29 minute read
Chapter 05: Temporomandibular Joint
Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition
Multiple Choice
1. The temporal bone and mandible come together to form the temporomandibular joint BECAUSE a joint is defined as a junction or union between two or more bones.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but NOT related.
c. The statement is correct, but the reason is NOT.
d. The statement is NOT correct, but the reason is correct.
e. NEITHER the statement NOR the reason is correct.
ANS: A
Feedback
A The statement is correct. The temporomandibular joint is a junction between the temporal bone and the mandible. The reason is correct. A joint is defined as a union between two or more bones.
B The statement and the reason are related. The temporal bone and mandible form the temporomandibular joint, which is a union between two bones.
C The reason is correct. A joint is formed by the union of two or more bones.
D The statement is correct. The temporal bone and the mandible join to form the temporomandibular joint.
E The statement and the reason are correct. The temporomandibular joint is a junction between the temporal bone and the mandible, and a joint is defined as a union between two or more bones.
DIF: Comprehension REF: p. 123 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true.
2. The temporomandibular joint is innervated by the maxillary nerve or second division of the fifth cranial or trigeminal nerve. The blood supply to the joint is from branches of the external carotid artery.
ANS: D
Feedback
A The first statement is false. The temporomandibular joint is innervated by the mandibular nerve or third division of the fifth cranial or trigeminal nerve.
B The second statement is true. The temporomandibular joint receives blood supply from branches of the external carotid artery.
C The first statement is false. The temporomandibular joint is innervated by the mandibular nerve or third division of the fifth cranial or trigeminal nerve. The second statement is true because the temporomandibular joint receives blood supply from branches of the external carotid artery.
D The first statement is false. The temporomandibular joint is innervated by the mandibular nerve or third division of the fifth cranial or trigeminal nerve, NOT the maxillary nerve or second division. The second statement is true because the temporomandibular joint receives blood supply from branches of the external carotid artery.
DIF: Recall REF: p. 123 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Submandibular b. Mandibular c. Pterygoid d. Temporal
3. What is another term used for articular fossa of the temporomandibular joint?
ANS: B
Feedback
A The submandibular fossa is located on the medial surface of the mandible, inferior to the mylohyoid line.
B The mandibular fossa or articular fossa is located on the temporal bone that articulates with the mandible at the temporomandibular joint.
C The pterygoid fossa is located between the medial and lateral pterygoid plates of the sphenoid bone.
D The temporal fossa is located on the lateral surface of the skull that contains the body of the temporalis muscle.
DIF: Recall REF: p. 124 OBJ: 2
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Sublingual fossa b. Supraorbital notch c. Temporal space d. Mandibular notch
4. What is the depression located between the condyle and coronoid process of the temporomandibular joint?
ANS: D
Feedback
A The sublingual fossa is located on the medial surface of the mandible, superior to the mylohyoid line.
B The supraorbital notch is located on the frontal bone superior to the orbit.
C The temporal space is formed by the temporal fascia covering the temporalis muscle.
D The mandibular notch is located on the mandible between the condyle and the coronoid process.
DIF: Recall REF: p. 128 OBJ: 2
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true.
5. The joint disc of the temporomandibular joint is a fibrous disc located between the temporal bone and the coronoid process of the mandible on each side. This disc conforms to the shape of the bones and is related to joint movement.
ANS: D
Feedback
A The first statement is false. The joint disc of the temporomandibular joint is located between the temporal bone and the condyle, NOT the coronoid process.
B The second statement is true. The shape of the joint disc conforms to the shape of the adjacent articulating bones of the temporomandibular joint and is related to joint movements.
C The first statement is false. The joint disc of the temporomandibular joint is located between the temporal bone and the condyle, NOT the coronoid process. The second statement is true. The shape of the joint disc conforms to the shape of the adjacent articulating bones of the temporomandibular joint and is related to joint movements.
D The first statement is false. The joint disc of the temporomandibular joint is located between the temporal bone and the condyle, NOT the coronoid process. The second statement is true. The shape of the joint disc conforms to the shape of the adjacent articulating bones of the temporomandibular joint and is related to joint movements.
