Subject: Manual therapy

Domain: Jaw (TMJ)

Assignment: Muscles of mastication
Submission by: Munazza Shah, roll no: 05,6th semester, DPT batch10

Temporo-mandibular joint:
The temporomandibular joint (TMJ) is formed by the bilateral, synovial articulation of the
mandible and the temporal bone of the cranium. It allows opening, closing, and a side to side
movement of the mouth. The TMJ is found anteriorly to the tragus of the ear, on the lateral
aspects of the face
This joint is unique in that it is a bilateral joint that functions as one unit.

Joint capsule:
The joint capsule originates from the border of the mandibular fossa, encloses the articular
tubercle of temporal bone and inserts at the neck of mandible above the pterygoid fovea. It is so
loose that the mandible can naturally dislocate anteriorly without damaging any fibers of the
capsule.
Ligaments:
The TMJ is supported by the following ligaments:

● The medial and lateral collateral ligaments (also known as the discal ligaments)
● The temporomandibular ligament
● The stylomandibular ligament
● The sphenomandibular ligament

Innervation:
● The mandibular nerve (third branch of the trigeminal nerve) provides the main nerve
supply of the TMJ.
● Additional innervation comes from the masseteric nerve and deep temporal nerves.
● Parasympathetic fibers of the otic ganglion stimulate the synovial production.
● Sympathetic neurons from the superior cervical ganglion reach the joint along the
vessels and play a role in pain reception and the monitoring of the blood volume.

Vascular supply
● The TMJ is supplied by three arteries.The main supply comes from the deep auricular
artery (from the maxillary artery) and the superficial temporal artery (a terminal branch of
the external carotid artery).In addition the joint is provided by the anterior tympanic artery
(also a branch of the maxillary artery).
● The venous blood drains through the superficial temporal vein and the maxillary vein.

Movements of TMJ:
A variety of movements occur at the TMJ. These movements are
● Mandibular depression and elevation
● Lateral deviation (which occurs to both the right and left sides),
● Retrusion and protrusion.

Each of these movements are performed by a number of muscles working together to perform
the movement while controlling the position of the condyle within the mandibular fossa.

Muscles Actions

Temporalis Elevates mandible

Masseter Elevates mandible

 Lateral pterygoid Protracts mandible, depresses chin, lateral deviation of mandible

Medial pterygoid Works with masseter to elevate mandible, aids in protrusion,

Function of TMJ:
● Speech
● Mastication

Mastication:
Mastication is the process of chewing food in preparation for deglutition and digestion; the act of
grinding or comminuting with the teeth.
It is a technical word for the act of chewing.

Muscles of mastication:
Each of these primary muscles of mastication is paired, with each side of the mandible
possessing one of the four. The muscles of mastication as same as stated above:
● Masseter
● Temporalis
● Medial pterygoid
● Lateral pterygoid
The muscles of mastication develop from the first pharyngeal arch.

1. Masseter
The masseter muscle is the most powerful muscle of mastication. It is quadrangular in shape,
and can be split into two parts: deep and superficial.

The entirety of the muscle lies superficial to the pterygoids and temporalis, covering them.

Attachments: The superficial part originates from the maxillary process of the zygomatic bone.
The deep part originates from the zygomatic arch of the temporal bone. Both parts attach to the
ramus of the mandible.
Actions: Elevates the mandible, closing the mouth.
Innervation: Mandibular nerve (V3).

2.Temporalis
The temporalis muscle originates from the temporal fossa – a shallow depression on the lateral
aspect of the skull. The muscle is covered by tough fascia which can be harvested surgically
and used to repair a perforated tympanic membrane (an operation known as a myringoplasty).
Attachments: Originates from the temporal fossa. It condenses into a tendon, which inserts
onto the coronoid process of the mandible.
Actions: Elevates the mandible, closing the mouth. Also retracts the mandible, pulling the jaw
posteriorly.
Innervation: Mandibular nerve (V3).

3.Medial Pterygoid:
The medial pterygoid muscle has a quadrangular shape, with two heads; deep and superficial. It
is located inferiorly to the lateral pterygoid.

Attachments:
The superficial head originates from the maxillary tuberosity and the pyramidal process of
palatine bone.
The deep head originates from the medial aspect of the lateral pterygoid plate of the sphenoid
bone.
Both heads attach to the ramus of the mandible near the angle of mandible.
Actions: Elevates the mandible, closing the mouth.
Innervation: Mandibular nerve (V3).

4.Lateral Pterygoid:
The lateral pterygoid muscle has a triangular shape, with two heads; superior and inferior. It has
horizontally orientated muscle fibres, and thus is the major protractor of the mandible.

Attachments:
The superior head originates from the greater wing of the sphenoid.
The inferior head originates from the lateral pterygoid plate of the sphenoid.
The two heads converge into a tendon which attaches to the neck of the mandible.
Actions: Acting bilaterally, the lateral pterygoids protract the mandible, pushing the jaw
forwards. Unilateral action produces the ‘side to side’ movement of the jaw.
Note: Contraction of the lateral pterygoid will produce lateral movement on the contralateral
side. For example, contraction of the left lateral pterygoid will deviate the mandible to the right.
Innervation: Mandibular nerve (V3).