Cranial Nerves and Pterygopalatine Fossa - Learning Objectives
Discuss the Pterygopalatine Fossa. Include contents, relationships, foramina, nerve distributions, and nerve embarrassment.
Discuss the symptoms of cavernous sinus infection. Include symptoms involving vasculature, endocrine function, autonomic disturbances, and cranial nerve injury.
Discuss the parasympathetic innervation to the head. Include preganglionic and postganglionic pathways, and symptoms resulting from injury to the parasympathetic ganglia.
Discuss the anatomy of the region of the lacerate foramen. Include a discussion of the symptoms expected to result when damage occurs to the contents of the lacerate foramen.
Anterior lip of the lacerate foramen
Pterygopalatine ganglion (truthfully, this can not be a short answer without further restriction)
Tympanic branch of the glossopharyngeal nerve
Pharyngeal plexus derived from the glossopharyngeal nerve
Pharyngeal plexus derived from the vagus nerve
Internal laryngeal nerve
The pharyngeal plexus derived from the vagus nerve supplies SVE fibers to the middle constrictor whereas the pharyngeal plexus derived from the glossopharyngeal nerve provides GVA fibers to pharyngeal mucosa lining the middle constrictor.
All three of the constrictor muscles receive motor innervation as SVE from the vagus whereas the mucosa on their internal surfaces have GSA for nasopharynx, GVA glossopharyngeal for oropharynx, and GVA vagus for hypopharynx.
Referred pain from laryngeal or pharyngeal cancers may occur at the external auditory meatus. This reflects the activities of the great auricular nerve and of the lesser occipital nerve.
The tympanic branch of the glossopharyngeal nerve passes through the mastoid canaliculus.
The zygomaticotemporal nerve leaves the lateral wall of the orbit superior to the exit of the zygomaticofacial nerve.
The SVA component of the greater superficial petrosal nerve distributes along all the branches of the maxillary nerve that occur within the pterygopalatine fossa.
Parasympathetic postganglionic fibers, but not postganglionic sympathetic fibers, distribute with the lateral posterior nasal nerves to the turbinates.
The recurrent tympanic nerve, a branch of the chorda tympani, enters the tympanic cavity to provide SVE innervation to salpingopharyngeus.
The superior alveolar processes receive GSA innervation by the superior posterior, middle, and anterior alveolar branches of the maxillary and infraorbital nerves.
The mucosa of the maxillary sinus receives postganglionic fibers having cell bodies in the ciliary ganglion.