1. A shallow fossa on the side of the head
Temporal fossa
A shallow fossa on the side of the head
Boundaries:
Zygomatic arch, below
Temporal lines, above
Frontozygomatic process, anteriorly
Supramastoid crest

2. Muscles of Mastication
Temporalis ms.
O: floor of temporal fossa & inner surface of temporal fascia
I: coronoid process of the mandible A:
elevation of the mandible
the posterior fibres retract the protruded mandible
N: deep temporal nerves (anterior division of mandibular nerve)
Masseter ms.
O: lower border and inner surface of zygomatic arch
I: outer surface of the ramus of mandible
A: elevation of the mandible
N: nerve to masseter (anterior division of mandibular nerve)
Temporalis &
Temporal fascia
Masseter
Temporalis

3. Lateral pterygoid ms. Medial pterygoid ms. O: by two heads
1.upper head: infratemporal crest and infratemporal surface of greater wing of sphenoid
2.lower head: lateral surface of lateral pterygoid plate
I: -pterygoid fovea (front of the neck of mandible)
-capsule and articular disc of temporomandibular joint
A: 1.pulls the head of mandible forwards (during opening of the mouth)
2.side to side movement of the mandible (chewing)
3.protrusion of the mandible
N: nerve to lateral pterygoid (anterior division of mandibular nerve)
Lateral
pterygoid
Medial pterygoid
Buccinator
Lateral pterygoid
Medial pterygoid
Medial pterygoid ms.
O: arises by two heads
-superficial head: tuberosity of the maxilla
-deep head: medial surface of lateral pterygoid plate
I: -inner surface of the ramus of mandible
A: -elevation of the mandible
-side to side movement (chewing)
-protrusion of the mandible
N: -nerve to medial pteryoid (trunk of mandibular nerve)

4. Infratemporal Fossa The space deep to the ramus of the mandible
Communicates with the temporal fossa deep to the zygomatic arch
Boundaries:
Ant: posterior surface of the maxilla
Lat: ramus of the mandible
Med: lateral pterygoid plate
pterygomaxillary fissure
Roof: infratemporal surface of the greater wing of sphenoid
Greater wing
of sphenoid
Zygomatic arch
M a x i l l a
Communications of the infratemporal fossa:
With the:
Temporal fossa: deep to the zygomatic arch
Pterygopalatine fossa: through the pterygomaxillary fissure
Orbital cavity: through the inferior orbital fissure
Lateral pterygoid
plate
Infratemporal fossa

5. Contents of the Infratemporal Fossa
Muscles:
Lateral & medial pterygoid ms.
Tensor & levator palati ms.
Insertion of temporalis ms.
Lateral pterygoid
Nerves:
Mandibular nerve
Otic ganglion
Maxillary nerve (a small part)
Chorda tympani (from facial N)
Maxillary artery
ECA
Medial pterygoid
Vessels:
Maxillary artery
Pterygoid plexus of veins
Trigeminal
ganglion
Mandibular n.
Maxillary n.

6. Levator & tensor palati
Tensor palati and levator palati muscles
Tensor palati:
O: -scaphoid fossa and posterior border of greater wing of sphenoid
-outer wall of auditory tube
I: palatine aponeurosis (the tendon hooks on the pterygoid hamulus and turns medially to reach insertion)
N: nerve to medial pterygoid (mandibular)
A: - muscles of both sides make the palate tense
-acting on one side, it pulls the soft palate to its side
Auditory
tube
Levator & tensor palati
Lateral
pterygoid
Levator
palati
medial
pterygoid
Tensor
palati
Pterygoid
hamulus
Soft palate
Levator palati:
O: -inferior surface of petrous temporal bone
-outer wall of auditory tube
I: palatine aponeurosis
N: cranial part of accessory nerve
A: -elevation of the soft palate

