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Norma Lateralis

The Lateral View of the Skull
The Bones Involved in
              Norma Lateralis
1.    Temporal Bone
2.    Parietal Bone
3.    Occipital Bone
4.    Frontal Bone
5.    Zygomatic Bone
6.    Maxilla
7.    Mandible
8.    Nasal Bone
9.    Sphenoid Bone
10.   Lacrimal Bone.
The Two Divisions of the Skull in
            Norma Lateralis

1. Cerebral Portion
   - located above the
   zygomatic arch.

2. Facial Portion
   - located below the
   zygomatic arch.
THE CHARACTERISTIC FEATURES OF THE
CEREBRAL PORTION
1.   Temporal Lines
2.   Supramastoid Crest
3.   Temporal Fossa
4.   Zygomatico-temporal
     foramen
5.   Zygomatic arch
6.   Infratemporal fossa
7.   Suprameatal triangle
8.   Pterion
9.   Asterion.
Pterion

- the thinnest part of the lateral wall of the
           skull.
 - an important area because it overlies the
      anterior division of the middle meningeal
           artery and vein.
Asterion


- point where the posteroinferior angle of the
   parietal bone meet the occipital bone and the
   mastoid part of the temporal bone.
THE CHARACTERISTIC FEATURES
OF THE
FACIAL PORTION
1. Zygomatic arch
2. Articular tubercle
3. External acoustic
   meatus
4. Mandibular fossa
5. Styloid process
6. Mastoid temporal
7. Mastoid process
8. Mastoid foramen
9. Gonion.
10. Pterygo-maxillary fissure
11.Pterygo-palatine fossa
12.Spheno-palatine foramen.
THE TEMPORAL BONE
Four Parts of the
               Temporal Bone
• 1. Squamous part

• 2. Mastoid part

• 3. Tympanic part

• 4. Petrous part
THE THREE FOSSAE IN
NORMA LATERALIS




 1.   Temporal Fossa

 2.   Infratemporal Fossa

 3.   Pterygopalatine Fossa
THE TEMPORAL FOSSA
A flat, fan-shaped depression on the
         lateral surface of the skull.

Bones involved:
1. Zygomatic Bone
2. Frontal Bone
3. Greater Wings of
   Sphenoid
4. Temporal Bone
5. Parietal Bone
BOUNDARIES OF THE TEMPORAL
FOSSA
Boundaries                Structure
Superior                Inferior Temporal Line
Anterior                Frontal Process of Zygomatc Bone
Medial                  Surface of parietal bone,Temporal
                        Bone, frontal bone and GWS
Lateral     Zygomatic Arch
Inferior    Infratemporal Crest of
            Sphenoid Bone
Posterior   Inferior Temporal line
Contents of the
               Temporal Fossa

1. Temporalis muscle is attached to its floor.

2. Pterion – a small circular area where the
   frontal, parietal, sphenoid, and temporal
   bones are close together.
THE INFRATEMPORAL FOSSA
- A paired depression that is inferior to anterior part of the
  temporal fossa.
- Divided from the temporal fossa by the crest of the greater
  wings of sphenoid.
BOUNDARIES OF THE
INFRATEMPORAL FOSSA
Boundaries               Structure

Superior                Greater wings of sphenoid
Anterior                Maxillary tuberosity
Medial                  Lateral pterygoid plate
Lateral     Mandibular ramus and
            zygomatic arch
Inferior    No border
Posterior   No border
Contents of the
           Infratemporal Fossa
1. The mandibular division of the
   trigeminal nerve,
2. Contains pterygoid plexus and the
   pterygoid muscles,
3. Maxillary artery and its branches,
   middle meningeal artery,
4. Inferior alveolar artery,
5. Posterior alveolar artery.
THE PTERYGOPALATINE FOSSA
A cone-shaped depression, deep into
      the infratemporal fossa.
It is located between the pterygoid process and the
   maxillary tuberosity near the apex of the orbit.
BOUNDARIES OF THE
PTERYGOPALATINE FOSSA
Boundaries                 Structure
Superior                Inferior surface of the body of the
                        sphenoid
Anterior                Maxillary tuberosity
Medial                  Vertical plate of the palatine bone
Boundaries                 Structure
Lateral                  Pterygomaxillary fissure
Inferior                 Pterygopalatine canal
Posterior                Pterygoid process of the sphenoid
                         bone
Contents of the
          Pterygopalatine Fossa

