Most important slides pdf - dr.motaz



Sutures – Immovable joints that join skull

bones together



Form boundaries between skull bones



Four sutures:

›

Coronal – between parietal and frontal

›

Sagittal– between parietal bones

›

Lambdoid – between the parietal and

occipital

›

Squamous – between the parietal and

temporal



Fontanels

– usually ossify by 2 years of age

Dr. Motaz Shieban



Bell’s Palsy:

›

Inhibition of facial

nerve (cranial nerve

VII) → inability to

control facial muscles

(resultant flaccidity)



Most common cause

of Acute Facial Nerve

Paralysis



Symptoms: weakness

on one side of face,

facial droop, pain on

affected side,

headache, loss of

taste



Cause: Inflammation

of facial nerve

(resultant pinching)



Infection or Virus

Dr. Motaz Shieban

1. The primary function is expression of the emotions.

2. The facial muscles are capable of performing

7000 expressions according to Coleman.

3. They are also responsible for the maintenance of

the posture of the facial structures.

4. The facial muscle also contributes to stabilization

of the mandible during the infantile swallowing

and chewing and swallowing in the occlusally

compromised adults.

5. It is also important for the visual and the spoken

communications.

Dr. Motaz Shieban



Movements of the mandible are

classified as:



● Elevation



● Depression



● Protrusion



● Retrusion



● Side-to-side (lateral) excursion

Dr. Motaz Shieban

Maxilla

Parietal bone

Squamous part of

Temporal bone

Mastoid part of

Temporal bone

Tympanic part of

Temporal bone

Styloid part of

Temporal bone

Zygomatic part of

Temporal bone

Palatine

Bone

Floor:

Temporal fossa/floor

parietal

frontal

sq.

temporal

Temporal Fossa

1- Superiorly:

Temporal

Lines

2- Inferiorly:

Infra-temporal

Crest

3- Laterally:

The Zygomatic Arch

4- Medially:

Bones Forming The Pterion

5- Anteriorly:

Zygomatic,

Frontal,

and

Greater Wing

6- Posteriorly:

Inferior Temporal line

•Temporal fascia

•Muscles:

A. Muscles of mastication:

1. Temporalis.
2. Masseter
3. Lateral pterygoid.
4. Medial pterygoid.

B. Muscles of the palate:

1. Tensor palati.
2. Levator palati.

•Nerves:

1. Mandibular nerve and its branches.
2. Maxillary nerve and its branches.
3. Chorda tympani.

•Parasympathetic ganglia:

1. Otic ganglion.
2. Sphenopalatine ganglion.

•Vessels:

1. Maxillary artery and its branches.
2. Pterygoid venous plexus, tributaries and
communications.

• Joints:

Temporomandibular joint.

Lateral pterygoid:

upper head

lower head

Line of action of lateral pterygoids is from
anterior to posterior in horizontal plane.
They PROTRACT or pull the mandible
forward.

INFRATEMPOR-
AL FOSSA

borders:

Lateral: ramus
of mandible

Medial: lateral
pterygoid plate

Roof: greater
wing of
sphenoid, adj.
maxilla &
palatine bones

Inferior:
continuous with
deep cervical
fascia

General scheme:-



Origin:-

All arise from the skull (temporal and infratemoral

region)



Insertion

: all are inserted in mandible



Nerve supply:-

all are supplied by

anterior division of

mandibular nerve

except

medial pterygoid by

trunk of mandibular nerve



Action

all causes

protraction of mandible

except

temporalis

which cause

retraction

All causes

elevation of the mandible

except

lateral

pterygoid

which causes

depression

Lateral +Medial pterygoid

= side to side movement

Masster + Medial pterygoid

=they regulate the

position of the angle of the mandible in the vertical

plane.

