Week 2: TMJ

Question 1

The TMJ is an articulation of the:

Answer 1

mandibular condyle and mandibular fossa or the temporal bone

Question 2

Osteology of the TMJ:

Answer 2

mandibular condyle
mandibular fossa
articular eminence of the temporal bone

Question 3

TMJ is a ____________ joint.

Answer 3

synovial or modified hinge

Question 4

The articular eminence and the mandibular condyle are both convex, which results in:

Answer 4

an incongruent joint

Question 5

The TMJ articulation is covered with ____________, not hyaline cartilage.

Answer 5

fibrocartilage

Question 6

The incongruence of the TMJ joint is addressed by:

Answer 6

the articular disc.

Question 7

The articular disc of the TMJ joint is:

Answer 7

biconcave

Question 8

what is the purpose of the articular disc?

Answer 8

it allows CONVEX surfaces to remain congruent through ROM
it increases stability
it minimizes loss of mobility
it reduces friction
it decreases biomechanical stress on TMJ

Question 9

The disc separates into the inferior TMJ and superior TMJ. The inferior TMJ is a simple _________ joint and the superior TMJ is a ___________ joint.

Answer 9

hinge; gliding

Question 10

The upper joint of the TMJ is an articulation between:

Answer 10

The articular eminence with superior disc

Question 11

The lower joint is an articulation of:

Answer 11

the condyle and inferior disc

Question 12

The disc is attached to the:

Answer 12

medial and lateral poles of the condyle

Question 13

The attachment of the articular disc to the medial and lateral poles of the condyle allow for the condyles to:

Answer 13

rotate freely on the disc in a AP direction

Question 14

The disc is also attached to the:

Answer 14

joint capsule and lateral pterygoid anteriorly

Question 15

The attachment of the articular disc to the joint capsule and lateral pterygoid anteriorly restricts:

Answer 15

posterior translation of the disc

Question 16

The articular disc is also attached to the _____________ retrodiscal pad posteriorly

Answer 16

bilaminar

Question 17

The superior lamina helps the disc in:

Answer 17

translating anteriorly with mandibular depression

Question 18

The inferior lamina:

Answer 18

limits forward translation

Question 19

Available joint motion of the TMJ is determined by:

Answer 19

elasticity of the joint capsule and ligaments

Question 20

Describe the capsule of the TMJ joint.

Answer 20

it is thin and loose anteriorly and posterior
it allows for anterior translation when mouth is open
TMJ is PREDISPOSED to anterior dislocation of the mandibular condyle due to lack of strength of the anterior capsule and the incongruence of the articular surfaces.

Question 21

what are the 3 ligaments in the TMJ?

Answer 21

Lateral Ligament
stylomandibular ligament
sphenomandibular ligament

Question 22

Which ligament has a primary function to stabilize lateral portion of the capsule and helps guide movement of condyle during opening?

Answer 22

Lateral ligament

Question 23

Which is the weakest of the 3 ligaments with questionable function?

Answer 23

stylomandibular ligament

Question 24

Which ligament is a swinging hinge that suspends the mandible?

Answer 24

sphenomandibular ligament

Question 25

TMJ resting position

Answer 25

lips closed | teeth several millimeters apart

Question 26

TMJ resting position is maintained by:

Answer 26

low level activity of the temporalis muscle

Question 27

The TMJ joint allows for which movements?

Answer 27

depression/elevation protrusion/ retrusion left and right lateral excursion

Question 28

There are two phases associated with depression and elevation:

Answer 28

early phase and late phase

Question 29

Depression in the early phase causes a __________ posterior in the lower joint.

Answer 29

roll

Question 30

depression in the late phase causes a ___________ anteriorly of the upper joint.

Answer 30

glide

Question 31

Elevation also has two phases:

Answer 31

early and late phase

Question 32

In the early phase of elevation, there is a ____________ posteriorly of the upper joint.

Answer 32

glide

Question 33

in the late phase of elevation, there is an ____________ roll of the lower joint.

Answer 33

roll

Question 34

protrusion occurs by:

Answer 34

an anterior and slightly inferior glide of the condyle and disc

Question 35

retrusion occurs by:

Answer 35

a posterior and slightly superior glide of condyle and disc

Question 36

No ____________ or ____________ occurs with protrusion and retrusion.

