Deep Face & Nasal Cavity

• What type of joint is the temporomandibular joint?

  Synovial type joint
• What articulates in the temporomandibular joint?

  The condylar process of the mandible and the mandibular fossa of the temporal bone
• What separates the temporomandibular joint?

  A fibrocartilaginous disc
• What movements are required for the jaw to fully open?

  Rotation and translation must occur
• What is the first movement that occurs when the jaw opens?

  Rotation of the condylar head around a horizontal axis in the joint capsule
• What is the second movement that occurs when the jaw opens?

  Translation of the condylar head anteriorly onto the articular eminence
• What are the primary muscles involved in the movement of the mandible?

  • Temporalis: Elevation & retraction of mandible
  • Masseter: Elevation of mandible
  • Lateral pterygoid: Protrusion and depression of mandible
  • Medial pterygoid: Elevation and side-to-side movement
• What is the function of the lateral pterygoid muscle?

  Protrusion of the condylar neck and depression of the mandible
• Where is the lateral pterygoid muscle located?

  Within the infratemporal fossa
• What is the primary function of the medial pterygoid muscle?

  Elevation of the mandible
• What allows the medial pterygoid muscle to facilitate side-to-side movement?

  Fibre orientation
• What is the anterior division of the mandibular nerve (V3) associated with?

  It is located within the infratemporal fossa
• What does the lingual branch of the posterior trunk of V3 provide sensation to?

  General sensation of the anterior 2/3 of the tongue
• What supplies the mandibular gums and teeth?

  The inferior alveolar branch of V3
• What does the mental nerve supply?

  The skin of the mandibular region
• How is taste from the anterior 2/3 of the tongue transmitted?

  By the facial nerve via the chorda tympani (VII)
• What are the walls of the infratemporal fossa?

  • Anterior wall: Posterior surface of the maxilla
  • Posterior wall: Tympanic plate, mastoid and styloid processes of the temporal bone
  • Medial wall: Lateral pterygoid plate of the sphenoid bone
  • Lateral wall: Ramus of mandible
  • Superior wall (roof): Greater wing of the sphenoid bone, temporal bone
• What are the contents of the infratemporal fossa?

  • Muscles: Medial and lateral pterygoids, temporalis
  • Nerves: Branches of CN V3, chorda tympani, and otic ganglion
  • Arteries: Maxillary artery and its branches
  • Veins: Maxillary vein and tributaries, pterygoid venous plexus
• What bones make up the external nose?

  Nasal bone, maxilla, ethmoid bone, vomer
• What are the three regions of the nasal cavity?

  • Lined with specialized epithelium
  • Two distinct cavities separated by a septum
• What forms the medial wall of the nasal cavity?

  The nasal septum
• What comprises the posterior part of the nasal septum?

  The ethmoid and vomer bones
• What comprises the anterior part of the nasal septum?

  The septal cartilage
• What covers the nasal septum?

  A mucosal layer
• How many bones and cartilage make up the nasal septum?

  Eight bones and hyaline cartilage
• What do the nasal conchae create?

  Passages called meatuses
• What is the function of the nasal conchae?

  To warm and humidify air
• What are the functions of the paranasal sinuses?

  • Decrease weight of skull
  • Increase vocal resonance
  • Air conditioning
  • Insulation
• What are the types of paranasal sinuses?

  Frontal, ethmoidal, maxillary
• Where do the frontonasal, maxillary, and some ethmoidal sinuses drain?

  Into the middle meatus
• What is a potential risk associated with the drainage of the sinuses?

  Potential route for spread of infection
• What is the arterial supply of the nasal cavity?

  Maxillary artery
• What is Little's area in the nasal cavity?

  A region prone to nasal perforation and septum deviation
• Why is the nose considered to be within the 'danger triangle'?

  Because the veins of the nose drain directly into the cranial cavity
• What is the potential consequence of infection in the 'danger triangle'?

  Potential to spread infection to the brain and face
• What nerve is responsible for the sense of smell?

  Olfactory nerve
• What provides general sensation to the nasal cavity?

  V1 and V2
• What branches does the ophthalmic nerve (V1) give after exiting the supraorbital fissure?

  Frontal, nasociliary, and lacrimal branches
• What does the nasociliary branch provide?

  The anterior and posterior ethmoidal branches
• What are the clinical conditions related to nasal anatomy?

  • Epistaxis (acute hemorrhage from the nose)
  • Nasal packing
  • Chemical cautery
  • Nasal fracture: Minor fractures require analgesia & anti-inflammatories; major fractures require realignment
  • Turbinate hypertrophy: Steroids to reduce mucosal inflammation/nasal congestion; turbinate reduction (surgical)
  • Anosmia (loss of sense of smell): Treatments for nasal congestion may help; limited recovery after head trauma; nasal perforation and septum deviation