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Occlusion > 2-Neuromuscular determinants > Flashcards

2-Neuromuscular determinants Flashcards

1
Q

TMJ type of joint

A

Ginglymoarthrodial

joint

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2
Q

2 types of TM joint movements

A

i) ROTATE (hinging movement lower compartment)

ii) TRANSLATE (gliding movement upper compartment)

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3
Q

NORMAL DISC POSITION -rest (o’clock)

A

12 o`clock

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4
Q

Opening

20-25 mm (limited mouth opening)

A

Rotation only:
so, ANTERIOR DISC DISPLACEMENT
WITHOUT REDUCTION

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5
Q

Opening

>40 mm (full mouth opening)

A

TRANSLATION

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6
Q

Type of cartilage on Synovial joint articular surfaces of TMJ (i.e Temporal bone articulating surface)

A

Hyaline cartilage

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7
Q

Type of cartilage on condyle of TMJ (i.e TMJ articular surfaces)

A

Fibrocartilage tissue

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8
Q

Function of Hyaline cartilage in TMJ

A

Absorbs shock and reduces friction

during movement.

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9
Q

Function of TMJ articular surfaces: Fibrocartilage in TMJ

A

Fibrous cartilage can withstand force of movements

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10
Q

** _____ TMJ cartilage has limited capacity to heal and repair

A

Hyaline cartilage (Synovial joint articular surfaces)

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11
Q

** _____ TMJ cartilage has greater capacity to heal and repair;
It is less susceptible to the effects of aging, less
likely to breakdown overtime

A

Fibrocartilage tissue (TMJ articular surfaces)

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12
Q

_______ prevents direct articulation of the condyle and temporal bone

A

Articular disc

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13
Q

Shape of articular disc

A

Biconcave (fibrocartilaginous structure)

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14
Q

Posterior attachment of the disc is called _______

A

retrodiscal tissue

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15
Q

Articular disc is innervated. T/F?

A

F.

Articular disc is “Non-innervated”

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16
Q

Retrodiscal tissue is Innervated. T/F?

A

T. Retrodiscal tissue is Innervated

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17
Q

When the jaws is closed, the anterior prominance of the condyle is at the _______ part of the disc.

A

central thin part of the disc

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18
Q

Disc follows the condyle during opening.T/F

A

T

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19
Q

Synovial membrane provides ____ and ____ lubrication.

A
  • Boundary lubrication

* Weeping Lubrication

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20
Q

Capsular ligament: Superior attachment

A

Superior: Attach temporal bone along the border of glenoid fossa and articular eminence

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21
Q

Capsular ligament: Inferior attachment

A

Condyle

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22
Q

Capsular ligament: Posterior attachment

A

Posteriorly: Postglenoid process

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23
Q

Capsular ligament: Function

A
  • Retain synovial fluid inside

* Resist any medial, lateral or inferior forces that tends to dislocate the articular surfaces

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24
Q

**TMJ lateral pole palpation: Painful

Which ligament is inflamed?

A

Capsular ligament

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25
Q

Capsular pain is provoked when the inflamed capsule

is stretched. T/F

A

T

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26
Q 
Which movement provokes the capsular pain?
A. Protrusion
B. Lateral movement
C. Medial movement
D. Wide opening of jaw
E. All of the above
A

E. All of the above

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27
Q

Temporomandibular (TM) ligament is also called

A

Lateral ligament

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28
Q

TM ligament attachments: Outer oblique

A

Outer oblique; is attached to the articular tubercule , runs posteroinferiorly to the outer surface of the condylar neck

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29
Q

TM ligament parts

A

1) Outer oblique

2) Inner horizontal

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30
Q

TM ligament attachments: Inner horizontal

A

Inner horizontal
; is attached articular tubercule , runs anteroposteriorly to attach to the lateral pole of the condyle and posterior part of the disc

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31
Q

Outer oblique ligament function

A

Limits rotational opening (20

25mm) and protects retromandibular structures

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32
Q

Inner horizontal ligament function

A
  • Limits posterior movement of condyle and disc to protect retrodiscal tissues.
  • Prevent the condyle from entering the middle cranial fossa during condylar neck fractures
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33
Q

Collateral Ligament is also called

A

discal ligament

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34
Q

Collateral Ligament attachment

A

Attach medial edge of the disc to the medial pole of the condyle and lateral edge of the disc to the lateral pole

