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Massage.
MuscleHead & facedeepBeyond Cert IVDraft

PterygoidsMusculi pterygoidei

Two deep jaw muscles inside the ramus of the mandible that move the jaw forward and side to side, with the medial pterygoid also helping to close it.

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LatinMusculi pterygoidei
Origin
  • Lateral pterygoid, upper head: infratemporal surface of the greater wing of the sphenoid bone
  • Lateral pterygoid, lower head: outer surface of the lateral pterygoid plate
  • Medial pterygoid, deep head: inner surface of the lateral pterygoid plate
  • Medial pterygoid, superficial head: pyramidal process of the palatine bone and the maxillary tuberosity
Insertion
  • Lateral pterygoid, upper head: articular disc and capsule of the temporomandibular joint (and the front of the condyle)
  • Lateral pterygoid, lower head: pterygoid fovea on the neck of the mandibular condyle
  • Medial pterygoid: inner surface of the ramus and angle of the mandible
Action
  • Lateral pterygoid: protrude the mandible and help open the mouth
  • Medial pterygoid: elevate the mandible (close the mouth) and help protrude it
  • Both, one side at a time: move the jaw to the opposite side (side-to-side grinding movement)
NerveNerves to the lateral and medial pterygoid, from the mandibular division of the trigeminal nerve (CN V3)
NameGreek pteryx, 'wing' — they attach to the wing-shaped pterygoid plates of the sphenoid bone.

Palpation

  1. Direct palpation of the pterygoids is not practical at Cert IV level; they lie inside the jaw, and reaching them requires working inside the mouth, which is outside Cert IV scope.
  2. Instead, work the surface area over them; client supine, therapist seated at the head of the table.
  3. Place your finger pads just under the cheekbone, in front of the ear and behind the masseter, where the jaw hinges.
  4. Ask the client to slowly open the mouth and push the jaw gently forward; feel the jaw joint glide forward under your fingers, which is the movement the lateral pterygoid produces.

The pterygoids are two deep muscles on the inner side of the jaw. The lateral pterygoid runs almost horizontally forward from the jaw joint, and pulls the jaw forward and helps it open. The medial pterygoid runs down the inside of the ramus, like a mirror image of the Masseter on the outside, and helps it close the jaw. Working one side at a time, the pterygoids move the jaw from side to side for chewing. Because they pull in different directions, the group has no single antagonist.

At Cert IV level you work these muscles indirectly, as part of general jaw and face work in Head, face and scalp — 20 min. Gentle circles over the masseter and around (not on) the jaw joint in front of the ear, with the client’s teeth apart and lips relaxed, help the whole jaw region soften. Intra-oral work on the pterygoids belongs to specialised remedial training.

Sources differ on the upper head of the lateral pterygoid. The Wikipedia infobox says it inserts on the front of the mandibular condyle, while its text (and most textbooks) say it attaches to the articular disc and capsule of the jaw joint. This note gives both.

Sources

  1. Wikipedia: Lateral pterygoid muscle
  2. Wikipedia: Medial pterygoid muscle