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This seminar explains about the development, relations, ligaments, various attachments, vascular and nervous supply and various surgical approaches and its modifications to TMJ
The maxillary artery arises from the external carotid artery and divides into three parts - the mandibular, pterygoid, and pterygopalatine parts. It supplies structures in the face like the maxilla and mandible. The maxillary artery and its branches anastomose with other vessels and are clinically significant for conditions like nosebleeds, epidural hematomas, and complications during procedures like Le Fort I osteotomies when the branches can be injured. Precise surgical techniques are important to avoid damaging branches like the descending palatine artery.
TMJ surgical anatomy and applied aspectsJoel D'silva
The temporomandibular joint (TMJ) allows for hinge and gliding motions that facilitate functions like chewing and speech. It is a synovial joint containing features like bone, fibrocartilage discs, fluid-filled cavities, and ligaments. The TMJ is unique in that its surfaces are covered by fibrocartilage instead of hyaline cartilage and it is the only joint with a rigid closure point provided by tooth occlusion. Development of the TMJ occurs relatively late in utero, beginning with the formation of cartilaginous condyles that later ossify and fuse to the mandible.
This document discusses various surgical approaches to the temporomandibular joint (TMJ). It begins by outlining important anatomical structures in the region, including nerves, arteries and layers of fascia. It then describes several common approaches - preauricular, endaural, postauricular, submandibular, retromandibular and intraoral. For each approach, it provides details on the surgical technique, indications, advantages and disadvantages. References are also provided at the end for further reading on the surgical anatomy of the cervical and mandibular distributions of the facial nerve.
The document discusses the facial artery, which arises from the external carotid artery. It has both cervical and facial parts. The cervical part runs upwards in the neck, allowing movement of neck structures. It gives off branches like the ascending palatine and tonsillar arteries. The facial part enters the face by piercing the mandible. In the face, it gives branches like the inferior and superior labial arteries and terminates by anastomosing with the ophthalmic artery. The document also discusses the common carotid artery and its branches.
This seminar explains about the development, relations, ligaments, various attachments, vascular and nervous supply and various surgical approaches and its modifications to TMJ
The maxillary artery arises from the external carotid artery and divides into three parts - the mandibular, pterygoid, and pterygopalatine parts. It supplies structures in the face like the maxilla and mandible. The maxillary artery and its branches anastomose with other vessels and are clinically significant for conditions like nosebleeds, epidural hematomas, and complications during procedures like Le Fort I osteotomies when the branches can be injured. Precise surgical techniques are important to avoid damaging branches like the descending palatine artery.
TMJ surgical anatomy and applied aspectsJoel D'silva
The temporomandibular joint (TMJ) allows for hinge and gliding motions that facilitate functions like chewing and speech. It is a synovial joint containing features like bone, fibrocartilage discs, fluid-filled cavities, and ligaments. The TMJ is unique in that its surfaces are covered by fibrocartilage instead of hyaline cartilage and it is the only joint with a rigid closure point provided by tooth occlusion. Development of the TMJ occurs relatively late in utero, beginning with the formation of cartilaginous condyles that later ossify and fuse to the mandible.
This document discusses various surgical approaches to the temporomandibular joint (TMJ). It begins by outlining important anatomical structures in the region, including nerves, arteries and layers of fascia. It then describes several common approaches - preauricular, endaural, postauricular, submandibular, retromandibular and intraoral. For each approach, it provides details on the surgical technique, indications, advantages and disadvantages. References are also provided at the end for further reading on the surgical anatomy of the cervical and mandibular distributions of the facial nerve.
The document discusses the facial artery, which arises from the external carotid artery. It has both cervical and facial parts. The cervical part runs upwards in the neck, allowing movement of neck structures. It gives off branches like the ascending palatine and tonsillar arteries. The facial part enters the face by piercing the mandible. In the face, it gives branches like the inferior and superior labial arteries and terminates by anastomosing with the ophthalmic artery. The document also discusses the common carotid artery and its branches.
The document discusses the embryological development, components, and drainage patterns of the lymphatic system in the head and neck region. It begins with the development of the initial lymph sacs between weeks 5-9 of embryogenesis. It then describes the lymphatic tissues, vessels, nodes and their functions in draining the head and neck areas. Key lymph nodes discussed include the parotid, submandibular, retropharyngeal and jugular nodes. The document also touches on lymphadenopathy and the clinical assessment of enlarged lymph nodes.
Applied surgical anatomy of facial nerve in oral and maxillofacial surgeryShalini Bhatia
The document describes the anatomy and clinical considerations related to the facial nerve. It begins by detailing the various branches of the facial nerve and their course through the parotid gland and across the face. It then discusses landmarks used during surgery to identify the nerve. Several causes of facial nerve paralysis are listed including Bell's palsy, Ramsay Hunt syndrome, Melkersson-Rosenthal syndrome, and complications from procedures like IANB. Classification systems for nerve injuries are also summarized.
The maxillary sinus is the largest of the paranasal sinuses. It develops within the body of the maxilla and communicates with the nasal cavity via the ostium in the middle meatus. The maxillary sinus has important anatomical relationships with surrounding structures like the orbit, teeth roots, and nerves. Diagnostic evaluation of the maxillary sinus involves medical history, clinical examination including transillumination, and imaging modalities like radiography, CT, MRI, ultrasound, and endoscopy.
The document discusses the development of the face and its structures from early embryonic development through the formation of the branchial arches and facial prominences. It describes how the frontonasal, maxillary, and mandibular processes merge in the midline to form structures of the face, including the lips, nose, and palate. The development of specific structures like the nose, paranasal sinuses, jaws, and palate are then examined in more detail. The role of the branchial arches and Meckel's cartilage in mandibular development is also summarized.
