Infratemporalna Fossa

8/18/2019 Infratemporalna Fossa

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Paul W. L. Kwan, Ph.D.ufts Univ. Sch. Med.

Temporal and Infratemporal Fossa


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Temporal and

Infratemporal Fossae

• The temporal and infratemporalfossae are interconnected spaceson the lateral side of the head.

• Temporal fossa --- above thezygomatic arch, communicates withinfratemporal fossa through the gapbetween the zygomatic arch and the

more medial surface of the skull.• Infratemporal fossa --- a wedge-

shaped space deep to the massetermuscle and underlying ramus of the

mandible.


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Temporal Infratemporal Fossa

•Osteolog

y

• Temporal Fossa, Boundaries & Contents

• Infratemporal Fossa, Boundaries & Contents

• Muscles of Mastication• Maxillary Artery

• Pterygoid Venous Plexus

•

Mandibular Nerve V3 • Temporomandibular Joint


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Mandible

Mandibular notch

13A ICON 2003

Condylar process

Coronoid process

Head

Pterygoid fovea

Neck

Lingula

Mandibular foramen

Ramus

Angle

Body

Mental foramen

Mylohyoid

line

Mylohyoid

groove

Mandibular notch

© Saunders Elsevier 2011


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• Osteology

• Temporal Fossa, Boundaries

Contents


• Muscles of Mastication

• Maxillary Artery

•Pterygoid Venous Plexus

• Mandibular Nerve V3

• Temporomandibular Joint


7/64Paul W. L. Kwan, Ph.D.ufts Univ. Sch. Med.

Temporal Fossa, Boundaries

S gw

PS/I Temporal lines

T sq

Z

Zygomatic arch

M

Pterion

F

Temporal

fossa

O




Contents of Temporal Fossa

• Temporalis muscle and fascia

• Superficial temporal artery and vein

• Nerves on the surface

– V Auriculotemporal nerve etc.

– VII Temporal and zygomatic branches



Contents of the Temporal Fossa



Dissection Into the Infratemporal Fossa

Spare the TMJ!

Coronoid

Process Head

To catch

on

lingula

Ramus33

Arch




• Osteology• Temporal Fossa, Boundaries & Contents

• Infratemporal Fossa,

Boundaries Contents



•Pterygoid Venous Plexus





M SPMP

Temporal,

squamousSphenoid,

GW Infratemporal crest

EAM

Mandibular fossa

Lateral

pterygoid plate

Foramen

ovale

Infratemporal Fossa, Exposed by removal of zygomatic arch and mandible



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Contents of the Infratemporal

Fossa• Temporalis muscle, inferior part

• Pterygoid muscles, medial and lateral

• Maxillary artery, first two parts

• Pterygoid venous plexus

•

Mandibular branch of CN V (V3)• Otic ganglion

• Chorda tympani (CN VII)


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Sphenoid GW

Pterygomaxillary fissure

Inferior orbital fissure

Infratemporal surface of maxilla

Sphenopalatine foramen

Pterygopalatine fossa

Lateral plate of pterygoid

process

Hamulus, medial

pterygoid plate

Foramen ovale

Infratemporal crest

Pterygopalatine Fossa



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Cranial Base: Inferior View



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Medial surface


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Superficial Arteries and Veins of Face and Scalp



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Facial Nerve Branches and Parotid Gland

M

PA

T

Z

B

C



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Cutaneous Nerves of Head and Neck

Auriculotemporal n.

L. Buccal n.

Mental n.



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•Osteology



•Muscles of Mastication



•



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Temporal

fascia

Zygomatic

arch

Articular disc

of TMJ

Deep &

Superficial

parts of

Masseter

muscle

Temporalis

Muscle

Muscles Involved In Mastication (1) Masseter



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Temporalis m.

Insertion of

temporalis

muscle to

coronoid process

of mandibleLateral pterygoid m.

Masseteric a. & n.

Maxillary artery

Insertion of

masseter m.

Muscles Involved In Mastication (2), Temporalis (masseter

removed)



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Spare the TMJ!

Coronoid

Process Head

To catch

on

lingula

Ramus33

Arch


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Medial surface


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sphenoid

Lat surface

Medial surface

Lateral

pterygoid plate

Sphenoid

Bone


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Muscles Involved in Mastication (3)

Deep, The Pterygoid Muscles

Articular disc of TMJ

Articular tubercle

Lateral pterygoid m.

Sphenomandibular lig.

Medial pterygoid m.

Buccinator m.



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Muscles Involved In Mastication (4) Deep, Posterior view

Lateral pterygoid plate

Lateral pterygoid muscle

Medial pterygoid muscle

TMJ

Medial pterygoid plate

Masseteric a.

Maxillary a.

Inferior alveolar n.

Nerve to mylohyoid

Lingual n.

Auriculotemporal n. SML

Levator veli palatini m.

Tensor veli palatini m.Pterygoid hamulus

MMA

OG



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•Osteology






•



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Maxillary Artery: Parts Branches

(1) Mandibular / bony foramina

(2)Pterygoid / muscles

(3) Pterygopalatine / PFossa


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Ext. Carotid

Superficial temporal

Maxillary artery

Middle meningeal a.

