Table A:infratemporal

Fossa and TMJ

Alyssa Morley & Brennan Smith
 Infratemporal Fossae Muscles
Muscle Origin Insertion Innervation Action

Temporalis temporalis fossa, coronoid process mandibular elevate

deep temporal and ramus of the nerve (branch of mandible,
fascia mandible trigeminal n. (CN posterior fibers
V)), deep retrude mandible
temporal nerves

Medial Pterygoid Medial surface of Medial surface of mandibular Bilaterally:

later pterygoid ramus and angle nerve (branch of protrude and
plate, maxillary of mandible; trigeminal n. (CN elevate mandible
tuberosity, inferior to V)), nerve to Unilaterally:
pyramidal mandibular medial pterygoid grinding side to
process of foramen side motion
palatine bone

Lateral Pterygoid Superior head: Pterygoid fovea, mandibular Bilaterally:

infratemporal capsule of TMJ, nerve (branch of protude
surface of articular disc trigeminal n. (CN mandible
greater sphenoid V)), muscular Unilaterally: side
bone branches from to side grinding
Inferior head: anterior division motion
lateral pterygoid
plate
Infratemporal Vessels
• Maxillary A.
• Terminal branch of external carotid a.
• Has 3 parts
• First part feeds inferior alveolar a.
• Second part feeds pterygoid branches
• Inferior alveolar a.
• From maxillary a.
• Goes to alveolar spaces: feed teeth in
mandible and other mandibular
structures
• Pterygoid venous plexus
• Drains pterygoid region
• Lies between temporalis m. and
lateral pterygoid
• Empties into maxillary v.
 Infratemporal Nerves
Nerve Origin Innervates

Mandibular Branch of Trigeminal (CN Muscles of mastication

V)
Inferior alveolar Branch of mandibular n. Supplies mandibular
teeth
Lingual Branch of mandibular n. Sensory to anterior 2/3
of tongue, floor of the
mouth
Buccal Branch of mandibluar n. Sensory of skin of the
cheek and molars
Chorda tympani Branch of facial (CN VII); Sensory taste of anterior
joins with lingual n. in 2/3 of tongue; supplies
the infratemporal fossa some salivary glands
Otic ganglion Derived mostly from Postsynaptic fibers go
(parasympathetic) glossopharyngeal n. through the
auriculotemporal n.
TMJ Joint Structures

Post Glenoid
Tubercle

Medial View
Mandible
 Muscles of Mastication
Muscle Origin Insertion Innervation Action

Temporalis temporalis fossa, deep coronoid process and mandibular nerve elevate mandible,
temporal fascia ramus of the mandible (branch of trigeminal posterior fibers
n. (CN V)), deep retrude mandible
temporal nerves

Medial Pterygoid Medial surface of later Medial surface of mandibular nerve Bilaterally: protrude
pterygoid plate, ramus and angle of (branch of trigeminal and elevate mandible
maxillary tuberosity, mandible; inferior to n. (CN V)), nerve to Unilaterally: grinding
pyramidal process of mandibular foramen medial pterygoid side to side motion
palatine bone

Lateral Pterygoid Superior head: Pterygoid fovea, mandibular nerve Bilaterally: protude
infratemporal surface capsule of TMJ, (branch of trigeminal mandible
of greater sphenoid articular disc n. (CN V)), muscular Unilaterally: side to
bone branches from anterior side grinding motion
Inferior head: lateral division
pterygoid plate
Masseter Inferior border and Angle and Lateral Anterior trunk of Elevated mandible,
medial surface of surface of ramus of mandibular nerve closing jaw; limited
maxillary process of mandible contribution to
zygomatic bone and protrusion of jaw
the zygomatic arch
Movements of TMJ (Moore pg 920)

Movements Muscles
Elevation (close mouth) Temporalis, masseter, and medial
pterygoid
Depression (open mouth) Mainly gravity, Lateral pterygoid-active
resistance
Protrusion (chin forward) Lateral pterygoid, some masseter and
medial pterygoid
Retrusion (chin back) Temporalis and masseter
Lateral (grinding/chewing) Temporalis of same side, pterygoids of
opposite side, and masseter
Clinical Applications

 TMJ dysfunction
 Covers all pain an problems of the muscles of mastication and
TMJ joint
 Symptoms can be stiff jaw, popping or locking of the jaw, etc.
 May go away on its own or require treatment, depends on the
specific problem
 Inferior alveolar nerve block
 Done through the mandibular foramen
 Anesthetizes all mandibular teeth to the median plane
 Dislocation of mandible
 Displacement of mandibular condyle from the TMJ
 Often caused by excessive blunt force to one side
 Leaves mandible depressed, unable to close mouth