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Dr. Ahmed Fathalla Ibrahim. TEMPORAL FOSSA INFRATEMPORAL FOSSA.

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Presentation on theme: "Dr. Ahmed Fathalla Ibrahim. TEMPORAL FOSSA INFRATEMPORAL FOSSA."— Presentation transcript:

1 Dr. Ahmed Fathalla Ibrahim

2 TEMPORAL FOSSA

3

4 INFRATEMPORAL FOSSA

5 TEMPORAL FOSSA BOUNDARIES: Anterior:Anterior: Zygomatic process of frontal bone + zygomatic bone Superior & Posterior:Superior & Posterior: Temporal lines Inferior:Inferior: Zygomatic arch

6 TEMPORAL FOSSA CONTENTS: 1.Temporalis muscle 2.Deep temporal nerve & vessels 3.Superficial temporal vessels 4.Auriculotemporal nerve

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

8 INFRATEMPORAL FOSSA COMMUNICATIONS: 1.With temporal fossa: 1.With temporal fossa: through a gap deep to zygomatic arch 2.With cranial cavity: foramen ovale, foramen spinosum, foramen lacerum 2.With cranial cavity: through foramen ovale, foramen spinosum, foramen lacerum 3.With orbit: inferior orbital fissure 3.With orbit: through inferior orbital fissure 4.With pterygopalatine fossa: pterygomaxillary fissure 4.With pterygopalatine fossa: through pterygomaxillary fissure

9 INFRATEMPORAL FOSSA CONTENTS: 1.Lateral & medial pterygoid muscles 2.Mandibular nerve & its branches 3.A part of maxillary nerve & 2 of its branches 4.Otic ganglion 5.Chorda tympani 6.A part of maxillary artery & 2 of its branches 7.Pterygoid plexus of veins

10 THE MANDIBLE

11 TEMPOROMANDIBULAR JOINT

12 TYPE:TYPE: synovial, condylar variety ARTICULAR SURFACES:ARTICULAR SURFACES: 1.Upper: 1.Upper: mandibular fossa + articular tubercle 2.Lower: 2.Lower: head of mandible CAPSULE:CAPSULE: attached to: 1.margins of mandibular fossa & articular tubercle 2.Neck of mandible

13 TEMPOROMANDIBULAR JOINT JOINT CAVITY:JOINT CAVITY: divided into upper & lower parts by an articular disc ARTICULAR DISC:ARTICULAR DISC: a plate of fibrocartilage with a concavoconvex upper surface and a concave lower surface LIGAMENTSLIGAMENTS 1.Lateral temporomandibular: 1.Lateral temporomandibular: from tubercle on the root of zygoma to lateral surface of neck of mandible 2.Sphenomandibular: 2.Sphenomandibular: from spine of sphenoid to lingula of mandible 3.Stylomandibular

14 TEMPOROMANDIBULAR JOINT NERVE SUPPLY:NERVE SUPPLY: auriculotemporal ARTERIAL SUPPLY:ARTERIAL SUPPLY: maxillary MOVEMENTS:MOVEMENTS: elevation, depression, protrusion, retraction, chewing (side-to- side) movements RELATIONSRELATIONS 1.Anterior: 1.Anterior: mandibular notch, masseteric nerve & vessels 2.Posterior: 2.Posterior: tympanic plate of temporal bone 3.Lateral: 3.Lateral: Parotid gland 4.Medial: 4.Medial: auriculotemporal nerve, maxillary artery

15 MUSCLES OF MASTICATION 1.TEMPORALIS 2.MASSETER 3.LATERAL PTERYGOID 4.MEDIAL PTERYGOID They are derived from mesoderm of 1 st branchial archThey are derived from mesoderm of 1 st branchial arch They originate from temporal or infratemporal fossaThey originate from temporal or infratemporal fossa They are inserted into ramus of mandibleThey are inserted into ramus of mandible They are supplied, through their deep surfaces by branches of mandibular nerveThey are supplied, through their deep surfaces by branches of mandibular nerve They act on temporomandibular jointThey act on temporomandibular joint

16 MUSCLES OF MASTICATION

17

18 TEMPORALIS ORIGIN:ORIGIN: floor of temporal fossa & deep surface of temporal fasica INSERTION:INSERTION: the tendon passes deep to zygomatic arch to be inserted to all coronoid process (except its lateral surface) NERVE SUPPLY: anterior divisionNERVE SUPPLY: 2 deep temporal nerves from anterior division of mandibular nerve ACTION:ACTION: 1.Elevation of mandible 2.Its posterior fibers retract the mandible