Lower head :



Lateral surface of

lateral pterygoid plate

Infratemporal crest

3- Pterygoid Fovea

Deep temporal

nerves

Buccal

Deep

then

Between 2

heads

then

Superficial to

lower head

Upper

head of

lateral

pterygoid

Lower head of

lateral

pterygoid

Sphenomandibular

ligament

Mandibular Nerve

and its Branches

Auriculo-Temporal nerve

Inferior Alveolar nerve

Lingual nerve

Chorda Tympani

nerve

ii- Nerves

Part of

Maxillary artery and it branches

Branches of 1

part of Maxillary artery

1- Deep auricular

2- Anterior Tympanic

3- Middlle meningeal

4- Accessory Meningeal

5- Inferior Alveolar

Lateral Pterygoid

iii- Vessels

Deep temporal vessels and nerve

vessels and nerve to masseter

Inferior alveolar nerve

Sphenomandibular

ligament

Lingual nerve

Buccal nerve

Maxillary artery

1- At the Upper Border

2- At the Lower Border

Inferior alveolar vessels

3- Between

The Two Heads

Pterygoid Plexus of Veins

Surrounds

The Whole Muscle

Dr. Motaz Shieban

The five muscles of the soft palate, play important roles in

swallowing and breathing. The muscles are:



Tensor veli palatini, which is involved in swalloing.



Palatoglossus, involved in swallowing



Palatopharyngeus, involved in breathing



Levator veli palatini, involved in swallowing



Musculus uvulae, which moves the uvula

Dr. Motaz Shieban

These muscles are innervated by the pharyngeal plexus via the vagus nerve, with the
exception of the tensor veli palatini. The tensor veli palatini is innervated by cranial nerve
5 branch V3 (which is the mandibular division of the trigeminal cranial nerve).

Dr. Motaz Shieban

The circular muscles contract sequentially from superior to inferior to constrict the
lumen and propel the bolus of food inferiorly into the oesophagus.
They are stacked like glasses and are an incomplete muscular circle, anteriorly
attaching to structures in the neck.
They are all innervated by the vagus nerve (CN X):

Superior pharyngeal constrictor

is found

in the oropharynx.

Middle pharyngeal constrictor

is found in

the laryngopharynx.

Inferior pharyngeal constrictor

is found in

the laryngopharynx and has two
components. The superior component
(thyropharyngeus) has oblique fibres that
attach to the thyroid cartilage and the inferior
component (cricopharyngeus) has horizontal
fibres that attach to the cricoid cartilage.

Lateral view of the deep structures of the pharynx.
Visible are the circular muscles of the pharynx, and
the stylopharyngeus.

Circular Muscles



Stylopharyngeus:

from the styloid

process of the temporal bone to

the pharynx, innervated by the

glossopharyngeal nerve (CN IX)



Palatopharyngeus:

from hard

palate of the oral cavity to the

pharynx, innervated by the vagus

nerve (CN X)



Salpingopharyngeus:

from the

Eustachian tube to the pharynx,

innervated by the vagus nerve

(CN X). In addition to contributing

to swallowing, it also opens the

Eustachian tube to equalize the

pressure in the middle ear with the

atmosphere

Dr. Motaz Shieban

The longitudinal muscles shorten and widen the pharynx, and elevate the larynx during
swallowing.

Posterior view of the pharynx. The pharynx has been split down
the midline and opened, to show the longitundinal muscles

Lower Limit of

Nasopharynx

Lower border of soft palate or

Junction b/w hard & soft palate

Oropharynx

Tip of epiglottis or

Body of hyoid bone or

Base of vallecula

Hypopharynx

Lower border of cricoid or

Lower border of C6 vertebra

Structures Passing

Between Skull Base &

Superior Constrictor

(Sinus of Morgagni)

Eustachian tube + Levator

palatini + Tensor palatini +

Ascending palatine artery

Between Superior &

Middle Constrictors

Glossopharyngeal nerve &

Stylopharyngeus muscle

Between Middle &

Inferior Constrictors

Internal Laryngeal nerve &

Superior Laryngeal artery

Below Inferior

Constrictor

Recurrent Laryngeal nerve

& Inferior Laryngeal artery

Dr. Motaz Shieban

Innervation

Innervation of the majority of the pharynx is
achieved by the pharyngeal plexus, which
comprises of:
Branches of the glossopharyngeal nerve
(CN IX)
Branches of the vagus nerve (CN X)
Sympathetic fibres of the superior cervical
ganglion.
Sensory: Each of the three sections of the
pharynx have a different innervation:
The nasopharynx is innervated by the
maxillary nerve (CN V2).
The oropharynx by the glossopharyngeal
nerve (CN IX).
The laryngopharynx by the vagus nerve
(CN X).
Motor: All the muscles of the pharynx are
innervated by the vagus nerve (CN X),
except for the stylopharyngeus, which is
innervated by the glossopharyngeal nerve
(CN IX).

