the head

Temporal & Infratemporal FossaByDr. Adel Sahib Al-Mayaly

Lateral view of skull

It is a fan-shape space that covers the lateral surface of the skull.
Boundaries
Content
Temporal fossa

Boundaries:-

Superior Margin: Pair of temporal lines (Superior and inferior temporal lines).
Lateral Margin: Temporal fascia, a fan-shaped Aponeurosis overlying the temporalis muscle
Anterior Margin: Posterior surface of the zygomatic bone.
Inferior Margin: Zygomatic arch laterally; Infratemporal crest of the greater wing of the sphenoid medially


Overview

■Temporalis muscle

■Deep temporal arteries
■Deep temporal nerves
■Superficial temporal artery (from external carotid)
Contents

Temporal Fossa

Contents of temporal fossa

It is the space located deep to the ramus of the mandible.

Boundaries:-
Anteriorly :- the posterior surface of the maxilla.
Posteriorly:-by the styloid apparatus, carotid sheath and deep part of the parotid gland.
Medially:- the lateral pterygoid plate and the superior constrictor muscle of the pharynx.
.


Infratemporal Fossa

Laterally:- the ramus of the mandible.

The roof:- the infratemporal surface of the greater wing of the sphenoid.
The infratemporal fossa has no anatomical floor, being continuous with tissue spaces in the neck
Infratemporal Fossa

• The lateral and medial pterygoid muscles

• The mandibular division of the trigeminal nerve
• The chorda tympani branch of the facial nerve
• The otic parasympathetic ganglion.
The maxillary artery.
Pterygoid venous plexus.
CONTENTS OF THE INFRATEMPORAL FOSSA

is the lateral pterygoid muscle.

This lies in the roof of the fossa, running anteroposteriorly in a horizontal plane from the region of the pterygoid plates to the
mandibular condyle.


The key to understanding the relationships of structures within the infratemporal fossa.



1-Deep to the muscle arise the branches of the mandibular nerve and the main origin of the medial Pterygoid muscle.
2- The maxillary artery generally passes superficial to the lower head of the lateral pterygoid.
3- The buccal branch of the mandibular nerve passes between the two heads of lateral pterygoid m.
4- Emerging below the inferior border of the muscle are the medial pterygoid muscle and the lingual and inferior alveolar nerves.
5- At the upper border emerge the deep temporal nerves and vessels
6- Concentrated around and within the lateral pterygoid muscle lies a venous network, the pterygoid venous plexus.
Relation of structures

This is the largest division of the trigeminal nerve and is the only one to contain motor as well as sensory fibres.
Developmentally, it is the nerve of the first branchial arch and is thus responsible for supplying structures derived from it.
Its sensory fibres supply the mandibular teeth and their supporting structures, the mucosa of the anterior two-thirds of the tongue

THE MANDIBULAR NERVE

The mandibular nerve; is formed in the infratemporal fossa by
union of sensory & motor roots.
It leaves the skull at F. ovale
it lies on the tensor veli palatini muscle and is covered laterally by the upper head of the lateral pterygoid muscle (slightly anterior to the neck of the mandible).
After a short course, the nerve divides into a smaller anterior division and a larger posterior division


Course & branches

Its motor fibres; supply

1- the four ‘muscles of mastication’
2- the mylohyoid, anterior belly of digastric, tensor veli palatini and tensor tympani muscles.

Course & branches

the main trunk gives off two branches;
1-the meningeal branch and
2- the nerve to medial pterygoid
Then anterior division is mainly motor while the posterior division is mainly sensory.
Course & branches

Branches of anterior division:-

1- Masseteric nerve
2- Deep temporal nerves
3- Nerve to lateral pterygoid
4- Buccal nerve.
Course & branches


Posterior division:-
1- Auriculotemporal nerve
2- Lingual nerve
3- Inferior alveolar nerve
Course & branches

This parasympathetic ganglion lies immediately below the foramen ovale.

