Provides a detailed description of the gross anatomy of the temporal fossa, infratemporal fossa & temporomandibular joint. The boundaries & the structures present in the temporal & infratemporal fossa, the formation & movements of the TMJ & also includes branches of the mandibular nerve & maxillary artery.

1. Temporal Region
Card-5
Item-3

2. Introduction
The Temporal region constitutes of the temporal and infratemporal fossae which are
interconnected spaces on the lateral side of the head.
 Temporal fossa: lies superiorly above the zygomatic arch
 Infratemporal fossa: lies inferiorly below the zygomatic arch

3. Bones of Temporal Region

4. Temporal Fossa: Borders
The temporal fossa is a
narrow fan-shaped space
that covers the lateral
surface of the skull
Borders:
 Superiorly and posteriorly
- superior temporal line
 Inferiorly - zygomatic arch
 Anteriorly - frontal
process of the zygomatic
bone and zygomatic
process of the frontal
bone

5. Temporal Fossa: Contents
Contents :
 Temporalis muscle
 Deep temporal arteries
 Middle temporal artery
 Zygomaticotemporal nerve from (CN-V2)
 Anterior and Posterior branches of the
deep temporal nerve
 Auriculotemporal nerve from (CN-V3)
 Temporal branches of the Facial Nerve (CN-
VII)
Temporalis muscle:
The temporalis muscle is a large, fan-shaped
muscle that fills much of the temporal fossa
 Origins: from the bony surfaces of the fossa
superiorly to the inferior temporal line and
is attached laterally to the surface of the
temporal fascia.
 Insertion: attaches down the anterior
surface of the coronoid process and along
the related margin of the ramus of the
mandible, almost to the last molar tooth
 Actions:
o powerful elevator of the mandible.
o retracts the mandible
o side-to-side mandible movement
 Innervation: deep temporal branches of
Mandibular Nerve (CN-V3)

6. Temporal Fossa: Contents
Deep temporal arteries
Normally 2 in number, these vessels
originate from the maxillary artery
in the infratemporal fossa
Middle temporal artery
The middle temporal artery
originates from the superficial
temporal artery just superior to the
root of the zygomatic arch
Auriculotemporal nerve
branch of the mandibular nerve [CN V3]
Zygomaticotemporal nerve
The zygomaticotemporal nerve is a
branch of the zygomatic nerve
which is a branch of the maxillary
nerve [V2]
Deep temporal nerves
2 deep temporal nerves, originate
from the anterior trunk of the
mandibular nerve [V3] in the
infratemporal fossa
Temporal branches of Facial nerve
(CNVII)
Arises from the facial nerve when it
divides into its 5 branches in the
parotid gland

7. Temporomandibular joint (TMJ)
Articulating Surfaces:
The temporomandibular joint consists of articulations
between 3 surfaces;
2 from the squamous part of the temporal bone
1) mandibular fossa
2) articular tubercle
3) head of mandible.
A unique feature of the TMJ is the fibrocartilaginous
articular disc, located within the joint capsule between
the mandibular fossa and condyle. The disc divides the
joint capsule into 2 distinct compartments:
1. Lower compartment: During the first 2 cm of opening
the mouth (depression) it enables the hinge-like
rotation of the mandibular condyle.
2. Upper compartment: For the mouth to be opened
>2cm, the upper compartment within the joint capsule
enables both the mandibular condyle and the articular
disc to slide anteriorly (protrusion).

8. (TMJ): Ligaments
Extracapsular ligaments
There are 3 extracapsular ligaments. They
act to stabilise the temporomandibular
joint.
1) Lateral ligament – runs from the
beginning of the articular tubule to the
mandibular neck. It is a thickening of the
joint capsule, and acts to prevent
posterior dislocation of the joint.
2) Sphenomandibular ligament – originates
from the sphenoid spine, and attaches to
the mandible at the lingula.
3) Stylomandibular ligament – It passes
from the styloid process of the temporal
bone to the posterior margin and angle
of the mandible.

9. (TMJ): Muscles of Mastication

10. (TMJ): Muscles of Mastication

11. (TMJ): Muscles of Mastication

12. (TMJ): Actions
 Clinical: TMJ Dislocation:
• A dislocation of the temporomandibular joint
can occur via a blow to the side of the face,
yawning, or taking a large bite.
• The head of the mandible ‘slips’ out of the
mandibular fossa, and is pulled anteriorly.
• The patient becomes unable to close their
mouth. The facial and auriculotemporal
nerves run close to the joint, and can be
damaged if the injury is high-energy.
 Clinical: TMJ disorder:
• TMJ disorder is associated with painful and
limited movement of the jaw.
• Symptoms of TMJ disorder include:
– Pain and tenderness in and around the jaw,
– Difficulty and painful chewing
– Headache
– Clicking sounds when the jaw opens and
closes.
• TMJ disorder can occur when the articular
disc is damaged, eroded, or slipped out of
alignment.