Blood Supply

Arterial supply is via branches of the
external carotid artery: ascending
pharyngeal, lingual, facial and
maxillary arteries.
Venous drainage is achieved by the
pharyngeal venous plexus, which
drains into the internal jugular vein.



Nasopharynx:

pterygo-palatine ganglion (V2)



Oropharynx:

glossopharyngeal & vagus nv



Hypopharynx:

Superior & recurrent laryngeal nv

All muscles by pharyngeal nerve plexus (vagus nv

carrying cranial part of accessory nv) except

stylopharyngeus (glossopharyngeal nv) &

cricopharyngeus (also by recurrent laryngeal)

Facial artery

Lingual artery

Ascending pharyngeal artery

Ascending palatine artery

Greater palatine artery

Artery of pterygoid canal

Superior laryngeal artery

Upper pharynx:



Pharyngeal venous plexus situated on middle

constrictor



pterygoid venous plexus &

internal jugular vein

Lower pharynx:



Inferior thyroid veins



Nasopharynx:

upper deep cervical + retro-

pharyngeal + parapharyngeal +

posterior triangle



Oropharynx:

upper deep cervical + retro-

pharyngeal + parapharyngeal



Hypopharynx:

deep cervical + parapharyngeal +

paratracheal + supraclavicular

Dr. Motaz Shieban (Surgical Oncologist)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

Path V1

It passes forward along the

lateral wall of the cavernous sinus

, below

the oculomotor and trochlear nerves; just before entering the orbit, through
the

superior orbital fissure

, it divides into three branches, lacrimal, frontal, and

nasociliary.

The lacrimal nerve

passes through the orbit superiorly to innervate the lacrimal

gland.

The frontal branch

passes through the orbit superiorly, then reenters the

frontal bone briefly before exiting above the orbit through the supraorbital
foramen and the supratrochlear notch to provide sensory innervation for the
skin of the forehead and scalp.

The nasociliary branch

gives off several sensory branches to the orbit and

then continues out through the

anterior ethmoidal foramen

, where it enters the

nasal cavity and provides innervation for much of the anterior nasal mucosa. It
also gives off a branch which exits through the nasal bones to form the

external nasal branch

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

Branches V1

Nasociliary nerve

1. Sensory root of ciliary ganglion
2. Posterior ethmoidal nerve
3. Long ciliary nerve
4. Infratrochlear nerve
5. Anterior ethmoidal nerve

Lacrimal nerve
Frontal nerve

1. Supratrochlear nerve
2. Supraorbital nerve

Dr. Motaz Shieban (Surgical Oncologist)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

PATH V2 Maxillary nerve.

Anterior to the trigeminal ganglion, the maxillary nerve passes through
the cavernous sinus and exits the skull through the

foramen rotundum

Thus it begins at the middle of the

trigeminal ganglion

as a flattened plexiform

band, and, passing horizontally forward, it leaves the skull through the

foramen

rotundum

, where it becomes more cylindrical in form, and firmer in texture.

It then crosses the

pterygopalatine fossa

, inclines lateralward on the back of

the

maxilla

, and enters the orbit through the

inferior orbital fissure

. It traverses

the infraorbital groove and canal in the floor of the orbit, and appears upon the
face at the

infraorbital foramen

. There, it is called the

infraorbital nerve

, a

terminal branch.

At its termination, the nerve lies beneath the quadratus labii superioris, and
divides into a leash of branches that spread out upon the side of the nose, the
lower eyelid, and the upper lip, joining with filaments of the facial nerve.

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

Branches V2

Its branches may be divided into four
groups, depending upon where they
branch off:
1. in the cranium
2. in the pterygopalatine fossa
3. in the infraorbital canal
4. in the face.

