General Anatomy 2

TEMPORAL AND INFRATEMPORAL FOSSA

TEMPORAL AND INFRATEMPORAL FOSSAE
→are interconnected spaces on the lateral side of
the head
→their boundaries are formed by bones and soft
tissues
TYMPANIC PART
→forms the posteromedial corner of the roof of
the infratemporal fossa
→flat concave plate of bone
→curves inferiorly from the back of the
mandibular fossa
→forms part of the wall of the external auditory
meatus
→articulates with the head of the mandible to
form the temporomandibular joint

Two features that participate in forming the

temporomandibular joint on the inferior aspect of
the root of the zygomatic process:
✓ Articular tubercle
✓ Mandibular fossa
• Both are elongate from medial to lateral

External acoustic meatus

- Posterior to the mandibular fossa

TYMPANOSQUAMOUS FISSURE
→Between the tympanic and squamous part of
the temporal bone

PETROTYMPANIC FISSURE
→small slip of bone from the petrous part of the
temporal bone
→insinuates itself into the fissure
BONY FRAMEWORK o Chorda tympani
- Exits the skull and enters the infratemporal
Bones that contribute significantly to the
fossa through the medial end of the
boundaries of the temporal and infratemporal
petrotympanic fissure
fossae:
• Temporal
LATERAL SURFACE
• Zygomatic
• Sphenoid bones →marked by two surface features on the medial
wall of the temporal fossa:
• Maxilla
• Mandible
• Supramastoid crest
• Parts of the frontal and parietal bones
• Groove for the middle temporal artery
TEMPORAL BONE SUPRAMASTOID CREST
• Squamous part
• Tympanic part →transversely oriented
• Lateral surface →extends posteriorly from the base of the
zygomatic process
SQUAMOUS PART →marks the posteroinferior border of the
temporal fossa
→forms part of the bony framework of the
temporal and infratemporal fossae
GROOVE FOR THE MIDDLE TEMPORAL ARTERY
→vertically oriented
→branch of the superficial temporal artery
 SPHENOID BONE
→form part of the bony framework of the
infratemporal fossa
• Lateral plate of the pterygoid process
• Greater wing

GREATER WING
→forms part of the medial wall of the temporal
fossa
→project laterally from the body and curve
superiorly
→one or more small sphenoidal emissary
foramina penetrate the base of the greater wing
anteromedial to the foramen ovale
It allows: MAXILLA
o Emissary veins (posterior surface)
- To pass between the pterygoid plexus of veins →contributes to the anterior wall of the
in the infratemporal fossa and the cavernous infratemporal fossa
sinus in the middle cranial fossa →marked by a foramen for the posterosuperior
alveolar nerve and vessels
Infratemporal crest →the superior margin forms the inferior border of
- Sharply angled the inferior orbital fissure
- Boundary between the lateral and inferior
surfaces of the greater wing
ZYGOMATIC BONE
→quadrangular-shaped
Two apertures pass through the base of the
→forms the palpable bony prominence of the
greater wing:
cheek
• Foramen ovale
→a thin plate of bone extends posteromedially
• Foramen spinosum
from the frontal process and contributes to the
lateral wall of the orbit on one side and anterior
Allows these structures to pass through:
wall of the temporal fossa on the other
o Mandibular nerve (V3)
• Maxillary process
o Middle meningeal artery
• Frontal process
To pass between:
• Temporal process
• Middle cranial fossa
• Infratemporal fossa
Zygomaticofacial foramen
SPINE OF THE SPHENOID (on the lateral surface of the zygomatic bone)
- Transmits the zygomaticofacial nerve and
→projecting vertically downward from the greater vessels onto the cheek
wing (on the temporal surface of the plate)
→medial to the foramen spinosum - Attaches to the frontal process
→irregularly shaped - Destined for the:
→attachment site for the cranial end of the o Zygomaticotemporal nerve
sphenomandibular ligament
MAXILLARY PROCESS
LATERAL PLATE OF THE PTERYGOID PROCESS
→extends anteromedially
→vertically oriented sheet of bone →articulate with the zygomatic process of the
→projects posterolaterally from the pterygoid maxilla
process
→its lateral and medial surfaces provide FRONTAL PROCESS
attachment for the lateral and medial pterygoid →extends superiorly
muscles →articulate with the zygomatic process of the
frontal bone

2
 TEMPORAL PROCESS HEAD OF THE MANDIBLE
→extends posteriorly →expanded medially
→articulate with the zygomatic process of the →participates in forming the temporomandibular
temporal bone to complete the zygomatic arch joint

RAMUS OF THE MANDIBLE NECK OF THE MANDIBLE

→quadrangular in shape →bears a shallow depression on its anterior
It has: surface
• Medial surface →for attachment of the lateral pterygoid muscle
• Lateral surface
• Condylar Pterygoid fovea
• Coronoid processes - Shallow depression

LATERAL SURFACE MEDIAL SURFACE

→smooth
→with the presence of a few obliquely oriented
ridges
→provides attachment for the masseter muscle
POSTERIOR AND INFERIOR BORDERS
→intersect to form the angle of the mandible
→lateral wall of the infratemporal fossa
→its most distinctive feature is the mandibular
foramen
→posteroinferior to the mylohyoid groove and
mandibular foramen
→roughened
→for attachment of the medial pterygoid muscle

SUPERIOR BORDER MANDIBUAR FORAMEN

→notched to form the mandibular notch
ANTERIOR BORDER
→sharp
→continuous below with the oblique line on the
body of the mandible
CORONOID PROCESS
→flat
→triangular process
→provides attachment for the temporalis muscle
→extends superiorly from the junction of the
anterior and superior borders of the ramus
CONDYLAR PROCESS
→extends superiorly from the posterior and
superior borders of the ramus
→superior opening of the mandibular canal
o Inferior alveolar nerve and vessels
Lingula
- Triangular elevation
- Anterosuperior to the mandibular foramen
- Attachment of the mandibular end of the
sphenomandibular ligament
Mylohyoid groove
- Elongate groove
- Extends anteroinferiorly from the mandibular
foramen
o Nerve to the mylohyoid

It consists of:
• Head of the mandible
• Neck of the mandible

3
 TEMPOROMANDIBULAR JOINTS
→allow opening and closing of the mouth
→allow complex-chewing or side-to-side
movements of the lower jaw
→each joint is synovial
→formed between the head of the mandible and
the articular fossa and articular tubercle of the
temporal bone
→covered by fibrocartilage
→completely divided by a fibrous articular disc
into two parts
• Lower part
• Upper part

LOWER PART
→allows mainly the hinge-like depression and
elevation of the mandible

