TMJ

Question 1

Posterior attachment

Answer 1

• Post attachment is a system of collagen and elastic fibers
• The retrodiscal tissues are vascular and highly innervated
• The retrodical is the main reason for TMJ dysfunction

Question 2

TMJ Ligaments

Answer 2

• True ligaments
  
  • Temporomandibular ligament
  • Fibrous capsule of the joint
• Accessory ligaments
  
  • Sphenomandibular ligament
  • Stylomandibular ligament

Question 3

TMJ Innervation

Answer 3

• Trigeminal CNV
  
  • Mandibular branch V3
    
    • Auriculotemporal nerve
    • Masseteric nerve

Question 4

TMJ Blood Supply

Answer 4

• Maxillary artery
  
  • Superficial temporal artery

Question 5

Normal function-Opening

Answer 5

• 2 seperate but coordinated movements
  
  • First the condyles rotate anteriorly on the disk (15-20mm)
  • Next the condyle and the disk translate anteriorly and inferiorly over the articular eminence of the temporal bone
• The articular disc can become anteriorly displaced

Question 6

Joint sounds

Answer 6

• Clicks and pops
  
  • When the condyle and disc translate together in the opening movement, very little sound is generated
  • If clicks and pops are heard it often indicates that the disk is already in an anteriorly dislocated position and
  • the forward movement of the condyle puts pressure on the disk and it pops back into its normal position

Question 7

Crepitus

Answer 7

• The continous noise during the movement of the joint caused by roughened articular surfaces
• This is the washboard effect
• It is common with degenerative joint disease

Question 8

Opening of the TMJ

Answer 8

• Normal is 40-55mm
• Deviations occur to the injured side
• Normal lateral range of movement is >7mm
• Conditions that prevent normal translaton of one condyle will not prevent the other condyle
• Lateral immobility will be away from the affected side
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