Infratemporal Infratemporal FossaFossaPart IIPart II

Infratemporal Infratemporal FossaFossaPart IIPart II

Deep Contents of the Deep Contents of the infratemporal fossainfratemporal fossa

MusclesMuscles: tensor palati and levator palati.: tensor palati and levator palati.

NerveNerve: Maxillary nerve and it branches.: Maxillary nerve and it branches.

Autonomic ganglionAutonomic ganglion: Spheno-palatine : Spheno-palatine ganglion.ganglion.

ArteriesArteries: 3: 3rdrd part of maxillary artery and its part of maxillary artery and its branches (mentioned before).branches (mentioned before).

Tensor PalatiTensor PalatiOriginOrigin:: 1. Spine of sphenoid1. Spine of sphenoid

2. Scaphoid fossa2. Scaphoid fossa

3. Outer wall of auditory tube3. Outer wall of auditory tube

InsertionInsertion:: P Palatine aponeurosis (the alatine aponeurosis (the tendon hooks on the pterygoid hamulus).tendon hooks on the pterygoid hamulus).

Nerve supplyNerve supply:: Nerve to medial pterygoid Nerve to medial pterygoid from main trunk of mandibular nerve.from main trunk of mandibular nerve.

ActionAction:: It tensesIt tenses the soft palate. the soft palate.

OriginOrigin:: 1. Spine of sphenoid1. Spine of sphenoid

2. Scaphoid fossa2. Scaphoid fossa

3. Outer wall of auditory tube3. Outer wall of auditory tube

InsertionInsertion:: P Palatine aponeurosis (the alatine aponeurosis (the tendon hooks on the pterygoid hamulus).tendon hooks on the pterygoid hamulus).

Nerve supplyNerve supply:: Nerve to medial pterygoid Nerve to medial pterygoid from main trunk of mandibular nerve.from main trunk of mandibular nerve.

ActionAction:: It tensesIt tenses the soft palate. the soft palate.

Levator PalatiLevator PalatiOriginOrigin:: 1. Inferior surface of the petrous 1. Inferior surface of the petrous

part of the temporal bone.part of the temporal bone.

2. Lower surface of auditory tube2. Lower surface of auditory tube

InsertionInsertion:: P Palatine aponeurosis.alatine aponeurosis.

Nerve supplyNerve supply:: Pharyngeal plexus Pharyngeal plexus (cranial part of accessory nerve).(cranial part of accessory nerve).

ActionAction:: It elevatesIt elevates the soft palate. the soft palate.

OriginOrigin:: 1. Inferior surface of the petrous 1. Inferior surface of the petrous

part of the temporal bone.part of the temporal bone.

2. Lower surface of auditory tube2. Lower surface of auditory tube

InsertionInsertion:: P Palatine aponeurosis.alatine aponeurosis.

Nerve supplyNerve supply:: Pharyngeal plexus Pharyngeal plexus (cranial part of accessory nerve).(cranial part of accessory nerve).

ActionAction:: It elevatesIt elevates the soft palate. the soft palate.

Maxillary nerveMaxillary nerveMaxillary nerveMaxillary nerveOne of the divisions of the trigeminal nerveOne of the divisions of the trigeminal nerve

It is a pure sensory nerve.It is a pure sensory nerve.

It passes in the lateral wall of the cavernous sinus.It passes in the lateral wall of the cavernous sinus.

Then leaves the skull through foramen rotundum to Then leaves the skull through foramen rotundum to enter the pterygopalatine fossa.enter the pterygopalatine fossa.

It curves laterally through the pterygomaxillary fissure It curves laterally through the pterygomaxillary fissure to lie deep in the infratemporal fossa.to lie deep in the infratemporal fossa.

Through the inferior orbital fissure, it enters the floor of Through the inferior orbital fissure, it enters the floor of the orbit and continues as infraorbital nerve, which the orbit and continues as infraorbital nerve, which runs in the infraorbital groove, canal then foramen and runs in the infraorbital groove, canal then foramen and terminates in the face.terminates in the face.

One of the divisions of the trigeminal nerveOne of the divisions of the trigeminal nerve

It is a pure sensory nerve.It is a pure sensory nerve.

It passes in the lateral wall of the cavernous sinus.It passes in the lateral wall of the cavernous sinus.

Then leaves the skull through foramen rotundum to Then leaves the skull through foramen rotundum to enter the pterygopalatine fossa.enter the pterygopalatine fossa.

It curves laterally through the pterygomaxillary fissure It curves laterally through the pterygomaxillary fissure to lie deep in the infratemporal fossa.to lie deep in the infratemporal fossa.

