Region 3: Infratemporal Fossa and Deep Face



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Region 3: Infratemporal Fossa and Deep Face

Landmarks

--Mastoid process

--Zygomatic arch

--Mandible: condylar process (w/ head and neck), ramus, angle, lower border

--Superior Temporal Line

Temporal Fossa

--Boundaries:

*superior and posterior: temporal lines

*inferior: zygomatic arch and infratemporal crest of sphenoid

--Contents:

*temporalis muscle

Infratemporal Fossa

--Boundaries:

*anterior: maxilla

*posterior: condylar process of mandible and styloid process of temporal bone

--Communicates with:

*temporal fossa (through gap bounded by zygomatic arch)

*orbit (through inferior orbital fissure)

*pterygopalatine fossa (through pterygomaxillary fissure)

*cranial cavity (through foramen ovale and foramen spinosum)

--Contents:

*medial and lateral pterygoid muscles

*maxillary artery and its branches

*mandibular nerve and its branches

*otic ganglion

*chorda tympani nerve

*posterior superior alveolar nerves and vessels



Muscles of Mastication: masseter, temporalis, medial pterygoid, and lateral pterygoid

Masseter

O

Zygomatic arch and bone

I

Lateral surface of ramus and angle of the mandible

Inn

Mandibular division of trigeminal nerve

Act

Closes the mouth

Temporalis

O

Temporal fossa

I

Apex and anterior part of the coronoid process of the mandible

Inn

Mandibular division of trigeminal nerve

Act

Closes the mouth

Medial Pterygoid

O

Medial surface of lateral pterygoid plate

I

On medial surface of the ramus and angle of mandible

Inn

Mandibular division of trigeminal nerve

Act

Closes the Mouth

Lateral Pterygoid

O

Infratemporal surface of sphenoid bone and lateral surface of lateral pterygoid plate

I

Temporomandibular joint capsule and condylar process

Inn

Mandibular division of trigeminal nerve

Act

OPENS THE MOUTH (only muscle)

Temporomandibular Joint

--Bones


*head of the mandible

*Mandibular fossa and temporal bone

*Articular tubercle of temporal bone

--Ligaments and Disk

*temporomandibular ligament

*sphenomandibular ligament: from spine of sphenoid to lingula of mandible, remanant of Meckel’s cartilage

*fibrocartilagenous disk (divides the synovial cavity into upper and lower compartments

Maxillary Artery and Pterygoid Plexus of Veins

--Branches of Mandibular portion of the Artery

*deep auricular and anterior tympanic arteries

*middle meningeal artery: sometimes (38%) passes b/w 2 roots of auriculotemporal nerve to enter the foramen spinosum  major supplier of blood to the dura

*Inferior alveolar artery: enters the mandible through the mandibular foramen and supplies the lower teeth

--Branches of the pterygoid portion (related to lateral pterygoid muscle)

*anterior and posterior deep temporal arteries

*buccal artery

Mandibular Division of the Trigeminal Nerve (leaves the middle cranial fossa to enter the infratemporal foss through the foramen ovale)

--Main Trunk

*nerve to medial pterygoid (also innervates tensor veli palatini and tensor tympani muscles–motor)

--Anterior Division

*nerve to the masseter (motor or masseter, sensory to temporomandibular joint)

*deep temporal nerves (motor)

*nerve to the lateral pterygoid (motor)

*buccal nerve (sensory—supplies skin of cheek and mucous membranes of cheek side of the oral cavity and adjacent gingiva)

--Posterior Divison

*auriculotemporal nerve:

~arises by 1-4 roots (50% one root), if there are 2 roots they will encircle the middle meningeal artery

~receives postganglionic parasympathetic fibers from the otic ganglion for the parotid gland (autonomic to gland) ~preganglionic fibers (lesser petrosal nerve) to otic ganglion

~sensory to skin in front of the ear and scalp

*Lingual nerve

~receives the chorda tympani nerve containing preganglionic parasympathetic fibers and taste fibers for the anterior 2/3 of the tongue (sensory cell bodies for taste to anterior 2/3 of tongue are in the geniculate ganglion)

~submandibular ganglion is associated w/ lingual nerve and serves the submandibular and sublingual salivary glands: receives preganglionic fibers via the chorda tympani nerve

~general sensory for anterior 2/3 of tongue plus oral mucosa and gum tissue lying beneath the tongue and lower front teeth, respectively

*Inferior Alveolar nerve

~enters mandibular forament after giving off the nerve to the mylohyoid (which gives off a branch to anterior belly of digastric)



~sensory to the lower teeth and skin on the chin by the mental nerve




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