This document provides an overview of surgical approaches to the temporomandibular joint (TMJ). It discusses several extraoral and intraoral approaches, including the preauricular, endaural, postauricular, coronal, retromandibular, and intraoral vestibular approaches. For each approach, it highlights considerations for exposure and visibility of the joint, avoidance of neurovascular structures, and postoperative aesthetics. Complications are also briefly mentioned. Detailed anatomical descriptions and illustrations are provided to demonstrate the surgical planning and exposure for different approaches.
The document summarizes the development of the face from the 4th week of embryonic development. It discusses how the frontonasal process, maxillary processes, and mandibular processes form the structures of the face, including the lips, nose, eyes, ears, and palate. It also describes the development of branchial arches and how they contribute to specific muscles, nerves, arteries, and bones. The formation and differentiation of the pharyngeal pouches and clefts that form parts of the ear, thyroid, parathyroid glands and thymus are also outlined.
The document describes the submandibular and retromandibular surgical approaches. The submandibular approach involves making a 1.5-2 cm incision inferior to the mandible and dissecting through the layers of the skin, subcutaneous tissue, platysma muscle, and pterygomasseteric sling. The retromandibular approach uses a vertical incision 2 cm posterior to the mandibular ramus and dissects through the same layers to the pterygomasseteric sling. Both approaches give access below the mandible for surgical procedures.
The document discusses the muscles of mastication, including their origin, insertion, relations, blood supply, innervation, actions, and clinical importance. It covers the major muscles - masseter, temporalis, medial pterygoid, and lateral pterygoid - in detail. It also briefly mentions the accessory muscles of mastication, including the digastric, mylohyoid, and geniohyoid muscles. The development and embryology of the muscles is summarized.
The lymphatic system consists of lymph capillaries that collect fluid from tissues, lymph vessels that transport the fluid, and lymph nodes that filter the lymph. The main functions are collecting and transporting tissue fluid, returning plasma proteins to blood, transporting fats and other molecules, and assisting the immune system. The components are lymph fluid, lymphatic vessels, lymphatic tissues in organs, and lymphatic organs where immune cells concentrate. Lymph nodes are commonly enlarged in infection or cancer metastasis.
This document provides an overview of maxilla anatomy and development. It discusses:
- The development of the maxilla from the first branchial arch during weeks 4-8 of gestation, including how the maxillary process, palatal shelves, and tongue form.
- Features of the adult maxilla, including its four surfaces and processes. It houses the maxillary sinus and articulates with several cranial bones.
- Age-related changes like a more vertical diameter in adults and absorption in older individuals.
- Considerations for periodontal and implant procedures related to anatomical structures like nerves, vessels and muscle attachments in the maxilla.
The maxillary sinus is the largest of the paranasal sinuses. It is located within the body of the maxilla and has a pyramidal shape. The maxillary sinus develops during fetal development from the maxillary process and reaches its maximum size by age 18. It is important for functions like voice resonance and warming inhaled air. Disease processes like sinusitis, cysts, tumors or dental infections can involve the maxillary sinus. Radiographs are important for evaluating the sinus floor and its relationship to tooth roots. Surgical procedures may be needed to treat conditions like oroantral fistulas or remove foreign bodies from the sinus.
The soft palate contains five muscles that are important for swallowing and breathing. The muscles are the tensor veli palatini, levator veli palatini, palatoglossus, palatopharyngeus, and musculus uvulae. Each muscle has a specific origin, insertion point, and action. For example, the levator veli palatini originates from the base of the skull and curves downward and forward to enter the palate, contracting to lift the soft palate upwards and backwards during swallowing. The muscles receive their nerve supply from either the trigeminal or accessory cranial nerves and are supplied by arteries including the facial and maxillary arteries.
Surgical anatomy of temporomandibular jointAaisha Ansari
The document provides information about the temporomandibular joint (TMJ). It begins by listing the presenters and guides. It then discusses the classification, components, articulation, innervation, biomechanics, and applied surgical anatomy of the TMJ. The key components discussed include the condyle, glenoid fossa, articular eminence, capsule, articular disc, discal ligaments, and synovial membrane. Disorders of the articular disc are also mentioned. Diagrams and figures are provided to illustrate the anatomical structures.
This document discusses the osteology of the maxilla and mandible bones. It covers the development, structure, age-related changes and prosthodontic considerations of each bone. For the maxilla, it describes the processes, surfaces, ossification centers and articulations. It also discusses the maxillary sinus and its openings. For the mandible, it outlines the body, ramus, processes including coronoid and condylar processes, and muscle attachments. The document provides detailed anatomical information on these important facial bones.
The applied anatomy of temporomandibular joint has many significant applications in maxillofacial surgery. Understanding these important anatomic relations- variations enables surgeons to perform the surgical procedures safely. Knowledge of these concepts helps us to recognize the problems and complications as and when they occur and manage them accordingly.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
This document discusses the nerve supply of the head and neck region. It begins with an introduction to neurons, nerve structures, and sensory receptors. It then covers the cutaneous supply of the head, which is provided by the trigeminal nerve, and the neck, which is provided by the cervical plexus. Specific branches of the trigeminal, facial, spinal accessory, and other cranial nerves are described. The motor innervation of head and neck muscles is also outlined. Key structures including ganglia and nuclei are defined.
The temporomandibular joint (TMJ) connects the mandible to the temporal bone. It is a compound joint composed of bone and soft tissue structures. The TMJ develops from condylar and temporal blastemas and its structures allow for both hinging and gliding movements. Clinically, the TMJ is examined through inspection, palpation, auscultation and assessment of range of motion. Abnormal findings may include swelling, crepitus, limited movement or clicking sounds.
The orbit is a pyramid-shaped cavity located in the skull that houses the eye and surrounding structures. It is formed by seven bones and contains the eyeball, extraocular muscles, blood vessels, nerves and other tissues. The orbit communicates with surrounding areas through several openings that transmit nerves and vessels between the orbit and other craniofacial regions. The complex anatomy of the orbit allows for movement of the eye while protecting its delicate contents.
