ANATOMY OF HEAD AND NECK

UNIT 9

UNIT 9. TEMPOROMANDIBULAR JOINT

A. Bony structures of the TMJ
a. Condylar head
b. Glenoid fossa
c. Articular eminence
B. Shoft tissues
a. Articular disc
b. Joint capsule
c. Ligaments
C. Muscles of the TMJ
a. Muscles involved in mastication
b. Facial muscles around the oral cavity
c. Muscles of the neck
D. Arterial and nerve supply

INTRODUCTION

Craniomandibular articulation
Connects the mandible to the skull
Regulates mandibular movements
Derivated from the first branchial arch
BYCONDYLAR JOINT
GINGLYMO-ARTRODIAL JOINT

A.- BONY STRUCTURES OF THE TMJ

1.- TEMPORAL BONE
Mandibular fossa

Oval depression in the infratemporal area (concave)

Between the articular eminence anteriorly and the external acoustic meatus
posteriorly.

Petrotympanic fissure or Glaserian fissure (posterior to glenoid fossa and lateromedial)

The deepest portion is thin (just a layer of cortical bone separates the fossa from the
craneal cavity)

The anterior portion is the only articular area of the glenoid fossa.

The posterior portion is not functional

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Articular eminence

Lateromedial, cilindrical elevation (anterior root of the zygomatic process)

Guides the condylar movement during the jaw opening (posterior slope)

Sagittal view: convex

Coronal section: slightly concave mediolaterally

2.- MANDIBLE
CONDYLAR HEAD

Ovoid condylar process (convex)

Two poles: medial and lateral (the medial is sharper)

o

15-20 mm side to side

8-10 mm from front to back

o Longest axis (oblique): 22 mm

Transverse crest that divides the superior surface into two parts:
o

The anterior or articular (facing the posterior slope of the articular eminence
of temporal bone) is the functional portion

The posterior is not functional

If the long axes of two condyles are extended medially, they meet at approximately
the basion forming an angle (145-160)

*Articular cartilage on the bone surfaces

B.- SHOFT TISSUES

a.- ARTICULAR DISC

Biconcave fibrocartilaginous structure located between the mandibular condyle and

the temporal bone.

Flexible

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Divides the joint into

o

A larger upper compartiment (disc-temporal bone)

A smaller lower compartiment (disc-mandible)

Attached all around the joint capsule and fix directly to the medial and lateral condylar
poles.

Four parts in the sagittal plane:

o

Anterior band:

Thickened portion in the anterior part of the disc

2 mm

Intermediate band:

1 mm thickness

Between the articular surface of the condyle and the posterior slope of
the articular eminence

Avascular

Posterior band

The thickest portion (3-4mm).

Innervated and vascular

Bilaminar zone: Divided into two parts. In between the two layers there are
blood vessels and nerves

Upper layer: attached to the posterior mergin of the glenoid fossa.

CONTAINS ELASTIC FIBERS. It prevents slipping of the disc while
yawning

Lower layer: attached to the posterior surface of the condylar head

and neck. CONTAINS COLLAGEN FIBERS. It prevents excessive rotation
of the disc over the condyle (stabilize the disc on the condyle)

The anterior extension of the disc (anterior to the anterior band) is attached to the
capsule superiorly and inferiorly. In between it gives insertion to the lateral pterygoid
muscle (upper head)

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b.-JOINT CAPSULE
Fibrous sheet of connective tissue that encloses the temporomandibular joint.
Boundaries:

Superior circumference: glenoid fossa and articular eminence.

Inferior circumference: narrower, the neck of the condyle.

Functions:

Resists to any internal or external force that tends to move or dislocate the joint
surfaces.

Retains the synovial fluid.

Proprioceptive feedback on the position and movement of the joint (condyle avoid
exaggerated movements).

Synovial fluid:

Metabolic needs

Lubricant

c.- LIGAMENTS
Restringe the movements of the mandible
1.- Temporomandibular ligament or lateral ligament:

Located on the anterior part of the lateral aspect of the joint.

Hard to distinguish the joint capsule from this ligament.

Designed in two distinct layers:

o

Outer oblique band (fan-shaped) from the outer surface of the articular
tubercle to the neck of the mandibular condyle.

Inner horizontal band: from the articular tubercle to to the lateral pole of the
condyle and to the back of the disc.

2.- Sphenomandibular: arises from the spine of the sphenoid bone and insert in the lingula
mandibulae
3.- Stylomandibular: from the styloid process of the temporal bone to the angle of the
mandible.

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4.- Pterygomandibular ligament or pterygomandibular raphe: from the hamulus to the
posterior end of the mylohyoid line of the mandible

C.- ARTERIAL SUPPLY

Branches of the superficial and deep temporal arteries

Enter the joint and form an arterial network around the joint caspule

D.- TRIGEMINAL NERVE

Auriculotemporal nerve

Masseteric nerve

OPENING MOVEMENT
1.- The condyle of the mandible rotates (hinge movement)
2.- The disc (united to the mandibular condyle) slides along the articular eminence.