TMJ

Question 1

TMJ

Answer 1

Synovial
Condylar
Fibrocartilaginous surface (not hyaline)
Articular disc

Question 2

Articular disc

Answer 2

Meniscus
Divides each joint into two cavities

Provides congruent contours and lubrication for the joint

Innervated along periphery but aneural and avascular in its intermediate (force bearing zone).

Question 3

What movements happen in the upper cavity of the TMJ?

Answer 3

Gliding

Translation (sliding)

Question 4

What movements occur in the lower cavity of the TMJ?

Answer 4

Rotation (hinge)

Question 5

TMJ: rotation

Answer 5

Occurs from beginning to midrange of movement
Primarily occurs in the inferior joint space

Pterygoid draws meniscus anteriorly

Condylar head rotates (post glide) past disc

Question 6

Opening mouth involved what two phases

Answer 6

Rotation

Gliding

Question 7

TMJ: gliding

Answer 7

Second half of opening jaw. Necessary past 15°
Mostly superior joint space

Anterior translation of condyle and disc together along slope of articular eminence

Question 8

TMJ: resting position

Answer 8

Slightly open
Lips touching
Teeth not touching

Question 9

TMJ: closed packed

Answer 9

Teeth clenched

Question 10

TMJ: capsular pattern

Answer 10

Limited opening

Question 11

Centric occlusion

Answer 11

Relation of jaws and teeth when there is maximum contact of teeth

Position of jaw while swallowing

Question 12

Median occlusal pattern

Answer 12

The position in which the teeth are fully interdigitated

Question 13

TMJ actively displaces ….

Answer 13

Anteriorly and slightly laterally

Question 14

Three Cardinal features of TMD

Answer 14

Orafacial pain
Restricted jaw motion
Joint noise

Question 15

Hyoid bone

Answer 15

“Skeleton of the tongue”

Attachment for extrinsic tongue and infrahyoid muscles.

Provides reciprocal stabilization during swallowing.

Can affect shoulder and cervical function

Question 16

TMJ innervation

Answer 16

Branches of auriculotemporal and masseteric branches of mandibular nerves.

Question 17

Temporomandibular ligament

Answer 17

AKA lateral ligament

Restrains movement of lower jaw; prevents compression of tissues behind condyles.

Connect zygomatic arch and neck of mandible with joint capsule

Question 18

Sphenoidmandibular ligaments

Answer 18

Attach sphenoid to mandible

Guide movement– keep disc, condyles and temporal bone firmly opposed.

Question 19

Stylomandibular ligament

Answer 19

Connects styloid process of temporal bone to ramus of mandible

Specialized band of deep cerebral fascia with thickening if parotid fascia

Guide movement– keep disc, condyles and temporal bone firmly opposed.

Question 20

How many deciduous teeth?

Answer 20

20

Question 21

How many permanent teeth?

Answer 21

32

Question 22

Pain in fully opened position

Answer 22

Probably extra-articular

Question 23

Pain with biting firm objects

Answer 23

Probably intra-articular

Question 24

Limited opening

Answer 24

Disc displaced anteriorly, inert tissue tightness, or muscle spasm.

Question 25

Vertical dimension

Answer 25

Distance between to arbitrary points in the face, where is above and the other below the face.

Question 26

Stiffness on waking, pain on function that improves over the day

Answer 26

Osteoarthritis

Question 27

Mouth breathing

Answer 27

Tongue does not sit in proper position against the palate Tongue normally provides internal pressure to shape the mouth; counterbalanced by buccinator and orbicularis oris complex.

Question 28

Clicking/crepitus

Answer 28

Results from abnormal motion of disc and mandible.

Question 29

Single click

Answer 29

Disc sticks early in opening, when condyle slides off rim into centre. Clicks when it snaps into place.

Question 30

Disc displacement with reduction

Answer 30

Partial anterior displacement of disc; needs to be overridden in order for condyle to reach normal open position (click) (Can click again when re-subluxes)

Question 31

Reciprocal clicking

Answer 31

First click when condyle moves along posterior border of disc Normal function When condyle moves back to posterior zone another click.

Question 32

Bruxism

Answer 32

Clenching, grinding of teeth. Can lead to facial, jaw, or tooth pain. Headaches. Adhesive clicking after clenching.

Question 33

TMD: stage 1

Answer 33

Disc slightly medial and anterior Inconsistent click Maybe pain. Maybe not

Question 34

TMD: stage 2

Answer 34

Disc anterior and medial Reciprocal click (early on opening; late on closing) Severe constant pain

Question 35

TMD: stage 3

Answer 35

Reciprocal constant click (later on opening; early on closing) Most painful

Question 36

TMD: stage 4

Answer 36

Click rare (disc no longer relocates) No pain

Question 37

Occlusal interference

Answer 37

Premature tooth contact that deflects jaw laterally and/or anteriorly.

Question 38

During cervical flexion the mandible moves

Answer 38

Up and forward

Question 39

During cervical extension the mandible moves

Answer 39

Back and down

Question 40

With side flexion, maximum occlusion occurs

Answer 40

On the ipsilateral side.