Notes for Dr. Manions fossa lecture:

The outline of the temporal fossa includes the zygomatic bone, lateral portion of frontal bone, superior temporal line, and the zygomatic arch. (NOTE: THE SUPERIOR TEMPORAL LINE IS THE ATTACHMENT FOR THE TEMPORAL FASCIA AND THE INFERIOR TEMPORAL LINE IS THE OUTER BORDER OF THE ORIGIN OF THE TEMPORALIS MUSCLE which inserts onto the coronoid process and ramus of the mandible!) The muscles that move the ear, auricular muscles, are SUPERFICIAL to the temporal fascia. The lateral boundary of the infratemporal fossa is the ramus of the mandible. The roof of the infratemporal fossa is the floor of the middle cranial fossa. The anterior boundary is the maxillae. There is NO posterior boundary to the infratemporal fossa. The medial boundary of the infratemporal fossa is the pharynx. The inferior orbital fissure (located within the infratemporal fossa) is a communicating point between the infratemporal fossa and the orbit. The pterygomaxillary fissure is a communicating point between the infraorbital fossa and the pterygopalatine fossa (location of the pterygopalatine ganglion). The infratemporal fossa is sandwiched between the ramus of the mandible and the pharynx. The roof once again is the floor of the middle cranial fossa. The main portion of the maxillary artery runs deep to the lateral ptyerygoid muscle. The artery that runs deep to the temporalis muscle and supplies it is the deep temporal artery which is a branch of the maxillary artery!! NOT THE SUPERFICIAL TEMPORAL ARTERY WHICH IS A BRANCH OF THE EXTERNAL CAROTID ARTERY! Another branch of the maxillary artery is the inferior alveolar artery which supplies the mandible and runs along the mandible to supply the teeth of the mandible and exits through the mental foramen as the mental artery which then supplies the skin of the chin. Some branches of the maxillary artery goes into the ptyerygopalatine fossa and some goes through the inferior orbital fissure and emerges as the infraorbital artery to supply the skin under the eye and the lower eyelid. There is a branch of the inferior alveolar artery called the lingual BRANCH of the inferior alveolar artery which supplies the buccal mucous membranes. The posterior superior alveolar artery supplies the teeth of the maxillae. The branch called the buccal artery supplies the buccinators muscle and the mucosa of the cheeks. Deep to the lateral pterygoid muscle, one would find the mandibular nerve coming through to foramen ovale. Another MAJOR branch of the maxillary artery is the sphenopalatine artery which travels through the sphenopalatine foramen to supply the mucosa of the conchae, meatuses, and paranasal sinuses. It is the artery commonly involved with nose bleeds. The middle meningeal artery, a branch of the maxillary artery, enters through the foramen spinosum to supply most of the dura of the brain. A branch of the middle meningeal artery called the accessory meningeal artery enters through the FORAMEN OVALE to supply some dura. It also supples the medial and lateral pterygoid muscles. There are some nerves of interest in the infratemporal fossa. The inferior alveolar nerve runs with the inferior alveolar artery along the mandible to innervate the gums of the teeth of the mandible. It then courses through the mental foramen with the mental artery to innervate the skin of the chin. The lingual nerve runs with the lingual BRANCH of the inferior alveolar artery to innvervate the anterior 2/3 of the tongue providing GENERAL sensation to that portion of the tongue which is also called the oral tongue. The buccal nerve is yet another branch of the mandibular nerve and it DOES NOT provide motor sensation to the buccinators muscle because the buccinators muscle receives its motor fibers from the facial nerve because it is a muscle of facial expression. The buccal nerve provides SENSORY innervation to mucous membranes on the inside of the cheeks. The deep temporal nerve is the nerve that innervates the temporalis muscle. It provides MOTOR fibers to the temporalis muscle and it is also a branch of the mandibular nerve. NOTE: THE MAXILLARY NERVES INNERVES THE SKIN OF THE CHEEKS, THE LOWER EYE LID, AND THE CONJUNCTIVA OF THE LOWER EYE LID. THE SUPERIOR ALVEOLAR NERVE, WHICH IS A BRANCH OF THE MAXILLARY NERVE, INNERVATES THE TEETH OF THE MAXILLAE. The chorda tympani (CNVII, preganglionic parasympathetic fibers) run with the lingual nerve to enter into the tongue but they innervate the taste buds of the tongue. After synapse in the mandibular ganglion, the postganlionic parasympathetic fibers go to supply the sublingual and submandibular gland with secretomotor fibers. NOTE: WITHIN THE INFRATEMPORAL FOSSA, ONE WOULD ALSO FIND THE OTIC GANGLION WHICH CONTAINS POSTGANGLIONIC PARASYMPATHETIC NEURONS THAT PROVIDE SECRETOMOTOR FIBERS TO THE PAROTID GLAND. THE PREGANLIONIC FIBERS COME FROM THE LESSER PETROSAL NERVE (CNIX) The two muscles of the infratemporal fossa are the lateral and medial pterygoid muscles. The lateral pterygoid muscle has a superior and inferior head. Between the superior and inferior heads one would find the buccal nerve as it is running inferiorly. The VERY SMALL pterygopalatine FOSSA borders are as follows: lateral pterygoid plate and posterior border of the maxillae. (MOST IMPORTANT STRUCTURE IN THERE IS THE PTERYGOPALATINE GANGLION THAT HAS THOSE POSTGANGLIONIC PARASYMPATHETIC NEURONS WHICH ARE SECRETOMOTOR TO THE LACRIMAL GLANDS.) NOTE: THERE IS A COMMUNICATING NERVE CALLED THE ZYGOMATIC NERVE THAT IS THE ACTUAL NERVE SUPPLYING THE FIBERS TO THE LACRIMAL GLAND. Within the pterygopalatine fossa, one would find the foramen rotundum which is the foramen that the maxillary nerve uses to enter the pterygopalatine fossa.