1. Maxillary artery and its branches,

2. Pterygopalatine ganglion,

3. Maxillary nerve.
The Temporomandibular Joint
- is a complex articulation of the movable
      mandible and the base of the skull.
Articulation takes place
    in two areas:
1. Between maxillary
    and mandibular
    teeth ( interjaw
    dental occlusion ),
    and
2. Between the
    mandibular condyle
    and the temporal
    bone.
Bones Involved in the TMJ

1. Condylar process
   or condyle of the
   mandible
2. Mandibular fossa
3. Articular
   emminence of
   the temporal
   bone
COMPONENTS OF THE TMJ
1. Articular or Fibrous
   Capsule

2. Temporo-
   mandibular
   (lateral) Ligament
3. Articular Disc

4. Joint Cavities
1. ARTICULAR OR FIBROUS CAPSULE
- encloses the joint
surfaces like a sleeve
that runs from the
temporal bone
superiorly, to the
condyle of the
mandible inferiorly.
The enclosed space
between the articular
surfaces is the joint
cavity
Superior attachment :
  area surrounding the
  mandibular fossa and
  articular eminence of
  the temporal bone.

  Inferior attachment:
  periphery of the
  mandibular condyle.
2. TEMPOROMANDIBULAR (LATERAL)
LIGAMENT
- is a lateral thickening of
   the joint capsule and is
   similar to the collateral
   ligaments of other joints.
- It prevents posterior and
   inferior displacement of
   the condyle but allows
   limited anterior
   movements of the condyle.
3.   ARTICULAR DISC
- it is composed of dense fibrous tissues and lies within the joint
capsule, intervening between the condyle and the mandibular fossa.

- It is a biconcave disc that serves to provide reciprocal articular
surfaces between its inferior surface and the condyle, and its superior
surface and the mandibular fossa and eminence.
Three zones of the articular disc:

1.   Posterior thickening –
     sits atop the condyle
     and fills the mandibular
     fossa above when the
     mandible is at rest.

2.   Anterior thickening -
     lies just below the
     posterior slope of the
     articular eminence.

3.   Intermediate zone - lies
     between the two
     previous zones.
4. JOINT CAVITIES
The disc effectively divides the joint cavity into two distinct upper and
lower compartment that allow two types of joint movements.

      These cavities are also filled with synovial fluid which nourishes the
articular disc.
Joint Cavities
ACCESSORY LIGAMENTS
Two accessory ligaments span the joint but do
     not significantly limit mandibular movements:


1.    Sphenomandibular
      ligament
      - it runs from the spine
      of the sphenoid bone to
      the lingula of the
      mandible.

2.    Stylomandibular
      ligament
      - it runs from the styloid
      process of the temporal
      bone to the angle of the
      mandible.
THE SYNOVIAL MEMBRANE
A layer of synovium lines the inner aspects of the
joint capsule. This relatively dense membrane does not
line the actual articular surfaces of the joints because
synovial joints are generally weight-bearing joints.

   The pressure in the TMJ is provided by the occluded
maxillary and mandibular teeth.

   Synovium secretes synovial fluids for lubrication
and nourishment of the opposing articular surfaces.
Two Layers of the
                Synovial Membrane

1. An intimal cellular layer
   - contains type A cells which are phagocytic,
   and type B cells which synthesize hyaluronate
   found in synovial fluid.

2. A vascular subintimal layer
   - Contains blood vessels, and lymphatics
      within the loose connective tissue matrix.
NERVE SUPPLY OF THE TMJ
1.   Branches of the
     temporalis N.

