Pterygopalatine fossa

Pterygopalatine fossa
ant.: post surface of maxilla
post.: lateral pterygoid plate and greater
wing
g of sphenoid
p
bone;
bone;
med.: perpendicular plate of palatine bone
lat.: open (pterygomaxillary fissure)
roof: body of sphenoid bone and orbital surface of palatine bone
1
Communications of the pterygopalatine fossa
palatine canal
Inferior orbital fissure
Downwards with the mouth via the palatine canal
Medially with the nasal cavity via sphenopalatine foramen
2
Forwards with the orbit and face via inferior orbital fissure
Communications of the pterygopalatine fossa
Foramen rotundum
Pterygoid canal
Backwards with the cranial cavity via the foramen
rotundum and the pterygoid canal
3
Communications of the pterygopalatine fossa
Foramen rotundum
Pterygoid canal
palatine canal
p
Downwards with the mouth via the palatine canal
Medially
y with the nasal cavityy via sphenopalatine
p
p
foramen
Backwards with the cranial cavity via the foramen
rotundum and the pterygoid canal
4
Sphenoid bone (Anterior view)
5
Sphenoid bone (posterior view)
F. rotundum
Pterygoid canal
6
Communications of the pterygopalatine fossa
7
Greater palatine canal
8
Lesser palatine canal
9
Spenopalatine foramen
10
Inferior orbital fissure
11
Foramen rotundum
12
Pharyngeal canal
13
Pterygoid canal
14
Communications of the pterygopalatine fossa
15
Contents of the pterygopalatine fossa
Maxillary
y artery
y ((3rd p
part))
Maxillary nerve (V2)
16
Maxillary a.(3rd part)
posterior superior alveolar a.:
a.: descend on the posterior part of the maxilla
and supply the gums,, molar teeth,
teeth, premolar teeth, and maxillary sinus
descending palatine a..: i) greater palatine a.: via greater palatine canal,, ii)
lesser palatine a
a.:
.:: via lesser palatine canal
infraorbital a.:: through the inferior orbital fissure
 infraorbital groove
and canal
 infraorbital foramen
17
Maxillary a.(3rd part)
sphenopalatine
p
p
a.:
.: via sphenopalatine
p
p
foramen
 nasal cavity
cavity
y p
post.
nasal lateral (superior) and septal branches
artery of pterygoid canal (or Vidian a.): courses posteriorly via pterygoid
canal
pharyngeal a.: via pharyngeal canal
 roof of pharynx
pharynx auditory tube
18
Maxillary
i
a.(3
( rdd part))
posterior superior alveolar a.:
a.:
descend on the posterior
part of the maxilla and
supply the gums,, molar
teeth,, premolar teeth, and
teeth
maxillary sinus
infraorbital a.:: through the inferior
orbital fissure
 infraorbital
groove and canall infraorbital
foramen
sphenopalatine a.:
.: via sphenopalatine
foramen
 nasal cavity
cavity post.
nasal lateral (superior) and septal
branches
19
Maxillary a.(3rd part)
artery of pterygoid canal (or Vidian a.): courses posteriorly via pterygoid canal
pharyngeal a.: via pharyngeal canal
 roof of pharynx
pharynx auditory tube
20
Maxillary a.(3rd part)
descending palatine a..: i) greater palatine a.:
.: via greater palatine
canal,, ii) lesser palatine a.: via lesser palatine canal
sphenopalatine a.:
.: via sphenopalatine foramen
 nasal cavity
cavity
post. nasal lateral (superior) and septal branches
21
Maxillary a.(3rd part)
descending palatine a..: i) greater palatine a.:
.: via greater palatine
canal,, ii) lesser palatine a.:
.: via lesser palatine canal
sphenopalatine a.:
.: via sphenopalatine foramen
 nasal cavity
cavity
post. nasal lateral (superior) and septal branches
22
Maxillary nerve (V2)
Maxillary nerve: leaves the middle cranial
f
fossa
via
i foramen
f
rotundum
t d
and
d
enters the pterygopalatine fossa,
from which its branches radiate
zygomatic n. — entering the orbit via the inferior orbital fissure — it divides
into: zygomaticotemporal,
zygomaticotemporal and zygomaticofacial nn
23
Maxillary nerve (V2)
a) Nerve of pterygoid canal,, b) pharyngeal n.,
., c) greater & lesser palatine n..,
d) nasopalatine n., e) post. sup. lateral nasal n.
24
Maxillary nerve (V2)
Maxillary nerve: leaves the middle
cranial fossa via foramen
rotundum and enters the
pterygopalatine fossa, from which
its branches radiate
zygomatic n. — entering the orbit via the inferior orbital fissure — it divides
into: zygomaticotemporal,
zygomaticotemporal and zygomaticofacial nn
25
Roots to the pterygopalatine ganglion
Pterygopalative
. — located
below
V2 inn.
the—upper
part of the
Nasopalatineganglion
n & posterior
n,
superior
nasal
via sphenopalatine
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pterygopalatine
fossa opposite the sphenopalatine foramen
foramen
Maxillary nerve (V2)
posterior superior alveolar n . — descend on the posterior part of the
maxillary bone
infraorbital n . — via inferior orbital fissure infraorbital groove and
canal branches
27
Infraorbital nerve
a) middle and anterior superior alveolar n.
b) inferior palpebral, external nasal, and superior labial n.
infraorbital foramen
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Sphenopalatine foramen
Nasopalatine n.
