TMJ Flashcards

1
Q

physical properties of the Joint Capsule and Lateral Ligaments of the TMJ

A

Thin, synovial joint capsule, reinforced by ligaments

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2
Q

Ligaments and capsule in TMJ important function

A

have sensory role in position and movement information regarding the TMJ

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3
Q

Lateral temporomandibular ligament prevents what kind of movment

A

Prevents excessive A-P and lateral movements

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4
Q

Lateral temporomandibular ligament is the Main suspension ligament during

A

during moderate opening
- talking, taking a drink

this is the most important for maintaining the suspension of the manible

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5
Q

Medial Ligaments of the TMJ

A

Sphenomandibular ligament
Stylomandibular ligament

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6
Q

Sphenomandibular ligament

A

Suspends mandible during wide opening

Screaming, eating an apple

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7
Q

Stylomandibular ligament

A

Acts as a stop to extreme opening
Keeps it from dislocation or sublexing

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8
Q

Articular Disc of the TMJ structure

A

Fibrocartilaginous structure

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9
Q

Articular Disc of the TMJ properties

A

Avascular, Aneural
Shock absorber, improves congruency of joint surfaces, improves stability

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10
Q

Articular Disc of the TMJ posterior and ant attachments

A

capsule ant
through bilaminar zone post

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11
Q

Articular Disc of the TMJ medial and lateral attachments

A

Inserts medially and laterally into poles of the condyle via medial and lateral collateral ligaments

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12
Q

Bilaminar zone other name

A

retro-discal tissue

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13
Q

Bilaminar zone attaches to

A

posterior capsule and to anterior tympanic plate.

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14
Q

Bilaminar zone function

A

Keeps disc from moving too far anteriorly.

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15
Q

Bilaminar zone is found where

A

Tissue right behind the disc

Maintains connection between the disc and posture part of the capsule

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16
Q

articular disc movement Properties

A

We want some movement of the disc – do not want to much movement

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17
Q

Articular Disc and pterygoid

A

Superior belly of lateral pterygoid attaches anteriorly to disc

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18
Q

what kind of movement does that articular disc control

A

Controls posterior movement during mouth closing

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19
Q

disc fowards or backwards when the mouth opens

A

forwards

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20
Q

disc forward or backwards when the mouth closes

A

backwards

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21
Q

TMJ Innervation

A

Innervation: V3 (mandibular branch of trigeminal nerve)

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22
Q

TMJ Vasculature

A

Blood supply: branches of external carotid
Mostly superficial temporal artery

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23
Q

Jaw Movements

A

Elevation, Depression
Protrusion, Retrusion
Chewing and Grinding

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24
Q

elevation movement

A

closing mouth

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25
Q

depression movement

A

opening the mouth

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26
Q

Protrusion movement

A

underbite

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27
Q

Retrusion movement

A

overbite

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28
Q

Mouth Opening and Closing (Depression and Elevation) axis

A

Coronal axis, passes through the condyles

Sagittal plane motion

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29
Q

Phase I of opening the mouth

A

rotation of condyle in lower compartment.

First 11 – 25 mm.

