WorksheetsOrofacial
Total questions: 112
Worksheet time: 1hrs 4mins
What does the stylomandibular ligament and sphenomandibular ligament control?
movement on the medial side
prevents injury- keeps the elastic lamina and disk from beig too far forward
- temporal bone- mandible
surface of one bone moves over the surface of the other
What is the articulation of the TMJ between?
surface of one bone moves over the surface of another bone
- temporal bone
- mandible
joining between two bones
- many types
surface of one bone moves over the surface of another bone
What is a joint?
surface of one bone moves over the surface of the other
move and function as one
- BILATERAL, two joints fused in the middle to interrelate movement
joining between two bones
- many types
mandible is fused at the midline
What is a suture?
of the skull and one type of joint
surface of one bone moves over the surface of the other
surface of one bone moves over the surface of another bone
move and function as one
- BILATERAL, two joints fused in the middle to interrelate movement
What kind of joint is the TMJ?
surface of one bone moves over the surface of the other
move and function as one
- BILATERAL, two joints fused in the middle to interrelate movement
surface of one bone moves over the surface of another bone
mandible is fused at the midline
What happens between the surfaces in the TMJ in articulation?
surface of one bone moves over the surface of the other
move and function as one
- BILATERAL, two joints fused in the middle to interrelate movement
small fiborous pad between bones of the TMJ
dense collagen tissue
What do the two joints do in the TMJ?
located above and below the articular disk
between the thickness of the posterior end and the middle (intermiddiate zone)
move and function as one
- BILATERAL, two joints fused in the middle to interrelate movement
epithelium
Why is the TMJ a bilateral joint?
dense collagen tissue
small fiborous pad between bones of the TMJ
upper surface is concave and convex to match the contours of the mandibular fossa and the articular eminence
mandible is fused at the midline
What is the articular disk?
small fiborous pad between bones of the TMJ
dense collagen tissue
upper surface is concave and convex to match the contours of the mandibular fossa and the articular eminence
concave to match the contour of the condyle
What is the articular disk made of?
dense collagen tissue
upper surface is concave and convex to match the contours of the mandibular fossa and the articular eminence
concave to match the contour of the condyle
posterior end (posterior band)
What does the upper surface of the articular disk look like?
concave to match the contour of the condyle
posterior end (posterior band)
upper surface is concave and convex to match the contours of the mandibular fossa and the articular eminence
in the middle (intermediate zone)
What does the lower surface of the articular disk look like?
posterior end (posterior band)
concave to match the contour of the condyle
in the middle (intermediate zone)
between the thickness of the posterior end and the middle (intermiddiate zone)
Where is the thickest part of the articular disk in the TMJ?
between the thickness of the posterior end and the middle (intermiddiate zone)
posterior end (posterior band)
located above and below the articular disk
in the middle (intermediate zone)
Where is the thinnest part of the articular disk in the TMJ?
in the middle (intermediate zone)
located above and below the articular disk
between the thickness of the posterior end and the middle (intermiddiate zone)
epithelium
What is the thickness of the anterior band in the articular disk?
located above and below the articular disk
epithelium
synovium
between the thickness of the posterior end and the middle (intermiddiate zone)
Where are the synovial cavities in the TMJ?
epithelium
located above and below the articular disk
synovium
secretes synovial fluids
What lines the synovial cavities?
epithelium
secretes synovial fluids
allows the surfaces to rub without irritation
synovium
What is the covering that lines the synovial cavity?
synovium
secretes synovial fluids
epithelium
allows the surfaces to rub without irritation
What does the epithelium do in the synovial cavities?
thick fiborous capsule
allows the surfaces to rub without irritation
secretes synovial fluids
epithelium
What does the synovial fluid allow the TMJ to do?
epithelium
thick fiborous capsule
secretes synovial fluids
allows the surfaces to rub without irritation
What is the TMJ surrounded by?
epithelium
secretes synovial fluids
thick fiborous capsule
synovium
What side does the temporomandibular ligament thicken?
prevents the condyle from being displaced too far inferiorly and posteriorly
- resistance to lateral displacement
lateral side
- between the articular tuburcle and the lateral pole of the condyle
- stylomandibular ligament
- sphenomandibular ligament
temporomandibular ligament
What does the temporomandibular ligament do?
prevents the condyle from being displaced too far inferiorly and posteriorly
- resistance to lateral displacement
- stylomandibular ligament
- sphenomandibular ligament
temporomandibular ligament
- medially
- laterally
What is the thick fibrous capsule on the lateral side of the TMJ called?
