Borders of the pterygopalatine fossa. Anatomy of the pterygopalatine fossa and its contents. VIII. temporal fossa

Pterygopalatine fossa, fossa pterygopalatina, is located in the anteromedial region. It is bounded behind by the pterygoid process, in front by the tubercle of the upper jaw, and from the inside by the perpendicular plate of the palatine bone. From the middle cranial fossa through the round opening of the skull, foramen rotundum, the maxillary nerve enters it, n. maxillaris (II branch of the trigeminal nerve). Its direct continuation is p. infraorbitalis, which enters the infraorbital canal (in the lower wall of the orbit formed by the maxillary bone) and, before entering the infraorbital region, gives off the upper alveolar and gingival branches that innervate the upper teeth and gums.

The eponymous process of the fatty body of the sheki rises into the pterygopalatine fossa from the buccal region.

The deepest part of the region is the pharynx with its surrounding peripharyngeal space, spatium peripharyngeum.

It consists of retropharyngeal space, spatium retropharyngeum, and two lateral, spatium lateropharyngeum.

retropharyngeal space located between the pharynx (with its fascia) and the prevertebral fascia and stretches from the base of the skull to the level of the VI cervical vertebra, where it passes into the spatium retroviscerale of the neck.

Bones of the brain and facial part of the skull, features of their structure.

Pterygopalatine fossa: structure, its message

The pterygopalatine fossa, fossa pterygopalatina, is formed by sections of the upper jaw, sphenoid and palatine bones. It connects with the infratemporal fossa, wide upward and narrow downward, by the pterygo-maxillary fissure, fissura pterygo-maxillaris. The walls of the pterygopalatine fossa are: in front - the infratemporal surface of the upper jaw, facies infratemporalis maxillae, on which the tubercle of the upper jaw is located, behind - the pterygoid process of the sphenoid bone, medially - the outer surface of the perpendicular wall of the palatine bone, from above - the maxillary surface of the large wing of the sphenoid bone.

In the upper part, the pterygopalatine fossa communicates with the orbit through the inferior orbital fissure, with the nasal cavity through the sphenopalatine foramen, with the cranial cavity through the foramen rotundum, and through the pterygoid canal, canalis pterygoideus, with the outer surface of the base of the skull and outside passes into the infratemporal fossa.

The sphenopalatine opening, foramen sphenopalatinum, on a non-macerated skull is closed by the mucous membrane of the nasal cavity (a number of nerves and arteries pass through the opening into the nasal cavity). In the lower section, the pterygopalatine fossa passes into a narrow canal, in the formation of the upper part of which large palatine grooves of the upper jaw, palatine bone and pterygoid process of the sphenoid bone participate, and the lower part consists only of the upper jaw and palatine bone.

The canal is called the greater palatine canal, canalis palatinus major, and opens on the hard palate with large and small palatine openings, foramen palatinum majus et foramina palatina minora (nerves and vessels pass through the canal).

The nasal cavity: structure, its messages

The nasal cavity, cavum nasi, is the initial section of the respiratory tract and contains the organ of smell. From the front, apertura piriformis nasi leads into it, from behind, paired openings, choanae, communicate it with the nasopharynx. Through the bony nasal septum, septum nasi osseum, the nasal cavity is divided into two not quite symmetrical halves. The nasal septum is distinguished: the membranous part of the pars membranacea and the bone part, pars ossea. The membranous part of the septum is formed by the cartilage of the nose, cartiiagines nasi: cartilage of the nasal septum, cartilage septi nasi, Lateral cartilage of the nose, cartilage nasi lateralis, Large cartilage of the wing, cartilage alaris major, In the nasal cavity, cavum nasi, distinguish between the vestibule of the nose, vestibulum nasi and its own cavity nose. In humans, there are four groups of sinuses, named according to their localization: 1) the maxillary (maxillary) sinus (steam room) - the largest of the paranasal sinuses, located in the upper jaw. 2) frontal sinus (steam room) - located in the frontal bone. 3) ethmoid labyrinth (paired) - formed by cells of the ethmoid bone. 4) sphenoid (main) sinus - located in the body of the sphenoid bone. Each half of the nasal cavity has five walls: superior, inferior, posterior, medial, and lateral. The upper wall of the nasal cavity is formed by a small part of the frontal bone The lower wall of the nasal cavity, or bottom, includes the palatine process of the upper jaw and the horizontal plate of the palatine bone

Eye socket: structure, its messages

The orbit, orbita, is a paired bone, in shape it resembles a faceted pyramid, the base directed anteriorly, and the apex posteriorly and medially. The base of the pyramid is represented by the entrance to the orbit, aditus orbitae. The canalis opticus runs at the top of the orbit.

