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Anatomy Module IV > Temporomandibular Joint (TMJ) > Flashcards

Temporomandibular Joint (TMJ) Flashcards

1
Q

bony structure of the TMJ

A

Articualar eminence / tubercles
MAndibualr fossa
condyle
mandible

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2
Q

TMJ

A

site of articualation between the mandible and the skull

modified hinge joint

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3
Q

Three components of the TMJ’s modified hinge joint

A

the articular eminence and tubercles of temporal bone
mandibular fossa of temporal bone
the condyle of the mandible

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4
Q

where are the articular eminence and tubercles associated with TMJ?

A

On the temporal bone

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5
Q

purpose of the articular eminence on the temporal bone

A

limiting forward movement of the condyle

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6
Q

Mandibular Fossa of the temporal bone

A

unique part of the synovial joint where where it is COVERED WITH DENSE FIBROUS TISSUE WITH CHONDROCYTES - movement here and subjected to force, so we have extra protective layer of fibrous tissue
- more like fibro cartilage than hyaline

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7
Q

what is the posterior aspect of the mandibular fossa?

A

SQUAMOTYPMANIC (lateral) and PETROTYMPANIC (more medial) fissures - demarcating squamous and petrous portions of the temporal bone
the post-glenoid tubercle

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8
Q

borders of the mandibular fossa

A

lateral
medial
posterior
anterior

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9
Q

lateral border of mandibular fossa

A

zygomatic process of the temporal bone

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10
Q

medial border of the mandibular fossa

A

spine of the sphenoid bone

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11
Q

anterior border of the mandibular fossa

A

articular eminence

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12
Q

posterior border of the mandibular fossa

details

A

squamotympanic fissure (more lateral aspect)
Petrotympanic fissure - this is more medial
fissures that going across the boundaries of the squamous and petroud portions of the temporal bone

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13
Q

squamotympanic fissure

A

separates the mandibular fossa of the squamous portion of the temporal bone from the tympanic plate of the temporal bone

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14
Q

petrotympanic fissure

A

‘small island of petrous bone’ appears within the MEDIAL half of the suture and complicates the nomenclature. The medial half of the fissure BECOMES THE PETROTYMPANIC FISSURE adjacent to the small wedge of petrous temporal bone

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15
Q

what passes through the petrotympanic fissure?

A

branch of CN VII – the chorda tympani leading it into the INFRATEMPORAL FOSSA where it is positioned medial to the spine of the sphenoid and courses anteriorly to JOIN THE LINGUAL NERVE to which it contributes GVE, SA, and GVA fibers

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16
Q

mandibular condyle components

A

medial and lateral poles
neck of condyle
articular surface of the condyle *

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17
Q

long axis of condyles is angled how?

A

posteriorly

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18
Q

neck of the condyle

A

connects the condyle to the ramus of the mandible

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19
Q

articular surface od the condyle

A

DENSE FIBROUS TISSUE, WITH ISOLATED GROUPS OF CHONDROCYTES AND LITTLE SURROUNDING MATRIX

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20
Q

bone formation type of the condyles and how you know

A

INTRAMEMBRANEOUS ossification because it has isolates groups of chondrocytes on it

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21
Q

external oblique line

A

serves as attachment site for the depressor anguli oris and majority is on the body

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22
Q

mental foramen

A

note its location on the mandibular body - lateral and anterior
inferior to the second pre molar

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23
Q

Gonial angle

A

angle between the posterior part of the ramus and the inferior border of the body of the mandible

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24
Q

antegonial angle

A

junction of the ramus and body of the mandible

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25
Q

Digastric fossa

A

internal feature of the mandible
TWO - found on the anterior internal aspect just above the inferior border and they are small depression on either side of the midline and reflect the bondy origins of the ANTERIOR BELLY OF THE DIGASTRIC MUSCLE

26
Q

Mental spine (genial tubercles) (MS)

A

internal feature of the mandible
lies in the middle superior to the digastric fossae.
there may be four separate spines or a fused spine
attached to the upper aspect of the spine is the ORIGIN OF THE GENIOGLOSSUS MUSCLE
attached to the lower aspect is the origin of the GENIOHYOID MUSCLE

27
Q

attached to upper aspect of the mental spine

attached to the lower aspect of the mental spine?

