602: Pterygopalatine Fossa

what structure leads to the pterygopalatine fossa?

pterygomaxillary fissure

cancer can spread along nerves, and if enters PPF, can travel to many sites. this is called

malignant perineural invasion

supraperiostal nerve block (what does it anesthetize? injection location?)

individual maxillary teeth (V2)

mucobuccal fold superior to tooth

inferior alveolar nerve block (what does it anesthetize? injection location?)

superior alveolar nerve block (what does it anesthetize? injection location?)

infraorbital nerve block (what does it anesthetize? injection location?)

mental nerve block (what does it anesthetize? injection location?)

what travels through the infraorbital fissure?

zygomatic n.
infraorbital n.
infraorbital v.

which maxillary teeth are innervated by anterior superior alveolar nerve

incisors and canines (6-11)

which maxillary teeth are innervated by middle superior alveolar nerve

premolars and ½ first molar

which maxillary teeth are innervated by posterior superior alveolar nerve

1/2 first molars, posterior 2 molars

anterior hard palate is innervated by

nasopalatine n

posterior hard palate is innervated by

greater palatine n

soft palate is innervated by

lesser palatine n.

right and left vestibular (buccal, labial) gingiva is innervated by

superior alveolar n.
infraorbital (anterior/middle)

superior lingual gingiva is innervated by

nasopalatine n.

right and left teeth/tooth pulp, PDL, alveolar processes are innervated by

superior alveolar n.

what travels through the palatine canal?

descending palatine a.
greater and lesser palatine nn.

what structures go through the sphenopalatine foramen?

sphenopalatine a.
nasopalatine and posterior lateral nasal nn.

traveling medially from the pterygomaxillary fissure will place you in the:

pterygopalatine fossa

what is the pterygopalatine fossa?

pyramidal space medial to the infratemporal fossa between sphenoid, maxilla, and palatine bone

the superior dental plexus is is made up of

posterior middle and anterior superior alveolar nerve (CN V2)

the ppf is a major distribution site for (what are the contents?)

maxillary a. (3rd part or pterygopalatine part)
maxillary n. (V2)
pterygopalatine ganglion

The pterygopalatine fossa is ________to the apex of the orbit.

inferior

The pterygopalatine fossa is ________ to the sphenopalatine foramen

lateral

what is the major somatic snesory nerve for the face, nasal cavity and nasopharynx, maxillary sinuses, meninges, and oral cavity?

CN V2

what parasymphatetic nerves are associated with the pterygopalatine ganglion?

greater petrosal n. (from VII) → lacrimation and gland secretion$

what symphatetic nerves are associated with the pterygopalatine ganglion?

deep petrosal n (from internal carotid plexus)

describe the path of the maxillary n. (V2)

1. middle cranial fossa at trigeminal ganglion

   (foramen rotundum)

2. pterygopalatine fossa (branches to nasal cavity, palate, maxillary teeth)

   (infraorbital fissure)

3. orbit (as infraorbital n)

   (infraorbital foramen)

4. face

which ganglion houses all the trigeminal somatic sensory nerve cell bodies?

trigeminal ganglion

preganglionic parasympathetic fibers from the greater petrosal n. synapse where?

pterygopalatine ganglion

greater petrosal n. enters the pterygopalatine fossa through what hole?

pterygoid canal

what 3 foramen are located on the posterior wall of the pterygopalatine fossa?

foramen rotundum
pterygoid canal
pharyngeal canal

if you move a probe medially in the pterygopalatine fossa to get to the nasal cavity, you must go through the:

sphenoplatine foramen

the lateral boundary of the pterygopalatine fossa is the:

pterygomaxillary fissure

the floor of the pterygopalatine fossa is the:

pterygopalatine canal

the anterior wall of the pterygopalatine fossa is formed by the:

posterior border of maxilla

what 3 bones make up the pterygopalatine fossa

maxilla
sphenoid
palatine

the posterior wall and roof of the pterygopalatine fossa is formed by the:

pterygoid process and greater wing of sphenoid bone

the medial wall of the pterygopalatine fossa is formed by the:

perpendicular plate of palatine bone

name the 2 fissures associated with the pterygopalatine fossa:

pterygomaxillary fissure
inferior orbital fissure

name the 2 foramen associated with the pterygopalatine fossa:

foramen rotundum
sphenopalatine foramen

name the 3 canals associated with the pterygopalatine fossa:

vidian canal/ pterygoid canal
pterygopalatine canal
pharyngeal canal

what hole in the head connects ITF and PPF?

pterygomaxillary fissure

what hole is located anterior and superior on the maxilla bone in the pterygopalatine fossa?

inferior orbital fissure

a probe from the pterygopalatine fossa through the infraorbital fissure, you would arrive in the:

orbit

if you wanted to go from the orbit to the pterygopalatine fossa, you'd go through the

inferior orbital fissure

what hole is located superiorly on the palatine bone?