The eye socket contains the eyeball, its muscles, the lacrimal gland and other auxiliary apparatus of the organ of vision. There are four walls of the orbit:

upper wall, paries superior, smooth, slightly concave, lies almost horizontally. In the lateral part of the upper wall of the orbit there is a shallow fossa of the lacrimal gland, fossa glandulae lacrimalis. at the medial edge of the upper wall, near the frontal notch, there is an inconspicuous depression - the trochlear fossa, fovea throchlearis, next to which sometimes a small spike protrudes - the trochlear spine, spina trochlearis. A cartilaginous block, trochlea, is attached here for the tendon of the superior oblique muscle of the eye. On the orbital margin, slightly lateral to it, there is an infraorbital notch, incisura supraorbitalis, occasionally it turns into an opening of the same name for the passage of blood vessels and nerves.

The medial wall, paries medialis, is located sagittally. In the anterior part of this wall there is a fossa of the lacrimal sac, fossa sacci lacrimalis, which is limited by the anterior and posterior lacrimal crests. From top to bottom, the fossa passes into the nasolacrimal canal, canalis nasolacrimalis, which opens into the nasal cavity, into the lower nasal passage. In the suture between the orbital plate of the ethmoid bone and the frontal bone there are two ethmoid openings, foramen ethmoidale anterius et foramen ethmoidale posterius. Through these holes, the vessels and nerves leave the orbit and penetrate to the cells of the labyrinth of the ethmoid bone.

The lower wall, paries inferior, is formed by the orbital surface of the body of the upper jaw. Behind it joins the orbital process, and in front of the zygomatic bone. In the lower wall of the orbit passes the infraorbital groove, which continues into the infraorbital canal, canalis infraorbitalis. The latter opens on the anterior surface of the upper jaw with the opening of the same name, foramen infraorbitalis.

The lateral wall, paris lateralis, is formed by the orbital surfaces of the greater wing of the sphenoid bone and the frontal process of the zygomatic bone, stands obliquely and is separated from the upper and lower walls of the orbit by slits. At the point of transition of the lateral wall to the lower one, the lower orbital fissure, fissure orbitalis inferior, is located. This fissure communicates the cavity of the orbit with the infratemporal and pterygopalatine fossa. On the lateral wall of the orbit there is a small zygomatic-orbital foramen, foramen zygomaticoorbitale, on the facial surface of the zygomatic bone, and a zygomatic-temporal foramen, foramen zygomaticotemporale, on its temporal surface.

Types of bone connection, characteristic

There are two types of bone connections: continuous (synarthrosis), synarthrosis and discontinuous (diarthrosis), diarthrosis. For continuous connections on the bones, tuberosities, ridges, lines, pits and roughness are characteristic, and for discontinuous - articular surfaces of various shapes.

Three groups of continuous connections:

fibrous connections - syndesmoses. These include ligaments, membranes, fontanelles, sutures, and impactions.

Ligaments, ligament - these are connections with the help of connective tissue, having the form of bundles of collagen and elastic fibers. Links do:

Holding or fixing role

The role of the soft skeleton, being the site of origin and attachment of muscles

Formative role, when they, together with the bones, form vaults or openings for the passage of blood vessels and nerves.

Membranes, membranae, are connections with the help of connective tissue, having the form of an interosseous membrane that, unlike ligaments, fills the vast gaps between the bones. They also hold bones together, serve as a starting point for muscles, and form openings for vessels and nerves to pass through.

Fontanelles, fonticuli, are connective tissue formations with a large amount of intermediate substance and sparsely located collagen fibers. They create conditions for the displacement of the bones of the skull during childbirth and contribute to the intensive growth of bones after birth.

