DEPARTMENT OF ANATOMY

ORAL CAVITY

Dr. SREEKANTH THOTA

Pterion

Infratemporal
fossa
 Bounded by the inferior
temporal line, frontal
process of zygomatic
bone & zygomatic arch.
Contains the temporalis
muscle, deep temporal
artery & nerve &
zygomaticotemporal
nerve.
Pterion is an important
landmark.
 The mandible is the bone of
the lower jaw.
It consists of a body of right
and left parts, which are fused
anteriorly in the midline, and
two rami.
The site of fusion is visible on
the external surface of the
bone as a small vertical ridge
in the midline (mandibular
symphysis).
 Theupper surface of the body of mandible
bears the alveolar arch, which anchors the
lower teeth, and on its external surface on
each side is a small mental foramen.
 The ramus of mandible, one on each side, is
quadrangular shaped and oriented in the
sagittal plane. On the medial surface of the
ramus is a large mandibular foramen for
transmission of the inferior alveolar nerve
and vessels.
Above the anterior one-third of the
mylohyoid line is a shallow depression (the
sublingual fossa), and below the posterior
two-thirds of the mylohyoid line is another
depression (the submandibular fossa).
 Area behind the maxilla.
Communicates with the orbit via the inferior
orbital fissure & the pterygopalatine fossa
via the pterygomaxillary fissure.

Contains:
1. Mandibular nerve
2. Chorda Tympani nerve
3. Maxillary artery
4. Medial & lateral pterygoids
5. Lower part of temporalis
 Synovial Joint
(Gliding) between
the:
Condyle of mandible
Mandibular fossa &
articular tubercle of
temporal bone

Capsule:
Loose capsule
surrounds the joint &
extends posteriorly to
enclose part of the
neck of the mandible.
 Fibrocartilage that
separates the joint cavity
into an upper & lower
compartment.
The gliding movements of
protrusion and retrusion
(translation) occur in the
superior compartment
Hinge movements of
depression and elevation
occur in the inferior
compartment.
Slight opening
of jaw = Hinge Jaw opens
action. widely = Hinge +
sliding forward
movement
 Temporomandibular ligament:
Reinforces joint on the
lateral surface.

Sphenomandibular ligament:
From the spine of sphenoid to
the lingula of mandible.
Lies on the medial side of the
TMJ.

Stylomandibular ligament:
From the styloid process to
the ramus of mandible above
the angle.
 Important muscles supplied by the
mandibular nerve.

1. Temporalis
2. Masseter
3. Medial Pterygoid
4. Lateral Pterygoid
5. Anterior belly of Digastric
6. Mylohyoid
 Extends from the
temporal fossa to the
coronoid process &
anterior border of
the ramus.
Elevates & retracts
the mandible.
 Extends from the
inferior surface of
the zygomatic arch
to the angle of the
mandible.
Elevates the
mandible.
Crossed superficially
by the transverse
facial artery, parotid
duct & buccal branch
of facial nerve.
 Arises from the
greater wing of
sphenoid & lateral
pterygoid plate.
Attaches to the neck
of the mandible &
the articular disc.
Protracts & depresses
the mandible.
Deviates mandible to
the other side.
 Arises from the
medial surface of the
lateral pterygoid
plate & maxillary
tuberosity.
Attaches to the
medial surface of the
angle of the
mandible.
Protracts & elevates
the mandible.
 Terminal branch of the external carotid artery given
deep to the neck of the mandible.
Lies superficial (or in some cases deep) to the lateral
pterygoid muscle.
Runs in the infratemporal fossa towards the
pterygomaxillary fissure.
Divided into 3 parts.
First part Second Part Third Part

Deep auricular Deep Temporal Posterior

superior
alveolar
Anterior Masseteric Artery of
tympanic Pterygoid canal
Middle Pterygoid Infraorbital
meningeal
Inferior alveolar Buccinator Pharyngeal

Accessory Descending
Meningeal palatine
Sphenopalatine
 Veinsthat drain regions supplied by arteries branching
from the maxillary artery in the infratemporal fossa and
pterygopalatine fossa connect with the pterygoid plexus.
These tributary veins include those that drain the nasal
cavity, roof and lateral wall of the oral cavity, all teeth,
muscles of the infratemporal fossa, paranasal sinuses, and
nasopharynx.
In addition, the inferior ophthalmic vein from the orbit
drains through the inferior orbital fissure into the
pterygoid plexus.
 The mandibular nerve [V3] is the largest of
the three divisions of the trigeminal nerve
[V].
Unlike the ophthalmic [V1] and maxillary [V2]
nerves, which are purely sensory, the
mandibular nerve [V3] is both motor and
sensory.
All branches of the mandibular nerve [V3]
originate in the infratemporal fossa.
 Soon after the sensory and motor roots join,
the mandibular nerve [V3] gives rise to a
small meningeal branch and to the nerve to
medial pterygoid, and then divides into
anterior and posterior trunks
branches from the anterior trunk are the
buccal, masseteric, and deep temporal
nerves, and the nerve to lateral pterygoid,
all of which, except the buccal nerve (which
is predominantly sensory) are motor nerves
Figure 8.138 Mandibular nerve [V3]-meningeal nerve and nerve to medial pterygoid.