DIF: Comprehension REF: p. 125 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.
6. Including examination of the temporomandibular joint during the extraoral examination is important to detect changes such as disc perforation BECAUSE disc perforation is commonly found in females and males during puberty.
Feedback
A The reason is NOT correct. Disc perforation is caused by the age process or from traumatic injury.
B The reason is incorrect. Disc perforation is caused by the age process or from traumatic injury. Also, the statement and reason are related.
C The statement is correct. Examination of the temporomandibular joint must be part of the extraoral examination in order to determine if changes or deviations within the joint have occurred. The disc perforation is caused by the age process or traumatic injury.
D The statement is correct. Examination of the temporomandibular joint must be part of the extraoral examination in order to determine if changes or deviations within the joint have occurred.
E The statement is correct. Examination of the temporomandibular joint must be part of the extraoral examination in order to determine if changes or deviations within the joint have occurred.
DIF: Application REF: p. 125 OBJ: 4
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, I. B. Preliminary Physical Examination |
CDA: General Chairside, II. C. Describe how to perform and/or assist with intraoral procedures |
CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy |
NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care a. Temporomandibular joint ligament b. Sphenomandibular ligament c. Stylomandibular ligament d. Stylohyoid ligament
7. Which of the following ligaments is NOT associated with the temporomandibular joint?
ANS: D
Feedback
A The temporomandibular joint ligament is associated with the temporomandibular joint. The oblique, or outer, component goes from the articular tubercle to the neck of the mandible. The horizontal, or inner, component goes from the lateral pole of the condyle and the posterior aspect of the joint disc to the articular tubercle.
B The sphenomandibular ligament is associated with the temporomandibular joint. It attaches the angular spine of the sphenoid bone superiorly to the lingula of the mandible foramen.
C The stylomandibular ligament is associated with the temporomandibular joint. It connects the styloid process of the temporal bone with the angle of the mandible.
D The stylohyoid ligament is NOT associated with the temporomandibular joint. It connects the styloid process with the lesser horn of the hyoid bone.
DIF: Recall REF: pp. 125-127 OBJ: 2 | 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Temporomandibular joint ligament b. Sphenomandibular ligament c. Stylomandibular ligament d. Stylohyoid ligament
8. Which ligament associated with the temporomandibular joint prevents excessive retraction or moving backward of the mandible?
ANS: A
Feedback
A The temporomandibular joint ligament prevents excessive retraction or moving backward of the mandible, a situation that might lead to problems with the temporomandibular joint.
B The sphenomandibular ligament becomes accentuated and taut when the mandible is protruded.
C The stylomandibular ligament is also engaged when the mandible is protruded.
D The stylohyoid ligament is NOT associated with the temporomandibular joint.
DIF: Comprehension REF: p. 125 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Temporomandibular joint ligament b. Sphenomandibular ligament c. Stylomandibular ligament d. Stylohyoid ligament
9. Which ligament associated with the temporomandibular joint is a landmark for the administration of inferior alveolar local anesthetic nerve block?
ANS: B
Feedback
A The temporomandibular joint ligament is NOT a landmark for the administration of inferior alveolar local anesthetic nerve block.
B The sphenomandibular ligament is a landmark for the administration of the inferior alveolar local anesthetic nerve block. The injection site for the inferior alveolar block injection is at the depth of the pterygomandibular space, which is lateral to both the pterygomandibular fold and the sphenomandibular ligament.
C The stylomandibular ligament is NOT a landmark for the administration of the inferior alveolar local anesthetic nerve block.
D The stylohyoid ligament is NOT a landmark for the administration of the inferior alveolar local anesthetic nerve block.
DIF: Application REF: p. 127 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1
Head and Neck Anatomy a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true.
10. The temporomandibular joint allows for movement of the mandible during speech and mastication. Two basic types of movement are performed by the joint and its associated muscles: a gliding movement and a rotational movement.