Sutures, suturae, are thin layers of connective tissue containing a large amount of collagen fibers, located between the bones of the skull. They serve as a zone of growth of the bones of the skull and have a shock-absorbing effect during movement, protecting the brain, the organ of vision, the organ of hearing and balance from damage.

Impaction, gomphosis - connection of teeth with cells of the alveolar processes of the jaws with the help of dense connective tissue, which has a special name - periodontium. Although this is a very strong connection, it still has pronounced cushioning properties when the tooth is loaded.

Cartilaginous joints - synchondrosis. These compounds are represented by hyaline or fibrous cartilage. With the help of hyaline cartilage, the metaphyses and epiphyses of the tubular bones and individual parts of the pelvic bone are connected. Fibrous cartilage mainly consists of collagen fibers, therefore it is more durable and less elastic. The main purpose of synchondroses is to mitigate shocks and stress during heavy loads on the bone and to ensure a strong connection of the bones.

Connections with the help of bone tissue - synostoses. These are the strongest connections from the group of continuous ones, but they have completely lost their elasticity and shock-absorbing properties. Under normal conditions, temporary synchondrosis undergoes synostosis. In some diseases, ossification can occur not only in all synchondroses, but also in all syndesmoses.

Discontinuous connections are joints, or synovial connections.

A joint, articulation, is a discontinuous cavitary connection formed by articulating articular surfaces covered with cartilage, enclosed in an articular bag, which contains synovial fluid. The role of articular cartilage, cartilage articularis, is that it smooths out the irregularities and roughness of the articular surface of the bone, giving it greater congruence. Due to its elasticity, it softens shocks and shocks, therefore, in joints that carry a large load, the articular cartilage is thicker.

Synovial fluid performs the following role:

Lubricates articular surfaces

It connects the articular surfaces, holds them relative to each other.

Softens the load

Nourishes articular cartilage

Participates in metabolism

Joints, main and auxiliary elements of the structure. Classification of joints.

Connection of the spinal column.

Joints of the upper limbs.

The shoulder joint, articulatio humeri, is formed by caput humeri and cavitas glenoidalis scapulae. The articular cavity has an oval shape, slightly concave and only a quarter of the surface of the head. It complements the articular lip, labrum glenoidale. The articular capsule is attached to the scapula along the edge of the articular lip, and on the humerus along the collum anatomicum. The synovial membrane also forms a second permanent eversion - the subtendinous bursa of the subscapularis muscle, bursa subtendinea musculus subscapularis. The capsule of the shoulder joint is thin, from above and behind it is strengthened by the coraco-brachial and articular-shoulder ligaments: coraco-shoulder ligament (ligamentum coracohumerale), articular-shoulder ligaments (ligament glenohumeralia). The shoulder joint is spherical in shape, multiaxial, the most mobile of all the discontinuous connections of the bones of the human body. Its movements: flexion and extension, abduction and adduction, rotation of the shoulder in and out, circular motion.

In the formation of the elbow joint, articulation cubiti, three bones take part - the humerus, ulna and radius. Three joints are formed between them: the shoulder joint, articulatio humeroulnaris, is formed by the articulation of trochlea humeri and incisura trochlearis ulnae. The joint is helical in shape, uniaxial. The shoulder joint, articulatio humeroradialis, is the articulation of the head of the condyle of the humerus with the articular fossa of the head of the radius. The joint is spherical. The proximal radioulnar joint, articulatio radioulnaris proximalis, is a cylindrical joint formed by the articulation of circumferentia articularis radii and incisura radialis ulnae. All three joints are covered by one common joint capsule. His movements: flexion extension.

The wrist joint, articulatio radiocarpea, is formed by: the carpal articular surface, facies articularis carpea radii, supplemented by the articular disc, discus articularis; articular surfaces of the proximal row of carpal bones, ossa scaphoideum, lunatum et triquetrym. The articular disc separates the head of the ulna from the proximal row of carpal bones. On the lateral side is the radial collateral ligament of the wrist, ligamentum collaterale carpi radiale, which starts from the processus styloideus radii to os trapezium. On the medial side is the ulnar collateral ligament of the wrist, ligamentum collaterale carpi ulnare to os trapezium and to os pisiforme. On the palmar and dorsal surfaces there are ligaments, ligamentum radiocarpeum dorsale and ligamentum radiocarpeum palmare.

jointslowerlimbs.