2.   Branches of the
     auriculotemporal N.

3.   Branches of the
     masseteric N.
BLOOD SUPPLY OF THE TMJ
1. Superficial temporal artery

2. Muscular branches of the maxillary artery
TEMPOROMANDIBULAR JOINT
IN ACTION
MUSCLES ACTING ON THE TMJ
1.   Masseter
2.   Temporalis
3.   Lateral Pterygoid
4.   Medial Pterygoid
Protrussion:


1. Lateral pterygoid
  m.
2. Medial pterygoid
  m.
Retraction


1. Temporalis M.

Synergists:
a. Masseters
b. Digastric
c. Geniohyoid
Elevation


1. Temporalis
2. Masseter
3. Medial
   pterygoid
Depression


1. Lateral pterygoid

Synergists:
1. Digastric
2. Geniohyoid
3. Mylohyoid
Lateral movements


1. Medial
   pterygoid m.
2. Lateral pterygoid
   m.

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Norma lateralis

  • 1. Norma Lateralis The Lateral View of the Skull
  • 2.
  • 3. The Bones Involved in Norma Lateralis 1. Temporal Bone 2. Parietal Bone 3. Occipital Bone 4. Frontal Bone 5. Zygomatic Bone 6. Maxilla 7. Mandible 8. Nasal Bone 9. Sphenoid Bone 10. Lacrimal Bone.
  • 4. The Two Divisions of the Skull in Norma Lateralis 1. Cerebral Portion - located above the zygomatic arch. 2. Facial Portion - located below the zygomatic arch.
  • 5. THE CHARACTERISTIC FEATURES OF THE CEREBRAL PORTION
  • 6. 1. Temporal Lines 2. Supramastoid Crest 3. Temporal Fossa 4. Zygomatico-temporal foramen 5. Zygomatic arch 6. Infratemporal fossa 7. Suprameatal triangle 8. Pterion 9. Asterion.
  • 7. Pterion - the thinnest part of the lateral wall of the skull. - an important area because it overlies the anterior division of the middle meningeal artery and vein.
  • 8. Asterion - point where the posteroinferior angle of the parietal bone meet the occipital bone and the mastoid part of the temporal bone.
  • 9. THE CHARACTERISTIC FEATURES OF THE FACIAL PORTION
  • 10. 1. Zygomatic arch 2. Articular tubercle 3. External acoustic meatus 4. Mandibular fossa 5. Styloid process 6. Mastoid temporal 7. Mastoid process 8. Mastoid foramen 9. Gonion.
  • 11. 10. Pterygo-maxillary fissure 11.Pterygo-palatine fossa 12.Spheno-palatine foramen.
  • 13. Four Parts of the Temporal Bone • 1. Squamous part • 2. Mastoid part • 3. Tympanic part • 4. Petrous part
  • 14. THE THREE FOSSAE IN NORMA LATERALIS 1. Temporal Fossa 2. Infratemporal Fossa 3. Pterygopalatine Fossa
  • 16. A flat, fan-shaped depression on the lateral surface of the skull. Bones involved: 1. Zygomatic Bone 2. Frontal Bone 3. Greater Wings of Sphenoid 4. Temporal Bone 5. Parietal Bone
  • 17. BOUNDARIES OF THE TEMPORAL FOSSA
  • 18. Boundaries Structure Superior Inferior Temporal Line Anterior Frontal Process of Zygomatc Bone Medial Surface of parietal bone,Temporal Bone, frontal bone and GWS
  • 19. Lateral Zygomatic Arch Inferior Infratemporal Crest of Sphenoid Bone Posterior Inferior Temporal line
  • 20. Contents of the Temporal Fossa 1. Temporalis muscle is attached to its floor. 2. Pterion – a small circular area where the frontal, parietal, sphenoid, and temporal bones are close together.
  • 22. - A paired depression that is inferior to anterior part of the temporal fossa. - Divided from the temporal fossa by the crest of the greater wings of sphenoid.
  • 24. Boundaries Structure Superior Greater wings of sphenoid Anterior Maxillary tuberosity Medial Lateral pterygoid plate
  • 25. Lateral Mandibular ramus and zygomatic arch Inferior No border Posterior No border
  • 26. Contents of the Infratemporal Fossa 1. The mandibular division of the trigeminal nerve, 2. Contains pterygoid plexus and the pterygoid muscles, 3. Maxillary artery and its branches, middle meningeal artery, 4. Inferior alveolar artery, 5. Posterior alveolar artery.
  • 28. A cone-shaped depression, deep into the infratemporal fossa.
  • 29. It is located between the pterygoid process and the maxillary tuberosity near the apex of the orbit.
  • 30.
  • 32. Boundaries Structure Superior Inferior surface of the body of the sphenoid Anterior Maxillary tuberosity Medial Vertical plate of the palatine bone