7. Mandibular Nerve Branches: From the trunk:
The largest division of the trigeminal nerve
A mixed nerve, formed of a thick sensory and a small motor root
The two roots leave the cranial cavity through the Foramen Ovale
Below the foramen ovale, the 2 roots unite to form the trunk of the nerve
The trunk is very short and divides into anterior and posterior divisions
The anterior division is mainly motor
The posterior division is mainly sensory
Lesser
petrosal n.
Tensor tympani
Nervus
spinosus
Medial & sensory roots
of mandibular n
Otic ganglion
Tensor palati
Auriculotemporal n.
Lingual n.
Chorda tympani
Inferior alveolar n.
Branches:
Mylohoid nerve
From the trunk:
Nerve to medial pterygoid (motor):
It gives a branch which runs through the otic ganlion without relay and divides into 2 branches which supply the tensor palati and tensor tympani ms.
Nervus spinosus (sensory):
Passes through the Foramen spinosum into the cranial cavity
Medial pterygoid

8. From the anterior division:
(muscular branches + one sensory branch)
Deep temporal nerves (supply the temporalis ms)
Nerve to masseter
Nerve to lateral pterygoid
Buccal nerve (sensory): supplies skin over the buccinator, and mucosal lining of buccinator ms.
Deep temporal
nerves
Auriculotemporal
nerve
Inferior alveolar
nerve
Lingual
nerve
Buccal nerve
From the posterior division: (sensory branches + one muscular branch)
Auriculotemporal nerve
arises by 2 roots (which embrace the middle meningeal artery) and passes backwards deep to the neck of the mandible to enter the parotid gland
Leaves the gland through its upper end and supplies the scalp
Supplies sensory fibres to the parotid gland and carries postganglionic parasympathetic fibres from the otic ganglion to the parotid gland

9. Joined by the chorda tympani at the lower border of lateral pterygoid
2. Lingual nerve
Joined by the chorda tympani at the lower border of lateral pterygoid
Descends between the ramus of mandible and medial pterygoid.
Reaches the floor of the mouth by passing on the medial side of the 3rd molar tooth (dangerous position)
Carries general sensations from the anterior 2/3 of the tongue
The chorda tympani carries taste sensations from the anterior 2/3 of the tongue and preganglionic parasympathetic fibres to the submandibular and sublingual glands
3. Inferior alveolar nerve
Runs with the inferior alveolar vessels (behind the lingual nerve) to reach the mandibular foramen
Before it passes through the mandibular foramen it gives the mylohyoid nerve (motor)
The mylohyoid nerve supplies the mylohyoid ms and anterior belly of digastric
The inferior alveolar nerve continues through mandibular canal and divides into mental and incisive branches
The mental branch comes out of the mental foramen to supply skin of the chin
Inferior alveolar
nerve
Lingual nerve
Mylohoid nerve
& vessels
Mylohoid m.

10. Otic Ganglion
A parasympathetic ganglion which lies in the infratemporal fossa just below the foramen ovale
Otic ganglion
Tensor tympani & n.
Lesser petrosal n.
Roots:
Parasympathetic root: from the inferior salivary nucleus (carried by the lesser petrosal nerve)
Sympathetic root: from the plexus around the middle meningeal artery
Motor root: from the nerve to medial pterygoid
Auriculo-
temporal n.
Tensor palati & n.
ECA
Inferior alveolar n.
Branches:
Postganglionic parasympathetic fibers carried by the auriculotemporal nerve to the parotid gland
Sympathetic fibers to the parotid vessels
Motor fibres: to the tensor palati and tensor tympani ms.
Medial pterygoid
Mylohyoid n.

