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NBDE Review > 100 Facts of TMJ > Flashcards

100 Facts of TMJ Flashcards

1
Q

What are considered to be the accessory ligaments of the TMJ?

A
  • Sphenomandibular ligament

- Stylomandibular ligament

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2
Q

What is the function of the Sphenomandibular ligament + stylomandibular ligament?

A

Limit excessive openings

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3
Q

Where is the sphenomandibular ligament attached?

A

Lingula of the mandible

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4
Q

Where does the stylomandibular ligament attach?

A

Angle of the mandible

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5
Q

What ligament is most damaged when using an inferior alveolar nerve block?

A

Sphenomandibular ligament

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6
Q

Where does the temporomandibular ligament run?

A

From the articular eminence to the mandibular condyle

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7
Q

What are the (3) functions of the temporomandibular ligament?

A
  • Provides lateral reinforcement
  • Prevents posterior and inferior displacement of condyle
  • Main stabilizing ligament
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8
Q

What is another name for temporomandibular ligament?

A

Lateral ligament

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9
Q

What is another name for collateral ligaments?

A

Discal ligaments

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10
Q

Where does the collateral ligaments run?

A

Arise from the periphery of the disc and are attached to the medial and lateral poles of the condyle

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11
Q

What is the function of the collateral ligaments?

A
  • Stabilize the disc on top of the condyle

- Resist movements of disc away from condyle during function

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12
Q

What are collateral ligaments (discal ligaments) made from?

A

Collagenous connective tissue – it does not stretch

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13
Q

Which muscle will cause a deviation of the mandible when protruding to the side of the damage?

A

Lateral pterygoid

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14
Q

What are the two parts of the lateral pterygoid?

A

Superior belly and inferior belly

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15
Q

Where does the inferior belly of the lateral pterygoid run?

A

From lateral pterygoid plate to neck of condyle

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16
Q

Where does the superior belly of the lateral pterygoid run?

A

Greater wing of the sphenoid & infratemporal crest

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17
Q

Where does the superior belly of the lateral pterygoid insert?

A

Inserts on joint capsule, articular disk and condyle of neck

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18
Q

What is the function of the superior belly of the lateral pterygoid muscle?

A

Assist in stabilizing the position of the articular disk during closing

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19
Q

What is the function of the masseter?

A

Elevation of the mandible (jaw closing)

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20
Q

What is the function of the temporalis?

A
  • Elevation of mandible (jaw closing) anterior fibers (run vertical)
  • Retraction of the mandible (lower jaw backward) posterior fibers (run horizontally)
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21
Q

What is the function of the medial pterygoid?

A

Elevation of the mandible (jaw closing)

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22
Q

What is the function of the inferior heads of the lateral pterygoid?

A

Slight depression of the mandible (jaw closing)

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23
Q

What occurs with unilateral contraction of the lateral pterygoids?

A

Lateral deviation of mandible

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24
Q

What occurs with bilateral contraction of the lateral pterygoid muscles?

A

Protrusion of the mandible

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25
Q

Where do you test a patient’s temporomandibular joint tenderness and noise?

A

Joint palpated laterally over the posterior surface of the condyles with the mouth open

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26
Q

TRUE OR FALSE:

Condyles are not symmetrical nor identical.

A

True

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27
Q

Dislocation of the TMJ is almost always? ___

It happens during? ___ or ____

A
  • Anteriorly

- Laughing or yawning

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28
Q

What is dislocation also referred as?

A

Open lock

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29
Q

Hypermobility or hypertranslation of the mandible?

A

Subluxation

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30
Q

What is the difference between dislocation and subluxation?

A

With subluxation patient can return the mandible to its normal position without assistance
of the dentist

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31
Q

Which component of the TMJ has the most vasculature and innervation?

A

Retrodiscal tissue

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32
Q

Articular disc is composed of ____ fibrous connective tissue.

A

dense

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33
Q

Articular disc is positioned in between the:

A

condyle and the fossa

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34
Q

Articular disc divides the joint into:

A

superior and inferior spaces

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35
Q

What is the middle part of the articular disk called?

A

Thinner central intermediate zone

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36
Q

Which band is the thicker of the two on the articular disk? Anterior or posterior?

A

Posterior

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37
Q

What kind of tissue is attached to the posterior articular disk?

A

Retrodiscal tissue

38
Q

What are the articular surfaces of the TMJ covered with?

A

Dense fibrous connective tissue

39
Q

What does the layer of fibrocartilaginous tissue provide to the TMJ?

A

Offers resistance against both compressive and lateral forces

40
Q

What is the shape of the condyle?

A

Elliptically shaped long axis is oriented mediolaterally

41
Q

What test is considered to be the gold standard for providing an image of the soft tissue of the TMJ, especially the position of the articular disc?

A

MRI

42
Q

What is the major advantage of the MRI technique?

A

No exposure of the patient to x-ray radiation

43
Q

What sound is made by the articular disc when displaced to the anterior of the condyle?

A

Clicking

44
Q

What is a crepitation sound or a crepitus in the TMJ usually associated with?

A

Degenerative process (osteoarthritis) of the condyle

45
Q

What is a dull thud in the TMJ usually associated with?

