Tempormandibular Joint :- TM J

- it is synovial J.(Modified hing).

Articular surface -
involved:-
- condyle of mandible(head)
- articular tubercle (eminence) of
temporal bone and mandibular
fossa (glenoid fossa).
- Fibrons capsule:- is loose , attaches
to margin of articular area on temporal
bone and around neck of mandible.
- Articular disc:- divide the joint into
two separate compartment, it is fibrous
plate.
- upper compart: permit gliding
movement of protrusion and retrusion
- lower compart: permit depression
and elevation (gliding + rotatory)
Ligaments of Joint:
- Lateral ligament
(temporamandibular)
- strengthen TMJ laterally
- prevent post dislocation of joint
- extend from root of zygomectic
arch, attached to posterolate aspect
of neck of mandible.
- stylomandibular ligament:
- thicken part of deep cervical fascia
- separted parotid from submandib.
Gland
- attached to lat.surface of styl.
process and to angle of mandib.
- sphenomandibular ligament:
Run from spine of sphenoid to
lingua of mandible.
Muscles Producing movement of
mandible at TMJ are:
* Depression (open mouth):
- gravity
- suprahyaid and infrahyaid
muscles(Digastric,Mybhyaid,genaid)
- lat. Pterygoid m.
* Elevation (closed mouth):
- temporal
- masseter
- medial pterygaid of both side
* Protrusion (protraction of chin):
- lateral pterygoid m.
- medial pterygoid m.
- masseter (superficial)
* Retrusion (retraction):
- temporal (post., middle, fibres)
- masseter (middle, deep fibres)

* lateral or side to side movement produce

by medial, lateral pterygaid of each side
act alternatively.
Muscles of chewing + Grinding:

- temporalis of the same side.

- pterygoids of the opposite side.

Relation of T.M. joint:
- Laterally___ skin , fascia
Parotid gland
Temporal branch of fascial

- Medially___ tympanic plate which

separate the joint from
I.C.A.
Sphine of sphenoid and
sphenomandibular ligament
middle meningal a.
- Anterior___ lateral pterygaid m.
Masseteric n. and vessels

- Posterior___ parotid separate joint

from external auditory
meatus
Superfial temporal
vessels
Auriculo temporal
vessels
- Superior____ middle cranial fossa
Middle meningel vessels

- Inferior___ axillary artery and nerves

Blood supply of joint: -

- superficial temporal a.
- Maxillary a.
Nerves supply of joint:-
- auriculotemporal n.
- Masseteric n.
Applied Anatomy

- Dislocation of mandible

- Dearrangement of articular dis (clicking)

- Arthritis of TMJ
 Pterygo palatine fossa
* small pyramidal space inferior to the
apex of orbit.
Boundary:

Anteriory ___ post. aspect of maxilla

Posteriorly___ pterygaid process of
sphenoid bone
Medially___ palatine bone (vertical
plate)
Roof ___ greater using of sphenoid
Floor ___ pyramidal process of palatine
bone.
 Communication of fossa
*it is slilike open laterally into
infratemporal fossa through pterygo-
maxillary fissure.

* Medially with nasal cavity through

spheno-palatine foramen

* Anterosuperiorly with the orbit through

inferior orbital fissure

* Posterosuperiorly with middle cranial

fossa through foramen rotundom and
pterygaid canal
Contents:
Terminal (3rd)part of maxillary artery
Maxillary nerves
Nerve of pterygaid canal
Pterygopalatine ganglia
Maxillary artery:
* pass over Lat. Pteryg. m. and enter
pterygopal. fossa
* pass through pterygomaxillary fissure
where it lies anterior to pterygopalatine
ganglia
* Artery give branches that accompany all
nerves in the fossa with same names.
*Branches of pterygopalatin part of
maxillary artery are:
1- posterior superior alveolar a.
2- Descending palatine a. divided into:-
greater palatine a.and lesser palatine a
3- Artery of pterygoid canal
4- spheno palatine artery divided into :
- posterior lateral nasal a. to lat.wall of
nasal cavity and paranasal sinus
- posterior nasal septal a.
5- infra orbital a. which give rise to
anterior superior alveolar a.
Maxillary nerves:
* leave cranial cavity through foramen
rotundum
* cross pterygopal. fossa
* continues forward through infer. orbital
fissure into orbit.
* terminate as infraorbital nerve traverse
the infraorbital canal to reach the face
* it has branches arising in :-
- pterygopalatine fossa
- in floor of orbit
- on the face
* in pterygopalatine fossa:-
1- two branches suspend the
pterygopataline ganglia called
pterygopalatine nerve
2- posterior superior alvealor n. for upper
molar teeth
* in the floor of orbit:
1- middle superior alveolar n.
2- anterior superior alveolar n.
In lateral , anterior wall of maxilla
3- zygomatic nerve which divided into
zygomatico temporal, zygomaticofacial
infra orbital nerve:•

emerge into face through infra

orbital foramen supplies skin of

cheek , lower eyelid , upper lib ,

lateral surface of nose.

 Pterygo palatinr ganglion:

* it is relay situation betw.superior salivary nucleus in

pons and lacrimal gland and mucous and serous
gland of palate , nose, and paranasal sinus.
* it is ganglion of hay fever (running nose and eyes)
* There is autonomic root called nerve of pterygoid
canal(vidian nerve).
This nerve is formed in foramen lacerum by union of
greater(superf.) petrosal n. which containing
parasympathetic, secretomotor fibres, with deep
petrosal n. containing vasoconstrictor fibre.
Both nerve pass forward in pterygoid canal and join
the five branches of pterygopalatine ganglia:-
1- nasopalatine(long
sphenopalatine)n.

Spheno palatin foramen ___ supply nasal

septum

2- posterior superior lateral nasal

n.(short sphenopalatine n.)

Sphenopalatin foramen ___

posterosuperior quadrant of lateral wall
of nose.
3-anterior palatine n. (greater palatine n.)
Greater palatine canal___ foramen mucous
ml. of hard palate Medial wall of maxillary
sinus
4- middle, posterior palatine n.(lesser
palatine n.)
Lesser palatine foramen ___ mucous ml. of
soft palate supratonsillar racess
5- pharyngeal branch___ palatovaginal
canal___ mucous ml. of nasopharynx
Digastric and styloid muscles
Digastric muscles:
* consist of anterior belly & posterior belly
United by intermediate tendon
Posterior belly: attached to medial surface of mastaid
process inclined forward, downward, continuous with
intermediate tendon close to hyaid bone.Tendon pierced
the stylohyaid and is anchored by facial sling to hyaid
bone.innervaled by facial nerve.
Anterior belly: continuous forward from intermediate
tendon to attached to inferior border of mandible near
midline.innervated by mandibular division of
trigeminal n.
* digastric muscles elevate hyaid bone during
swallowing and assist mylohyaid and lateral pteryg.
in depressing mandible when opening the mouth
Muscles of styloid process:
3 muscles___ stylohyaid___ to hyaid bone
Stylopharyngius___ pharynx
Styloglossus___ tongue

* 2 ligament attached to styloid process:-

Stylohyaid ligament.
Stylomandibular ligament.