30
Q

Phase II of opening the mouth

A

translation of disc/condyle together in upper compartment

31
Q

what does Total excursion mean and how much do we see

A

40 to 50 mm

Teeth together –> teeth apart

32
Q

closing and opening the mouth different phases

A

Closing or elevation occurs in reverse pattern as opening

33
Q

Mandibular Protrusion and Retrusion are both what kind of movement

A

translation that occurs in the upper compartment

34
Q

what is happening during Protrusion

A

mandible juts forward, range is about 6-9 mm

x2-3then retrusion

35
Q

what is happening during Retrusion

A

mandible pulls back, range is about 3 mm

36
Q

Mandibular Lateral Deviation axis/es

A

2 possible axes

Vertical axis
A-P axis

37
Q

Vertical axis of Mandibular Lateral Deviation

A

Spin around ipsilateral condyle

Translation of contralateral condyle

Normal excursion is about 8 mm

38
Q

Lateral deviation at the mandible is what kind of movement

A

side to side movement

39
Q

A-P axis of Mandibular Lateral Deviation

A

Swing in frontal plane of ipsilateral condyle

Depression (distraction) of contralateral condyle

40
Q

Tightness in right TMJ - what do we do

A

deviate to the left to cause distraction

41
Q

Masseter Attachments

A

inferior border & medial surface of zygomatic arch

lateral surface of ramus of mandible and coronoid process

42
Q

Masseter Actions

A

elevates and protrudes mandible; deep fibers retrude it

43
Q

Temporalis Attachments

A

Temporal fossa and deep surface of temporal fascia

Tip and medial surface of coronoid process and ramus of mandible

44
Q

Temporalis actions

A

elevates mandible

posterior fibers retrude mandible after protrusion

45
Q

Lateral Pterygoid Superior Head Attachments

A

infratemporal surface & crest of greater wing of sphenoid bone

46
Q

Lateral Pterygoid inferior Head Attachments

A

lateral surface of lateral pterygoid plate

47
Q

Lateral Pterygoid insertions for both inf and sup head

A

Both heads of lateral pterygoid attach at neck of mandible

48
Q

Lateral Pterygoid insertions for sup head

A

Superior head also attaches to anterior part of articular disc and capsule of TMJ

49
Q

Lateral Pterygoid action bilarterally

A

Acting bilaterally, protrude mandible

50
Q

Lateral Pterygoid action unilaterally

A

Acting alone and alternately, produce side to side movements of mandible

51
Q

Lateral Pterygoid superior head actions

A

controls posterior movement of articular disc during mouth closing

52
Q

Medial Pterygoid attachments Deep Head

A

medial surface of lateral pterygoid plate

53
Q

Medial Pterygoid Superficial Head Attachments

A

tuberosity of maxilla

54
Q

Medial Pterygoid Attachments both heads

A

Both heads of medial pterygoid attach at medial surface of ramus of mandible

55
Q

Medial Pterygoid actions bilatterally

A

Acting bilaterally, elevate mandible, & help to protrude mandible

56
Q

Medial Pterygoid actions Acting alternately

A

produce grinding motion

57
Q

is there is any spefic muscle that depresses the mouth (opens)

A

no mainly done by gravity

help from:
Inferior lateral pterygoid
Anterior digastric

58
Q

Mandibular Elevators (Closing) muscles

A

Temporalis
Masseter
Medial Pterygoid
Superior lateral pterygoid plays role by keeping disc slightly forward during closing

59
Q

Right Lateral Deviators

A

Left Medial and Lateral Pterygoids and Right Posterior Temporalis Muscle

60
Q

Left Lateral Deviators

A

Right Medial and Lateral Pterygoids and the Left Posterior Temporalis Muscle

61
Q

Protruders

A

Bilateral Lateral Pterygoids

Assist by Medial Pterygoids and Masseter

62
Q

Retruders

A

Posterior Temporalis Muscle

Posterior Digastric

Deep Masseter

63
Q

3 primary types of dysfunction in the TMJ

A

Anterior Displacement with Reduction
Anterior Displacement without Reduction
Internal Derangement

64
Q

Anterior Displacement with Reduction
serveness

A

Least serve

65
Q

Anterior Displacement with Reduction
mechanism

A

the disc rotates to far anteriorly, stretches bilaminar zone tissue, tissue pulls it back, and then snaps back into place

66
Q

what is heard with Anterior Displacement with Reduction

A

pop or click

this is the dics snapping back into place

67
Q

Anterior Displacement without Reduction
mechanism

A

The disc is ahead of the condyle (ant), there is not click or pop because the disc does not flip back into place

68
Q

Anterior Displacement without Reduction Typically results in

A

limited opening - the disc is blocking

69
Q

Anterior Displacement without Reduction
pt reaction

A

Pt is very symptomatic

70
Q

Internal Derangement

A

Meniscus is permently anteriorly displaced in front of condyle

the retrodiscal tissue will changes if format and become more disc like in natural