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Infratemporal fossa
- 1. INFRATEMPORAL FOSSA Dr Saim Hasan Associate Professor SHKM GMC
- 2. TEMPORAL& INFRATEMPORALFOSSA • INTRODUCTION • BOUNDARY • CONTENTS:- 1.MUSCLES-MUSCLESOFMASTICATION i.e -TEMPORALIS,MASSETER, LATERAL& MEDIALPTERYGOID 2.VESSELS-MAXILLARYART.,VEIN& PTERYGOIDPLEXUSOFVEINS 3.NERVES-MANDIBULARNERVE& OTICGANGLION 4.TEMPOROMANDIBULAR JOINT
- 5. • Describe the boundaries and contents of bony infratemporal fossa. • Describe the maxillary artery and its branches &add a note on its clinical importance • Describe the muscles of mastication –its attachments, nerve supply blood supply and action. • Describe the Temperomandibular joints and its movements
- 6. IT IS A FOSSA SITUATED BETWEEN PHARYNX AND RAMUS OF MANDIBLE AND BELOW MIDDLE CRANIAL FOSSA ABOVE—Infratemporal surface of greater wing of sphenoid bone BELOW –open and become continuous with Tissue space of pharynx and oesophagus INFRONT- posterior surface of the body of maxilla. BEHIND- styloid process of temporal bone and carotid sheath MEDIAL WALL—formed by Lateral pterygoid plate LATERAL WALL—FORMED by ramus of mandible with its coronoid process
- 7. a) Infront : with orbit through inferior orbital fissure b) Medially: with pterygopalatine fossa through pterygomaxillary fissure Above and medially: with middle cranial fossa through foramen ovale and foramen spinosum a) Above and laterally :with temporal fossa through the space between side of the skull and zygomatic arch COMMUNICATIONS
- 17. DEEPDISSECTIONOFTEMPORAL& INFRATEMPORAL REGION AFTERREMOVINGAPARTOFRAMUSOFMANDIBLE WITH MASSETER& INSERTIONOFTEMPORALISMUSCLE ZYGOMATICARCH HASBEENREMOVED
- 22. • C.ThirdPart:- 1.Posterior Superior Alveolar 2.Infraorbital 3.Greater Palatine 4.Pharyngeal 5.Artery Of Pterygoid Canal 6.Sphenopalatine [Terminalpart of maxillary artery]
- 23. PTERYGOID PLEXUSOFVEINS 1-SITUATEDaroundthe lateral Pterygoid Muscle 2-Tributaries are thoseveinswhich accompany branchesof maxillary artery 3Plexusisdraind bymaxillaryvein 4Maxillary veinisonly accompanyto first part of maxillary artery 5 Maxillary vein unite with superficialtemporal veinto form retromandibular vein COMMUNICATIONS:- 1.With inferior ophthalmic veinthroughthe inferior orbital fissure 2.With cavernoussinusthrough emissary vein passingthroughforamen lacerum & ovale 3.With facial veinthroughdeep facial vein
- 26. Branchesof Mandibular Nerve:- 1.FromMain trunk:- a. Meningeal branch b. Nerve to Medial Pterygoid muscle 2.FromAnterior divisionof trunk :- a. Sensory-Buccal nerve b. Motor branchesto Masseter [Nerve to masseter], Temporalis[DeepTemporalnerves], Lateral Pterygoid Msucle 3.FromPosteriordivisionof trunk a. Auriculotemporal nerve b. Lingualnerve c. Inferior alveolar nerve
- 29. OTICGANGLION • Introduction:- Aperipheral parasympathetic ganglion which supply secretomotor fibres toparotid gland • Topographically:- It is connected toMandibular nerve but functionally to GlossopharyngealNerve • Size& Situation:- 2-3 mm in size& is situated in infratemporal fossajust below the foramenOvale between Mandibular nerve [lateral side ]&Tensor Veli Palatini muscle [medial side]
- 30. Connections& Branches:- 1. Motor or ParasympatheticRoot:- Bylesserpetrosal nerve Thepre ganglionicfibres from inf.salivatory nucleus–IX Cn.-to- tympanicbranch-to-the tympanicplexus-to-thelesser petrosal nerve to- otic ganglion ThePostganglionicfibresfrom otic ganglion-through- auriculotemporalnerve –to- ParotdGland [SECRETOMOTORTOPAROTIDGLAND] 2. Sympathetic Root:- Nerve fibresfrom plexusonthe middle meningealartery [ Theseare postganglionicfibres from sup.cervicalsympathetic ganglion]-to otic ganglion-to auriculotemporalnerve –to parotd gland [VASOMOTORIN FUNCTION] 3. SensoryRoot:-Sensoryfibresfrom parotid Gland Through auriculotemporalnerve
- 31. 4.Other Connectionsto otic ganglion:- 1. Abranchfrom nerve to medial pterygoidwhichpassesas suchthroughoticganglionto supplyTensorveli palatini & tensorTympani 2. TheChordatympanicnerve isconnectedto otic ganglion. thisconnectionprovideanalternate pathway of taste from ant.2/3 of thetongue.
