LP 3
LP 3
LP 3
Temporo-zygomatico-pterygo-masticatory space
• Masseter
• Temporalis
• Lateral pterygoid
• Medial pterygoid
Function
The lateral pterygoid muscle functions as the sole muscle of mastication to causes depression of the
mandible. This being the case, depression of the mandible is largely the result of gravity.
It also assists with protrusion and side to side movement of the mandible.
Accessory Muscles of Mastication
Suprahyoid muscles
The suprahyoid muscle group is made up of the digastric muscle, mylohyoid muscle, and geniohyoid
muscle. They depress the mandible against resistance when infrahyoid muscles fix or depress the
hyoid bone.
Infrahyoid muscles
They are made up of the omohyoid, sternohyoid, sternothyroid, and thyrohyoid. They fix or
depresses hyoid bone.
Buccinator
The buccinator is a facial expression muscle that helps in mastication by keeping food pushed back
within the oral cavity.
The Infratemporal Fossa
The infratemporal fossa is a complex area located at the base of the skull, deep to the masseter muscle.
It is closely associated with both the temporal and pterygopalatine fossae and acts as a conduit for
neurovascular structures entering and leaving the cranial cavity.
Borders
The infratemporal fossa can be said to have a wedge shape. It is located deep to the masseter muscle and
zygomatic arch (to which the masseter attaches). The fossa is closely associated with both the pterygopalatine
fossa, via the pterygomaxillary fissure, and also communicates with the temporal fossa, which lies superiorly .
The boundaries of this complex structure consists of both bone and muscle:
Contents
The infratemporal fossa is associated with the muscles of mastication. The medial and lateral pterygoids are located
within the fossa itself, whilst the masseter and temporalis muscles insert and originate into the borders of the fossa.
Nerves
The infratemporal fossa forms an important passage for a number of nerves originating in the cranial cavity :
It is located between the maxilla, sphenoid and palatine bones, and communicates with other regions of the skull and facial
skeleton via several canals and foramina. Its small volume combined with the numerous structures that pass through makes
this a complex region for anatomy students.
Borders
Maxillary Nerve
The maxillary nerve is the second branch of the trigeminal
nerve (CNV2). It passes from the middle cranial fossa into the
pterygopalatine fossa through the foramen rotundum.
Postsynaptic parasympathetic fibres leave the ganglion and distribute with branches of the maxillary nerve
(CNV2). These fibres are secretomotor in function, and provide parasympathetic innervation to the lacrimal gland,
and muscosal glands of the oral cavity, nose and pharynx.
Maxillary Artery
The maxillary artery is a terminal branch of the external carotid artery. The terminal portion of the maxillary artery lies
within the pterygopalatine fossa. Here, it separates into several branches which travel through other openings within the
fossa to reach the regions they supply.
These branches include, but are not limited to:
Pterygomaxillary Fissure
The pterygomaxillary fissure connects the infratemporal fossa with the pterygopalatine fossa .It transmits two
neurovascular structures:
Posterior superior alveolar nerve – a branch of the maxillary nerve. It exits through the fissure into the
infratemporal fossa, where it goes on to supply the maxillary molars.
Terminal part of the maxillary artery – enters the pterygopalatine fossa via the fissure.
Foramen Rotundum
The foramen rotundum connects the pterygopalatine fossa to the middle cranial fossa. It is one of three
openings in the posterior boundary of the pterygopalatine fossa. It conducts a single structure, the maxillary
nerve.
Pterygoid and Pharyngeal Canals
These two canals, along with the foramen rotundum, are the three openings in the posterior wall of the
pterygopalatine fossa:
• Pterygoid canal – runs from the middle cranial fossa and through the medial pterygoid plate. It carries the
nerve, artery and vein of the pterygoid canal.
• Pharyngeal canal – communicates with the nasopharynx. It carries the pharyngeal branches of the
maxillary nerve and artery.
The inferior orbital fissure forms the superior boundary of the pterygopalatine fossa and communicates with
the orbit. It is a space between the sphenoid and maxilla bones.