ANS: A
Feedback
A Both statements are true. The temporomandibular joint does allow for movement during speech and mastication with a gliding and rotational movement.
B Both statements are true. The temporomandibular joint does allow for movement during speech and mastication with a gliding and rotational movement.
C The second statement is true. The temporomandibular joint moves with gliding and rotational movements.
D The first statement is true. The temporomandibular joint allows for movement of the mandible during speech and mastication.
DIF: Recall REF: p. 127 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1
Head and Neck Anatomy a. Retraction b. Protrusion c. Elevation d. Depression
11. The gliding movement of the temporomandibular joint allows the lower jaw to move forward or backward. What movement of the mandible is involved when the lower jaw moves forward?
ANS: B
Feedback
A Bringing the lower jaw backward involves retraction of the mandible.
B Bringing the lower jaw forward involves protrusion of the mandible.
C Lowering the lower jaw involves depression of the mandible.
D Raising the lower jaw involves elevation of the mandible.
DIF: Comprehension REF: p. 127 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1
Head and Neck Anatomy a. Retraction b. Protrusion c. Rotation d. Gliding
12. What movement of the temporomandibular joint occurs MAINLY between the joint disc and the condyle of the mandible in the lower synovial cavity?
ANS: C Feedback
A Retraction is a gliding movement that occurs between the joint disc and the articular eminence of the temporal bone in the upper synovial cavity.
B Protrusion is a gliding movement that occurs between the joint disc and the articular eminence of the temporal bone in the upper synovial cavity.
C The rotation movement of the temporomandibular joint occurs mainly between the joint disc and the condyle of the mandible in the lower synovial cavity.
D Gliding movements of the temporomandibular joint occur between the joint disc and the articular eminence of the temporal bone in the upper synovial cavity.
DIF: Comprehension REF: p. 127 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true.
13. Opening the jaws during speech and mastication involves BOTH elevation and retraction of the mandible. When the jaws close, this involves BOTH depression and protrusion of the mandible.
ANS: B
Feedback
A Both statements are false. The opening of the jaws during speech and mastication involves both depression and protrusion of the mandible. When the jaws close, this involves both elevation and retraction of the mandible.
B Both statements are false. The opening of the jaws during speech and mastication involves both depression and protrusion of the mandible. When the jaws close, this involves both elevation and retraction of the mandible.
C The first statement is false. The opening of the jaws during speech and mastication involves both depression and protrusion of the mandible.
D The second statement is false. When the jaws close, this involves both elevation and retraction of the mandible.
DIF: Comprehension REF: pp. 127-128 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Gliding movement on both sides b. Rotational movement on both sides c. Gliding movement on one side and no movement on the other side d. Gliding movement on one side and rotational movement on the other side
14. What type of temporomandibular joint movement(s) occurs during lateral deviation of the mandible or shifting of the lower jaw to one side?
ANS: D
Feedback
A Lateral deviation involves both the gliding and rotational movements of the opposing temporomandibular joints in their respective joint cavities.
B Lateral deviation involves both the gliding and rotational movements of the opposing temporomandibular joints in their respective joint cavities.
C Movement is required of the opposing temporomandibular joints in their respective joint cavities.
D Lateral deviation involves both the gliding and rotational movements of the opposing temporomandibular joints in their respective joint cavities. During lateral deviation, one disc plus the condyle glide forward and medially on the articular eminence in the upper synovial cavity, while the other condyle and disc remain relatively stable in position, producing a rotation around the more stable condyle.
DIF: Comprehension REF: p. 128
OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.
15. The rest position of the temporomandibular joint is NOT with the teeth biting together BECAUSE as we observe during mastication of food, the mandible returns to the center.
ANS: B
Feedback
A Even though the statement and reason are correct, they are NOT related. The statement describes the rest position of the temporomandibular joint, while the reason describes the power stroke that occurs during mastication.
B Both statements are true but are NOT related. The statement describes the rest position of the temporomandibular joint, while the reason describes the power stroke that occurs during mastication.