Through the inferior orbital fissure, it enters the floor of Through the inferior orbital fissure, it enters the floor of the orbit and continues as infraorbital nerve, which the orbit and continues as infraorbital nerve, which runs in the infraorbital groove, canal then foramen and runs in the infraorbital groove, canal then foramen and terminates in the face.terminates in the face.

BranchesBranchesBranchesBranchesFrom of maxillary nerveFrom of maxillary nerve::

1.1. Meningeal branch:Meningeal branch: supplies the dura of the supplies the dura of the middle cranial fossa.middle cranial fossa.

2.2. Two ganglionic branches:Two ganglionic branches: which hang the which hang the sphenopalatine ganglion, they contain sensory sphenopalatine ganglion, they contain sensory fibers coming from nose, palate and pharynx fibers coming from nose, palate and pharynx and postganglionic fibers going to the lacrimal and postganglionic fibers going to the lacrimal gland.gland.

3.3. Zygomatic branch:Zygomatic branch: arises in the arises in the pterygopalatine fossa and enters the orbit pterygopalatine fossa and enters the orbit through the inferior orbital fissure. It divides into through the inferior orbital fissure. It divides into zygomatico-temporal and zygomatico-facial zygomatico-temporal and zygomatico-facial branches that supply skin of the face.branches that supply skin of the face.

From of maxillary nerveFrom of maxillary nerve::1.1. Meningeal branch:Meningeal branch: supplies the dura of the supplies the dura of the

middle cranial fossa.middle cranial fossa.2.2. Two ganglionic branches:Two ganglionic branches: which hang the which hang the

sphenopalatine ganglion, they contain sensory sphenopalatine ganglion, they contain sensory fibers coming from nose, palate and pharynx fibers coming from nose, palate and pharynx and postganglionic fibers going to the lacrimal and postganglionic fibers going to the lacrimal gland.gland.

3.3. Zygomatic branch:Zygomatic branch: arises in the arises in the pterygopalatine fossa and enters the orbit pterygopalatine fossa and enters the orbit through the inferior orbital fissure. It divides into through the inferior orbital fissure. It divides into zygomatico-temporal and zygomatico-facial zygomatico-temporal and zygomatico-facial branches that supply skin of the face.branches that supply skin of the face.

BranchesBranchesBranchesBranches4.4. Posterior superior alveolar nerve:Posterior superior alveolar nerve: arises arises

in the pterygopalatine fossa and pierces the in the pterygopalatine fossa and pierces the posterior surface of the maxilla to supply posterior surface of the maxilla to supply the maxillary sinus, the upper molar teeth the maxillary sinus, the upper molar teeth and adjoining parts of the gum and cheek.and adjoining parts of the gum and cheek.From of infraorbital nerveFrom of infraorbital nerve::

5.5. Middle superior alveolar nerve:Middle superior alveolar nerve: arises in arises in the infraorbital groove and descends on the the infraorbital groove and descends on the lateral wall of the maxillary sinus to supply lateral wall of the maxillary sinus to supply the upper premolar teeth and adjoining the upper premolar teeth and adjoining parts of the gum and cheek.parts of the gum and cheek.

4.4. Posterior superior alveolar nerve:Posterior superior alveolar nerve: arises arises in the pterygopalatine fossa and pierces the in the pterygopalatine fossa and pierces the posterior surface of the maxilla to supply posterior surface of the maxilla to supply the maxillary sinus, the upper molar teeth the maxillary sinus, the upper molar teeth and adjoining parts of the gum and cheek.and adjoining parts of the gum and cheek.From of infraorbital nerveFrom of infraorbital nerve::

5.5. Middle superior alveolar nerve:Middle superior alveolar nerve: arises in arises in the infraorbital groove and descends on the the infraorbital groove and descends on the lateral wall of the maxillary sinus to supply lateral wall of the maxillary sinus to supply the upper premolar teeth and adjoining the upper premolar teeth and adjoining parts of the gum and cheek.parts of the gum and cheek.

BranchesBranchesBranchesBranches6.6. Anterior superior alveolar nerve:Anterior superior alveolar nerve:

arises in the infraorbital canal and arises in the infraorbital canal and descends on the anterior wall of the descends on the anterior wall of the maxillary sinus to supply the upper maxillary sinus to supply the upper canine and incisor teeth and adjoining canine and incisor teeth and adjoining parts of the gum and a small part of the parts of the gum and a small part of the lateral wall and floor of the nasal cavitylateral wall and floor of the nasal cavity

7.7. Terminal Branches in the face:Terminal Branches in the face: after its after its exit through the infraorbital foramen it exit through the infraorbital foramen it divides into palpebral, nasal and labial divides into palpebral, nasal and labial branches which supply skin of the face.branches which supply skin of the face.

