Head and Neck – Session 4
1
Max.
Mark
What shape is the Infratemporal Fossa? Where is it located?
Irregular
Lateral aspect of the skull
Actual
Mark
1
2
What portions of which muscles are within the Infratemporal
Fossa?
Inferior portion of the temporalis muscle (x1)
Inferior portions of the medial and lateral pterygoid muscles (x1)
Max.
Mark
Actual
Mark
2
3
What arteries run through the Infratemporal Fossa? What are
they branches of?
Maxillary Artery – Large terminal branch of the external carotid (x1)
Middle Mesangial Artery – Branch of the Maxillary Artery (x1)
Superficial Temporal Artery – Smaller branch of the external carotid
(x1)
Max.
Mark
Actual
Mark
3
4
What veins run through the Infratemporal Fossa?
Max.
Mark
Maxillary veins (x1)
Middle Meningeal Vein(s) (x1)
Pterygoid Venous Plexus (x1)
Actual
Mark
3
5
What nerves run through the Infratemporal Fossa?
Mandibular Nerve – 3rd branch of the Trigeminal (CN V3) (x1)
Branches of the Mandibular Nerve – (Auriculotemporal, Inferior
Alveolar, Lingual, Buccal, Chorda Tympani (Branch of Facial)) (x1)
Otic Ganglion (x1)
Max.
Mark
3
Actual
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6
Max.
Mark
What are the openings of the Infratemporal Fossa? Name any
important neurovascular structures that go through them
Foramen Ovale (x1) – Mandibular Division of the Trigeminal Nerve
(CN V3)
Foramen Spinosm (x1) – Middle Meningeal Artery
Alveolar Canal (x1)
Inferior Orbital Fissure (x1)
Pterygomaxillary Fissure (x1)
Actual
Mark
6th mark awarded for correct naming and course of both the
neurovascular structures
6
7
Where would you inject anaesthetic if you were performing a
Mandibular Nerve Block?
Near where it enters the infratemporal fossa, near the foramen
ovale (x1)
Max.
Mark
Actual
Mark
1
8
Max.
Mark
What nerves are affected in a Mandibular Nerve Block?
Inferior Alveolar (x1)
Lingual (x1)
Buccal (x1)
Auricotemporal (x1)
Actual
Mark
4
9
Max.
Mark
2
When is an Inferior Alveolar Nerve Block performed? Where is
the anaesthetic injected?
Dental procedures (x1)
Injected around the Mandibular Foramen, located on the medial
side of the mandible (x1)
Actual
Mark
10
Describe some structures are anesthetised in an Inferior
Alveolar Nerve Block
All mandibular teeth on the medial side (x1)
Skin and mucous membranes of lower lip (x1)
Labial alveolar muscoa (x1)
Gingivae (x1)
Skin of the (cheek?) (x1)
Max.
Mark
Maximum of 2 of the above.
Actual
Mark
2
11
What type of joint is the Temporomandibular joint? Where is it
located?
Modified hinge type synovial joint (x1)
Between mandible and cranium (x1)
Max.
Mark
Actual
Mark
2
12
Max.
Mark
How many superior articular surfaces of the TMJ are there?
Name it/them and describe its/their shape
Mandibular Fossa (x1) – Posterior and Concave (x1)
Articular Tubercle (x1) – Anterior and Convex (x1)
Actual
Mark
4
13
Describe the location of the inferior articular surface
Head of the mandible (x1)
Max.
Mark
Actual
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1
14
Max.
Mark
2
What is the Articular Disc of the TMJ also known as? What is it
comprised of?
Meniscus (x1)
Tough fibrocartilage (x1)
Actual
Mark
15
What does the presence of the articular disc of the TMJ
create?
Creates two separate compartments, the superior articular cavity
(x1) and the inferior articular cavity (x1). They are lines by superior
synovial membrane (x1) and inferior synovial membrane (x1)
respectively.
Max.
Mark
Actual
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4
16
What are movements of the TMJ caused by?
Displacements (x1) in either the:
Superior Joint Cavity (x1)
Inferior Joint Cavity (x1)
Max.