11. The preganglionic fibres arise from the inferior salivary nucleus in the brain stem
They run with CN IX, then through its tympanic branch to join the tympanic plexus
The fibres are then carried by the lesser petrosal nerve which leaves through the foramen ovale and terminates in the otic ganglion
Foramen ovale
Tympanic plexus
Glossopharyngeal nerve
Inferior salivary nucleus
Tympanic branch
of glossopharyngeal
Lesser petrosal nerve
Auriculotemporal nerve
Otic ganglion

12. Maxillary Nerve One of the 3 divisions of trigeminal nerve
A pure sensory nerve
Course:
Leaves the cranial cavity by passing through the foramen rotundum into the pterygopalatine fossa
Deviates laterally through the pterygomaxillary fissure for a short distance
Passes through the inferior orbital fissure to continue as the infraorbital nerve
The infraorbital nerve passes through the infraorbital groove, canal and foramen and terminates in the face
Ophthalmic n.
Infraorbital nerve
Trigeminal
ganglion
Maxillary nerve
Mandibular n.

13. Branches From the maxillary nerve: From the infraorbital nerve:
Meningeal branch: arises in the cranial cavity
Two roots to the sphenopalatine ganglion
Zygomatic nerve: passes through the inferior orbital fissure into the orbit
Posterior superior alveolar nerve: passes through the posterior surface of the maxilla, and supplies upper molar teeth
From the infraorbital nerve:
Middle superior alveolar: supplies upper premolar teeth
Anterior superior alveolar: (nervus sinuosus) supplies upper canine and incisors
Terminal branches in the face: palpebral, nasal, labial
Zygomatic n.
Terminal branches
in the face
Meningeal branch
Sphenopalatine
ganglion
Posterior superior
alveolar n.
Middle & anterior
superior alveolar n.

14. Maxillary Artery Origin: Course: One of the 2 terminal branches of ECA
Takes origin behind the neck of the mandible, inside the parotid gland
Lateral pterygoid m
Maxillary artery
ECA
Course:
1st part: runs deep to the neck of the mandible
2nd part: runs on the outer surf of lateral pterygoid
3rd part: dips between the 2 heads of lateral pterygoid, then through the pterygomaxillary fissure to terminate in the pterygoplatine fossa

15. Branches of the Maxillary Artery
1st part:
Deep auricular
Anterior tympanic
Middle meningeal
Accessory meningeal
Inferior alveolar
Meningeal & accessory
meningeal a.
Deep auricular &
anterior tympanic a.
Deep auricular artery
Ascends through the parotid gland
Enters the external acoustic meatus to supply the outer surface of the tympanic membrane
Anterior tympanic artery
Ascends though the parotid gland
Passes through the petrotympanic fissure to reach the middle ear
Anastomoses with the posterior tympanic and caroticotympanic arteries forming an arterial circle on the inner surface of tympanic membrane
Maxillary a.
Inferior alveolar a.
ECA
Middle meningeal artery
Runs upwards between the 2 roots of auriculotemporal nerve
Enters the cranial cavity through the foramen spinosum
Accessory meningeal artery
Runs upwards and enters the cranial cavity through the foramen ovale

16. 2nd part: (muscular branches)
Masseteric
Deep Temporal
Pterygoid
Buccal
Deep temporal a.
Maxillary a.
Inferior alveolar a.
ECA
Muscular branches

17. 3rd part: (terminal branches)
Greater palatine
Posterior superior alveolar
Naso-palatine (sphenopalatine)
Infraorbital
Pharyngeal branch &
Artery of pterygoid canal
Infraorbital a.
Nasopalatine a.
Posterior superior
alveolar a.
Pharyngeal a.
& artery of
pterygoid canal
Greater palatine artery
Descends through the greater palatine canal
Comes out through the greater palatine foramen
Runs forwards on the under surface of the palate
Ascends through the incisive foramen to reach the nasal septum
Terminates by anastomosing with the nasopalatine artery at Little’s area
In the greater palatine canal, it gives the lesser palatine arteries which come out through the lesser palatine foramina.
Nasopalatine artery
Passes through the nasopalatine foramen to reach the nose
Crosses the roof of the nose and descends on the nasal septum
Terminates by anastomosing with the greater palatine artery at Little’s area
At its beginning, it gives the posterior lateral nasal artery to supply lateral wall of the nose
Lesser
palatine a.
Greater palatine a.
Pharyngeal branch and artery of pterygoid canal
Run backwards through the pharyngeal and pterygoid canals, respectively, to reach the nasopharynx

