Upload By : Ahmed Ali Abbas Babylon University College of Dentistry download this file from Website on Google  TheOptimalSmile.wix.com

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Babylon University College of DentistryBabylon University College of Dentistry
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2. • 1.Bone,fossa and space
• 2.Muscles of mastication
• 3.Maxillary artery and pterygoid
venous plexus
• 4.Mandibular and maxillary
nerves,pterygomandibular
space
• 5.Temporomandibular joint
• 6.Clinical correlation

3. • 1.Maxilla:Alveolar process,
• tuberosity(O:superficial fibers of
• medial pterygoid m.)
• 2.Mandible:Condyle(TMJ),coronoid process
• (I:Temporalis),ramus,body,mandibular
• Foramen(inferior alveolar n.&vessels enter)
• ramus,mental foramen,angle(I:Masseter
and medial
• Pterygoid)
• 3.Zygoma:Temporal process(zygomatic
arch is the origin of masseter)
• 4.Temporal:Zygomatic process,
• glenoid fossa and articular tubercle are
the component of temporomandibular
joint(TMJ)

4. • 5.Sphenoid:Infratemporal crest(O:upper
head of
• lateral pterygoid m.)
• ** Three foramina
• -Rotundum(V2 Exit)
• -Ovale(V3 Exit,accessory meningeal
a. enter)
• -Spinosum(Entering of meningeal
branch of V3and middle meningeal a.)
• -pterygoid plate(medial and lateral**)
• 6.Pterion:Area between
frontal,parital,temporal,
• and sphenoid bone(Thin bone and the
middle
• meningeal a. located beneath this area)
•

5. T em poral fossa
I nfratem poral foss

6. M andible
Maxilla
Z ygom a

7. Pterion
Temporal
Parietal
Frontal
Greater wing of
sphenoid

8. M andibular foram en
R am us
AngleB ody
R etrom olar(retrom andiuula
triangle is landm ark for
m andibular nerve block

9. Sphenoid bone
Spinosum f
O vale f.
R otundum f.

10. Pterygom andibular fossa
L ateral pterygoid plate
G reater wing of sphenoid

11. Sphenoid bone

12. Pterygopalatine fossaPterygopalatine fossa
M axilla
Sphenoid
Alveolar foram en
Sphenopalatine f.
R otundum f.
I nferior orbital fissure
Palatine

13. G ateway of pterygopalatine fossa
R otundum f.
Sphenopalatine f.
Pterygom axillary fissure

14. • 2.Masseter
•
• 1.Medial
pterygoid
• 2.Lateral
pterygoid
• 1.Tempora
lis

15. M asseter

16. T em poralis m .
process and anterior
border of m andible
O rigin: Temporal
fossa
and temporalis fascia
I nsertion:C oronoid

17. M asseter m .
D eep part
Superficial part
I nsertion:R am us and
angle of m andible
O rigin:Z ygom atic arch

18. • Upper head:Origin
from infratem poral
crest of sphenoid
bone
• Lower head:Origin
• from lateral side of
lateral pterygoid
plate
• Insertion:Articular
capsule of TMJ and
mandibular neck

19. L ateral pterygoid m uscle
L ower head
U pper head

20. M edial pterygoid m .
D eep head of m edial
pterygoid m .
Superficial head of M PG m .

21. • 1.Temporaris:Anterior
and middle fiber:elevate
• Posterior
fiber:Retract
• 2.Masseter:Super
• ficial fiber:Elevate
• Deep fiber:
t
T em poralis

22. • 3.Medial
pterygoid
m.:Elevate
• 4.Lateral
pterygoid
m:Protract
• (protrude)

23. 3.T he M axillary Artery
and Ptergoid V enous
Plexus
M axillary a.
Pterygoid plexu

24. • It is the terminal part of the
• External carotid artery.
• The maxillary artery is divided
• into four parts
• 1.Mandibular part
• 2.Muscular part
•
3.Infraorbital part
4.Sphenopalatine(pterygo
• palatine)

25. 1.T he m andibular part of
m axillary artery
There are four branches from this
part
• 1.Deep auricular and
anterior
• tympanic arteries
• 2.Middle meningeal
artery***
• 3.Accessory meningeal

26. M axillary artery
M iddle m eningeal a
Auriculotem poral n.
D eep tem poral a.

27. 2.The muscular part of
maxillary artery
• The branches are;
• 1.D eep tem poral
arteries***
• 2.M assetric and
pterygoid arteries
• 3.B uccal artery

28. N erve and artery of tem poral fossa
E xternal carotid artery
M axillary artery
D eep tem poral nerve
D eep tem poral artery
Superficial tem poral arte
M andibular nerve(V 3

29. 3.I nfraorbital part
I t give off the superior
alveolar
• arteries and traverse
infraorbital canal to exit the
infraorbital foram en
becom ing infraorbital artery
• which supply the cheek and
inferior

30. M axillary artery in pterygopalatine fossa
I nfraorbital a. Sphenopalatine a.
M axillary a.
G reater palatine a.
Posterior superior alveolar a.

