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Occlusion > L2 - Neuromuscular Determinant > Flashcards

L2 - Neuromuscular Determinant Flashcards

1
Q

Two bones of the TMJ

A 
Mandibular condyle 
Temporal bone (squamous part)

+ articular disc

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2
Q

description of mandibular condyle

general parts /shape

A 
top of mandibular neck 
articulates with glenoid (mandibular fossa)
convex
elliptical shape 
medial and lateral poles
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3
Q

Temporal bone - which part and describe shape - what it determines

A

SQUAMOUS portion

articular eminence
- steepness and condylar guidance

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4
Q

roof of glenoid?

A

THIN - glenoid fossa is thin at top

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5
Q

TMJ does what movement?

A

HINGE and GLIDING

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6
Q

ginglymoarthrodial joint

A

2 types of joint movement occur

Gingylmoid = hinge
Gliding = arthrodial = plane joint
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7
Q

Rotate? motion and where?

A

HINGING movement in the LOWER compartment

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8
Q

Translate? motion and where?

A

GLIDING movement in the upper compartment

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9
Q

ginglymoarthrodial joint

A

TMJ synovial type
two types of movement
rotating at hinge - ginglymoid
gliding at arthroidal

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10
Q

TMJ articular surfaces and implication

A

Fibrocartilage tissue
* fibrocartilage can withstand force of movements and it has a great ability to repair itself (as opposed to hyaline cartilage that does not)

LESS susceptible to the effects of aging and less likely to breakdown overtime

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11
Q

two differences in TMJ vs other synovial joints

A

TMJ does two movements and articular surfaces are covered by fibrocartilage

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12
Q

anatomy of the articular disc

A

biconcave fibrocartilaginous structure

flexible and can adapt to the functional demands

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13
Q

what does articular disc prevent?

A

prevents direct articulation of the condyle and temporal bone

the articulating surfaces of the two bone are incompatible so disc prevents from damage

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14
Q

anterior prominence of condyle where?

A

CENTRAL THIN PART OF THE DISC

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15
Q

posterior border of the articular disc?

A

at a 12 o’clock position on the condyle

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16
Q

function of synovial fluid

A

lubrication and nutrition

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17
Q

boundary lubrication vs weeping lubrication

A

boundary - lubrication continues - goes in and out of articular surfaces

weeping = lubrication when we keep closed

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18
Q

general characteristics of the ligaments of the TMJ

A
  1. fibrous connective tissue that connects two bones
  2. no active participation in the TMJ function
  3. passive restraining
  4. do not stretch
  5. extensive forces may cause elongation which will compromise the joint function

*ONLY restrict the excessive functions

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19
Q 
capsular ligament 
superior?
inferior?
posterior?
function?
A

superior? = attach temporal bone along the border of glenoid fossa and articular eminence

inferior?= attach to condyle

posterior?= postglenoid process

encompass the TMJ

function? –> retain synovial fluid inside
RESISTS any medial, lateral, or inferior forces that tends to dislocate the articular surfaces

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20
Q

Temporomandibular (lateral) ligament

location and function of outer oblique?

A

Outer oblique = is attached to the articular tubercule, and runs posterioinferiorly to the outer surface of the condylar neck

*LIMITS rotational opening (20-25 mm) and protects retromandibular structures

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21
Q

Temporomandibular (lateral) ligament

location and function of inner horizontal?

A

it is attached to the articular tubercle, runs anteriorposteriorly to attach to the lateral pole of the condyle and posterior part of the disc

FUNCTION: limits posterior movement of condyle and disc to protect the retrodiscal tissue

Under extreme force? : condylar neck fractures to prevent the condyle from entering the middle cranial fossa?

22
Q

collateral (discal) ligaments
Attach?
Function?

A

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

Function: allows disc to move passively with the condyle as it glides

Divides joint into superior and inferior cavities

23
Q

Sphenomandibular ligament

attach and action

A

Spine of the sphenoid bone, runs downward and outward to lingula of the mandible

NO influence on mandibular movement

24
Q

Stylomandibular ligament
attach
function

A

Styloid process to the angle and posterior border of the mandibular ramus

Limits excessive mandibular protrusive movement

25
Q

functions of muscles of mastication?