Mimic and chewing muscles of the head: their functions and structural features.

Mimic muscles are thin and small muscle bundles that are grouped around natural openings: the mouth, nose, palpebral fissure and ear, taking part in one way or another in closing or, conversely, expanding these openings. Muscles of the eye circumference: 1 M. procerus, the muscle of the proud, starts from the bony back of the nose and aponeurosis m. nasalis and ends in the skin of the glabellae region, connecting with the frontalis muscle. 2 M. orbicularis oculi, the circular muscle of the eye, surrounds the palpebral fissure, located with its peripheral part, pars orbitalis, on the bony edge of the orbit, and the internal, pars palpebralis, on the eyelids. There are also 3 small parts, pars lacrimals, which arise from the wall of the lacrimal sac and, expanding it, affect the absorption of tears through the lacrimal canaliculi. Pars palpebralis closes the eyelids. The orbital part, pars orbitalis, with a strong contraction, closes the eyes. Muscles of the circumference of the mouth: 4. M. levator labii superioris, the muscle that lifts the upper lip, starts from the infraorbital edge of the upper jaw and ends mainly in the skin of the nasolabial fold. 5. M. zygomaticus minor, a small zygomatic muscle, starts from the zygomatic bone, is woven into the nasolabial fold, which deepens during contraction. 6. M. zygomaticus major, a large zygomatic muscle, goes from the facies lateralis of the zygomatic bone to the corner of the mouth and partly to the upper lip. m. zygomaticus is par excellence the muscle of laughter. 7. M. risorius, muscle of laughter, a small transverse bundle going to the corner of the mouth, is often absent. 8. M. depressor anguli oris, the muscle that lowers the corner of the mouth, begins on the lower edge of the lower jaw lateral to the tuberculum mentale and is attached to the skin of the corner of the mouth and upper lip. 9. M. levator anguli oris, the muscle that raises the angle of the mouth, lies under m. levator labii superioris, etc. zygomaticus major - originates from fossa canina (which is why it was previously called m. canfnus) below the foramen infraorbi-tale and is attached to the corner of the mouth. 10. M. depressor labii inferioris, muscle that lowers the lower lip. It starts at the edge of the lower jaw and attaches to the skin of the entire lower lip. 11. M. mentalis, mentalis muscle, departs from the juga alveolaria of the lower incisors and canine, attaches to the skin of the chin 12. M. buccinator, buccal muscle, forms the lateral wall of the oral cavity .. Its beginning is the alveolar process of the upper jaw, buccal ridge and alveolar part lower jaw, pterygo-mandibular suture. Attachment - to the skin and mucous membrane of the corner of the mouth, where it passes into the circular muscle of the mouth. 13. M. orbicularis oris, the circular muscle of the mouth, which lies in the thickness of the lips around the oral fissure. Muscles of the circumference of the nose: 14. M. nasalis, the actual nasal muscle, is poorly developed, partially covered by the muscle that raises the upper lip, compresses the cartilaginous part of the nose

By changing the shape of the holes and moving the skin with the formation of different folds, the mimic muscles give the face a certain expression corresponding to one or another experience.

Muscles of the neck, their functions.

The muscles of the neck keep the head in balance, are involved in the movement of the head and neck, as well as in the processes of swallowing and pronouncing sounds. The muscles of the neck are divided into: 1) superficial muscles or derivatives of gill arches: Subcutaneous muscle of the neck, platysma,.. Sternocleidomastoid muscle, m. sternocleidomastoideus, located behind (under) platysma. The muscle begins with two heads (legs): lateral - from the sternal end of the clavicle and medial - from the front surface of the handle 2) muscles of the hyoid bone: 1. M. mylohyoideus, maxillofacial muscle, starting from linea. mylohyoidea of ​​the lower jaw, ends at the tendon suture, raphe,. . 2. M. dig "astricus, digastric muscle, consists of two abdomens, 3. M. stylohyoideus, stylohyoideus muscle, descends from processus styloideus 4. M. geniohyoideus, chin-hyoid muscle, lies above m. mylohyoideus on the side of raphe, Function All four described muscles raise the hyoid bone upward 1. M. sternohyoideus, sternohyoid muscle, starts from the back surface of the sternum handle, goes up and attaches to the lower edge of the hyoid bone. Function. Pulls down the hyoid bone. 2. M. sternothyroldeus, sternothyroid muscle, lies under the previous. Function. Lowers the larynx down. 3. M. thyrohyoideus, thyroid-hyoid muscle. Function. With a fixed hyoid bone, pulls up the larynx. 4. M. omohydideus, scapular-hyoid muscle, consists of two bellies Function M. omohyoideus lies in the thickness of the cervical fascia, which it stretches during its contraction,