C The reason is correct. The mandible is brought back to the center during mastication due to the power stroke or the teeth crunching the food.
D The statement is correct. The teeth are NOT occluding or biting together when the temporomandibular joint is at rest.
The statement and the reason are both correct. The teeth are NOT occluding or biting together when the temporomandibular joint is at rest. The mandible is brought back to the center during mastication due to the power stroke or the teeth crunching the food.
DIF: Application REF: p. 128 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true.
16. The dental professional plays an important role in the recognition, treatment, and maintenance of patients with temporomandibular disorder. All signs and symptoms related to temporomandibular disorder need to be recorded by the dental professional, as well as any parafunctional habits and related systematic diseases.
ANS: A
Feedback
A Both statements are true. The dental professional is skilled and has knowledge of the temporomandibular joint, which is examined during the extraoral examination. All relevant information, such as the amount of the mandibular opening and facial pain, needs to be recorded by the dental professional.
B Both statements are true. The dental professional is skilled and has knowledge of the temporomandibular joint, which is examined during the extraoral examination. All relevant information, such as the amount of the mandibular opening and facial pain, needs to be recorded by the dental professional.
C The second statement is true. All relevant information, such as the amount of the mandibular opening and facial pain, needs to be recorded by the dental professional.
D The first statement is true. The dental professional is skilled and has knowledge of the temporomandibular joint, which is examined during the extraoral examination.
DIF: Application REF: p. 129 OBJ: 4
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, I. B. Preliminary Physical Examination |
CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true.
17. When examining the joint, joint sounds may be heard because of disc derangement. Joint sounds are a reliable indicator of temporomandibular disorder.
ANS: C
Feedback
A The second statement is false. Joint sounds are NOT a reliable indicator of temporomandibular disorder because they can change over time.
B The first statement is true. Joint sounds occur because of disc derangement. The posterior portion of the joint disc gets caught between the condyle head and the articular eminence.
C The first statement is true: joint sounds occur because of disc derangement. The second statement is false because joint sounds are NOT a reliable indicator of temporomandibular disorder since they can change over time.
D The first statement is true; the second statement is false. Joint sounds occur because of disc derangement. Joint sounds are NOT a reliable indicator of temporomandibular disorder because they can change over time.
DIF: Application REF: p. 129 OBJ: 4
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Subluxation b. Cellulitis c. Paresthesia d. Thrombus
18. What occurs with the dislocation of BOTH the temporomandibular joints on a patient?
ANS: A Feedback
A Subluxation occurs when the head of the condyle moves too far anterior on the articular eminence.
B Cellulitis is the diffuse inflammation of soft tissue spaces.
C Paresthesia is an abnormal sensation from an area such as burning or prickling.
D Thrombus is an intravascular clot.
DIF: Application REF: p. 129 OBJ: 4
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Temporal fossa b. Infratemporal fossa c. Pterygopalatine fossa d. Articular fossa
19. What is the fossa located on the temporal bone that articulates with the mandible?
ANS: D
Feedback
A The temporal fossa is a flat, fan-shaped paired depression on the lateral surface of the skull.
B The infratemporal fossa is a paired depression that is inferior to the anterior part of the temporal fossa.
C The pterygopalatine fossa is a cone-shaped paired depression deep to the infratemporal fossa and posterior to the maxilla on each side of the skull.
D The articular fossa is posterior to the articular eminence and consists of an ovalshaped depression on the temporal bone, posterior and medial to the zygomatic process of the temporal bone.
DIF: Recall REF: p. 124 OBJ: 2
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true.
20. The joint disc of the temporomandibular joint is attached to the lateral and medial poles of the mandibular condyle. The disc is fully attached to the temporal bone to all sides of the bone.
ANS: C
Feedback
A The first statement is true; the second is false. The joint disc of the temporomandibular joint is attached to the lateral and medial poles of the mandibular condyle. The disc is NOT attached to the temporal bone anteriorly, except indirectly through the capsule.