The zygomatic branch of the maxillary nerve and the infraorbital artery and vein pass through the inferior
orbital fissure.
Greater Palatine Canal
The greater palatine canal lies in the inferior boundary of the pterygopalatine fossa, and communicates with
the oral cavity. The canal is formed by a vertical groove in the palatine bone which is closed off by an
articulation with the maxilla. Branching from the greater palatine canal are the accessory lesser palatine
canals.
The greater palatine canal transmits the descending palatine artery and vein, the greater palatine nerve and
the lesser palatine nerve.
Sphenopalatine Foramen
This foramen is the only opening in the medial boundary. It connects the pterygopalatine fossa to the nasal
cavity – specifically the superior meatus.
It is formed by the sphenopalatine notch at the superior aspect of the perpendicular plate of the palatine bone
and the body of the sphenoid.
The sphenopalatine foramen transmits the sphenopalatine artery and vein, as well as the nasopalatine nerve
(a large branch of the pterygopalatine ganglion – CNV2).
Facial artery and vein, distribution territories
Blood Supply
Facial Vein
Sensory Motor
Branches of Branches of
Trigeminal Nerve 5th Facial nerve
cranial nerve 7th cranial nerve
Sensory supply
Cutaneous innervation of the face is by
Trigeminal nerve
Areas supplied :
Of lower lip
Buccal
• Cervical - platysma
Cervical
Mandibular
Supra nuclear lesion
Including:
• The conjunctiva
• Parotid area
Middle territory-
Submandibular nodes
• External nose
• Upper lip
Lower territory –
Submental nodes
• Central part of the lower lip
• Chin
Parotid duct (Stensen Duct)
Two major ducts arising from the parotid gland unite within the
substance of the organ to form the parotid duct of Stensen. The
parotid duct is roughly 7 cm x 3 mm long and leaves the
superior part of the anteromedial surface of the gland. It
passes horizontally over the surface of the masseter muscle
then courses medially toward the anterior border of the
muscle. The duct then makes an abrupt right turn to cross the
buccinator muscle and associated buccal fat pad.
Vascular supply
The arteries and veins that traverse the substance of the parotid gland are also responsible for supplying and
draining the organ. The arterial supply arises from branches of the external carotid artery, while the venous
drainage is via the retromandibular vein. Lymphatic fluid drains to the superior deep cervical lymph nodes.
Arterial supply
The branches of the external carotid artery that supply the parotid gland are the superficial temporal,
maxillary, and (indirectly) the transverse facial arteries. The external carotid artery travels parallel to the
mandible after leaving the carotid bifurcation. It continues toward the parotid gland to enter the substance of
the organ. Here, it gives off the superficial temporal and maxillary arteries (which are both terminal branches
of the external carotid artery).
The superficial temporal artery supplies the superior aspect of the gland, while the maxillary artery supplies
the medial aspect of the gland. The transverse facial artery arises off the superficial temporal artery. Not only
does it supply the parotid gland, but also the duct and nearby masseter muscle as well.
Venous drainage
There are numerous lymph nodes distributed throughout and around the substance of the parotid
gland. This is an exception to the norm as all other salivary glands (both major and minor) do not have
lymph nodes within the glandular tissue and have far fewer nodes surrounding them. The lymph nodes
of the parotid gland are distributed throughout the superficial and deep lobes of the gland.
The majority of the lymph nodes (about 90%) are found in the superficial node. The nodes themselves
are situated close to the surface of the gland, between the capsule and glandular tissue. The superficial
set of lymph nodes drains the external acoustic meatus, auricle (pinna), scalp, eyelids, and lacrimal
glands in addition to the parotid gland. The deep set of lymph nodes also drains other structures in
addition to the parotid gland: external acoustic meatus, soft palate, middle ear, and nasopharynx.
Innervation
Every structure in the human body have interactions with the
brain through any varying combinations of cranial and
peripheral nerves. There are two major modalities that are
transmitted to and from the parotid gland - autonomic
instructions and sensory perceptions. These nerve impulses are
transmitted along cranial nerves to the gland.