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

A) In the cranium

1.Middle meningeal nerve in the meninges

B ) From the pterygopalatine fossa

1. Infraorbital nerve

through Infraorbital canal

2. Zygomatic nerve (zygomaticotemporal nerve, zygomaticofacial nerve)

through Inferior

orbital fissure

3. Nasal Branches (nasopalatine)

through Sphenopalatine foramen

4. Superior alveolar nerves (Posterior superior alveolar nerve , Middle superior alveolar

nerve, Anterior superior alveolar nerve)

5. Palatine Nerves (Greater palatine nerve, Lesser palatine nerve), including

the Nasopalatine nerve

6. Pharyngeal nerve

C) In the infraorbital canal

1. Anterior superior alveolar nerve
2. Infraorbital nerve

D) In the face

1. Inferior palpebral nerve
2. Superior labial nerve

Dr. Motaz Shieban (Surgical Oncologist

)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

Roots

It is made up of two roots:

a large

sensory root

proceeding from the inferior angle of the

trigeminal

ganglion

a small

motor root

(the motor part of the trigeminal), which passes

beneath the ganglion, and unites with the sensory root, just after its exit
through

the

foramen ovale.

Path

The two roots (sensory and motor) exit the

middle cranial fossa

through

the

foramen ovale

The two roots then combine Immediately in the

infratemporal fossa

beneath

the base of the skull, the nerve gives off two branches from its medial side: a
recurrent branch (

nervus spinosus

) and the nerve to the

medial pterygoid

muscle

. The mandibular nerve then divides into two trunks, an anterior and a

posterior.

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

Branches of Mandibular Nerve

From the main trunk of the nerve

(before the division)

muscular branches, which are efferent nerves for the medial pterygoid,
tensor tympani, and tensor veli palatini muscles (motor)

meningeal branch (a sensory nerve)

From the anterior division

masseteric n.(motor)

deep temporal nerves , anterior and posterior (motor)

buccal n. (a sensory nerve)

lateral pterygoid n. (motor

)

From the posterior division

auriculotemporal n. (a sensory nerve)

lingual n. (a sensory nerve)

inferior alveolar n. (a motor nerve and a sensory nerve)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

Supplies V3 Anterior Division:

(Motor Innervation

–Muscles of Mastications

)

•Masseteric nerve



Masseter

•Medial pterygoid nerve



Medial Pterygoid



Tensor Tympani



Tensor Veli Palatini Nerve



Tensor Veli Palatini

•Lateral pterygoid nerve



Lateral pterygoid

•Deep temporal nerve



Temporalis

(

Sensory Innervation)

•Buccal nerve



Inside of the Cheek (

buccal mucosa

)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

Lingual Split :

1- (Sensory Innervation - NOT Taste) Anterior 2/3
of

Tongue

(

mucous membrane

)

Inferior Alveolar Split:

(Motor Innervation)

•Mylohyoid

•Digastric

(Anterior Belly)

(Sensory Innervation)

•Teeth

and

Mucoperiosteum

of mandibular teeth

•Chin

and

Lower Lip

Auriculotemporal Split

•Scalp

(

auricula / temporal region

)

Supplies V3 Posterior Division:

Dr. Motaz Shieban (Surgical Oncologist)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

4/ Dec /2014

Distal to stylomastoid foramen, the following nerves branch

off the facial nerve



Posterior auricular nerve

controls movements of some

of the scalp muscles around the ear



Branch to

Posterior belly of Digastric

muscle as

well as the

Stylohyoid muscle

Five major facial branches (in parotid gland) -

To Zanzibar By Motor Car:

Temporal branch of the facial nerve

Zygomatic branch of the facial nerve

Buccal branch of the facial nerve

Marginal mandibular branch of the facial nerve

Cervical branch of the facial nerve

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

1- The temporal branches

run crosses the zygomatic

arch to the temporal region, supplying the auriculares

anterior and superior, and joining with

the zygomaticotemporal branch of the maxillary nerve, and

with the auriculotemporal branch of the mandibular nerve.

The more anterior branches supply the frontalis, the orbicularis

oculi, and corrugator supercilii, and join the supraorbital

and lacrimal branches of the ophthalmic. The temporal

branch acts as the efferent limb of the corneal reflex.