- stylomandibular ligament
- sphenomandibular ligament
some fibers of the superior head of the lateral pterygoid muscle
- penetrate the capsule and insert into the disk
temporomandibular ligament
- medially
- laterally
What ligaments control movement to the medial side?
- stylomandibular ligament
- medially
- laterally
- sphenomandibular ligament
Where is the articular disk attached to in the poles of the condyles?
- laterally
- medially
retrodiscal pad
some fibers of the superior head of the lateral pterygoid muscle
- penetrate the capsule and insert into the disk
Where is the articular disk attached to in the poles of the condyles?
some fibers of the superior head of the lateral pterygoid muscle
- penetrate the capsule and insert into the disk
retrodiscal pad
movement on the medial side
relatively loose connectice tissue where much of the blood and nerve supply is located
What is the area that is posterior to the articular disk?
relatively loose connectice tissue where much of the blood and nerve supply is located
retrodiscal pad
medially and laterally to the poles of the condyle
movement on the medial side
What is the retrodiscal pad made of?
relatively loose connectice tissue where much of the blood and nerve supply is located
medially and laterally to the poles of the condyle
fibers of the superior head of the lateral pterygoid muscle
movement on the medial side
What does the stylomandibular ligament and sphenomandibular ligament control?
medially and laterally to the poles of the condyle
fibers of the superior head of the lateral pterygoid muscle
movement on the medial side
posterior to the disk
Where are the attachments of the articular disk to the poles of the condyle?
posterior to the disk
medially and laterally to the poles of the condyle
external cartoid artery
fibers of the superior head of the lateral pterygoid muscle
Where do the attachments of the articular disk attach?
posterior to the disk
external cartoid artery
fibers of the superior head of the lateral pterygoid muscle
three branches of the trigeminal nerve
Where is the retrodiscal pad located?
external cartoid artery
- elastic lamina/tissue layer above the retrodiscal pad
three branches of the trigeminal nerve
posterior to the disk
What blood supplies the TMJ?
- ascending pharyngeal
- superficial temporal
- deep auricular
- anterior tympanic arteries
WHat common place do all the blood comes from?
three branches of the trigeminal nerve
external cartoid artery
attaches to the tympanic plate of the temporal bone
- elastic lamina/tissue layer above the retrodiscal pad
What nerve supplies the TMJ?
- elastic lamina/tissue layer above the retrodiscal pad
attaches to the tympanic plate of the temporal bone
three branches of the trigeminal nerve
collagenous lamina
- below retrodiscal pad and attaches to the posterior neck of the condyle where the capsule attaches to it
What are the three branches of the trigeminal nerve?
- deep temporal
- articulotemporal
collagenous lamina
- masseteric nerves
What is on the upper posterior part of the disk?
attaches to the tympanic plate of the temporal bone
- elastic lamina/tissue layer above the retrodiscal pad
- rotation
- gliding
collagenous lamina
- below retrodiscal pad and attaches to the posterior neck of the condyle where the capsule attaches to it
What is on the posterior part of the disk?
collagenous lamina
rotational movement in the lower synovial cavity between the disk and the condyle below
attaches to the tympanic plate of the temporal bone
pulls posteriorly on the disk
- condyle rotates on one another
What is on the lower posterior border part of the disk?
rotational movement in the lower synovial cavity between the disk and the condyle below
moves further in a rotational movement
pulls posteriorly on the disk
- condyle rotates on one another
collagenous lamina
- below retrodiscal pad and attaches to the posterior neck of the condyle where the capsule attaches to it
What are the two types of movement in the TMJ?
- hinge and sliding joint
- rotation
- gliding joint
- gliding
What is the name of the joint in the TMJ?
- hinge and sliding joint
- gliding joint
moves further in a rotational movement
between the disk and the temporal bone
What movement happens as the teeth begin to separate?
moves further in a rotational movement
rotational movement in the lower synovial cavity between the disk and the condyle below
additional anterior gliding movement along the posterior slope of the articular eminence
pulls posteriorly on the disk
- condyle rotates on one another
What does the posterior elastic lamina do in the TMJ?
pulls posteriorly on the disk
- condyle rotates on one another
between the disk and the temporal bone
moves further in a rotational movement
additional anterior gliding movement along the posterior slope of the articular eminence
What happens in movement as the jaw opens further?
additional anterior gliding movement along the posterior slope of the articular eminence
between the disk and the temporal bone
move forward until slightly anterior to the crest of the articular eminence
moves further in a rotational movement
What is the other movement that happens as the TMJ is opened with rotational movement?
between the disk and the temporal bone
additional anterior gliding movement along the posterior slope of the articular eminence
superior head of lateral pterygoid
move forward until slightly anterior to the crest of the articular eminence
Where does the gliding movement happen?
move forward until slightly anterior to the crest of the articular eminence
between the disk and the temporal bone
superior head of lateral pterygoid
- controls the release of contraction
- balances the posterior pull exerted by the elastic lamina
Where does the condyle and disk move in the gliding movement?
