ORAL BIOLOGY TWO

"Maxillary Sinus "

&
"TMJ"

QUESTIONS
 Maxillary sinus – A. Ezz

I) COMPLETE:
-the largest paranasal air sinus is called........................................

Ans. Maxillary sinus

-maxillary sinus is defined as................................................................

Ans .Bilateral largest air sinus situated in the body of the maxilla

-the most related teeth to maxillary sinus are.....................................

(‫)ﻻزم ﺑﺎﻟﺗرﺗﯾب‬

Ans .upper 6,7,5,4,8,3

-the process by which maxillary sinus enlarges is called......................

Ans. pneumatization

-pneumatization is...............................................................................

Ans. "hollowing out of maxillary sinus by bone resorption on the sinus side and bone
deposition from the external side"

-the shape of the maxillary sinus is.............................ans."pyramidal"

-the base formed by..........................

apex formed by.......................

Roof formed by...............................

.floor formed by...........................

Anterior wall formed by..................

.posterior wall formed by.............

Answer: lateral wall of nose - zygomatic process - floor of orbit- alveolar process- facial
surface of maxilla- infra temporal surface of maxilla

-the maxillary sinus opens in the nasal cavity by an opening

called......................ans."ostium maxillare"
-the site where the ostium maxillare opens in the nasal cavity
is...............................ans."middle nasal meatus"

-the size of the sinus at birth is : 8 X 4 X 6 mm

-the sinus of the sinus at adult is : 2.3 X 3.4 X 3.3 cm

-the average capacity of maxillary sinus is.......mL

Ans. 15 mL

-the directions where the maxillary sinus enlarges

are......................,....................,.........................,....................&............

Ans. Frontal process, zygomatic process, zygomatic bone, maxillary tuberosity & alveolar
process

-the extension of the maxillary sinus into alveolar process may

cause............................................or..............................................or..................................
.................

Ans- presence of bony plate between sinus floor and upper teeth

Or -the maxillary sinus floor found between roots of the same teeth Or -the roots of
upper teeth are inside the sinus cavity

-the mucous membrane lining of maxillary sinus composed

of..........................................................

Ans: Epithelium ( pseudostratified collumnar ciliated epithelium with goblet cell) +

Basement membrane + lamina propria + no submucosa

-the epithelial lining of the maxillary sinus lining is .........................................................

Ans."pseudo stratified ciliated collumnar epithelium with goblet cell"

-the goblet cell is considered as ..................................gland,and it

secretes.............................and its shape is...............................

Ans. Unicellular apocrine- mucin- wine glass

-the cilia of the maxillary sinus lining is not under nervous control but
...............................,and they beat in one direction only which is toward
.................................................

Ans."automatic – ostium maxillare"

-the cilia is composed of....................................

Ans."9 + 1 pair of microtubules"

-the lamina propria of the maxillary sinus lining contain..........................

Ans."mixed glands"

-the lamina propria of the maxillary sinus lining is fused directly to bone,
because..........................

Ans." There is no submucosa in the lining of maxillary sinus"

-the maxillary sinus has the following

functions.....................,.......................,........................&......................

Ans. –Warming ,moistening of air

-Vocalization and phonation

-Lighten the weight of skull

-antibacterial lysozyme secretion

-Enhance resistance to mechanical shock

-the close relation between the maxillary sinus and the upper teeth can
cause.................................

Ans."periapical infection in upper teeth can cause sinus infection"

Or "infection of the sinus may lead to referred pain in the upper teeth"

Or " sinus damage during surgery"

Or "perforation of the sinus and forcing the root in the sinus"  "m7md 7amed"

-the secretions present inside the sinus are from...................................

Answer:

goblet cell secrete mucin

Mixed glands in the lamina propria secrete serous and mucous secretions
II) GIVE SCIENTIFIC TERM:
-the process by which the maxiilary sinus enlarges by hollowing out of the maxillary sinus
by bone resorption on the sinus side and bone deposition on the facial side of maxilla.

Ans. pneumatization

-a unicellular gland that secretes its mucin by rupturing the apical cell membrane then
again regenerate,so it is apocrine gland.

