Infratemporal
p
regions
g
Infratemporal fossa:
fossa space behind the maxilla,
maxilla
b l
below
& deep
d
to
t the
th zygomatic
ti arch
h
1
Infratemporal fossa
Ant.: posterior aspect of the
maxilla
Med.: lateral pterygoid plate
Post.: tympanic plate,
plate, mastoid
and styloid processes
Lat: ramus of the mandible
2
Infratemporal fossa
Sup : infratemporal surface of the greater wing of the sphenoid bone
Sup.:
Inf.: where the medial pterygoid m. attaches
3
Contents of the infratemporal fossa
temporalis m.
Lat. pterygoid m.
Med pterygoid m
Med.
m.
4
Contents of the infratemporal fossa
temporalis m.
5
Contents of the infratemporal fossa
Lat. pterygoid m.
Med. pterygoid m.
6
Contents of the infratemporal fossa
Lat. pterygoid m.
Med. pterygoid m.
7
Contents of the
infratemporal fossa
Med pterygoid m
Med.
m.
8
Contents of the infratemporal fossa
Pterygoid venous plexus: located between the temporalis & the lat.
pterygoid m.,
m and partly between two pterygoid m.
m
Connect with a) cavernous sinus, b) vein of obit, c) pharyngeal
plexus, d) facial v., e) maxillary v.
9
Maxillary a.
Deep
p auricular a.: ascend in
the parotid gland posterior
to the TMJ
Ant. tympanic a.: enter the
tympanic cavity
Inf. alveolar a.: descend with the inf. alveolar n.
to the mandibular foramen
Middle meningeal a.:
a : between the sphenomandibular lig
lig. and lat.
lat pterygoid m
m.
m.,
enter the foramen spinosum
Accessory meningeal a.: enter the foramen ovale
10
Maxillary a.
Masseteric a.: passes laterally
through mandibular notch
Deep temproal a.: passes between
the temporalis m. and
pericranium
p
Pterygoid br.: to lat. and med.
pterygoid m.
Buccal a
a.:: courses between the heads of
the lat. pterygoid m.., in
11
company with buccal n.
Maxillary a.
Middle meningeal a.: between the
sphenomandibular
h
dib l lig.
li and
d lat.
l t
pterygoid m.,
m. enter the
foramen spinosum
Inf. alveolar a.: descend with the inf.
alveolar n. to the mandibular
foramen
Masseteric a.: passes laterally
through mandibular notch
Buccal a.: courses between the heads of
the lat. pterygoid m.
m., in company
with buccal n.
12
Mandibular division of trigeminal n.
Mandibular division of
trigeminal nerve via the
foramen ovale
Meningeal br.: passes back via the foramen spinosum in
company with
ith middle
iddl menigeal
i
l a.
Medial pterygoid n.: via the otic ganglion to supply medial
pterygoid m.
m
Lateral pterygoid n.: enter the deep surface of lat. pterygoid m.
13
Mandibular division of trigeminal n.
Deep ttemporall n.: superior
D
i to
t lat.
l t pterygoid
t
id m.,
m. enter
t th
the deep
d
surface
f
off
temporalis m.
Masseteric n.: passes through the mandibular notch to supply
masseteric m. and TM joint
Buccal n.: passes between the two heads of the lateral pterygoid m.
14
Mandibular division of trigeminal n.
Auriculotemporal n
n.:: arises by two roots which encircle the middle meningeal a
a.
and form a single trunk, processed between the neck of the mandible and the
sphenomandibular ligament
I f i alveolar
Inferior
l
l n: company with
ith lingual
li
l n. , via
i mandibular
dib l foramen
f
Lingual n.: courses between the medial pterygoid m.. and the body of the mandible 15
Mandibular division of trigeminal n.
Inferior alveolar n: company with lingual n. ,
via mandibular foramen
Mylohyoid n.: arises near the mandibular
foramen from the inf. alveolar n., to
supply mylohyoid m. and ant. belly of
digastric m.
Lingual n.: courses between the medial
pterygoid m. and the body of the
mandible
Chorda tympanic n.: belong to facial n. ,
jjoins with lingual
g
n.,, to synapse
y p the
submandibular ganglion to supply the
submandibular and sublingular glands.
Otic ganglion: is located just below the
foramen ovale
16
Mandibular division of trigeminal n.
Chorda tympani
B
Buccal
l n.
Auriculotemporal n.
Inferior alveolar n.
Lingual n.
Mylohyoid n.
Auriculotemporal n.: arises by two roots which encircle the middle meningeal a.
and form a single trunk, processed between the neck of the mandible and the
sphenomandibular ligament
Buccal n.: passes between the two heads of the lateral pterygoid m.
