Applied Surgical Anatomy - TMJ and Mandible
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Questions and Answers

Which direction should the mandible be moved to reduce a bilateral TMJ dislocation?

  • Downward, forward, and upward
  • Backward, downward, and upward
  • Upward, backward, and downward
  • Downward, backward, and upward (correct)

What type of fracture occurs when a forceful trauma to the midline of the mandible results in a symphyseal fracture?

  • Undisplaced fracture
  • Indirect fracture
  • Displaced fracture
  • Direct fracture (correct)

What is the primary cause of Bell's palsy?

  • Unilateral dislocation of TMJ
  • Unilateral bony ankylosis of TMJ
  • Unilateral fibrous ankylosis of TMJ
  • None of the above (correct)

When making a submandibular skin incision to avoid injury of the mandibular branch of the facial nerve, what is the recommended distance from the inferior border of the mandible?

<p>2-4 mm (C)</p> Signup and view all the answers

What is the motor function of the mandibular branch of the facial nerve?

<p>Motor nerve for chewing muscles (D)</p> Signup and view all the answers

What type of TMJ condition does NOT typically lead to Bell's palsy?

<p>None of the above (D)</p> Signup and view all the answers

Which mandibular fracture is characterized by displacement?

<p>Mandibular body fracture with displacement (C)</p> Signup and view all the answers

Which of the following describes the condition of having a step deformity at the inferior border of the mandible?

<p>Mandibular fracture (B)</p> Signup and view all the answers

MMF in the context of mandibular fracture management refers to what?

<p>Maxillomandibular fixation (C)</p> Signup and view all the answers

What characterizes bilateral TMJ dislocation?

<p>Displacement of both joints (D)</p> Signup and view all the answers

Which of the following is NOT considered an area of weakness in the mandible?

<p>Area of the maxillary sinus (B)</p> Signup and view all the answers

What is the most common site of mandibular fracture in healthy adults?

<p>Condylar fracture (B)</p> Signup and view all the answers

What does ORIF stand for in the context of managing displaced mandibular fractures?

<p>Open reduction &amp; internal fixation (D)</p> Signup and view all the answers

A patient with bilateral condylar fractures has sustained what type of injury?

<p>Indirect fracture (B)</p> Signup and view all the answers

Which of the following best describes a mandibular para symphyseal fracture?

<p>Fracture occurring close to the midline of the mandible (C)</p> Signup and view all the answers

What indicates a direct fracture in mandibular injuries?

<p>Fracture resulting from impact at the fracture site (B)</p> Signup and view all the answers

What is the gonial angle defined as?

<p>The angle between the ramus and the body of the mandible (C)</p> Signup and view all the answers

Which of the following is an incorrect clinical feature of unilateral ankylosis of the TMJ?

<p>Facial asymmetry known as bird face appearance (B)</p> Signup and view all the answers

In the context of TMJ dysfunction, which statement about anterior disc displacement is true?

<p>Both statements regarding anterior disc displacement and TMJ dysfunction are true (C)</p> Signup and view all the answers

What provisional diagnosis would a clinician likely give to a patient with TMJ pain and reciprocal clicking?

<p>Anterior disc displacement with reduction (A)</p> Signup and view all the answers

Regarding a preauricular skin incision, which statements are accurate?

<p>Both statements are true (D)</p> Signup and view all the answers

What occurs in a case of TMJ dislocation?

<p>The condyle becomes dislocated outside of the glenoid fossa (A)</p> Signup and view all the answers

Which of the following is not a common symptom of TMJ dysfunction?

<p>Sharp hearing loss (D)</p> Signup and view all the answers

In cases of anterior disc displacement without reduction, which of the following is a typical symptom?

<p>Limited movement of the jaw (B)</p> Signup and view all the answers

What characterizes an indirect mandibular fracture?

<p>Fracture occurs away from the site of trauma (A)</p> Signup and view all the answers

In the event of trauma to the mandible, what forces are experienced on the external and internal surfaces?

<p>External surface experiences tension forces while internal experiences compression forces (C)</p> Signup and view all the answers

Which of the following is not commonly found in patients with mandibular fractures?

<p>Weight loss and abdominal cramps (A)</p> Signup and view all the answers

What causes ecchymosis and bruises in mandibular body and angle fractures?

