Steven J. Zehren, Ph.D.

TEMPORAL & INFRATEMPORAL FOSSAE; TMJ

OSTEOLOGY

BOUNDARIES OF TEMPORAL FOSSATemporal fossa

Superior temporal line

Zygomatic arch

Squamous temporalParietal

Pterion

Greater wingof sphenoid

Frontal

Zygomatic bone

BOUNDARIES OF THE INFRATEMPORAL FOSSA --- I

Ramus of mandible(lateral wall)

Infratemporal surface of maxilla (anterior wall)Styloid process

(posterior wall)

Lateral pterygoid plate(medial wall)

Infratemporal surface ofgreater wing of sphenoid(roof)

Infratemporal crest ofgreater wing of sphenoid

Temporal fossa

BOUNDARIES OF THE INFRATEMPORAL FOSSA --- II

Maxillary tuberosity

COMMUNICATIONS OF INFRATEMPORAL FOSSA --- I

Inf. orbital fissure(to orbit)

Pterygomaxillary fissure(to pterygopalatine fossa)

Petrotympanic fissure(to tympanic cavity)

COMMUNICATIONS OF INFRATEMPORAL FOSSA --- II

F. ovale (to middle cranial fossa)

F. spinosum (to middle cranial fossa)

Spine of sphenoid

Coronoid process

Condylar process Head

Neck

Pterygoid fovea

Mandibular notchLingulaMandibular f.

Mylohyoid groove

Mental foramen

Body

Ramus

Angle

FEATURES OF MANDIBLE

MUSCLES OFMASTICATION

Temporalis m.

Temporalis fascia

Zygomatic arch

Deep part (masseter m.)

Superficial part(masseter m.)

TEMPORALIS & MASSETER MUSCLES

Temporalis m.

Insertion of temporalis m.(into coronoid process)

Insertion of masseter m.(into ramus)

Masseteric n. & a.

TEMPORALIS & MASSETER MUSCLES

Superior and inferior headsof lateral pterygoid m.

Superficial and deep headsof medial pterygoid m.

Articular disc of TMJ

Pterygoid foveaof neck of mandble

Angle of mandible

LATERAL & MEDIAL PTERYGOID MUSCLES

“SPHENOMENISCUS M.”

ANTERIOR

Articular disc(meniscus)

Lateral pterygoid plate

Lateral pterygoid m.

Medial pterygoid m.

LATERAL & MEDIAL PTERYGOID MUSCLES (POSTERIOR VIEW)

EFFECT OF MANDIBULAR N. (V3) LESION

NERVES

V. TRIGEMINAL N.SKELETAL MOTOR --- TO MUSCLES OF MASTICATION , ETC. (ARCH 1) GENERAL SENSORY-- FROM FACE, NASAL & ORAL CAVITIES, ETC.

OPHTHALMIC N. (VI)(general sensory)

MAXILLARY N. (V2) (general sensory)

MANDIBULAR N. (V3)(general sensory, skeletal motor)

V GANGLION(general sensory)

A

Site of midbrain

Lens placode

Nasal placode

Stomodeum Heart

Somites

Pharyngeal(branchial) arches

12

3 4

Slide 10.1

PHARYNGEAL ARCHES IN 4-WEEK EMBRYO

PHARYNGEAL ARCH NERVES

MAXILLARY N. (V2)

MANDIBULAR N. (V3)

Temporalis fascia and m.

Ant. division (V3) (mostly motor)

Post. division (V3) (mostly sensory)

Foramen ovale

Auriculotemporal n.

Inferior alveolar n. (cut)

Inferior alveolar n. (cut)

Lingual n.

Chorda tympani n.(br. of VII)

Posterior andanterior deep temporal nn.

Masseteric n.

Lateral pterygoid n.and m.

Buccal n.

Mylohyoid m. (cut)

Digastric m. (anterior belly)

Mylohyoid n.

Mental n.Submandibular ganglion & gland

Sublingual gland

MANDIBULAR NERVE (V3)

V3

Medial pterygoid n. & m.

Tensor palatini n. & m.

Otic ganglion

Lesser petrosal n. (IX)

Facial n. (VII)

Chorda tympani n.