The document provides information on the growth and development of the maxilla. It begins with definitions of growth and development. It then discusses prenatal and postnatal growth of the maxilla, including formation from the first pharyngeal arch and development of related structures like the palate. The document outlines the anatomy of the maxilla including its surfaces, processes, sinuses and articulations. It notes age-related changes and clinical and prosthodontic considerations for treating developmental anomalies and edentulous patients.
The temporomandibular joint (TMJ) is a synovial joint that connects the mandible to the temporal bone. It is a compound joint composed of the head of the mandible, mandibular fossa, articular disc, articular eminence, and surrounding ligaments. The TMJ allows hinge-like opening and closing of the jaw as well as gliding movements. It is innervated by the trigeminal nerve and irrigated by blood vessels including the middle meningeal artery.
This document provides an overview of the anatomy, components, relations, blood supply, nerve supply, muscles, and age changes of the temporomandibular joint (TMJ). It discusses the bony and soft tissue structures of the TMJ, including the condyle, glenoid fossa, articular eminence, articular disc, ligaments, and synovial fluid. It also describes the muscles associated with TMJ function and common symptoms and findings associated with TMJ disorders.
The document discusses the embryological development, components, and drainage patterns of the lymphatic system in the head and neck region. It begins with the development of the initial lymph sacs between weeks 5-9 of embryogenesis. It then describes the lymphatic tissues, vessels, nodes and their functions in draining the head and neck areas. Key lymph nodes discussed include the parotid, submandibular, retropharyngeal and jugular nodes. The document also touches on lymphadenopathy and the clinical assessment of enlarged lymph nodes.
Applied surgical anatomy of facial nerve in oral and maxillofacial surgeryShalini Bhatia
The document describes the anatomy and clinical considerations related to the facial nerve. It begins by detailing the various branches of the facial nerve and their course through the parotid gland and across the face. It then discusses landmarks used during surgery to identify the nerve. Several causes of facial nerve paralysis are listed including Bell's palsy, Ramsay Hunt syndrome, Melkersson-Rosenthal syndrome, and complications from procedures like IANB. Classification systems for nerve injuries are also summarized.
The maxillary sinus is the largest of the paranasal sinuses. It develops within the body of the maxilla and communicates with the nasal cavity via the ostium in the middle meatus. The maxillary sinus has important anatomical relationships with surrounding structures like the orbit, teeth roots, and nerves. Diagnostic evaluation of the maxillary sinus involves medical history, clinical examination including transillumination, and imaging modalities like radiography, CT, MRI, ultrasound, and endoscopy.
The document discusses the development of the face and its structures from early embryonic development through the formation of the branchial arches and facial prominences. It describes how the frontonasal, maxillary, and mandibular processes merge in the midline to form structures of the face, including the lips, nose, and palate. The development of specific structures like the nose, paranasal sinuses, jaws, and palate are then examined in more detail. The role of the branchial arches and Meckel's cartilage in mandibular development is also summarized.
This document provides an overview of surgical approaches to the temporomandibular joint (TMJ). It discusses several extraoral and intraoral approaches, including the preauricular, endaural, postauricular, coronal, retromandibular, and intraoral vestibular approaches. For each approach, it highlights considerations for exposure and visibility of the joint, avoidance of neurovascular structures, and postoperative aesthetics. Complications are also briefly mentioned. Detailed anatomical descriptions and illustrations are provided to demonstrate the surgical planning and exposure for different approaches.
The document summarizes the development of the face from the 4th week of embryonic development. It discusses how the frontonasal process, maxillary processes, and mandibular processes form the structures of the face, including the lips, nose, eyes, ears, and palate. It also describes the development of branchial arches and how they contribute to specific muscles, nerves, arteries, and bones. The formation and differentiation of the pharyngeal pouches and clefts that form parts of the ear, thyroid, parathyroid glands and thymus are also outlined.
The document describes the submandibular and retromandibular surgical approaches. The submandibular approach involves making a 1.5-2 cm incision inferior to the mandible and dissecting through the layers of the skin, subcutaneous tissue, platysma muscle, and pterygomasseteric sling. The retromandibular approach uses a vertical incision 2 cm posterior to the mandibular ramus and dissects through the same layers to the pterygomasseteric sling. Both approaches give access below the mandible for surgical procedures.
The document discusses the muscles of mastication, including their origin, insertion, relations, blood supply, innervation, actions, and clinical importance. It covers the major muscles - masseter, temporalis, medial pterygoid, and lateral pterygoid - in detail. It also briefly mentions the accessory muscles of mastication, including the digastric, mylohyoid, and geniohyoid muscles. The development and embryology of the muscles is summarized.
The lymphatic system consists of lymph capillaries that collect fluid from tissues, lymph vessels that transport the fluid, and lymph nodes that filter the lymph. The main functions are collecting and transporting tissue fluid, returning plasma proteins to blood, transporting fats and other molecules, and assisting the immune system. The components are lymph fluid, lymphatic vessels, lymphatic tissues in organs, and lymphatic organs where immune cells concentrate. Lymph nodes are commonly enlarged in infection or cancer metastasis.
This document provides an overview of maxilla anatomy and development. It discusses:
- The development of the maxilla from the first branchial arch during weeks 4-8 of gestation, including how the maxillary process, palatal shelves, and tongue form.
- Features of the adult maxilla, including its four surfaces and processes. It houses the maxillary sinus and articulates with several cranial bones.
- Age-related changes like a more vertical diameter in adults and absorption in older individuals.
- Considerations for periodontal and implant procedures related to anatomical structures like nerves, vessels and muscle attachments in the maxilla.
The maxillary sinus is the largest of the paranasal sinuses. It is located within the body of the maxilla and has a pyramidal shape. The maxillary sinus develops during fetal development from the maxillary process and reaches its maximum size by age 18. It is important for functions like voice resonance and warming inhaled air. Disease processes like sinusitis, cysts, tumors or dental infections can involve the maxillary sinus. Radiographs are important for evaluating the sinus floor and its relationship to tooth roots. Surgical procedures may be needed to treat conditions like oroantral fistulas or remove foreign bodies from the sinus.
