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NBDE Review > 100 Facts of TMJ > Flashcards

100 Facts of TMJ Flashcards

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1
Q

What are considered to be the accessory ligaments of the TMJ?

A
  • Sphenomandibular ligament

- Stylomandibular ligament

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2
Q

What is the function of the Sphenomandibular ligament + stylomandibular ligament?

A

Limit excessive openings

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3
Q

Where is the sphenomandibular ligament attached?

A

Lingula of the mandible

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4
Q

Where does the stylomandibular ligament attach?

A

Angle of the mandible

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5
Q

What ligament is most damaged when using an inferior alveolar nerve block?

A

Sphenomandibular ligament

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6
Q

Where does the temporomandibular ligament run?

A

From the articular eminence to the mandibular condyle

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7
Q

What are the (3) functions of the temporomandibular ligament?

A
  • Provides lateral reinforcement
  • Prevents posterior and inferior displacement of condyle
  • Main stabilizing ligament
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8
Q

What is another name for temporomandibular ligament?

A

Lateral ligament

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9
Q

What is another name for collateral ligaments?

A

Discal ligaments

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10
Q

Where does the collateral ligaments run?

A

Arise from the periphery of the disc and are attached to the medial and lateral poles of the condyle

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11
Q

What is the function of the collateral ligaments?

A
  • Stabilize the disc on top of the condyle

- Resist movements of disc away from condyle during function

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12
Q

What are collateral ligaments (discal ligaments) made from?

A

Collagenous connective tissue – it does not stretch

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13
Q

Which muscle will cause a deviation of the mandible when protruding to the side of the damage?

A

Lateral pterygoid

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14
Q

What are the two parts of the lateral pterygoid?

A

Superior belly and inferior belly

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15
Q

Where does the inferior belly of the lateral pterygoid run?

A

From lateral pterygoid plate to neck of condyle

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16
Q

Where does the superior belly of the lateral pterygoid run?

A

Greater wing of the sphenoid & infratemporal crest

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17
Q

Where does the superior belly of the lateral pterygoid insert?

A

Inserts on joint capsule, articular disk and condyle of neck

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18
Q

What is the function of the superior belly of the lateral pterygoid muscle?

A

Assist in stabilizing the position of the articular disk during closing

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19
Q

What is the function of the masseter?

A

Elevation of the mandible (jaw closing)

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20
Q

What is the function of the temporalis?

A
  • Elevation of mandible (jaw closing) anterior fibers (run vertical)
  • Retraction of the mandible (lower jaw backward) posterior fibers (run horizontally)
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21
Q

What is the function of the medial pterygoid?

A

Elevation of the mandible (jaw closing)

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22
Q

What is the function of the inferior heads of the lateral pterygoid?

A

Slight depression of the mandible (jaw closing)

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23
Q

What occurs with unilateral contraction of the lateral pterygoids?

A

Lateral deviation of mandible

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24
Q

What occurs with bilateral contraction of the lateral pterygoid muscles?