UPPER PART
→allows the head of the mandible to translocate
forward (protrusion) onto the articular tubercle
JOINT CAPSULE
→allows the head of the mandible to translocate
backward (retraction) into the mandibular fossa • Synovial membrane
• Fibrous membrane
Opening the mouth
- involves both depression and protrusion SYNOVIAL MEMBRANE
→lines all non-articular surfaces of the upper and
Forward or protrusive movement lower compartments
- allows greater depression of the mandible →attached to the margins of the articular disc
- prevents backward movement of the angle of
the mandible into structures in the neck FIBROUS MEMBRANE
→encloses the temporomandibular joint complex

Attached along the:

- Above along the anterior margin of the
articular tubercle
- Laterally and medially along the margins of the
articular fossa
- Posteriorly to the region of the
tympanosquamous suture
- Below around the upper part of the neck of the
mandible

• The articular disc attaches around its

periphery to the inner aspect of the fibrous
membrane

EXTRACAPSULAR LIGAMENTS
• Lateral
• Sphenomandibular
• Stylomandibular

LATERAL LIGAMENT
→closest to the joint
→lateral to the capsule
→runs diagonally backward from the margin of
the articular tubercle to the neck of the mandible

4
 SPHENOMANDIBULAR LIGAMENT ELEVATION
→medial to the temporomandibular joint →very powerful movement
→runs from the spine of the sphenoid bone at the • Temporalis
base of the skull to the lingula on the medial side of • Masseter
the ramus of the mandible • Medial pterygoid muscles
→also involves movement of the head of the
STYLOMANDIBULAR LIGAMENT mandible into the mandibular fossa
→passes from the styloid process of the temporal
bone to the posterior margin and angle of the PROTRACTION
mandible Mainly achieved by:
• Lateral pterygoid muscle
With some assistance by the:
• Medial pterygoid muscle

RETRACTION
• Geniohyoid
• Digastric
• Posterior and deep fibers of the temporalis
and masseter muscles

Geniohyoid muscle
o C1 spinal nerve
All muscles that move the TMJs
o Mandibular nerve (V3)
- By branches that originate in the infratemporal
fossa

MOVEMENTS OF THE MANDIBLE

→chewing or grinding motion occurs when the
movements at the TMJ on one side are
coordinated with a reciprocal set of movements at
the joint on the other side
• Depression
• Elevation
• Protrusion
• Retraction

DEPRESSION
Generated by the:
• Digastric muscle
• Geniohyoid muscle
• Mylohyoid muscle
→normally assisted by gravity
→involves forward movement of the head of the
mandible onto the articular tubercle
• Lateral pterygoid muscle is also involved

5
 MUSCLES OF MASTICATION
MASSETER
→powerful muscle of mastication
→elevates the mandible
→quadrangular in shape
- Zygomatic arch
ORIGIN - Maxillary process of the
zygomatic bone
INSERTION - Lateral surface of ramus of
mandible
o Masseteric nerve
- From the Mandibular nerve (V3)
- Supplied with blood by the Masseteric artery TEMPORALIS
from the Maxillary artery →elevation and retraction of mandible
ORIGIN - Bone of temporal fossa
MASSETERIC NERVE AND ARTERY - Temporal fascia
→originate in the infratemporal fossa - Coronoid process of
→pass laterally over the margin of the mandibular mandible
notch to enter the deep surface of the masseter INSERTION - Anterior margin of ramus of
muscle mandible almost to last
molar tooth
o Deep temporal nerves
- From the anterior trunk of the Mandibular
nerve (V3)

MEDIAL PTERYGOID
→elevation and side-to-side movements of the
mandible
o Nerve to Medial pterygoid
- From the Mandibular nerve (V3)
• Deep head
• Superficial part
• Superficial head
• Deep part
DEEP HEAD
SUPERFICIAL PART
→originates from the maxillary process of the - Medial surface of lateral
zygomatic bone ORIGIN plate of pterygoid process
→anterior two-thirds of the zygomatic process of - Pyramidal process of
the maxilla palatine bone
→inserts into the angle of the mandible and INSERTION - Medial surface of mandible
related posterior part of the lateral surface of the near angle
ramus of the mandible
SUPERFICIAL HEAD
DEEP PART
- Tuberosity of maxilla
→originates from the medial aspect of the ORIGIN - Pyramidal process of
zygomatic arch and the posterior part of its palatine bone
inferior margin INSERTION - Medial surface of mandible
→inserts into the central and upper part of the near angle
ramus of the mandible as high as the coronoid
process

6
 LATERAL PTERYGOID TEMPORAL FASCIA
→protrusion →tough
→side-to-side movements of the mandible →fan-shaped aponeurosis
o Nerve to Lateral pterygoid →overlying the temporalis muscle
- From the anterior trunk of the Mandibular →limits the temporal fossa laterally
nerve (V3) or from the Buccal branch →attached by its outer margin to the superior
• Upper head temporal line
• Lower head →attached by its inferior margin to the zygomatic
arch
UPPER HEAD
• It is limited anteriorly by the posterior surface
ORIGIN - Roof of infratemporal fossa of the frontal process of the zygomatic bone
- Capsule of TMJ in the region and the posterior surface of the zygomatic
of attachment to the process of the frontal bone, which separate
INSERTION articular disc the temporal fossa behind from the orbit in
- Pterygoid fovea on the neck front
of the mandible
INFERIOR MARGIN
LOWER HEAD →marked by the zygomatic arch laterally
ORIGIN - Lateral surface of lateral →marked by the infratemporal crest of the
plate of the pterygoid greater wing of the sphenoid medially
process • Between these two features the floor of the
- Capsule of TMJ in the region temporal fossa is open medially to the
infratemporal fossa
of attachment to the
• And laterally to the region containing the
INSERTION articular disc
masseter muscle
- Pterygoid fovea on the neck
of the mandible
CONTENTS
TEMPORAL FOSSA • Temporalis muscle
• Zygomaticotemporal branch of the Maxillary
→narrow fan-shaped space
nerve (V3)
→covers the lateral surface of the skull
→superior to the infratemporal fossa
TEMPORALIS MUSCLE
→above the zygomatic arch
→communicates with the infratemporal fossa →large
through the gap between the zygomatic arch and →fan-shaped muscle
the more medial surface of the skull →fills much of the temporal fossa
→powerful elevator of the mandible
→retracts the mandible or pulls it posteriorly
→participates in side-to-side movements of the
mandible
→involves posterior translocation of the head of
the mandible from the articular tubercle of the
temporal bone and back into the mandibular
fossa
ORIGIN - Bony surfaces of the fossa
superiorly to the inferior
temporal line
- Temporal fascia
- Coronoid process of
mandible
UPPER MARGIN
INSERTION - Anterior margin of ramus of
→defined by a pair of temporal lines that arch mandible almost to last
across the skull molar tooth
→from the zygomatic process of the frontal bone o Deep temporal nerves
to the supramastoid crest of the temporal bone - Originate from the Mandibular nerve (V3) in
the infratemporal fossa