Ans. Goblet cell

-the opening of the maxillary sinus inside the nose

Ans. Ostium maxillare.

-the location of the opening of the maxillary sinus inside the nasal cavity.

Ans. Middle nasal meatus

-the bone that form the anterior wall of the maxillary sinus

Ans. Facial surface of maxilla

-the epithelium of the mucous membrane that lines the maxillary sinus

Ans. Pseudo stratified ciliated columnar epithelium with goblet cells

III) give reasons:

-the size of the sinus changes from birth to adult.

Due to pneumatization that is defined as.............

-care must be taken during operation in the upper 6

Because the upper 6 is the most related tooth to the floor of the sinus so
care must be taken to avoid sinus damage during surgery or perforation of
the sinus  " m7md 7amed"

-the upper teeth is in close relation to the maxillary sinus

Beacuse the floor of the sinus is formed from alveolar process of the
maxilla that attach the upper teeth

-the goblet cell is considered as unicellular apocrine gland

Because it secretes its mucin secretion by rupturing its apical cell

membrane then again regenerate.

-the goblet cell and cilia are both important in the lining of the sinus
lining.( muco- ciliary system is important)

Goblet cell  liberate mucous to trap particles

Cilia  force the foreign particles towards the nose automatically

-the lamina propria in the lining of the sinus is directly attached to bone

Because there is no submucosa in the lining of max sinus

-maxillary sinus is important

Write the functionS of the max sinus...

(IV)MCQ

1- Which of the following is NOT FOUND in the epithelium of the maxillary sinus:

A. Goblet cells

B. Ciliated cells

C. Microtubules

D. Non of the above

2- Which of the following is true concerning the maxillary sinus?

A. It begins to develop at age 6 months .

B. Its growth is by pneumatization.

C. It is lined by pseudostratified squamous epithelium.

D. Its opening is in the oral cavity.

3- Maxillary sinus open in the:

A. Medial nasal conche.

B. Superior nasal meatus.

C. Inferior nasal meatus.

D. Medial nasal meatus.

4- The maxillary sinus

A. Is covered by stratified squamous non keratinized epithelium

B. Is connected to the orbit

C. Is the largest of the paranasal sinuses

D. Often contain the roots of the central incisors

IV) ESSAY:

Q1)Anatomy & Enlargement of "maxillary sinus"??

Answer:
I)anatomy:

Shape..:4 sided pyramid ,base.............................apex............................

Roof ............................floor...........................
Anterior wall...............posterior wall..............
Opening: name.......................
Location of opening inside the nose.....................

Capacity:.....................mL

Dimentions:...............X................X.................c.m

II)enlargement:

Pneumatization .................................................(define.)

The directionS of enlargement ........................................................(5)

The extentions of the maxillary sinus toward the alveolar process may
cause........................................(3)"look in the complete
 Q2)Histology of mucous membrane lining of the
maxillary sinus?
Answer

• Epithelium + basement membrane + lamina propria

A) Epithelium:
-Pseudo stratified collumnar
Single raw of cells , all resting on the same basement membrane , but it apperas
stratified because the nuclei at more than one level

-Cilia:
composed of: 9 pairs + a central pair of microtubules.
Function:"move foreign materials towards the nasal cavity"
Automatic not under nervous control

-goblet cell:
Shape : glass in shape with swollen apical end & short stalk like basal end
containing the nucleus
Considered as.:"unicellular apocrine gland"
Organelles inside it : rER , golgi , vesicles , large nucleus
Function : secrete mucous to trap particles

B) Basement memrane:

C) Lamina propria:
Contain collagen fibers+ elasic fibers + mixed glands

D) No submucosa
 Q3)Histology of epithelial lining of maxillary sinus?

The answer will be epithelium only

Therefore the answer will be

• Epithelium:
-Pseudo stratified collumnar.....................................(explain)

-Cilia: composed of...............

Function..........

-goblet cell: shape................

Considered as.........................
Organelles inside it.......................
Function........................

GOOD LUCK..Ezz
 T.M.J – A.Ezz
I)COMPLETE:
-the T.M.J is a movable joint between...............&.....................

