THE INFRATEMPORAL

FOSSA

Boundaries

Side wall of pharynx

Mandibular ramus
Posterior wall of maxilla
Styloid and carotid sheath
Base of the skull
Down???

Contents

Pterygoid muscles
Mandibular nerve
Maxillary artery
Pterygoid venous plexus

Lateral pterygoid muscle

Two heads
Origin.
Insertion
Condyle of mandible
Articular disc
Capsule

Active opener of the mouth

Medial pterygoid

Two heads
Downwards, backwards and laterally
Pulls upwards, forwards and medially
Chewing

Maxillary artery

Between the two heads of L. pterygoid

through the pterygo-maxillary fissure
Enters the pterygo-palatine fossa
Three parts

Pterygoid plexus

Connections with cavernous sinus

Peripheral heart

Spheno-mandibular ligament

Between the spine of sphenoid and lingula

Auriculo-temporal nerve, maxillary artery
Inferior alveolar vessels
Mylo-hyoid nerve pierces it

The mandibular Nerve

From the Meckel's cave with the motor
root enters the foramen ovale
Lies deep to lateral pterygoid on the tensor
palatini
Otic ganglion..

Anterior division

Temporalis
Masseter
Lateral pterygoid
Buccal

From the main trunk

Meningeal
Motor to medial pterygoid
Motor to both palatini through the otic
ganglion

Posterior division
Auriculo-temporal nerve
Embraces the middle meningeal artery
Supplies the TM joint
Auricular part- pinna, Ex. Meatus, Tympanic m.
Temporal part- Temple
Secreto-motor- Parotid gland

 Inferior alveolar nerve

Runs in the mandibular canal
Gives off the mylo-hyoid nerve

Lingual nerve
On the side wall of the pharynx
Comes into contact with the mandible
Joined by the chorda tympani nerve

Anterior wall

Posterior superior alveolar nerves

Posterior part
Carotid sheath
Internal carotid
Internal jugular
IX, X, XI, XII nerves

Sympathetic trunk posterior to carotid

sheath

Between internal and external

carotids

Stylo-pharyngeus
Glosso-pharyngeal nerve
Pharyngeal branch of the vagus

Internal carotid
Arises at upper border of thyroid cartilage
C3/C4
Carotid sinus
Rich nerve supply from IX

Carotid plexus
No branches in the neck

Carotid body

Yellowish gray structure posterior to

common carotid bifurcation
Chemo receptors
IX nerve

Internal jugular vein

Beginning- receives the inferior petrosal
sinus
Termination- lies beneath the two heads of
sterno-cleidomastoid muscle
Joins the subclavian behind the sternoclavicular joint

Cranial nerves in carotid sheath

Glosso-pharyngeal
Anterior part of jugular foramen
Petrous ganglion
Stylo-pharyngeus muscle
To the tounge

 Branches
Meningeal
Tympanic branch (Jacobsons nerve)
Motor branch
Senssory
Sinu-carotid nerve
Glosso- posterior 1/3 tounge
Pharyngeal
Secreto-motor

Vagus nerve
From the middle part
Superior and inferior ganglia
Receives the cranial accessory nerve
Cell bodies in the nucleus ambiguus
Supplies muscles of the pharynx, soft palate,
oesophagus and larynx

Passes in front of the subclavian artery

Branches

Meningeal
Auricular
Pharyngeal
Superior laryngeal nerve
Cervical cardiac branches
Recurrent laryngeal nerve

Accessory nerve

Cranial and spinal roots

Middle part of the jugular foramen
Cranial
Spinal Sterno-cleidomastoid

Hypoglossal nerve
Emerges from the anterior condylar
foramen
Purely a motor nerve
Hitch-hike with C1 fibres (for strap
muscles)