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laterally: Zygomatic arch Inferiorly: infratemporal crest Floor: pterion Roof: temporal fascia TEMPORAL FOSSA CONTENTS: Temporalis muscle Deep temporal nerve & vessels Superficial temporal vessels Auriculotemporal nerve
INFRATEMPORAL FOSSA BOUNDARIES: Superficial (lateral): Ramus of mandible Deep (medial): Lateral pterygoid plate Superior: Infratemporal surface of greater wing of sphenoid Anterior: Tuberosity of maxilla Antly: post aspect of maxilla Postly: tympanic plate and mastoid and styloid process oof the temporal bone Inf: where the medial ptwerygoid m attaches to the mandible near the angle. INFRATEMPORAL FOSSA COMMUNICATIONS:
With temporal fossa: through a gap deep to zygomatic arch With cranial cavity: through foramen ovale, foramen spinosum, foramen lacerum With orbit: through inferior orbital fissure With pterygopalatine fossa: through pterygomaxillary fissure INFRATEMPORAL FOSSA CONTENTS: Lateral & medial pterygoid muscles Mandibular, inf alveolar, lingual, buccal, chorda tympani & Otic ganglion A part of maxillary nerve & 2 of its branches Pterygoid plexus of veins Inf part of temporal m TEMPORALIS ORIGIN: floor of temporal fossa & deep surface of temporal fasica INSERTION: the tendon passes deep to zygomatic arch to be inserted to all coronoid process (except its lateral surface) NERVE SUPPLY: 2 deep temporal nerves from anterior division of mandibular nerve ACTION: Elevation of mandible Its posterior fibers retract the mandible LATERAL PTERYGOID ORIGIN: Upper head: infratemporal surface of greater wing of sphenoid Lower head: lateral surface of lateral pterygoid plate INSERTION: pterygoid fovea (in front of neck of mandible) + capsule & articular disc of TMJ
NERVE SUPPLY: from anterior division of mandibular nerve ACTION: Pulls the condylar process forward to depress the mandible Protrusion of mandible (when muscles on both sides act together) Side-to-side movement (when muscles on both sides act alternatively)
MEDIAL PTERYGOID ORIGIN: Superficial head: tuberosity of maxilla Deep head: medial surface of lateral pterygoid plate INSERTION: medial surface of ramus & angle of mandible NERVE SUPPLY: from trunk of mandibular nerve ACTION: Elevation of mandible Protrusion of mandible (when muscles on both sides act together) Side-to-side movement (when muscles on both sides act alternatively)
Are supplied by anterior division of mandibular nerve EXCEPT Medial pterygoid MAXILLARY ARTERY
ORIGIN: It is the larger of the 2 terminal branches of external carotid artery, behind the neck of mandible (within parotid gland) COURSE: It is divided into 3 parts: First part (mandibular part): runs deep to neck of mandible (below auriculotemporal nerve) & emerges from the lower border of lateral pterygoid Second part (pterygoid part): ascends superficial (sometimes deep) to lower head of lateral pterygoid Third part (pterygopalatine part): passes between the 2 heads of lateral pterygoid then through pterygomaxillary fissure to reach pterygopalatine fossa where it terminates BRANCHES OF MAXILLARY ARTERY FROM SECOND PART: Muscular branches: to muscles of mastication Buccal artery: same course & distribution as buccal nerve (to the buccintor) Deep temporal arteries supply the temporal m
BRANCHES OF MAXILLARY ARTERY FROM THIRD PART: Infraorbital artery: supply inf eye lid, lacrimal sac, side of the nose& sup lip Posterior superior alveolar artery: supply maxillary molar & premolar teeth, the lining of maxillary sinus &the gingiva Greater palatine artery: passes through greater palatine canal & foramen to the palate, supplies hard palate & gums, gives lesser palatine artery supplying soft palate & tonsils Sphenopalatine artery: passes through sphenopalatine foramen to the nose, supplies nasal cavity & nasal septum, lat nasal wall
Artery of pterygoid canal: supplies auditory tube, tympanic cavity & pharynx Pharyngeal artery: supplies nasopharynx, sphenoidal air sinuses (roof or pharynx) Descending palatine a supply maxillary gingiva, palatine glands & the MM of the roof of the mouth. PTERYGOID PLEXUS OF VEINS SITE: It surrounds & lies in substance of lateral pterygoid muscle TRIBUTARIES: correspond to branches of maxillary artery TERMINATION: It forms the maxillary vein that passes deep to neck of mandible & unite with superficial temporal vein to form retromandibular vein (inside parotid gland) COMMUNICATIONS: With cavernous sinus: by emissary veins through foramen ovale & lacerum With facial vein: by deep facial vein With inferior ophthalmic vein: by communicating veins through inferior orbital fissure MANDIBULAR NERVE COMPOSITION: Formed of 2 roots: motor & sensory ORIGIN: Sensory root: peripheral processes of cells of trigeminal ganglion in the middle cranial fossa Motor root: axons of cells of motor nucleus of trigeminal nerve in pons MANDIBULAR NERVE COURSE: Both roots emerge separately through foramen ovale to infratemporal fossa
The 2 roots unite, below foramen ovale The nerve soon divides into a small anterior & a large posterior division