The soft palate contains five muscles that are important for swallowing and breathing. The muscles are the tensor veli palatini, levator veli palatini, palatoglossus, palatopharyngeus, and musculus uvulae. Each muscle has a specific origin, insertion point, and action. For example, the levator veli palatini originates from the base of the skull and curves downward and forward to enter the palate, contracting to lift the soft palate upwards and backwards during swallowing. The muscles receive their nerve supply from either the trigeminal or accessory cranial nerves and are supplied by arteries including the facial and maxillary arteries.
Surgical anatomy of temporomandibular jointAaisha Ansari
The document provides information about the temporomandibular joint (TMJ). It begins by listing the presenters and guides. It then discusses the classification, components, articulation, innervation, biomechanics, and applied surgical anatomy of the TMJ. The key components discussed include the condyle, glenoid fossa, articular eminence, capsule, articular disc, discal ligaments, and synovial membrane. Disorders of the articular disc are also mentioned. Diagrams and figures are provided to illustrate the anatomical structures.
This document discusses the osteology of the maxilla and mandible bones. It covers the development, structure, age-related changes and prosthodontic considerations of each bone. For the maxilla, it describes the processes, surfaces, ossification centers and articulations. It also discusses the maxillary sinus and its openings. For the mandible, it outlines the body, ramus, processes including coronoid and condylar processes, and muscle attachments. The document provides detailed anatomical information on these important facial bones.
The applied anatomy of temporomandibular joint has many significant applications in maxillofacial surgery. Understanding these important anatomic relations- variations enables surgeons to perform the surgical procedures safely. Knowledge of these concepts helps us to recognize the problems and complications as and when they occur and manage them accordingly.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
This document discusses the nerve supply of the head and neck region. It begins with an introduction to neurons, nerve structures, and sensory receptors. It then covers the cutaneous supply of the head, which is provided by the trigeminal nerve, and the neck, which is provided by the cervical plexus. Specific branches of the trigeminal, facial, spinal accessory, and other cranial nerves are described. The motor innervation of head and neck muscles is also outlined. Key structures including ganglia and nuclei are defined.
The temporomandibular joint (TMJ) connects the mandible to the temporal bone. It is a compound joint composed of bone and soft tissue structures. The TMJ develops from condylar and temporal blastemas and its structures allow for both hinging and gliding movements. Clinically, the TMJ is examined through inspection, palpation, auscultation and assessment of range of motion. Abnormal findings may include swelling, crepitus, limited movement or clicking sounds.
The orbit is a pyramid-shaped cavity located in the skull that houses the eye and surrounding structures. It is formed by seven bones and contains the eyeball, extraocular muscles, blood vessels, nerves and other tissues. The orbit communicates with surrounding areas through several openings that transmit nerves and vessels between the orbit and other craniofacial regions. The complex anatomy of the orbit allows for movement of the eye while protecting its delicate contents.
The document provides information on the growth and development of the maxilla. It begins with definitions of growth and development. It then discusses prenatal and postnatal growth of the maxilla, including formation from the first pharyngeal arch and development of related structures like the palate. The document outlines the anatomy of the maxilla including its surfaces, processes, sinuses and articulations. It notes age-related changes and clinical and prosthodontic considerations for treating developmental anomalies and edentulous patients.
The temporomandibular joint (TMJ) is a synovial joint that connects the mandible to the temporal bone. It is a compound joint composed of the head of the mandible, mandibular fossa, articular disc, articular eminence, and surrounding ligaments. The TMJ allows hinge-like opening and closing of the jaw as well as gliding movements. It is innervated by the trigeminal nerve and irrigated by blood vessels including the middle meningeal artery.
This document provides an overview of the anatomy, components, relations, blood supply, nerve supply, muscles, and age changes of the temporomandibular joint (TMJ). It discusses the bony and soft tissue structures of the TMJ, including the condyle, glenoid fossa, articular eminence, articular disc, ligaments, and synovial fluid. It also describes the muscles associated with TMJ function and common symptoms and findings associated with TMJ disorders.
The document provides an overview of the temporomandibular joint (TMJ), including its anatomy, components, development, function, and age-related changes. Key points include:
- The TMJ is a synovial joint that permits hinge and gliding movements of the mandible and involves the condyle of the mandible articulating with the temporal bone.
- Its main components are the mandibular condyle, glenoid fossa, articular disc, articular capsule, synovial membrane, and ligaments.
- It develops from Meckel's cartilage and functions in speech, mastication, and deglutition.
- Age-related changes include fl
The TMJ is a complex and precisely integrated bilateral
joint structure .
Formed by the articulation of lower jaw with cranium
and the upper facial skeleton
This presentaion was submitted in Dept.of Oral pathology in Goverment Dental College Raipur.
This document discusses the histology of the temporomandibular joint (TMJ). It describes the four main anatomical parts: the mandibular condyle, mandibular fossa and articular eminence, articular disc, and articular capsule. The mandibular condyle articulates with the temporal bone and is composed of cancellous bone covered by fibrous tissue. The mandibular fossa and articular eminence are composed of bone and fibrous tissue. The articular disc separates the joint into two compartments and is composed of dense fibrous tissue. The articular capsule encloses the joint and is lined by a synovial membrane that produces synovial fluid to lubricate
This document provides an overview of the anatomy and physiology of the temporomandibular joint (TMJ). It describes the development, components, ligaments, vascularization, innervation and relationships of the TMJ. The key components discussed include the articular disc, condyle, articular eminence, glenoid fossa, capsule and ligaments. The functions of synovial fluid in lubrication and the receptors and nerves involved in proprioception are also summarized.