19 MASSETER ORIGIN:ORIGIN: lower border & inner surface of zygomatic arch INSERTION:INSERTION: lateral surface of ramus of mandible NERVE SUPPLY: anterior divisionNERVE SUPPLY: from anterior division of mandibular nerve ACTION:ACTION: 1.Elevation of mandible 2.Protrusion of mandible (when muscles on both sides act together) 3.Side-to-side movement (when muscles on both sides act alternatively)

20 LATERAL PTERYGOID ORIGIN:ORIGIN: 1.Upper head: 1.Upper head: infratemporal surface of greater wing of sphenoid 2.Lower head: lateral surface 2.Lower head: lateral surface of lateral pterygoid plate INSERTION:INSERTION: pterygoid fovea (in front of neck of mandible) + capsule & articular disc of TMJ NERVE SUPPLY: anterior divisionNERVE SUPPLY: from anterior division of mandibular nerve ACTION:ACTION: 1.Pulls the condylar process forward to depress the mandible 2.Protrusion of mandible (when muscles on both sides act together) 3.Side-to-side movement (when muscles on both sides act alternatively)

21 MEDIAL PTERYGOID ORIGIN:ORIGIN: 1.Superficial head: 1.Superficial head: tuberosity of maxilla 2.Deep head: medial surface 2.Deep head: medial surface of lateral pterygoid plate INSERTION:INSERTION: medial surface of ramus & angle of mandible NERVE SUPPLY: trunkNERVE SUPPLY: from trunk of mandibular nerve ACTION:ACTION: 1.Elevation of mandible 2.Protrusion of mandible (when muscles on both sides act together) 3.Side-to-side movement (when muscles on both sides act alternatively)

22 ALL MUSCLES OF MASTICATION Elevate mandible EXCEPT Lateral pterygoidLateral pterygoid Protrude mandible EXCEPT TemporalisTemporalis Are supplied by anterior division of mandibular nerve EXCEPT Medial pterygoidMedial pterygoid

23 MANDIBULAR NERVE

24 INFRATEMPORAL FOSSA

25 MANDIBULAR NERVE COMPOSITION:COMPOSITION: 2 rootsmotor & sensoryFormed of 2 roots: motor & sensory ORIGIN:ORIGIN: Sensory root:Sensory root: peripheral processes of cells of trigeminal ganglion in the middle cranial fossa Motor root:Motor root: axons of cells of motor nucleus of trigeminal nerve in pons

26 MANDIBULAR NERVE COURSE:COURSE: separately foramen ovale infratemporal fossaBoth roots emerge separately through foramen ovale to infratemporal fossa unite, belowThe 2 roots unite, below foramen ovale dividesa small anterior & a large posterior divisionThe nerve soon divides into a small anterior & a large posterior division

27 MANDIBULAR NERVE RELATIONS:RELATIONS: 1.Superficial: 1.Superficial: lateral pterygoid 2.Deep: 2.Deep: otic ganglion 3.Posterior: 3.Posterior: middle meningeal artery

28 BRANCHES FROM TRUNK OF MANDIBULAR NERVE One motor: medial pterygoid: tensor palatitensor tympani musclesOne 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)One sensory: meningeal branch (nervus spinosus) passing through foramen spinosum to supply meninges of middle cranial fossa

29 BRANCHES FROM ANTERIOR DIVISION OF MANDIBULAR NERVE Four branches Three motor: Masseteric nerve:Masseteric nerve: emerges through upper border of lateral pterygoid & turns along mandibular notch to reach masseter Deep temporal nerves:Deep temporal nerves: emerge through upper border of lateral pterygoid Nerve to lateral pterygoidNerve to lateral pterygoid One sensory: Buccal nerve:Buccal nerve: emerges between the 2 heads of lateral pterygoid, supplies skin & mucous membrane overlying buccinator

30 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 sensory branchesGives sensory branches to skin of auricle, temple, TMJ & parotid gland postganglionic parasympathetic secretomotorCarries postganglionic parasympathetic secretomotor fibers from otic ganglion to parotid gland

31 BRANCHES FROM POSTERIOR DIVISION OF MANDIBULAR NERVE Lingual nerve: Emerges through lower border of lateral pterygoid then superficial to medial pterygoid Joins chorda tympani dangerous positionRuns just below 3 rd 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

32 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 mental nerveEmerges through mental foramen as mental nerve supplying skin of lower lip & chin

33 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 mylohyoid & anterior belly of digastric musclesSupplies mylohyoid & anterior belly of digastric muscles

34 RELATIONS OF LATERAL PTERYGOID

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


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