tm & shoulder jointslecture objectives •describe the components of tm joint. •list the...
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TM & Shoulder Joints
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Lecture Objectives
• Describe the components of TM joint.• List the ligaments associated with TM joint and their attachment.• Describe the type and the components of the shoulder joint.• List the ligaments associated with the shoulder joint and their attachment.
• Describe the muscles acting on the shoulder joint according to the type and movement they perform.
• Describe the major palpable bony prominences of the shoulder joint.
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Temporomandibular Joint (TMJ)
• Between mandibular fossa & articular tubercle of temporal bone and the head of mandible
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Temporomandibular Joint: Innervation
• Nerve supply: auriculotemporal & masseteric branches of mandibular division of trigeminal nerve
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Temporomandibular Joint: Ligaments• Lateral temporomandibular ligament
– Between the articular tubercle and neck of mandible• Sphenomandibular ligament
– Between spine of sphenoid and lingula of mandibular foramen• Stylomandibular ligament
– Between the styloid process of temporal bone and angle of mandible
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Temporomandibular Joint (TMJ)• Articular disc
– Attached to the capsule and the head of mandible– Divide the joint into two cavities
• Upper cavity– Gliding movement
• Lower cavity– Hinge movement
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Muscles of Mastication
• Masseter, temporalis & pterygoids• Arise from skull & insert on mandible• Cranial nerve V (trigeminal nerve) –
mandibular division• Protracts, elevates or retracts
mandible
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Muscles of Mastication
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Lateral Pterygoid
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TMJ: Movements
• Depression– Lateral pterygoids, digastrics,
geniohyoids and mylohyoids• Elevation
– Temporalis, masseter & medial pterygoids
• Protrusion– Pterygoids
• Retraction– Temporalis
• Lateral movement– Protrusion on one side and
retraction on another– Muscles of mastication
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Sternoclavicular Joint
• Sternum and clavicle• Double plane joint• Articular disc• Gliding movement of the clavicle:
– Forward and backward in medial part– Elevation and depression in lateral part
• Sternoclavicular ligament• Accessory ligament: costoclavicular
ligament• Nerve supply: supraclavicular nerve
and nerve to subclavius muscle
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Acromioclavicular Joint
• Acromion and clavicle• Plane joint• Superior and inferior acromioclavicular ligaments
• Fibrocartilaginous disc• Accessory ligament: coracoclavicular ligament
• Gliding movement• Nerve supply: suprascapular nerve
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Shoulder Joint• Head of humerus and glenoid cavity of scapula
• Ball and socket– All types of movements
• Nerve supply– Axillary and suprascapular
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Glenohumeral (Shoulder) Joint
• Articular capsule from glenoid cavity to anatomical neck• Synovial membrane
– Long head of biceps– Continuation (openings)
• Tendon sheath• Subscapularis bursa
• Glenoid labrum deepens socket
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Shoulder Joint: Synovial Membrane
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Supporting Structures at Shoulder• Associated ligaments strengthen joint capsule– Glenohumeral ligaments
• Anteriorly
– Coracohumeral ligament• Root of coracoid to greater tuberosity• Superiorly
– Transverse humeral ligament • Holds biceps tendon in place
• Accessory ligaments– Coracoacromial ligament
• Subacromial bursa
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Rotator Cuff Muscles
• Attach humerus to scapula• Encircle the joint supporting the capsule
– Weak capsule inferiorly• Hold head of humerus in socket
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Movements of Shoulder Joint
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Arterial Anastomosis around the Shoulder Joint
• Subclavian a.– Suprascapular a.– Superficial cervical a.
• Deep branch
• Axillary a.– Subscapular a.
• Circumflex scapular a.
– Anterior circumflex humeral a.– Posterior circumflex humeral a.
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Surface Anatomy of Upper Limb Bones
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Coracoid Process Palpation
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Surface Anatomy of Shoulder Region
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Surface Anatomy of Shoulder Region
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Surface Anatomy of Shoulder Region