TEMPORAL

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TEMPORAL INFRATEMPORAL FOSSA I
Dr. Ahmed Fathalla Ibrahim
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TEMPORAL FOSSA
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TEMPORAL FOSSA
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INFRATEMPORAL FOSSA
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TEMPORAL FOSSA

• BOUNDARIES
• Anterior Zygomatic process of frontal bone
  zygomatic bone
• Superior Posterior Temporal lines
• Inferior Zygomatic arch

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TEMPORAL FOSSA

• CONTENTS
• Temporalis muscle
• Deep temporal nerve vessels
• Superficial temporal vessels
• Auriculotemporal nerve

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INFRATEMPORAL FOSSA

• BOUNDARIES
• Superficial (lateral) Ramus of mandible
• Deep (medial) Lateral pterygoid plate
• Superior Infratemporal surface of greater wing
  of sphenoid
• Anterior Tuberosity of maxilla

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INFRATEMPORAL FOSSA

• COMMUNICATIONS
• With temporal fossa through a gap deep to
  zygomatic arch
• With cranial cavity through foramen ovale,
  foramen spinosum, foramen lacerum
• With orbit through inferior orbital fissure
• With pterygopalatine fossa through
  pterygomaxillary fissure

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INFRATEMPORAL FOSSA

• CONTENTS
• Lateral medial pterygoid muscles
• Mandibular nerve its branches
• A part of maxillary nerve 2 of its branches
• Otic ganglion
• Chorda tympani
• A part of maxillary artery 2 of its branches
• Pterygoid plexus of veins

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THE MANDIBLE
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TEMPOROMANDIBULAR JOINT
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TEMPOROMANDIBULAR JOINT

• TYPE synovial, condylar variety
• ARTICULAR SURFACES
• Upper mandibular fossa articular tubercle
• Lower head of mandible
• CAPSULE attached to
• margins of mandibular fossa articular tubercle
• Neck of mandible

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TEMPOROMANDIBULAR JOINT

• JOINT CAVITY divided into upper lower parts by
  an articular disc
• ARTICULAR DISC a plate of fibrocartilage with a
  concavoconvex upper surface and a concave lower
  surface
• LIGAMENTS
• Lateral temporomandibular from tubercle on the
  root of zygoma to lateral surface of neck of
  mandible
• Sphenomandibular from spine of sphenoid to
  lingula of mandible
• Stylomandibular

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TEMPOROMANDIBULAR JOINT

• NERVE SUPPLY auriculotemporal
• ARTERIAL SUPPLY maxillary
• MOVEMENTS elevation, depression, protrusion,
  retraction, chewing (side-to- side) movements
• RELATIONS
• Anterior mandibular notch, masseteric nerve
  vessels
• Posterior tympanic plate of temporal bone
• Lateral Parotid gland
• Medial auriculotemporal nerve, maxillary artery

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MUSCLES OF MASTICATION

• TEMPORALIS
• MASSETER
• LATERAL PTERYGOID
• MEDIAL PTERYGOID
• They are derived from mesoderm of 1st branchial
  arch
• They originate from temporal or infratemporal
  fossa
• They are inserted into ramus of mandible
• They are supplied, through their deep surfaces by
  branches of mandibular nerve
• They act on temporomandibular joint

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MUSCLES OF MASTICATION
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MUSCLES OF MASTICATION
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TEMPORALIS

• ORIGIN floor of temporal fossa deep surface of
  temporal fasica
• INSERTION the tendon passes deep to zygomatic
  arch to be inserted to all coronoid process
  (except its lateral surface)
• NERVE SUPPLY 2 deep temporal nerves from
  anterior division of mandibular nerve
• ACTION
• Elevation of mandible
• Its posterior fibers retract the mandible

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MASSETER

• ORIGIN lower border inner surface of zygomatic
  arch
• INSERTION lateral surface of ramus of mandible
• NERVE SUPPLY from anterior division of
  mandibular nerve
• ACTION
• Elevation of mandible
• Protrusion of mandible (when muscles on both
  sides act together)
• Side-to-side movement (when muscles on both sides
  act alternatively)

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LATERAL PTERYGOID

• ORIGIN
• Upper head infratemporal surface of greater wing
  of sphenoid
• Lower head lateral surface of lateral pterygoid
  plate
• INSERTION pterygoid fovea (in front of neck of
  mandible) capsule articular disc of TMJ
• NERVE SUPPLY from anterior division of
  mandibular nerve
• ACTION
• Pulls the condylar process forward to depress the
  mandible
• Protrusion of mandible (when muscles on both
  sides act together)
• Side-to-side movement (when muscles on both sides
  act alternatively)