The temporomandibular joint is a synovial joint formed by the condyle of the mandible and the temporal bone. It contains an articular disc that divides the joint into two compartments. The joint is surrounded by a capsule and strengthened by ligaments like the collateral, capsular, and temporomandibular ligaments. The joint is innervated by branches of the trigeminal nerve and vascularized by small vessels that enter through the marrow spaces in the condyle.
The temporomandibular joint (TMJ) connects the jaw bone to the skull. It is a complex synovial joint that allows for movement of the mandible during chewing and talking. The TMJ has both bony and soft tissue components including the condyle, glenoid fossa, articular disc, joint capsule, ligaments and muscles. The TMJ develops late in utero and has a complex anatomy that facilitates its range of motion. Disorders can affect the TMJ resulting in problems like pain, limited movement or locking of the jaw.
ANATOMY TEMPOROMANDIBULAR JUNCTION OF HUMANDesiFitriani85
The temporomandibular joint (TMJ) connects the mandible to the skull and regulates movement of the mandible, which is important for chewing and speaking. It is a synovial joint with both gliding and hinge-like movements. The TMJ consists of the mandibular condyle, glenoid fossa, articular eminence, articular disc, synovial membrane, and surrounding ligaments. It allows the mandible to open and close via hinge movement of the condyle and sliding of the articular disc. The synovial membrane lubricates the joint and nourishes the articulating bones. Various muscles like the masseter and lateral pterygoid are
This document provides an overview of the temporomandibular joint (TMJ), including its:
- Types (synovial, bicondylar, ginglymoarthroidal)
- Anatomy (bones, articular disc, ligaments, muscles)
- Histology of the articular surfaces
- Biomechanics and functions like opening and closing the mouth
- Age-related changes like flattening of bones and thinning of tissues
This document provides an overview of the anatomy and biomechanics of the temporomandibular joint (TMJ). It describes the TMJ as a compound synovial joint that connects the lower jaw to the skull. The TMJ allows for complex movements through its articular disc and surrounding ligaments. The document outlines the embryonic development of the TMJ and provides detailed descriptions of the anatomical structures that make up the joint, including the articular surfaces, disc, ligaments, innervation, and vascularization. It explains the biomechanical functions of these structures during jaw movements like opening, closing, and rotating.
The document discusses diseases of the temporomandibular joint (TMJ). It begins with an introduction to the anatomy of the TMJ, including its components like the articular disc. It then discusses various disorders that can affect the TMJ, classifying them as structural disorders like developmental issues, inflammation, infection, or degenerative changes, or functional disorders like pain/dysfunction syndrome. Specific conditions that can cause limited or excessive mobility of the joint like trismus, pseudoankylosis, and true ankylosis are then explained in more detail.
DEFINITION, ANATOMY, AND FUNCTIONS OF TEMPOROMANDIBULAR JOINT.
Joint between the head (condyle) of the mandible and the undersurface (articular fossa)of the squamous part of the temporal bone is the temporomandibular joint.
Type of joint : synovial joint (condylar variety).
Capable of providing-hinging (rotation) -gliding (translation) movement.
Sustains incredible forces of mastication.
articulating surfaces-articualar tubercle, mandibular fossa.
functions-Chewing
Sucking
Swallowing
Phonation
Facial expressions
Breathing Protrusion,
Retrusion,
Lateralization of the jaw
Opening the mouth
Maintain the correct pressure of the middle ear
Blood supply- Branches from superficial temporal and maxillary artery.
Veins follow the arteries.
Nerve supply-Auriculotemporal nerve (branch of mandibular nerve) and masseteric nerve (motar branch of anterior division of mandibular nerve).
movemnets of tmj- protraction, retraction, elevation, depression, side to side grinding.
examination of tmj- preauricular method and intraauricular method.
The temporomandibular joint (TMJ) permits the mandible to move through gliding and hinge movements. It consists of the mandibular condyle, mandibular fossa, articular disc, and articular capsule. The condyle articulates with the fossa and articular eminence, while the articular disc separates the joint into upper and lower compartments. The joint capsule surrounds the joint and is lined with a synovial membrane that produces lubricating synovial fluid. Accessory ligaments and the lateral temporomandibular ligament provide stability to the joint. The TMJ undergoes age-related changes including flattening of the condyle and thinning of the
Temporomandibular joint Disorder in oral pathology HIMANSHU DHAKAD
In this slide we talk about temporomandibular joint disorders
Its introduction,classification , anatomy , histology in details
Also cover articular disorder
Traumatic disturbances
Non articular disorders
Development disturbance etc.
Anatomy and physiology of temporomandibular joint Akshay Karve
The temporomandibular joint (TMJ) connects the mandible to the temporal bone. It has bony, cartilaginous, and ligamentous components. The condyle of the mandible fits into the mandibular fossa of the temporal bone. An articular disc divides the joint cavity into upper and lower compartments and aids movement. Several ligaments support and restrict movement of the TMJ, which functions to allow opening and closing of the jaw during activities like chewing.
Basics about TMJ ( development fuction movement etc ) with classification of tmj disorders and stress on tmj examination.
Also covers muscles of masstication
The temporomandibular joint (TMJ) connects the mandible to the temporal bone and allows hinge and gliding motions. It is composed of articular surfaces covered in fibrocartilage, a specialized articular disc, synovial fluid, and several ligaments and muscles that control jaw movement. The muscles of mastication - the masseter, medial and lateral pterygoid, and temporalis muscles - originate on the skull and insert on the mandible to elevate and move the jaw. Disorders of the TMJ can include dislocation or ankylosis where the jaw bones fuse.
The document defines various anatomical structures and movements of the temporomandibular joint (TMJ). It describes the TMJ as a synovial joint that allows hinge-like and sliding movements between the condyle of the mandible and temporal bone. Key terms defined include the articular disc, ligaments, muscles of mastication, and different movements such as protrusion, retrusion, and lateral excursions.