3) Deep neck muscles: 1. M. scalenus anterior, anterior scalene muscle, starting from the anterior tubercles and attached to tuberculum m. scaleni anterioris. 2. M. scalenus m "edius, middle scalene muscle, starts from the anterior tubercles and is attached to the 1st rib. 3. M. scalenus posterior, posterior scalene muscle, starts from the posterior tubercles of the three lower cervical vertebrae and is attached to the outer surface Function. Mm scaleni raise the upper ribs, acting as inspiratory muscles. Neck triangles. Both mm. sternocleidomastoidei are divided into three triangles: one anterior and two lateral. Each half of the neck on the sides of the midline is divided by the sternocleidomastoid muscle into two triangles: medial and lateral. The medial triangle of the neck is bounded by the lower edge of the mandible, the median line of the neck, and the anterior edge of the sternocleidomastoid muscle. The sleepy triangle, trigonum caroticum, is limited by: the posterior belly of the digastric muscle, Fascia of the neck:. The first fascia, or superficial fascia of the neck, fascia colli superficialis, is part of the general superficial (subcutaneous) fascia of the body and passes without interruption from the neck to neighboring areas. covers the entire neck, like a collar, and covers the muscles above and below the hyoid bone, salivary glands, vessels and nerves. The third fascia, or deep leaf of the neck's own fascia, lamina profunda fasciae colli propriae, is expressed only in the middle section of the neck. The fourth fascia, or internal the fascia of the neck, fascia endocervicalis, fits the cervical innards (larynx, trachea, thyroid gland, pharynx, esophagus and large vessels). It consists of two sheets - visceral, and parietal, which covers all these organs together and forms a vagina for important vessels

Topography of the neck.

Muscles of the chest: structures, functions.

Superficial and deep muscles.

Abdominal muscles and their functions.

The inguinal canal, its structure, the contents of the canal in men and women.

Vagina rectus abdominis.

Muscles of the shoulder girdle and shoulder, their functions.

Muscles of the forearm, anterior and posterior groups, their functions.

Topography of the upper limb.

Pterygopalatine fossa, pterygopalatine fossa (Latin fossa pterygopalatina) - a slit-like space in the lateral parts of the skull. It is located in the infratemporal region, communicates with the middle cranial fossa, orbit, nasal cavity, oral cavity and external base of the skull. It has 4 walls: the medial wall of the pterygopalatine fossa (perpendicular plate of the palatine bone), the anterior wall of the pterygopalatine fossa (tubercle of the maxillary bone), the posterior wall of the pterygopalatine fossa (pterygoid process), the upper (lower lateral surface of the body and the base of the greater carpal of the sphenoid bone ) Holes: sphenopalatine opening (foramen sphenopalatinum), round, pterygoid canal, large palatine canal, inferior orbital fissure.

14. Temporal and infratemporal fossa.

The infratemporal fossa (fossa infratemporalis) is a depression on the lateral surface of the skull, bounded in front by the tubercle of the upper jaw, from above by the greater wing of the sphenoid bone, medially by the pterygoid process, laterally by the zygomatic arch and the branch of the lower jaw; contains fiber, pterygoid muscles, maxillary artery, pterygoid venous plexus and mandibular nerve. Temporal fossa (fossa temporalis, PNA, BNA, JNA; syn. temple) - a paired depression on the skull, formed by the scales of the temporal bone, part of the parietal bone, a large wing of the sphenoid and zygomatic process of the frontal bone.

