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Histopathology > TMJ > Flashcards

TMJ Flashcards

1
Q

describe mandible growth

A

different parts grow in congruence with each other but in general tends to happen in anterior posterior direction as well as in a flaring direction

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2
Q

what does an overdeveloped ramus/body do to the jaw

A

flat angle of jaw

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3
Q

what does an underdeveloped ramus/body do to the jaw

A

steeper incline/angle of the jaw which can lead to crowding

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4
Q

what are the TMJ innervation receptors and what do they each do

A

-ruffini corpuscles: proprioception
-pacinian corpuscle: dynamic mechnoreception (chewing)
- golgi tendon organs: static mechanoreceptors (rest)
- free nerve endings: detect pain

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5
Q

what is the joint classification of the TMJ

A

synovial sliding ginglymoid joint

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6
Q

what does a synovial joint do

A

permits movement between 2 bones

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7
Q

what does the sliding joint classification of the TMJ describe

A

the second part of jaw opening, sliding anterior of the condyle over the glenoid fossa

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8
Q

what does the ginglymoid joint classification of the TMJ describe

A

the first part of opening, hinge portion

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9
Q

what is the joint cavity filled with

A

synovial fluid that is derived from villus cells which line the internal space of the capsule

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10
Q

what does the fibrous disc do

A

separates the bones preventing damage

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11
Q

how do the condylar neck and head develop

A

endochondral ossification

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12
Q

what is multidirectional growth capacity

A

unlike long bones of the body the cartilage cells in the condylar head and neck do not exhibit ordered columns

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13
Q

what does the fibrous capsule encapsulate

A

the entire joint

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14
Q

what does the superior lateral pterygoid attach to

A

joint capsule and articular disc

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15
Q

what does the inferior lateral pterygoid attach to

A

condylar neck in pterygoid fossa

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16
Q

what is the glenoid fossa

A

bony part of the temporal bone that allows for articular surface of mandibular condyle to fit in

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17
Q

describe the collagen fibers in the glenoid fossa

A

arranged in multiple directions allowing for a more robust surface of articulation

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18
Q

what are the inner perpendicular collagen fibers on the posterior slope of the TMJs articular eminence responsible for

A

resisting compression of the mandibular condyle against the articular surface of bone

19
Q

how do the articulating surfaces of the TMJ change with age

A

covered with a layer of fibrous tissue, with increasing age the deeper portions of the fibrous covering may exhibit islands of cartilage

20
Q

how do the condylar heads of the TMJ change with age

A

the condylar head becomes less cellular

21
Q

how does the articular disc of the TMJ change with age

A

becomes more cellular

22
Q

what is the retrodiscal connective tissue made of

A

comprised of collagen and elastic fibrous connective tissue, fat cells, and is highly vascular

23
Q

what does the composition of the retrodiscal connective tissue allow for

A

mandible to move freely in an anterior motion

24
Q

is there articulation between the retrodiscal connective tissue and the condyle

A

no

25
Q

what do the elastic fibers of the retrodiscal connective tissue insert into posteriorly

A

petrotympanic fissure

26
Q

what do the elastic fibers of the retrodiscal connective tissue insert into anteriorly

A

superior head of the lateral pterygoid

27
Q

describe anterior dislocation of the disc

A

the disc is attached to the medial and lateral surfaces of the condyle but not the temporal bone. when the mandible moves the disc moves as well. movement of the disc back and forth can cause asymptomatic clicking sound present in 70% of population

28
Q

where is all articulation of the disc

A

on the fibrous portion/dense area

29
Q

what does the dense area of the disc restrict

A

the posterior movement of the mandible and maintains the condyle in the anterior part of the glenoid fossa

30
Q

what is the function of the synovial membrane and where is it located

A

function: necessary for sliding movement
location: inner surface of the fibrous capsule

31
Q

what are the 3 distinct layers of tissue in the TMJ synovial membrane

A

-the most peripheral/external layer is the fibrous capsule of the joint
- the intermediate layer is the vascular subintima
- the most internal layer is termed the intimal layer

32
Q

what two cell types does the intimal layer contain and what do each do

A

-type A synovial cells: macrophage like cells that exhibit phagocytic functions and are capable of producing inflammatory cytokines such as interleukins or tumor necrosis factors
-type B synovial cells: fibroblast like cells that synthesize hyaluronate which is a major component of the synovial fluid in the superior and inferior compartments of the joint

33
Q

what is hyaluronate

A

major part of slippery synovial fluid that allows for free movement of the joint

34
Q

what happens in inflammatory joint disease in chronic or acute traumas

A

type A cells fuse and transform into a mulitnucleated giant cell and function like osteoclasts, resorbing bone and cartilage and elevate cytokine levels

35
Q

if intense enough what can inflammatory joint disease reaction cause

A

resorption within spongiosa of head and neck with resorption occurring simultaneously on internal and external surfaces of the condyle

36
Q

what is the arachidonic acid pathway

A

trauma -> activation of arachidonic pathway -> leukotrienes, thromboxanes and prostaglandins activate type A cells -> increased IL and TNF -> macrophage/osteoclastic activity -> tissue destruction

37
Q

what is arthritic degeneration

A

flattened condylar head occurs due to osteoclastic activity causing an almost bone on bone contact due to lack of cartilage layer

38
Q

what are found on condylarheads in arthritic degeneration

A

osteophytes

39
Q

what is the result of the degeneration of tissue in arthritic degeneration

A

decreased vascularity found in the retrodiscal area leading to pain on function

40
Q

what is internal derangement and what does it result in

A

disc is trapped in the antero medial position leading to limited opening, pain, and clicking upon opening

41
Q

what is ankylosis

A

loss of articular coverings and synovial membranes lead to direct bone to bone fusion

42
Q

what is ankylosis caused by

A

untreated fracture

43
Q

what can anklyosis in the TMJ lead to

A

specific malocclusion issues

44
Q

what is the result of the activation of leukotrienes, prostaglandins, and thromboxane’s activation of Type A cells

A

swelling, pain and vasoconstriction

Histopathology (14 decks)

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