A

origin of the genioglossus muscle

lower = origin of the geniohyoid muscle

28
Q

sublingual fossa

A

shallow concavity above the mylohyoid line that accomodates the sublingual gland

29
Q

submandibular fossa

A

located below the mylohyoid line and accomodates the submandibular gland

30
Q

mylohyoid ridge/line

A

raised line that runs OBLIQUELY from the lateral aspect of the digastric fossae to the area below the lingual alveolar crest of the LAST MANDIBULAR molar it is the origin of the MYLOHYOID MUSCLE

31
Q

mandibular foramen

A

is an oblique opening at the midpoint of the rectangular ramus of the mandible
a few millimeters below the occlusal line of the mandibular molars

32
Q

mandibular canal

A

continuation of the mandibular foramen deep into the mandible
CARIES THE INFERIOR ALVEOLAR NERVE AND ARTERY to the mandibular teeth.
canal runs inferior and anterior through the body and ramus just below the roots of the mandibular teeth
cutaneous branches of the nerve and artery pass to the facial aspect of the mandible through the MENTAL FORAMEN

33
Q

lingula

A

tongue-like projectoin of bone guarding the superoanterior border of the mandibular foramen.
could potentially interfere with anesthetic injections of the inferior alveolar nerve at the mouth of the mandibular foramen

34
Q

attachement for sphenomandibular ligament

A

lingula on internal feature of the mandible

35
Q

mylohyoid sulcus/groove

A

is a narrow groove that runs downward and forward from the inferior border of the mandibular foramen
NERVE TO MYLOHYOID MUSCLE IN THIS GROOVE

36
Q

internal oblique line, or temporal crest

A

buttressing ridge of bone on the internal surface of the ramus
it begins indistinctly on the coronoid process and slopes downward and forward

37
Q

what happens as the internal oblique line approaches the last molar?

A

divides to pass around the last molar, and the divisions becoming CONTINUOUS WITH THE BUCCAL AND LINGUAL ALVEOLAR CRESTS
the enclosed triangle is the RETROMOLAR TRIANGLE

38
Q

retromolar fossa

A

depression between the anterior border of the ramus and the temporal crest

39
Q

shape of articular disc and some details

A

bi-concave and this shape allows flexibility in the disc so it can conform during TMJ motion and results in the disc being self-centered

it is INTRAARTICULAR and fibrocadtilagenous and suspended within joint capsule to stay in place as the joint capsule divides into two separate spaces and disc suspended by the lamellae

40
Q

articular disc divides..

A

divides the joint into two separate compartments - superior and inferior

41
Q

superior and inferior sheets or lamellae

A

the disc is ATTACHED TO THE INNER PERIPHERY OF THE ARTICULAR CAPSULE BY THE SUPERIOR AND INFERIOR SHEETS/LAMELLAE that continue superiorly and inferiorly to blend with the walls of the capsular ligament

42
Q

description of the superior and inferior lamella

A

superior is more elastic and the inferior is primarily collagen

43
Q

joint capsule intrinsic ligaments of the TMJ

A

capsular ligament and the lateral/temporomandibular ligament

unique in that they are not completely separate structures but regions of the capsule - thickenings of the joint capsule

all synovial joints have fibrous capsule that encloses the joint surfaces

44
Q

capsular ligament and the lateral/temporomandibular ligamen

A

reinforcements WITHIN REGIONS of joint capsule and they prevent excessive movements in the lateral and posterior directions
preventing dislocation posteriorly

45
Q

extrinsic ligaments

A

stylomandibular ligament and sphenomandibular ligament

named for their attachements

46
Q

stylomadnibular ligament

A

runs from the styloid process to the angle of the mandible and limits protrusion (coming from back so limits the protrusive movements)