Sphenopalatine a.
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Pterygopalatine ganglion
Pterygopalative ganglion— located below V2 in the upper part of the
pterygopalatine fossa opposite the sphenopalatine foramen
branch
b
h from
f
maxillary
ill
nerve (V2) via
i the
th pterygopalatine
t
l ti ganglion
li
(
(no
synapse))
to nose (GSA)
30
Pterygopalatine ganglion
from superior cervical ganglion to form postganglionic sympathetic
fib
fibers
by
b internal
i t
l carotid
tid a. via
i deep
d
petrosal
t
l n.. nerve off the
th
pterygoid canal pterygopalatine ganglion (no synapse) nose,
palate, and pharynx
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preganglionic parasympathetic fibers from facial n. greater petrosal
n. nerve off the pterygoid
i cana pterygopalatine
i
ganglion
i
(synapse) zygomatic n.  lacrimal n. innervate lacrimal gland
32
Pterygopalatine fossa
1)
2)
3)
4)
Downward: palatine canal
Inward: sphenopalatine foramen
F
Forward:
d inferior
i f i orbital
bit l fissure
fi
Backward: foramen rotundum, pterygoid canal,
palatovaginal groove
5) Outward: pterygomaxillary fissure
Maxillary
M
ill
artery:
t
Infraorbital a., descending (greater &
lesser) palatine a.,
a sphenopalatine a
a.
Maxillary
y nerve:
Infraorbital n., zygomatic n., greater &
lesser palatine n., nasopalatine n., nerve
off pterygoid
t
id canall
33
Pterygopalatine ganglion:
1) Sympathetic fibers deep petrosal n.
2) Parasympathetic fibers from facial n. great petrosal
n. Nerve of pterygoid canal pterygopalatine
ganglion zygomatic n.
n  lacrimal n
n.
 larimal
gland
1)+ 2)  Nerve
N
off pterygoid
t
id canall
34
Pterygopalatine fossa
Dr. Lue, Grossanatomy
Pterygopalatine fossa: a small pyramidal space inferior to the apex of the orbit
— bounded by: 1) Ant.: post surface of maxilla; 2) Post.: lateral pterygoid plate
and greater wing of sphenoid bone; 3) Med.: perpendicular plate of palatine
bone; 4) Lat.: open (pterygomaxillary fissure); 5) Roof: body of sphenoid
bone and orbital surface of palatine bone
This is an important region for the ENT territory. It communicates:
1) Downwards with the mouth via the palatine canal
2) Medially with the nasal cavity via sphenopalatine foramen
3) Forwards with the orbit and face via inferior orbital fissure
4) Backwards with the cranial cavity via the foramen rotundum, pterygoid
canal and palatovaginal groove (pharyngeal canal)
5) Laterally with the infratemporal fossa via the pterygomaxillary fissure
Contents of the pterygopalatine fossa
Maxillary artery (3rd part)
1) posterior superior alveolar a.: descend on the posterior part of the maxilla
and supply the gums, molar teeth, premolar teeth, and maxillary sinus
2) infraorbital a.: through the inferior orbital fissure infraorbital groove
and canal infraorbital foramen
i) anterior superior alveolar: supply maxillary sinus, canine and incisor teeth
3) descending palatine a.: through the palatine canal
i) greater palatine a.: via greater palatine canal hard palate incisive
canal nasal cavity
ii) lesser palatine a.: via lesser palatine canal soft palate
4) artery of pterygoid canal (or Vidian a.): courses posteriorly via pterygoid
canal
5) pharyngeal a.: via palatovaginal groove (pharyngeal canal) roof of
pharynx auditory tube
6) sphenopalatine a.: via sphenopalatine foramen nasal cavity lateral
and septal posterior nasal branches
Maxillary nerve (V2)
— leaves the middle cranial fossa via foramen rotundum and enters the
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pterygopalatine fossa, from which its branches radiate
zygomatic n. — entering the orbit via the inferior orbital fissure — it divides
into: zygomaticotemporal, and zygomaticofacial nn.
roots to the pterygopalatine ganglion related to the ganglion are branches:
a) nerve of pterygoid canal (Vidian n.)
b) pharyngeal n.
c) greater and lesser palatine n.
d) nasopalatine n.: via sphenopalatine foramen nasal septum
incisive canal
e) posterior superior lateral nasal n.: via sphenopalatine foramen
posterior part of nasal cavity sup. and middle conchae
posterior superior alveolar n.: descend on the posterior part of the maxillary
bone
infraorbital n.: via inferior orbital fissure infraorbital groove and canal
branches:
a) middle and anterior superior alveolar n.
b) inferior palpebral, external nasal, and superior labial n. infraorbital
foramen
Pterygopalative ganglion
— located below V2 in the upper part of the pterygopalatine fossa opposite the
sphenopalatine foramen
a) branch from maxillary nerve (V2) via the pterygopalatine ganglion (no synapse)
to nose (GSA)
b) from superior cervical ganglion to form postganglionic sympathetic fibers by
internal carotid a. via deep petrosal n. nerve of the pterygoid canal
pterygopalatine ganglion (no synapse) nose, palate, and pharynx
c) preganglionic parasympathetic fibers from facial n. great petrosal n.
forame lacerum nerve of the pterygoid canal pterygopalatine ganglion
(synapse) zygomatic n.  lacrimal n.  innervate lacrimal gland
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