- controls the release of contraction
- balances the posterior pull exerted by the elastic lamina
superior head of lateral pterygoid
prevents injury
- keeps the elastic lamina and disk from beig too far forward
move forward until slightly anterior to the crest of the articular eminence
What controls the posterior movement of the disk?
superior head of lateral pterygoid
move forward until slightly anterior to the crest of the articular eminence
- keeps the elastic lamina and disk from beig too far forward
- controls the release of contraction
- balances the posterior pull exerted by the elastic lamina
How does the posterior movement of the TMJ do?
prevents injury
- controls the release of contraction
- keeps the elastic lamina and disk from beig too far forward
- balances the posterior pull exerted by the elastic lamina
What does the lower posterior collagenous lamina do?
- controls the release of contraction
prevents injury
- keeps the elastic lamina and disk from beig too far forward
move forward until slightly anterior to the crest of the articular eminence
How does the mandible depress?
hyoid muscles
depresses it
mandible is depressed by hyoid muscles
- lateral pterygoid pulls forward and down
lateral pterygoid
What muscles are used during chewing?
depresses it
there is a possibility of injury to the structure
mandible is depressed by hyoid muscles
- lateral pterygoid pulls forward and down
lateral pterygoid
What movement does the hyoid muscles do to the mandible?
lateral pterygoid
forward and down
chewing side
depresses it
How does the mandible goes forward and down?
forward and down
lateral pterygoid
chewing side
there is a possibility of injury to the structure
How does the jaw look like when it is eating?
- lateral pterygoid: opposite the chewing side and pulls forward even more, mandible to go to lateral excrusion
- condyle
- chewing side: codyle, disc, and temporal bone touch
- nonchewing side: condyle, temporal, and disk do not touch and are slightly apart
WHat happens if the nonchewing side is unstable?
forward and down
there is a possibility of injury to the structure
disk
chewing side
What movement does the lateral pterygoid do to the mandible?
pulls the disk forward filling the space and stabilizing and balancing the joint
relaxing contracted fibers, upper head of lateral pterygoid controls he posterior movement of the disk with the posterior pull from the superior elastic lamina and a smooth closing movement takes place
pulls back on the coronoid process (posteriorly)
- allows the occlusal surface of the mandibular teeth to grind the food as the mandible moves from lateral excursion back into a more centric position
forward and down
Where does the mandible move in lateral excursion?
temporal surfaces pulled slightly apart
chewing side
condyle
disk
What positions are all the other things when the condyle is in position?
- condyle
- temporal bone all in contact
- disk
- temporal surfaces pulled slightly apart
What position is the non chewing side of the TMJ?
- disk
- condyle
- temporal bone all in contact
- temporal surfaces pulled slightly apart
What happens when the superior head of the lateral pterygoid muscle contracts?
pulls the disk forward filling the space and stabilizing and balancing the joint
relaxing contracted fibers, upper head of lateral pterygoid controls he posterior movement of the disk with the posterior pull from the superior elastic lamina and a smooth closing movement takes place
pulls back on the coronoid process (posteriorly)
- allows the occlusal surface of the mandibular teeth to grind the food as the mandible moves from lateral excursion back into a more centric position
grinds food
What do the posterior fibers of the temporalis muscle do on the non chewing side when it contracts?
relaxing contracted fibers, upper head of lateral pterygoid controls he posterior movement of the disk with the posterior pull from the superior elastic lamina and a smooth closing movement takes place
pulls back on the coronoid process (posteriorly)
- allows the occlusal surface of the mandibular teeth to grind the food as the mandible moves from lateral excursion back into a more centric position
can be referred pain
grinds food
How does a smooth closing of the jaw happen?
relaxing contracted fibers, upper head of lateral pterygoid controls he posterior movement of the disk with the posterior pull from the superior elastic lamina and a smooth closing movement takes place
posterior movement of the disk
- smooth closing movement
grinds food
condition in the sensory messages look like coming from TMJ but travel to the brain from other regions of the body
What does the occlusal surface of the mandibular teeth do?
posterior movement of the disk
- smooth closing movement
grinds food
- check radiograph
- palpate area
can be referred pain
What does the upper head of lateral pterygoid muscle control?
can be referred pain
posterior movement of the disk
- smooth closing movement
- check radiograph
- palpate area
condition in the sensory messages look like coming from TMJ but travel to the brain from other regions of the body
What is a possiility of the TMJ pain?
condition in the sensory messages look like coming from TMJ but travel to the brain from other regions of the body
can be referred pain
- palpate area
- check radiograph
What is referred pain?
