posterior superior aveolar artery?

Back 80

travels though alveolar foramen with nerve to the maxillary teeth

Front 81

What is the course of the greater palatine artery?

Back 81

enters palatine canal gives rise to the lesser palatine artery (they supply hard and soft palate respectively). Greater palatine also traverses incisive foramen to the anterior septal wall of the nasa cavity.

Front 82

What is the course of the sphenopalatine artery?

Back 82

enters sphenopalatine foramen, supplies lateral wall of nasal cavity, sinuses, nasal septum

Front 83

What is the course of the pharyngeal artery?

Back 83

passes through the palatovaginal canal with the pharyngeal nerve supplying the posterior part of nasal cavity, sphenoid sinus, and pharyngotympanic tube

Front 84

What is the course of the artery of the pterygoid canal?

Back 84

passes posteriorly into the pterygoid canal to supply surrounding tissues then passes inferior through the cartilage of foramen lacerum ending in the mucosa of the nasopharynx.

Front 85

Where do veins from the pterygopalatine fossa that have drained regions supplied by the branches of the maxillary artery pass?

Back 85

out of the pterygomaxillary fissure into the infratemporal fossa and drain into the pterygoid plexus of veins

Front 86

The pterygopalatine fossa communicates?

Back 86

Laterally with the infratemporal fossa
Medially with the nasal cavity
Anteriorly with the orbit
Inferiorly with the oral cavity
Posteriorly with the middle cranial fossa and base of the skull

Front 87

The pterygopalatine fossa contains?

Back 87

Pterygopalatine ganglion
Maxillary nerve
Preganglionic parasympathetic axons that course in the greater petrosal nerve (branch of CN VII)
Post ganglionic parasympathetic axons that supply mucous glands of nasal cavity, oral cavity, nasopharynx and lacrimal gland