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TMJ, Face, Skull

TMJ, Face, Skull. TMJ. Mandibular fossa of temporal bone with condyle of mandible Incongruent surfaces Two joint cavities with articular disc interposed Lower cavity = hinge joint Upper joint = gliding. TMJ. TMJ. Mandible. Mandible. TMJ. Capsule Surrounds the joint Encloses the disc

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TMJ, Face, Skull

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  1. TMJ, Face, Skull

  2. TMJ • Mandibular fossa of temporal bone with condyle of mandible • Incongruent surfaces • Two joint cavities with articular disc interposed • Lower cavity = hinge joint • Upper joint = gliding

  3. TMJ

  4. TMJ

  5. Mandible

  6. Mandible

  7. TMJ • Capsule • Surrounds the joint • Encloses the disc • Attaches above the margins of the mandibular fossa • To the neck of the mandible • Inner aspect of capsule attaches to disc • Above disc – capsule loose • Below disc - taut

  8. TMJ Capsule

  9. TMJ Capsule

  10. TMJ • Ligaments • Lateral ligament - AKA TMJ ligament • From zygomatic bone to run inferiorly and posteriorly to blend with the joint capsule to attach to lateral and posterior parts of the neck of the mandible • Sphenomandibular • Strong thin flat band lying on medial aspect of the joint • Passes inferiorly and forwards from the spine of the sphenoid to the lingula • Stylomandibular • Extends from the apex of the styloid process to the lower part of the posterior border of the ramus of the mandible, near the angle

  11. TMJ Capsule

  12. TMJ • Innervated by CN V, Mandibular branch • Movements • Elevation, depression, retraction, protraction, side to side • Elevation and depression involves the hinge like rotation of the condyle against the disc in the lower compartment • Protraction and retraction – actions whereby the condyle and disc move as one unit against the mandibular fossa. In protraction the condyle and disc glide forwards so that the condyle rides on the articular eminence – retraction = opposite

  13. CN V Trigeminal

  14. TMJ Motions

  15. TMJ Motions

  16. TMJ • Side to side – grinding movements • Mandible is alternately protracted and retracted with the two sides moving in opposite directions so that one side is protracted while the other is retracted • Actions combined with elevation and depression, rhythmically and alternately

  17. Muscles of Mastication • Masseter • Temporalis • Lateral pterygoid • Medial pterygoid • All innervated by CNV • Opening of jaw (depression) primarily passive or gravity assist

  18. Masseter

  19. Temporalis

  20. Pterygoids

  21. Pterygoids

  22. Pterygoids

  23. Nerve Supply to Face • Sensory by three divisions of CN V – opthalmic, maxillary, mandibular • Innervation of muscles of facial carried out by CN VII – the Facial Nerve • Origin, branches, motor functions, sensory functions, parasympatheric functions

  24. CN V

  25. CN V

  26. Sensory to Face

  27. Sensory

  28. Scalp • Three Layers • Outer = skin • Beneath that – subcutaneous layer with many nerves and vessels running through here, binds skin to inner layer • Galea Aponeurotica – AKA epicranial aponeurosis • Galea attaches to pericranium via loose CT • This allows scalp to move over the skull • Most muscles of face attach to skin, this arrangement allows them to be more mobile.

  29. Scalp

  30. Scalp

  31. CN VII – The Facial Nerve • Motor nerve to muscles of facial expression with one notable exception • Origin = lower pons • Branches – common nerve enters face • Temporal • Zygomatic • Buccal • Mandibular • Cervical

  32. Motor to Face CNVII

  33. CN VII • Motor Functions • Muscles of facial expression • External ear • Sensory functions • Ant. 2/3 of tongue • Soft palate • Pharynx • Parasympathetic • Gland stimulation

  34. CN VII

  35. Muscles of Facial Expression • Primary action is to act as either a sphincter or dilator of the orifices of the face • Facial expression is a by-product • Orifices • Lips = labia • Nose = nares; Nostrils, Septum, Ala, Apex, Root • Eyelids = palpebrae • External Ear = auricle, lobule = soft portion

  36. Selected Muscles of Facial Expression * = learn • Orbicularis Oculi • Levator Palpebrae Superioris* • O: Root of Orbital Cavity • I: Skin of upper eyelid • A: Raises upper eyelid • N: Note Well, Nerve = CN III • Ptosis is a condition of denervation to this muscle causing drooping of the eyelid, a clinical symptom indicating more loss

  37. Facial MM

  38. Facial MM

  39. Facial MM

  40. Facial MM

  41. Muscles Continued • Occipitofrontalis • Corrugator • Auricular muscles of the ear – ant., post., sup. • Nose • Nasalis • Procerus • Depressor Septi

  42. Facial MM

  43. Facial MM

  44. Ear MM

  45. Nose MM

  46. Nose MM

  47. Muscles • Mouth • Depressor anguli oris • Depressor labii inferior • Mentalis • Risorius • Orbicularis oris • Buccinator* • Zygomaticus major • Zygomaticus minor • Levator labii superioris • Platysma

  48. Platysma

  49. Mouth

  50. Facial MM

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