Infratemporal Fossa Part II

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Infratemporal FossaPart II
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Deep Contents of the infratemporal fossa

• Muscles tensor palati and levator palati.
• Nerve Maxillary nerve and it branches.
• Autonomic ganglion Spheno-palatine ganglion.
• Arteries 3rd part of maxillary artery and its
  branches (mentioned before).

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Tensor Palati

• Origin 1. Spine of sphenoid
• 2. Scaphoid fossa
• 3. Outer wall of auditory tube
• Insertion Palatine aponeurosis (the tendon hooks
  on the pterygoid hamulus).
• Nerve supply Nerve to medial pterygoid from main
  trunk of mandibular nerve.
• Action It tenses the soft palate.

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Levator Palati

• Origin 1. Inferior surface of the petrous
• part of the temporal bone.
• 2. Lower surface of auditory tube
• Insertion Palatine aponeurosis.
• Nerve supply Pharyngeal plexus (cranial part of
  accessory nerve).
• Action It elevates the soft palate.

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Maxillary nerve

• One of the divisions of the trigeminal nerve
• It is a pure sensory nerve.
• It passes in the lateral wall of the cavernous
  sinus.
• Then leaves the skull through foramen rotundum to
  enter the pterygopalatine fossa.
• It curves laterally through the pterygomaxillary
  fissure to lie deep in the infratemporal fossa.
• Through the inferior orbital fissure, it enters
  the floor of the orbit and continues as
  infraorbital nerve, which runs in the
  infraorbital groove, canal then foramen and
  terminates in the face.

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Branches

• From of maxillary nerve
• Meningeal branch supplies the dura of the middle
  cranial fossa.
• Two ganglionic branches which hang the
  sphenopalatine ganglion, they contain sensory
  fibers coming from nose, palate and pharynx and
  postganglionic fibers going to the lacrimal
  gland.
• Zygomatic branch arises in the pterygopalatine
  fossa and enters the orbit through the inferior
  orbital fissure. It divides into
  zygomatico-temporal and zygomatico-facial
  branches that supply skin of the face.

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Branches

• Posterior superior alveolar nerve arises in the
  pterygopalatine fossa and pierces the posterior
  surface of the maxilla to supply the maxillary
  sinus, the upper molar teeth and adjoining parts
  of the gum and cheek.
• From of infraorbital nerve
• Middle superior alveolar nerve arises in the
  infraorbital groove and descends on the lateral
  wall of the maxillary sinus to supply the upper
  premolar teeth and adjoining parts of the gum and
  cheek.

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Branches

• Anterior superior alveolar nerve arises in the
  infraorbital canal and descends on the anterior
  wall of the maxillary sinus to supply the upper
  canine and incisor teeth and adjoining parts of
  the gum and a small part of the lateral wall and
  floor of the nasal cavity
• Terminal Branches in the face after its exit
  through the infraorbital foramen it divides into
  palpebral, nasal and labial branches which supply
  skin of the face.

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Sphenopalatine ganglion

• A parasympathetic ganglion which lies in the
  pterygopalatine fossa, hanged by two roots from
  the maxillary nerve.
• Roots
• Preganglionic Parasympathetic root from the
  lacrimal nucleus (in the brain stem), to the
  facial nerve which gives the greater petrosal
  nerve which enters the pterygoid canal, unites
  with the deep petrosal nerve to form the nerve of
  pterygoid canal which joins the ganglion from its
  posterior aspect where they relay inside the
  ganglion and gives postganglionic branches.
• Postganglionic Sympathetic root from the deep
  petrosal nerve which is a branch from the
  internal carotid nerve in the foramen lacerum
  (the sympathetic plexus around the internal
  carotid artery from the upper deep cervical
  sympathetic ganglion). The deep petrosal nerve
  unites with the greater petrosal nerve to form
  the nerve of pterygoid canal (vedian nerve).
• Two Sensory roots from the maxillary nerve.

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Sphenopalatine ganglion

• Secretomotor Branches
• To the lacrimal gland through the maxillary
  nerve ? zygomatic branch ? zygomatico-temporal
  branch ? communicates with the lacrimal nerve ?
  the lacrimal gland.
• To the mucous glands of the nose, palate.
• Sensory Branches from the maxillary nerve to the
  nose, palate, pharynx and orbit
• Orbital branches through the inferior orbital
  fissure.
• Greater and lesser palatine nerves.
• Nasal branches.
• Pharyngeal branches.

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Pterygopalatine fossa

• Boundaries
• Anterior posterior surface of maxilla.
• Posterior pterygoid process.
• Medial perpendicular plate of palatine bone.
• Lateral infratemporal fossa (through
  pterygomaxillary fissure).
• Contents
• Maxillary nerve and branches.
• Sphenopalatine ganglion and branches.
• 3rd part of maxillary artery and branches.

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Pterygopalatine fossa

• Communications
• Ptergomaxillary fissure ? infratemporal fossa.
• Foramen rotundum ? middle cranial fossa.
• Sphenopalatine foramen ? nasal cavity.
• Inferior orbital fissure ? orbital cavity.
• Greater palatine canal ? palate.
• Palatinovaginal canal ? nasopharynx.
• Pterygoid canal ? foramen lacerum.

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