y

1. Dr. Ahmed Fathalla Ibrahim

2. TEMPORAL FOSSA

3. TEMPORAL FOSSA

4. INFRATEMPORAL FOSSA

5. TEMPORAL FOSSA
BOUNDARIES:
• Anterior: Zygomatic process of
frontal bone + zygomatic bone
• Superior & Posterior: Temporal
lines
• Inferior: Zygomatic arch

6. TEMPORAL FOSSA
CONTENTS:
1. Temporalis muscle
2. Deep temporal nerve & vessels
3. Superficial temporal vessels
4. Auriculotemporal nerve

7. 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

8. INFRATEMPORAL FOSSA
COMMUNICATIONS:
1. With temporal fossa: through a gap
deep to zygomatic arch
2. With cranial cavity: through foramen
ovale, foramen spinosum, foramen
lacerum
3. With orbit: through inferior orbital
fissure
4. With pterygopalatine fossa: through
pterygomaxillary fissure

9. INFRATEMPORAL FOSSA
CONTENTS:
1. Lateral & medial pterygoid muscles
2. Mandibular nerve & its branches
3. A part of maxillary nerve & 2 of its
branches
4. Otic ganglion
5. Chorda tympani
6. A part of maxillary artery & 2 of its
branches
7. Pterygoid plexus of veins

10. THE MANDIBLE

11. TEMPOROMANDIBULAR JOINT

12. TEMPOROMANDIBULAR JOINT
• TYPE: synovial, condylar variety
• ARTICULAR SURFACES:
1. Upper: mandibular fossa + articular
tubercle
2. Lower: head of mandible
• CAPSULE: attached to:
1. margins of mandibular fossa &
articular tubercle
2. Neck of mandible

13. TEMPOROMANDIBULAR JOINT
• JOINT CAVITY: divided into upper & lower
parts by an articular disc
• ARTICULAR DISC: a plate of fibrocartilage
with a concavoconvex upper surface and a
concave lower surface
• LIGAMENTS
1. Lateral temporomandibular: from tubercle
on the root of zygoma to lateral surface of
neck of mandible
2. Sphenomandibular: from spine of sphenoid
to lingula of mandible
3. Stylomandibular

14. TEMPOROMANDIBULAR JOINT
• NERVE SUPPLY: auriculotemporal
• ARTERIAL SUPPLY: maxillary
• MOVEMENTS: elevation, depression,
protrusion, retraction, chewing (side-to-
side) movements
• RELATIONS
1. Anterior: mandibular notch, masseteric
nerve & vessels
2. Posterior: tympanic plate of temporal bone
3. Lateral: Parotid gland
4. Medial: auriculotemporal nerve, maxillary
artery

15. MUSCLES OF MASTICATION
1. TEMPORALIS
2. MASSETER
3. LATERAL PTERYGOID
4. MEDIAL PTERYGOID
• They are derived from mesoderm of 1st
branchial arch
• They originate from temporal or
infratemporal fossa
• They are inserted into ramus of mandible
• They are supplied, through their deep
surfaces by branches of mandibular nerve
• They act on temporomandibular joint

16. MUSCLES OF MASTICATION

17. MUSCLES OF MASTICATION

18. 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:
1. Elevation of mandible
2. Its posterior fibers retract the mandible

19. MASSETER
• ORIGIN: lower border & inner surface of
zygomatic arch
• INSERTION: lateral surface of ramus of
mandible
• NERVE SUPPLY: from anterior division of
mandibular nerve
• ACTION:
1. Elevation of mandible
2. Protrusion of mandible (when muscles on
both sides act together)
3. Side-to-side movement (when muscles on
both sides act alternatively)

20. LATERAL PTERYGOID
• ORIGIN:
1. Upper head: infratemporal surface of greater wing
of sphenoid
2. 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:
1. Pulls the condylar process forward to depress the
mandible
2. Protrusion of mandible (when muscles on both
sides act together)
3. Side-to-side movement (when muscles on both
sides act alternatively)