6.6. Anterior superior alveolar nerve:Anterior superior alveolar nerve: arises in the infraorbital canal and arises in the infraorbital canal and descends on the anterior wall of the descends on the anterior wall of the maxillary sinus to supply the upper maxillary sinus to supply the upper canine and incisor teeth and adjoining canine and incisor teeth and adjoining parts of the gum and a small part of the parts of the gum and a small part of the lateral wall and floor of the nasal cavitylateral wall and floor of the nasal cavity

7.7. Terminal Branches in the face:Terminal Branches in the face: after its after its exit through the infraorbital foramen it exit through the infraorbital foramen it divides into palpebral, nasal and labial divides into palpebral, nasal and labial branches which supply skin of the face.branches which supply skin of the face.

Sphenopalatine ganglionSphenopalatine ganglionSphenopalatine ganglionSphenopalatine ganglionA parasympathetic ganglion which lies in the pterygopalatine A parasympathetic ganglion which lies in the pterygopalatine fossa, hanged by two roots from the maxillary nerve.fossa, hanged by two roots from the maxillary nerve.RootsRoots::

1.1. Preganglionic Parasympathetic root:Preganglionic Parasympathetic root: from the lacrimal nucleus from the lacrimal nucleus (in the brain stem), to the facial nerve which gives the greater (in the brain stem), to the facial nerve which gives the greater petrosal nerve which enters the pterygoid canal, unites with the petrosal nerve which enters the pterygoid canal, unites with the deep petrosal nerve to form the nerve of pterygoid canal which deep petrosal nerve to form the nerve of pterygoid canal which joins the ganglion from its posterior aspect where they relay inside joins the ganglion from its posterior aspect where they relay inside the ganglion and gives postganglionic branches.the ganglion and gives postganglionic branches.

2.2. Postganglionic Sympathetic root:Postganglionic Sympathetic root: from the deep petrosal nerve from the deep petrosal nerve which is a branch from the internal carotid nerve in the foramen which is a branch from the internal carotid nerve in the foramen lacerum (the sympathetic plexus around the internal carotid artery lacerum (the sympathetic plexus around the internal carotid artery from the upper deep cervical sympathetic ganglion). The deep from the upper deep cervical sympathetic ganglion). The deep petrosal nerve unites with the greater petrosal nerve to form the petrosal nerve unites with the greater petrosal nerve to form the nerve of pterygoid canal (nerve of pterygoid canal (vedian nervevedian nerve).).

3.3. Two Sensory roots:Two Sensory roots: from the maxillary nerve. from the maxillary nerve.

A parasympathetic ganglion which lies in the pterygopalatine A parasympathetic ganglion which lies in the pterygopalatine fossa, hanged by two roots from the maxillary nerve.fossa, hanged by two roots from the maxillary nerve.RootsRoots::

1.1. Preganglionic Parasympathetic root:Preganglionic Parasympathetic root: from the lacrimal nucleus from the lacrimal nucleus (in the brain stem), to the facial nerve which gives the greater (in the brain stem), to the facial nerve which gives the greater petrosal nerve which enters the pterygoid canal, unites with the petrosal nerve which enters the pterygoid canal, unites with the deep petrosal nerve to form the nerve of pterygoid canal which deep petrosal nerve to form the nerve of pterygoid canal which joins the ganglion from its posterior aspect where they relay inside joins the ganglion from its posterior aspect where they relay inside the ganglion and gives postganglionic branches.the ganglion and gives postganglionic branches.

2.2. Postganglionic Sympathetic root:Postganglionic Sympathetic root: from the deep petrosal nerve from the deep petrosal nerve which is a branch from the internal carotid nerve in the foramen which is a branch from the internal carotid nerve in the foramen lacerum (the sympathetic plexus around the internal carotid artery lacerum (the sympathetic plexus around the internal carotid artery from the upper deep cervical sympathetic ganglion). The deep from the upper deep cervical sympathetic ganglion). The deep petrosal nerve unites with the greater petrosal nerve to form the petrosal nerve unites with the greater petrosal nerve to form the nerve of pterygoid canal (nerve of pterygoid canal (vedian nervevedian nerve).).

3.3. Two Sensory roots:Two Sensory roots: from the maxillary nerve. from the maxillary nerve.

Sphenopalatine ganglionSphenopalatine ganglionSphenopalatine ganglionSphenopalatine ganglionSecretomotor Branches:Secretomotor Branches:

1.1. To the lacrimal gland: through the maxillary To the lacrimal gland: through the maxillary nerve nerve zygomatic branch zygomatic branch zygomatico- zygomatico-temporal branch temporal branch communicates with the communicates with the lacrimal nerve lacrimal nerve the lacrimal gland. the lacrimal gland.

