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Muscles of Mastication
Dr. Rabia Inam Gandapore
Assistant Professor
Head of Department
(Dentistry-BKCD)
B.D.S, M.Phil. Anatomy,
Dip.Implant, Dip. Arts, CHPE, CHR
Teaching Methodology
LGF (Long Group Format)
SGF (Short Group Format)
LGD (Long Group Discussion, Interactive discussion with the use of models or diagrams)
SGD (Short Group)
SDL (Self-Directed Learning)
DSL (Directed-Self Learning)
PBL (Problem- Based Learning)
Online Teaching Method
Role Play
Demonstrations
Laboratory
Museum
Library (Computed Assisted Learning or E-Learning)
Assignments
Video tutorial method
2
Goal/Aim (main objective)
To help/facilitate/augment the students about the:
 Explain origin, insertion, nerve supply, blood supply and actions of muscles of
mastication.
3
Specific Learning Objectives (cognitive)
At the end of the lecture the student will able to:
 Explain origin, insertion, nerve supply, blood supply and actions of
muscles of mastication.
4
Psychomotor Objective: (Guided response)
 A student to draw tabulated form of Muscles of Mastication.
5
Affective domain
 To be able to display a good code of conduct and moral values in the class.
To cooperate with the teacher and in groups with the colleagues.
To demonstrate a responsible behavior in the class and be punctual, regular, attentive and on
time in the class.
To be able to perform well in the class under the guidance and supervision of the teacher.
Study the topic before entering the class.
Discuss among colleagues the topic under discussion in SGDs.
Participate in group activities and museum classes and follow the rules.
Volunteer to participate in psychomotor activities.
Listen to the teacher's instructions carefully and follow the guidelines.
Ask questions in the class by raising hand and avoid creating a disturbance.
To be able to submit all assignments on time and get your sketch logbooks checked.
6
Lesson contents
 Clinical chair side question: Students will be asked if they know
what is the function of Muscles of Mastications
Outline:
Activity 1 Describe features of Muscles of Mastication
7
Recommendations
 Students assessment: MCQs, Flashcards, Diagrams labeling.
Learning resources: Langman’s T.W. Sadler, Laiq Hussain Siddiqui,
Snell Clinical Anatomy, Netter’s Atlas, BD Chaurasia’s Human
anatomy, Internet sources links.
8
Muscles of Mastication
9
Masseter
 Muscle: Masseter
Origin: Zygomatic arch
Insertion: Lateral surface/ ramus of mandible
Nerve supply: Mandibular division of trigeminal nerve
Action: Elevates mandible to occlude teeth
10
11
TEMPORALIS
MASSETER
Temporalis
 Muscle: Temporalis
Origin: Floor of temporal fossa (superior
temporal like entire fossa)
Insertion: Coronoid process of mandible
Nerve supply: Mandibular division of
trigeminal nerve
Action: Anterior and superior fibers
elevate mandible; posterior fibers retract
mandible
12
Lateral Pterygoid
 Muscle: Lateral pterygoid (two heads) –Infra
temporal fossa
a. Upper Head
b. Lower Head
Origin: Upper head: Greater wing of sphenoid
and Lower Head: lateral pterygoid plate
Insertion: Neck of mandible and articular disc
Nerve supply: Mandibular division of
trigeminal nerve
Action: Pulls neck of mandible forward,
Protract mandible
13
LATERAL
PTERYGOID
14
TEMPORALIS
MEDIAL
PTERYGOID
LATERAL
PTERYGOID
MASSETER
Medial Pterygoid
 Muscle: Medial pterygoid (two heads) –Infra
temporal fossa
a. Superficial
b. Deep
Origin: Superficial: Tuberosity of maxilla and
Deep: Medial surface of lateral pterygoid plate
Insertion: Medial surface of angle of mandible
Nerve supply: Mandibular division of trigeminal
nerve
Action: Elevates mandible
15
16
17
18
Clinical Relevance
19
Muscle Pain Limited to OroFacial Region
 Overuse
 Chronic involuntary contraction (clenching/dystonia)
 Ischemia of a normal muscle can cause pain.
 Systemic neuromuscular disorders that cause muscle
deterioration & pain, including muscles in orofacial region.