B The first statement is true; the second is false. The joint disc of the temporomandibular joint is attached to the lateral and medial poles of the mandibular condyle. The disc is NOT attached to the temporal bone anteriorly, except indirectly through the capsule.
C The first statement is true; the second is false. The joint disc of the temporomandibular joint is attached to the lateral and medial poles of the mandibular condyle. The disc is NOT attached to the temporal bone anteriorly, except indirectly through the capsule.
D The first statement is true; the second is false. The joint disc of the temporomandibular joint is attached to the lateral and medial poles of the mandibular condyle. The disc is NOT attached to the temporal bone anteriorly, except indirectly through the capsule.
DIF: Comprehension REF: p. 125 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true.
21. As a person ages or undergoes trauma to the area, the joint disc of the temporomandibular joint can become thicker or even perforated. Perforation can lead to clinical problems.
ANS: D
Feedback
A The first statement is false; the second is true. As a person ages or undergoes trauma to the area, the joint disc of the temporomandibular joint can become thinner or even perforated. Perforation can lead to clinical problems.
B The first statement is false; the second is true. As a person ages or undergoes trauma to the area, the joint disc of the temporomandibular joint can become thinner or even perforated. Perforation can lead to clinical problems.
C The first statement is false; the second is true. As a person ages or undergoes trauma to the area, the joint disc of the temporomandibular joint can become thinner or even perforated. Perforation can lead to clinical problems.
D The first statement is false; the second is true. As a person ages or undergoes trauma to the area, the joint disc of the temporomandibular joint can become thinner or even perforated. Perforation can lead to clinical problems.
DIF: Application REF: p. 125 OBJ: 4
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true.
22. The sphenomandibular ligament is a landmark for the administration of (long) buccal nerve block and is also involved in troubleshooting the injection due to its location.
ANS: B Feedback
A Both statements are false. The sphenomandibular ligament is a landmark for the administration of inferior alveolar nerve block and is also involved in troubleshooting the inferior alveolar nerve block due to its location since it may actually block the injection if the needle does NOT contact the mandible.
B Both statements are false. The sphenomandibular ligament is a landmark for the administration of inferior alveolar nerve block and is also involved in troubleshooting the inferior alveolar nerve block due to its location since it may actually block the injection if the needle does NOT contact the mandible.
C Both statements are false. The sphenomandibular ligament is a landmark for the administration of inferior alveolar nerve block and is also involved in troubleshooting the inferior alveolar nerve block due to its location since it may actually block the injection if the needle does NOT contact the mandible.
D Both statements are false. The sphenomandibular ligament is a landmark for the administration of inferior alveolar nerve block and is also involved in troubleshooting the inferior alveolar nerve block due to its location since it may actually block the injection if the needle does NOT contact the mandible.
DIF: Application REF: p. 127 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.
23. The base of the triangular temporomandibular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive protrusion or moving forward for the mandible, a situation that might lead to problems with the temporomandibular joint.
ANS: C
Feedback
A The statement is correct, but the reason is NOT. The base of the triangular temporomandibular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive retrusion or moving backward of the mandible, a situation that might lead to problems with the temporomandibular joint.
B The statement is correct, but the reason is NOT. The base of the triangular temporomandibular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive retrusion or moving backward of the mandible, a situation that might lead to problems with the temporomandibular joint.
C The statement is correct, but the reason is NOT. The base of the triangular temporomandibular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive retrusion or moving backward of the mandible, a situation that might lead to problems with the temporomandibular joint.
D The statement is correct, but the reason is NOT. The base of the triangular temporomandibular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive retrusion or moving backward of the mandible, a situation that might lead to problems with the temporomandibular joint.
E The statement is correct, but the reason is NOT. The base of the triangular temporomandibular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive retrusion or moving backward of the mandible, a situation that might lead to problems with the temporomandibular joint.
DIF: Comprehension REF: p. 125 OBJ: 4
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy a. biting gently together b. apart at approximately 2 to 4 mm c. resting firmly together d. apart at approximately 6 to 10 mm
24. The resting position of the temporomandibular joint can be noted with the teeth _____ so as to allow a physiologic rest for the mandible.
