# Maxillary Artery

> Maxillary artery anatomy for MBBS Anatomy: three parts with all branches, middle meningeal artery and extradural haematoma, sphenopalatine artery and epistaxis.

- Canonical URL: https://prepelephant.com/topics/mbbs/anatomy/maxillary-artery
- Exam / course: MBBS · Subject: Anatomy
- Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team
- First published: 2026-10-02
- Last updated: 2026-10-02
- How to cite: "Maxillary Artery", PrepElephant, https://prepelephant.com/topics/mbbs/anatomy/maxillary-artery

## Direct answer

Behind the neck of the mandible begins the maxillary artery, the larger terminal branch of the external carotid, which runs forward through the infratemporal fossa and ends in the pterygopalatine fossa as the sphenopalatine artery. Its seventeen branches fall into three parts named by the lateral pterygoid muscle: a mandibular part inside the parotid giving the middle meningeal artery through the foramen spinosum; a pterygoid part supplying the muscles of mastication; and a pterygopalatine part whose branches supply the nose, palate and upper teeth. The middle meningeal artery's injury at the pterion is the anatomy of extradural haematoma, and the sphenopalatine artery is the anatomy of severe epistaxis.

## What you must remember

- First (mandibular) part: deep auricular, anterior tympanic, middle meningeal (through foramen spinosum), accessory meningeal (through foramen ovale) and inferior alveolar (through the mandibular foramen) arteries.
- Second (pterygoid) part: deep temporal (anterior and posterior), pterygoid, masseteric and buccal branches, running superficial or deep to the lateral pterygoid.
- Third (pterygopalatine) part: posterior superior alveolar, infraorbital (giving middle and anterior superior alveolar), descending palatine, artery of the pterygoid canal, pharyngeal and sphenopalatine arteries.
- The middle meningeal artery grooves the inner table of the temporal bone and is bound to the squamous temporal bone at the pterion, where a blow tears it and produces a lucid-interval extradural haematoma.
- The sphenopalatine artery enters the nose through the sphenopalatine foramen behind the middle concha and supplies most of the nasal cavity, including Little's area.
- The inferior alveolar artery follows the inferior alveolar nerve in the mandibular canal, ending as the mental artery.
- Branches of the third part are the target of endoscopic ligation or embolisation for posterior epistaxis.

## Walking through the artery of extradural haematoma, then epistaxis

Take first the trauma case. A young cricketer struck on the temple sits up in the casualty department, chats, and an hour later lapses into coma with a dilated right pupil. The sequence is pure maxillary artery anatomy. The pterion — where frontal, parietal, temporal and sphenoid bones meet — lies directly over the middle meningeal artery's anterior branch grooving the inner table; bone and vessel fracture together. Arterial blood strips the dura from the bone, forming a lentiform clot that compresses the hemisphere, and the expanding volume drives the medial temporal lobe against the tentorial edge to stretch the third nerve, paralysing the pupil. The CT shows a biconvex hyperdense clot limited by skull sutures; management is immediate evacuation with clipping or diathermy of the vessel per current neurosurgical practice, because this is a surgical emergency with no place for observation once the pupil signs appear.

Take second the epistaxis case. An elderly hypertensive man bleeds posteriorly despite anterior packing. The sphenopalatine artery — terminal part of the maxillary artery's third part — enters behind the middle concha; its septal branches meet anterior ethmoidal, greater palatine and superior labial contributions at Little's area on the anteroinferior septum. Endoscopic diathermy or clipping of the artery at its foramen is first-line per current ENT practice; embolisation of the internal maxillary artery in the interventional suite is reserved for failure, with the ophthalmic artery's origin carefully avoided during microcatheterisation.

## Where students slip

Part-two branch lists get scrambled most often; the reliable mnemonic for the second part is that it feeds the muscles of mastication plus the cheek — deep temporal, pterygoid, masseteric, buccal — all named after their destination. The first error to avoid is sending the middle meningeal artery through the foramen ovale; the foramen spinosum is its channel, the ovale belongs to the accessory meningeal with the mandibular nerve. Second, students attribute epistaxis control to the "external carotid artery" generically; examiners want the chain — maxillary artery, third part, sphenopalatine artery — because ligation or embolisation is done at that level. Third, the inferior alveolar artery is confused with the nerve's course only proximally: both enter the mandibular foramen, but the artery's mental branch emerges with the nerve at the mental foramen to supply the chin, and bleeding after third molar surgery is often from this vessel or its dental branches.

## Frequently asked questions

### How is the maxillary artery divided, and by what?
Into mandibular (first), pterygoid (second) and pterygopalatine (third) parts, related to the lateral pterygoid muscle.

### Which foramen transmits the middle meningeal artery?
The foramen spinosum, alongside the nervus spinosum from the mandibular nerve.

### Why does pterion injury cause extradural haematoma?
The anterior branch of the middle meningeal artery grooves the inner table at the pterion and is tethered to the bone, so a fracture there tears it directly.

### Which artery is ligated or embolised for refractory posterior epistaxis?
The sphenopalatine (or its parent internal maxillary) artery, entering the nose at the sphenopalatine foramen behind the middle concha.

### What does the third part supply besides the nose?
The upper teeth through posterior superior alveolar and infraorbital branches, the palate through descending palatine branches, the nasopharynx and the auditory tube through pharyngeal and pterygoid canal arteries.