7
Blood supply is by the: DEEP TEMPORAL ARTERIES
o Deep temporal arteries →normally two in number
- Travel with the nerves, and the middle →originate from the Maxillary artery in the
temporal artery infratemporal fossa
- Penetrates the temporal fascia at the posterior →travel with the deep temporal nerves around the
end of the zygomatic arch infratemporal crest of the greater wing of the
sphenoid
→anastomose with branches of the middle
temporal artery

It supplies the:
✓ Temporalis muscle

MIDDLE TEMPORAL ARTERY

→originates from the Superficial temporal artery
just superior to the root of the zygomatic arch
→penetrates the temporal fascia
→passes under the margin of the temporalis
muscle
→travels superiorly on the deep surface of the
temporalis muscle
→anastomose with branches of the deep
temporal arteries

More anterior fibers It supplies the:

- Oriented vertically ✓ Temporalis
More posterior fibers
- Oriented horizontally
• These fibers converge inferiorly to form a
tendon which passes between the zygomatic
arch and the infratemporal crest of the greater
wing of the sphenoid
• Insert on the coronoid process of the mandible

DEEP TEMPORAL NERVES

→usually, two in number
→originate from the anterior trunk of the
Mandibular nerve (V3) in the infratemporal fossa
→pass superiorly and around the infratemporal
crest of the greater wing of the sphenoid
→enter the temporal fossa deep to the temporalis
muscle
It supplies the:
✓ Temporalis muscle
ZYGOMATICOTEMPORAL NERVE
→branch of the zygomatic nerve
→enters the temporal fossa through one or more
small foramina on the temporal fossa surface of
the zygomatic bone
Zygomatic nerve
- Branch of the Maxillary nerve (V2)
- Originates in the pterygopalatine fossa and
passes into the orbit
INFRATEMPORAL FOSSA
→wedge-shaped space
→inferior to the temporal fossa
→between the ramus of the mandible laterally
and the wall of the pharynx medially
→deep to the masseter muscle and the underlying
ramus of the mandible
Structures that pass through:
✓ Pterygopalatine fossa
✓ Floor of the oral cavity
✓ Floor of the orbit
✓ Temporal fossa
✓ Superficial regions of the head

8
It has a:
• Roof
• Lateral wall
• Medial wall

ROOF
→lateral to the infratemporal crest of the greater
wing of the sphenoid
→open superiorly to the temporal fossa

It is formed by:
✓ Inferior surfaces of the greater wing of the
sphenoid CONTENTS
✓ Temporal bone • Sphenomandibular ligament
• Medial and Lateral pterygoid muscles
It contains the: • Maxillary artery
✓ Foramen spinosum • Mandibular nerve (V3)
✓ Foramen ovale • Branches of the Facial nerve (VII)
✓ Petrotympanic fissure • Glossopharyngeal nerve (IX)
• Pterygoid plexus of veins
LATERAL WALL
→medial surface of the ramus of the mandible SPHENOMANDIBULAR LIGAMENT
→contains the opening to the mandibular canal →extracapsular ligament of the TMJ
→attached superiorly to the spine of the sphenoid
MEDIAL WALL bone
→contains the pterygomaxillary fissure anteriorly →expands inferiorly to attach to the lingula of the
mandible and the posterior margin of the
It is formed by: mandibular foramen
Anteriorly
✓ Lateral plate of the pterygoid process MEDIAL PTERYGOID
Posteriorly →quadrangular
✓ Pharynx →elevates the mandible
✓ Two muscles of the soft palate →passes obliquely backward
(tensor and levator veli palatini muscles) →insert into the mandible
→assists the lateral pterygoid muscle in
Pterygomaxillary fissure protruding the lower jaw
- Allows structures to pass between the o Nerve to the Medial Pterygoid from
infratemporal and pterygopalatine fossae the Mandibular Nerve (V3)
• Deep head
ANTERIOR WALL • Superficial head
→formed by part of the posterior surface of the
maxilla DEEP HEAD
→contains the alveolar foramen
→attached above to the medial surface of the
→the upper part opens as the inferior orbital
lateral plate of the pterygoid process and the
fissure into the orbit
associated surface of the pyramidal process of the
palatine bone
Muscles of mastication:
Masseter →descends obliquely downward
- Lateral to the infratemporal fossa →medial to the sphenomandibular ligament
→attach to the roughened medial surface of the
Two Pterygoid muscles
ramus of the mandible near the angle of the
- In the temporal fossa
mandible
Temporalis
- fills the temporal fossa

9
SUPERFICIAL HEAD
→originates from the tuberosity of the maxilla and
adjacent pyramidal process of the palatine bone
→joins with the deep head to insert on the
mandible

MANDIBULAR NERVE (V3)

→largest
→both motor and sensory
→it also carries motor innervation to most of the
muscles that move the mandible, tensor tympani,
and tensor veli palatini
LATERAL PTERYGOID
→all branches originate in the infratemporal fossa
→thick triangular muscle →the sensory part originates from the trigeminal
→major protruder of the lower jaw ganglion in the middle cranial fossa
→has two heads
→pulls the articular disc and head of the mandible It carries general sensation from:
forward onto the articular tubercle ✓ Teeth
o Nerve to the Lateral pterygoid from ✓ Gingivae of the mandible
the Mandibular nerve (V3) ✓ Anterior two-thirds of the tongue
• Upper head ✓ Mucosa on the floor of the oral cavity
• Lower head ✓ Lower lip
UPPER HEAD
✓ Skin over the temple and lower face
→originates from the roof of the infratemporal ✓ Part of the cranial dura mater
fossa ✓ Mandibular nerve (V3)
→lateral to the foramen ovale and foramen
spinosum SENSORY PART
LOWER HEAD
→drops vertically through the foramen ovale
→larger →enters the infratemporal fossa between the
→originates from the lateral surface of the lateral tensor veli palatini muscle and the upper head of
plate of the pterygoid process the lateral pterygoid muscle
→inferior part insinuates itself between the cranial
attachments of the two heads of the medial SMALL MOTOR ROOT OF THE TRIGEMINAL NERVE (V)
pterygoid →passes medial to the trigeminal ganglion
→passes through the foramen ovale
• The fibers from both heads converge to insert →joins the sensory part of the mandibular nerve
into the pterygoid fovea of the neck of the (V3)
mandible
• It also inserts into the capsule of the TMJ in the
BRANCHES OF THE MANDIBULAR NERVE
region where the capsule is attached internally
→after the sensory and motor root joins, the
to the articular disc
mandibular nerve (V) gives rise to:
✓ Small meningeal branch
✓ Nerve to the Medial Pterygoid