15. Nasal cavity, walls.

The nasal cavity, cavum nasi, is located in the middle, in the upper part of the facial skull. The composition of the cavity includes the nasal cavity itself and the paranasal sinuses, lying upward, outward and posterior to it. The nasal cavity is divided into two halves by a septum and passes through the choanae to the upper part of the pharyngeal cavity - the nasopharynx. There are three walls of the nasal cavity: The upper one is formed partially by the frontal bone, the ethmoid plate of the ethmoid bone, and the sphenoid bone. The olfactory nerves pass through the openings of the cribriform plate. The lateral is formed by the nasal bone, the frontal process and the nasal surface of the upper jaw, the lacrimal bone, the medial plate of the pterygoid process of the sphenoid bone. On this wall there are three turbinates, limiting the three nasal passages: upper, middle and lower. The lower passage goes under the lower shell, the middle one - between the lower and middle shells, the upper one - between the upper and middle shells. The lower one is formed by the palatine process of the upper jaw and the horizontal plate of the palatine bone. Additional cavities of the nose are the sinuses - the frontal, maxillary (Gymorova) and sphenoid, as well as the cells of the labyrinth of the ethmoid bone.

16. Messages of the nasal cavity.

The nasal cavity communicates with the external environment through the nasal openings - the nostrils, and with the nasopharynx - through the choanae (posterior nasal openings).

17. Eye socket, walls.

The orbit is a paired cavity in the skull. The base is turned forward and forms an entrance to the orbit. The apex is directed backward and medially to the visual canal. orbitae, formed by the orbital part of the frontal bone), medial (paries medialis orbitae, formed (from front to back) by the lacrimal bone, orbital plate, lamina orbitalis, ethmoid bone and the lateral surface of the body of the sphenoid bone), lower (paries inferior orbitae, formed mainly by the orbital surface upper jaw) and lateral (paries laleralis orbitae, formed in the posterior region by the orbital surface of the large wing of the sphenoid bone, in the anterior by the orbital surface of the zygomatic bone)

This is an anatomical formation, which is located in the lateral region of the skull. The very name of this fossa indicates which bones (mostly) are involved in its formation - these are the palatine and sphenoid bones.

Now consider the walls of the pterygopalatine fossa:

Anterior: tubercle of the upper jaw;

Posterior: base of the pterygoid process of the sphenoid bone + pyramidal process of the palatine bone;

Upper: maxillary surface of the greater wings of the sphenoid bone;

Medial: perpendicular plate of the palatine bone;

There is no bottom wall, because the pterygopalatine fossa descends into the greater and lesser palatine canals;

There is no lateral wall, it is absent due to the presence of the pterygomaxillary fissure;

Communications of the pterygopalatine fossa.

If we compare the pterygopalatine fossa with a prism, then, as you know, it has 6 walls, but the pterygopalatine fossa lacks the lower and lateral walls, and yet, it is possible to draw a message from each wall of this prism. So there are 6 messages of the pterygopalatine fossa:

1. Anteriorly: through the inferior orbital fissure with the orbit;

2. Posteriorly: through the pterygoid canal with the area of ​​the torn foramen;

3. Above: through a round hole with the region of the middle cranial fossa;

4. Down: through the large and small palatine canals with the oral cavity;

5. Medially: through the pterygopalatine opening with the upper nasal passage;

6. Laterally: through the pterygomaxillary fissure with the infratemporal fossa.

Contents of the pterygopalatine fossa:

1. Pterygopalatine venous plexus;

2. Pterygopalatine section (3rd section) of the maxillary artery with branches;

3. Part of the mandibular vein;

4. Pterygopalatine node, which is formed by preganglionic fibers from the large stony nerve (vegetative part of the facial nerve - VII pair of cranial nerves; or an integral part of the intermediate nerve);

5. Sympathetic fibers passing through the pterygopalatine ganglion from the deep stony nerve, which, in turn, from the internal carotid sympathetic plexus;

6. Maxillary nerve (2nd branch of the V pair of cranial nerves), which is divided into the infraorbital nerve and zygomatic.

