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MOVEMENT SCIENCE > LECTURE 4- TMJ > Flashcards

LECTURE 4- TMJ Flashcards

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1
Q

what are the main 2 articular structures that make up the TMJ

A

mandible and temporal

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2
Q

other bones contributing to the TMJ structure

A

maxilla , zygomatic , sphenoid, hyoid

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3
Q

what forms the 2 TMJs

A

condole of mandible and articular eminence of temporal

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4
Q

what type of joint is the TMJ

A

synovial joint

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5
Q

are the surfaces of the TMJ covered in fibrocartilage or hyaline cartilage?

A

fibrocartilage allowing it to move more

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6
Q

what type of movement joint is the TM joints

A

ginglymoarthrodial (diarthrosis) allowing for free movement

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7
Q

which layers of the joint surfaces are perpendicular to bony surface and what do they do

A

deep layers and withstand stress

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8
Q

how are the superficial layers of the joint surfaces arranged and what do they facilitate in the TMJ

A

parallel and facilitate sliding of joint

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9
Q

how much can a bite force be

A

up to 1200 N

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10
Q

what structure is the largest of facial bones

A

mandible

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11
Q

where do the mandible structures sit

A

anterior to external auditory meatus

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12
Q

what part of the mandible is the attachment site for temporalis muscle

A

coronoid process

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13
Q

what makes up for joint incongruence and separates articulation into inferior and superior TMJ functions

A

articular disc

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14
Q

how does the inferior TMJ function

A

as an hinge joint - rolling posterior during opening

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15
Q

how does the superior TMJ function

A

as a plane joint , sliding anterior during opening

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16
Q

the articular disc of the TMJ is

A

bioconcave

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17
Q

what purposes do the articular disc of the TMJ serve

A

joint stanbility
minimize loss of mobility
reduce frication
decrease biomechanical stress at joint

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18
Q

where are the articular disc attach to

A

medial and lateral poles of the mandible condyle
joint capsule and tendon of lateral pteryoid muscle anteriorly
bilaminar retrodiscal pad posterior

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19
Q

what do superior and inferior lateral pterygoid muscle restrict ?

A

posterior translation

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20
Q

what does the superior lamina allow the disc to do

A

translate anteriorly by stretching

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21
Q

what does the interior lamina limit

A

forward translation

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22
Q

what is the articular disc of the TMJ made up of

A

collagen , proteoglycans , and elastin

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23
Q

what is the vascularity of the anterior band of the disc and where does it attach to

A

minimal to no vascular supply and attaches to joint capsule anteriorly

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24
Q

what is the vascularity of the intermediate zone of the disc and where does it attach to

A

no vascular supply and attached to medal and lateral condyle of mandible

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25
Q

what is the vascularity of the posterior band of the disc and where does it attach to

A

rich innervation and vascular supply from retrodiscal tissue and attached to retrodiscal tissue which is attached to capsule

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26
Q

where is the capsule for TMJ the stronger

A

laterally

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27
Q

what is the vascularity of the capsule forTMJ

A

highly vascular and innervated

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28
Q

3 ligaments of the TMJ

A

TM lig
stylomandibular lig
sphenomandibular lig

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29
Q

what does the oblique TM lig do

A

limits downward and posterior motion/ rotation of mandible

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30
Q

what does the horizontal TM lig do

A

resist posterior motion of condyle

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31
Q

what do both TM ligs do

A

resists lateral displacement

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32
Q

what does the stylomandibular lig do

A

may limit protrusion of jaw , weakest

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33
Q

what ligament may prevent forward translation

A

sphenomandibular lig

34
Q

when is the TMJ engaged

A

mastication , swallowing and speaking

35
Q

what are the arthokinematic movements of the TMJ

A

rolling
anterior slide
distraction
lateral glide

36
Q

what are the osteokinematic motions of TMJ

A

depression
elevation
protrusion
retrusion
L/R lateral excursions

37
Q

what is the Normal depression ROM of the TMJ

A

40-50 mm

38
Q

how do u test of normal depression ROM

A

have pt open mouth and use their fingers to test it
2 fingers is function and 3 fingers is normal

39
Q

what happens 1st during normal depression

A

11-25 mm anterior rotation of condyle on disc which leads to posteior roll of mandible

40
Q

what happens 2nd during normal depression

A

translation : both condyle and disc anterior and interior which leads to anterior slide of condyle

41
Q

during depression what control of the disc translate along the articular eminence and retrodiscal lamina limits translation