2- The zygomatic branches

run across the zygomatic

bone to the lateral angle of the orbit , where they supply

the Orbicularis oculi , and join with filaments from

the lacrimal nerve and the zygomaticofacial branch of

the maxillary nerve

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

larger size than the rest of the branches, pass horizontally forward to be

distributed below the orbit and around the mouth.

BRANCHES :



The superficial branches

run beneath the skin and above

the superficial muscles of the face, which they supply: some are

distributed to the Procerus, joining at the medial angle of the orbit

with the infratrochlear and nasociliary branches of the ophthalmic.



The deep branches

pass beneath the Zygomaticus

and

the Quadratus labii superioris, supplying them and forming an

infraorbital plexus with the infraorbital branch of the maxillary nerve.

These branches also supply the small muscles of the nose.



The lower deep branches

supply the Buccinato and

Orbicularis oris, and join with filaments of the buccinator branch of

the mandibular nerve.

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

4- The marginal mandibular branch

passes

forward beneath the platysma and depressor anguli oris,

supplying the muscles of the lower lip and chin, and

communicating with the mental branch of the inferior

alveolar nerve.



Depressor labii inferioris



Depressor anguli oris



Mentalis

5-The cervical branch

runs forward beneath

the Platysma, and forms a series of arches across the side

of the neck over the suprahyoid region.



One branch descends to join the cervical cutaneous

nerve from the cervical plexus; others supply the

Platysma. Also supplies the depressor anguli oris.

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

The posterior auricular nerve

arises close to the stylomastoid

foramen and runs upward in front of the mastoid process; here it is joined by

a filament from the auricular branch of the vagus and communicates with

the posterior branch of the great auricular as well as with the lesser occipital.

As it ascends between the external acoustic meatus and mastoid process it

divides into auricular and occipital branches.



The auricular branch

supplies the auricularis posterior and the intrinsic

muscles on the cranial surface of the auricula.



The occipital branch

, the larger, passes backward along the superior nuchal

line of the occipital bone and supplies the occipitalis.

The digastric branch of facial nerve

arises close to the stylomastoid

foramen , and divides into several filaments, which supply the posterior belly

of the Digastricus ; one of these filaments joins the glossopharyngeal nerve .

The stylohyoid branch of facial nerve

frequently arises in

conjunction with the digastric branch; it is long and slender, and enters

the Stylohyoideus about its middle

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)



Greater petrosal nerve

provides

parasympathetic innervation to several glands,

including the nasal gland,palatine gland, lacrimal

gland, and pharyngeal gland. It also provides

parasympathetic innervation to thesphenoid

sinus, frontal sinus, maxillary sinus, ethmoid

sinus and nasal cavity



Nerve to stapedius

provides motor innervation

for stapedius muscle in middle ear



Chorda tympani

›

Submandibular gland

›

Sublingual gland

›

Special sensory taste fibers for the anterior 2/3 of the

tongue.

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

4/ Dec /2014

Dr. Motaz Shieban (Surgical Oncologist)

4/ Dec /2014

Carotid Sinus

At its point of division, the common carotid

artery shows a localized dilatation, called

carotid sinus



It serves as a reflex pressoreceptor

mechanism



A rise in blood pressure causes a slowing of

the heart rate and vasodilatation of the

arterioles

Carotid Body



It is a small structure lies posterior to the point

of bifurcation of the common carotid artery



It is innervated by glossopharyngeal nerve



It serves as a chemoreceptor



Sensitive to excess carbon dioxide and

reduced oxygen tension in the blood



It is embedded in the carotid sheath throughout its

course



Closely related with the internal jugular vein and

vagus nerve



Apart from the two terminal branches, the common

carotid artery gives off no branch in the neck



Relations



Anterolaterally: The skin, fascia, sternocleidomastoid,

sternohyoid, sternothyroid, and posterior belly of

omohyoid



Posteriorly: The transverse processes of lower four

cervical vertebrae, the prevertebral muscles,

sympathetic trunk, vertebral vessels in the lower part

of the neck



Medially: The larynx, pharynx, and below these, the

trachea and esophagus, the lobe of thyroid gland

Superior thyroid artery

Ascending pharyngeal artery

Lingual artery

Facial artery

Occipital artery

Posterior auricular artery

Superficial temporal artery

Maxillary artery

It arises in the carotid triangle from

the external carotid artery a little

above the lingual artery and,

sheltered by the ramus of the

mandible, passes obliquely up

beneath the digastric and stylohyoid

muscles, over which it arches to

enter a groove on the posterior

surface of the submandibular gland.