21. MEDIAL PTERYGOID
• ORIGIN:
1. Superficial head: tuberosity of maxilla
2. Deep head: medial surface of lateral pterygoid
plate
• INSERTION: medial surface of ramus & angle of
mandible
• NERVE SUPPLY: from trunk of mandibular nerve
• ACTION:
1. Elevation of mandible
2. Protrusion of mandible (when muscles on both
sides act together)
3. Side-to-side movement (when muscles on both
sides act alternatively)

22. ALL MUSCLES OF
MASTICATION
Elevate mandible EXCEPT
• Lateral pterygoid
Protrude mandible EXCEPT
• Temporalis
Are supplied by anterior division of
mandibular nerve EXCEPT
• Medial pterygoid

23. MANDIBULAR NERVE

24. INFRATEMPORAL FOSSA

25. 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

26. 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

27. MANDIBULAR NERVE
• RELATIONS:
1. Superficial: lateral pterygoid
2. Deep: otic ganglion
3. Posterior: middle meningeal artery

28. BRANCHES FROM TRUNK
OF MANDIBULAR NERVE
• One motor: Nerve to medial
pterygoid: supplies medial
pterygoid & gives off 2 branches
that pass through otic ganglion
(without relay) & supply tensor
palati & tensor tympani muscles
• One sensory: meningeal branch
(nervus spinosus) passing through
foramen spinosum to supply
meninges of middle cranial fossa

29. BRANCHES FROM ANTERIOR
DIVISION OF MANDIBULAR NERVE
Four branches
Three motor:
• Masseteric nerve: emerges through upper
border of lateral pterygoid & turns along
mandibular notch to reach masseter
• Deep temporal nerves: emerge through
upper border of lateral pterygoid
• Nerve to lateral pterygoid
One sensory:
• Buccal nerve: emerges between the 2 heads
of lateral pterygoid, supplies skin & mucous
membrane overlying buccinator

30. BRANCHES FROM POSTERIOR
DIVISION OF MANDIBULAR NERVE
Four branches
Three sensory:
Auriculotemporal nerve:
• Arises by 2 roots encircling middle
meningeal artery
• Runs backward, deep to neck of
mandible
• Gives sensory branches to skin of
auricle, temple, TMJ & parotid gland
• Carries postganglionic
parasympathetic secretomotor fibers
from otic ganglion to parotid gland

31. BRANCHES FROM POSTERIOR
DIVISION OF MANDIBULAR NERVE
Lingual nerve:
• Emerges through lower border of lateral
pterygoid then superficial to medial
pterygoid
• Joins chorda tympani
• Runs just below 3rd molar tooth (dangerous
position because it is only covered by
muscous membrane)
• Runs superficial to hyoglossus & is
connected to submandibular ganglion by 2
roots
• Carries general sensations from anterior 2/3
of tongue

32. BRANCHES FROM POSTERIOR
DIVISION OF MANDIBULAR NERVE
Inferior alveolar nerve:
• Emerges through lower border of
lateral pterygoid then superficial to
medial pterygoid, behind lingual nerve
• Passes through mandibular foramen &
canal to supply lower teeth
• Emerges through mental foramen as
mental nerve supplying skin of lower
lip & chin

33. BRANCHES FROM POSTERIOR
DIVISION OF MANDIBULAR NERVE
One motor:
Mylohyoid nerve:
• A branch of inferior alveolar nerve just
above mandibular foramen
• Passes in mylohyoid groove of
mandible
• Supplies mylohyoid & anterior belly of
digastric muscles

34. RELATIONS OF LATERAL
PTERYGOID

35. RELATIONS OF LATERAL
PTERYGOID
• Superficial: temporalis, masseter, ramus of
mandible, maxillary artery, buccal nerve
• Deep: medial pterygoid, mandibular nerve,
middle meningeal artery, otic ganglion
• Emerging through its upper border: deep
temporal & masseteric nerves
• Emerging through its lower border: lingual &
inferior alveolar nerves + maxillary artery
• Emerging between its 2 heads: buccal nerve,
maxillary artery