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

2. TEMPORAL FOSSA

3. TEMPORAL FOSSA

4. INFRATEMPORAL FOSSA

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

6. TEMPORAL FOSSA CONTENTS: Temporalis muscle
Deep temporal nerve & vessels
Superficial temporal vessels
Auriculotemporal nerve

7. 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

8. 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

9. 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

10. THE MANDIBLE

11. TEMPOROMANDIBULAR JOINT

12. 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

13. 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

14. 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

15. 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

16. MUSCLES OF MASTICATION

17. MUSCLES OF MASTICATION

18. 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

19. 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)

20. 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)

21. 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)

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

23. MANDIBULAR NERVE

24. INFRATEMPORAL FOSSA

25. 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

26. 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

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

28. BRANCHES FROM TRUNK OF 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

29. 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

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
Gives sensory branches to skin of auricle, temple, TMJ & parotid gland
Carries 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
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

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
Emerges 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
Supplies mylohyoid & anterior belly of digastric muscles

34. RELATIONS OF LATERAL PTERYGOID

35. 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