17
18
Temporomandibular joint (TMJ)
Articular tubercle
Head of condyloid process
Mandibular
of mandible
fossa
The TMJ is a synovial joint between (i) the articular tubercle, the
mandibular fossa of the temporal bone above, and (ii) the head of the
condyloid process of the mandible below
19
Temporomandibular joint (TMJ)
articular capsule:
from rim of mandibular fossa and
articular tubercle to neck of condyloid
process
lateral (temporomandibular) lig.
articular disk
lower surface is concave and
upper surface is concavoconvex
a thickened part of the capsule,
extends from the zygomatic arch to
the neck of the mandible
20
Temporomandibular joint (TMJ)
sphenomandibular ligament
from the spine of the sphenoid
bone to the lingula of the
mandible
stylomandibular ligament
from the apex of the styloid
process to the posterior border of
the ramus of the mandible near
21
its angle
Temporomandibular joint (TMJ)
lateral (temporomandibular) lig.
a thickened part of the capsule,
extends from the zygomatic arch
to the neck of the mandible
stylomandibular ligament
from the apex of the styloid
process to the posterior border of
the ramus of the mandible near its
angle
sphenomandibular ligament
from the spine of the sphenoid
bone to the lingula of the
mandible
22
Temporomandibular joint (TMJ)
blood supply
pp y — superficial
p
temporal
p
branch of the external
carotid a., masseteric a.
innervation — branches of the auriculotemporal and masseteric
nerves.
23
Muscles of mastication
temporalis: from temporal line to
coronoid process and ant.
border of the ramus of the
mandible
masseter: from inferior border of
zygomatic arch to lateral
surface of the ramus of the
mandible and coronoid process
lateral pterygoid: from greater wing of the
sphenoid bone and lateral pterygoid
plate to neck of the mandible
medial pterygoid: from tuberosity of the
maxilla and the medial surface of the
lateral pterygoid plate to the angle and
ramus of the mandible
24
Actions of temporomandibular joint
25
Actions of temporomandibular joint
26
Infrafemporal fossae
Contents of the infratemporal fossa:
part of the temporalis, lateral and medial pterygoid
muscles,
l
maxillary
ill
artery,
t
pterygoid
t
id venous plexus,
l
and
d th
the
mandibular and chorda tympani nerves
Maxillary artery:
Middle meningeal a., inferior alveolar a., masseteric a., buccal
a.
Mandibular division:
Masseteric n., buccal n., auriculotemporal n., lingual n., inferior
alveolar n., mylohyoid n.
Otic ganglion:
Lesser petrosal n.,
n auriculotemporal n
n., parotid gland
27
Temporomandiblular joint (TMJ)
The TMJ is a synovial joint between (i) the articular tubercle,
the mandibular fossa of the temporal bone above, and (ii) the
head of the condyloid process of the mandible below
Ligament:
Articular capsule, lateral (temporomandibular) ligament,
articular disk,
disk sphenomandibular ligament,
ligament
stylomandibular ligament
Muscles of mastication :
T
Temporalis,
li masseter,
t
l t l pterygoid,
lateral
t
id medial
di l pterygoid
t
id
28
Infratemporal Regions and TM Joint
Dr. Lue, Grossanatomy
Infrafemporal fossae
Infratemporal fossa: is the irregularly shaped space behind the maxilla, below and
deep to the zygomatic arch
1) bounded by: Lat.: ramus of the mandible; Med.: lateral pterygoid plate; Ant.:
post. aspect of the maxilla; Post.: tympanic plate, mastoid and styloid
processes; Sup.: infratemporal surface of the greater wing of the sphenoid
bone; Inf.: where the medial pterygoid m. attaches
2) the contents of the infratemporal fossa: part of the temporalis, lateral and
medial pterygoid muscles, maxillary artery, pterygoid venous plexus, and
the mandibular and chorda tympani nerves
Mm of mastication
Pterygoid venous plexus— located partly between the temporalis and the lateral
pterygoid, and partly between the two pterygoid muscles
- connects with a) cavernous sinus; b) veins of the orbit; c) pharyngeal plexus
of veins; d) facial v.; e) maxillary v.