  • 33. Boundaries Structure Lateral Pterygomaxillary fissure Inferior Pterygopalatine canal Posterior Pterygoid process of the sphenoid bone
  • 34. Contents of the Pterygopalatine Fossa 1. Maxillary artery and its branches, 2. Pterygopalatine ganglion, 3. Maxillary nerve.
  • 36. - is a complex articulation of the movable mandible and the base of the skull. Articulation takes place in two areas: 1. Between maxillary and mandibular teeth ( interjaw dental occlusion ), and 2. Between the mandibular condyle and the temporal bone.
  • 37. Bones Involved in the TMJ 1. Condylar process or condyle of the mandible 2. Mandibular fossa 3. Articular emminence of the temporal bone
  • 39. 1. Articular or Fibrous Capsule 2. Temporo- mandibular (lateral) Ligament
  • 40. 3. Articular Disc 4. Joint Cavities
  • 41. 1. ARTICULAR OR FIBROUS CAPSULE
  • 42. - encloses the joint surfaces like a sleeve that runs from the temporal bone superiorly, to the condyle of the mandible inferiorly. The enclosed space between the articular surfaces is the joint cavity
  • 43. Superior attachment : area surrounding the mandibular fossa and articular eminence of the temporal bone. Inferior attachment: periphery of the mandibular condyle.
  • 45. - is a lateral thickening of the joint capsule and is similar to the collateral ligaments of other joints. - It prevents posterior and inferior displacement of the condyle but allows limited anterior movements of the condyle.
  • 46. 3. ARTICULAR DISC
  • 47. - it is composed of dense fibrous tissues and lies within the joint capsule, intervening between the condyle and the mandibular fossa. - It is a biconcave disc that serves to provide reciprocal articular surfaces between its inferior surface and the condyle, and its superior surface and the mandibular fossa and eminence.
  • 48. Three zones of the articular disc: 1. Posterior thickening – sits atop the condyle and fills the mandibular fossa above when the mandible is at rest. 2. Anterior thickening - lies just below the posterior slope of the articular eminence. 3. Intermediate zone - lies between the two previous zones.
  • 50. The disc effectively divides the joint cavity into two distinct upper and lower compartment that allow two types of joint movements. These cavities are also filled with synovial fluid which nourishes the articular disc.
  • 53. Two accessory ligaments span the joint but do not significantly limit mandibular movements: 1. Sphenomandibular ligament - it runs from the spine of the sphenoid bone to the lingula of the mandible. 2. Stylomandibular ligament - it runs from the styloid process of the temporal bone to the angle of the mandible.
  • 55. A layer of synovium lines the inner aspects of the joint capsule. This relatively dense membrane does not line the actual articular surfaces of the joints because synovial joints are generally weight-bearing joints. The pressure in the TMJ is provided by the occluded maxillary and mandibular teeth. Synovium secretes synovial fluids for lubrication and nourishment of the opposing articular surfaces.
  • 56. Two Layers of the Synovial Membrane 1. An intimal cellular layer - contains type A cells which are phagocytic, and type B cells which synthesize hyaluronate found in synovial fluid. 2. A vascular subintimal layer - Contains blood vessels, and lymphatics within the loose connective tissue matrix.
  • 57. NERVE SUPPLY OF THE TMJ
  • 58. 1. Branches of the temporalis N. 2. Branches of the auriculotemporal N. 3. Branches of the masseteric N.
  • 59. BLOOD SUPPLY OF THE TMJ
  • 60. 1. Superficial temporal artery 2. Muscular branches of the maxillary artery
  • 62. MUSCLES ACTING ON THE TMJ
  • 63. 1. Masseter 2. Temporalis 3. Lateral Pterygoid 4. Medial Pterygoid
  • 64. Protrussion: 1. Lateral pterygoid m. 2. Medial pterygoid m.
  • 65. Retraction 1. Temporalis M. Synergists: a. Masseters b. Digastric c. Geniohyoid
  • 67. Depression 1. Lateral pterygoid Synergists: 1. Digastric 2. Geniohyoid 3. Mylohyoid
  • 68. Lateral movements 1. Medial pterygoid m. 2. Lateral pterygoid m.