A

passively

42
Q

if there is active depression of the disc what happens

A

there is no active contraction of superior lateral pterygoid

43
Q

what happens passively during elevation of the mandible

A

elasticity of the superior retrodisc lamina apples traction force posteriorly

44
Q

during active elevation of what eccentrically contracts to control posterior gliding and rotation of condyle

A

superior lateral pterygoid

45
Q

during active elevation what attached to anterolateral portion of the disc to counteract the lateral pterygoid

A

masseter

46
Q

what 3 muscles provide contrast pressure on disc to prevent dislocation during elevation

A

temporalis , medial pterygoid and masseter

47
Q

where do protrusion and retrusion occurs

A

in superior portion of the joint

48
Q

what is anterior translation without rotation of inferior joint

A

protrusion

49
Q

bilateral lamina stretch _____ to allow complete motion during protrusion

A

6-9mm

50
Q

during protrusion teeth touching = ____ and lower teeth passing upper teeth = ___

A

normal
max

51
Q

what does retrusion do

A

translation posteriorly (3mm)

52
Q

what is retrusion limited by

A

TM lig and soft tissue in retrodiscal area

53
Q

what is a important component of mandibular elevation from maximally depressed mandible

A

retrusion

54
Q

what is the normal range of lateral excursion

A

8-11 mm

55
Q

if someone does a right lateral excursion what happens at the joint

A

right TMJ rotation and L TMJ translation

56
Q

if someone has tight right side muscles then what excursion will be limited

A

L side bc the R side will not be able to go into translation

57
Q

during lateral excursion there is an …

A

ipsilateral mandibular condyle rotation and contralateral mandibular condyle translations

58
Q

what is it called if the mandible moves away from mandible during mandibular depression and stays to the L or R

A

deviation

59
Q

what is a deflection

A

when the mandible move away from madeline during depressions or protrusion but then returns to midline at end range

60
Q

what muscles help depression

A

digastric & suprahyoids
inferior lateral pterygoid
gravity

61
Q

what muscles help elevation

A

temporalis
masseter
medial pterygoid
superior lateral pterygoid

62
Q

what muscles help assist protrusion

A

Bil: masseter , medial and lateral pterygoid

63
Q

what muscles help assist with retrusion

A

bil: temporalis , assisted by anterior digastric

64
Q

what muscles help with lateral deviation

A

unilateral contraction of medial and lateral pterygoids to pull to contralateral side ( R medial and lateral will pull to L)
temporalis will pull to ipsilateral side

65
Q

what are considered secondary muscle of TMJ

A

diagastric muscle (anterior belly)
mylohyoid
stylohyoid
geniohyoid

66
Q

what are considered deep cervical flexors

A

longus colli and longus capitus

67
Q

what are the bilateral and unilateral actions of the longus colli

A

bilateral: neck flexion
uni: SB with contralateral rotations

same as SCM

68
Q

what is the unilateral and bilateral action for longus capitus

A

bilateral: neck flexion
unilateral: SB with ipsilaterla rotation

69
Q

what does forward heard posture result in

A

retraction of mandible after malalignment

70
Q

Should the teeth touch during the day at rest?

A

no

71
Q

what is the freeway space of the teeth

A

normal rest position with 1-5 mm of space between supper and lower teeth at rest

72
Q

what are teh structural changes of the disc

A

wear and tear may lead to OA

73
Q

capsular fibrosis of TMJ will lead to

A

overproduction of connective tissue leading to loss of tissue function

74
Q

inflammation of TMJ will lead to

A

capsulitis and synovitis leading to RA

75
Q

joint hyper mobility of the TMJ is when there is …

A

an opening over 40 mm

76
Q

if you have joint hypermobility at the TMJ what will happen

A

there will be a deflection of mandible to contralateral side when opening

77
Q

what muscle hypertrophy, atrophy, or contracture if someone has joint hypermobility

A

lateral pterygoid muscle

78
Q

dislocation of the TMJ will cause

A

opening with deviation and inability to close due to anterior translated disc

79
Q

if you have an articular disc displacement with reduction then what happens

A

the condyle is behind the disk at rest so it translates anteriorly with depression with a click and translates posterior and slips out from under the disc during elevation with a click

80
Q

if you have articular disc displacement without reduction then what happens

A

the posterior attachments to the disc are overstretched and are unable to relocate during depression

no clicking

81
Q

if you have articular disc displacement without reduction when do you have pain

A

chewing , talking , yawning

MOVEMENT SCIENCE (13 decks)

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