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    Temple, Infratemporal Fossa, TMJ: - Code: NS29 - Lecturer: Dr. S. Kandiah - Date: 9 October 2013

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    Nolan
    This document provides an overview of the temple, infratemporal fossa, and temporomandibular joint (TMJ). It discusses the divisions of the trigeminal nerve and their exits from the skull. It also describes the boundaries and contents of the infratemporal fossa, including the mandibular nerve and branches, maxillary artery, and venous drainage. Finally, it reviews the osteology, movements, innervation and blood supply of the TMJ.

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    Temple, Infratemporal Fossa, TMJ: - Code: NS29 - Lecturer: Dr. S. Kandiah - Date: 9 October 2013

    Uploaded by

    Nolan
    18 views37 pages
    This document provides an overview of the temple, infratemporal fossa, and temporomandibular joint (TMJ). It discusses the divisions of the trigeminal nerve and their exits from the skull. It also describes the boundaries and contents of the infratemporal fossa, including the mandibular nerve and branches, maxillary artery, and venous drainage. Finally, it reviews the osteology, movements, innervation and blood supply of the TMJ.

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    This document provides an overview of the temple, infratemporal fossa, and temporomandibular joint (TMJ). It discusses the divisions of the trigeminal nerve and their exits from the skull. It also describes the boundaries and contents of the infratemporal fossa, including the mandibular nerve and branches, maxillary artery, and venous drainage. Finally, it reviews the osteology, movements, innervation and blood supply of the TMJ.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    18 views37 pages

    Temple, Infratemporal Fossa, TMJ: - Code: NS29 - Lecturer: Dr. S. Kandiah - Date: 9 October 2013

    Uploaded by

    Nolan
    This document provides an overview of the temple, infratemporal fossa, and temporomandibular joint (TMJ). It discusses the divisions of the trigeminal nerve and their exits from the skull. It also describes the boundaries and contents of the infratemporal fossa, including the mandibular nerve and branches, maxillary artery, and venous drainage. Finally, it reviews the osteology, movements, innervation and blood supply of the TMJ.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 37

    Temple, Infratemporal Fossa, TMJ

    Code: NS29
    Lecturer: Dr. S. Kandiah
    Date: 9th October 2013

    Learning Objectives
    Mandible and muscles of the first
    branchial arch
    Temporomandibular joint
    Maxillary artery
    Lingual nerve

    The divisions of the trigeminal nerve are segregate to exit


    the skull through separate foramen

    Opthalmic (V1) Maxillary (V2) Mandibular (V3)


    Standing Room Only
    Superior Orbital Fissure (V1) Foramen Rotundum (V2) Foramen Ovale (V3)

    The mandibular division of the trigeminal is both


    sensory and motor
    Trigeminal nerve (V) Motor Supply to
    Opthalmic (V1)

    Muscles of mastication
    Sensory
    -Temporalis
    2 Large
    -Masseter
    Maxillary nerve (V2)
    -Medial Pterygoid
    2 Pterygoids
    Sensory
    -Lateral Pterygoid
    And others
    Mandibular division (V3) -mylohyoid
    Sensory
    -Ant. Belly of Digastric
    2 Floor
    st
    Motor(1 Branchial arch)
    -Tensor Tympani
    -Tensor Palati
    2 Tensors

    The cutaneous branches of the trigeminal V3 division

    1) Auriculotemporal
    2) Buccal
    3) Mental

    V3 dermatome

    What is Hiltons Law?

    The boundaries of the temporal fossa

    Temporal fossa
    1)Occupied by
    temporalis
    2)Superior temporal
    line
    3)Zygomatic arch

    Boundaries of the infratemporal fossa.


    Temporal Fossa

    Frontal

    Parietal

    Sphenoid

    Temporal

    Boundaries:
    Lateral=Ramus of Mandible
    Anterior=Maxilla
    Medial=Lat. Pterygoid Plate
    Roof=Sphenoid

    Maxilla
    Lat. Pterygoid Plate
    Pterygomaxillary Fissure

    Infratemporal Fossa

    Osteology of the mandible


    Mandibu
    lar
    notch
    Condyl
    e

    Corono
    id
    proces
    s
    Body

    Neck
    Ram
    us
    Angl
    e

    Mandibular nerve & branches in the infratemporal fossa

    1) Auriculotemporal Nerve
    1) Skin over the Temple
    2) Parasymapthetic to parotid gland (IX nerve)
    2) Inferior Alveolar Nerve
    1) Lower Teeth and associated gingivae
    2) Mental Nerve
    3) Lingual Nerve

    1) Anterior 2/3 of the tongue General Sensatio


    4) Buccal Nerve
    1) Skin over the cheek + 2nd/3rd Molar Teeth
    5) Motor Nerves (Masseteric etc.)