2.2. To the mucous glands of the nose, palate.To the mucous glands of the nose, palate.Sensory Branches from the maxillary nerve to Sensory Branches from the maxillary nerve to the nose, palate, pharynx and orbit :the nose, palate, pharynx and orbit :

3.3. Orbital branches: through the inferior orbital Orbital branches: through the inferior orbital fissure.fissure.

4.4. Greater and lesser palatine nerves.Greater and lesser palatine nerves.5.5. Nasal branches.Nasal branches.6.6. Pharyngeal branches.Pharyngeal branches.

Secretomotor Branches:Secretomotor Branches:1.1. To the lacrimal gland: through the maxillary To the lacrimal gland: through the maxillary

nerve nerve zygomatic branch zygomatic branch zygomatico- zygomatico-temporal branch temporal branch communicates with the communicates with the lacrimal nerve lacrimal nerve the lacrimal gland. the lacrimal gland.

2.2. To the mucous glands of the nose, palate.To the mucous glands of the nose, palate.Sensory Branches from the maxillary nerve to Sensory Branches from the maxillary nerve to the nose, palate, pharynx and orbit :the nose, palate, pharynx and orbit :

3.3. Orbital branches: through the inferior orbital Orbital branches: through the inferior orbital fissure.fissure.

4.4. Greater and lesser palatine nerves.Greater and lesser palatine nerves.5.5. Nasal branches.Nasal branches.6.6. Pharyngeal branches.Pharyngeal branches.

Pterygopalatine fossaPterygopalatine fossaBoundariesBoundaries:: – Anterior:Anterior: posterior surface of maxilla. posterior surface of maxilla.– Posterior:Posterior: pterygoid process. pterygoid process.– Medial:Medial: perpendicular plate of palatine bone. perpendicular plate of palatine bone.– Lateral:Lateral: infratemporal fossa (through infratemporal fossa (through

pterygomaxillary fissure).pterygomaxillary fissure).

ContentsContents::

1.1. Maxillary nerve and branches.Maxillary nerve and branches.

2.2. Sphenopalatine ganglion and branches.Sphenopalatine ganglion and branches.

3.3. 33rdrd part of maxillary artery and branches. part of maxillary artery and branches.

BoundariesBoundaries:: – Anterior:Anterior: posterior surface of maxilla. posterior surface of maxilla.– Posterior:Posterior: pterygoid process. pterygoid process.– Medial:Medial: perpendicular plate of palatine bone. perpendicular plate of palatine bone.– Lateral:Lateral: infratemporal fossa (through infratemporal fossa (through

pterygomaxillary fissure).pterygomaxillary fissure).

ContentsContents::

1.1. Maxillary nerve and branches.Maxillary nerve and branches.

2.2. Sphenopalatine ganglion and branches.Sphenopalatine ganglion and branches.

3.3. 33rdrd part of maxillary artery and branches. part of maxillary artery and branches.

Pterygopalatine fossaPterygopalatine fossaCommunicationsCommunications::

1.1. Ptergomaxillary fissure Ptergomaxillary fissure infratemporal fossa.infratemporal fossa.

2.2. Foramen rotundum Foramen rotundum middle cranial middle cranial fossa.fossa.

3.3. Sphenopalatine foramen Sphenopalatine foramen nasal nasal cavity.cavity.

4.4. Inferior orbital fissure Inferior orbital fissure orbital cavity. orbital cavity.5.5. Greater palatine canal Greater palatine canal palate. palate.6.6. Palatinovaginal canal Palatinovaginal canal nasopharynx. nasopharynx.7.7. Pterygoid canal Pterygoid canal foramen lacerum. foramen lacerum.

CommunicationsCommunications:: 1.1. Ptergomaxillary fissure Ptergomaxillary fissure

infratemporal fossa.infratemporal fossa.2.2. Foramen rotundum Foramen rotundum middle cranial middle cranial

fossa.fossa.3.3. Sphenopalatine foramen Sphenopalatine foramen nasal nasal

cavity.cavity.4.4. Inferior orbital fissure Inferior orbital fissure orbital cavity. orbital cavity.5.5. Greater palatine canal Greater palatine canal palate. palate.6.6. Palatinovaginal canal Palatinovaginal canal nasopharynx. nasopharynx.7.7. Pterygoid canal Pterygoid canal foramen lacerum. foramen lacerum.