MRCEM Notes

Temporomandibular joint (TMJ)

TMJ Key Points

  • The joint between the mandibular head (condyle) and the squamous temporal bone is synovial
  • The lateral temporomandibular ligament limits movement of the mandible posteriorly
  • The sphenomandibular ligament limits movement of the mandible inferiorly
  • The joint is least stable when the mandible is in the open position
  • The TMJ allows multidirectional movement of the mandible under the actions of several muscles which are summarised in the table below.

Wikipedia

The tables below show mandibular movements broken down by movement and by muscles moving the mandible

MovementMuscles responsible
Elevation of mandible
  • Medial pterygoid
  • Masseter
  • Temporalis
Depression of mandible
  • Lateral pterygoid
  • Above assisted by digastric, mylohyoid and geniohyoid muscles at start of action
Retraction of mandible
  • Temporalis
Protrusion
  • Lateral pterygoid
  • Masseter
  • Minor contribution from medial pterygoid

MuscleMovement of mandible
Medial pterygoidElevation of the mandible
Minimal assistance to lateral pterygoid with protrusion
Lateral pterygoidDepression and protrusion
MasseterElevation and protusion
TemporalisElevation and retraction
DigastricComplex jaw movements
Elevates hyoid, if hyoid stabilised depresses mandible
Full-size image