learning objective answers to the pterygopalatine fossa
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| Where is the pterygopalatine fossa? | A pyramidal space between the maxilla, sphenoid and palatine bones.
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| List the boundaries of the pterygopalatine fossa: anterior, posterior, lateral, medial, superior, and inferior. | A pyramidal space between the maxilla, sphenoid and palatine bones.
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| Identify the various foramina in the anterior boundary and what passes through it. | infraorbital canal (infraorbital nerve - V2 and nerve)
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| Identify the various foramina in the posterior boundary and what passes through it | foramen rotundum (V2) and pterygoid canal (nerve of the pterygoid canal)
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| Identify the various formamina in the lateral boundary and what passes through it | pterygomaxillary fissure (maxillary a.)
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| Identify the various foramina in the medial boundary and what passes through it | sphenopalatine foramen (sphenopalatine a., nasopalatine n.)
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| Identify the various formina in the superior boundary and what passes through it | inferior orbital fissure (maxillary nerve and artery)
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| Identify the various foramina in the inferior boundary and what passes through it | greater and lesser palatine canals (greater and lesser palatine nerves).
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| List the important branches of the maxillary artery in the fossa. | posterior superior alveolar nerve, descending palatine a., sphenopalatine a. and infraorbital nerve
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| What does the posterior superior alveolar nerve supply? | upper teeth and maxillary sinus
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| What does the descending palatine a. branch into and supply? | greater and lesser palatine aa. that supply the hard/soft palate respectively
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| What does the sphenopalatine a. supply? | nasal cavity
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| What does the infraorbital nerve supply? | cheek region.
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| How does the maxillary division of the maxillary division of CN V enter the fossa? | Via the foramen rotundum.
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| List the branches off the maxillary nerve within the fossa. | The zygomatic n., posterior superior alveolar n., and the infraorbital n.,
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| What are the branches of the maxillary nerve? | Zygomatic nerve; posterior superior alveolar nerve; infraorbital nerve
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| Where does the zygomatic nerve exits and communicate? | via the inferior orbital fissure and communicates with the lacrimal nerve (postganglionic parasympathetic fibers access the lacrimal gland via this branch)
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| Where does the posterior superior alveolar nerve enter and supply? | maxillary sinus and innervates the maxillary molar teeth and mucosal lining of the maxillary sinus
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| What does the infraorbital nerve supply and exit? | the premolars and incisors and canines + the sinus mucosa - it exits onto the face for sensory supply to the cheek
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| What is the innervation loop of the upper teeth? | The infraorbital nerve gives off 3 main branches - the posterior, middle and anterior superior alveolar nerves that between the three supply all the upper teeth of the maxilla as well as the lining of the maxillary sinus.
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| What is the pterygopalatine ganglion? List all structures that are found within it. | The infraorbital nerve gives off 3 main branches - the posterior, middle and anterior superior alveolar nerves that between the three supply all the upper teeth of the maxilla as well as the lining of the maxillary sinus.
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| How do the sensory fibers enter the ganglion? | Via the communicating branches from the maxillary nerve.
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| What fiber types enter the ganglion via the nerve of the pterygoid canal? | Postganglionic sympathetic and preganglionic parasympathetic.
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| How is the nerve of the pterygoid canal formed? | By the union of the deep petrosal nerve and the greater petrosal nerve.
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| What fiber type is carried by each of the nerves forming the nerve of the pterygoid canal? | The deep petrosal nerve carries postganglionic sympathetic fibers; the greater petrosal nerve carries preganglionic parasympathetic.
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| Where do the postganglionic sympathetic fibers of the deep petrosal nerve come from? | Postganglionic sympathetic fibers from the superior cervical ganglion travel in a plexus along the internal carotid a. leaving it in the foramen lacerum to join the deep petrosal nerve.
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| Where are these postganglionic sympathetic fibers distributed? | They are distributed with branches of V2 to the lacrimal gland, mucosa of the nasal cavity, palate and maxillary sinus.
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| Where do the preganglionic parasympathetic fibers of the greater petrosal nerve come from? | The preganglionic sympathetic fibers arise in the superior salivatory nucleus and travel in the facial nerve (CN VII).
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| Describe how the pathway that these fibers take to get to the pterygopalatine fossa. | As the facial nerve passes through the facial canal leave to enter the middle cranial fossa. They travel under the dura to the foramen lacerum where they join the deep petrosal nerve to form the nerve of the pterygoid canal.
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| How do the postganglionic parasympathetic fibers get to the lacrimal gland to supply it with secretomotor (GVE) fibers? | Via the maxillary nerve and its zygomatic branch.
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| What modalities are carried by the outgoing nerves of the pterygopalatine ganglion? | They carry sensory, postganglionic sympathetic and parasympathetic fibers.
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| What structures are supplied by these outgoing nerves? | They supply the mucosa of the hard and soft palate, nasal cavity, superior pharynx, maxillary sinus and lacrimal gland.
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| Name the nerves that bring these fibers to: the hard palate; the soft palate; the nasal cavity. | Hard palate: greater palatine nerve; Soft palate: lesser palatine nerve; Nasal cavity: sphenopalatine nerve branches.
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