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35
Q

Collateral Ligament function

A

Allows disc to move passively with the condyle as it glides

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36
Q

________ ligament divides the TMJ into Divides joint into superior and inferior joint cavities

A

Collateral (discal) Ligament

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37
Q

Sphenomandibular ligament

A

Spine of the sphenoid bone, runs downward and

outward to lingula of the mandible

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38
Q

________ TMJ ligament does NOT influence on mandibular movement

A

Sphenomandibular ligament

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39
Q

Stylomandibular ligament :attachment

A

Styloid process to the angle and posterior border of mandibular ramus

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40
Q

Stylomandibular ligament: function

A

Limits excessive mandibular protrusive movement

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41
Q

Masticatory muscles

A
  • Temporalis Muscle
  • Masseter Muscle
  • Medial Pterygoid Muscle
  • Lateral Pterygoid Muscle
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42
Q

Accessory masticatory muscles

A
  • Suprahyoid Muscles
  • Infrahyoid Muscles
  • Sternocleidomastoid Muscle
  • Trapezius Muscle
  • Splenius Capitis Muscle
  • Platysma
  • Buccinator Muscle
43
Q

Temporalis: Origin

A

Temporal fossa and the lateral surface of

the skull

44
Q

Temporalis: Insertion

A

as a tendon into the coronoid process

of the mandible

45
Q

Temporalis: Action

A

Elevates and retrudes mandible

46
Q

Masseter Muscle: Origin

A

Origin from the inferior border and medial surface

of the zygomatic arch

47
Q

Masseter Muscle: Insertion

A

Insertion into angle and the ramus of mandible

48
Q

Masseter Muscle:Action

A

Action powerful elevator of the mandible

Superficial part involved in protrusion

49
Q

Medial Pterygoid: Origin

A

Origin: from the pterygoid fossa of the sphenoid bone

and the tuberosity of the maxilla

50
Q

Medial Pterygoid: Insertion

A

Insertion into the medial surface of the mandible

51
Q

Inferior Lateral Pterygoid: Origin

A

Origin: lateral surface of the lateral pterygoid plate

52
Q

Inferior Lateral Pterygoid: Insertion

A

Insertion: pterygoid fovea of the condyle neck

53
Q

Inferior Lateral Pterygoid: Action

A

Action: (O-PC)
i) Active during opening in conjunction with mand.
depressors,
ii) protrusion
iii) In unilateral contraction mediotrusive movement

54
Q

Superior Lateral Pterygoid: Origin

A

Origin: infratemporal surface of the sphenoid bone

55
Q

Superior Lateral Pterygoid: Insertion

A

Insertion: onto the pterygoid fovea under the condyloid process of the mandible , capsule, disc (

56
Q

Superior Lateral Pterygoid: Action

A

Action: active only in conjunction with elevator muscles and during power stroke (clenching)

57
Q

Suprahyoid muscles

A
  • Digastric Muscle
  • Stylohyoid Muscle
  • Mylohyoid Muscle
  • Geniohyoid Muscle
58
Q

Infrahyoid muscles

A
  • Sternohyoid Muscle
  • Sternothyroid Muscle
  • Thyrohyoid Muscle
  • Omohyoid Muscle
59
Q

Digastric Muscle: Origin

A

from the digastric groove medial to the mastoid

process to the hyoid bone

60
Q

Digastric Muscle: Insertion

A

into the lower border of the mandible

61
Q

Digastric Muscle: Action

A

elevates the hyoid bone when the mandible is fixed
and

depresses and pull backward the mandible when the hyoid bone is fixed by the suprahyoid and infrahyoid musles

62
Q

Stylohyoid Muscle: Origin & Insertion

A
  • Origin: Styloid process

* Insertion: hyoid bone

63
Q

Stylohyoid Muscle: Action

A

elevation and retraction of the hyoid bone during swallowing

64
Q

Masseter: Innervation

A
  • Masseteric nerve.

- mOTOR: Mandibular Branch of CN V

65
Q

TMJ: Innervation

A

Innervation (CN V3):

  • Auriculotemporal Nerve
  • Deep temporal Nerve
  • Masseteric Nerve
66
Q

Temporalis: Innervation

A
  • Anterior and Posterior Deep Temporal Nerve
  • Motor Innervations (Mandibular Branch of
    CN V)
67
Q

Medial Pterygoid: Innervation

A
  • Medial Pterygoid Nerve
  • Motor Innervations (Mandibular Branch of
    CN V)
68
Q

Lateral Pterygoid: Innervation

A
  • Lateral Pterygoid nerve
  • Motor Innervations (Mandibular Branch of
    CN V)
69
Q

