Assessment, Dx, and Mngmt of TMD

Question 1

3 main skeletal components

Answer 1

maxilla
temporal bone
mandible

Question 2

maxilla

Answer 2

upper facial skeleton
2 maxillary bones fused at midpalatal suture
dentoalveolar support
bony attachment to skull

Question 3

mandible

Answer 3

body and ramus
lower facial skeleton
dentoalveolar support
no bony attachment to skull -muscle and ligament suspension, mobile
process of the ramus - coronoid and condylar process

Question 4

temporal bone

Answer 4

supports the mandible at articulation with cranium

Question 5

mandibular condyles

Answer 5

articulates with cranium bilaterally
medial and lateral planes
M-L = 18-23 mm
A-P = 8-10 mm

Question 6

condylar process

Answer 6

condyle and condylar neck

Question 7

glenoid fossa

Answer 7

site of mandibular condyle articulation
oval depression of inferior aspect of temporal bone
located anterior to external auditory meatus

Question 8

articular eminences

Answer 8

anterior limit of mand. fossa
convex = thick dense bone
variable degree of convexity - dictates protrusive path of mand condyle

Question 9

gross anatomy of tmj

Answer 9

complex diarthrodial joint - 2 functional movements
Rotation
translation

Question 10

rotatory movement

Answer 10

inferior compartment
condyle and articular disc

Question 11

translation (sliding) movement

Answer 11

superior compartment
disc and temporal component

Question 12

articular disc

Answer 12

divides joint - superior and inferior
avascular dense fibrous CT
biconcave, oval
anterior and posterior bands, intermediate zone b/w
medial and lateral attachments

Question 13

superior compartment location

Answer 13

b/w disc and fossa

Question 14

inferior compartment location

Answer 14

b/w disc and condyle

Question 15

retrodiscal tissue

Answer 15

posterior attachment
bilaminar zone
loose neruovascular CT bordered by 2 lamina = superior, inferior

Question 16

superior lamina

Answer 16

temporal posterior attachment

Question 17

inferior lamina

Answer 17

condylar posterior attachment

Question 18

tmj capsule

Answer 18

fibrous
non elastic membrane
surrounds tmj

Question 19

ligaments

Answer 19

thick fibrous tissue
limit joint movement

Question 20

tmj capsule function

Answer 20

create a seal for joint space
stability
limits separation and range of mvmenet of articular components - prevents tissue damage and lateral and medial dislocation of joint

Question 21

tmj ligaments

Answer 21

temporomandibular ligament
sphenomandibular ligament
stylomandibular ligament

Question 22

masticatory muscles

Answer 22

masseter
temporalis
medial pterygoid
lateral pterygoid

Question 23

importance of muscles of masticaion

Answer 23

maintain position of mandible at rest against gravity
tmj pain typically involve pain here

Question 24

suprahyoid muscles

Answer 24

digastric
stylohyoid
mylohyoid
geniohyoid

Question 25

infrahyoid muscles

Answer 25

omohyoid sternohyoid sternothyroid thyrohyoid

Question 26

other accessory muscles of mastication

Answer 26

platsyma orbicularis oris buccicnator

Question 27

masseter

Answer 27

quadrilateral shape covers lateral aspect of ramus

Question 28

superficial masseter origin

Answer 28

inf bod ant 2/3 zygomatic arch

Question 29

superficial masseter insertion

Answer 29

angle of mandible

Question 30

superficial masseter action

Answer 30

elevation, bilateral ipsilateral excursion protrusion, bilateral

Question 31

deep head masseter origin

Answer 31

inf border of post. 1/3 and internal aspect of zygomatic arch

Question 32

deep head masseter insertion

Answer 32

lateral superior ramus

Question 33

deep head masseter action

Answer 33

elevation, bilateral ipsilateral excursion retrusion, bilateral

Question 34

temporalis

Answer 34

fan shaped

Question 35

temporalis origin

Answer 35

inf temporal line of skull temporal fossa

Question 36

temporalis insertion

Answer 36

coronoid process

Question 37

temporalis action

Answer 37

elevation, bilateral retrusion (post fiber)

Question 38

medial pterygoid, deep head origin

Answer 38

pterygoid fossa b/w lateral + medial pterygoid plates

Question 39

medial pterygoid, superficial head origin

Answer 39

pyramidal process of palatine bone, max tuberosity

Question 40

medial pterygoid insertion

Answer 40

angle of mandible medial ramus

Question 41

medial pterygoid action

Answer 41

elevation, bilateral protrusion, bilateral contralateral excursion, unilateral

Question 42

lateral pterygoid superior head origin

Answer 42

greater wing of sphenoid bone, inf aspect

Question 43

lateral pterygoid superior head insertion

Answer 43

tmj capsule, disc, anterior condylar neck

Question 44

lateral pterygoid superior head action

Answer 44

stabilization of disc position

Question 45

lateral pterygoid inferior head origin

Answer 45

lateral pterygoid plate of sphenoid bone

Question 46

lateral pterygoid inferior head insertion

Answer 46

condylar neck

Question 47

lateral pterygoid inferior head action

Answer 47

protrusion, bilateral depression, bilateral contralateral excursion, unilateral