- spasms in the neck muscles
- muscles of mastication
condition in the sensory messages look like coming from TMJ but travel to the brain from other regions of the body
- malocllusion with the shift, wear, or loss in teeth
What do you do to check refered pain?
- check radiograph
- muscle spasms
- ear
- palpate area
Where does pain often come from when the TMJ hurts?
- ear
- muscle spasms
- spasms in the neck muscles
- malocclusion
What are the 4 nerves that supply the sensory areas that are around the ear?
- V
- X
- VII
- IX
Where can pain of the TMJ come from?
- spasms in the neck muscles
- malocllusion with the shift, wear, or loss in teeth
- muscles of mastication
- medial and lateral attachments of the disc to the condyle
What area of the TMJ can get pain?
- anterior and posterior attachments
- medial and lateral attachments of the disc to the condyle
- ear pain/tinnitus
- headaches/migranes
What is myofacial pain dysfucntion?
all kinds of possibilities of cancer
- phydical therapy
- muscle relaxants
- jaw pain
What are the pains from the TMJ?
- headaches/migranes
- jaw pain
- eye pain
- ear pain/tinnitus
- dental damage
- neck and shoulder pain
What can help with relieving pain from the TMJ?- muscle relaxants
- muscle relaxants
without pain
- phydical therapy
when the disk is pulled too far forward when opening
What can happen with popping, clicking, or grinding of the TMJ?
when the disk is pulled too far forward when opening
without pain
pop posteriorly from trapped position
may be too faint to hear but can be felt on palpitation
When does popping or clicking happen?
when the disk is pulled too far forward when opening
pop posteriorly from trapped position
- thick area caught between the head of the condyle and the articular eminence
- band can pop forward or posteriorly to make the sound
What happens to the posterior band in the TMJ when it is popping, clicking, or grinding?
pop posteriorly from trapped position
- thick area caught between the head of the condyle and the articular eminence
- band can pop forward or posteriorly to make the sound
may be too faint to hear but can be felt on palpitation
What is a reciprocal pop?
pop posteriorly from trapped position
on one side
may be too faint to hear but can be felt on palpitation
- ultrasonography
What can the sound be like when listening for it?
on one side
may be too faint to hear but can be felt on palpitation
- arthritic changes
- plastic splint
Where is the popping problem usually visible?
- ultrasonography
on one side
- physical therapy
- plastic splint
What are treatments to the popping and clicking of the TMJ?
- ultrasonography
- adhesions in synovial membranes of joints
- physical therapy
- plastic splint
Where can the grinding sound of the TMJ come from?
- adhesions in synovial membranes of joints
- arthritic changes
- ultrasonography
- preforations of the disk
What are treatments for the grinding TMJ?
ultrasonography
constant anterior displacement of the disk
can recur
permenant anterior dislacement
What can happen to the grinding of the TMJ after a while from ultrasonography?
constant anterior displacement of the disk
can recur
medial or lateral attachments to the condyle poles
permenant anterior dislacement
What causes permenant damage to the disk components?
permenant anterior dislacement
medial or lateral attachments to the condyle poles
constant anterior displacement of the disk
lateral pole attachment
What happens when the posterior laminae is torn?
medial or lateral attachments to the condyle poles
permenant anterior dislacement
lateral pole attachment
requires surgery
What posterior laminae attachments can be torn?
lateral pole attachment
requires surgery
medial or lateral attachments to the condyle poles
condition in which a person opens his or her mouth too wide and is not able to close it again or closing it causes a popping back into position
What is the attachment that is usually torn in the posterior laminae?
lateral pole attachment
- cannot close it
requires surgery
- popping when closing
How is the posterior laminae fixed when torn?
requires surgery
- cannot close it
- popping when closing
condition in which a person opens his or her mouth too wide and is not able to close it again or closing it causes a popping back into position
What happens when a person opens their mouth too wide?