It then curves upward over the body

of the mandible at the antero-

inferior angle of the masseter; passes

forward and upward across the

cheek to the angle of the mouth,

then ascends along the side of the

nose, and ends at the medial

commissure of the eye, under the

name of the angular artery.

The facial artery is remarkably

tortuous. This is to accommodate

itself to neck movements such as

those of the pharynx in deglutition;

and facial movements such as those

of the mandible, lips, and cheeks.

Cervical

Ascending palatine artery

Tonsillar branch

Submental artery

Glandular branches

Facial

Inferior labial artery

Superior labial artery

Lateral nasal branch to nasalis

muscle

Angular artery - the terminal

branch

First portion

The first or mandibular portion passes horizontally

forward, between the neck of the mandible and the

sphenomandibular ligament, where it lies parallel to

and a little below the auriculotemporal nerve; it

crosses the inferior alveolar nerve, and runs along the

lower border of the lateral pterygoid muscle.

Branches include:

Deep auricular artery

Anterior tympanic artery

Middle meningeal artery

Inferior alveolar artery

which gives off its mylohyoid

branch just prior to entering the mandibular foramen

Accessory meningeal artery

Second portion:

The second or pterygoid portion runs obliquely forward and upward under cover of
the ramus of the mandible and insertion of the temporalis, on the superficial (very
frequently on the deep) surface of the lateral pterygoid muscle; it then passes between
the two heads of origin of this muscle and enters the fossa.

Branches include:

1) Masseteric artery
2) Pterygoid branches
3) Deep temporal arteries (anterior and posterior)
4) Buccal artery

Third portion
The third or pterygomaxillary portion lies in the pterygopalatine fossa in relation with
the pterygopalatine ganglion. This is considered the terminal branch of the maxillary
artery.
Branches include:

1) Sphenopalatine artery

(Nasopalatine artery is the terminal branch of the Maxillary

artery)

2) Descending palatine artery
3) Infraorbital artery
4) Posterior superior alveolar artery
5) Artery of pterygoid canal
6) Pharyngeal artery
7) Middle superior alveolar artery

(a branch of the infraorbital artery)

8) Anterior superior alveolar arteries

(a branch of the infraorbital artery)

9) Greater palatine artery

›

is formed by the

union of the

supraorbital and

supratrochlear veins

the medial canthus

to form the angular

vein

›

Communicate with

the cavernous sinus

through the

ophthalmic vein via

the supraorbital



descend on the face

behind the facial artery to

the lower border of the

mandible



to be joined by the

anterior division of the

retomandibular vein



Joins the:

›

pterygoid plexus

through

deep facial vein

›

Cavernous sinus through

superior ophthalmic

vein

›

A short trunk accompany

the first part of the artery.

›

Formed by confluence of

the veins of the pterygoid

plexus.

›

It passes backward

between the

sphenomandibular

ligament and the neck of

the mandible

›

Unite with the

superficial

temporal vein

to form the

retromadibular vein.

›

A network of very small veins,

lie around and within the

lateral pterygoid muscle in

the infratemporal region

›

receive some of the veins that

correspond to the maxillary

artery, inferior ophthalmic

vein (internal carotid blood)

and the deep facial vein.



Drain into a pair of large,

short maxillary veins which

join the superficial

temporal vein to form the

retromandibular.



Deep facial vein drain the

plexus into the

facial vein

if the maxillary is

occluded



Act as

peripheral pump

, to aid

venous return by the pumping

action of the muscle every time the

mouth is opened.



Yawing

a prolonged and forcible

contraction of the lateral pterygoid

to open the mouth, is accompanied

by contraction of the diaphragm

and stretching of limbs, is a reflex

triggered by venous stagnation