    Mandibular Nerve & Branches

    1) Inferior alveolar nerve supplies


    lower jaw teeth
    2) Local anesthetic injected deep to
    last molar close to mandibular
    foramen for dental surgery (can
    spread to mental and lingual
    nerves)
    3) Mental nerve is a cutaneous
    branch
    4) Root canal surgery can damage
    mental nerve leading to
    numbness on the lower jaw skin

    Maxillary Artery
    One of two terminal
    branches of the
    external carotid artery
    It passes deep to the
    neck of the mandible
    and enters the
    infratemporal fossa
    Supplies muscles of
    mastication

    Maxillary Artery

    1) Branches
    supply muscles
    of mastication
    2) Lower jaw teeth
    3) Skin on the jaw
    4) Middle
    meningeal
    artery

    Medial view of infratemporal fossa showing external


    carotid branches including maxillary artery

    Middle meningeal artery

    Middle meningeal artery supplies the meningeal layers protecting the brain. If the
    middle menigeal artery ruptures where would bleeding occur?

    Surface marker for middle meningeal artery

    Jugal point

    Venous Drainage
    1) Pterygoid plexus
    drain muscles of
    mastication
    2) Drains into
    maxillary and
    facial vein
    3) Maxillary and
    superficial
    temporal vein
    form
    retromandibular
    which drains into
    both external and
    internal veins
    4) Emissary veins
    connect to
    cavernous
    sinus(route for
    infection)

    Other neural structures in the infratemporal fossa

    1) Otic ganglion;Post-ganglionic parasympathetic to parotid gland


    2) IX nerve supply pre-ganglionic parasympathetic fibers to otic
    ganglion
    3) Chorda tympani (branch of the facial)

    The temporomandibular joint is the only movable


    joint in
    the skull
    Articular
    eminence
    Mandibular
    fossa

    Condyle

    Osteology of the mandible


    Mandibu
    lar
    notch
    Condyl
    e

    Corono
    id
    proces
    s
    Body

    Neck
    Ram
    us
    Angl
    e

    Temporomandibular Joint - Mandible

    Temporomandibular Joint
    Synovial Joint, atypical
    Condyloid process (head) of mandible
    and articular margins and tubercle of
    the mandibular fossa on squamous
    part of the temporal bone
    Capsule - fossa and neck of mandible

    Temporomandibular Joint
    fibrocartilagenous disc - upper and
    lower compartments
    articular surface of joint lined with
    fibrous cartilage, not hyaline cartilage
    like other synovial joints

    Dislocation of TMJ
    Dislocation - anteriorly most common,
    condyloid process moves forward onto
    articular eminence
    Inferiorly into infratemporal fossa
    Posteriorly into EAM and tympanic
    cavity

    Movements at TMJ
    Upper compartment
    - protraction - lateral pterygoids
    - retraction - posterior fibres temporalis
    Lower compartment
    - depression - lateral pterygoids,
    mylohyoid, anterior digastric
    - elevation - medial pterygoids,
    masseter, temporalis

    Temporomandibular Joint - Movements

    Masseter
    Originates from the
    zygomatic arch
    Inserts onto the lateral side
    of the mandibular ramus
    V3 Massetric nerve
    Masseteric artery(branch
    of maxillary)
    Closes the mouth,
    clenches the teeth, and
    protrudes the jaw

    Temporalis
    Temporalis muscle arises
    from the temporal fossa
    Fan shape with
    anterior,middle and
    posterior parts

    Temporali
    s

    Inserts onto the coronoid


    process and the anterior
    border of the mandibular
    ramus
    Action: closes and retracts
    mandible (posterior fibres)

    Masseter

    Lateral Pterygoid

    Arises from the lateral


    side of lateral pterygoid
    plate

    Inserts into the neck of


    mandible, the articular
    disc in the TMJ and the
    capsule of the joint

    Action: opens the mouth


    and protrudes the jaw

    The lateral pterygoid opens the mouth


    and protrudes the mandible

    Medial Pterygoid

    Originates from the


    medial side of the
    lateral pterygoid plate

    Inserts onto the


    medial side of the
    mandibular ramus

    Actions: like
    masseter, but also
    draws mandible to
    opposite side during
    chewing
    What then attaches to
    the medial pterygoid
    plate?

    The suprahyoid muscles, especially the


    digastric, help to depress the mandible

    Nerve and Blood Supply


    Superficial temporal, maxillary arteries
    Auriculotemporal off Vc - referred pain
    to ear and lower teeth
    Mandibular Vc - muscles of
    mastication, 1st Branchial Arch
    Other muscles use to masticate?

    FORAMEN
    OVALE

    The auriculotemporal
    nerve is the principal
    nerve supplying the
    temporomandibular joint

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