VII. Infratemporal fossa.

Walls:

1. Anterior: tubercle of the upper jaw;

2. Upper: infratemporal surface of the greater wing of the sphenoid bone + infratemporal crest;

3. Medial: lateral plate of the pterygoid process of the sphenoid bone;

4. Lateral: branch of the lower jaw;

5. Posterior: condylar process of the lower jaw;

Messages:

1. Down: with the mandibular canal;

2. Anteriorly: through the inferior orbital fissure with the orbit;

3. Above and behind: through the oval hole with the middle cranial fossa;

4. Above and laterally: through the spinous foramen with the middle cranial fossa;

5. Above: through the infratemporal crest with the temporal fossa;

6. Medially: through the pterygomaxillary fissure with the pterygopalatine fossa;

Content:

1. The final section of the temporal muscle;

2. Lateral pterygoid muscle;

3. Most of the mandibular vein;

4. Maxillary and pterygoid sections (1st and 2nd) of the maxillary artery with branches (middle meningeal artery, mandibular artery, pterygoid arteries, temporal, masticatory, etc.);

5. Mandibular nerve (3rd branch of the 5th pair of cranial nerves) with branches: inferior alveolar nerve, maxillofacial, lingual nerve, etc.;

6. Drum string (sensitive and autonomic part of the facial nerve - VII pair of cranial nerves or an integral part of the intermediate nerve);

7. Submandibular and sublingual nodes (for innervation of the glands of the same name);

VIII. Temporal fossa.

Borders and walls:

1. Upper conditional boundary: upper temporal line of the temporal, parietal and frontal bones;

2. Anterior wall: zygomatic process of the frontal bone and temporal surface of the zygomatic bone;

3. Outside: zygomatic arch (temporal process of the zygomatic bone + zygomatic process of the temporal bone);

4. Medially: the lower part of the outer surface of the parietal bone, the outer surface of the scales of the temporal bone, the temporal surface of the greater wing of the sphenoid bone.

26. Pterygopalatine fossa, its walls, messages and contents.

pterygopalatine (pterygopalatine) fossa, fossa pterygopa- Iatina, has four walls: anterior, superior, posterior and medial. The anterior wall of the fossa is the tubercle of the maxilla, the upper wall is the inferolateral surface of the body and the base of the greater wing of the sphenoid bone, the posterior wall is the base of the pterygoid process of the sphenoid bone, and the medial wall is the perpendicular plate of the palatine bone. On the lateral side, the pterygopalatine fossa has no bone wall and communicates with the infratemporal fossa. The pterygopalatine fossa gradually narrows down and passes into the large palatine canal, canalis palatinus major, which at the top has the same walls as the fossa, and below it is delimited by the upper jaw (laterally) and the palatine bone (medially). There are five openings into the pterygopalatine fossa. On the medial side, this fossa communicates with the nasal cavity through the sphenopalatine foramen, superiorly and posteriorly with the middle cranial fossa through a round foramen, posteriorly with the region of the torn foramen via the pterygoid canal, downwardly with the oral cavity through the greater palatine canal.

The pterygopalatine fossa is connected to the orbit through the inferior orbital fissure.

27. Structure and classification of muscles.

The following areas of the neck are distinguished: anterior, sternocleidomastoid - right and left, lateral - right and left and back.

Anterior neck area(anterior triangle of the neck), region cervicalis anterior, has the form of a triangle, the base of which is turned up. This area is bounded from above by the base of the lower jaw, from below by the jugular notch of the sternum, on the sides by the anterior edges of the right and left sternocleidomastoid muscles. The anterior midline divides this region of the neck into the right and left medial triangles of the neck.

sternocleidomastoid region,region sternocleido- mastoidea, steam room, corresponds to the location of the muscle of the same name and extends in the form of a strip from the mastoid process above and behind to the sternal end of the clavicle below and in front.

Lateral region of the neck(posterior triangle of the neck), region cer­ vicalis lateralis, steam room, has the form of a triangle, the top of which is turned upwards; the area is located between the posterior edge of the sternocleidomastoid muscle in front and the lateral edge of the trapezius muscle in the back. Below is limited by the clavicle.

The back of the neck (notch area),region cervicalis post­ rior, on the sides (right and left) it is delimited by the lateral edges of the corresponding trapezius muscles, above - by the upper nuchal line, below - by a transverse line connecting the right and left acromions and drawn through the spinous process VII cervical vertebra. The posterior midline divides this region of the neck into right and left parts.

