The pterygomandibular raphe (pterygomandibular fold or pterygomandibular ligament) is a thin tendinous band of buccopharyngeal fascia. It is attached superiorly to the

pterygoid hamulus The pterygoid hamulus is a hook-like process at the lower extremity of the medial pterygoid plate of the sphenoid bone of the skull. It is the superior origin of the pterygomandibular raphe, and the tensor veli palatini muscle courses around it ...

of the medial pterygoid plate, and inferiorly to the posterior end of the

mylohyoid line The mylohyoid line is a bony ridge on the internal surface of the mandible. It runs posterosuperiorly. It is the site of origin of the mylohyoid muscle, the superior pharyngeal constrictor muscle, and the pterygomandibular raphe. Structure The ...

of the

mandible In jawed vertebrates, the mandible (from the Latin ''mandibula'', 'for chewing'), lower jaw, or jawbone is a bone that makes up the lowerand typically more mobilecomponent of the mouth (the upper jaw being known as the maxilla). The jawbone i ...

. It gives attachment to the

buccinator muscle The bucinator () is a thin quadrilateral muscle occupying the interval between the maxilla and the Human mandible, mandible at the side of the face. It forms the anterior part of the cheek or the lateral wall of the oral cavity.Illustrated Anatom ...

(in front), and the

superior pharyngeal constrictor muscle The superior pharyngeal constrictor muscle is a quadrilateral muscle of the pharynx. It is the uppermost and thinnest of the three pharyngeal constrictors. The muscle is divided into four parts according to its four distincts origins: a pterygop ...

(behind).

Structure

The pterygomandibular

raphe Raphe ( ; from ;Liddell, H.G. & Scott, R. (1940). ''A Greek-English Lexicon. revised and augmented throughout by Sir Henry Stuart Jones. with the assistance of. Roderick McKenzie.'' Oxford: Clarendon Press. : raphae or raphes) has several differe ...

is a tendinous band formed by the buccopharyngeal fascia. It is a paired structure, with one on each side of the mouth. Superiorly, it is attached to the

of the medial pterygoid plate of the

sphenoid bone The sphenoid bone is an unpaired bone of the neurocranium. It is situated in the middle of the skull towards the front, in front of the basilar part of occipital bone, basilar part of the occipital bone. The sphenoid bone is one of the seven bon ...

; inferiorly, it is attached to the posterior end of the

of the

Relations

*Its ''medial surface'' is covered by the mucous membrane of the

mouth A mouth also referred to as the oral is the body orifice through which many animals ingest food and animal communication#Auditory, vocalize. The body cavity immediately behind the mouth opening, known as the oral cavity (or in Latin), is also t ...

. * Its ''lateral surface'' is separated from the

ramus of the mandible In jawed vertebrates, the mandible (from the Latin ''mandibula'', 'for chewing'), lower jaw, or jawbone is a bone that makes up the lowerand typically more mobilecomponent of the mouth (the upper jaw being known as the maxilla). The jawbone ...

adipose tissue Adipose tissue (also known as body fat or simply fat) is a loose connective tissue composed mostly of adipocytes. It also contains the stromal vascular fraction (SVF) of cells including preadipocytes, fibroblasts, Blood vessel, vascular endothel ...

. * Its ''posterior border'' gives attachment to the

. * Its ''anterior border'' attaches to the posterior edge of the

. The pterygomandibular raphe is the common meeting point of the

and the

. This common attachment makes the raphe a junction of the oral cavity, oropharynx, and nasopharynx. The

inferior alveolar nerve The inferior alveolar nerve (IAN) (also the inferior dental nerve) is a sensory branch of the mandibular nerve (CN V3) (which is itself the third branch of the trigeminal nerve (CN V)). The nerve provides sensory innervation to the lower/mandibu ...

passes lateral to the raphe; the raphe is therefore a landmark for a

nerve block Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. #Local anesthetic nerve block, Local anesthetic nerve block (sometimes referred to as simply "nerve b ...

of this nerve. The general location of the raphe is indicated by the pterygomandibular fold.

Attachments

The pterygomandibular raphe gives attachment to the central portion of the

anteriorly, and to the

posteriorly.

Variation

In foetuses, the pterygomandibular raphe is always very prominent. However, in adults, it may become less distinctive. It is very large and distinctive, in around 36% adults. It is fairly small, and only an upper triangular portion visible, in around 36% of adults. It is not visible in around 28%, making the

and the

continuous. This may vary by

ethnic group An ethnicity or ethnic group is a group of people with shared attributes, which they collectively believe to have, and long-term endogamy. Ethnicities share attributes like language, culture, common sets of ancestry, traditions, society, re ...

Clinical significance

When the

is splinted for gradual realignment (such as to treat

sleep apnea Sleep apnea (sleep apnoea or sleep apnœa in British English) is a sleep-related breathing disorder in which repetitive Apnea, pauses in breathing, periods of shallow breathing, or collapse of the upper airway during sleep results in poor vent ...

), the pterygomandibular ligament slightly resists the realignment. The raphe is a landmark for administration of inferior alveolar nerve blocks.

Structure

Relations

Attachments

Variation

Clinical significance

History

See also

References

External links