sphenopalatine foramen

a probe from the pterygopalatine fossa through the sphenopalatine foramen, you would arrive in the:

nasal cavity

if you wanted to go from the nasal cavity to the pterygopalatine fossa, you'd take the

sphenopalatine foramen

a probe from the pterygopalatine fossa through the foramen rotundum, you would arrive in the:

middle cranial fossa

what hole is located superiorly on the sphenoid bone?

foramen rotundum

if you wanted to go from the middle cranial fossa to the pterygopalatine fossa, you'd take the

foramen rotundum

a probe from the pterygopalatine fossa through the pharyngeal canal, you would arrive in the:

nasopharynx

if you wanted to go from the nasopharynx to the pterygopalatine fossa, you'd take the

pharyngeal canal

a probe from the pterygopalatine fossa through the vidian canal/ pterygoid canal, you would arrive in the:

foramen lacerum

if you wanted to go from the foramen lacerum to the pterygopalatine fossa, you'd take the

vidian canal/ pterygoid canal

a probe from the pterygopalatine fossa through the pterygopalatine canal, you would arrive in the:

oral cavity

if you wanted to go from the oral cavity to the pterygopalatine fossa, you'd take the

pterygopalatine canal

the maxillary division of CV inter the pterygopalatine fossa via the:

foramen rotundum

V2 after fibers pass through the infraorbital fissure is called the:

infraorbital n.

which branch from V2 does NOT pass through the foramen rotundum?

meningeal n. branch

provides sensory innervation to the dura mater:

meningeal n. branch

meningeal nerve branch is a branch of:

V2

meningeal nerve branch travels with what structure?

middle meningeal a.

identify the structure:

meningeal n. branch

if this structure was lacerated, what function would be diminished

sensory innervation of dura mater

the zygomatic nerve enters leaves the pterygopalatine fossa and enters the:

inferior orbital fissure

the zygomatic nerve divides into two branches:

zygomatico-facial n.
zygomatico-temporal n.

the zygomatic n. is a branch of:

V2

identify the structure:

zygomatic n.

if this structure was lacerated, what function would be diminished

cutaneous sensation from skin over anterior temporal region and skin anterior to zygomatic bone

which V2 nerve communicates with V1's lacrimal n. in the orbit?

zygomaticotemporal n.

these fibers suspend the pterygopalatine ganglion:

2 short pterygopalatine nn.

the branches of the ganglion are branches of:

V2

neurons in this ganglion are unipolar and carry sensation from periphery to brainstem

trigeminal ganglion

what nerve provides sensory innervation to maxillary third molar, second molar, palatal and distobuccal roots of first molar, associated buccal gingiva and maxillary sinus

posterior superior alveolar nn.

anterior and middle superior alveolar nerves are branches of the:

infraorbital n.

which nerve that provides sensory innervation to the maxillary teeth does not travel through the inferior orbital fissure?

posterior superior alveolar nn.

which nerve branching from the infraorbital nerve has branches that will innervate the floor and lateral wall of the nasal cavity?

anterior superior alveolar nn.

what nerve provides cutaneous sensory innervation to the muscles of facial expression, lateral nose and upper lip?

infraorbital n.

provide sensory innervation from periosteum of orbit, sphenoidal sinus and posterior ethmoidal air cells

orbital branches of the ganglion

the pharyngeal n. lies _______ to the vidian/pterygoid canal

medially

provides sensory innervation for septum, mucoperiosteum of anterior hard palate

nasopalatine n.

provides sensory innervation for superior turbinate, superior meatus, middle turbinate

posterior superior lateral nasal n.

what nerves of the ganglia travel anteriorly?

orbital branches

what nerves of the ganglia travel medially?

nasopalatine n.
posterior superior lateral nasal n.

what nerves of the ganglia travel inferiorly?

palatine n.
-greater and lesser palatine nn.
-posterior inferior lateral nasal n.

what nerves of the ganglia travel posteriorly?

pharyngeal n.
pterygoid/vidian n.

which nerve of the ganglia is the only one that does not transmit V2 sensory fibers?

pterygoid/vidian n.

parasympathetic fibers from which cranial nerve pass through the pterygopalatine fossa?

CN VII

preganglionic parasympathetic cell bodies for CN VII are located in the:

superior salivatory nucleus

autonomic fibers leave the pterygopalatine ganglion and travel with branches of what nerve

V2

the greater petrosal n. carries ____ _____ fibers:

preganglionic parasympathetic

parasympathetic fibers of CN VII will first travel through the ____ to enter the temporal bone:

internal acoustic meatus

parasympathetic fibers of CN VII will leave the temporal bone via the:

hiatus of facial canal

parasympathetic fibers of CN VII after leaving the hiatus of facial canal turn into the:

greater superficial petrosal n.

the greater superficial petrosal n. will join the deep petrosal n. at the:

vidian canal/ pterygoid canal

parasympathetics of VII heading to the lacrimal gland after jumping on the 2 short pterygopalatine nn. will travel on:

V2

parasympathetics of VII heading to the lacrimal gland after synapsing will travel on the:

2 short pterygopalatine nn.