- 32. Larger terminal branch of external carotid artery arising within the parotid gland . Runs forwards between the neck of mandible and sphenomandibular ligament to the lower border of lateral pterygoid. Runs on the surface of the lower head of Lateral pterygoid. Passes between the two heads of lateral pterygoid. Then through the pterygomaxillary fissure to the pterygopalatine fossa Continues as sphenopalatine artery. MAXILLARY ARTERY
- 33. MAXILLARY ARTERY HAS 3 PARTS. 1stpart-[mandibular part] from its origin to lower border of lateral pterygoid. 2nd part-[ pterigoid part]-lies on superfecial usually or deep to lateral pterygoid. 3rdpart [pterigopalatne part] passes through the pterygomaxillary fissure to pterigopalatine fossa
- 37. Venous networksituated pertly between temporalis and lateral pterigoid and partly between two pterigoid muscles 1. Communication facial vein 2. Cavernous sinus by emmissary vein through foramen lacerum ,ovale ,spinosum
- 38. Tributaries 1. Spenopalatine 2. Deep temporal 3. pterigoid 4. Masseteric 5. Buccal 6. Dental 7. Greater palatine 8. Middle meningeal vein 9. Inferior ophthalmic vein
- 39. It is the largest devision division of the trigeminal nerve Mixed :Both Senory and motor roots Larger sensory root arise from convex aspects of trigeminal ganglion Smallar motor root from motor nucleus of trigiminal nerve in the pons
- 40. MANDIBULAR NERVE merge form the foramen ovale and unite with the trunk of the mandibular nerve in the infratemporal fossa In the infratemporalfossa it terminates by dividing in to anterior and posterior devision and gives branches Before devision 2 branches 1.Meningeal branch 2.Nerve to medial Pterygoid 3.Anterior Division motor branches a) masseteric b) deep temporal c) nerve to lateral Pterygoid sensory branch 1. Buccal nerve supplies skin over buccinator branches N. to the Mylohyoid Mental incisive branch Post. Division 1. Auriculotemporal 2. Lingual 3. Inferior Alveolar and dental branch
- 43. Otic ganglion :This is a small, oval, flat reddish-grey ganglion situated just below the foramen ovale. It is a peripheral parasympathetic ganglion related topographically to the mandibular nerve, but connected functionally with the glossopharyngeal nerve .situated in the infratemporal fossa just below the foramen ovale Like all parasympathetic ganglia, there are three roots, motor, sympathetic and sensory. Only the parasympathetic fibres relay in the ganglion. The 4 th root being motor passes without relay to tympani and palati ms. The motor, parasympathetic, root of the otic ganglion is the lesser petrosal nerve, conveying preganglionic fibres from the glossopharyngeal nerve which originate from neurones in the inferior salivatory nucleus.