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NBDE Quiz # 30
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1. Question
A 43-year-old male presents with trismus and pain localized to the right preauricular region. On examination, he has limited range in jaw movements, and it is noted that he has a right posterior open bite. CT maxillofacial shows a calcified growth of his right condyle, which you suspect to be an osteochondroma. You plan to resect the right condyle and condylar neck. What muscle would be required to be stripped,according to your plan, to remove the condylar segment successfully?
Correct
The correct answer is C. The lateral pterygoid is composed of a superior head that originates from the infratemporal surface of the greater wing of the sphenoid and an inferior head that originates from the lateral surface of the lateral pterygoid plate. These will insert into the anterior portion of the condylar neck and
TMJ capsule. The other muscles are not specifically located around the condyle or condylar neck.
Temporalis:
Origin: floor of temporal fossa, deep surfaceof temporal fascia;
Insertion: coronoid process, anterior border of mandibular ramus.
Masseter:
Origin: superficial portion—anterior twothirds of lower border of zygomatic arch; deep portion—medial surface of zygomatic arch.
Insertion: lateral surface of ramus, coronoid process, and angle of mandible.
Medial pterygoid:
Origin: deep head—medial surface of lateral pterygoid plate; pyramidal process of palatine bone; superficial head—maxillary tuberosity.
Insertion: medial surface of ramus inferior to mandibular foramen
Incorrect
The correct answer is C. The lateral pterygoid is composed of a superior head that originates from the infratemporal surface of the greater wing of the sphenoid and an inferior head that originates from the lateral surface of the lateral pterygoid plate. These will insert into the anterior portion of the condylar neck and
TMJ capsule. The other muscles are not specifically located around the condyle or condylar neck.
Temporalis:
Origin: floor of temporal fossa, deep surfaceof temporal fascia;
Insertion: coronoid process, anterior border of mandibular ramus.
Masseter:
Origin: superficial portion—anterior twothirds of lower border of zygomatic arch; deep portion—medial surface of zygomatic arch.
Insertion: lateral surface of ramus, coronoid process, and angle of mandible.
Medial pterygoid:
Origin: deep head—medial surface of lateral pterygoid plate; pyramidal process of palatine bone; superficial head—maxillary tuberosity.
Insertion: medial surface of ramus inferior to mandibular foramen