This document provides an overview of the temporomandibular joint (TMJ), including its classification, development, anatomy, biomechanics, innervation, and surgical approaches. Key points covered include that the TMJ is a synovial joint that connects the mandible to the skull and allows for hinge and gliding movements. It has several unique features, such as having an articular disc and fibrocartilage surfaces. The document describes the anatomy of the TMJ in detail, including the mandibular fossa, condyle, articular disc, ligaments, vascular supply, and innervation. Finally, common surgical approaches to access the TMJ are summarized.
Similar to Surgical anatomy of the temporomandibular joint and surgical (nx power lite) /certified fixed orthodontic courses by Indian dental academy (20)
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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Surgical anatomy of the temporomandibular joint and surgical (nx power lite) /certified fixed orthodontic courses by Indian dental academy
1. SURGICAL ANATOMY AND
APPROACHES TO THE
TEMPOROMANDIBULAR JOINT
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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2.
INTRODUCTION OF THE TMJ
ARTICULATORY SYSTEM
TMJ CAPSULE
ARTICULAR DISK
LIGAMENTS
BLOOD AND NERVE SUPPLY
MUSCLES
MOVEMENTS OF THE TMJ
SURGICAL ANATOMY
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3. INTRODUCTION
The TMJ is also known as the craniomandibular
joint/articulation.
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4.
The TMJ is a gingylmoarthrodial joint that is freely mobile with superior and
inferior joint cavities separated by the meniscus (articular disc).
It is considered as a complex joint because it involves two separate joints (rt.
& lt.) in which there is presence of intracapsular disc and both joints have to
function in coordination.
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5. ARTICULATORY SYSTEM
The articulatory system comprises of the following :
The TMJ
The masticatory and accessory muscles
The occlusion of the teeth.
The function is governed by sensory and motor branches of he
third division of the trigeminal nerve (mandibular) and a few
fibers of the facial nerve.
The occlusion of the teeth plays an imp. role in he function of
the TMJ. Normally, the greatest part of the force of mastication
is borne by the dentition of the jaws, but in case of occlusal
disharmony, a great deal of force can be shifted to the joint itself.
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6. CRANIAL COMPONENT
Mandibular ( glenoid fossa) :
It is an anterior articular area formed by the inferior aspect of
temporal squama. It’s surface is smooth, oval and deeply hollow
and the bone is very thin at the depth of the fossa. The fossa is
lined by dense avascular fibrocartilage.
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7. CRANIAL COMPONENT
Limits are :
Anteriorly – articular
eminence or tubercle
Posteriorly – post glenoid
tubercle
Medially – spine of he
sphenoid bone
Laterally – root of the
zygomatic process of
temporal bone
Superiorly – separated from
MCF by thin plate of bone at
apex
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8. MANDIBULAR COMPONENT
Mandibular condyle :
The articular part of the
mandible is an ovoid
condylar process (head)
with narrow mandibular
neck. It is broad laterally
and narrower medially.
The articular part of the
condyle is covered by
fibrocartilage.
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9. MANDIBULAR COMPONENT
Mediolateral dimension
varies bn. 13 – 25 mm.
Anteroposterior width varies
bn. 5.5 – 16 mm.
Majority of the human
condyles (58%) are slightly
convex superiorly.
25% of the condyles may be
flat superiorly.
12% are pointed or angular
in shape.
3% are bulbous or rounded
in shape.
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10. TMJ CAPSULE
TMJ capsule is a thin sleeve of
fibrous tissue investing the joint
completely, it defines the
anatomic and functional
boundaries of the TMJ.
It is a funnel shaped capsule,
which blends with the
periosteum of the mandibular
neck and it envelops the
articular disc.
On the temporal bone, the
articular capsule surrounds the
articular surfaces of the
eminence and fossa.
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11. TMJ CAPSULE
Attachments
Anteriorly – ant. border of the
articular eminence.
Posteriorly – lip of
squamotympanic fissure and
ant. sf. of postglenoid pss.
Laterally – edge of the
eminence and glenoid fossa.
Medially – along the
sphenosquamosal suture.
Below – neck of the condyle
medially and laterally.
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12. TMJ CAPSULE
Each part of the joint is surrounded by short capsular fibers
which stretch from the condyle to the disc, and from the disc to
the temporal bone forming two joint capsules.
Longer bands extending from the condyle to the temporal bone
may be regarded as reinforcing fibers.
Capsular fibers passing bn. the mandible and temporal bone are
present only on the lateral side.
The cavities are lined with synovial tissue with villi extending
from anterior and posterior part of the articular disk to the
attachments to the temporal bone and mandibular condyle.
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13. ARTICULAR DISK
The articular disk, an oval
plate of fibrous tissue shaped
like a tweaked cap,
completely divides the
articular space into two
compartments:
The inferior compartment –
condylodiscal complex
between the condyle and the
disc.
The superior compartment –
temporodiscal complex
between the disc and the
glenoid fossa.
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14. ARTICULAR DISK
The disk is biconcave in the sagittal section.
The superior surface is concavoconvex to
match the anatomy of the glenoid fossa and the
inferior surface is concave to fit over the
condylar head.
Histologically the disk is a meshwork of firmly
woven avascular fibrous connective tissue.
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15. ARTICULAR DISK
The disc is a complex
structure.
It has three different zones
(Rees 1954) posterior band,
intermediate band and
anterior band.
The disk blends medially and
laterally with the capsule,
which is attached to the
medial and lateral poles of
the condyle.
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16. ARTICULAR DISK
The meniscus projects
anteriorly to form a footshaped process the pes
meniscus. This pss. is attached
superiorly to the articular
eminence and superior belly
of the lat. pterygoid muscle.
Inferiorly the pes meniscus is
attached to the articular
margin of the condyle.
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17. ARTICULAR DISK
The posterior meniscus
attachment is the bilaminar
zone, composed if two strata
of fibres separated by a
central zone composed of
loose areolar connective
tissue.