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MEDIAL PTERYGOID

• ORIGIN
• Superficial head tuberosity of maxilla
• Deep head medial surface of lateral pterygoid
  plate
• INSERTION medial surface of ramus angle of
  mandible
• NERVE SUPPLY from trunk of mandibular nerve
• ACTION
• Elevation of mandible
• Protrusion of mandible (when muscles on both
  sides act together)
• Side-to-side movement (when muscles on both sides
  act alternatively)

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ALL MUSCLES OF MASTICATION

• Elevate mandible EXCEPT
• Lateral pterygoid
• Protrude mandible EXCEPT
• Temporalis
• Are supplied by anterior division of mandibular
  nerve EXCEPT
• Medial pterygoid

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MANDIBULAR NERVE
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INFRATEMPORAL FOSSA
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MANDIBULAR NERVE

• COMPOSITION
• Formed of 2 roots motor sensory
• ORIGIN
• Sensory root peripheral processes of cells of
  trigeminal ganglion in the middle cranial fossa
• Motor root axons of cells of motor nucleus of
  trigeminal nerve in pons

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MANDIBULAR NERVE

• COURSE
• Both roots emerge separately through foramen
  ovale to infratemporal fossa
• The 2 roots unite, below foramen ovale
• The nerve soon divides into a small anterior a
  large posterior division

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MANDIBULAR NERVE

• RELATIONS
• Superficial lateral pterygoid
• Deep otic ganglion
• Posterior middle meningeal artery

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BRANCHES FROM TRUNKOF MANDIBULAR NERVE

• One motor Nerve to medial pterygoid supplies
  medial pterygoid gives off 2 branches that pass
  through otic ganglion (without relay) supply
  tensor palati tensor tympani muscles
• One sensory meningeal branch (nervus spinosus)
  passing through foramen spinosum to supply
  meninges of middle cranial fossa

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BRANCHES FROM ANTERIOR DIVISION OF MANDIBULAR
NERVE

• Four branches
• Three motor
• Masseteric nerve emerges through upper border of
  lateral pterygoid turns along mandibular notch
  to reach masseter
• Deep temporal nerves emerge through upper border
  of lateral pterygoid
• Nerve to lateral pterygoid
• One sensory
• Buccal nerve emerges between the 2 heads of
  lateral pterygoid, supplies skin mucous
  membrane overlying buccinator

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BRANCHES FROM POSTERIOR DIVISION OF MANDIBULAR
NERVE

• Four branches
• Three sensory
• Auriculotemporal nerve
• Arises by 2 roots encircling middle meningeal
  artery
• Runs backward, deep to neck of mandible
• Gives sensory branches to skin of auricle,
  temple, TMJ parotid gland
• Carries postganglionic parasympathetic
  secretomotor fibers from otic ganglion to parotid
  gland

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BRANCHES FROM POSTERIOR DIVISION OF MANDIBULAR
NERVE

• Lingual nerve
• Emerges through lower border of lateral pterygoid
  then superficial to medial pterygoid
• Joins chorda tympani
• Runs just below 3rd molar tooth (dangerous
  position because it is only covered by muscous
  membrane)
• Runs superficial to hyoglossus is connected to
  submandibular ganglion by 2 roots
• Carries general sensations from anterior 2/3 of
  tongue

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BRANCHES FROM POSTERIOR DIVISION OF MANDIBULAR
NERVE

• Inferior alveolar nerve
• Emerges through lower border of lateral pterygoid
  then superficial to medial pterygoid, behind
  lingual nerve
• Passes through mandibular foramen canal to
  supply lower teeth
• Emerges through mental foramen as mental nerve
  supplying skin of lower lip chin

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BRANCHES FROM POSTERIOR DIVISION OF MANDIBULAR
NERVE

• One motor
• Mylohyoid nerve
• A branch of inferior alveolar nerve just above
  mandibular foramen
• Passes in mylohyoid groove of mandible
• Supplies mylohyoid anterior belly of digastric
  muscles

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RELATIONS OF LATERAL PTERYGOID
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RELATIONS OF LATERAL PTERYGOID

• Superficial temporalis, masseter, ramus of
  mandible, maxillary artery, buccal nerve
• Deep medial pterygoid, mandibular nerve, middle
  meningeal artery, otic ganglion
• Emerging through its upper border deep temporal
  masseteric nerves
• Emerging through its lower border lingual
  inferior alveolar nerves maxillary artery
• Emerging between its 2 heads buccal nerve,
  maxillary artery