Download Infratemporal fossa II2010-10-01 03:412.6 MB

Dr. Ahmed Fathalla Ibrahim
THE PTERYGOPALATINE FOSSA
THE PALATE
THE PTERYGOPALATINE FOSSA
• BOUNDARIES:
1. ANTERIOR: Maxillary bone
2. POSTERIOR: Pterygoid process of
sphenoid bone
3. MEDIAL: Perpendicular plate of
palatine bone
THE PTERYGOPALATINE FOSSA
• COMMUNICATIONS:
1. With infratemporal fossa: through
pterygomaxillary fissure
2. With cranial cavity: through foramen
rotundum
3. With nasal cavity: through sphenopalatine
foramen
4. With orbit: through inferior orbital fissure
5. With palate: through greater & lesser
palatine canals & foramina
6. With pharynx: through pterygoid canal &
palatovaginal canal
THE PTERYGOPALATINE FOSSA
•
1.
2.
3.
CONTENTS:
Pterygopalatine ganglion
Maxillary nerve
Maxillary artery
MAXILLARY NERVE
• ORIGIN: It arises from the trigeminal
ganglion in the middle cranial fossa
• TYPE OF FIBERS: Pure sensory
(general somatic afferent)
MAXILLARY NERVE
ZF
ZT
Zygomatic
Meningeal
PSA
MSA
ASA
COURSE OF MAXILLARY NERVE
• THE CRANIAL CAVITY: It passes in the lateral
wall of cavernous sinus then passes through
the foramen rotundum to enter:
• THE PTERYGOPALATINE FOSSA: It passes
through pterygomaxillary fissure to enter:
• THE INFRATEMPORAL FOSSA: It crosses the
fossa & passes through the inferior orbital
fissure to enter:
• THE ORBIT: The nerve is now called the
infraorbital nerve. It runs on the floor of the
orbit & passes through the infraorbital
groove, canal & foramen to enter:
• THE FACE
BRANCHES OF MAXILLARY
NERVE
•
1.
IN THE CRANIAL CAVITY:
Meningeal branch: supplies middle cranial fossa
•
1.
IN THE PTERYGOPALATINE FOSSA:
Two ganglionic branches connecting the nerve to
pterygopalatine ganglion: contain postganglionic
parasympathetic fibers to lacrimal gland & sensory
fibers from nose, palate & pharynx
•
1.
IN THE INFRATEMPORAL FOSSA:
Posterior superior alveolar nerve: supplies
maxillary sinus & upper molar teeth
Zygomatic nerve: passes through inferior orbital
fissure to enter the orbit & divides into
zygomaticotemporal & zygomaticofacial nerves
2.
BRANCHES OF INFRAORBITAL
NERVE
• IN THE INFRAORBITAL CANAL:
1. Middle superior alveolar nerve: supplies
maxillary sinus & upper premolar teeth
2. Anterior superior alveolar nerve: supplies
maxillary sinus & upper canine & incisors
•
1.
2.
3.
IN THE FACE:
Palpebral: supplies lower eyelid
Nasal: supplies ala of nose
Labial: supplies upper lip
MAXILLARY ARTERY
MAXILLARY ARTERY
Sphenopalatine
ASA
PSA
Lesser palatine
Greater palatine
MAXILLARY ARTERY
• ORIGIN: It is the larger of the 2 terminal
branches of external carotid artery, behind
the neck of mandible (within parotid gland)
• COURSE: It is divided into 3 parts:
• First part: runs deep to neck of mandible
(below auriculotemporal nerve) & emerges
from the lower border of lateral pterygoid
• Second part: ascends superficial (sometimes
deep) to lower head of lateral pterygoid
• Third part: passes between the 2 heads of
lateral pterygoid then through
pterygomaxillary fissure to reach
pterygopalatine fossa where it terminates
BRANCHES OF MAXILLARY
ARTERY
• FROM FIRST PART:
1. Middle meningeal artery: lies deep to lateral
pterygoid, behind the trunk of mandibular
nerve, between the 2 roots of
auriculotemporal nerve. It passes through
foramen spinosum to reach cranial cavity
2. Inferior alveolar artery: same course &
distribution as inferior alveolar nerve
3. Deep auricular & anterior tympanic arteries:
supply external auditory meatus &
tympanic membrane
BRANCHES OF MAXILLARY
ARTERY
• FROM SECOND PART:
1.Muscular branches: to muscles of
mastication
2.Buccal artery: same course &
distribution as buccal nerve
BRANCHES OF MAXILLARY
ARTERY
•
1.
2.
3.
4.
5.
6.
FROM THIRD PART:
Infraorbital artery: same course & distribution as
infraorbital nerve
Posterior superior alveolar artery: same course &
distribution as posterior superior alveolar nerve
Greater palatine artery: passes through greater
palatine canal & foramen to the palate, supplies
hard palate & gums, gives lesser palatine artery
supplying soft palate & tonsils
Sphenopalatine artery: passes through
sphenopalatine foramen to the nose, supplies
nasal cavity & nasal septum
Artery of pterygoid canal: supplies auditory tube,
tympanic cavity & pharynx
Pharyngeal artery: supplies nasopharynx,
sphenoidal air sinuses
•
PTERYGOID PLEXUS OF VEINS
SITE: It surrounds & lies in substance of
lateral pterygoid muscle
• TRIBUTARIES: correspond to branches of
maxillary artery
• TERMINATION: It forms the maxillary vein
that passes deep to neck of mandible &
unite with superficial temporal vein to form
retromandibular vein (inside parotid gland)
• COMMUNICATIONS:
1. With cavernous sinus: by emissary veins
through foramen ovale & lacerum
2. With facial vein: by deep facial vein
3. With inferior ophthalmic vein: by
communicating veins through inferior
orbital fissure