The meniscus is highly
vascular in this region and is
called the genu vasculosa.
( sensory branches of the
auriculotemporal n.)
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18. ARTICULAR DISK
The posterior meniscus
attaches via the superior
stratum (elastic fibers) to
the tympanic plate of the
temporal bone.
The inferior stratum
(inelastic collagen)
attaches to the neck of
the condyle.
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19. SYNOVIAL MEMBRANE
The inside of the TMJ capsule and the nonarticulating surfaces
of the disk ligaments are lined with synovial membrane.
It has been estimated that the volume of synovial fluid in the
superior joint compartment is 1.2ml and in the posterior
compartment is 0.9ml.
The synovial fluid contains a glycoprotein known as lubricin,
which serves to lubricate and minimize friction between articular
surfaces of the joint.
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20. TEMPOROMANDIBULAR LIGAMENT
TMJ capsule is reinforced by
this main stabilizing ligament.
It extends downward and
backward from the lat. aspect of
the articular eminence to the
external and posterior aspect of
the condylar neck.
This ligament functions like a
pendulum, which allows
translation but resists abnormal
lateral condyle displacement.
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21. SPHENOMANDIBULAR LIGAMENT
It is a flat, thin band
descending from the spine of
the sphenoid and widening to
reach the lingula of the
mandibular foramen.
It is imp. landmark during
surgery as the maxillary artery
and the auriculotemporal n.
lies between it and the
mandibule.
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22. STYLOMANDIBULAR LIGAMENT
The stylomandibular
ligament, a specialized band
of deep cervical fascia
stretches from the apex and
adjacent anterior aspect of
the styloid process to the
mandible’s angle and
posterior border.
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23. BLOOD SUPPLY
The lateral aspect is supplied by superficial temporal artery.
Rich vascular supply to the deep and posterior aspect of the
retrodiscal capsular part by deep auricular, posterior auricular
and the masseteric artery.
Vascular supply to the lateral pterygoid muscle also supplies the
head of the condyle by penetration of numerous nutrient
foramina vessels.
The venous pattern is more diffuse forming a plentiful plexus all
around the capsule.
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24. NERVE SUPPLY
The mandibular nerve innervates the TMJ.
Three branches from this nerve send terminals to the joint
capsule:
Largest – Auriculotemporal n. – posterior, medial and lateral
parts of the joint.
Massseteric nerve.
Branch from the posterior deep temporal nerve supplies the
anterior parts of the joint.
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25. MUSCLES OF MASTICATION
MASSETER : Two heads
The superficial head originates
on the anterior zygomatic arch,
runs downward and backward
and inserts on the angle and the
ramus.
The deep head originates from
the posterior part of the zygoma,
runs vertically downwards and
inserts on the ramus and the
coronoid process.
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26. MUSCLES OF MASTICATION
TEMPORALIS :
Originates from – the lower
temporal line, the temporal fossa,
temporal fascia.
Fibers converge into a tendinous
band which then divides into 2
parts.
Superficial group of fibers inserts
on the superolateral sf. of the
coronoid pss.
Deeper larger fibers form a band
along the inner coronoid pss.
extending inferiorly to the ant.
border of the ramus.
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27. MUSCLES OF MASTICATION
MEDIAL PTERYGOID :
Superficial head from
tuberosity and adjoining
bone.
Deep head from medial sf.
of lat. Pterygoid plate and
palatine bone.
Fibers run posteroinferiorly
inserting on the medial
surface of the ramus and the
angle.
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28. MUSCLES OF MASTICATION
LATERAL PTRYGOID :
Upper head arises from the
infratemporal sf. and crest of
of the greater wing of the
sphenoid.
Lower head arises from lat.
Pterygoid plate.
Fibers run posterolaterally
and converge to insert onto:
Pterygoid fovea
Ant. margin of the articular
disc and capsule of the TMJ.
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29. ACCESSORY MUSCLES - SUPRAHYOID
DIGASTRIC :
The ant. belly originates near
the mandibular symphysis.
The post. belly originates on
the mastoid notch.
The ant. belly runs downwards
and backward and post. belly
forwards to meet the
intermediate tendon.
This tendon is held by a
fibrous pulley attached to the
hyoid bone
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30. ACCESSORY MUSCLES - SUPRAHYOID
GENIOHYOID : Originates from
the genial tubercle and runs
backward to insert into anterior
surfacef of body of the hyoid.
MYLOHYOID : Originates from
the mylohyoid line.
Fibers run medially and slightly
downwards. Post. Fibers insert into
body of hyoid. Middle & ant. fibers
insert into the median raphe that
unites the rt. & lt. muscles.
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31. ACCESSORY MUSCLES - SUPRAHYOID
STYLOHYOID : Originates from the post. surface of the styloid process.
The tendon divides into two slips that pass on either sides of the digastric
tendon to insert into the hyoid bone.
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32. ACCESSORY MUSCLES - INFRAHYOID
STERNOTHYROID : Originates on the manubrium of the sternum and
inserts at the thyroid cartilage.
THYROHYOID :Originates on the thyroid cartilage and inserts on the hyoid
bone.
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33. ACCESSORY MUSCLES - INFRAHYOID
OMOHYOID :Originates on the superior part of the scapula
and inserts at the lateral border of the hyoid bone.
STERNOHYOID : Originates on the manubrium of the
sternum and inserts on the body of the hyoid bone.
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34. MOVEMENTS OF THE TMJ
Motions of the TMJ are manifold. It is a ginglimus, diarthrodial
type of joint, as it is capable of rotating around more than one axis
and is capable of hinge/rotatory movement and also capable of
gliding/translatory movement.
A hinge type of movement takes place in the lower compartment
between inferior aspect of the stationary disc and the moving
condyle.
Gliding type of movement takes place in the upper compartment
between the superior surface of the disc, which moves with the
condyle ,and the stationary mandibular fossa and eminence.