13. Infratemporal fossa: Borders
Description: The wedge-shaped infratemporal
fossa is inferior to the temporal fossa and
between the ramus of the mandible laterally
and the wall of the pharynx medially.
Borders:
 Lateral – coronoid process and ramus of the
mandible bone
 Medial – lateral pterygoid plate; tensor veli
palatine, levator veli palatine and superior
constrictor muscles
 Anterior – posterior border of the maxillary
sinus
 Posterior – carotid sheath, styloid and
condylar processes
 Roof – inferior surfaces of the greater wing of
the sphenoid bone and temporal bone
 Floor – medial pterygoid muscle

14. Infratemporal fossa: Borders

15. Infratemporal fossa: Contents
 Ligaments: sphenomandibular ligament
 Muscles: temporalis, lateral pterygoid, medial pterygoid

16. Infratemporal fossa: Contents
 Arterial Supply
Maxillary artery: The terminal
branch of the external carotid
artery. It travels through the
infratemporal fossa. Important
branches here are:
– Middle meningeal artery:
Ascends through the foramen
spinosum, coursing between the
roots of the auriculotemporal
nerve; provides the principal blood
supply to intracranial dura mater.
– Inferior alveolar artery.
Accompanies the inferior alveolar
nerve into the mandibular
foramen.

17. Branches of Maxillary artery

18. Branches of Maxillary artery
• The main trunk of the maxillary artery is divided into 3 parts. These three parts are the:
1) Mandibular part (1st part) – named as such because it winds around deep to the neck of the mandible.
Branches here:
1) D – deep auricular artery
2) A – anterior tympanic artery
3) M – middle meningeal artery
4) I – inferior alveolar artery
5) A – accessory meningeal artery
2) Pterygoid part (2nd part) – it has this name because it travels between the two heads of the lateral
pterygoid muscle . Branches here:
1) M – masseteric artery
2) P – pterygoid artery
3) D – deep temporal artery
4) B – buccal or buccinator artery
3) Pterygopalatine part (3rd part) – this part derived its name from the pterygopalatine fossa, into which it
enters. Branches here:
1) S – sphenopalatine artery
2) D – descending palatine artery
3) I – infraorbital artery
4) P – posterior superior alveolar artery
5) M - middle superior alveolar artery
6) P – pharyngeal artery
7) A - anterior superior alveolar artery
8) A – artery of the pterygoid canal
• MNEMONIC: DAMn I AM Piss Drunk But Stupid Drunk I Prefer, Must Phone Alcoholics Anonymous

19. Infratemporal fossa: Contents
Venous Drainage
 Pterygoid venous plexus – drains the eye and is directly connected to the
cavernous sinus. It provides a potential route by which infections of the face can
spread intracranially.
 Maxillary vein
 Middle meningeal vein

20. Infratemporal fossa: Contents
 Nerves of the Infratemporal fossa:
 Mandibular nerve [CN-V3]
 Posterior superior alveolar nerve- branch of Maxillary nerve [CN-V2]
 Otic ganglion- ganglion where lesser petrosal synapses
 Chorda tympani- branch of Facial nerve [CN-IX] hitch-hikes Lingual nerve from CN-V3
 Lesser petrosal nerve- branch of Glossopharyngeal nerve [CN-IX] hitch-hikes Auriculotemporal nerve
from CN-V3

21. Mandibular Nerve- Trunk &Anterior Division
The sensory and motor roots of [CN
V-3] fuse together as a trunk and
descend into the infratemporal
fossa via the foramen ovale.
• Trunk (pre-division): Branches
arising are
– Meningeal branch- (General Sensory)
from dura mater, mainly of the
middle cranial fossa, and the mastoid
cells.
– Nerve to the medial pterygoid –
(Motor)
• Medial pterygoid muscle
• Tensor veli palatini muscle
• Tensor tympani muscle
• Anterior division:
– Deep temporal nerves- (Motor)
Temporalis muscle
– Masseteric nerve- (Motor) Masseter
muscle
– Nerve to lateral pterygoid- (Motor)
Lateral pterygoid muscle
– Buccal nerve- (General Sensory) skin
of the cheek

22. Mandibular Nerve- Posterior Division
• Posterior division:
– Auriculotemporal nerve-
• (General Sensory) to the
temporal region of the face
and scalp, and external ear.
• postganglionic
parasympathetic nerves
from the lesser petrosal
nerve [CN IX] to the parotid
gland.
– Lingual nerve- (General sensory)
from the anterior 2/3s of the
tongue
– Inferior alveolar nerve- (General
sensory) all lower teeth and
much of the associated gingivae,
it also supplies the mucosa and
skin of the lower lip and skin of
the chin.
– Nerve to the mylohyoid: (Motor)
• Mylohyoid muscle
• Anterior belly of the digastric
muscle.

23. Chorda Tympani & Lesser Petrosal
• Chorda tympani nerve [CN VII]:
Enters the infratemporal fossa via the
petrotympanic fissure, where it joins with the
lingual nerve. The chorda tympani nerve
provides:
– (Special sensory) taste from the anterior
2/3 s of the tongue,
– Visceral motor parasympathetic
innervation to the submandibular and
sublingual salivary glands.
• Submandibular ganglion: Suspended from the
lingual nerve, where preganglionic and
postganglionic parasympathetic neurons
from the chorda tympani nerve (CN VII)
synapse en route to innervating the
submandibular and sublingual salivary
glands.
• Lesser petrosal nerve [CN IX] :
– The lesser petrosal nerve carries mainly
parasympathetic fibers destined for the
parotid gland.
– Enters the infratemporal fossa via the
foramen ovale, where it synapses in the
otic ganglion.
• Otic ganglion: Preganglionic parasympathetic
neurons from lesser petrosal nerve [CN IX]
exit the middle ear and synapse in the otic
ganglion. Postganglionic parasympathetic
neurons "hitch-hike" along with the
auriculotemporal nerve and innervate the
parotid gland

24. Chorda Tympani & Lesser Petrosal