18. Anterior superior alveolar a. Posterior superior alveolar a.
Posterior superior alveolar artery
Passes through the posterior surface of maxilla
Supplies the upper molars and premolars
Infraorbital artery
Reaches the orbit through the inferior orbital fissure
Passes through the infraorbital groove and canal, and comes out through the infraorbital foramen
Gives the anterior superior alveolar artery which supplies the canine and incisor teeth
Gives terminal branches in the face
Infraorbital a.
Anterior superior alveolar a.
Posterior superior alveolar a.

19. Pterygoid plexus of veins
A plexus of veins between the two pterygoid muscles
The plexus collects posteriorly to form the maxillary vein
The maxillary vein:
runs backwards deep to the neck of the mandible
passes through the anteromedial surface of the parotid gland
joins the superficial temporal vein to form the retromandibular vein
The pterygoid plexus receives veins corresponding
to the branches of the maxillary artery:
Sphenopalatine
Greater palatine
Superior alveolar
Inferior alveolar
Infraorbital
Muscular veins (masseteric, temporal, pterygoid, buccal)
Middle meningeal
Cavernous sinus
Pterygoid plexus
of veins
Communications:
The pterygoid plexus of veins communicates with:
The cavernous sinus: through emissary veins
The inferior ophthalmic vein: through the inferior orbital fissure
The facial vein: through the deep facial vein

20. Structures running between the ramus of the
mandible and the sphenomandibular ligament:
1st part of maxillary Artery.
Maxillary Vein.
Inferior alveolar artery.
Middle meningeal artery.
Inferior alveolar nerve.
Auriculotemporal nerve.
Middle meningeal a.
Auriculotemporal nerve
Inferior alveolar nerve
Structures which pierce the
sphenomandibular ligament:
Mylohyoid nerve
Mylohyoid vessels
Maxillary artery
Inferior alveolar artery
Sphenomandibular ligament
Stylomandibular ligament
Mylohyoid nerve and vessels

21. Sphenopalatine ganglion
Pterygopalatine Fossa
Boundaries:
Ant: posterior surface of maxilla
Med: perpendicular palatine plate
Post: pterygoid process
Lat: communicates with the infratemporal fossa
through the pterygomaxillary fissure
Contents:
Maxillary nerve
Third part of maxillary artery
Sphenopalatine ganglion
maxilla
Maxillary nerve
Lateral
pterygoid plate
Sphenopalatine ganglion
Pterygopalatine
fossa
Pterygomaxillary
fissure
Communications: the fossa communicates with:
Infratemporal fossa through pterygomaxillary fissure
Middle cranial fossa through foramen rotundum
Nasal cavity through nasapalatine foramen
Orbital cavity: through inferior orbital fissure
Palate through greater palatine canal
Nasopharynx through pharyngeal and pterygoid canals

22. Sphenopalatine Ganglion
The largest parasympathetic ganglion, located in the pterygopalatine
Fossa, in front of pterygoid canal and below the maxillary nerve
Roots:
Parasymp: greater petrosal N. (from facial N)
(fibers originate from the sup salivary nucleus)
Symp: deep ptrosal N.
(fibers originate from the plexus around ICA)
Sensory: maxillary N.
Facial nerve
Maxillary n.
Greater
petrosal n
Superior salivary
nucleus
Deep
petrosal n.
The parasympathetic and sympathetic roots (greater & deep petrosal nerves) join each other in the Foramen lacerum to form the nerve of pterygoid canal, which passes through the canal to reach the sphenopalatine ganglion
Nerve of
pterygoid canal
ICA
Sphenopalatine
ganglion
Sympathetic
chain

23. Branches of the sphenopalatine ganglion:
Orbital:
Palatine:
Nasal:
Pharyngeal: