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BDS3 BAMS Anatomy > Week 6 - TMJ, Temporal & Infratemporal Region > Flashcards

Week 6 - TMJ, Temporal & Infratemporal Region Flashcards

1
Q

What forms the TMJ ?

A

Mandibular fossa of temporal bone and condylar process of mandible.

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2
Q

What type of joint is the TMJ ?

A

Modified hinge (atypical) synovial joint.

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3
Q

What makes the TMJ a synovial joint ?

A

Has a joint capsule.

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4
Q

What makes the TMJ a modified hinge ?

A

Permits gliding motions and some degree of rotation as well as elevation and depression.

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5
Q

What makes the TMJ an atypical joint ?

A

Surfaces of articulating surfaces are covered in fibrocartilage rather than hyaline cartilage - this is however more typical for synovial joint.

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6
Q

What are the names of the ligaments associated with the TMJ ?

A

2 extrinsic - sphenomandibular and stylomandibular ligament.
1 intrinsic - lateral ligament.

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7
Q

Where is the sphenomandibular ligament and what is its function ?

A

From spine of sphenoid bone to lingual of mandible.
Main passive support of mandible (with MOM).

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8
Q

Where is the stylomandibular ligament ?

A

From styloid process to angle of mandible - thickening of fibrous capsule of parotid gland.

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9
Q

What is the function of the lateral ligament ?

A

Strengthens the joint laterally and acts to prevent posterior dislocation.

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10
Q

What are the 5 movements of the TMJ ?

A

Protrusion, retraction, elevation, depression, lateral.

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11
Q

What muscles contribute to elevation of the mandible (closing of the mouth) ?

A

Temporalis.
Masseter.
Medial pterygoid.

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12
Q

What muscles contribute to depression of the mandible (opening of the mouth) ?

A

Lateral pterygoid.
Supra and infrahyoid muscles.

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13
Q

What muscles contribute to protrusion of the mandible (protrude chin) ?

A

Lateral pterygoid.
Masseter.
Medial pterygoid.

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14
Q

What muscles contribute to retrusion of the mandible (retrude chin) ?

A

Temporalis - posterior oblique and near horizontal fibres.

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15
Q

What muscles contribute to lateral movements of the mandible (grinding and chewing) ?

A

Temporalis of same side.
Pterygoids of opposite side.
Masseter.

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16
Q

When is the TMJ most unstable and results in anterior dislocation into Infratemporal fossa ?

A

Depression - when condylar processes move anteriorly.

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17
Q

What is the origin of the temporalis ?

A

Floor of temporal fossa and deep surface of temporal fascia.

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18
Q

What is the insertion of the temporalis ?

A

Medial surface of coronoid process of mandible.
Anterior border of the ramus of mandible near the last molar.

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19
Q

What area does the temporalis occupy ?

A

Temporal fossa.

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20
Q

What is the action of the temporalis ?

A

Retract and elevate mandible.

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21
Q

What is the innervation of temporalis ?

A

Deep temporal nerve from anterior trunk of CNV3.

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22
Q

What is the origin of masseter ?

A

Maxillary process of zygomatic bone and anterior 2/3 of inferior border of zygomatic arch.

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23
Q

What is the insertion of the masseter ?

A

Angle and lateral surface of ramus of mandible.

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24
Q

What is the action of the masseter ?

A

Elevates the mandible.

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25
Q

What is the innervation of masseter ?

A

Masseteric nerve from anterior trunk of CNV3.

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26
Q

What is the origin of the medial pterygoid ?

A

Deep head - medial surface of lateral pterygoid plate.
Superficial head - maxillary tuberosity and pyramidal process of palatine bone.

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27
Q

What is the insertion of the medial pterygoid ?

A

Medial surface of the ramus and angle of the mandible.

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28
Q

What is the innervation of the medial pterygoid ?

A

Nerve to medial pterygoid from main trunk of CNV3.

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29
Q

What is the origin of the lateral pterygoid ?

A

Upper head - infratemporal surface of greater wing of sphenoid bone.
Lower head - lateral surface of lateral pterygoid plate.

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30
Q

What is the insertion of the lateral pterygoid ?

A

Front of neck of the mandible.

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31
Q

What is the action of the lateral pterygoid ?

A

Protrude and depress mandible and assists medial pterygoid in lateral movement.

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32
Q

What is the innervation of the lateral pterygoid ?

A

Nerve to lateral pterygoid and buccal nerve from anterior trunk of CNV3.

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33
Q

What is the relevance to dentures of the mylohyoid line ?

A

Lower denture must stop short of mylohyoid otherwise contraction would lift it when speaking of chewing.

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34
Q

What is the relevance to Ludwig’s angina of the mylohyoid line ?

A

Infection spread from lower teeth below mylohyoid line into floor of submandibular region.

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35
Q

What is the relevance to prosthodontics of the oblique line ?

A

Buccal edge of the mandible should stop short of oblique line or buccinator will interfere.

36
Q

What is the superior and posterior border of the temporal fossa ?

A

Superior and inferior temporal lines.

37
Q

What is the anterior border of the temporal fossa ?

A

Frontal process of zygomatic bone and zygomatic process of frontal bone.

38
Q

What is the inferior border of the temporal fossa ?

A

Infratemporal crest deep to zygomatic arch.

39
Q

What is the floor of the temporal fossa ?

A

Frontal, parietal, temporal and greater wing of the sphenoid bone (including pterion).

40
Q

What is the roof of the temporal fossa ?

A

Temporal fascia.

41
Q

What is the temporal fascia ?

A

Tough layer of fascia to superior temporal line and splits into two layers inferiorly to attach to zygomatic arch.

42
Q

What is the function of the temporal fascia ?

A

Provides the resistance to masseter.

