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OMM-PPC Lecture 08 – TMJ Evaluation and Treatment – Block 7 TMJ anatomy – Capsule Synovial joint Differs from other joints: o Covered by fibrocartilage rather than hyaline cartilage o Joint cavity is divided into two separate compartments by an articular disc or meniscus More like 2 joints instead of one Talking/gentle chewing confined to 1st compartment Eating/yawning (high-opening) involves the 2nd compartment (between the disc and the temporal fossa) o MOST DYSFUNCTION OCCURS HERE!!! Jaw Opening 40 -50 mm Facial nerve in front of, auriculotemporal nerve behind Otalgia in children may be TMJ Palpation of TMJ: 1. Preauricular area, just anterior to tragus 2. Within the external auditory canal 3. Orally along the last molar TMJ motions Depression (opening of the mouth from rest) Suprahyoid and infrahyoid muscles contract, moving the head of the mandible and the articular disc anteriorly Elevation (closing of the mouth to rest) Temporalis (vertical fibers), masseter and medial pterygoid muscles contract, pulling the head of the mandible and the articular disc posteriorly; very powerful movement Protrusion (carrying the mandible forward from rest) Masseter, lateral pterygoid and medial pterygoids contract, causing the head of the mandible to glide anteriorly but the articular disc to slide posteriorly Retraction (carrying the mandible back to rest) Temporalis (horizontal fibers) and masseter contract to pull the head of the mandible posteriorly and slide the articular disc anteriorly Anteriorly displaced mandible can’t close (more common) Posteriorly displaced mandible can’t open Tenderpoints - Masseter – in belly of muscle, push posterior o Jaw towards - Medial Pterygoid – posterior part of jaw 2 cm above angle, push anterior o Jaw away - Lateral Pterygoid – right in front of top part of mandible, push medial/posterior o Jaw away - Temporalis – anywhere in the muscle (sides of forehead) o Jaw towards OMM-PPC Lecture 08 – TMJ Evaluation and Treatment – Block 7