exam 3: TMJ

Question 1

TMJ innervation
ruffini corpuscles

Answer 1

proprioception

Question 2

TMJ innervation
pacinian corpuscles

Answer 2

dynamic mechanoreception

Question 3

TMJ innervation
golgi tendon organs

Answer 3

static mechanoreception

Question 4

TMJ innervation
free nerve endings

Answer 4

pain

Question 5

the TMJ is is classified as a

Answer 5

synovial sliding-ginglymoid (hinged) joint

Question 6

synovial joints permit movement between

Answer 6

2 bones

Question 7

each bone of a synovial joint is covered by

Answer 7

hyaline cartilage

Question 8

in a synovial joint, the two bones are united and surrounded by a

Answer 8

fibrous capsule thereby creating a joint cavity

Question 9

the synovial joint cavity is filled with:
1mL
that is derived from villus cells which line the internal surface of the capsule

Answer 9

synovial fluid

Question 10

what separates the the bones in tmj synovial joint

Answer 10

fibrous disc

Question 11

in tmj, both the condylar neck and head develop by

Answer 11

endochondral ossification

Question 12

both the condylar neck and head develops by

Answer 12

endochondral ossification

Question 13

the condylar head develops by endochondral ossification and has multidirectional growth capacity.
Unlike long bones of the body, which also develop by endochondral ossification, the cartilage cells in the head and neck do NOT exhibit__________(a characteristic of the epiphyseal growth plates in long bone)

Answer 13

ordered columns

Question 14

bones of the TMJ are the ______ and the ____

Answer 14

glenoid fossa and
mandibular condyle

Question 15

what attaches to the joint capsule and articular disc (aka meniscus)

Answer 15

superior head of lateral pterygoid

Question 16

what attaches to the condylar in the pterygoid fovea

Answer 16

inferior head of lateral pterygoid

Question 17

the articulating surfaces are covered with a layer of:

Answer 17

fibrous tissue

Question 18

with increasing age, the deeper portions of the fibrous covering may exhibit

Answer 18

islands of cartilage

Question 19

comprised of collagen and elastic fibrous connective tissue, fat cells, and is highly vascular.
elastic fibers from this insert into the petrotympanic fissure

Answer 19

retrodiscal connective tissue (aka bilaminar zone)

Question 20

the disc is attached to what surfaces of the condyle but not attached to:
thus, when the mandible moves the disc moves as well, traveling all over the anterior surface of the articular fossa

Answer 20

attached to medial and lateral surfaces of condyle but not temporal bone

Question 21

all articulation is on what portion of the disc

Answer 21

fibrous

Question 22

this dense area also restricts the posterior movement of the mandible and maintains the condyle in the anterior part of the glenoid fossa

Answer 22

disc

Question 23

what area allows the mandible to move freely in an anterior direction

Answer 23

vascular retrodiscal area

Question 24

what lines the inner surface of the fibrous capsule

Answer 24

synovial membrane

Question 25

the tmj synovial membrane consists of three distinct layers of tissue.
1. most peripheral (external) layer is the
2. intermediate layer is the
3. most internal layer is

Answer 25

1. fibrous capsule of the joint
2. vascular subintima
3. intimal layer

Question 26

intimal layer contains 2 cell types:

Answer 26

type A synovial cells
type B synovial cells

Question 27

macrophage-like cells that exhibit phagocytic functions and are capable of producing inflammatory cytokines

Answer 27

type A synovial cells( of intimal layer)

Question 28

fibroblast-like cells that synthesize hyaluronate which is a major component of the synovial fluid in both the superior and inferior compartment of the joint

Answer 28

type B synovial cells

Question 29

chronic or acute joint trauma may cause the type A synovial cells to undergo a ______transformation into multinucleated giant cells that exhibit osetoclastic-like functions (resorption of bone and cartilage)

thus, the articular surfaces, including the joint meniscus, are subjected to cellular mediated surface resorption as long as levels of IL-1, IL-6, IL-8 and TNF are elevated

Answer 29

syncytial (fusing)

Question 30

if the inflammatory response is of sufficient intensity and duration, bone and cartilage resorption can also take place within the ____________ of the condylar head and subjacent condylar neck. this resorption can actually occur simultaneously on both the external and internal surfaces of the condyle

Answer 30

spongiosa of condylar head and neck

Question 31

arachidonic acid pathway

Answer 31

1. injury to cell membrane
2. membrane phospholipid
3. phospholipase
4. arachidonic acid
   splits into lipoxygenase and cycloxygenase

Question 32

(arachidonic acid pathway)
lipoxygenase:

cycloxygenase:

Answer 32

lipoxygenase:
to leukotrienes
to chemotaxis vascular permeability

cycloxygenase:
splits into both prostaglandins
(vasodilation/edema/pain) and
thromboxanes (vasoconstriction)

Question 33

(inflammatory joint disease)
1. chronic or acute joint trauma

Answer 33

2. activation of arachidonic acid pathway
3. leukotrienes, thromboxanes, prostaglandins
4. type A synovial cells
5. IL-1, IL-6, IL-8, TNF-a
6. macrophage/osteoclastic activation
7. tissue destruction

Question 34

with these chronic inflammatory changes, _______are noted on the condylar heads. also a decreased vascularity is found in the retrodiscal area, leading to pain on function

Answer 34

osteophytes

Question 35

the disc is trapped in the antero-medial position, causing limited opening, pain, and clicking upon opening

Answer 35

internal derangement

Question 36

loss of articular coverings and synovial membranes, leading to direct bone-to-bone fusion

Answer 36

ankylosis resulting from untreated fracture