AT anterior neck area three triangles are distinguished on each side: carotid, muscular (scapular-tracheal) and submandibular.

1. sleepy triangle, trigonum caroticum, behind it is limited by the anterior edge of the sternocleidomastoid muscle, in front and below - by the upper belly of the scapular-hyoid muscle, from above - by the posterior belly of the digastric muscle.

2. Muscular(scapular-tracheal) triangle, trigonum musculare, located between the anterior edge of the sternocleidomastoid muscle behind and below, the upper belly of the scapular-hyoid muscle above and laterally, and the anterior median line medially.

3. Submandibular triangle, trigoPetesubmandibulare, limited from below by the anterior and posterior belly of the digastric muscle, from above by the body of the lower jaw. Within the limits of the submandibular triangle, a small, but very important for surgery, lingual triangle, or Pirogov's triangle, is isolated. In front, it is limited by the posterior edge of the maxillohyoid muscle, behind and below - by the posterior belly of the digastric muscle, from above - by the hypoglossal nerve.

AT lateral region of the neck allocate the scapular-clavicular triangle and a large supraclavicular fossa.

Scapular-clavicular triangle, trigonum omoclaviculare, limited from below by the clavicle, from above - by the lower abdomen of the scapular-hyoid muscle, in front - by the posterior edge of the sternocleidomastoid muscle.

Lesser supraclavicular fossa, fossa supraclavicularis minor, - this is a well-defined depression above the sternal end of the clavicle, which corresponds to the gap between the lateral and medial legs of the sternocleidomastoid muscle.

AT neck area distinguish also sternocleidomastoid region, region sternocleidomastoidea.

28. Auxiliary apparatus of muscles: fascia, synovial sheaths, mucous and synovial bags, sesamoid bones. The concept of a soft core. The role of N.I. Pirogov!!! in the development of the doctrine of the soft core.

Fascia, fascia, - it is the connective tissue covering of the muscle. Forming cases for the muscles, the fasciae limit them from each other, create support for the muscle belly during its contraction, and eliminate the friction of the muscles against each other.

Distinguish fascia own, fasciae propriae, and superficial fascia fasciae superficiales. Each area has its own fascia (for example, the shoulder - fascia brachii, forearm - fascia antebrachii).

Sometimes the muscles lie in several layers. Then between adjacent layers there is a deep fascia, lamina profunda.

In places where the muscles partially start from the fascia, the fasciae are well developed and do a lot of work; they are dense, supported by tendon fibers and in appearance resemble a thin wide tendon (fascia lata, fascia of the leg).

Muscles that do less work have a fragile, loose fascia, without a definite orientation of connective tissue fibers. Such thin loose fasciae are called felt-type fasciae.

The channels formed between the retainers of the muscles and the adjacent bones, in which the long thin tendons of the muscles pass, are called tendon canals(bone-fibrous or fibrous canals). This channel forms the tendon sheath, vagina tendinis, which can be common to several tendons or divided by fibrous bridges into several independent sheaths for each tendon.

The movement of the tendon in its vagina occurs with the participation synovial tendon sheath, vagina synouialis tendinis, which eliminates the friction of the tendon in motion against the fixed walls of the canal. The synovial sheath of the tendon is formed by the synovial membrane, or synovial layer, stratum synoviale, which has two parts - plates (leaves) - internal and external.

The tendon and parietal parts of the synovial layer pass into each other at the ends of the synovial sheath of the tendon, as well as throughout the vagina, forming the mesentery of the tendon - mesotendinium, mesotendineum. The synovial layer may surround one tendon or several if they lie in the same tendon sheath.

In places where the tendon or muscle is adjacent to the bone protrusion, there are synovial bags, which perform the same functions as the tendon sheaths (synovial), - eliminate friction. synovial bag, bursa synovialis, has the form of a flattened connective tissue sac, which contains a small amount of synovial fluid. The walls of the synovial bag on one side are fused with a moving organ (muscle), on the other - with a bone or other tendon.

Often, the synovial bag lies between the tendon and the bony protrusion, which has a groove covered with cartilage for the tendon. Such a protrusion is called muscle block. It changes the direction of the tendon, serves as a support for it and at the same time increases the angle of attachment of the tendon to the bone, thereby increasing the leverage for applying force.