Anatomy of the Infratemporal

Fossa, Temporomandibular
joint
FERNANDO J. PERALDO, MD, MPH
TEMPORAL AND INFRATEMPORAL FOSSA
• Introduction
• Boundaries
• Contents:
1. muscles: muscles of mastication
2. vessels: maxillary artery and vein, pterygoid plexus of veins
3. nerves: mandibular nerve and otic ganglion
4. temporomandibular joint
The infratemporal fossa
• the region deep to the ramus of the mandible.
• located at the base of the skull, deep to the masseter muscle.
• closely associated with both the temporal and pterygopalatine fossae
• acts as a conduit for neurovascular structures entering and leaving
the cranial cavity
• accommodates the insertion of the temporalis muscle, medial and
lateral pterygoid muscles, mandibular nerve CN V-3, otic ganglion,
chorda tympani nerve, maxillary artery, and the pterygoid plexus of
the veins.
 The infratemporal fossa
Boundaries:
- Deep to the zygomatic arch.
- Anterior to the mastoid and
styloid processes of the
temporal bone.
- Posterior to the maxilla.
- Medial to the ramus of the mandible.
- Lateral to the pterygoid plate and
the pterygomaxillary fissure, a
communication between the
infratemporal fossa and the
pterygopalatine fossa.
Infratemporal fossa
Boundaries:
•Lateral – condylar process and ramus of the mandible bone
•Medial – lateral pterygoid plate; tensor veli palatine, levator veli
palatine and superior constrictor muscles
•Anterior – posterior border of the maxillary sinus
•Posterior – carotid sheath
•Roof – greater wing of the sphenoid bone
•Floor – medial pterygoid muscle
Infratemporal fossa
• The roof of the infratemporal fossa, formed by the greater wing of
the sphenoid bone, provides an important passage for the
neurovascular structures transmitted through the foramen ovale
and spinosum. Among these are the mandibular branch of the
trigeminal nerve and the middle meningeal artery.
Infratemporal fossa
Contents:
•The infratemporal fossa acts as a pathway for neurovascular
structures passing to and from the cranial cavity, pterygopalatine fossa
and temporal fossa.
•also contains some of the muscles of mastication.
•the branches of the mandibular nerve lay deep to the muscle
•the maxillary artery is superficial to it.
Infratemporal fossa

Contents:
1. Muscles
The infratemporal fossa is
associated with the 
muscles of mastication.
The medial and lateral
pterygoids are located
within the fossa itself,
while the masseter and
temporalis muscles insert
and originate into the
borders of the fossa
 Infratemporal fossa
Contents:
2. Nerves
Mandibular nerve – a branch of the
trigeminal nerve (CN V). It enters the fossa
via the foramen ovale, giving rise to motor
and sensory branches. The sensory branches
continue inferiorly to provide innervation to
some of the cutaneous structures of the face.
Auriculotemporal, buccal, lingual and
inferior alveolar nerves – sensory branches
of the trigeminal nerve.
Chorda tympani – a branch of the facial
nerve (CN VII). It follows the anatomical
course of the lingual nerve and provides taste
innervation to the anterior 2/3 of the tongue.
Otic ganglion – a parasympathetic collection
of neurone cell bodies. Nerve fibres leaving
this ganglion ‘hitchhike’ along the
auriculotemporal nerve to reach the parotid
gland.
 Infratemporal fossa
Contents:
3. Vasculature
Maxillary artery – the terminal branch of the
external carotid artery. It travels through the
infratemporal fossa.
Within the fossa, it gives rise to the middle
meningeal artery, which passes through the
superior border via the foramen spinosum.
Pterygoid venous plexus – drains the eye and is
directly connected to the cavernous sinus.
It provides a potential route by which
infections of the face can spread
intracranially.
Maxillary vein
Middle meningeal vein
Otic Ganglion
TMJ: Articulations
TMJ (Temporomandibular Joint)
• The articulations between
the temporal bone (mandibular
fossa) and the mandibular condyle 
- condylar process of
mandible articulates with
glenoid fossa of temporal
bone
• form a synovial joint
Anatomy of TMJ
 Condylar process, continued
– lined by fibrous tissues, primarily hyaline
cartilage
– this is the primary growth center of the
mandible
 damage leads to facial maldevelopment,
including both the mandible and the maxilla
 Coronoid process
– insertion for portions of temporalis and
masseter
MANDIBLE
- The lower jaw
-the bone that forms the lower
part of the skull, and along with
the maxilla (upper jaw), forms
the mouth structure.
-Movement of the lower jaw
opens and closes the mouth and
also allows for the chewing of
food.
-The lower set of teeth in the
mouth is rooted in the lower jaw.
Anatomy of TMJ
 Meniscus (disc)
– synovial fluid above and below disc
– “shock absorber”
– internal derangement in 50% of all
people
 anteriorly and medially most common
 jaw “pops”
– held in place by medial and lateral
capsular ligaments and retrodisc pad
Anatomy of TMJ

• TMJ is diarthrodial (  which is a discontinuous articulation of bones

permitting freedom of movement )
• also a synovial joint, lined on its inner aspect by a synovial membrane,
which secretes synovial fluid. The fluid acts as a joint lubricant and
supplies the metabolic and nutritional needs of the nonvascularized
internal joint structures.
 Anatomy of TMJ
FUNCTIONALLY
•The TMJ is a compound
joint, composed of four
articulating surfaces:
- the articular facets of
the temporal bone and
of the mandibular
condyle and the superior
and inferior surfaces of
the articular disk.
TMJ: CAPSULAR
LIGAMENT 
It encompasses each joint,
attached superiorly to the
temporal bone along the border
of the mandibular fossa and
eminence and inferiorly to the
neck of the condyle along the
edge of the articular facet.
It surrounds the joint spaces and
the disk, attaching anteriorly and
posteriorly as well as medially
and laterally, where it blends
with the collateral ligaments.
 TMJ: CAPSULAR
LIGAMENT 
FUNCTION:
- resist medial, lateral,
and inferior forces, thereby
holding the joint together. It
offers resistance to movement
of the joint only in the
extreme range of motion.
A secondary function of the capsular
ligament is to contain the synovial fluid
within the superior and inferior joint spaces
TMJ: Accessory
ligaments
• Sphenomandibular ligament - a
flate band arising from the
spine of sphenoid & the
petrotympanic fissure, runs
downward medially to the TMJ
capsule and inserted on the
lingula of the mandible.
• Remnant of Meckle’s cartilage.
• maxillary artery and
auriculotemporal nerve lies
between it in mandibular neck. 
TMJ: Articular disc ( meniscus )
 
• Composed of dense fibrous connective tissue and is nonvascularized
and noninnervated.
• Anatomically the disk can be divided into three general regions as
viewed from the lateral perspective: 
1. The anterior band
2. the central intermediate zone 
3. the posterior band.
TMJ
• Blood supply
- Branches from Superficial temporal & Maxillary Artery
• Nerve supply
- Auriculotemporal & Masseteric Nerve
Movements of the TMJ
• The left and right TMJ's work together, enabling the mandible to move as
follows:
- Elevation (up). Generated by the temporalis, masseter, and medial
pterygoid muscles.
- Depression (down). Generated by the digastric, geniohyoid, and
mylohyoid muscles, and assisted by gravity.
- Protraction. Generated primarily through the lateral pterygoid
muscle. Involves the anterior movement of the mandibular condyle and
the articular disc.
- Retraction. Generated by the geniohyoid, digastricus, and temporalis
muscles.
- Side-to-side. Generated by the pterygoid muscles.
End of Lecture
Thank you