Medial Pterygoid

The Medial Pterygoid is a facial muscle.

Anatomical Attachments:

• Origin: Attaches to the medial surface of the lateral pterygoid plate and the palatine bone, with a small attachment to the maxillary tuberosity.
• Insertion: Attaches to the inferior, posterior and medial surfaces of the ramus and the angle of the mandible.

Action: This muscle of mastication extends and elevates the lower jaw and aids in the rotation motion while chewing.

Synergist: Temporalis, Masseter, and Lateral Pterygoid.

Antagonist: Inferior division of Lateral Pterygoid, Digastric.

Nerve Supply: Mandibular division of the trigeminal nerve (Cranial nerve V)

Nerve Entrapment: Entrapment of the chorda tympani portion of the lingual nerve, which may result in oral paresthesia. This must be differentiated between that of a nerve entrapment and the occasional paresthesia accompanying trigger points of the platysma.

Vascular supply: Pterygoid branches of the maxillary and facial arteries.

• Primary: The pain refers inside the region of the mouth (tongue, pharynx and the hard plate), inferiorly and posteriorly to the Temporal Mandibular Joint (TMJ), and also deep within the ear, excluding the teeth.
• Satellite or associated triggers: Sternocleidomastoid, Digastric, Longus capitis, Longus colli, Lateral Pterygoid, Masseter.

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Trigger Point Signs and Symptoms: Stuffiness of the ears, sore throat, painful swallowing, and restricted jaw opening.

Trigger Point Activating and Perpetuating Factors: Prolonged forward head bending, chewing, clenching of teeth, anxiety or emotional tension.

Differential Diagnosis: Tinnitus, Ear drum perforation, Ear infection, Mastoiditis, (Segmental, Subluxation, Somatic dysfunction) C2 radiculopathy, Temporomandibular joint disorder (TMD), Pharyngitis, laryngitis, common cold, influenza, Strep infection, Tetanus, Tonsillitis, Oral cancer, Neuralgia, Canker sore, Dry mouth, Glossitis, Mononucleosis, Smoke inhalation, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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