Answer 36

rotation or rolling

Question 37

Lateral excursion is a side to side _____________ of the condyle and disc within the fossa.

Answer 37

translation

Question 38

The ipsilateral condyle is a relatively fixed pivot point during _________ excursion.

Answer 38

lateral

Question 39

Left lateral excursion:

Answer 39

right condyle glides anteriorly and to the left | left condyle spins

Question 40

right lateral excursion

Answer 40

left condyle glides anterior and to the right. | right condyle spin

Question 41

Depression is caused by:

Answer 41

gravity digastrics suprahyoid lateral pterygoid

Question 42

Elevation of TMJ is caused by:

Answer 42

temporalis masseter medial pterygoid control of disc via superior lateral pterygoid

Question 43

Protrusion is able to occur due to these muscles:

Answer 43

B masseters B medial pterygoids B lateral pterygoids

Question 44

Retrusion of the TMJ occurs due to:

Answer 44

B temporalis B masseter B digastric (assist)

Question 45

lateral deviation can happen thanks to:

Answer 45

contralateral med/lateral pterygoid ipsilateral temporalis ipsilateral masseter

Question 46

What is formed around the angle of the mandible by the masseter and medial pterygoid?

Answer 46

a functional sling

Question 47

Contraction of what two muscles produces a powerful bite?

Answer 47

masseter and medial pterygoid

Question 48

interaction between what two muscles are also very effective at grinding and crushing food?

Answer 48

masseter and medial pterygoid.

Question 49

explain the process of the interaction of the masseter and medial pterygoid between grinding and crushing food.

Answer 49

The R medial pterygoid and the L masseter produce L lateral deviation which creates shear force between molars and foods.

Question 50

Normal depression of TMJ:

Answer 50

35 - 50 mm

Question 51

mastication requires _____ mm of _______________.

Answer 51

18; depression

Question 52

functional screen of mandibular depression:

Answer 52

2 knuckles: functional | 3 knuckles: normal

Question 53

normal protrusion of TMJ =

Answer 53

3 - 6 mm

Question 54

Normal retrusion of TMJ is:

Answer 54

3 - 4 mm

Question 55

normal lateral deviation of TMJ =

Answer 55

10 - 15 mm

Question 56

Temporomandibular dysfunction is a broad term used to describe:

Answer 56

dysfunctions associated with TMJ

Question 57

What are some dysfunctions associated with TMJ?

Answer 57

``` Pain Popping reduced bite force reduced ROM with mouth open headaches tinnitus trigger points ```

Question 58

Factors associated with TMD include:

Answer 58

``` stress/emotional disturbances daily oral parafunctional habits asymmetric muscle activity sleep bruxism chronic forward head posture C - Spine pathology ```

Question 59

Deviations and deflections can result from:

Answer 59

differently shaped mandibular condyle heads or may indicate a pathology

Question 60

Deviations are motions that produce:

Answer 60

"S" curve with depression or protrusion

Question 61

Deflections are motions that produce a:

Answer 61

"C" curve with depression or protrusion

Question 62

What occurs when a disc subluxes beyond articular eminence?

Answer 62

articular disc displacement

Question 63

articular displacement can result in 2 ways. What are those?

Answer 63

Disc displacement with reduction | disc displacement without reduction

Question 64

disc displacement with reduction is produces a:

Answer 64

CLICK during mandibular depression and mandibular elevation

Question 65

Disc displacement without reduction means:

Answer 65

the disc does not relocate and the patient will demonstrate limited mandibular motion due to mechanical obstruction due to the disc

Question 66

The later the click occurs in the opening phase (depression):

Answer 66

The greater degree of dislocation

Question 67

Head and neck position can affect tension in the ______muscles, which can ultimately:

Answer 67

cervical; influence the function of the mandible

Question 68

Many TMJ dysfunction symptoms are similar to those of individuals with:

Answer 68

primary cervical spine impairments

Question 69

What should be examined in patients with TMJ complaints?

Answer 69

C - spine and upper quarter