Temperomandibular joint

1. TEMPOROMANDIBULAR JOINT
Dr. Prabhakar Yadav
Associate Professor
Department of Human Anatomy
B.P. Koirala Institute of Health Sciences

2. articular eminence/tubercle
Mandibular fossa
Head of mandible

3. Fibro cartilage
Intra articular disc

4. Ligaments:
1.Fibrous capsule
Articular tubercle
circumference of
mandibular fossa
Squamotympanic
fissure
Neck of mandible
Capsule:
loose above the
articular disc
Tight below the disc

6. 2.Lateral/temporo-
mandibular ligament:
Articular tubercle
Postero -laterlal aspect of
neck of Mandible
Reinforce fibrous capsule
Limits the movement of
mandible in posterior
direction- protects the
external acoustic meatus

7. lateral ligament: prevent fracture of tympanic plate and protect
eternal acoustic meatus when severe blow falls on chin.

8. Spine of
sphenoid
3.Sphenomandibular
ligament
Spine of sphenoid
Lingula of mandible
Is remnant of dorsal part of
Mickel’s cartilage

9. Structures lateral to
sphenomandibular
ligament:
Lateral pterygoid
Auriculotemporal nerve
Chorda tympani nr.
Maxillary artery
Lower end – pierced by
mylohyoid nerve and
vessels.

10. 4.Stylomandibular ligament:
Thickened part of deep cervical
fascia; separates parotid and
submandibular glands.
Apex and lateral surface of styloid
Process
Angle and ramus of mandible

11. Articular disc:
oval shaped fibrocartilage
Upper- concavoconvex surface
Lower – concave surface
Meniscotemporal compartment:
Lie between:
permits- gliding movement
Meniscomandibular compartment:
Lie between:
Permits:rotatory + gliding movement
attached to fibrous capsule
circumferentially
Disc has thick margin- peripheral
annulus & central depression on its
inferior surface.
central part of the disc is avascular

12. Intermediate zone
Anterior
extension
Attached in front to :
tendon of lateral pterygoid and
Head of mandible
Ensure forward and
backward movement of
head of mandible during
protraction and retraction

14. Blood supply:
Arteries from branches of:
superficial temproal art.
Maxillary artery.
Venous drainage to:
superficial temproal vein
Maxillary vein

15. Nerve supply:
auriculotemporal Nerve
Masseteric nerve.

16. Relation:
Lateral:
Skin,
fascia,
parotidgland,
temporal branch of
facial nerve

17. Spine of sphenoid
Auticulotemporal nerve
Chorda tympani nerve
Medially:
1.tympanic plate
separating joint form
Internal carotid artery
2.Middle meningeal
artery.
3. Spine of sphenoid
with upper end of
sphenomandibular
ligament
4.Auriculotemporal
nerve
5. Chorda tympani nerve

18. Posteriorly:
parotid gland
Auriculotemporal nerve
Superficial temporal vessels

19. Anteriorly:
Lateral pterygoid artery:
Masseteric artery
Lateral pterygoid nerve
Masseteric nerve

20. Movement of TMJ
Slight opening of mouth: Head of
mandible moves on undersurface of
articular disc.- hinge movement
protraction and retraction: articular disc
glides forward over upper articular surface
& head of mandible move with it .
Wide opening of mouth: hinge movement
is followed by gliding movement of disc
and head of mandible
Side to side movement: head of one side
glide forward along with disc as in
protraction and head of other side rotates
on vertical axis ; alternate movement
result in chewing movenent.

21. Muscele producing movements:
Depression: lateral pterygoid,
digastric, geniohyoid, mylohyoid
Elevation: muscle of mastication except lateral pterygoid – antigravity muscle
Protusion: pterygoids
Retraction: posterior fibers of temporalis
Side to side : turning chin to right side produced by right lateral pterygoid
and left medial pterygoid and vice versa

22. Dislocation of
temperomandibular jt.
mandible depressed-
both head of mandible & articular disc
reach summit of articular tubercle
Cause: minor blow or sudden contraction
of lateral pterygoid – pulls disc further
beyond summit causing dislocation.
Rx.:
press downward on lower molar teeth
(overcome the tension of temporalis and
masseter)
&
push the jaw back , at same time elevate
chin. ( overcome the spasm of lateral
pterygoid)

23. Thank You