- cannot close it
- condyle cannot reposition into its proper place
- popping when closing
- remians forward and cannot move back because the muscles are trying to pull up and back and the articular eminence does not allow the condyle to move back
What is subluxation?
someties used to help relax the muscles and to allow a pivot point to help manipulate the lower jaw
codyle glides too far forward and moves anterior to the articular eminence
- remians forward and cannot move back because the muscles are trying to pull up and back and the articular eminence does not allow the condyle to move back
condition in which a person opens his or her mouth too wide and is not able to close it again or closing it causes a popping back into position
What happens in subluxation and the condyle?
codyle glides too far forward and moves anterior to the articular eminence
- condyle cannot reposition into its proper place
- remians forward and cannot move back because the muscles are trying to pull up and back and the articular eminence does not allow the condyle to move back
thumbs on occlusal surface of the mandibular posterior teeth with index fingers beneath the inferior border of the mandible and push down and lowly pushing the jaw back into the posterior position
How is the jaw in subluxation moved back?
someties used to help relax the muscles and to allow a pivot point to help manipulate the lower jaw
thumbs on occlusal surface of the mandibular posterior teeth with index fingers beneath the inferior border of the mandible and push down and lowly pushing the jaw back into the posterior position
- position of capsule around the joint (controls the amount of contraction of the lateral pterygoid muscle)
- depth of condylar fossa and height of articular emience
What is a posterior bite block?
someties used to help relax the muscles and to allow a pivot point to help manipulate the lower jaw
surgery
- depth of condylar fossa and height of articular emience
- position of capsule around the joint (controls the amount of contraction of the lateral pterygoid muscle)
What are the possible causes of subluxation?
- position of capsule around the joint (controls the amount of contraction of the lateral pterygoid muscle)
- depth of condylar fossa and height of articular emience
- decrease the height of the articular eminence
- sometimes during waking hours
What is the treatment for subluxation?
tooth grinding
surgery
usually during sleep
- decrease the height of the articular eminence
What is bruxism?
usually during sleep
tooth grinding
- sometimes during waking hours
-wear down teeth over time
When does bruxism happen?
usually during sleep
tenderness in the TMJ area
-wear down teeth over time
- sometimes during waking hours
What does bruxism create?
tenderness in the TMJ area
- sore and tired TMJ
-wear down teeth over time
muscles of mastication become tired
WHat happens over a long time with bruxism?
-wear down teeth over time
muscles of mastication become tired
- sore and tired TMJ
- pain felt in the joint
What happens to the muscles when bruxism causes tenderness in the TMJ?
muscles of mastication become tired
- pain felt in the joint
- pain is still a problem
- covers the upper teeth (maxillary)
What is the treatment of bruxism?
- plastic night guard
eliminates the wear on teeth and tenderness of teeth from stress on the periodontal ligament
- covers the upper teeth (maxillary)
relief with tranquilizers to relieve tension
What does the night guard do?
eliminates the wear on teeth and tenderness of teeth from stress on the periodontal ligament
relief with tranquilizers to relieve tension
- cortisone
- pain is still a problem
What are other treatments for bruxism?
- cortisone
- pain is still a problem
relief with tranquilizers to relieve tension
- stress bearing joint
What can treat artharitis?
- cortisone
- pain is still a problem
- too much stress may cause it to wear out early in life and cause problems
- stress bearing joint
What does it mean when there is a grinding sensation in the joint?
- condyles fractured severely and removed surgically and the patient coninued to function well without a real joint = not enough is known about the TMJ and more complex than formerly believed
wear away
- rebuild teeth to original height and eases the pain
result of excess wear on the disk in the joint so that htere is no longer a smooth glinding movement within synovial cavities
What type of joint is the TMJ?
- rebuild teeth to original height and eases the pain
- too much stress may cause it to wear out early in life and cause problems
wear away
- stress bearing joint
WHat do we not know about the TMJ?
wear away
- condyles fractured severely and removed surgically and the patient coninued to function well without a real joint = not enough is known about the TMJ and more complex than formerly believed
not in the join but in the muscles of mastication
- rebuild teeth to original height and eases the pain
What can happen to the occlusal surfaces over time and causes TMJ pain?
- rebuild teeth to original height and eases the pain
- other neck and head muscles
wear away
- occlusion of teeth
Where does artharitis and other pain usually show up?
- rebuild teeth to original height and eases the pain
- other neck and head muscles
not in the join but in the muscles of mastication
- occlusion of teeth