It divides into:
• Anterior trunk
• Posterior trunk

10
ANTERIOR TRUNK NERVE TO MEDIAL PTERYGOID
✓ Buccal →supply the deep surface of the medial pterygoid
✓ Masseteric muscle
✓ Deep temporal nerves →originates medially from the Mandibular nerve
✓ Nerve to the Lateral pterygoid (V3)
→it has two small branches
• All nerves except the buccal, are motor
• Buccal nerve is sensory • One of these supplies the tensor veli palatini
• The other ascends to supply the tensor
tympani muscle, which occupies a small bony
above and parallel to the pharyngotympanic
tube

BUCCAL NERVE
→predominantly sensory nerve
→may also carry motor innervation to the lateral
pterygoid muscle and to part of the temporalis
muscle
→branch of the anterior trunk of the mandibular
nerve (V3)
POSTERIOR TRUNK →passes laterally between the upper and lower
✓ Auriculotemporal heads of the lateral pterygoid
✓ Lingual →descends around the anterior margin of the
✓ Inferior alveolar nerves insertion of the temporalis muscle to the anterior
margin of the ramus of the mandible
• All except the nerve to the mylohyoid that →continues into the cheek lateral to the
branches from the inferior alveolar nerve, are buccinator muscle
sensory nerves →supply general sensory nerves to the adjacent
skin and oral mucosa and the buccal gingivae of
the lower molars

MASSETERIC NERVE
→branch of the anterior trunk of the mandibular
nerve (V3)
→passes laterally over the lateral pterygoid
muscle and through the mandibular notch
→supply the temporalis muscle from its deep
surface

NERVE TO LATERAL PTERYGOID

MENINGEAL BRANCH →branch from the anterior trunk of the
→sensory for the dura mater, mainly of the middle mandibular nerve (V3) or from its buccal branch
cranial fossa →passes directly into the deep surface of the
→supplies the mastoid cells that communicate lateral pterygoid muscle
with the middle ear
→originates from the medial side of the
mandibular nerve (V3)
→ascends to leave the infratemporal fossa with
the middle meningeal artery
→reenter the cranial cavity through the foramen
spinosum

11
 AURICULOTEMPORAL NERVE
→first branch of the posterior trunk of the
Mandibular nerve (V3)
→originates as two roots
→pass posteriorly around the middle meningeal
artery
→ascends from the maxillary artery to the
foramen spinosum
→passes first between the tensor veli palatini
muscle and the upper head of the lateral
pterygoid muscle
→curves laterally around the neck of the mandible
→ascends deep to the parotid gland between the
TMJ and ear
→its terminal branches carry general sensation
from skin over a large area of the temple
→also delivers postganglionic parasympathetic
nerves from the glossopharyngeal nerve (IX) to the
parotid gland
It contributes to:
✓ Sensory innervation of the external ear
✓ External auditory meatus
✓ Tympanic membrane
✓ Temporomandibular joint
LINGUAL NERVE
→major sensory branch of the posterior trunk of
the mandibular nerve (V3)
→first descends between the tensor veli palatini
and the lateral pterygoid
→joined by the chorda tympani
→descends across the lateral surface of the
medial pterygoid muscle to enter the oral cavity
→passes into the tongue on the lateral surface of
the hyoglossus muscle where it is attached to the
submandibular ganglion
Carries general sensation from:
✓ Anterior two-thirds of the tongue
✓ Oral mucosa on the floor of the oral cavity
✓ Lingual gingivae associated with the lower
teeth
→joined in the high infratemporal fossa by the
chorda tympani branch of the facial nerve (VII)
Carries:
• Taste from the anterior two-thirds of the
tongue
• Parasympathetic fibers to all salivary glands
below the level of the oral fissure
Submandibular ganglion
- Where the preganglionic parasympathetic
fibers synapse with postganglionic
parasympathetic fibers
- Preganglionic fibers are carried from the
infratemporal fossa into the floor of the oral
cavity on the lingual nerve
The thin lingual nerve enters the oral cavity
between the posterior attachment of the
mylohyoid muscle to the mylohyoid line and the
attachment of the superior constrictor of the
pharynx to the pterygomandibular raphe. The
lingual nerve enters the floor of the oral cavity in
a shallow groove on the medial surface of the
mandible, inferior to the last molar tooth. The
nerve is palpable through the oral mucosa in
this position, and in danger when one is
operating on the molar teeth and gingivae
INFERIOR ALVEOLAR NERVE
→major sensory branch of the posterior trunk of
the Mandibular nerve (V3)
→originates deep to the lateral pterygoid muscle
from the posterior trunk of (V3)
→it descends on the lateral surface of the medial
pterygoid muscle
→it passes between the sphenomandibular
ligament and the ramus of the mandible
→enters the mandibular canal through the
mandibular foramen
→gives origin to the nerve to the mylohyoid
→it divides into two terminal branches
• Incisive nerve
• Mental nerve
12
It innervates:
✓ All lower teeth
✓ Associated gingivae
✓ Mucosa
✓ Skin of the lower lip
✓ Skin of the chin

It also supplies branches to the:

✓ 3 molar teeth
✓ Second premolar tooth
✓ Associated labial gingivae

The inferior alveolar nerve passes anteriorly

within the mandibular canal of the lower jaw.
The mandibular canal and its contents are
inferior to the roots of the molar teeth, and the
roots can sometimes curve around the canal
making extraction of these teeth difficult.
→it has one motor branch (nerve to the
mylohyoid)
It innervates:
✓ Mylohyoid muscle
✓ Anterior belly of the digastric muscle
CHORDA TYMPANI AND THE LESSER PETROSAL
Nerve to the mylohyoid NERVE
- Lies on the mylohyoid groove inferior to the →branches of two cranial nerves join branches of
foramen the mandibular nerve (V3) in the infratemporal
- Continues anteriorly below the floor of the oral fossa
cavity • Chorda tympani of the Facial nerve (VII)
• Lesser petrosal nerve
INCISIVE NERVE
→continues in the mandibular canal CHORDA TYMPANI
→carries taste from the anterior two-thirds of the
It supplies the: tongue
✓ First premolar →carries parasympathetic innervation to all
✓ Incisor salivary glands below the level of the oral fissure
✓ Canine →originates from the Facial nerve (VII) within the
✓ Related gingivae temporal bone
→in association with the mastoid wall of the
MENTAL NERVE middle ear
→exits the mandible through the mental foramen →passes anteriorly through a small canal, and
enters the lateral aspect of the middle ear
It supplies the: →separated from the tympanic membrane by the
✓ Lower lip handle of the malleus
✓ Chin →leaves the middle ear through the medial end of
the petrotympanic fissure
The mental nerve is palpable and sometimes →joins the lingual nerve
visible through the oral mucosa adjacent to the →the preganglionic parasympathetic fibers it
roots of the premolar teeth. carries synapse with postganglionic
parasympathetic fibers in the submandibular
ganglion
→hangs off the lingual nerve in the floor of the oral
cavity