A

Protrusion of the mandible

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25
Where do you test a patient’s temporomandibular joint tenderness and noise?
Joint palpated laterally over the posterior surface of the condyles with the mouth open
26
TRUE OR FALSE: | Condyles are not symmetrical nor identical.
True
27
Dislocation of the TMJ is almost always? ___ | It happens during? ___ or ____
- Anteriorly | - Laughing or yawning
28
What is dislocation also referred as?
Open lock
29
Hypermobility or hypertranslation of the mandible?
Subluxation
30
What is the difference between dislocation and subluxation?
With subluxation patient can return the mandible to its normal position without assistance of the dentist
31
Which component of the TMJ has the most vasculature and innervation?
Retrodiscal tissue
32
Articular disc is composed of ____ fibrous connective tissue.
dense
33
Articular disc is positioned in between the:
condyle and the fossa
34
Articular disc divides the joint into:
superior and inferior spaces
35
What is the middle part of the articular disk called?
Thinner central intermediate zone
36
Which band is the thicker of the two on the articular disk? Anterior or posterior?
Posterior
37
What kind of tissue is attached to the posterior articular disk?
Retrodiscal tissue
38
What are the articular surfaces of the TMJ covered with?
Dense fibrous connective tissue
39
What does the layer of fibrocartilaginous tissue provide to the TMJ?
Offers resistance against both compressive and lateral forces
40
What is the shape of the condyle?
Elliptically shaped long axis is oriented mediolaterally
41
What test is considered to be the gold standard for providing an image of the soft tissue of the TMJ, especially the position of the articular disc?
MRI
42
What is the major advantage of the MRI technique?
No exposure of the patient to x-ray radiation
43
What sound is made by the articular disc when displaced to the anterior of the condyle?
Clicking
44
What is a crepitation sound or a crepitus in the TMJ usually associated with?
Degenerative process (osteoarthritis) of the condyle
45
What is a dull thud in the TMJ usually associated with?
Self-reducing subluxation of the condyle
46
What is another term for ear ringing?
Tinnitus
47
A patient has clicking in their TMJ where is this joint most likely to be displaced?
Anteromedial
48
What occurs during disc displacement of the TMJ?
* Collateral ligaments become elongated/torn. | * Allows lateral pterygoid to pull articular disc out of place
49
What type of joint is the TMJ?
Ginglymoarthroidal joint
50
What type of movements does the TMJ allow?
Hinge like rotation & sliding
51
What is considered to be the nonfunctioning portion of the TMJ?
Articular fossa (anterior 3/4 of large mandibular fossa)
52
What is considered to be the functional part of the TMJ?
Articular eminence
53
What is it that connects the mandible to the temporal bone?
Combined hinge and gliding joint
54
What is the only movable joint in the skull that has dense fibrous connective tissue on its articular surfaces?
TMJ
55
The vessels that supplies the TMJ?
* Deep temporal and masseteric of maxillary artery | * Branches of superficial temporal from external carotid
56
What is the venous drainage of the TMJ?
* Superficial temporal vein * Maxillary vein * Pterygoid plexus
57
What is the capsule of the TMJ innervated by?
Auriculotemporal nerve (V3)
58
What is the anterior region of the TMJ innervated by?
* Masseteric and deep temporal from V3 | * Sensory from V3
59
What path do the nerve fibers that innervate the TMJ follow?
* Vessels of the blood supply | * End as free nerve endings
60
What parts of the TMJ are not innervated?
Articular cartilage & central part of the articular disc
61
Are myelinated or unmyelinated nerves seen in the TMJ?
Both
62
What is the source of proprioception in the TMJ?
Retrodiscal tissue
63
What structure of the TMJ secretes the fluid that lubricates the TMJ?
Inner synovial layer of fibrous capsule
64
The fibrous capsule of the TMJ is fairly thin except where?
Laterally where it forms the temporomandibular ligament (lateral)
65
Where is the fibrous capsule of the TMJ firm? ___ and ___ | Why?
Medially and laterally | It stabilizes mandible during movement
66
Where is the fibrous capsule of the TMJ loose? ___ and ___ | Why?
Anterior and posterior | Allow mandibular movement
67
Large amounts of synovial fluids in the TMJ an indication of?
Painful internal derangements
68
What is the purpose of the joint capsule and ligaments of the TMJ?
Restrict excessive displacement of the mandible
69
Thicker layer of fibrous tissue which is reinforced by accessory ligaments?
Outer fibrous layer of the fibrous capsule of the TMJ
70
Translation take place in which compartment of the TMJ?
Upper compartment (mandibular fossa - articular disc)
71
Rotation take place in which compartment of the TMJ?
Lower compartments (condyle - articular disc) - hinge-type rotation
72
TRUE OR FALSE: | The mandible will always deviate to the side of injury.
True
73
Retrusion of jaw results from the bilateral contraction of?
Bilateral contraction of posterior fibers (horizontal fibers) of the temporalis muscle.
74
Anteroinferior aspect of mandibular condyle is ____?
Concave
75
Posterior aspect of mandibular condyle is ____?
Rounded & convex
76
Do central portion of articular disc is vascular?
Avascular & lack of innervation at central portion of articular disc
77
Nonfunctional part of TMJ?
Articular fossa
78
Functional part of TMJ?
Articular eminence/articular tubercle
79
_______belly of lateral pterygoid inserts on the neck of the condyle?
Inferior belly
80
Dislocation of either or both TMJ can occur?
When the condyle translates anterior to the crest of the articular eminence
81
Pure rotation of mandible involves which two planes of movement?
* Frontal plane - up and down | * Sagittal plane - forward & backward
82
Most stable & most easily reproduced position?
Initiating position (centric relation)
83
The maximum opening movement of mandible depending on the age and size?
50-60mm
84
Which movements are the limits to which mandible can move?
Border movements
85
Which movements generally occur within the border movements?
Functional movements
86
Which jaw position is ligament guided position?
Centric relation
87
In protrusive movements, the condyles of mandible have moved in which direction?
Downward & forward direction
88
Which movement require condyles to move backward and upward?
Retrusive movement
89
Anterior guidance/anterior coupling is determined by?
* Overbite | * Overjet
90
Anterior guidance is the guidance provided by the anterior teeth when the mandible goes into a _____ movement?
Lateral or protrusive movement
91
Muscle guided position?
Rest position of mandible or postural position.
92
Tooth guided position?
Centric occlusion / intercuspal position

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