<p>Extravasation of blood from injured capillaries (C)</p> Signup and view all the answers

In unilateral condylar fractures, which of the following is not commonly observed?

<p>Pain and tenderness on the contralateral side (C)</p> Signup and view all the answers

Which statement about indirect mandibular fractures is true?

<p>They can involve various locations, such as the condylar region (A)</p> Signup and view all the answers

What is a common finding in patients with mandibular fractures?

<p>Facial asymmetry (A)</p> Signup and view all the answers

How does the body primarily respond to the injury causing ecchymosis?

<p>By triggering an inflammatory response (B)</p> Signup and view all the answers

What does the finding suggest about the possibility of mandibular fractures?

<p>It indicates an associated condylar neck fracture. (B)</p> Signup and view all the answers

Which anatomical areas are considered strong points of the mandible?

<p>Eternal oblique ridge and internal oblique ridge (D)</p> Signup and view all the answers

Which management technique is NOT applicable for mandibular fracture?

<p>Surgical extraction (C)</p> Signup and view all the answers

If a patient has TMJ ankylosis on the right side, where will the mandible shift towards?

<p>Left side (D)</p> Signup and view all the answers

What does closed lock of TMJ signify in medical terms?

<p>Anterior disc displacement without reduction (A)</p> Signup and view all the answers

What diagnosis is associated with a bird face appearance?

<p>Unilateral bony TMJ ankylosis (B)</p> Signup and view all the answers

What is the diagnostic sign of reciprocal clicking in TMJ problems?

<p>Anterior disc displacement with reduction (B)</p> Signup and view all the answers

In managing a bilateral TMJ dislocation, how should the mandible be repositioned?

<p>Downward, forward, and upward (D)</p> Signup and view all the answers

In unilateral TMJ dislocation with dislocated condyle on the right side, which direction will the mandible shift?

<p>Left side (B)</p> Signup and view all the answers

Which statement about the preauricular skin incision is correct?

<p>The 1st statement is true &amp; the 2nd statement is false. (B)</p> Signup and view all the answers

Bell’s palsy is usually caused by which condition?

<p>Unilateral affection and/or paralysis of the facial nerve. (D)</p> Signup and view all the answers

What occurs during TMJ dislocation when the condyle becomes fixed?

<p>Anterior to the articular eminence. (D)</p> Signup and view all the answers

To minimize the risk of injury to the mandibular branch of the facial nerve, where should a submandibular skin incision be made?

<p>0.5 – 1.5 cm below &amp; parallel to the inferior border of the mandible. (C)</p> Signup and view all the answers

What type of surgical technique is ORIF considered for the management of mandibular fractures?

<p>Rigid fixation. (B)</p> Signup and view all the answers

Which statement about unilateral anterior disc displacement without reduction in TMJ is correct?

<p>It can affect mandible movement. (B)</p> Signup and view all the answers

In the context of TMJ disorders, which direction is least likely for the condyle to become displaced?

<p>Inferiorly. (B)</p> Signup and view all the answers

Flashcards

Anterior Disc Displacement with Reduction

A condition where the articular disc of the temporomandibular joint (TMJ) dislocates from its normal position, but then reduces (returns) back into place.

What is the gonial angle?

The angle formed between the ramus and the body of the mandible.

TMJ Ankylosis

A condition where the TMJ joint is fused, preventing any movement of the mandible.

What is TMJ ankylosis?

A condition where the temporomandibular joint (TMJ) is fused, preventing movement of the jaw.

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What is anterior disc displacement?

A common TMJ disorder where the disc that cushions the joint displaces forward, disrupting normal jaw movement.

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Bilateral TMJ Dislocation

A condition where both TMJ joints have dislocated and the mandible is displaced out of its normal position.

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What is TMJ dislocation?

A condition where the jawbone (mandible) moves out of its socket in the temporomandibular joint (TMJ).

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Mandible Reduction Direction

The direction to maneuver the mandible during reduction of a bilateral TMJ dislocation.

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What is anterior disc displacement with reduction?

A type of internal derangement that affects the temporomandibular joint (TMJ), characterized by pain, tenderness, and clicking sounds when opening and closing the mouth.

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Bell's Palsy

A condition that causes facial paralysis due to damage to the facial nerve, often affecting one side of the face.

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Submandibular Incision Location

The safest location for an incision near the mandible to avoid damaging the mandibular branch of the facial nerve.

