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 26 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 28 Sphenopalatine foramen Nasopalatine n. Sphenopalatine a. 29 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 31 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 5 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 6
© Copyright 2024