 Examples of painful systemic neuromuscular disorders
modulated by immune system include:
Polymyalgia Rheumatica (PMR)
Polymyositis (PM)
Dermatomyositis (DM)
Rhabdomyolysis (RM)
Systemic Lupus Erythematosus (SLE)
Fibromyalgia Syndrome (FMS.)
20
Myalgia (Muscle Pain)
 Common muscle pain complaint in jaw area is
localized dull aching, aggravated by normal jaw
function, parafunction (jaw clenching/teeth grinding)
or jaw trauma.
 Associated with tenderness/pain to palpation at one
or more jaw muscle sites.
Management:
 Relaxation of painful muscles, muscle stretching,
increasing blood flow to & from muscles
 pain management
 control of etiologic/aggravating/perpetuating factors.
21
Myofacial Pain Disorder (MPD)
 Involvesdistinct palpable pain of muscle,
 nodules/points (Trigger Points) or
zones (Trigger Zones) that refer pain
along a predictable pattern, beyond
boundaries of muscle being palpated.
 Example:
Masseter Muscle Trigger Point can refer
pain to Mandibular Posterior Teeth on
same side, with teeth often feeling more
pain than Masseter Muscle.
22
Tendonitis
 Involves pain, inflammation & deterioration
of tendon origin, tension on tendon from
contraction of muscle cause limited range of
motion of joint.
 1. Temporalis Tendon: referred pain to
Maxillary Posterior Teeth, Maxillary Sinus,
behind Eye, inside Ear, Temporal
Headache, TMJ, Temporalis Muscle/Temple
& Lateral/Posterior Neck on same side.
Greater Occipital Nerve exits spine &
passes up through Temporalis Tendon, as it
travels up back of skull.
23
24
 2. Upper Trapezius Tendon:
referred pain down Back, onto
Shoulder, pain in Occipital Area
& up back of Head). It can
entrap & compress the Greater
Occipital Nerve, resulting in
Occipital Neuritis pain,
Occipital, Cervicogenic and/or
Frontal Headaches.
 3. Occipital Neuralgia: pain
referral travels up back & over
top of Head, terminating in
Frontal area, over eyes.
Tendinosis/Enthesopathy
 Similar to Tendonitis, pain & referral patterns,
except there is no inflammation present in
Tendinosis.
 found at tendinous attachment of bone(s)
muscle attaches to specific area where tendon
fibers attach to bone, is called Enthesis.
 At Enthesis, collagen fibers of tendon inserts
into very small holes in bone.
 These tendon fibers contain numerous nerve
endings that transmit pain (nociceptors) &
muscle tension/contraction forces
(mechanoreceptors).
25
26
 With acute trauma or chronic tension on
Enthesis fiber attachments, fibers can be
overstretched (strained/sprained), torn or
pulled away from fibrous-bone
attachment, causing a pathological
condition called Enthesopathy.
 Enthesopathies are not inflamed & very
painful.
 There are no blood vessels present in
enthesis structures, making healing very
slow, or no healing with chronic pain.
Myositis
 Acute painful generalized inflammation
usually of entire muscle, which results
from infection, overuse or trauma.
 Painful swelling of muscle, with limited
range of motion.
 Clinical characteristics:
Inflammation edema
Erythema
Increased temperature.
27
Muscle Spasm
 Sudden, involuntary, painful
contraction of masticatory
muscle characterized by acute
severe pain & limitation of
range of movement.
 Acute changes in bite present
with spasms on masticatory
muscles.
28
Jaw Movement Disorders
 1. Orofacial dyskinesia:
involves involuntary movements
that involve
Face
Lips
Tongue
Jaw
& result in traumatic injury to
Oral mucosa
Tongue
Teeth
29
30
 2. Dyskinesias: common with
advancing age & in patients with a
history of using neuroleptic medication,
associated with traumatic brain injury,
psychiatric conditions, or other
neurologic disorders.
 Myalgia of facial muscles & arthralgia of
TMJ present.
31
 3. Oromandibular dystonia:
involves excessive,
involuntary & sustained
muscle contractions that
involve face, lips, tongue or
jaw muscles.
32
 4. Dystonia: could be a symptom of
several central nervous system
disorders.
 Acute trauma to brain, head & neck can
trigger onset of transient or permanent
dystonia of masticatory muscles.