It lies on the medial surface of the main trunk of the
mandibular nerve.
It is concerned primarily with supplying the parotid gland.
THE OTIC GANGLION





The preganglionic parasympathetic fibres originate from the inferior salivatory nucleus in the brain stem.
The fibres pass out in the glossopharyngeal nerve (preganglionic).
Postganglionic fibres pass to the gland via the auriculotemporal nerve.
Otic Ganglion


is a terminal branch of the external carotid artery.
It arises within the parotid gland at the level of the neck of the condyle of the mandible.
It enters the infratemporal fossa between the deep surface of the condyle and the sphenomandibular ligament.
At this point, it lies below the auriculotemporal nerve and above the maxillary vein.

Maxillary Artery

It is closely related to the lateral pterygoid muscle.

The course is before, superficial to (2/3 of cases) & after the lateral pterygoid m.
It divides into 3 parts:-
1- Mandibular (first part).
2- Pterygoid (Second part).
3- Pterygopalatine (third part).


Maxillary artery

has five branches and all enter bone.

1- the deep auricular artery.
2- the anterior tympanic artery
3- The middle meningeal artery
4- Accessory meningeal artery
5- The inferior alveolar artery
The first part (Mandibular)

The second part has muscular branches

1- Deep temporal arteries.
2- pterygoid arteries
3- masseteric arteries.
4- A buccal artery
5- Small branch with buccal nerve.
Second Part (Pterygoid)


in the pterygopalatine fossa,
Gives five branches in the pterygopalatine F.
1- infraorbital artery:- It passes into the orbit via inferior orbital fissure (terminal branch)
It passes in the infra orbital canal & passes out at intraorbital foramen .
2- Sphenopalatine A ( Artery of epistaxis).
3- Posterior superior alveolar A (upper jaw).
4- The greater palatine artery.
5- The very small pharyngeal artery.
Third part(Pterygopalatine)

This is situated around, and within, the lateral pterygoid muscle and surrounds the maxillary artery.
Its tributaries correspond to the various branches of the maxillary artery
THE PTERYGOID VENOUS PLEXUS

The plexus communicates with:-

1- cavernous sinus.
2- the facial vein,
3-the inferior ophthalmic vein and
4- the pharyngeal plexus.
and then emerges as the maxillary vein
. This unites with the superficial temporal vein to form the retromandibular (posterior facial) vein.

Communications

The plexus receives blood from the following :-
1- pterygoid muscles,
2- the deep temporal veins,
3- the middle meningeal veins and
4- from parotid veins).

Tributaries

The Pterygopalatine fossa
Inverted ‘pyramid' -shaped space

Between bones on the lateral side of the skull

Immediately posterior to the maxilla

Small in size

Structures

Border

Infratemporal surface of the maxilla

Anterior wall

1-
Pterygoid process of the sphenoid

Posterior wall

2-
Perpendicular plate of the palatine


Medial wall

3-
Pterygomaxillary fissure
Lateral wall

4-
Inferior surface of the sphenoid and the orbital plate of the palatine bone

Superior wall

5-
None
Inferior wall

6-
Borders and Openings

1. The maxillary nerve [V2]

2. Terminal part of the maxillary artery


4. The pterygopalatine ganglion

5. Veins and lymphatics

Contents

Maxillary Nerve

1- within cranium;- MIDDLE MENINGEAL N.

2- PTERYGOPALATINE fossa;- 4 branches:-
1- Posterior superior alveolar n.
2- Zygomatic n.
3- Ganglionic branches
4- Infraorbital n.
Within infraorbital canal;-
1- middle superior alveolar n.
2- anterior sup. Alveolar n.


Branches

Entry point:- enters the fossa via pterygomaxillary fissure.

Course: runs through the pterygopalatine fossa.
• Its terminal branch, the sphenopalatine artery, passes through the sphenopalatine foramen
• Supplies:
Orbit
Anterior of face
Paranasal sinuses
Nasal cavity
Nasopharynx
Upper teeth
Palate

Pterygopalatine Segment of the Internal Maxillary Artery

The pterygopalatine ganglion is a relay station between
the superior salivary nucleus in the pons and the lacrimal
gland and mucous and serous glands of the palate, nose
and paranasal sinuses.
It is the ganglion of hay fever
Pterygopalatine ganglion


The ganglion lies below and medial to the foramen rotundum
Preganglionic nerves:-
1- greaterb petrosal nerve ( parasympathetic)
2- deep petrosal n. (sympathetic).
Pterygopalatine ganglion

Post-ganglionic nerves:-

Maxillary nerve.
Pterygopalatine ganglion