Читать книгу Temporomandibular Disorders - Robin J. M. Gray - Страница 70

This muscle can be examined by palpating its origin extraorally. Ask the patient to clench the teeth together and the outline of the muscle origin can be identified, especially the anterior fibres. Digital palpation can be preformed between the superior and inferior temporal lines extending posteriorly (Figure 3.9).

Figure 3.9 Palpation of the anterior vertical fibres of the temporalis.

(M. Ziad Al‐Ani, Robin J.M. Gray.)

The anterior, more vertical fibres comprise the main elevator muscle of the jaw and are most commonly tender on palpation. The posterior fibres are almost horizontal in orientation and less frequently tender because their main function is to retrude the mandible.

It is suggested that the insertion of the temporalis muscle into the anterior margin of the coronoid process can be palpated intraorally by placing the little finger on the anterior border of the ramus and running it upwards, but this is not a reliable test because this is an uncomfortable and inaccessible area to try to access even in those who do not have muscle tenderness.