13
Postganglionic parasympathetic fibers leave the
submandibular ganglion and either:
- Re-enter the lingual nerve to travel with its
terminal branches to reach target issues
- Pass directly from the submandibular ganglion
into glands
• The taste (SA) fibers do not pass through the
ganglion and are distributed with terminal
branches of the lingual nerve.
LINGUAL NERVE INJURY
→An injury proximal to where the chorda
tympani join it in the infratemporal fossa
Will produce loss of general sensation from:
• The anterior two-thirds of the tongue
• Oral mucosa
• Gingivae
• Lower lip
• Chin
→nerve lesion is distal to the site where it is joined
by the chorda tympani
It results lost in:
• Secretion from the salivary glands between the
oral fissure
• Taste from the anterior two-thirds of the
tongue
LESSER PETROSAL NERVE
→carries mainly parasympathetic fibers destined
for the parotid gland
→contains mainly preganglionic parasympathetic
fibers
→leaves the middle ear and enters the middle
cranial fossa through a small opening on the
anterior surface of the petrous part of the
temporal bone
→inferior to the opening for the greater petrosal
nerve
→passes medially and descends through the
foramen ovale with the mandibular nerve (V3)
Preganglionic parasympathetic fibers
- Located in the glossopharyngeal nerve (IX) as
it exits the jugular foramen at the base of the
skull
- In the infratemporal fossa, it synapses with the
cell bodies of postganglionic parasympathetic
fibers in the otic ganglion, on the medial side of
the mandibular nerve
Postganglionic parasympathetic fibers
- Leave the otic ganglion
- Join the auriculotemporal nerve, which carries
them to the parotid gland
Tympanic nerve
- Branching from the glossopharyngeal nerve
either within or outside the jugular foramen
- Reenters the temporal bone through a small
foramen on the ridge of bone separating the
jugular foramen from the carotid canal
- Ascends through a small bony canal to the
promontory located in the labyrinthine wall of
the middle ear
- It participates in the formation of the tympanic
plexus
- The lesser petrosal nerve is a branch of this
plexus
Inferior tympanic canaliculus
- Small bony canal
DENTAL ANESTHESIA
→anesthesia of the inferior alveolar nerve
→widely practiced by most dentists
→needle is placed lateral to the anterior arch of
the fauces (palatoglossal arch) in the oral cavity
→advanced along the medial border around the
inferior third of the ramus of the mandible
→it is also possible to anesthetize the infra-orbital
and buccal nerves, depending on where the
anesthesia is needed
Inferior third of the ramus of the mandible
- Anesthetic can be deposited in this region
14
• Dental procedures require perineuronal BRANCHES OF THE MAXILLARY ARTERY:
infiltration of the inferior alveolar nerve by - Between the neck of the
local anesthetic mandible and the
sphenomandibular ligament
INFERIOR ALVEOLAR NERVE - Gives origin to two major
→one of the largest branches of the branches
Mandibular nerve (V3) First part o Middle meningeal
→carries sensory branches from the teeth and o Inferior alveolar artery
mandible - Gives off to smaller branches
→receives sensory information from the skin over o Deep auricular
most of the mandible o Anterior tympanic
→passes into the mandibular canal o Accessory meningeal
→courses through the body of the mandible - Related to the lateral pterygoid
→emerges through the mental foramen into the muscle
chin - Gives origin to:
o Deep temporal
MAXILLARY ARTERY Second o Masseteric
→largest branch of the external carotid artery part o Buccal
→passes through and supplies the infratemporal o Pterygoid branches
fossa - Course with the branches of
→enters the pterygopalatine fossa, where it gives Mandibular nerve
origin to terminal branches Third part - In the pterygopalatine fossa
→originates within the substance of the parotid
gland MIDDLE MENINGEAL ARTERY
→ascends obliquely through the infratemporal →largest of the meningeal vessels
fossa to enter the pterygopalatine fossa by →ascends vertically from the maxillary artery
passing through the pterygomaxillary fissure →passes through the foramen spinosum to enter
→it may pass through either the lateral or medial the cranial cavity
to the lower head of the lateral pterygoid →in the infratemporal fossa, it passes superiorly
→major source of blood supply for: between the sphenomandibular ligament on the
✓ Nasal cavity medial side and the lateral pterygoid on the lateral
✓ Lateral wall of the oral cavity side
✓ Roof of the oral cavity →it passes between the two roots of the
✓ All teeth auriculotemporal nerve
✓ Dura mater in the cranial cavity
It supplies:
• If it passes through the medial to the lower, the ✓ Much of the dura mater
maxillary artery then loops laterally between ✓ Bone
the upper and lower head of the lateral ✓ Related bone marrow of the cranial cavity
pterygoid to access the pterygomaxillary walls
fissure. Within the cranial cavity, the middle
meningeal artery and its branches travel in
the periosteal (outer) layer of dura mater,
which is tightly adherent to the bony walls. As
the major branches of the middle meningeal
artery pass superiorly up the walls of the
cranial cavity, they can be damaged by lateral
blows to the head. When the vessels are torn,
the leaking blood, which is under arteria
pressure, slowly separates the dura mater
from its attachment to the bone, resulting in
extradural hematoma.

