1. Diseases affecting Temporomandibular Joint (1)
口腔病理學
Diseases affecting Temporomandibular Joint (1)
顳 顎 關 節 疾 病 (1)
陳玉昆教授: 高雄醫學大學 口腔病理科
~2755

2. 學 習 目 標 Understanding: 1. Vocabulary
2. Anatomy of temporomandibular joint
3. Normal joint function
4. Function of muscles of mastication

3. 參考資料
References:
Oral Pathology for the Dental Hygienist. Olga AC Ibsen, Joan Anderson Phelan, 4th edition, 2004, Chapter 10, p
Eric Whaites: Essentials of dental radiography & radiology 3rd edition, Chapter 29, p
Peggy Woodward MRI for technologists McGraw-Hill, Chapter 1 pp. 1-12
購網路資源：super_toolcool

4. Temporomandibular Joint
Vocabulary
Arthrocentesis(關節穿刺術): Surgical puncture of a joint for withdrawal of fluid.
Arthrography(關節造影術): Radiography of a joint after infection of opaque contrast material.
Arthroscopy(關節鏡): Method for evaluating & manipulating a joint via the insertion of a camera & instruments.
Ref. 1

5. Temporomandibular Joint
Vocabulary
Articulation: Joint.
Auscultation(聽診): Listening to sounds within the body using a stethoscope(聽筒).
Crepitus(捻發音): Dry, cracking sound.
Iatrogenic(醫源性): Induced inadvertently by a medical or dental care provider or by medical treatment or a diagnostic procedure.
Ref. 1

6. Temporomandibular Joint
Vocabulary
Magnetic resonance imaging (MRI): Noninvasive diagnostic technique that uses radio waves to produce computerized images of internal body tissues.
Dr. Raymond Damadian built 1st whole body MRI machine
Dr Raymond Damadian & his associates, Drs Larry Minkoff & Michael Goldssmith, completed the world's 1st whole body MRI scanner. Named Indomitable to capture the spirit of its 7-year construction (now located at Smithsonian Ins, Washington, DC)
The first whole body transaxial image took 4 h 45 min to produce. Made on July 3, 1977, it shows the thoracic spine of Larry Minkoff
Indomitable
Indomitable: 百折不撓
Ref. 3

7. Temporomandibular Joint
Vocabulary
Palpation: Physical examination using pressure of hand or fingers.
Sign: Objective evidence of disease that can be observed by a health care provider rather than by patient.
Symptom: Subjective evidence of disease or a physical disorder that is observed by patient.
Trismus(牙關緊閉): Spasm of muscles of mastication.
Refs. 1, 4

8. Anatomy of the Temporomandibular Joint
Temporomandibular joint is articulation between condyle of mandible & glenoid fossa of temporal bone.
Ref. 1

9. Anatomy of the Temporomandibular Joint
Temporomandibular joint is a highly specialized joint that differs from other joints because of fibrocartilage that covers bony articulating surfaces, its ginglymoarthrodial (rotational & translational) movement.
Ref. 1

10. Anatomy of the Temporomandibular Joint
Temporomandibular joint depends on contralateral joint. An articular disk is interposed in the space between temporal bone & mandible. The disk divides the space into an upper (superior joint space) & a lower compartment (inferior joint space).
Ref. 1

11. Anatomy of the Temporomandibular Joint
Translational movements occur in upper compartment, whereas lower compartment functions primarily as hinge or rotational component.
Ref. 1

12. Anatomy of the Temporomandibular Joint
Superior & inferior spaces contain synovial fluid, which is produced by synovial membrane that lines the joint. Synovial fluid provides nourishment & lubrication of avascular structures.
Ref. 1

13. Anatomy of the Temporomandibular Joint
Articular disk is attached to lateral & medial aspects of condyle, to superior belly of lateral pterygoid muscle, & to joint capsule.
Ref. 1

14. Anatomy of the Temporomandibular Joint
Disk & bony surfaces are avascular (without blood vessels).
Joint is further surrounded & protected by fibrous connective tissue joint capsule.
Ref. 1

15. Anatomy of the Temporomandibular Joint
Basic components of TMJ include:
Mandibular component: head condyle
Disc
Temporal component: glenoid fossa & articular eminence
Capsule surrounding the joint
Condyle head
Disc/meniscus
Glenoid fossa
Lateral pterygoid
attachment
Upper joint space
Lower joint space
Ext auditory
meatus
Ref. 2

16. Anatomy of the Temporomandibular Joint
Lateral
Anterior
Base
Ref. 2

17. Function of muscles of mastication
Understanding location & action of muscles of mastication is important in evaluation of disorders affecting temporomandibular joint.
Ref. 1

18. Function of muscles of mastication
Palpation of muscles of mastication during a clinical evaluation is used to determine whether muscle spasm or dysfunctional muscle activity is occurring.
Ref. 1

19. Function of muscles of mastication
Muscles of mastication include masseter, temporalis, medial pterygoid, lateral pterygoid, anterior digastric, & mylohyoid (suprahyoids).
Ref. 1

20. Function of muscles of mastication
Masseter, medial pterygoid, & temporalis, are elevator muscles that, when activated, close the mandible.
Ref. 1

21. Function of muscles of mastication
Opening, or depressor, function is accomplished mainly by lateral pterygoid muscle with some help from anterior digastric muscle.
Ref. 1

22. Function of muscles of mastication
Suprior belly of pterygoid muscle seats articular disk on eminence of articulating surface.
Inferior belly is attached to mandibular condyle & functions during mouth opening.
Ref. 1

23. Summaries Knowing: Vocabulary related to TMJ
Anatomy related to TMJ (glenoid fossa, disk,
condyle, capsule, superior belly of lateral
pterygoid muscle)
3. Function of muscles of mastication