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2005 Elsevier
 auriculotemporal, lingual, and inferior
alveolar nerves, all of which, except a small
nerve (nerve to mylohyoid) that branches
from the inferior alveolar nerve, are sensory
nerves.
 Anesthesia of the inferior
alveolar nerve is widely
practiced by most dentists.
The inferior alveolar nerve
passes into the mandibular
canal and runs within the
medullary cavity of the
mandible, piercing the
anterior aspect of the
mandible through the
mental foramen.
 Branches of two cranial nerves join branches
of the mandibular nerve [V3] in the
infratemporal fossa
Chorda tympani branch of the facial nerve
[VII] and the lesser petrosal nerve, a branch
of the tympanic plexus in the middle ear,
which had its origin from a branch of the
glossopharyngeal nerve [IX].
 Thechorda tympani carries taste from the
anterior two-thirds of the tongue and
parasympathetic innervation to all salivary
glands below the level of the oral fissure.
Lesser petrosal nerve
Thelesser petrosal nerve carries mainly
parasympathetic fibers destined for the
parotid gland
 Sweating and flushing of skin along distribution
of auriculotemporal nerve
Auriculotemporal branch of Mandibular nerve
carries sympathetic fibers to sweat glands of
scalp and parasympathetic fibers to parotid
gland
Causes
Frey's syndrome often results as a side effect
of parotid gland surgery or due to injury to
auricotemporal nerve.
 Symptoms of Frey's
syndrome are redness
and sweating on
the cheek area adjacent to
the ear.
They can appear when the
affected person eats, sees,
dreams, thinks about or
talks about certain kinds
of food which produce
strong salivation.
Observing sweating in the
region after eating a
lemon wedge may be
diagnostic.
 Lymph from the upper lip
and lateral parts of the
lower lip drains to the
submandibular nodes.
Lymph from the middle
part of the lower lip drains
to the submental nodes.
 The different types of teeth are distinguished
on the basis of morphology, position, and
function
The gingivae (gums) are specialized regions
of the oral mucosa that surround the teeth
and cover adjacent regions of the alveolar
bone
 All teeth are supplied by vessels that branch
either directly or indirectly from the
maxillary artery.
All lower teeth are supplied by the inferior
alveolar artery
All upper teeth are supplied by anterior and
posterior superior alveolar arteries.
 All nerves that innervate the teeth and
gingivae are branches of the trigeminal nerve
[V]
The lower teeth are all innervated by
branches from the inferior alveolar nerve
All upper teeth are innervated by the
anterior, middle, and posterior superior
alveolar nerves, which originate directly or
indirectly from the maxillary nerve [V2].
 The roof of the oral cavity consists of the
palate, which has two parts-an anterior hard
palate and a posterior soft palate
 Thesoft palate is formed and moved by four
muscles and is covered by mucosa that is
continuous with the mucosa lining the
pharynx and oral and nasal cavities.
The small tear-shaped muscular projection
that hangs from the posterior free margin of
the soft palate is the uvula.
 Allmuscles of the palate are innervated by
the vagus nerve [X] except for tensor veli
palatini, which is innervated by the
mandibular nerve [V3] (via the nerve to
medial pterygoid).
 The tongue is completely divided into a left
and right half by a median sagittal septum
composed of connective tissue.
This means that all muscles of the tongue
are paired. There are intrinsic and extrinsic
lingual muscles.
Except for the palatoglossus, which is
innervated by the vagus nerve [X], all
muscles of the tongue are innervated by the
hypoglossal nerve [XII].
 Superior longitudinal
Inferior longitudinal
Transverse
Vertical muscles
alter the shape of the
tongue by: lengthening
and shortening it;
curling and uncurling
its apex and edges;
flattening and rounding
its surface.
 There are four major extrinsic muscles on
each side,
Genioglossus
Hyoglossus
Styloglossus
Palatoglossus.
These muscles protrude, retract, depress,
and elevate the tongue.
 Lesion of hypoglosal nerve: Ipsilateral tongue
deviation.
Lesion of Corticobulbulbar fibers to
Hypoglosal nerve: Contralateral tongue
deviation