15
 INFERIOR ALVEOLAR ARTERY
→descends from the maxillary artery
→enters the mandibular foramen and canal with
the inferior alveolar nerve
→before entering the mandible, it gives origin to a
small mylohyoid branch, which accompanies the
nerve to mylohyoid
→distributed with the inferior alveolar nerve
It supplies:
✓ All lower teeth
It contributes to the supply of:
✓ Buccal gingivae
✓ Chin
✓ Lower lip
DEEP AURICULAR, ANTERIOR TYMPANIC, AND
ACCESSORY MENINGEAL ARTERIES
→small branches from the first part of the
maxillary artery
It contributes to the blood supply of
✓ External acoustic meatus
✓ Deep surface of the tympanic membrane
✓ Cranial dura mater
Accessory meningeal branch
- also contributes small branches to surrounding
muscle in the infratemporal fossa
- ascends through the foramen ovale into the
cranial cavity to supply the dura mater
BRANCHES FROM THE SECOND PART
→numerous pterygoid arteries also originate from
the second part of the maxillary artery
→supply the pterygoid muscles
DEEP TEMPORAL ARTERIES
→usually, two in number
→originate from the second part of the maxillary
artery
→travel with the deep temporal nerves
→it supplies the temporalis muscle in the
temporal fossa
MASSETERIC ARTERY
→accompanies the masseteric nerve laterally
through the mandibular notch
→supplies the masseter muscle
PTERYGOID PLEXUS
→network of veins
→between the medial and lateral pterygoid
muscles
→between the lateral pterygoid and temporalis
muscles
→veins that drain regions supplied by arteries
branching from the maxillary artery in the
infratemporal fossa connect with the pterygoid
plexus
These tributary veins include those that drain:
• Nasal cavity
• Roof of the oral cavity
• Lateral wall of the oral cavity
• All teeth
• Muscles of the infratemporal fossa
• Paranasal sinuses
• Nasopharynx
Inferior ophthalmic vein
- Can drain through the inferior orbital fissure
into the pterygoid plexus
The small emissary veins, often connect the
pterygoid plexus in the infratemporal fossa to
the cavernous sinus in the cranial cavity. The
emissary veins, which pass through the
foramen ovale, through the cartilage that fills
the foramen lacerum, and through a small
sphenoidal foramen on the medial side of the
lateral plate of the pterygoid process a t the
base of the skull, are a route by which
infections can spread into the cranial cavity
from structures, such as teeth, that are drained
by the pterygoid plexus. Also, because there
are no valves in veins of the head and neck,
anesthetic inadvertently injected under
pressure into veins of the pterygoid plexus can
backflow into tissue or into the cranial cavity.
The pterygoid plexus connects:
- Via a short maxillary vein
Posteriorly - With the retromandibular
vein in the neck
- Via a deep facial vein
Anteriorly - With the facial vein on the
face
16
 PTERYGOPALATINE FOSSA SKELETAL FRAMEWORK
• Palatine
→inverted teardrop-shaped space • Maxilla
→small in size • Sphenoid
→has a strategic location
IT CONSISTS OF:
→major site of distribution for the maxillary nerve
Anterior wall ✓ Posterior surface of Maxilla
and for the terminal part of the maxillary artery
Medial wall ✓ Lateral surface of Palatine
→between bones on the lateral side of the skull
Posterior wall ✓ Parts of the Sphenoid bone
immediately posterior to the maxilla
and Roof
→contains the pterygopalatine ganglion
→communicates via fissures and foramina in its
walls SPHENOID
→anterosuperior surface of the pterygoid process
It communicates with the: →opening onto this surface are two large
• Middle cranial fossa foramina
• Infratemporal fossa • Foramen rotundum
• Floor of the orbit • Anterior opening of the pterygoid canal
• Lateral wall of the nasal cavity
• Oropharynx
• Roof of the oral cavity

Pterygopalatine ganglion
- Where preganglionic parasympathetic fibers
originating from the Facial nerve (VII) synapse
with postganglionic parasympathetic fibers
• These fibers along with sympathetic fibers
originating from the T1 spinal cord level join
branches of the Maxillary nerve (V2)
• All upper teeth
Innervation:
o Maxillary nerve (V2)
Blood supply:
o Terminal part of the maxillary artery
- They pass through the pterygopalatine fossa
FORAMEN ROTUNDUM
→most lateral and superior
→communicates posteriorly with the middle
cranial fossa
o Maxillary nerve (V2)
ANTERIOR OPENING OF THE PTERYGOID CANAL
→more medial and inferior foramen
o Greater petrosal nerve from the
Facial nerve (VII)
o Sympathetic fibers from the internal
carotid plexus
• They join to form the nerve of the pterygoid
canal that passes forward into the
pterygopalatine fossa through this foramen

17
 PTERYGOID CANAL INFERIOR ORBITAL FISSURE
→bony canal →the superior aspect of the anterior wall of the
→runs horizontally through the root of the fossa opens into the floor of the orbit through this
pterygoid process of the sphenoid bone fissure
→opens anteriorly into the pterygopalatine fossa
→continues through the cartilage filling the
foramen lacerum posteriorly
→opens into the middle cranial fossa just
anteroinferior to the internal carotid artery

Internal carotid artery

- Enters the cranial cavity through the carotid
canal

CONTENTS
• Maxillary nerve (V2)
• Terminal part of the maxillary artery
• Branch within the pterygopalatine fossa
• Nerve of the Pterygoid canal

• Veins and lymphatics also pass through the

pterygopalatine fossa

Nerve of the pterygoid canal carries:

✓ Preganglionic parasympathetic fibers
✓ Postganglionic sympathetic fibers
GATEWAYS
Preganglionic parasympathetic fibers
→seven foramina and fissures provide apertures
- From the Greater petrosal branch of the Facial
through which structures enter and leave the
pterygopalatine fossa nerve (VII)
- Synapse in the pterygopalatine ganglion
Postganglionic sympathetic fibers
FORAMEN ROTUNDUM AND PTERYGOID CANAL
- From the Deep petrosal branch of the carotid
→communicates with the middle cranial fossa
plexus
→open onto the posterior wall
- Together with the sympathetic fibers they pass
with branches of the Maxillary nerve (V2) out
PALATOVAGINAL CANAL
of the fossa
→small
→opens onto the posterior wall
MAXILLARY NERVE (V2)
→leads to the nasopharynx
→purely sensory
→originates from the trigeminal ganglion in the
PALATINE CANAL
cranial cavity
→leads to the roof of the oral cavity (hard palate) →exits the middle cranial fossa
→opens inferiorly →enters the pterygopalatine fossa through the
foramen rotundum
SPHENOPALATINE FORAMEN →passes anteriorly through the fossa
→opens onto the lateral wall of the nasal cavity →exits as the infra-orbital nerve through the
→in the medial wall inferior orbital fissure

PTERYGOMAXILLARY FISSURE As it passes through the pterygopalatine fossa it

→the lateral aspect of the pterygopalatine fossa is gives rise to:
continuous with the infratemporal fossa through ✓ Zygomatic nerve
this large gap ✓ Posterior superior alveolar nerve
→between the posterior surface of the maxilla and ✓ Two ganglionic branches
pterygoid process of the sphenoid bone

18
 Posterior inferior nasal nerves
- Pass medially through small foramina in the
perpendicular plate of the palatine bone
It contributes to the innervation of:
✓ Lateral nasal wall