ANS: B
Feedback
A The resting position of the temporomandibular joint is not with the teeth biting together. Instead, the muscular balance and proprioceptive feedback allow a physiologic rest for the mandible, an interocclusal clearance or freeway space, which is approximately 2 to 4 mm between the teeth.
B The muscular balance and proprioceptive feedback allow a physiologic rest for the mandible, an interocclusal clearance or freeway space, which is approximately 2 to 4 mm between the teeth.
C The resting position of the temporomandibular joint is NOT with the teeth resting together. Instead, the muscular balance and proprioceptive feedback allow a physiologic rest for the mandible, an interocclusal clearance or freeway space, which is approximately 2 to 4 mm between the teeth.
D The muscular balance and proprioceptive feedback allow a physiologic rest for the mandible, an interocclusal clearance or freeway space, which is approximately 2 to 4 mm between the teeth.
DIF: Comprehension REF: p. 128 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1
Head and Neck Anatomy a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true.
25. When considering temporomandibular disorders, MOST symptoms seem to originate from the nerve surrounding the joint. In addition, MOST recent studies support the role of temporomandibular disorders in directly causing headaches, neck or back pain, or instability.
ANS: B
Feedback
A Both statements are false. Most symptoms seem to originate from the muscles. Most recent studies do NOT support the role of temporomandibular disorders in directly causing headaches, neck or back pain, or instability; headaches are usually caused by muscle tension or vascular changes.
B Both statements are false. Most symptoms seem to originate from the muscles. Most recent studies do NOT support the role of temporomandibular disorders in directly causing headaches, neck or back pain, or instability; headaches are usually caused by muscle tension or vascular changes.
C Both statements are false. Most symptoms seem to originate from the muscles. Most recent studies do NOT support the role of temporomandibular disorders in directly causing headaches, neck or back pain, or instability; headaches are usually caused by muscle tension or vascular changes.
D Both statements are false. Most symptoms seem to originate from the muscles. Most recent studies do NOT support the role of temporomandibular disorders in directly causing headaches, neck or back pain, or instability; headaches are usually caused by muscle tension or vascular changes.
DIF: Comprehension REF: p. 129 OBJ: 4
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy
Multiple Response
1. From the following list of actions involving the temporomandibular joint, select those that are DIRECTLY associated with lateral deviation of the joint. (Select all that apply.)
a. Single lateral pterygoid muscle contraction b. Gliding movement c. Rotational movement d. Both lateral pterygoid muscle contractions
ANS: A, B, C
Feedback
Correct Lateral deviation is directly associated with a single lateral pterygoid muscle contraction and gliding movement but also includes rotational movement of the temporomandibular joint.
Incorrect Lateral deviation is directly associated with a single lateral pterygoid muscle contraction and NOT contractions of both lateral pterygoid muscles, as well as including both gliding and rotational movements of the temporomandibular joint.
DIF: Comprehension REF: p. 128 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy |
NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics |
NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care a. Patient biting on wax impression b. Bilateral palpation of all joint movements c. Digital palpation of external acoustic meatus d. Ausculation of the joint e. Extraoral radiography of the joint region
2. From the following list of actions, select the procedures USUALLY used during an examination of the temporomandibular joint. (Select all that apply.)
ANS: B, C, D
Feedback
Correct The usual procedures for the examination of the temporomandibular joint include the bilateral palpation of all joint movements, digital palpation of the external acoustic meatus, and possibly auscultation.
Incorrect The patient biting on wax impression and extraoral radiography of the joint are NOT a part of the usual procedures for examining the temporomandibular joint.
DIF: Application REF: p. 128 OBJ: 4
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, I. B. Preliminary Physical Examination |
CDA: General Chairside, II. C. Describe how to perform and/or assist with intraoral procedures |
CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy |
NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care a. Thinner b. Perforated c. Dislocated d. Thicker
3. From the following list of descriptions, select those that can occur with aging of the joint disc of the temporomandibular joint. (Select all that apply.)