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35. MOVEMENTS OF THE TMJ
The mandible can be depressed, elevated, protruded or retruded.
Lateral excursions can also be carried out.
There is a variation of normal patterns of motion in different
individuals, which are caused by many factors, including the
following:
Condyle head size, shape and inclinaiton.
Glenoid fossa depth and angulation.
Articular eminence height and degree of inclination.
Length and laxity of ligaments comprising the joint capsule.
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36. MOVEMENTS
Degenerative joint disease state resulting either from local
causes or systemic causes.
Strength, length, position and tonicity of muscles of
mastication and the suprahyoid musculature.
Neuromuscular control of the muscles.
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38. MOVEMENTS (CLOSURE)
It is accomplished by the
simultaneous contraction
of the masseter, medial
pterygoid and temporalis
muscle of both the sides.
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39. MOVEMENTS (DEPRESSION)
Digastric muscle contraction
depresses the body of the
mandible.
This action is assisted by the
suprahyoid, sternohyoid, and
geniohyoid muscles.
The lateral pterygoid is the
trigger and contracts to pull
the condylar head downward
and forward on the articular
eminence.
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41. MOVEMENTS (RETRUSION)
Retrusion is brought
about by the posterior
fibres of the temporalis
muscle, assisted by the
masseter, digastric and
geniohyoid muscles.
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43. FACIAL NERVE
The main trunk of the facial nerve exits from the skull at the
stylomastoid foramen.
Approximately 1.3 cm of the nerve is visible before it divides
into temporofacial and cervicofacial branches.
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44. FACIAL NERVE
In the classis article by Al-Kayat and Bramley the distance from
the lowest point of the external bony auditory canal to the
bifurcation was found to be 1.5 cm to 2.8 cm (mean 2.3 cm)
Distance from the post-glenoid tubercle to the bifurcation was
2.4 to 3.5 cm (mean 3.0 cm)
The distance from the most anterior concavity of the bony
external auditory canal to the most posterior significant temporal
branch of the facial nerve was 0.8 to 3.5 cm (mean 2.0 cm)
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45. FACIAL NERVE
Knowledge of the distances and the range of the facial nerve
branches from fixed bony landmarks within the surgical field
alerts the surgeon to the areas of highest risk.
During surgery by incising the superficial layer of the temporalis
fascia and the periosteum over the arch inside the 8 mm
boundary, damage to the branches of the upper trunk can be
prevented.
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46. FACIAL NERVE
The temporal branch of the facial nerve emerges from the
parotid gland and crosses the zygoma under the temporoparietal
fascia to innervate the frontalis, the corrugator, the procerus and
occasionally a portion of he orbicularis oculi muscle.
Post surgical palsy manifests as an inability to raise the eyebrow
or wrinkle the forehead and ptosis of the brow.
Damage to the zygomatic branch results in temporary or
permanent paresis to the orbicularis oculi. (may require
temporary patching of the eye to prevent corneal dessication)
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47. AURICULOTEMPORAL NERVE
The auriculotemporal nerve
supplies sensation to parts of the
auricle, the external auditory
meatus, the tympanic membrane,
and skin in the temporal area.
It courses form the medial side of
the posterior neck of the condyle
and turns superiorly, running over
the zygomatic root of the temporal
bone.
Just anterior to the auricle, the
nerve divides into its terminal
branches in the skin of the
temporal area.
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48. AURICULOTEMPORAL NERVE
Damage to this nerve can be prevented during surgery by
incising and dissecting in close apposition to the cartilaginous
portion of the external auditory meatus.
The nerve runs somewhat anteriorly as it courses from lateral to
medial.
Temporal extension of the skin incision should be located
posteriorly so that the main distribution of the nerve is dissected
and retracted forward with the flap.
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49.
The superficial temporal artery one of the terminal branches of
the ECA, begins behind the mandibular condylar neck deep to
the parotid gland as it emerges from behind the parotid gland.
It crosses over the posterior root of the zygomatic process of the
temporal bone and enters the temporal region of the scalp.
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50.
The transverse facial artery arises form the base of the superficial
temporal artery and runs almost transversely across the face,
lying upon the outer surface of the masseter muscle about 1.5 cm
below the zygomatic arch but above the parotid duct.
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51. LAYERS OF THE TEMPOROPARIETAL
REGION
The temporoparietal fascia is the most superficial layer beneath
the subcutaneous fat.
This fascia is the lateral extension of the galea and is continuous
with the superficial musculoaponeurotic layer (SMAS).
The blood vessels of the scalp run along its superficial aspect
closely related to the subcutaneous fat.
The motor nerves run on the deep surface of the
temporoparietal fascia.
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52.
The temporalis fascia is the fascia of the temporalis muscle.
This fascia arises from the superior temporal line and fuses with
the pericranium.
Inferiorly at the level of the superior orbital rim, the temporalis
fascia splits into the superficial layer attaching to the lateral
border and the deep layer attaching to the medial border of the
zygomatic arch.
A small quantity of fat is found in between these two layers and
it is sometimes referred to as the superficial temporal fat pad.
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53. REFERENCES
GRAY’S ANATOMY – 38 TH EDITIION
COLOR ATLAS OF TMJ SURGERY – PETER D. QUINN
FONSECA ORAL AND MAXILLOFACIAL SURGERY
VOL. 4 – BAYS and QUINN
THE TMJ AND RELATED OROFACIAL DISORDERS –
BUSH and DOLWICK
SURGICAL APPROACHES TO THE FACIAL SKELETON
– EDWARD ELLIS
THE ANATOMICAL BASIS OF DENTISTRY – LEIBGOTT
SURGERY OF THE TMJ. SURGICAL ANATOMY AND
SURGICAL INCISIONS – KREUTZIGER (ORAL
SURGERY. 58; 637-646, 1984)
CLINICALLY ORIENTED ANATOMY – KEITH L.
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