The Medial Pterygoid Muscle

• This is a thick, quadrilateral muscle that also has two heads or origin.
• It embraces the inferior head of the lateral pterygoid muscle.
• It is located deep to the ramus of the mandible.

• Origin: deep head—medial surface of lateral pterygoid plate and pyramidal process of palatine bone, superficial head—tuberosity of maxilla.
• Insertion: medial surface of ramus of mandible, inferior to mandibular foramen.
• Innervation: mandibular nerve via medial pterygoid nerve.

• It helps to elevate the mandible and closes the jaws.
• Acting together, they help to protrude the mandible.
• Acting alone, it protrudes the side of the jaw.
• Acting alternately, they produce a grinding motion.

Nerve Supply of the Muscles of the Orbit (pp. 715-6)

• Three cranial nerves supply the muscles of the eyeball; the oculomotor (CN III), trochlear (CN IV) and abducent (CN IV) nerves.
• All three enter the orbit via the superior orbital fissure.

• The trochlear nerve supplies the superior oblique muscle.
• The abducent nerve supplies the lateral rectus muscle.
• The oculomotor nerve supplies everything else.

• A mnemonic that is used is this formula for this strange sulfate: SO₄(LR₆)₃

The Nasal Mucosa

• Mucosa lines the entire nasal cavities except for the vestibule of the nose.
• The nasal mucosa is firmly bound to the periosteum and perichondrium of the supporting structures of the nose.
• It is continuous with the adjoining cavities to which the nasal cavity communicates (e.g., the nasopharynx and paranasal sinuses).

• The inferior 2/3 of the nasal mucosa is called the respiratory area and air passing over this is warmed and moistened before it passes into the lungs.
• The superior 1/3 is called the olfactory area.

The Olfactory Area of Nasal Mucosa

• This area contains the peripheral organ of smell.
• Sniffing draws air into this area
• Olfactory receptor cells (from the olfactory nerve, CN I, are located in the mucosa of this area in the nose.

Nerves to the Respiratory Area of Nasal Mucosa

• The inferior 2/3 of the nasal mucosa are supplied chiefly by the trigeminal nerve (CN V).

• The mucous membrane of the nasal septum is supplied chiefly by the nasopalatine nerve, a branch of the maxillary nerve (CN V²).
• Its anterior portion is supplied by the anterior ethmoidal nerve (a branch of the nasociliary nerve) which is derived from the ophthalmic nerve (CN V¹).

• The lateral walls of the nasal cavity are supplied by branches of the maxillary nerve (CN V²); the greater palatine nerve, and the anterior ethmoidal nerve.

Arteries of the Nasal Mucosa

• The blood supply of the mucosa of the nasal septum is derived mainly from the maxillary artery.

• The sphenopalatine artery, a branch of the maxillary, supplies most of the blood of the nasal mucosa.
• It enters by the sphenopalatine foramen and sends branches to the posterior regions of the lateral wall and to the nasal septum.

• The greater palatine artery, also a branch of the maxillary, passes through the incisive foramen to supply the nasal septum.

• The anterior and posterior ethmoidal arteries, branches of the ophthalmic artery, supply the anterosuperior part of the mucosa of the lateral wall of the nasal cavity and nasal septum.

• Three branches of the facial artery (superior labial, ascending palatine, and lateral nasal) also supply the anterior parts of the nasal mucosa.

Veins of the Nasal Mucosa

• The veins of the nasal mucosa form a venous network of plexus in the connective tissue of the nasal mucosa.
• Some of the veins open into the sphenopalatine vein and drain to the pterygoid plexus.
• Others join the facial and infraorbital veins.
• Some empty into the ophthalmic veins and drain into the cavernous sinus.

The Inferior Wall of the Orbit

• The thin inferior wall of the orbit or the floor is formed mainly by the orbital surface of the maxilla and partly by the zygomatic bone, and orbital process of the palatine bone.

• The floor of the orbit forms the roof of the maxillary sinus.

• The floor is partly separated from the lateral wall of the orbit by the inferior orbital fissure.

The Temporalis Muscle

• This is an extensive fan-shaped muscle that covers the temporal region.
• It is a powerful masticatory muscle that can easily be seen and felt during closure of the mandible.

• Origin: floor of temporal fossa and deep surface of temporal fascia.
• Insertion: tip and medial surface of coronoid process and anterior border of ramus of mandible.
• Innervation: deep temporal branches of mandibular nerve (CN V³).

• The temporalis elevates the mandible, closing the jaws; and its posterior fibres retrude the mandible after protrusion.

A. Anatomic position-erect body position with the arms at the sides and the palms  upward

B. Plane or section

1. Definition-imaginary flat surface formed by an extension through an axis

2. Median plane-a vertical plane. that divides a body into right and left halves

3. Sagittal plane

• Any plane parallel to the median plane
• Divides the body into right and left portions

4. Frontal plane

• Vertical plane that forms at right angles to the sagittal plane
• Divides the body into anterior and posterior sections
• Synonymous with the term coronal plane

5. Transverse plane

• Horizontal plane that forms at right angles to the sagittal and frontal planes
• Divides the body into upper and lower portions
• Synonymous with the term horizontal plane

C. Relative positions

1. Anterior

• Nearest the abdominal surface and the front of the body
• Synonymous with the term ventral
• In referring to hands and forearms, the terms palmar and Volar are used

2. Posterior

• Back of the body
• Synonymous with the term dorsal

3. Superior

• Upper or higher
• Synonymous with the term cranial (head)

4. Inferior

• Below or lower
• Synonymous with the term caudal (tail)
• In referring to the top of the foot and the sole of the foot. the terms dorsal and plantar are used respectively

5. Medial-near to the median plane

6. Lateral-farther away from the median plane

7. Proximal-near the source or attachment

8. Distal-away from the source or. attachment

9. Superficial-near the surface

10. Deep-away from the surface

11. Afferent-conducting toward a structure

12. Efferent-conducting away from a structure