Courtney Takahashi

Anatomy 4 – Deep Face

23 September 2006

Identify the following skeletal elements:

 Mandible
 Temporal fossa (p. 979 of Moores)
 Infratemporal fossa (p. 979 of Moores)
 TMJ
 Pterygomaxillary fissure (plate 4 of netters)
 Pterygopalatine fossa (small pyramidal space inferior to apex of the orbit) (plate 4)

Grants:
o Superior and inferior temporal lines
o Zygomatic arch
o Mandibular fossa and articular tubercle

Within the temporal mandibular joint:

 Condyle of the mandible (palpable, just anterior to the tragus) (plate 13)
 Mandibular fossa (plate 14)
 Articular disc (plate 14)
 Stylomandibular ligament (plate 14)

Grants:
o Lingular
o Mandibular foramen
o Mylohyoid groove
o Pterygomaxillary fissure
o Inferior orbital fissure
o Infratemporal surface of maxilla
o Greater wing of sphenoid bone
o Lateral plate of pterygoid process
o Pterygopalatine fossa
o Sphenopalatine foramen

Maxillary Artery
 Mandibular
o Deep auricular
o Deep temporal
o Anterior tympanic
o Middle meningeal
o Accessory meningeal
o Inferior alveolar
 Pterygoid
 o Masseteric artery
o Temporals
o Pterygoid
o Buccal
 Pterygopalatine
o Posterior superior alveolar
o Infraorbital artery with branches to maxillary teeth
o Descending palatine with greater and lesser palatine branches
o Artery to pterygoid canal
o Sphenopalatine artery, arteries to nasal cavity

Maxillary Vein, terminates when it joins with temporal vein and forms retromandibular vein

Trigeminal Nerve (CN V)

Maxillary Division (V2)
o Infraorbital nerve
o Posterior superior alveolar nerve
o Middle superior alveolar nerve
o Anterior superior alveolar nerve
o Palatine nerve
o Zygomaticofacial and zygomaticotemporal nerve
o Nasopalatine nerve

Mandibular division
o Buccal nerve
o Auriculotemporal
o Lingual*, find, and provides general sensation to anterior 2/3 of tongue
o Inferior alveolar nerve, mental nerve

Muscles of Mastication (what is their innervation?)

 Temporalis muscle
o Blood supply? Maxillary and superficial temporal arteries
o Functions? Elevate mandible, retract mandible
 Masseter
o Attachments? Zygomatic to ramus angle of mandible
o Blood supply? Masseteric branch of maxillary artery
o Function? Elevates mandible and occludes teeth during mastication
 Medial pterygoid
o Attachments? Medial surface of lateral pterygoid plate and internal angle of mandible
o Blood supply? Pterygoid branch of maxillary artery
o Functions? Elevates mandible, grinding, protrude mandible
 Lateral pterygoid
o Attachments? Zygomatic to angle of mandibular ramus
o Blood supply? Masseteric branch of maxillary artery
 o Function? Protrude jaw, swings mandible to contralateral side during chewing
 Digastrics?
o Attachments? Post. belly  mastoid, ant  digastric fossa of mandible, both to hyoid
o Blood? Post  post auricular, occipital; Ant.  submental branch of facial
o Function? Depress mandible and stabilize hyoid
o Nerve? Post.  VII, Ant.  V3

How could a person dislocate
the TMJ?
What are signs of arthritis TMJ?
What are the communications of
the pterygopalatine fossa?
What are the contents of the
pterygopalatine fossa?
1st 15° condylar head rotation, but beyond 15°, the condyle translates
laterally. Thus, if a person had a shallow mandibular opening, the jaw can
become displaced.
Malocclusion and crepitus
Lateral – Pterygomaxillary fissure  infratemporal fossa
Medial – Nasal cavity  sphenopalatine foramen
Anterosuperiorly – Inferior orbital fissure  orbit
Posterosuperiorly – f. rotundum and pterygoid canal  middle cranial fossa
Pterygopalatine portion of maxillary artery with branches
Maxillary nerve components, including:
 Pterygopalatine ganglion
 Descending palatine nerve
 Infraorbital branch of V2
 Nerve to pterygoid canal