Masseter: Blood supply

A

Maxillary artery

70
Q

Temporalis: Blood supply

A

Middle and deep temporal
artery (Branch of external
carotid and maxillary arteries)

71
Q

Medial Pterygoid: Blood supply

A

Maxillary artery

72
Q

Lateral Pterygoid: Blood supply

A

Maxillary artery

73
Q

TMJ: Blood supply

A

-Deep auricular and anterior
tympanic artery ( Branches of
m axillary artery)

-Superficial temporal (Branch of
external carotid)

74
Q

Sensory neuron

A

carry information from organ (muscle) to CNS

75
Q

Motor neuron

A

carry information from CNS to organ (muscle)

76
Q

** Muscle spindles are found in ____________ muscles (elevators/depressors)

A

elevator muscles

77
Q

** Muscle spindles send signals to contract to oppose the ________ force

A

gravity force

78
Q

Golgi tendon monitor _____ of the muscle

A

tension

Eg : Chewing gum muscle tension

79
Q

** Nociceptors: Tissues of masticatory system for ___ stimulus

A

pain

80
Q

**Myotatic (stretch) reflex on masseter

A

-A sudden downward force is applied to the chin
(small rubber hammer)

-Activate muscle spindles response masseter contraction

81
Q

**The Myotatic (stretch) reflex is important in determining the ______ position of the jaw

A

resting

82
Q

**Nociceptive (flexor) reflex

A

Reflex to painful stimulus–
protective.
-In masticatory system it is activated by unexpectedly biting on a hard object

83
Q

**Elevators ______(START/STOP) CONTRACTING and DEPRESSOR _____ (START/STOP)
CONTRACTING to open the jaw

A

Elevators STOP CONTRACTING and DEPRESSOR START CONTRACTING to open the jaw

84
Q

**When the Condyle rotates up to 20
25mm opening
____ ligament
tightens and limits rotation

A

TM ligament

85
Q

**Condyle translates up to max opening of 40-60 mm

_____ ligament prevents further movement

A

Capsular ligament

86
Q

**The opening movement (depression of mandible): Muscles

A

(LG MD)

  • lateral pt ,
  • geniohyoid ,
  • mylohyoid,
  • digastric
87
Q

**The closing movement (elevation of mandible): Muscles

A

(MTMp)

  • Masseter,
  • temporal,
  • medial pt

Note: Disc and condyle moves back

88
Q

**Primary muscle for protrusion

A

Primarily inferior lateral pterygoid muscle

89
Q

Describe protrusion

A

Condyles and discs are pulled forward by Inferior lateral pterygoid m.

90
Q

**Muscles involved in protrusion on the mandible

A
  • Primarily inferior lateral pterygoid muscle

- Slight activity of the masseter & medial pt muscle to stabilize the position of the mandible

91
Q

**Protrusion of mandible is limited by __?

A

Forward movement is limited by the posterior portion of the joint capsule

92
Q

**Retrusion is limited by _______?

A

The capsular and TM ligament of the TMJ limit retrusion further

93
Q

**Muscles involved in retrusion

A

From the max protruded position, the posterior temporalis assist the middle
temporalis during mandible retrusion

94
Q

**Left lateral movement of the mandible: Muscles involved

A
  • The Rt (BS) lateral pt & Rt Medial Pt muscle active

- The middle portion of the Lt ( ws ) temporalis & masseter muscles assist to stabilize the condyle

95
Q

**Left lateral movement of the mandible: Left condyle?

A

-The left Lateral pole of the condyle can move backward only about 1 to 2 mm
until restricted by the deep horizontal band of TM Ligament
•Under guidance of this ligament , the center of the Lt condyle is forced to `move slightly anteriorly and laterally

96
Q

**Left lateral movement of the mandible: Right condyle?

A

•RT condyle is pulled forward , downward, and medially along the articular eminence

97
Q

Clicking (TMJ)

A

A click (pop) is a single sound of short duration

98
Q

Crepitation (TMJ)

A

Crepitation is a grating sound of two bones

99
Q

Range of motion should be assessed with a ruler during wide opening between the ________

A

incisor edges

100
Q

Opening pattern should be _____ (curved/straight)

A

straight

101
Q

**A restricted mouth opening

______ indicates TMJ and/or muscle problem

A

< 40

102
Q

In individuals with increased overbite, amount of overbite should be ______(added/subtracted) to/from the measured range of movement

A

added

103
Q

Any lateral movement less than ____ is recorded as a restricted movement

A

8mm

104
Q

Protrusive movement less than _____ is recorded as a restricted movement

A

8mm

Occlusion (4 decks)

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