31. 4.Spheopalatine part of
the
m axillary artery
• T his part gives off the
branches which supply
• 1.T he nasal cavity
• 2.T he palate of oral
cavity

32. • I t is the venous plexus which locate
around the pterygoid
m uscle.M oreover,it has connection to
these veins# # #
• 1.T he m axillary vein
• 2.D eep facial vein
• 3.I nferior ophthalm ic vein
• 4.Cavernous sinus(in the cranial
cavity)
• T herefore,the infection could invade
from
• external to internal area****

33. Pterygoid venous plexus of vein
M axillary v.
D eep facial v.
I nferior ophthalm ic v.
E m issary vein connect to
cavernous sinus in brain

34. I ntracranial venous connection
C avernous sinus
Pterygoid venous plexu

35. • 1.จรรยาแพทย์ รักษาและดูแลผู้ป่วย
• ด้วยหัวใจความเป็นมนุษย์(Humanized Doctor)
มีคุณธรรม เมตตา ความรับผิดชอบต่อ
หน้าที่และเสียสละ
• ต่อผู้ป่วยที่ต้องมากพอ ไม่โลภและเห็นแก่
เงินจน
• ลืมไปว่าที่ท่านเรียนสำาเร็จมาได้เพราะ
ส่วนหนึ่ง
• จากเงินภาษีอากรของประชาชนที่

36. 1 จรรยาแพทย์ ปฏิบัติต่อผู้ป่วยด้วยหัวใจความเป็นมนุษย์(Humanized
• 2.จรรยาเพศ สตรีเพศคือเพศแม่ บุรุษ
เพศคือเพศพ่อ หาก
• ไม่รักจริงไม่ควรล่วงเกินหรือฟันแล้วทิ้ง
• กฎแห่งกรรมนั้นมีจริงผลกรรมจะตกแก่รุ่นลูก
ของ
• ท่าน
• 3 คุณธรรมของมนุษย์ มีเมตตาและไม่
เบียดเบียนหรือ
• เอาเปรียบผู้อื่น ความซื่อสัตย์และการตรงต่อเวลา
เป็นคุณสม
• บัติที่สำาคัญ รวมทั้งความรับผิดชอบต่อหน้าที่ ต่อ
ตนเองและผู้อื่น

37. • I t is the third division of
trigerm inal nerve and
being the
• m ixed nerve.I t leaves the
skull
• by foram en ovale.T here
are the

38. O phthalm ic n.(V 1) M axillary n.(V 2)
M andibular n.(V 3)
T rigem inal nerve(V ) leaving the skull

39. C utaneous distribution of trigem inal nerve(V )

40. • I t gives off
m eningeal
branch,
• m edial
pterygoid
nerve,nerve to
• tensor tym pani
and tensor veli
palatini

41. M andibular(V 3) nerve branches

42. –All branches of this
division are m otor nerve
except
• buccal nerve.T he branches
of this division are:
• 1.D eep tem poral n.(m otor)
• 2.L ateral pterygoid n.
(m otor)
• 3.M asseteric n.(m otor)

44. • All branches are sensory
nerve
• except m ylohyoid nerve
• T he branches from this
division
• are :
• 1.L ingual nerve(sensory)
• 2.I nferior alveolar
nerve(sensory)
• 3.Auriculotem poral

45. M H
I A
C h T y

46. Posterior division of m andibular nerve
L ingual n.
I nferior alveolar n
M ylohyoid n.
Auriculotem poral n.
C horda tym pani n
M M A

47. • I t receive general
sensation(pain and
tem perature)of 2/3 anterior
of tongue
• M oreover,it receive
additional branch
• from C N .V I I (facial n.)
which is called chorda

48. • T his nerve is the C N .V I I branch
• T he chorda tym pani nerve consist of
two parts:
• 1.T he preganglionic fibers of
• C N .V I I to synapse with subm andibular
ganglion and postganglionic fibers
supplying
• the subm andibular and sublingual
gland
• 2.T he taste sensation fibers from

49. L esser petrosal n.of C N .I X
C horda tym pani
Auriculotem poral n.
L ingual n.
Parotid gland
Subm andibular gland
Subm andibular ganglion
Sublingual gland

50. T he Auriculotem poral
N erve
• I t supply the tem poral region
• anterior to the ear(pain and
• T em perature).M oreover,it receive
additional branch from
• C N .I X (lesser petrosal n.) which
• already had synapsed with otic
• ganglion and run in the auriculo-
• tem poral n. to supply the parotid
gland

51. • I t is the only m otor nerve
from the posterior
division
• of the m andibular nerve.
• T he m ylohyoid nerve
supply
• anterior belly of digastric

53. Mandibular nerve block
• It is the procedure for dentist to
anesthesize nerve supply of lower
teeth and gum before dental
treatment.
• Landmark:Internal and external
oblique ridge,retromolar triangle.
• Space:Pterygomandibular space
• (locate between medial mandibular
ramus and medial pterygoid m.)
• Nerves block:1.Inferior alveolar
n.,2.Lingual n. and 3.buccal n.