 The affected muscles are often painful
& can make opening and closing mouth
difficult, impair speech, swallowing &
chewing.
Any Questions?
THANK YOU!
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  • 1. Muscles of Mastication Dr. Rabia Inam Gandapore Assistant Professor Head of Department (Dentistry-BKCD) B.D.S, M.Phil. Anatomy, Dip.Implant, Dip. Arts, CHPE, CHR
  • 2. Teaching Methodology LGF (Long Group Format) SGF (Short Group Format) LGD (Long Group Discussion, Interactive discussion with the use of models or diagrams) SGD (Short Group) SDL (Self-Directed Learning) DSL (Directed-Self Learning) PBL (Problem- Based Learning) Online Teaching Method Role Play Demonstrations Laboratory Museum Library (Computed Assisted Learning or E-Learning) Assignments Video tutorial method 2
  • 3. Goal/Aim (main objective) To help/facilitate/augment the students about the:  Explain origin, insertion, nerve supply, blood supply and actions of muscles of mastication. 3
  • 4. Specific Learning Objectives (cognitive) At the end of the lecture the student will able to:  Explain origin, insertion, nerve supply, blood supply and actions of muscles of mastication. 4
  • 5. Psychomotor Objective: (Guided response)  A student to draw tabulated form of Muscles of Mastication. 5
  • 6. Affective domain  To be able to display a good code of conduct and moral values in the class. To cooperate with the teacher and in groups with the colleagues. To demonstrate a responsible behavior in the class and be punctual, regular, attentive and on time in the class. To be able to perform well in the class under the guidance and supervision of the teacher. Study the topic before entering the class. Discuss among colleagues the topic under discussion in SGDs. Participate in group activities and museum classes and follow the rules. Volunteer to participate in psychomotor activities. Listen to the teacher's instructions carefully and follow the guidelines. Ask questions in the class by raising hand and avoid creating a disturbance. To be able to submit all assignments on time and get your sketch logbooks checked. 6
  • 7. Lesson contents  Clinical chair side question: Students will be asked if they know what is the function of Muscles of Mastications Outline: Activity 1 Describe features of Muscles of Mastication 7
  • 8. Recommendations  Students assessment: MCQs, Flashcards, Diagrams labeling. Learning resources: Langman’s T.W. Sadler, Laiq Hussain Siddiqui, Snell Clinical Anatomy, Netter’s Atlas, BD Chaurasia’s Human anatomy, Internet sources links. 8
  • 10. Masseter  Muscle: Masseter Origin: Zygomatic arch Insertion: Lateral surface/ ramus of mandible Nerve supply: Mandibular division of trigeminal nerve Action: Elevates mandible to occlude teeth 10
  • 12. Temporalis  Muscle: Temporalis Origin: Floor of temporal fossa (superior temporal like entire fossa) Insertion: Coronoid process of mandible Nerve supply: Mandibular division of trigeminal nerve Action: Anterior and superior fibers elevate mandible; posterior fibers retract mandible 12
  • 13. Lateral Pterygoid  Muscle: Lateral pterygoid (two heads) –Infra temporal fossa a. Upper Head b. Lower Head Origin: Upper head: Greater wing of sphenoid and Lower Head: lateral pterygoid plate Insertion: Neck of mandible and articular disc Nerve supply: Mandibular division of trigeminal nerve Action: Pulls neck of mandible forward, Protract mandible 13 LATERAL PTERYGOID
  • 15. Medial Pterygoid  Muscle: Medial pterygoid (two heads) –Infra temporal fossa a. Superficial b. Deep Origin: Superficial: Tuberosity of maxilla and Deep: Medial surface of lateral pterygoid plate Insertion: Medial surface of angle of mandible Nerve supply: Mandibular division of trigeminal nerve Action: Elevates mandible 15
  • 16. 16
  • 17. 17
  • 18. 18
  • 20. Muscle Pain Limited to OroFacial Region  Overuse  Chronic involuntary contraction (clenching/dystonia)  Ischemia of a normal muscle can cause pain.  Systemic neuromuscular disorders that cause muscle deterioration & pain, including muscles in orofacial region.  Examples of painful systemic neuromuscular disorders modulated by immune system include: Polymyalgia Rheumatica (PMR) Polymyositis (PM) Dermatomyositis (DM) Rhabdomyolysis (RM) Systemic Lupus Erythematosus (SLE) Fibromyalgia Syndrome (FMS.) 20