47
Q

sphenomandibular ligament

A

runs from the spine of the sphenoid to the lingula of the mandible
supports weight of the mandible and prevents excessive lateral movements of the mandible

48
Q

movements of mandible

A

elevation(closing), depression (opening), protrusion, retrusion, lateral excursion (deviation)

49
Q

Hinge and gliding at the TMJ

A

movements of the mandible
hinge = in the inferior os lower joint compartment

translation/gliding takes place in the upper joint compartmentn

upon opening both condyle and the disc translate forward to sit on the articular eminence

50
Q 
Temporalis muscle
action 
bilateral 
unilateral 
innervation
A

muscle of mastication

attachments - temporal fossa and tip of coronoid process, ramus of mandible

action
bilateral - elevation, retrusion of mandible
unilateral - ipsilateral deviation and holds onto the position of the mandible

innervation - deep temporal branches

51
Q

what covers the temporalis

A

covered by a thick sheet of fascia, the temporalis fascia

52
Q

Masseter Muscle

attachments 
action 
bilateral 
unilateral 
innervation
A

muscle of mastication

attachments - outer and inner surfaces of the zygomatic bone and arch and angle, and lateral surface of ramus of mandible

action
bilateral - elevation, protrusion of mandible
unilateral - ipsilateral deviation

innervation - masseteric nerve

53
Q

lateral pterygoid muscle

attachments 
action 
bilateral 
unilateral 
innervation
A

muscle of mastication

attachments
superior head - greater wing of sphenoid bone
inferior head - lateral pterygoid plate
both - capsule, disc, condyle

action
bilateral - depresses (opens) , and protracts mandible
unilateral - contralateral deviation

innervation - lateral pterygoid nerves

ONLY MUSCLE THAT OPENS/ DEPRESSES MANDIBLE

54
Q 
Medial pterygoid muscle  
attachments 
action 
bilateral 
unilateral 
innervation
A

muscle of mastication

attachments - lateral pterygoid plate, tuberosity of maxilla and medial ramus of mandible, inferior to the mandibular foramen - on internal aspect

action
bilateral - elevation, protrusion
unilateral - contralateral deviation

innervation - medial pterygoid nerve

55
Q

medial and lateral pterygoid muscles both come off of?

A

lateral pterygoid plate

56
Q

nerve supply to TMJ

A

Most of it is supplied by sensory branches of teh AURICULOTEMPORAL NERVE
and a smalll anterior portion is supplied by sensory fibers usually arising from the masseteric branches of V3

57
Q

pain impulses from TMJ?

A

the posterior and posterolateral regions of the joint capsule contain free nerve endings and conduct pain impulses from the joint
*this is part of a feedback mechanism to protect against excessive mandibular movements

58
Q

what is in the retrodiscal inferior lamella regarding nerves?

A

contains PROPRIOCEPTIVE MECHANORECEPTORS THAT DETECT CONDYLAR MOVEMENT AND POSITION
- also providing feedback on pain and forces/ pressure

59
Q

blood supply to the TMJ

A

articular branches arise from the SUPERFICIAL TEMPORAL ARTERY to supply most of the joint
- this is a terminal branch from the external carotid artery

additionally there are small arterial twigs from muscular branches of the maxillary artery (also a terminal branch of the external carotid artery) that supply the ANTERIOR aspect of the joint

60
Q

how would you reposition a dislocated mandibular condyle?

A

HAVE TO PUSH DOWNWARD PRESSURE FIRST TO GET BELOW THE ARTICULAR EMINENCE - then should re position itself

also have to do this one side at a time

61
Q

muscles palpated in the TMJ region?

A

Temporalis and masseter

62
Q

examine TMJ from anterior and posterior

A

anterior - just anterior to the ear

posterior - place fingers inside ears, and press gently anteriorly

Anatomy Module IV (12 decks)

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