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Pt 620 TMJ
| Question | Answer |
|---|---|
| What bony features are anterior to the TMJ? | 1. Mandibular Fossa 2. Articular Tubercle |
| What is the shape of the condyle of the mandible? | football-shaped, long axis medial to lateral |
| What are the two characteristics of the fibrous capsule? | 1. Lax 2. lateral thickening |
| The lateral thickening of the fibrous capsule is called the ... | lateral ligament |
| Are there 1 or 2 synovial cavities in the TMJ? | 2 |
| What separates the 2 synovial cavities? | articular capsule |
| What is the upper cavity located between? | disc and skull |
| What is the lower cavity located between? | disc and condylar process |
| The articular disc is made up of what? | 1. fibrocartilage 2. dense fibroconnective tissue |
| What is its strongest attachment (anteriorly)? | capsule and mandible |
| Is the posterior attachment strong or loose? | loose |
| What is the widest point on the disc? | anterior and posterior (middle is thinnest) |
| The disc moves with the _______ of the mandible. | head |
| The movement of the TMJ is a combination of ________ and _________. | rotation and gliding |
| Intially there is ________ of the condyle against the ________. | rotation, disc |
| Secondly there is ______ of the disc ________. | glide, forward |
| The initial rotation of the condyle is what joint cavity? | lower |
| The glide of the disc is movement in what joint cavity? | upper |
| What occurs when the rotation and glide do not work in proper order? Why? | abnormal movement, resulting from laxity of soft tissues |
| In dysfunction the _________ may move _________ to the disc. | head, anterior |
| With abduction to the left the _______condyle slides forward an the _______ rotates around a vertical axis. | right, left |
| What are the muscles of mastication? | 1. Masseter 2. Temporalis 3. Lateral Pterygoid 4. Medial Pterygoid |
| What muscle runs from the zygomatic arch to the ramus of the mandible? | Masseter |
| What muscle runs from the temporal foassa to the coronoide process of the mandible? | Temporalis |
| What muscle runs from the lateral pterygoid plate (lateral surf.) to the neck of mandible, TMJ capsule, and articular disc? | Lateral Pterygoid |
| What muscle runs form the medial surface of the lateral pterygoid plate to the inner surface of the ramus of the mandible? | Medial Pterygoid |
| The masseter muscles are all innervated by? | CN V (v3) |
| What muscle opens the jaw? | lateral pterygoid |
| What muscles close the jaw? | temporalis, masseter, medial pterygoid |
| Protraction is done by what two muscles? | 1. lateral pterygoid (mostly) 2. masseter |
| What retracts the jaw? | 1. posterior fibers of temporalis 2. deep fibers of masseter |
| Side to side is done by... (to left) | left: temporalis posterior fibers (masseter deep fibers) right: lateral pterygoid |
| side to side is done by...(to right) | right: temporalis posterior fibers (masseter deep fibers) left: lateral pterygoid |
| What are the to nerves that provide cutaneous innervation to the scapula and deltoid region? | supraclavicular and upper lateral cutaneous nerve of the arm |
| The supraclavicular nerve is a branch of what? | cervical plexus, C3.4 |
| The upper lateral cutaneous nerve of the arm is a branch of what nerve? | axillary |
| What nerve is affected when there is sensory loss over the deltoid? | upper lateral cutaneous nerve of the arm |
| Dermatome of lateral arm | C5 |
| dermatome of the lateral forearm to index finger | C6 |
| dermatome of middle finger | C7 |
| dermatome of medial hand and digits 4 and 5 | C8 |
| dermatome of medial forearm into arm | T1 |
| dermatome of medial arm into axilla | T2 |
| What muscle goes from the lower margin of the spine of the scapula, acromio, and lower margin of lateral 1/3 of scapula to deltoid tuberosity of humerus? | deltoid m. |
| What is the action of the anterior fibers of the deltoid? | flexion and adduction |
| What is the action of the posterior fibers of the deltoid? | extension and adduction |
| The middle fibers of the deltoid _______ the arm. | abduct |
| The deltoid helps the joint capsule in what way? | stabilizes the joint |
| The deltoid m. is innervated by... | axillary n. |
| The muscle that runs from the costal surface of the scapula to the lesser tubercles of the humerus. | subscapularis |
| subscapularis does what action? | medial rotation and stabilizes the joint |