A

Self-reducing subluxation of the condyle

46
Q

What is another term for ear ringing?

A

Tinnitus

47
Q

A patient has clicking in their TMJ where is this joint most likely to be displaced?

A

Anteromedial

48
Q

What occurs during disc displacement of the TMJ?

A
  • Collateral ligaments become elongated/torn.

* Allows lateral pterygoid to pull articular disc out of place

49
Q

What type of joint is the TMJ?

A

Ginglymoarthroidal joint

50
Q

What type of movements does the TMJ allow?

A

Hinge like rotation & sliding

51
Q

What is considered to be the nonfunctioning portion of the TMJ?

A

Articular fossa (anterior 3/4 of large mandibular fossa)

52
Q

What is considered to be the functional part of the TMJ?

A

Articular eminence

53
Q

What is it that connects the mandible to the temporal bone?

A

Combined hinge and gliding joint

54
Q

What is the only movable joint in the skull that has dense fibrous connective tissue on its articular surfaces?

A

TMJ

55
Q

The vessels that supplies the TMJ?

A
  • Deep temporal and masseteric of maxillary artery

* Branches of superficial temporal from external carotid

56
Q

What is the venous drainage of the TMJ?

A
  • Superficial temporal vein
  • Maxillary vein
  • Pterygoid plexus
57
Q

What is the capsule of the TMJ innervated by?

A

Auriculotemporal nerve (V3)

58
Q

What is the anterior region of the TMJ innervated by?

A
  • Masseteric and deep temporal from V3

* Sensory from V3

59
Q

What path do the nerve fibers that innervate the TMJ follow?

A
  • Vessels of the blood supply

* End as free nerve endings

60
Q

What parts of the TMJ are not innervated?

A

Articular cartilage & central part of the articular disc

61
Q

Are myelinated or unmyelinated nerves seen in the TMJ?

A

Both

62
Q

What is the source of proprioception in the TMJ?

A

Retrodiscal tissue

63
Q

What structure of the TMJ secretes the fluid that lubricates the TMJ?

A

Inner synovial layer of fibrous capsule

64
Q

The fibrous capsule of the TMJ is fairly thin except where?

A

Laterally where it forms the temporomandibular ligament (lateral)

65
Q

Where is the fibrous capsule of the TMJ firm? ___ and ___

Why?

A

Medially and laterally

It stabilizes mandible during movement

66
Q

Where is the fibrous capsule of the TMJ loose? ___ and ___

Why?

A

Anterior and posterior

Allow mandibular movement

67
Q

Large amounts of synovial fluids in the TMJ an indication of?

A

Painful internal derangements

68
Q

What is the purpose of the joint capsule and ligaments of the TMJ?

A

Restrict excessive displacement of the mandible

69
Q

Thicker layer of fibrous tissue which is reinforced by accessory ligaments?

A

Outer fibrous layer of the fibrous capsule of the TMJ

70
Q

Translation take place in which compartment of the TMJ?

A

Upper compartment (mandibular fossa - articular disc)

71
Q

Rotation take place in which compartment of the TMJ?

A

Lower compartments (condyle - articular disc) - hinge-type rotation

72
Q

TRUE OR FALSE:

The mandible will always deviate to the side of injury.

A

True

73
Q

Retrusion of jaw results from the bilateral contraction of?

A

Bilateral contraction of posterior fibers (horizontal fibers) of the temporalis muscle.

74
Q

Anteroinferior aspect of mandibular condyle is ____?

A

Concave

75
Q

Posterior aspect of mandibular condyle is ____?

A

Rounded & convex

76
Q

Do central portion of articular disc is vascular?

A

Avascular & lack of innervation at central portion of articular disc

77
Q

Nonfunctional part of TMJ?

A

Articular fossa

78
Q

Functional part of TMJ?

A

Articular eminence/articular tubercle

79
Q

_______belly of lateral pterygoid inserts on the neck of the condyle?

A

Inferior belly

80
Q

Dislocation of either or both TMJ can occur?

A

When the condyle translates anterior to the crest of the articular eminence

81
Q

Pure rotation of mandible involves which two planes of movement?

A
  • Frontal plane - up and down

* Sagittal plane - forward & backward

82
Q

Most stable & most easily reproduced position?

A

Initiating position (centric relation)

83
Q

The maximum opening movement of mandible depending on the age and size?

A

50-60mm

84
Q

Which movements are the limits to which mandible can move?

A

Border movements

85
Q

Which movements generally occur within the border movements?

A

Functional movements

86
Q

Which jaw position is ligament guided position?

A

Centric relation

87
Q

In protrusive movements, the condyles of mandible have moved in which direction?

A

Downward & forward direction

88
Q

Which movement require condyles to move backward and upward?

A

Retrusive movement

89
Q

Anterior guidance/anterior coupling is determined by?

A
  • Overbite

* Overjet

90
Q

Anterior guidance is the guidance provided by the anterior teeth when the mandible goes into a _____ movement?

A

Lateral or protrusive movement

91
Q

Muscle guided position?

A

Rest position of mandible or postural position.

92
Q

Tooth guided position?

A

Centric occlusion / intercuspal position

NBDE Review (14 decks)

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