  • 21. Myalgia (Muscle Pain)  Common muscle pain complaint in jaw area is localized dull aching, aggravated by normal jaw function, parafunction (jaw clenching/teeth grinding) or jaw trauma.  Associated with tenderness/pain to palpation at one or more jaw muscle sites. Management:  Relaxation of painful muscles, muscle stretching, increasing blood flow to & from muscles  pain management  control of etiologic/aggravating/perpetuating factors. 21
  • 22. Myofacial Pain Disorder (MPD)  Involvesdistinct palpable pain of muscle,  nodules/points (Trigger Points) or zones (Trigger Zones) that refer pain along a predictable pattern, beyond boundaries of muscle being palpated.  Example: Masseter Muscle Trigger Point can refer pain to Mandibular Posterior Teeth on same side, with teeth often feeling more pain than Masseter Muscle. 22
  • 23. Tendonitis  Involves pain, inflammation & deterioration of tendon origin, tension on tendon from contraction of muscle cause limited range of motion of joint.  1. Temporalis Tendon: referred pain to Maxillary Posterior Teeth, Maxillary Sinus, behind Eye, inside Ear, Temporal Headache, TMJ, Temporalis Muscle/Temple & Lateral/Posterior Neck on same side. Greater Occipital Nerve exits spine & passes up through Temporalis Tendon, as it travels up back of skull. 23
  • 24. 24  2. Upper Trapezius Tendon: referred pain down Back, onto Shoulder, pain in Occipital Area & up back of Head). It can entrap & compress the Greater Occipital Nerve, resulting in Occipital Neuritis pain, Occipital, Cervicogenic and/or Frontal Headaches.  3. Occipital Neuralgia: pain referral travels up back & over top of Head, terminating in Frontal area, over eyes.
  • 25. Tendinosis/Enthesopathy  Similar to Tendonitis, pain & referral patterns, except there is no inflammation present in Tendinosis.  found at tendinous attachment of bone(s) muscle attaches to specific area where tendon fibers attach to bone, is called Enthesis.  At Enthesis, collagen fibers of tendon inserts into very small holes in bone.  These tendon fibers contain numerous nerve endings that transmit pain (nociceptors) & muscle tension/contraction forces (mechanoreceptors). 25
  • 26. 26  With acute trauma or chronic tension on Enthesis fiber attachments, fibers can be overstretched (strained/sprained), torn or pulled away from fibrous-bone attachment, causing a pathological condition called Enthesopathy.  Enthesopathies are not inflamed & very painful.  There are no blood vessels present in enthesis structures, making healing very slow, or no healing with chronic pain.
  • 27. Myositis  Acute painful generalized inflammation usually of entire muscle, which results from infection, overuse or trauma.  Painful swelling of muscle, with limited range of motion.  Clinical characteristics: Inflammation edema Erythema Increased temperature. 27
  • 28. Muscle Spasm  Sudden, involuntary, painful contraction of masticatory muscle characterized by acute severe pain & limitation of range of movement.  Acute changes in bite present with spasms on masticatory muscles. 28
  • 29. Jaw Movement Disorders  1. Orofacial dyskinesia: involves involuntary movements that involve Face Lips Tongue Jaw & result in traumatic injury to Oral mucosa Tongue Teeth 29
  • 30. 30  2. Dyskinesias: common with advancing age & in patients with a history of using neuroleptic medication, associated with traumatic brain injury, psychiatric conditions, or other neurologic disorders.  Myalgia of facial muscles & arthralgia of TMJ present.
  • 31. 31  3. Oromandibular dystonia: involves excessive, involuntary & sustained muscle contractions that involve face, lips, tongue or jaw muscles.
  • 32. 32  4. Dystonia: could be a symptom of several central nervous system disorders.  Acute trauma to brain, head & neck can trigger onset of transient or permanent dystonia of masticatory muscles.  The affected muscles are often painful & can make opening and closing mouth difficult, impair speech, swallowing & chewing.
  • 34. 34
  • 35. 35