54. 5. The maxillary
nerve (V2)It is pure sensory nerve and divided into
three ramus as follows:
1.External ramus(Zygomatic n.):They are
zygomaticofacial and zygomaticotemporal
nerves
2.Intermediate ramus:It is infraorbital nerve
which gives off branches.
2.1.Posterior,middle and superior alveolar
nerves which supply alveolar and upper teeth
2.2.Infraorbital nerve which traverses
infraorbital foramen to supply cheek and
lower eyelid.

55. 5.Maxillary nerve (V2)(continue)
• 3.Internal ramus(pterygopalatine or
sphenopalatine n.):It supplies nasal
cavity and palate.The branches are
following.
• 3.1.Sphenopalatine nerve:It
enters the
• sphenopalatine foramen to supply
nasal cavity.Its
• terminal branch is incisor nerve
which supplies upper incisor.
• 3.2.Descending palatine
nerve:After descendent,this nerve
ramified to be these
• branches.
• 3.2.1.Greater palatine
n.which supplies hard palate.

56. 5.Maxillary
nerve(V2)(continue)• Moreover,pterygopalatine ganglion
situated medial to rostral internal
ramus(pterygopalatine n.).The greater
petrosal n.(preganlionic fiber) of CN.VII
(facial n.) came to synapse with this
ganglion.The postganglionic fibers merged
• with internal ramus branches to supply
seromucous gland in palate and nasal
cavity.
• There was some postganglionic fiber
• running with zygomaticotemporal n. to
meet the lacrimal n.(sensory)of V1.It came
along with this nerve to supply lacrimal
gland for gland secretion.

57. A.Maxillary n.branches B.Pterygopalatine ganglion
nfraorbital n.
ygom aticofacial n.
Z ygom aticotem poral n.
Z ygom atic n.
L esser palatine
G reater palatine
terior,m iddle and posterior superior alveolar n.
V 2
Pterygopalatine
ganglion
Palatine n.
I nfraorbital n.
Z ygom atic n
N asal n.(sphenopalatine
Sphenopalatine f.

58. I nnervation of lacrim al gland
Pterygopalatine ganglion
Z ygom atic n.
Z ygom aticotem poral n.
L acrim al n.
L acrim al gland
M axillary n.(V 2)
Z ygom aticofacial n.
G reater petrosal n

59. 5.T em porom andibular
joint
5.1.Temporomandibular
joint (Articulation)
5.2.Ligaments
5.3.M ovem ents
5.4.B lood and nerve
supply

60. • Articulation:T he m andibular
condyle(head) and glenoid fossa of
the tem poral bone.
• . T his joint has articular tubercle
of the tem poral bone for dislocated
prevention.
• T he articular disk locates inside
the
• joint cavity,and separates the
condyle and glenoid fossa.

61. • L igam ents:T em porom andibula
r
• (lateral lig.)**,*
sphenom andibular and
stylom andibular are im portant
• for D entist career
• N erve supply:Auriculotem poral
and

62. T em porom andibular joint A.M outh closed B .M outh open
M andibular fossa
Articular disc
C apsule
C ondyle
L ateral pterygoid m .
Articular tubercle

63. L igam ents of tem porom andibular joint
L ateral ligam ent
Sphenom andibular lig. C apsule
Stylom andibular lig.
T ym panic plate of
E xternal auditory m eatu

64. M ovem ent of tem porom andibular join

65. • 1.I m paction of tooth
• 2.T rism us:T he spasm of
the
• m asticatory m uscles
which caused from
infection,and affect
• the patient inability to

66. • 3.T ic D ourulaux:T he
excruciating pain along the
T rigem inal nerve branches.
• . 4.Posterior dislocation of the
T M J:
• I t caused from strong force to
the anterior part of m andible
and affected tym panic plate of
the external auditory m eatus

67. • 1.Current Textbook of
Anatomy,
• Surgery,Orthopaedics,Dentist
• 2.Current Website of Temporal
• and infratemporal Region,
• Especially
:htt://www.dartmouth.
• edu/~ humananatomy_8/chapte
r_