43
Q

What is the lateral boundary of infratemporal fossa ?

A

Ramus of the mandible.

44
Q

What is the medial boundary of infratemporal fossa ?

A

Lateral pterygoid plate of sphenoid bone.

45
Q

What is anterior boundary of infratemporal fossa ?

A

Posterior aspect of maxilla.

46
Q

What is posterior boundary of infratemporal fossa ?

A

Tympanic plate, mastoid and styloid processes.

47
Q

What is superior boundary of infratemporal fossa ?

A

Infratemporal crest of sphenoid bone.

48
Q

What is inferior boundary of infratemporal fossa ?

A

Angle of mandible.

49
Q

What 3 muscles are found in infratemporal fossa ?

A

Medial, lateral pterygoid and inferior part of temporalis.

50
Q

What are the two terminal branches of external carotid artery ?

A

Superficial temporal and maxillary.

51
Q

What are the 6 most relevant branches of maxillary artery ?

A

Middle meningeal.
Inferior alveolar.
Anterior and posterior deep temporal.
Masseteric.
Buccal.
Superior alveolar.

52
Q

What foramen does the middle meningeal artery pass through to enter middle cranial fossa ?

A

Foramen spinosum.

53
Q

What foramen does inferior alveolar artery pass through to enter mandible ?

A

Mandibular foramen.

54
Q

What branch of the maxillary artery passes through mandibular notch ?

A

Masseteric artery.

55
Q

What does the middle meningeal artery supply ?

A

Dura matter of the brain.

56
Q

What anatomical landmark can be seen from the inside of the skull relevant to the middle meningeal artery ?

A

Middle meningeal groove.

57
Q

The middle meningeal artery passes through a split in what nerve ?

A

Auriculotemporal nerve branch of CNV3.

58
Q

What route does the anterior and posterior deep temporal arteries take in the infratemporal fossa ?

A

Pass superiorly and laterally across roof of infratemporal fossa.

59
Q

The masseteric artery supplies the masseter via what surface ?

A

Deep surface.

60
Q

What does the buccal artery supply ?

A

Buccinator, cheek and buccal oral mucosa.

61
Q

What is the 1st part of the maxillary artery called ?

A

Mandibular part.

62
Q

What is the 2nd part of the maxillary artery called ?

A

Pterygoid part.

63
Q

What is the 3rd part of the maxillary artery called ?

A

Pterygopalatine part.

64
Q

What muscle is the maxillary artery divided into parts in relation to ?

A

Lateral pterygoid.

65
Q

What two main arterial branches are associated with the mandibular part of the maxillary artery ?

A

Middle meningeal and inferior alveolar arteries.

66
Q

What three main arterial branches are associated with the pterygoid part of the maxillary artery ?

A

Anterior and posterior deep temporal, masseteric and buccal arteries.

67
Q

What main arterial branch is associated with the pterygopalatine part of the maxillary artery ?

A

Superior alveolar artery.

68
Q

What fissure and then fossa does the third part of maxillary artery enter (pterygopalatine part) ?

A

Pterygomaxillary fissure and into pterygopalatine fossa.

69
Q

What artery runs deep between lateral and medial pterygoid muscles ?

A

Maxillary artery - first part i.e. mandibular part with branches - middle meningeal and inferior alveolar.

70
Q

What fossa does the trigeminal ganglion lie ?

A

Middle cranial fossa.

71
Q

What foramen does the mandibular nerve (CNV3) pass through ?

A

Foramen ovale.

72
Q

What is the corticobulbar tract responsible for ?

A

Voluntary motor control of head (skeletal muscle) - including muscles of facial expression, infra/suprahyoids, intrinsic and extrinsic muscles of the tongue and muscles of mastication.

73
Q

Where is the primary motor cortex located ?

A

Anterior to central sulcus.

74
Q

What fibres run from primary motor cortex to internal capsule ?

A

Corona radiata.

75
Q

What area of the internal capsule does the corticobulbar tract run through towards the brainstem ?

A

Genu (central point of the triangle made by the internal capsule).

76
Q

What is the genu ? And where is it located ?

A

Tunnel of white matter through middle of basal ganglia beneath corona radiata.

77
Q

What motor cranial nerves are associated with the midbrain ?

A

CNIII (oculomotor) and CNIV (trochlear).

78
Q

What motor cranial nerves are associated with pons ?

A

CNV (trigeminal), CNVI (abducens), CNVII (facial).

79
Q

What motor cranial nerves are associated with medulla ?

A

CNIX (glossopharyngeal), CNX (vagus), CNXI (accessory, CNXII (hypoglossal).

80
Q

The ‘nucleus ambiguwus’ is a shared nucleus in the corticobulbar tract by what 2 cranial nerves ?

A

CNX and CNIX.

81
Q

What is pseudobulbar palsy ?

A

Mild form of weakness in associated muscles.

82
Q

What two cranial nerves are an exception to “bilateral rule of innervation” in corticobulbar tract ?

A

CNVII and CNXII.

83
Q

Explain why facial nerve’s motor innervation differs from the “bilateral rule of innervation” in corticobulbar tract.

A
  • Facial nuclei split into upper and lower.
  • Upper nuclei UMN - innervated bilaterally for ipsilateral side.
  • Lower nuclei UMN - single contralateral innervation to nucleus.
84
Q

Explain why hypoglossal nerve’s motor innervation differs from the “bilateral rule of innervation” in corticobulbar tract.

A

Single contralateral innervation to nucleus.

85
Q

What makes trochlear nerve unusual in the corticobulbar tract ?

A

UMN innervation - bilateral.
LMN innervation - contralateral.
LMN crosses to opposite sides.

BDS3 BAMS Anatomy (11 decks)

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