Nerve to Medial Pterygoid — MFDS Part 1 MCQ

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HardAnatomy (Head & Neck)Nerve to Medial PterygoidMFDS Part 1

During dissection of the infratemporal fossa, a slender motor nerve is identified supplying the medial pterygoid muscle. It also gives filaments associated with the otic ganglion and supplies tensor tympani and tensor veli palatini. From which nerve does this branch normally arise?

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Correct answer: A — Main trunk of the mandibular nerve (V3)

The correct answer is A. The nerve to medial pterygoid is normally a direct motor branch of the main trunk of the mandibular nerve, arising before V3 divides into its anterior and posterior divisions. It supplies medial pterygoid and carries fibres to tensor tympani and tensor veli palatini, with filaments related to the otic ganglion. V2 is entirely sensory and the facial nerve supplies the muscles of facial expression, not the muscles of mastication. The inferior alveolar and lingual nerves arise from the posterior division of V3 and are not the usual origin of this motor branch. Rare variant innervation from the lingual nerve does not alter the expected anatomical answer.

Reference: Dupont G, Iwanaga J, Tubbs RS. Variant Innervation of the Medial Pterygoid Muscle from the Lingual Nerve. Kurume Medical Journal. 2021;66(2):135-138. https://pubmed.ncbi.nlm.nih.gov/34135200/