Auriculotemporal n.TMJ

Not Shown:

Deep auricular a.

Anterior tympanic a.

Accessory meningeal a.

Inferior alveolar a.

Branch to mylohyoid

Mental

branch of

inferior

alveolar

Maxillary Artery (1) Mandibular Part



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Maxillary Artery (1a) Mandibular Part

External

carotid

Superficial

temporal

Deep auricular

Anterior

tympanic

Auriculotemporal n.

Accessory and

Middle meningeal

Inferior alveolar,

cut



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Middle Meningeal Artery

95 ICON 2003

Pterion


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Acute Epidural Hematoma

Lenticular (lens shaped)


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Epidural Hematoma


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Subdural Bleeding


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Stroke


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Deep temporal Ant.Post.aa./nn.

Masseteric a./n.

Lateral pterygoid a./m.

Medial pterygoid a./m.

Buccal a./n.

Maxillary

artery

Maxillary Artery (2) Pterygoid Part / Muscles


Vessel issuperficial to

LP muscle in

2/3 of time


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Maxillary Artery (3) Pterygopalatine Part

Post.Sup.Alveolar

Infraorbital

Angular

Ophthalmic

Maxillary

artery

Middle

Anterior



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Maxillary Artery (3) Pterygopalatine Part

APCPASphenopalatine

Infraorbital

Post. Superior Alveolar

Descending palatine

in pterygopalatine

fossa

MaxillaryArtery



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•

Osteology• Temporal Fossa, Boundaries & Contents








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The Pterygoid Venous Plexus

Angular

Facial

Emissary v.

communicating

with cavernoussinus

Superior

ophthalmic

Superficial

temporal

Retromandibular

Ext. jugularPterygoid

plexus

Maxillary veins



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The Cavernous

Sinus

Copyright 2003 ICON Learning Systems

98

Cavernous sinus

III

IV

VI

V1

V2

C Pituitary

104



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Pterygoid Plexus, Cavernous Sinus, Facial

Vein

Angular v.

Facial v.

Deep facial v.

Retromandibular v.

Pterygoid plexus

Cavernous sinusOphthalmic vv.

Maxillary v



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Cavernous sinus-01


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Danger Triangle of the Face


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The Cavernous Sinus


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•






• Mandibular Nerve V

3



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Mandibular Nerve (V

3

)

SENSORY

• Long Buccal

• Auriculotemporal *

• Lingual * ♠ • Inferior alveolar

• Meningeal branch

* Also carries parasympatheticfibers

♠ and special sense of taste

MOTOR• Medial pterygoid

– N. to tensor veli palatini

– N. to tensor tympani

• Masseteric

• Deep temporal

• Lateral pterygoid

• N. to mylohyoid – N. to ant. belly digastric

Motor


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Auriculotemporal

Inferior alveolar

(cut)

N. To mylohyoid /

a.b. d

Lingual

♠

Mental

Deep Temporal Ant./Post. Foramen ovale

MB

FS

MMA

CTLong buccal

SMG

Mandibular Nerve (V

3

)

46


Motor

Sensory

+ ANS


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Mandibular Nerve (V

3

) Medial View


Facial

Chorda tympani

Motor root

Sensory root

Trigeminal ganglion

V1, Ophthalmic

V2, Maxillary

V3

Tensor veli palatini n./m.

Medial pterygoid n./m.

Lingual

Inferior alveolarMylohyoid n.

Auriculotemporal

Maxillary

artery

MM a.

OG

LP

Tensor

tympani n./m.


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Dermatomes of Head and Neck


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•







•Temporomandibular Joint


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Mandible

Condylar process

Coronoid process

Head

Pterygoid fovea

Neck

Mandibular notchLingula

Mandibular foramen

Ramus

Angle

Body

Mental foramen

Mylohyoid

line

Mylohyoid

groove



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Temporomandibular Joint (1)

Lateral View

Medial View

(1) Joint capsule

(2) Lateral (TMJ) ligament

(3) Sphenomandibular ligament

(4) Stylomandibular ligament

1

2

3

3

Mylohyoid a./n/

Mandibular n./Otic ganglion

Max.a.

4



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Temporomandibular Joint (3)


Glid /S i


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Movements of the Temporomandibular Joint

Glide/Superior

Hinge/Lower


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Movement of the Temporomandibular Joint-2


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Jaw Dislocation

Dislocation of the


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Temporomandibular Joint


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Sphenoid GW

Pterygomaxillary fissure

Inferior orbital fissure

Infratemporal surface of maxilla

Sphenopalatine foramen

Pterygopalatine fossa

Lateral plate of pterygoid

process

Hamulus, medial

pterygoid plate

Foramen ovale

Infratemporal crest

Pterygopalatine Fossa



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Spare the TMJ!

Coronoid

Process Head

To catch

on

lingula

Ramus3 3

Arch

The


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For those who

really want to

study the

maxillaryartery

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Infratemporalna Fossa