A

muscles of mastication open, close, rotate, and protrude the jaw

enables to talk, chew and swallow

26
Q

major muscles of masitcation

A

Temporalis
masseter
medial pterygoid
lateral pterygoid

27
Q

Temporalis
Origin
Insertion
Function

A

Origin : Temporal fossa and lateral surface of the skull
Insertion: as a tendon into the coronoid process of the mandible
there are posterior, middle, and anterior portions

Function: close - elevate the jaw and retrudes mandible

28
Q

Masseter muscle
Origin
Insertion
Function

A

Origin : from the inferior border and medial surface of the zygomatic arch
Insertion: into the angle and the ramus of the mandible

Function: powerful elevator (closure) of the jaw
+ the superficial part is involved in protrusion

29
Q

medial pterygoid
Origin
Insertion
Function

A

Origin: from the pterygoid fossa of the sphenoid bone and the tuberosity of the maxilla

Insertion: into the medial surface of the mandible

Function: elevation and protrusion;
unilateral contraction causes mediotrusive movement

30
Q

muscles that are primarily involved with mandibular protrusion?

A

INFERIOR LATERAL PTERYGOID
and
medial pterygoid

31
Q

unilateral contraction of the medial pterygoid

A

mediotrusive movement

32
Q

inferior lateral pterygoid
Origin
Insertion
Function*

A

Origin : on the lateral surface of the lateral pterygoid plate

Insertion : the pterygoid fovea of the condyle neck

Function: active during opening in conjunction with mandibular depressors and protrusion + UNILATERAL CONTRACTION = mediotrusive movement

33
Q

action of infrahyoid muscles?

A

depresses the hyoid bone during swallowing

34
Q

nerve innervations of masticatory muscles and TMJ?

A

Cranial nerve - V (trigeminal)

Facial Nerve - CN VII

35
Q

anterior prominence of condyle?

A

opposes the central thin part of the articular disc

36
Q

myotatic reflex - AKA

A

STRETCH REFLEX

  • IMPORTANT IN DETERMINING THE RESTING POSITION OF THE JAW
  • a sudden downward force is applied to the chin and activates muscle spindles - response is contraction in the massater muscle
37
Q

Nociceptive reflex AKA

A

FLEXOR REFLEX
*REFLEX TO PAINFUL STIMULUS AND IS PROTECTIVE
it is activated by unexpectedly biting on a hard object.
elevators STOP CONTRACTING and DEPRESSERS START contracting to open the jaw

38
Q

which ligament limits rotation?

A

TM ligament
condyle rotates up to 20-25 mm opening and tightening of the TM ligament limits the rotation
- the outer oblique portion

39
Q

which ligament prevents further movement in translation?

A

Capsular ligament

condyle will translate up to maximum of 40-60mm opening and capsular will limit further

40
Q

mandibular free opening movement is done by a combination of?

A

lateral pterygoid, geniohyoid, mylohyoid, digastric

41
Q

mandibular free closing movement function of which muscles?

A

masseter, temporal, medial pterygoid

42
Q

protrusion done by primarliy?

A

inferior lateral pterygoids

43
Q

retrusion is protected by?

A

Capsular ligaments and the TM (lateral) ligament (more of the internal aspect)

44
Q

what to ask when palpating the masseter and temporal muscles?

A

Is it the familiar pain (similar pain) that you are complaining about?
do you feel pain anywhere else?

45
Q

significance in palpating the lateral pterygoid muscle

A

basic to jaw movement but NEARLY IMPOSSIBLE TO PALPATE

however if resist the patient when they go into protrusion and there is pain - this could be the source

46
Q

range of motion and clinical implications of limited range of opening?
what is limited range?

A

limited range of motion is opening less than 40 mm and this indicates that there may be problems with the TMJ or muscles

47
Q

range of motion in patients with an increased overbite?

A

in individuals with increased overbite- the amount of overbite should be added to the measured range of motion

48
Q

lateral excursion range of motion

what is a limited value?

A

Any lateral movement that is less than 8mm is considered restricted

also note and account for any midline shift

49
Q

protrusive movement range of motion

what is a limited value?

A

protrusive movement less than 8mm is considered a restricted movement

50
Q

superior Aspect of lateral pterygoid function?

A

Active only with elevator muscles and during CLENCHING / power stroke

Occlusion (10 decks)

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