LESSER PALATINE NERVE

→after it passes through the lesser palatine
foramen it passes posteriorly and supply:
✓ Soft palate
Two ganglionic branches NASAL NERVES
- Originate from its inferior surface
→approximately seven in number
- Pass through the pterygopalatine ganglion
→pass medially through the sphenopalatine
foramen to enter the nasal cavity
Postganglionic parasympathetic fibers
- arise in the pterygopalatine ganglion
→most pass anteriorly to supply
- join the general sensory branches of the
✓ Lateral wall of the nasal cavity
Maxillary nerve (V2) in the pterygopalatine
→others pass across the roof to supply
ganglion
✓ Medial wall
The three types of fibers leave the ganglion as:
• One of the nerves passing across the roof to
✓ Orbital branches
supply the medial wall of the nasal cavity is the
✓ Palatine branches
nasopalatine nerve
✓ Nasal branches
✓ Pharyngeal branches NASOPALATINE NERVE

BRANCHES →largest of the nasal nerves

ORBITAL BRANCHES →pass anteriorly down the nasal septum through
→small the incisive canal and fossa in the hard palate to
→pass through the inferior orbital fissure enter the roof of the oral cavity

It contributes to the supply of: It supplies the:

✓ Orbital wall ✓ Mucosa
✓ Sphenoidal sinuses ✓ Gingiva
✓ Ethmoidal sinuses ✓ Glands adjacent to the incisor teeth

GREATER AND LESSER PALATINE NERVES PHARYNGEAL NERVE

→pass inferiorly from the pterygopalatine →passes posteriorly from the pterygopalatine
ganglion ganglion
→enter and pass through the palatine canal →leaves the fossa through the palatovaginal canal
→enter the oral surface of the palate through the
greater and lesser palatine foramina It supplies the:
✓ Mucosa
GREATER PALATINE NERVE ✓ Glands of the nasopharynx

→passes forward on the roof of the oral cavity ZYGOMATIC NERVE

→originates directly from the Maxillary nerve (V2)
Innervates the:
in the pterygopalatine fossa
✓ Mucosa
→it leaves the fossa to enter the orbit through the
✓ Glands of the hard palate
inferior orbital fissure
✓ Adjacent gingiva (almost as far forward as the
→it passes forward on the lateral orbital wall and
incisor teeth)
divides into two branches
• Zygomaticotemporal
• It gives origin to posterior inferior nasal
• Zygomaticofacial
nerves in the palatine canal

19
ZYGOMATICOTEMPORAL BRANCH - Which ultimately join the superior alveolar
→continues forward at the base of the lateral plexus
orbital wall It supplies the:
→passes through a small bony canal in the ✓ Upper teeth
zygomatic bone
MIDDLE SUPERIOR ALVEOLAR NERVE
→enter the temporal fossa through a small
foramen in the lateral orbital margin on the It also supplies the:
posterior surface of the frontal process of the ✓ Maxillary sinus
zygomatic bone
→passes superficially ANTERIOR SUPERIOR ALVEOLAR NERVE
→also gives origin to a small nasal branch
It supplies: →passes medially through the lateral wall of the
✓ Skin over the temple nasal cavity
ZYGOMATICOFACIAL BRANCH
It supplies the:
→passes forward at the base of the lateral orbital ✓ Parts of the areas of the nasal floor and walls
wall
→leaves through a small bony canal in the orbital As the infra-orbital nerve exits the infra-orbital
margin foramen, it divides into:
→opens via multiple small foramina on the • Nasal
anterolateral surface of the zygomatic bone • Palpebral
• Superior labial branches
Its branches supply:
✓ Adjacent skin NASAL BRANCHES
It supplies the:
POSTERIOR SUPERIOR ALVEOLAR NERVE ✓ Skin over the lateral aspect of the external
→originates from the Maxillary nerve (V2) nose
→passes laterally out of the fossa through the ✓ Part of the nasal septum
pterygomaxillary fissure to enter the infratemporal
fossa PALPEBRAL BRANCHES
→continues laterally and inferiorly
It supplies the:
→enter the posterior surface of the maxilla
✓ Skin of the lower eyelid
through a small alveolar foramen approximately
midway between the last molar tooth and the
SUPERIOR LABIAL BRANCHES
inferior orbital fissure
→passes inferiorly deep to the mucosa of the It supplies the:
maxillary sinus to join the superior dental plexus ✓ Skin over the cheek
✓ Upper lip
It supplies the: ✓ Related oral mucosa
✓ Molar teeth
✓ Adjacent buccal gingivae NERVE OF THE PTERYGOID CANAL
It contributes to the: →formed in the middle cranial fossa
✓ Supply of the maxillary sinus →carries mainly preganglionic parasympathetic
and postganglionic sympathetic fibers
INFRA-ORBITAL NERVE →passes into the pterygopalatine fossa
→anterior continuation of the Maxillary nerve (V2) →joins the pterygopalatine ganglion
→leaves the pterygopalatine fossa through the
inferior orbital fissure It is formed by the union of:
→lies in the infra-orbital groove in the floor of the • Greater petrosal nerve
orbit • Deep petrosal nerve
→exits the infra-orbital canal through the infra-
orbital foramen inferior to the orbital margin
→continues forward in the infra-orbital canal
→while in the infra-orbital groove and canal, it
gives origin to:
• Middle and Anterior superior alveolar nerves

