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TEMPORAL & INFRATEMPORAL FOSSAE TEMPORAL FOSSA INFRA-TEMPORAL FOSSA - they are interconnected spaces on the lateral side

of the head - their boundaries are formed by bone & soft tissues - superior to the infratemporal fossa - a wedge-shaped space - above the zygomatic arch - below the zygomatic arch - communicates with the infratemporal fossa below through the gap - deep to the masseter muscle & the underlying between the zygomatic arch & the more medial surface of the skull ramus of mandible contents : 2 muscles : medial & lateral pterygoids 2 nerves : mandibular nerve & chorda tympani 2 vessels : maxillary artery & pterygoid plexus of veins 1. ganglion : otic ganglion

BONY BOUNDARIES OF INFRATEMPORAL FOSSA anterior posterior medial lateral roof maxilla free lateral pterygoid plate ramus of mandible infratemporal surface of greater wing of sphenoid

MUSCLES OF MASTICATION (in relation with temporal & infratemporal fossae) Move the lower jaw at the temporo-mandibular joint masseter - lateral to infratemporal fossa lateral & medial pterygoids - in the infratemporal fossa temporalis - fills the temporal fossa

ANATOMY OF SKULL

ANATOMICAL FEATURES OF MANDIBLE

MUSCLES OF MASTICATION All muscles of mastication elevate the mandible ( except lateral pterygoids depress the mandible) All muscles of mastication protrude the mandible ( except temporalis retract the mandible) Medial & lateral pterygoids side to side movements All muscles of mastication are supplied by mandibular nerve TEMPORALIS - floor of temporal fossa - deep surface of temporal fascia - inferior temporal line MASSETER - lower border & inner surface of zygomatic arch - lateral aspect of the ramus of mandible LATERAL PTERYGOID upper head lower head infratemporal surface lateral surface of of greater wing of lateral pterygoid plate sphenoid bone - anterior aspect of the neck of mandible - articular disc of temporo-mandibular joint MEDIAL PTERYGOID superficial head deep head maxillary medial surface of tuberosity lateral pterygoid plate medial surface of the angle of mandible main trunk of mandibular nerve - elevation - protraction - side to side movement

origin

insertion

- coronoid process - anterior border of ramus of mandible nerve deep temporal nerves (from supply ant. division of mandibular n.) action - elevation (anterior fibers) (upon - retraction ( middle & posterior mandible) fibers)

anterior division of mandibular nerve - elevation -protraction - depression (pulls the head of mandible forward during opening of the mouth) - protraction - side to side movement

ACCESSORY MUSCLES OF MASTICATION 1. Digastric 2. Mylohyoid 3. Geniohyoid All originate from mandible Action : depress & elevate hyoid bone

MANDIBULAR NERVE branches of the trunk 1. Nerve to medial pterygoid, supplying : Medial pterygoid Tensor palate Tensor tympani branches of anterior division 3 motor/muscular branches i. Masseter ii. Lateral pterygoid iii. Temporalis branches of posterior division 1 motor branch = Nerve to mylohyoid (from inferior alveolar n. before entering mandibular canal), supplies : Mylohyoid Anterior belly of digastrics 3 sensory branches

OTIC GANGLION A parasympathetic ganglion Situated in the infratemporal fossa, below foramen ovale Medial to the main trunk of mandibular nerve sensory mandibular nerve motor nerve to medial pterygoid sympathetic plexus around middle meningeal artery parasympathetic lesser superficial petrosal nerve (glossopharyngeal n.) *the only root that relays in ganglion! postganglionic branch to parotid gland

roots

2. Meningeal branch , supplying : Meninges of middle cranial fossa

1 sensory branch = Buccal nerve - Supplies skin covering buccinators muscle - Pierces buccinators to supply mucous membrane of the mouth (in the inner surface of buccinators)

branches i. Inferior alveolar nerve , branches into : - incisive branch, innervates : 1st molar, canine & incisor teeth with associated vestibular gingiva - mental nerve, innervates : chin & lower lip ii. Lingual nerve iii. Auriculo-temporal nerve, supplies Scalp over temporal region & anterior to the ear near the vertex

to parotid gland

to tensor palate & tensor tympani

blood vessels of parotid gland

MANDIBULAR NERVE Root : - large sensory root - smaller motor root Course : 1. enters the infratemporal fossa, through foramen ovale 2. in foramen ovale, - both roots join to form the trunk of the nerve (very short) 3. below foramen, - trunk rapidly divides into anterior & posterior division

Branches of the trunk: 1. Nerve to medial pterygoid 2. Meningeal branch (enters foramen spinosum)

Branches of anterior division: 1. Muscular branches : masseter, lateral pterygoid, temporalis 2. Buccal nerve

Branches of posterior division: 1. Inferior alveolar nerve (innervates lower teeth) - enter mandibular foramen with accompanying vessels (*before entering mandibular canal, it gives motor nerve to mylohyoid & anterior belly of digastrics) travels anteriorly through the bone in the mandibular canal - adjacent to 1st molar tooth, it divides into : i) incisive branch ii) mental nerve (exits mandible thru mental foramen) 2. Lingual nerve - originates in infratemporal fossa passes anteriorly into the floor of oral cavity continues forwards on the medial surface of mandible (adjacent to 1st molar tooth) continues antero-medially across the floor of oral cavity ascends into the tongue (on external & superior surface of hyoglossus muscle) 3. Auriculo-temporal nerve - surrounding the middle meningeal artery - passes upwards deep in parotid gland passes just anterior to the ear continues superiorly anterior to the ear until nearly reaching the vertex of head

MAXILLARY ARTERY Largest branch of external carotid artery in the neck Major source of blood supply for : nasal cavity, lateral wall & roof of oral cavity, all teeth & dura mater in the cranial cavity from external carotid artery, within the substance of parotid gland (at the neck of mandible) 1ST/MANDIBULAR PART 2ND/PTERYGOID PART 3RD/PTERYGOPALATINE PART (between the neck of mandible (related to the lateral pterygoid muscle) (in the pterygopalatine fossa) & sphenomandibular ligament) - divided into 3 parts according to its relation with the lateral pterygoid muscle enters infratemporal fossa, by - passes forward through infratemporal fossa, - ascends obliquely through the infratemporal fossa to enter passing forward, between the above the lateral pterygoid muscle pterygopalatine fossa, neck of mandible & - may pass either lateral or medial to the lower head of lateral by passing through pterygopalatine fissure sphenomandibular ligament pterygoid *if it passes medial to lower head, then maxillary artery then loops laterally between the upper & lower heads of lateral pterygoids to access the pterygomaxillary fissure 1. middle meningeal artery 1. deep temporal artery 1. posterior superior alveolar artery 2. inferior alveolar artery 2. masseteric artery 2. infraorbital artery 3. smaller branches : 3. buccal artery 3. greater palatine artery - deep auricular artery 4. pterygoid artery 4. pharyngeal artery - anterior tympanic artery *course with the branches of mandibular nerve 5. sphenopalatine artery - accessory meningeal artery 6. artery of pterygoid canal *collectively, supply the nasal cavity, roof of oral cavity, upper teeth, sinuses, oropharynx & floor of orbit

origin parts

course

branches