Mark
Actual
Mark
3
17
Describe TMJ flexion, including where it occurs and what
muscles are involved
“Closing the mouth” (x1)
Occurs in inferior compartment (x1)
Temporalis, Masseter, Medial Pterygoid (x1)
Max.
Mark
Actual
Mark
3
18
Describe TMJ extension, including where it occurs, what
muscles are involved and what is the primary mover
“Opening the mouth” (x1)
Occurs in the inferior compartment (x1)
Prime mover is gravity (x1)
Lateral Pterygoid, Suprahyoid, Infrahyoid (x1)
Max.
Mark
4
Actual
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19
Max.
Mark
Describe TMJ gliding, including the muscles involved and
where it occurs
Protrusion AND retrusion of the jaw (x1)
Protrusion – Lateral Pterygoid, Medial Pterygoid, Masseter (x1)
Retrusion – Temporalis, Masseter (x1)
Occurs in superior compartment (x1)
Actual
Mark
4
20
Max.
Mark
Describe what compartment rotation of the TMJ occurs in
Inferior compartment (x1)
Actual
Mark
1
21
Describe the process of opening movement of the TMJ,
including what motions, muscles and compartments are
involved (This is a massive question, I am sorry)
1) Condyles are pulled forwards (x1)
- Protrusion/Gliding (x1)
- Lateral Pterygoid (x1)
- Superior Compartment (x1)
2) Chin moves down and back (x1)
- Hinge movement (x1)
- Usually by gravity but Suprahyoid and Infrahyoid can get
involved (x1)
Inferior compartment (x1)
Max.
Mark
8
Actual
Mark
22
Max.
Mark
Describe the process of closing movements of the TMJ,
including what motions, muscles and compartments are
involved.
1)Retraction of the mandible (x1)
Retrusion/Gliding (x1)
Superior Compartment (x1)
Posterior fibres of the temporalis muscle (x1)
2)Elevation of the mandible (x1)
Hinge movement (x1)
Inferior compartment (x1)
Remainder of temporalis, Massester and Medial pterygoids (x1)
Actual
Mark
4
23
Max.
Mark
Describe the properties of the TMJ joint capsule and the
advantages this brings. How is it strengthened?
Capsule is loose and thin (x1) to permit the movement of the joint
(x1)
Strengthened by extra-capsular ligaments (x1)
Actual
Mark
3
24
Describe the attachments of the TMJ joint capsule
Max.
Mark
Superiorly – Circumference of the mandibular fossa and articular
tubercle (x1)
Actual
Mark
Inferiorly – Neck of the condyle of the mandible (x1)
2
25
Describe the Extra-Capsular ligaments of the TMJ
Lateral – 1 strong ligament, the Temporomandibular ligament (x1)
Max.
Mark
Medial – 2 accessory ligaments, the Sphenomandibular ligament
(x1) and the Stylomandibular ligament (x1)
1 extra mark for correct positioning (lateral, medial)
4
Actual
Mark
26
When is the TMJ most stable? Why is this?
When jaw is closed (x1)
Mandibular condyles are in contact with mandibular fossa (x1)
Teeth are in occlusal contact (x1)
Max.
Mark
Actual
Mark
3
27
What is the most common cause of TMJ dislocation? Describe
which side becomes dislocated
Most commonly from a sideways blow to the chin when the mouth
is open (x1)
TMJ dislocates on the side that receives the blow (x1)
Max.
Mark
Actual
Mark
2
28
Max.
Mark
What else can cause TMJ dislocation? How?
Yawning or taking a large bite/Excessive contraction of the lateral
pterygoids (x1)
Causes the heads of the mandible to dislocate anteriorly (x1)
Mouth remains depressed and the person is unable to close their
mouths (x1)
Actual
Mark
3
29
Max.
Mark
What is Bruxism?
Grinding of teeth when asleep (x1)
Actual
Mark
1
30
Name two cause of TMJ muscle pain
Temporomandibular Pain Dysfunction Disorders (x1)
Mal-Occlusion Syndromes (x1)
Max.
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2
Actual
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