20
 GREATER PETROSAL NERVE
→originates from the geniculate ganglion of the
Facial nerve (VII) in the temporal bone
→exits the temporal bone through a small canal
that opens via a fissure onto the anterior surface
of the petrous part of the temporal bone
→passes anteromedially along the posterior
margin of the middle cranial fossa
→passes under the internal carotid artery to
reach the cartilage filling the foramen lacerum
→it also carries some taste (SA) fivers from the
soft palate in the lesser palatine nerve
→carries parasympathetic innervation to all
glands above the oral fissure
GLANDS INNERVATED BY THE GREATER
PETROSAL NERVE
Mucous glands - In the nasal cavity
Salivary glands - In the upper half of the
oral cavity
Lacrimal gland - In the orbit
DEEP PETROSAL NERVE
→formed by postganglionic sympathetic fibers
→originate in the superior cervical sympathetic
ganglion in the neck
→leave the ganglion as the internal carotid nerve
→leaves the internal carotid plexus and joins the
greater petrosal branch of the Facial nerve (VII)
→carries postganglionic sympathetic fibers
destined mainly for blood vessels
• Preganglionic fibers that synapse in the
ganglion are from the T1 spinal nerve
• Some of the fibers from the internal carotid
plexus in converge to form the deep petrosal
nerve
Internal carotid nerve
- Forms the internal carotid plexus around the
internal carotid artery
• The nerve of the pterygoid canal enters the
superior surface of the cartilage that fills the
foramen lacerum
• The nerve passes anteriorly through the
cartilage through the pterygoid canal in the
root of the pterygoid process of the sphenoid
bone
• It passes through the canal and into the
pterygopalatine fossa, where it joins the
pterygopalatine ganglion formed around
branches of the Maxillary nerve
PTERYGOPALATINE GANGLION
→largest of the four parasympathetic ganglia
→ formed by cell bodies of the postganglionic
neurons associated with preganglionic
parasympathetic fibers of the Facial nerve (VII)
→carried by the greater petrosal nerve and the
nerve of the pterygoid canal
• The postganglionic parasympathetic fibers
together with postganglionic sympathetic
fibers that originate in this ganglion, pass
through the ganglion and join the fibers from
the ganglionic branches of the Maxillary nerve
They form the:
✓ Orbital branch
✓ Palatine branch
✓ Nasal branch
✓ Pharyngeal branch
• Other postganglionic parasympathetic and
sympathetic fibers pass superiorly through
the ganglionic branches of the Maxillary nerve
to enter the main trunk of the maxillary nerve
and be distributed
It is distributed into:
✓ Zygomatic nerves
✓ Posterior superior alveolar nerves
✓ Infra-orbital nerves
• The postganglionic parasympathetic and
sympathetic fibers that pass into the orbit
with the zygomatic nerve are particularly
important because they innervate the lacrimal
gland.
INNERVATION OF THE LACRIMAL GLAND
→the postganglionic parasympathetic and
sympathetic fibers leave the zygomaticotemporal
branch of the zygomatic nerve and form a special
autonomic nerve
→this special autonomic nerve travels up the
lateral orbital wall to join the lacrimal nerve
LACRIMAL NERVE
→major general sensory branch of the ophthalmic
nerve (V1)
→passes forward in the orbit at the margin
between the lateral wall and roof
21
• The postganglionic parasympathetic and
sympathetic fibers pass with the lacrimal
nerve to the lacrimal gland
A lesion anywhere along the course of the
parasympathetic fibers that leave the brain as
part of the facial nerve (VII) and are ultimately
carried to the lacrimal gland along branches of
the ophthalmic nerve (V1) results in dry eye
and can eventually lead to loss of vision in the
affected eye.
MAXILLARY ARTERY
→major branch of the external carotid artery in
the neck
→originates adjacent to the neck of the mandible
→passes forward through the infratemporal fossa
→enters the pterygopalatine fossa through the
pterygomaxillary fissure
→the third part of the maxillary artery in the
pterygopalatine fossa is anterior to the
pterygopalatine ganglion
→it gives origin to branches of the maxillary nerve
and the pterygopalatine ganglion
Branches of the maxillary artery:
• Posterior superior alveolar
• Infra-orbital
• Greater palatine
• Pharyngeal
• Sphenopalatine arteries
• Artery of the pterygoid canal
BRANCHES
POSTERIOR SUPERIOR ALVEOLAR ARTERY
→originates from the maxillary artery
→passes through the pterygomaxillary fissure
→meets the posterior superior alveolar nerve and
accompanies it through the alveolar foramen on
the infratemporal surface of the maxilla
It supplies the:
✓ Molar
✓ Premolar teeth
✓ Adjacent gingiva
✓ Maxillary sinus
INFRA-ORBITAL ARTERY
→passes forward with the infra-orbital nerve
→leaves the pterygopalatine fossa through the
inferior orbital fissure
→it lies in the infra-orbital groove and canal with
the infra-orbital nerve
→it emerges through the infra-orbital foramen
It supplies the:
✓ Parts of the face
Within the infra-orbital canal, it gives origin to:
• The branches that contribute to the blood
supply of structures near the floor of the
orbit
• Anterior superior alveolar arteries
Structures near the floor of the orbit that is
supplied by the infra-orbital artery:
✓ Inferior rectus
✓ Inferior oblique muscles
✓ Lacrimal sac

ANTERIOR SUPERIOR ALVEOLAR ARTERIES

It supplies the:
✓ Incisor
✓ Canine
✓ Maxillary sinus
These branches supply:
✓ Nasal cavity GREATER PALATINE ARTERY
✓ Roof of the oral cavity →passes inferiorly with the palatine nerves into
✓ All upper teeth the palatine canal
→gives origin to a lesser palatine branch
They contribute to the blood supply of: →passes forward on the inferior surface of the
✓ Sinuses palate to enter the incisive fossa
✓ Oropharynx →pass superiorly through the incisive canal
✓ Floor of the orbit
It supplies the:
✓ Anterior aspect of the septal wall of the nasal
cavity

22
LESSER PALATINE BRANCH VEINS
→passes through the lesser palatine foramen →drain areas supplies by branches of the terminal
It supplies the: part of the maxillary artery generally travel with
✓ Soft palate these branches back into the pterygopalatine
fossa
→continues through the greater palatine foramen →veins coalesce in the pterygopalatine fossa
It supplies the: →pass laterally through the pterygomaxillary
✓ Hard palate fissure to join the pterygoid plexus of veins in the
infratemporal fossa
PHARYNGEAL BRANCH
→travels posteriorly INFRA-ORBITAL VEIN
→leaves the pterygopalatine fossa through the →drains the inferior aspect of the orbit
palatovaginal canal with the pharyngeal nerve →may pass directly into the infratemporal fossa
through the lateral aspect of the inferior orbital
It supplies the: fissure, bypassing the pterygopalatine fossa
✓ Posterior aspect of the rood of the nasal cavity
✓ Sphenoidal sinus
✓ Pharyngotympanic tube

SPHENOPALATINE ARTERY
→terminal branch of the maxillary artery
→leaves the pterygopalatine fossa medially
through the sphenopalatine foramen
→accompanies the nasal nerves

It gives off:
• Posterior lateral nasal arteries
• Posterior septal branches

POSTERIOR LATERAL NASAL ARTERIES

It supplies the:
✓ Lateral wall of the nasal cavity
✓ Paranasal sinuses

POSTERIOR SEPTAL BRANCHES

→travels medially across the roof

It supplies the:
✓ Nasal septum

• The largest of these branches passes anteriorly

down the septum to anastomose with the end
of the greater palatine artery

ARTERY OF THE PTERYGOID CANAL

→passes posteriorly into the pterygoid canal
→terminates after passing inferiorly through
cartilage filling the foramen lacerum in the
mucosa of the nasopharynx

It supplies the:
✓ Surrounding tissues

23