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What is anterior disc displacement without reduction?

A type of internal derangement that affects the temporomandibular joint (TMJ), characterized by pain, tenderness, and locking jaw causing difficulty opening the mouth.

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What is TMJ surgery?

A surgical procedure to repair a damaged temporomandibular joint (TMJ).

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Symphyseal Fracture

A fracture of the mandible at the symphysis, where the two halves of the mandible meet in the midline.

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Where should the mandibular condyle be located?

The specific location where the mandibular condyle (jawbone) should be located.

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Step Deformity in Mandibular Fracture

A fracture where the broken bone ends are not aligned and a visible step is present.

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Mandibular Body Fracture with Displacement

A fracture of the mandibular body with a visible shift or displacement of the bone fragments.

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Maxillomandibular Fixation (MMF)

A procedure where the jaws are immobilized using wires or bands to hold them together.

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Areas of Weakness in the Mandible

The areas on the mandible that are more susceptible to fractures due to their anatomical structure.

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Common Site of Mandibular Fracture

The most common site of fracture in a normal adult mandible.

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Open Reduction and Internal Fixation (ORIF)

A surgical technique where the fracture is exposed and fixed using metal plates or screws.

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Indirect Mandibular Fracture

Fractures that occur due to a force that is applied indirectly to the mandible, often involving a blow to the chin.

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Direct Mandibular Fracture

A fracture that occurs when a force is directly applied to the site of the fracture.

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Bilateral Condylar Fracture

Fractures of both condyles of the mandible, usually resulting from a blow to the chin.

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Mandible Trauma Forces

The outer surface of the mandible experiences tension forces, while the inner surface experiences compression forces during trauma.

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Ecchymosis in Mandibular Fractures

The presence of bruising and discoloration around the area of a mandibular fracture.

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Extravasation of Blood

The escape of blood from broken capillaries, leading to the formation of ecchymosis in mandibular fractures.

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Midline Deviation in Condylar Fracture

A condition where a patient's mandible shifts towards the injured side due to a unilateral condylar fracture.

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Absent Condyle Movement

The inability to palpate (feel) movement of the condylar process on the injured side in a patient with a unilateral condylar fracture.

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Pain and Tenderness in Condylar Fracture

Pain and tenderness upon palpation of the condylar process on the side of a unilateral condylar fracture.

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Mandibular Shift in Unilateral TMJ Dislocation

In a unilateral TMJ dislocation, if the right condyle is dislocated, the mandible will shift towards the left side.

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Preauricular Skin Incision

A preauricular skin incision should be made within the skin creases but should not extend to the earlobe to prevent facial nerve damage.

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What Is Bell's Palsy?

Bell's palsy is a condition characterized by unilateral facial nerve paralysis, leading to partial or complete facial drooping.

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Location of Displaced Condyle in TMJ Dislocation

In TMJ dislocation, the condyle is dislocated anterior to the articular eminence, causing a painful locking sensation.

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Safe Submandibular Incision

To avoid injury to the mandibular branch of the facial nerve, a submandibular incision should be made 0.5 - 1.5 cm below and parallel to the inferior border of the mandible.

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ORIF Technique

ORIF (Open Reduction and Internal Fixation) is a surgical technique for managing mandibular fractures that uses rigid fixation methods.

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Ipsilateral Dislocation

In a unilateral TMJ dislocation, the dislocated condyle is located on the ipsilateral side, meaning the same side as the dislocated condyle.

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Unilateral Anterior Disc Displacement

Unilateral anterior disc displacement without reduction is a condition where the articular disc of the TMJ is displaced forward and doesn't return to its normal position.

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What finding suggests a potential condylar neck or symphysis fracture?

Condylar neck and/or symphysis fractures are possible when a patient presents with a specific finding.

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Are the eternal and internal oblique ridges strong or weak areas?

The eternal and internal oblique ridges are strong areas of the mandible.

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What parts of the mandible are relatively weak?

The mental foramen area and angle of the mandible are areas of weakness.

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How are mandibular fractures managed?

Management of mandibular fractures includes IMF, MMF, and ORIF.

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If the right TMJ is ankylosed, which way does the mandible shift?

In TMJ ankylosis on the right side, the mandible shifts to the left side.

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What is a closed lock of TMJ?

