Laboratory Identifications and Relations -- Pterygopalatine Fossa
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[ SBMP ] [ Skull ] [ Face ]
[ Cavernous Sinus ] [ Orbit ]
[ Parotid Region, TMJ, Mandible ] [ Infratemporal Fossa ]
[ Pterygopalatine Fossa ]
Boundaries
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anterior: inferior orbital fissure
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posterior: foramen rotundum and pterygoid canal
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superior: body of sphenoid bone
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inferior: pharyngeal canal, greater and lesser palatine canals
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medial: sphenopalatine foramen, perpendicular plate of palatine bone, medial
pterygoid plate
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lateral: pterygomaxillary fissure
Related Bony Landmarks
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sphenoid sinus - bisected skull, posterior to pterygopalatine fossa
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pterygoid canal - floor of sphenoid sinus, vidian nerve (nerve of pterygoid
canal)
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posterior nasal aperature (piriform aperture) - anterior boundary of nasopharynx
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pharyngeal tubercle of occipital bone - attachment of buccopharyngeal fascia,
region of distribution of pharyngeal nerve
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region of soft palate - between the hamuli of the medial pterygoid plates,
region of distribution for lesser palatine nerve
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inferior opening of lesser palatine canal
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hard palate - horizontal plate of palatine bone - distribution of greater
palatine nerve
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inferior opening of greater palatine canal
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incisive foramen - transmits terminal branches of nasopalatine nerves from
nasal cavity to anterior hard palate
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superior, middle, and inferior, nasal conchea - region of distribution
for lateral posterior nasal nerves
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nasal septum - perpendicular plate of ethmoid bone and the vomer, region
of distribution for nasopalatine nerve
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sphenopalatine foramen - viewed from lateral nasal wall, transmits lateral
posterior nasal nerves and nasopalatine nerve
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foramen on posterior aspect maxilla for posterior superior alveolar nerve
Contents
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maxillary nerve - enters lateral roof of pterygopalatine fossa via foramen
rotundum, leaves via inferior orbital fissure as infraorbital nerve
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vidian nerve (nerve of pterygoid canal) - continuation of GSPN and deep
petrosal nn., enters pterygopalatine ganglion
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pterygopalatine ganglion - site of postganglionic parasympathetic cell
bodies
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motor root of pterygopalatine ganglion - carries GVE postganglionic fibers
to maxillary nerve
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sensory root of pterygopalainte ganglion - branch of maxillary nerve
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pharyngeal nerve - through pharyngeal canal to nasopharynx
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lesser palatine nerve - through lesser palatine canal to soft palate
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greater palatine nerve - through greater palatine canal to hard palate
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superior, middle, and inferior lateral posterior nasal nerves - to the
turbinates, through sphenopalatine foramen
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nasopalatine nerve - to the nasal septum, through sphenopalatine foramen
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posterior superior alveolar nerve - to the maxillary sinus, through pterygomaxillary
fissure to foramen on posterior maxilla
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zygomatic nerve - enters orbit through inferior orbital fissure, carries
GVE to zygomaticotemporal nerve (to lacrimal n. to lacrimal g.)
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maxillary artery and terminal branches
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artery of maxillary nerve - not easily demonstrated
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artery of pterygoid canal - not easily demonstrated
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pharyngeal artery
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greater and lesser palatine arteries
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lateral posterior nasal arteries
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posterior septal artery
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infraorbital artery (may not enter pterygopalatine fossa)
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posterior superior alveolar artery - usually not in pterygopalatine fossa
as is the nerve
Comments
Each of the branches of the maxillary nerve provide a trigeminal pathway
followed by postganglionic parasympathetic fibers (GVE) from the pterygopalatine
ganglion. Additionally, GVE postganlionic sympathetic fibers derived from
the deep petrosal nerve follow each of these same pathways. Parasympathetic
GVE fibers control mucosal secretions of the oral/nasal cavity, sphenoid
sinus, maxillary sinus, ethmoidal air cells, and secretions of the lacrimal
gland. Sympathetic GVE fibers control vasoconstriction to these same regions.
Additionally, taste fibers (SVA) derived from the greater superficial petrosal
nerve (facial nerve) follow the greater and lesser palatine nerves to the
hard and soft palate. GVA fibers from the greater superifical petrosal
nerve are thought to follow the lesser palatine nerve to the soft palate.
This last distribution is often questioned.