Anatomic Relations Summary

Done by:

Sohayyla Yasin Dababseh

Anatomic Relations

Part-1

Lecture 1

- The medial wall of the nose is the septum.

- The vestibule lies directly inside the nostrils (Nares).

- The nasal venous plexus is placed on the lateral wall

of the nasal cavity.

- Superior meatus is located between superior and

middle conchae.

- Middle meatus is located between middle and inferior

conchae.

- Inferior meatus is located between inferior concha

and floor of nasal cavity.

- Nares are the anterior openings of the nasal cavity.

- Choanae are the posterior openings of the nasal

cavity (they open into the nasopharynx).

Now the Prof. emphasized on memorizing the

surrounding bones of choanae which are the

following:

1- Superiorly; Sphenoidal process of palatine

bone and superior to it; lies the Palatovaginal

canal.

2- Inferiorly; Horizontal plate of palatine bone.

3- Laterally; Medial pterygoid plate of sphenoid.

4- Medialy; Vomer (which actually separates the

two openings apart).

- All choncae extend medially across the nasal cavity.

- Ethmoidal bulla is an elevation of the lateral wall of

the middle meatus, inferior to it; lies Hiatus

semilunares.

- Sphenopalatine artery enters the nasal cavity by

passing medially through sphenopalatine foramen.

- Anterior ethmoidal artery descends lateral to crista

galli.

- Alar branches of the superior labial artery pass

around the lateral margin of Nares to supply the

vestibule.

- Apex of the maxillary sinus is directed laterally and

the base is deep to the lateral wall of adjacent nasal

cavity.

- Relations of the maxillary sinuses (Important)

1- Related above to the orbit.

2- Related below to the roots of upper molar and

premolar tooth.

3- Related behind to infratemporal fossa.

4- Related medially to the lower part of nasal

cavity.

- Relations of the sphenoidal sinuse (Important)

1- Related above to the pituitary gland and optic

chiasm.

2- Related laterally to the cavernous sinus and its

contents which are the following:

*Note: The structures that lie within the

cavernous sinus are; internal carotid artery,

sympathetic fibers and Abducens nerve. The

structures that lie within the lateral wall of the

cavernous sinus are; Ophthalmic, Trochlear and

Oculomotor nerves. So, all of the

aforementioned structures are lateral to the

sphenoidal sinuses.

3- Below and front of the sinus lies the nasal

cavity.

- Note: Maxillary air sinuses are the largest and

ethmoidal air sinuses are the smallest.

Blood supply of the nasal cavity.

Su

pp

ly

1-A

Larg

e p

art

of th

e late

ral

wall

(sup.p

ost.quadra

nt)

. 2-

Th

e n

asal septu

m.

1-S

oft p

ala

te.

2-A

nte

rio

r re

gio

ns o

f th

e

septu

m a

nd a

dja

cent flo

or.

(poste

ro-in

ferio

r and a

nte

ro-

infe

rio

r quadra

nt)

.

1-A

la a

nd s

urr

oundin

g n

are

s

passin

g la

tera

l to

it to

supply

the v

estib

ule

.

2-A

nte

rio

r re

gio

ns o

f nasal

septu

m.

Late

ral and m

edia

l w

alls

of

nasal cavity (

Ante

rio

r superio

r

quadra

nt)

.

Upper

part

s o

f m

edia

l and

late

ral w

alls

.

Co

urs

e

Th

e m

ajo

r art

ery

passes

me

dia

lly t

hro

ugh

sphenopala

tin

e fora

me

to

ente

r nasal cavity.

Th

e lo

ng

bra

ch p

asses o

ver

the r

oof

of

the n

asal cavity a

nd in

to the

septu

m.

Th

e g

reate

r pala

tin

e e

nte

rs

nasal th

rough t

he in

cis

ive

canal.

Not

me

ntio

ned

Passes la

tera

l to

crista

galli

th

rough a

slit

-lik

e f

ora

me

n.

Passes t

hro

ugh the c

rib

rifo

rm

pla

te.

Bra

nc

hes

1-P

oste

rio

r la

tera

l

bra

nch(s

hort

sphenopala

tin

e)

2-

Poste

rio

r

sepata

l

bra

nch(lo

ng

sphenopala

tin

e)

1-le

sser

pala

tin

e.

2-G

reate

r

pala

tin

e.

1-A

lar

bra

nch

2-S

epta

l bra

nch

none

none

Art

ery

Sp

he

no

pa

la

tin

e a

rtery

Pala

tin

e

art

ery

Su

pe

rio

r la

bia

l art

ery

An

teri

or

eth

mo

ida

l

art

ery

Po

ste

rio

r eth

mo

ida

l

art

ery

Notes:

- Sphenopalatine and palatine arteries are

branches of maxillary artery in pterygopalatine

fossa.

- Superior labial artery is a branch of facial artery.

- Anterior and posterior ethmoidal arteries are

branches of ophthalmic artery.

Lecture 2:

- The pterygopalatine fossa (sphenopalatine) lies on

the lateral side of the skull.

- Walls of Pterygopalatine fossa:

1- Anterior wall: Posterior surface of maxillary

bone.