ANS: A, B
Feedback
Correct When the joint disc of the temporomandibular joint ages, it can become thinner and even perforated.
Incorrect When the joint disc of the temporomandibular joint ages, it does NOT become thicker but thinner and even perforated. At any age, the disc may become dislocated by injury to its attachments and NOT just due to aging but instead injury to the joint.
DIF: Application REF: p. 128 OBJ: 4
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy |
NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care a. Wraps around only the superior part b. Wraps around articular eminence and fossa c. Wraps around the condyle circumference d. Wraps around the coronoid process circumference e. Wraps around only the inferior part
4. From the following list of descriptions, select those descriptions that can be applied to the joint capsule of the temporomandibular joint. (Select all that apply.)
ANS: B, C
Correct
Feedback
The joint capsule of the temporomandibular joint encloses the entire joint and NOT just its superior or inferior parts; it wraps around the temporal bone’s articular eminence and articular fossa as well as the circumference of the mandibular condyle, including the condyle’s neck.
Incorrect
The joint capsule of the temporomandibular joint encloses the entire joint and NOT just the superior or inferior parts, and it does NOT wrap around the circumference of the coronoid process but the circumference of the mandibular condyle, including the condyle’s neck as well as the temporal bone’s articular eminence and articular fossa.
DIF: Recall REF: p. 125 OBJ: 2 | 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1
Head and Neck Anatomy a. Anatomically variable ligament b. Formed from sphenomandibular ligament extension c. Formed from thickened area cervical fascia d. Consistent ligament anatomically e. Becomes taut with mandibular protrusion
5. From the following list of descriptions, select those descriptions that can be applied to the stylomandibular ligament of the temporomandibular joint. (Select all that apply.)
ANS: A, C, E
Feedback
Correct The stylomandibular ligament of the temporomandibular joint is a variable ligament anatomically, formed from thickened area cervical fascia, and becomes taut with mandibular protrusion.
Incorrect The stylomandibular ligament of the temporomandibular joint is NOT formed from a sphenomandibular ligament extension and is NOT consistent anatomically as a ligament but is a variable ligament anatomically and formed from thickened area cervical fascia.
DIF: Recall REF: pp. 125-127 OBJ: 3
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy |
NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics |
NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene a. Disc degeneration may be involved b. Calcifications may be present c. Joint disc may be thinner or even perforated d. Aging or trauma may be involved
6. If your patient has a history of impaired movement of the temporomandibular joint, what may be occurring? (Select all that apply.)
ANS: A, B, C, D
With aging or trauma to the area, the joint disc of the temporomandibular joint can become thinner or even perforated. Recent studies suggest this disc degeneration may also cause calcifications within the disc, changes that may lead to impaired movement of the joint.
DIF: Application REF: p. 125 OBJ: 4
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care a. Opening and closing the mouth several times b. Moving the jaw only forward and backward c. Palpating the depression inferior to the zygomatic arch d. Placing a finger over the maxillary sinus region during movement
7. Which of the following needs to be included during an effective extraoral examination of the temporomandibular joint of a patient? (Select all that apply.)
ANS: A, C
Feedback
Correct The temporomandibular joint is palpated laterally at a depression inferior to the zygomatic arch during an extraoral examination. This includes asking the patient to open and close the mouth several times and then to move the opened lower jaw to the left, then to the right, and then forward. To further assess the mandible moving, use digital palpation by gently placing a finger into the outer part of the external acoustic meatus. Incorrect Moving the jaw only forward and backward is NOT effective in the extraoral examination of the temporomandibular joint NOR is placing a finger over the maxillary sinus region during movement.
DIF: Application REF: p. 128 OBJ: 4
TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, I. B. Preliminary Physical Examination |
CDA: General Chairside, II. C. Describe how to perform and/or assist with intraoral procedures |
CDA: General Chairside, V. A. Oral Health Information
MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy |
NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care