Tympanic membrane

Auriculotemporal n.

Lingual n.

Inf. alveolar n.

Mylohyoid n.

Tensor tympani n. & m.

MANDIBULAR NERVE (V3) (MEDIAL VIEW)

Mental n.

Buccal n.

Auriculotemporal n.

V3 dermatome

cCUTANEOUS BRANCHES OF V3

Herpes Zoster(also called shingles)

Which branchof what nerve?

-is considered alatent response to a chicken pox virus located in thetrigeminal ganglion

HERPES ZOSTER INFECTION (SHINGLES)

Temporal branchesZygomatic branches

Buccal branches

Marginal mandibular branch

Cervical branch

Main trunk of VII

TO ZANZIBAR BY MOTOR CAR

FACIAL NERVE BRANCHES IN PAROTID GLAND

VESSELS

Maxillary a.

Inferior alveolar a.

Middle meningeal a.

Ant. and post. deep temporal aa.

Medial pterygoid a. and m.

Buccal a.

Lateral pterygoid a. and m.

Masseteric a.

Post. superior alveolar a.

Infraorbital a.

MAXILLARY A.

BRANCHES OF 1ST (MANDIBULAR) PART

BRANCHES OF 2ND (PTERYGOID) PART

BRANCHES OF 3RD (PTERYGOPALATINE) PART

Ext. carotid a.

MAXILLARY ARTERY

Middle meningeal a.

Auriculotemporal n.

Maxillary a.

Ext. carotid a.

RRELATIONSHIPS OF MIDDLE MENINGEAL A.

Ant. & post. branchesof middle meningeal a.

MIDDLE MENIGEAL A. SUPPLIES DURA MATER

PTERION: LANDMARK FOR MIDDLE MENINGEAL A.

EPIDURAL (EXTRADURAL) HEMORRHAGE

Pterygoid plexus

Maxillary vv.

Superficial temporal v.

Retromandibular v.

PTERYGOID PLEXUS OF VEINS

Inf. alveolar v.

Post. sup. alveolar v.

Cavernous sinus

Pterygoid plexus

Facial v.

Inf. ophthalmic v.

Deep facial vv.

Emissary vv.(via f. ovale)

COMMUNICATIONS OF PTERYGOID PLEXUS

Int. carotid a.

Sphenoid sinus

HypophysisVI (abducens)

Cavernous sinus

III

IV

V2 (Maxillary n.)

V1 (Ophthalmic n.)

CAVERNOUS SINUS (CORONAL SECTION)

TEMPOROMANDIBULAR JOINT

SQUAMOUS TEMPORAL BONE

Articular tubercle

Mandibular fossa(articular part)

Postglenoid tubercle

HEAD OF MANDIBLE

TYMPANIC TEMPORAL BONE(nonarticular part of mandibular fossa)

ARTICULATING BONES OF TMJ

Joint capsuleLateral (temporomandibular) lig.

Sphenomandibular lig.Styloid process

Stylomandibular lig.

V3 and otic ganglion

Joint capsule

Mid. meningeal a. Auriculotemporal n.

Maxillary a.

Inferior alveolar n.Lingual n.

Mylohyoid a. and n.

INTRINSIC LIGAMENT

EXTRINSIC LIGAMENTS

Stylomandibular lig.Sphenomandibular lig.

LIGAMENTS, NERVES & BLOOD SUPPLY OF TMJ

Articular discArticular tubercle

Joint capsule

JAWS CLOSED

JAWS SLIGHTLY OPENED(HINGE ACTION PREDOMINATES)

JAWS WIDELY OPENED(HINGE AND GLIDING ACTION COMBINED)

Upper joint compartment (gliding action)

Lower joint compartment (hinge action)

MOVEMENTS OCCURRING AT TMJ

A.

B.

C.

Articular tubercle

MOVEMENTS OCCURRING AT TMJ

DISLOCATION OF TMJ

Middle cranial fossa(superior)

Articular disc

Spine of sphenoid(medial)

Lateral pterygoid m.(anterior)Maxillary a. & v.

Skin (lateral)

Mandibular fossa

RELATIONSHIPS OF TMJ (CORONAL SECTION)

END OF LECTURE