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The temporomandibular joint (TMJ) is a joint
on each side of the head that allows for movement of the mandible for speech and mastication
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A joint is
a site of junction or union between two or more bones.
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The TMJ is innervated by the
mandibular nerve (or division) of the fifth cranial or trigeminal nerve
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The blood supply to the joint is from branches of the
external carotid artery
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The TMJ has two sets of
articulation
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________ articulates with the mandible at the TMJ by way of the _______
- The temporal bone
- disc of the joint
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What are the bones involved in the temporal bone
- The articular eminence
- The articular fossa
- the postglenoid process
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The articulating surface of the condyle is strongly _______ and only slightly _______.
- convex in the anteroposterior direction
- convex mediolaterally
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A ________ completely encloses the TMJ
fibrous joint capsule
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The fibrous disc of the joint or ______ is located between the ______ bone and _________ on each side
- meniscus
- temporal
- mandibular condyle
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The disc completely divides the TMJ into two compartments or ________: ______ and _______
- synovial cavities
- upper and lower
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The membranes lining the inside of the joint capsule secrete ______ that helps ________
- synovial fluid
- lubricate the joint and fills the synovial cavities
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The mandible is joined to the cranium by _________ of the TMJ
ligaments
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A ligament is a
band of fibrous tissue that connects bones
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Three paired ligaments are associated with the TMJ
temporomandibular, stylomandibular, and sphenomandibular
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________ is considered the major ligament for the TMJ and located on the _______
- The temporomandibular ligament
- lateral side of each joint
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The TMJ ligament prevents the
excessive retraction or moving backward of the mandible
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The stylomandibular ligament is a ligament that becomes
taut when the mandible is protruded.
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The sphenomandibular ligament is not strictly considered part of the TMJ but is located .
on the medial side of the mandible, some distance from the joint
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the sphenomandibular ligament becomes ________ when the mandible is protruded.
accentuated and taut
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Which ligament is a landmark for the administration of inferior alveolar block
The sphenomandibular ligament
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What are the two basic types of movement performed by the joint and its associated muscles
gliding and rotational
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What is rotation
first 20 mm. millimeters (approx.) of opening – the condyles remain up in mandibular fossa (condyle rotates on the disc)
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What is gliding or ________
- translation
- opening wide (usually around 35 to 40mm) w/ condyles sliding down slope of articular eminence w/ disc interposed between the condyle and the articular eminence
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Retrodiscal pad is part
ligament, part nerve and blood supply, and part elastic fibers to help return structures to normal in closing
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The gliding movement of the TMJ occurs mainly between the ________ in the upper ______
- disc and the articular eminence of the temporal bone
- synovial cavity
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The gliding movement allows the lower jaw to
move forward or backward
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Bringing the lower jaw forward involves ________ of the mandible which involves the bilateral contraction of both of the _________
- protrusion
- lateral pterygoid muscles
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Bringing the lower jaw backward involves _______ of the mandible which involves the contraction of the __________
- retraction
- posterior parts of both temporalis muscles
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The rotational movement of the TMJ occurs mainly between the disc and the condyle in the _______ and the movements accomplished are ________.
- lower synovial cavity
- depression or elevation of the mandible
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lateral movement of the jaw is _______ which involves contraction of
- shifting from side to side
- contralateral lateral pterygoid
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What muscles are involved in depressing the mandible
- BILATERAL CONTRACTION OF LATERAL PTERYGOIDS
- SUPRAHYOID GROUP
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What muscles are involved in the elevation of the mandible
- MASSETERS
- TEMPORALIS
- MEDIAL PTERYGOIDS
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When the TMJ is at rest, there is an ___________ ( a space between the upper and lower teeth). This is called the _______ position
- interocclusal clearance or freeway space
- physiologic rest
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A patient may have pathology associated with one or both of the TMJs or a
temporomandibular disorder (TMD).
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__% of patients with pain in their joint really have ______
- 95%
- tenderness in the muscles invloved
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Popping or clicking is a result of the disc getting _______ and _______
pulled anteriorly during function and the condyle clicking as it goes onto it and off of it
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An acute episode of TMD can occur when a patient opens the mouth too wide causes
subluxation or dislocation of both joints
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Treatment of subluxation consists of
relaxing these muscles and having the clinician carefully shift the mandible downward and back gently with the finger and thumbs of both hands, equally on both sides
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trismus
or the inability to normally open the mouth
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What are the steps to treating trismus
- Possibly use anti-inflammatory medicines – aspirin, ibuprofen
- Use cold at first to reduce swelling in the muscles. After a day or so
- Place warm compresses
- Begin to massage the jaw muscles
- Exercise the jaw muscles
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The main functions of the tongue are
pushing food into the oropharynx during swallowing and forming words during speaking, although it is also implicated in mastication, taste, and oral cleansing
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The posterior third of the tongue is the
base of the tongue or pharyngeal part
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The base of the tongue attaches to the ________ and does not lie ________
- floor of the mouth
- within the oral cavity
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Three parts of the pharynx
nasopharynx, oropharynx, and laryngopharynx
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The laryngopharynx is located more _______, close to the _______
- inferior
- laryngeal opening
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The nasopharynx is ________ and located _______
- continuous with the nasal cavity
- superior to the level of the soft palate
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The oropharynx is located between the ______ and the ________
the soft palate and the opening of the larynx
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The epiglottis is a _______ and located behind ______ and in front of ________
- flap of cartilage
- the base of the tongue
- the oropharynx
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The vallecula is the ________and forms the _______
- the space between the base of the tongue and the epiglottis
- the inferior border of the oropharynx
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The opening from the oral region into the oropharynx is the
fauces
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