Temporal and Infratemporal Regions

What is the infratemporal fossa?

a deep facial region that contains two of the four muscles of mastication

the infratemporal fossa communicates with a more medial space known as what?

pterygopalatine fossa

what are the boundaries of the infratemporal fossa?

Lateral: ramus of the mandible & zygomatic arch

Medial: lateral pterygoid plate of the sphenoid bone

Anterior: posterior aspect of maxilla

Posterior: Temporomandibular (TMJ) joint

Superior: Greater wing of Sphenoid

what is located within the infratemporal fossa?

- medial pterygoid

- lateral pterygoid

- maxillary artery

- pterygoid plexus of veins

- mandibular division (V3)

- Otic Ganglion

to get to the deep infratemporal fossa what must be removed?

- zygomatic arch and part of the ramus

- lateral pterygoid removed

what is the attachment of the temporalis muscle?

temporal fossa to coronoid process

what is the action of temporalis on the mandible?

elevate and retract

the posterior fibers of the temporalis are the ones responsible for what action?

retraction

to elevate the jaw means to do what?

close the jaw

what is the attachment for the masseter?

zygomatic arch to the superficial side of the angle of the mandible

what is the action of the masseter on the mandible?

elevate

what is the attachment of the medial pterygoid?

- Superficial Head: maxilla to the deep side of the mandibular angle

- Deep Head: lateral pterygoid plate to the deep side of the mandibular angle

what is the action of the medial pterygoid?

elevates mandible

what is the attachment of the lateral pterygoid?

Superior Head: greater wing of sphenoid

Deep Head: lateral pterygoid plate

both attach to the condyloid process at the temporomandibular Joint (TMJ)

what is the action of the lateral pterygoid?

protract and depress mandible (chin)

what type of joint is the temporomandibular joint (TMJ)?

a modified hinge joint divided into two cavities by an articular disc

What are the articular surfaces for the temporomandibular joint?

mandibular fossa and the articular tubercle of the temporal bone with the head of the mandible (Condylar process)

what type of glide occurs between the articular disc and the mandibular fossa at the superior joint cavity?

anterior gliding

what type of motion occurs between the mandibular condyle and the articular disc at the inferior joint cavity?

rotation

what are the important arteries of the infratemporal region?

- maxillary artery

- middle meningeal artery

- inferior alveolar artery

the maxillary artery can be divided into what 3 portions during its course?

1st: lies deep to the ramus of the mandible

2nd: lies anterior to the ramus (location of muscular branches)

3rd: begins at the entrance of the pterygopalatine fossa and continues into the fossa

what does the middle meningeal artery supply?

the meninges

what is the course of the middle meningeal artery?

it passes between the two roots of the auriculotemporal nerve to enter the foramen spinosum

how does the meningeal artery enter the cranium?

foramen spinosum

what does the inferior alveolar artery supply?

the teeth

how does the inferior alveolar artery get into the area to supply the teeth?

it enters the mandibular foramen (basically goes into the bone) and comes out of the jaw as mental artery

what are the V3 branches of the infratemporal fossa?

- inferior alveolar nerve

- lingual nerve

- buccal nerve

- auriculotemporal nerve

what are the V2 branches of the Pterygopalatine Fossa?

- infraorbital nerve

- zygomatic nerve

- posterior superior alveolar nerve

- sphenopalatine nerves

- descending palatine nerves

how does the mandibular nerve enter the infratemporal fossa?

through the foramen ovale

what are the branches of the mandibular nerve?

- inferior alveolar nerve

- auriculotemporal nerve

- lingual nerve

- buccal nerve

how does the inferior alveolar nerve enter?

mandibular foramen

what does the inferior alveolar nerve innervate?

mandibular teeth sensation

what is the termination of the inferior alveolar nerve?

mental nerve

which nerve has two roots surrounding the middle meningeal artery? (actually splits around this artery)

auriculotemporal nerve

what does the auriculotemporal nerve supply?

sensory to the skin anterior to the ear

what offers general sensory innervation to the tongue?

lingual nerve

what is the innervation to the inside of the cheek? (pierces through buccinator)

buccal nerve

nerves to the muscles of mastication are independent branches of what that travel to their respective muscles?

branches of V3

V3 is what nerve?