| What nerve innervates subscapuris? | upper and lower subscapular nn. |
| The muscle that runs from the supraspinatus fossa to the lesser tubercle of the humerus (superior facet) | supraspinatus |
| What are the actions of the supraspinatus m. | 1. abduct 2. stabilize joint 2. depress head during abduction. |
| Why must the head of the humerus be depressed during abduction? | It would hit the acromion process. |
| The muscle that foes from the infraspinatus fossa to the greater tubercle of the humerus | Infraspinatus |
| Infraspinatus _________ rotates the arm and _________ the joint. | laterally, stabilizes |
| Infraspinatus is innervated by what nerve? | suprascapular n. |
| The muscle that runs from the lateral border of the scapula (above teres major) and goes to the greater tubercle (lower facet) | teres minor |
| Teres minor mirrors the actions of infrapinatus which are? | lateral rotation and stabilization of the joint |
| The muscle that goes from the lower lateral border of the scapula( as far as inferior angle) to the medial lip of bicipital groove | teres major |
| Teres minor is innervated by... | axillary n. |
| The action of teres major is.. | 1. medial rotation 2. adduction 3. extension |
| Teres major is innervated by... | lower subscapular n. |
| The muscle has digitations from ribs 1-8 and goes to the vertebral border of the scapula on the costal surface and inferior angle of the scapula | serratus anterior |
| what is the action of serratus anterior? | protraction and rotates gelnoid upward |
| Serratus Ant. is innervated by? | long thoracic n. |
| If serratus anterior is deinnervated what happens to the scapula? | It wings out, because the serratus ant. can no longer hold it against the thoracic wall |
| The serratus anterior is important in what rhythm? | scapulohumeral |
| The C5 myotome is tested by what actions? | shoulder abduction and extension |
| What is the scapulohumeral rhythm? | 2:1 ratio of humeral to scapular movement |
| What muscles make up the rotator cuff? (SITS) | 1, supraspinous 2. infraspinous 3. teres minor 4. subscapularis |
| What do the tendons of the rotator cuff blend with? | joint capsule |
| The rotator cuff muscles act collectively to ________ the humerus while the deltoid ________ the arm. | depress, elevates |
| The collection of the tendons of the rotator cuff muscles add _____ to the joint. | stability |
| The suprascapular nerve comes from what trunk of the brachial plexus. | upper |
| When it branches it travels through what "hole"? | suprascapular notch |
| After it passes through the suprascapular notch it goes to what muscle? | supraspinatus |
| It passes between what other notch before heading to infraspinatus muscle? | spinoglenoid notch |
| Then it runs with what artery superior to a _________ | supraascapular a., ligament |
| What cord does the axillary nerve come off of? | posterior |
| It runs backards through the _________ space, and supplies what two muscles? | quadrangular, teres minor and deltoid |
| What cord does both the upper and lower subscapular nerves come off of? | posterior |
| The upper subscapular n. goes directly to what muscle? | subscapularis |
| The lower subscapular n. goes to what two muscles? | teres major and subscapularis |
| Borders of the quadrangular space: 1.Superior 2.Inferior 3.Medial 4.Lateral | 1. Teres Minot 2. Teres major 3. Surgical Neck of Humerus 4. Long head of triceps |
| What are the contents of the quadrangular space? | 1. Posterior humeral circumflex artery 2. axillary n. |
| Borders of the Triangular Space: 1. Superior 2. Inferior 3. lateral | 1. Teres Minor 2.Teres Major 3. lateral head of triceps |
| What are the contents of the triangular space? | Scapular circumflex a. |
| Borders of the Triangular interval: 1. Superior 2. Medial 3. Lateral | 1. Teres Major 2. Long head of the triceps 3. Lateral head of the triceps |
| Contents of the triangular interval | 1. radial n. 2. profunda brachii artery |
| What branches from the subclavian artery supplies the scapular? | transverse circumflex and suprscapular |
| What artery comes from the subscapular branch of the axillary artery? | scapular circumflex |
| What two branches from from the axillary artery directly? | Posterior humeral circumflex and thoracromial trunk |
| What does the posterior humeral circumflex artery supply? | acromion and neck of humerus |
| The thoracoacromial trunk sends branches to the _________ | acromion |
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