Maxillary artery
The first part of the maxillary artery passes through bony canals
deep auricular a.: ascend in the parotid gland posterior to the TMJ external
auditory meatus
anterior tympanic a.: enter the tympanic cavity
middle meningeal a.: between the sphenomandibular lig. and lat. pterygoid m.,
enter the foramen spinosum
accessory meningeal a.: enter the foramen ovale
inferior alveolar a.: descend with the inferior alveolar n. to the mandibular
foramen
The second part supplies muscles of mastication and buccinator muscles
masseteric a.: passes laterally through the mandibular notch
deep temporal aa. (anterior and posterior): passes between the temporalis m.
and pericranium
pterygoid branches. lateral and medial pterygoid muscles
buccal a.: courses between the heads of the lateral pterygoid muscle and in
1
company with the buccal nerve
Mandibular division of trigeminal nerve via the foramen ovale
A. Undivided trunk
(a) meningeal br.: passes back via the foramen spinosum in company with
middle meningeal a.
(b) medial pterygoid n. via otic ganglion to supply medial pterygoid muscle
— also provides the nerve to the tensor veli palatini muscle and the nerve to
the tensor tympani m.
B. Anterior division
(a) masseteric n.: passes through the mandibular notch to supply masseteric
m. and TM joint
(b) lateral pterygoid n.: enter the deep surface of that muscle
(c) deep temporal n. (anterior & posterior): superior to lateral pterygoid m.,
enter the deep surface of temporalis m.
(d) buccal n.: passes between the two heads of the lateral pterygoid m., to
innervate skin of the cheek and mucous membrane of the mouth
C Posterior division
auriculotemporal n.: arises by two roots which encircle the middle meningeal a.
and form a single trunk, proceeds between the neck of the mandible and the
sphenomandibular ligament, supplies parts of the auricle, external acoustic
meatus, tympanic membrane and skin in temporal region
— carries postganglionic parasympathetic fibers (belonging to the
glossopharyngeal nerve) from otic ganglion to parotid gland
lingual n.: course between the medial pterygoid m. and the body of mandible,
GSA to anterior 2/3 of tongue and contiguous gums; joined by chorda
tympani n., which consists of: i) carries preganglionic parasympathetic fibers
(belonging to facial n.) to synapse in the submandibular ganglion to
innervate the submandibular and sublingual glands; and ii) SVA for anterior
2/3 of the tongue
inferior alveolar n.: company with the lingual n.
— via mandibular foramen mandibular canal a) incisive n.; b) inf. dental
plexus; and c) mental n. (mental foramen)
— mylohyoid n.: arises near the mandibular foramen from the inferior alveolar
2
nerve innervate mylohyoid m. and anterior belly of digastric m.
Otic ganglion: is located just below the foramen ovale, below passes though it:
a) nerve to medial pterygoid, tensor tympani and tensor veli palatini m. (no synapse)
b) postganglionic sympathetic from plexus on middle meningeal a. (no synapse)
c) preganglionic parasympathetic (lesser petrosal n.)from IX (synapse), then by
auriculotemporal n. to innervate parotid gland
Temporomandiblular joint (TMJ)
The TMJ is a synovial joint between (i) the articular tubercle, the mandibular
fossa of the temporal bone above, and (ii) the head of the condyloid process of
the mandible below.
Ligaments
1) articular capsule: from rim of mandibular fossa and articular tubercle to neck of
condylar process
2) lateral (temporomandibular) ligament — a thickened part of the capsule,
extends from the zygomatic arch to the neck of the mandible
3) articular disk: lower surface is concave and upper surface is concavoconvex
4) sphenomandibular ligament: from the spine of the sphenoid bone to the
lingula of the mandible
5) stylomandibular ligament : from the apex of the styloid process to the
posterior border of the ramus of the mandible near its angle.
Innervation and blood supply
blood supply— superficial temporal branch of the external carotid a.,
masseteric a.
innervation — branches of the auriculotemporal and masseteric nerves.
Muscles of mastication
1) temporalis: from temporal line to coronoid process and ant. border of the ramus
of the mandible
2) masseter: from inferior border of zygomatic arch to lateral surface of the ramus
of the mandible and coronoid process
3) lateral pterygoid: from greater wing of the sphenoid bone (sup. head) and lat.
surface of lateral pterygoid plate (inf. head) to neck of the mandible
4) medial pterygoid: from tuberosity of the maxilla (superficial head) and the
3
medial surface of the lateral pterygoid plate (deep head) to the angle and ramus
of the mandible
The chief factors responsible for these movements may be summarized as follows:
Action
Muscles provided
depression
lateral pterygoid, digastric, gravity
elevation
temporalis, masseter, medial pterygoid
protrusion
lateral and medial pterygoids, masseter
retraction
temporalis (post. fibers)
lateral movement
temporalis and masseter (ipsilateral), medial and lateral
pterygoids (contralateral)
4