Week 11 & 12

Question 1

What is the stomatognathic system?

Answer 1

A complex interaction between bones, joints, muscles, vascular system, lymphatic system and palate/gums/glands that make up the mouth/nose area of the face.

Question 2

What kind of joint is the TMJ?

Answer 2

a bilateral diarthrodial joint lined with fibrocartilage

Question 3

Articular surfaces of the TMJ.

Answer 3

mandibular condyle and mandibular fossa

Question 4

What structure is commonly problematic in the TMJ?

Answer 4

the articular disc (it can sublux, get in the way of movement, has attachment to the lateral pterygoid muscle)

Question 5

Why can the retrodiscal pad be a source of pain?

Answer 5

it is richly innervated and attaches to the articular disc allowing movement and restraint during TMJ movement.

Question 6

What is the primary nerve supply for the TMJ?

Answer 6

trigeminal nerve (cranial nerve 5), particularly the mandibular portion/3rd portion of this nerve.

some innervation from the upper 3 cervical nerve roots (hence link with cervical spine)

Question 7

What are the 4 key muscles of mastication?

Answer 7

temporalis, masseter (jaw elevation)

lateral pterygoid (protrusion/laterotrusion to opposite side)

medial pterygoid (jaw elevation/laterotrusion to opposite side)

Question 8

What is the purpose of the suprahyoid muscles?

Answer 8

depress mandible (open mouth)

elevate hyoid bone (swallow)

Question 9

What is the purpose of the infrahyoid muscles?

Answer 9

depress hyoid bone (swallow)

connection with scapula/shoulder girdle

Question 10

What are the three-movement phases of the TMJ?

Answer 10

anterior rotation, anterior translation, anterior rotation

Question 11

How can we feel each phase distinctly?

Answer 11

ask patient to hold their tongue on the roof of their mouth, open as much as then can while maintaining the tongue position (rotation phase)

continue with opening with tongue no longer on roof of mouth (translation phase)

Question 12

What is a good resting jaw position?

Answer 12

tongue up, teeth apart, lips closed

Question 13

What are some precautions to TMJ presentations?

Answer 13

recent trauma

lock jaw

persistent/worsening symptoms despite treatment

Question 14

What are some red flags for TMJ presentations?

Answer 14

unrelenting pain

non-mechanical pain

systemic features i.e. fever, weight loss, whole body aches

night pain

abnormal neurological findings i.e. cranial nerve dysfunction, cognitive changes

facial/neck masses

unilateral hearing loss