Mandibular Nerve which is a branch of Trigeminal

what branch of the mandibular nerve appears from between the two heads of the lateral pterygoid?

Buccal

what branches of the mandibular nerve are located at the inferior aspect of the inferior head of the lateral pterygoid muscle?

- lingual nerve

- inferior alveolar nerve

list inferior alveolar nerve, lingual nerve, and buccal nerve from lateral to medial:

inferior alveolar nerve, lingual nerve, buccal

the inferior alveolar nerve enters the bone of the mandible, does the nerve to the mylohyloid and lingual nerve enter the bone?

no! they travel just deep to the bone.

- inferior dives deep, goes into bone, and comes out mental

- the lingual is deep to bone going to the tongue

the mandibular division of trigeminal (V) has a large sensory and small motor component, which of the branches of the trigeminal are predominantly motor?

the branches from the stem and anterior division

the buccal nerve branches from the anterior division of the trigeminal, but what is important to note?

it is SENSORY to the inside of the cheek

the posterior division of the trigeminal nerve gives off what major sensory nerves?

- auriculotemporal nerve

- lingual nerve

- inferior alveolar

the lingual nerve accepts what as a hitch hiker? what is its role?

the chorda tympani from the facial nerve that carries the special fibers for taste

the chorda tympani carries sympathetics or parasympathetics for submandibular region?

parasympathetics

terminal branches of the inferior alveolar nerve exit as what? through where? supplying what?

the mental nerve through the mental foramen supplying sensory innervation to the skin over the mandible

the mental nerve gives off a small motor branch called what?

nerve to the mylohyoid

where does the nerve to the mylohyoid travel?

down superficial to the muscles of the floor of the mouth to innervate the mylohyoid and the anterior belly of the digastric

what are the parasympathetic pathways associated with the infratemporal fossa?

- innervation of the sublingual and submandibular glands

- innervation of the parotid gland

what are the innervations of the sublingual and submandibular glands?

- CN VII

- Preganglionic sympathetic neuron: superior salivary nucleus

- postganglionic sympathetic neuron: submandibular ganglion

what are the innervations of the parotid glands?

- CN IX

- preganglionic parasympathetic neuron: inferior salivary nucelus

- postganglionic parasympathetic neuron: Otic Ganglion

what is the continuation of the maxillary artery called after it passes through the pterygomaxillary?

sphenopalatine artery

what does the continuation of the maxillary artery, sphenopalatine artery, supply?

the nasal cavity

what are the 3 clinically important branches of the maxillary artery? what do they supply?

Inferior Alveolar: lower teeth

middle meningeal: dura and meninges

posterior superior alveolar: upper teeth and maxillary sinus

what are the branches of the mandibular division of the trigeminal nerve from the stump of V3?

auriculotemporal

what are the branches of the mandibular division of the trigeminal nerve anterior division?

- motor branches to muscles of mastication

- buccal

what are the branches of the mandibular division of the trigeminal nerve posterior division?

- lingual

- inferior alveolar

which of the major sensory branches gives off a small root to the region under the mandible?

inferior alveolar

what is the motor root/nerve that inferior alveolar gives off? what is it supplying in this region?

nerve to the mylohyoid; its motor to the mylohyoid and anterior belly of digastric

how does the special sense of taste reach the tongue?

the fibers for special sensation of taste leave the facial nerve as it travels within the temporal bone in a branch called the chorda tympani.

the chorda tympani passes through the middle ear cavity and enters the back side of the lingual nerve within the infratemporal fossa.

taste fibers for the anterior 2/3 of the tongue are then distributed with the lingual nerve.