2- Posterior wall: Lateral pterygoid plate of

sphenoid.

3- Medial wall: The lateral surface of palatine

bone.

4- Roof (above it): The greater wing of sphenoid.

5- Lateral to it (not an actual wall): The

infratemporal fossa.

- Foramen rotundum and pterygoid canal open into the

superoanterior surface of the ptyregoid process of

sphenoid bone. So, foramen rotundum is the lateral and the superior one and pterygoid canal

is the medial and inferior one.

- The pterygoid canal opens in the middle cranial fossa

anteroinferiorly to the internal carotid artery; it also

continues superomedially for a short distance in the

cartilage that fills foramen lacerum.

- The gates ways of pterygopalatine fossa: (Important)

1- To the middle cranial fossa via foramen

rotundum and pterygoid canal.

2- To the nasopharynx via palatovaginal canal; it

opens into the posterior surface of the

pterygopalatine fossa and is superior to the

foramen rotundum.

3- To the roof of the oral cavity (hard palate) via

palatine canal; it opens inferiorly.

4- To the lateral wall of the nasal cavity via

sphenopalatine foramen; it is located on the

medial wall (palatine bone) of pterygopalatine

fossa.

5- Lateral aspect of pterygopalatine fossa

communicates with infratemporal fossa via

pterygomaxillary fissure.

6- Superior aspect of pterygopalatine fossa

communicates with the orbit via inferior orbital

fissure.

Nerves that arise from the

pterygopalatine ganglion

Su

pp

ly

Orbital wall

lacrim

al gland and

sphenoidal sinus.

Mucosa and glands

of the

nasopharynx.

Mucosa and glands

of hard palate,

adjacent gingiva

asfar forw

ard as

the incisor teeth

and the mucosa

over the middle

and lower part of

the lateral wall of

the nasal cavity.

Co

urs

e

Passes through inferior orbital

fissure.

Passes posteriorly from the

pterygopalatine ganglion & leaves

it through

palatovaginal canal.

Passes through palatine canal and

passes forw

ard on the roof of the

oral cavity through greater

palatine foramen.

Nerv

e

1-O

rbit

al n

erv

e

2-P

ha

ryn

ge

al n

erv

e

3-G

reate

r p

ala

tin

e

(an

ate

rio

r p

ala

tin

e)

The soft palate

The mucosa of

the posterior

superior

quadrant of the

nasal cavity.

mucosa, gingiva,

and glands

adjacent to the

incisor teeth.

Passes through palatine canal

and passes posteriorly through

lesser palatine foramen.

Passes medially through the

sphenopalatine foramen to enter

the nasal cavity.

Passes medially through the

sphenopalatine

foramen to enter the nasal cavity

and then passes anteriorly

grooving down the nasal septum

and then hrough the incisive canal

and fossa in the hard palate.

4-L

esser

pa

lati

ne (

mid

dle

an

d

po

ste

rio

r p

ala

tin

e

5-S

ho

rt s

ph

en

o-p

ala

tin

e

6-N

aso

pa

lati

ne

ne

rve (

lon

g

Sp

he

no

pa

lati

ne

Branches of the Maxillary nerve:

**The table is on the last page

1- Meningeal ; before it enters the

pterygopalatine fossa

2- Two ganglionic branches that carry sensory

fibers to the pterygopalatine ganglion.

3- Zygomatic nerve

4- Posterior superior alveolar nerve.

5- Infra-orbital nerve.

Maxillary artery

- Is the major branch of the external carotid artery in the neck, originating adjacent to the neck of mandible within the substance of the parotid gland. It passes forward through the infratemporal fossa and enters the pterygopalatine fossa through the pterygomaxillary fissure (the third part)

- The maxillary artery is divided into three parts: Relations of the first part: Laterally; the neck of mandible Medially; sphenomandibular ligament Above it: auriculo-temporal nerve Below it: maxillary vein It gives origin to two major branches: 1) The middle meningeal artery which passes through foramen spinosum. 2) Inferior alveolar artery which supplies teeth of the lower jaw.

Smaller branches:

- Deep auricular and anterior tympanic arteries which supply the auricle.

- Accessory meningeal artery which passes through foramen ovale to the middle cranial fossa.

Relations of the second part: (Muscular part) It's related to the lateral pterygoid muscle.

- Gives origin to deep temporal, masseteric, buccal, and pterygoid branches (muscles of mastication).

- Courses with branches of the mandibular nerve. Relations of the third part:

- Arises in the pterygopalatine fossa anterior to the pterygopalatine ganglion.

- It Gives origin to branches that accompany branches of the maxillary nerve [V2] and the pterygopalatine ganglion.

Branches of the third part: 1. The posterior superior alveolar artery 2. Infra-orbital artery 3. Greater palatine artery 4. Pharyngeal artery 5. Sphenopalatine arteries. 6. The artery of the pterygoid canal

Note: check the relations of the branches from slides. Besides, this summary wasn't corrected by anyone so please if you find any wrong information, contact Raghad Abu-Jebbeh as soon as you can to have it corrected and excuse my typos btw.

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