Closed lock of TMJ refers to anterior disc displacement without reduction.

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What condition is indicated by a bird face appearance?

Bird face appearance is a sign of unilateral bony TMJ ankylosis.

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What does reciprocal clicking of TMJ indicate?

Reciprocal clicking of TMJ is a sign of anterior disc displacement with reduction.

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Study Notes

Applied Surgical Anatomy - MCQ Study Notes

  • Gonial Angle: The angle between the ramus and the body of the mandible.

  • Unilateral Ankylosis of TMJ: Clinical features include deviation of the mandible to the affected side, facial asymmetry (bird face), and limited mouth opening, along with malocclusion.

  • Anterior Disc Displacement: A type of internal TMJ derangement. It can be a sign of TMJ dysfunction/disorders.

  • TMJ Diagnosis: A 24-year-old patient with TMJ pain, tenderness, and reciprocal clicking likely has anterior disc displacement (with possible reduction).

  • Preauricular Incision: The incision should be positioned above the ear's lobule, avoiding the trigeminal nerve.

  • TMJ Dislocation: The condyle moves outside the glenoid fossa, usually to the anterior side of the articular eminence.

  • Muscles for Mandibular Lateral Movement: The pterygoid muscles are responsible for side-to-side movements of the mandible.

  • Unilateral Condylar Fracture: Common symptoms include a midline shift of the mandible, limited lateral movements, and tenderness on palpation of the affected condyle.

  • Bilateral Condylar Fracture: Common finding is deviation of the mandible to the contralateral side.

  • Rare Mandibular Fracture: Symphyseal and parasmphyseal fractures are less common following RTA.

  • Dentoalveolar Fracture: This type of mandibular fracture involves the alveolar processes and supporting teeth. It's often associated with step deformities.

  • Management of Mandibular Fracture - IMF: Intermaxillary fixation (IMF).

  • Mandibular Fracture Signs: A step deformity at the lower premolar area of the mandible suggests a mandibular body fracture, possibly with displacement.

  • Mandibular Fracture - Natural Weaknesses: The neck of the condyle, internal oblique ridge, and the angle regions of the mandible are areas of weakness.

  • Common Mandibular Fracture Site: The condyle is the most common site of fracture in healthy adults.

  • Mandibular Fracture - ORIF: Open reduction and internal fixation (ORIF) for displaced mandibular body fractures.

  • Indirect Mandibular Fracture: A fracture that occurs away from the site of trauma, like a condylar fracture in chin trauma.

  • TMJ Ankylosis Facial Asymmetry: A patient with unilateral ankylosis exhibiting left-sided jaw shift suggests left TMJ ankylosis, while bilateral symptoms would suggest bilateral ankylosis.

  • TMJ Closed Lock: A medical term for anterior disc displacement.

  • Mandibular Branch of Facial Nerve: To avoid nerve damage, submandibular skin incisions should be 2-4 mm below the inferior border of the mandible, going parallel.

  • Causes of Mandibular Fracture: Trauma (e.g., road traffic accidents) can lead to mandibular fractures, and these may be unilateral or bilateral.

  • Natural Anatomic Strength Areas: The external and internal oblique ridges and the mylohyoid ridge.

  • Common Mandibular Fracture Findings: Common findings include pain, tenderness, ecchymosis, and malocclusion.

  • Unilateral Condylar Fracture Findings: Typically show deviation of the mandible to the contralateral side, along with pain and midline shift.

  • Mandibular Fracture Types: Direct, indirect, displaced, undisplaced, condyle, symphyseal, and angle.

  • Natural Anatomic Areas of Weakness: Areas like the neck of the mandible, angle, internal oblique ridge, and mental foramen are generally weaker spots in the bone.

  • Management of Mandibular Fractures: Often involve Intermaxillary Fixation (IMF) and/or Open Reduction Internal Fixation (ORIF).

  • Muscles for Ramus Upward Displacement: The masseter and medial pterygoid muscles are associated with upward ramus displacement in condylar fractures.

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Applied Surgical Anatomy Past Paper PDF - Fall 2024 Revision - 60 MCQ

Description

Test your knowledge on applied surgical anatomy focusing on the temporomandibular joint (TMJ) and related structures. This quiz covers topics such as gonial angle, TMJ disorders, and diagnostic techniques. Perfect for students and professionals in the medical field.

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