Answer: head of condyle-temporal bone

-the T.M.J is of ......................................type

Answer: modified hinge

-T.M.J is defined as...................................................................

Answer: bilateral movable joint of modified hinge type between the head of the condyle
and the temporal bone

-the T.M.J compartments are.................,.................,...................,..............&...................

Answer: condyle- temporal fossa- temporal eminence-disc-capsule

-the bony parts of the TMJ is formed of ...........................................

Answer: condyle , temporal fossa , temporal eminence

-the bone forming the roof of the TMJ is called......................

Answer : temporal bone

-the condyle is formed histologically of....................................

Answer: spongy bone covered with compact bone

-the bone trabeculae of the spongy bone of the condyle is reaching the outer surface by
an angle.............and this is to..............................

Answer: 90 - give maximum strength to the condyle

-by aging the condyle shows.....................&............................

Answer:

bone marrow spaces decrease in size.

red bone marrow change to fat bone marrow.

increase number of chondrocytes in the fibrocartiligenous layer.

Disappearance of hyaline cartilage.

-the condyle & the temporal bone are covered from the outer surface by........................

Answer: fibro cartiligenous layer

- under the age of 20 years between the fibrocartiligenous layer & the underlying
compact bone of the condyle ,there is a layer of.....................................,and it serves
as......................

Answer: hyaline cartilage- growth centre for the condyle

-the function of the hyaline cartilage in the condyle under the age of 20 years
is......................................................

Answer: act as growth centre for the condyle

-by E.M there is layer of 1-2 u thick separating the condyle from the joint cavity
called...........................................

Answer: lamina splendens

-the articular eminence is formed histologically of..................

Answer: spongy bone covered by a layer of compact bone

-while the articular fossa is formed histologically of.................

Answer: compact bone only

-over the eminence and the fossa , there is a layer of...............

Answer: fibrocartiligenous layer

-the fibrocartilagenous layer covering the articulating surfaces of the T.M.J is formed
of...................................................

Answer: fibers + fibroblast + chondrocyte + UMC

-the articular disc is .....................in top view.

Answer: oval

-the upper surface of the disc is....................in shape,while the lower surface is
............................in shape

Answer :convexo concave - concave

-the articular disc is formed histologically of...........................

Answer: dense collagen fibers

Few elastic fibers

Fibroblast with elongated processes

Chondrocytes ( in old age )

-the disc can be classified into 3 zones ( bands )...............,...............&.................

Answer: anterior –intermediate – posterior zones

-the thinnest zone of the disc is the ..................zone, while the thickest zone is
the........................zone

Answer:intermediate - posterior.

-the anterior zone of the disc is divided into 2 lamellae ,the upper one is attached
to........................while the lower one is attached to............................

Answer: temporal eminence – anterior surface of the condyle

-the only part of the articular disc that is vascularised (containing blood vessels) is the
..........................

Answer: upper posterior lamellae

-the upper posterior lamellae of the articular disc contain.......................&.......................

Answer: blood vessels + elastic fibers + nerves

-the cavity of the T.M.J is divided by the disc into...............................&.............................

Answer: upper joint cavity & lower joint cavity

-the capsular ligament of the T.M.J is attached superiorly to................................and

inferiorly to...........................

Answer: temporal bone - condyle neck

-the lateral part of the capsular ligament of the TMJ is thickened to form..........................

Answer: temporomandibular ligament

-the capsule ligament of the TMJ is formed of.......................layer & ..........................layer

Answer: outer fibrous layer & inner synovial membrane

-the TMJ cavity is lined by....................................

Answer: synovial membrane

-the synovial membrane is formed of 2 layers; ..........................&..............................

Answer: vascular subintima & cellular intima

-the cellular intima of the synovial membrane of TMJ contain 3 types of cells
................,................&................. while the vascular subintima
contains..................................................

Answer: fibroblast like cells , macrophage like cells , intermediate cells – fat cell,
fibroblast, macrophage, mast cell, blood vessels.

-the disc divides the joint cavity into..................&.......................compartments

Answer: upper& Lower

-which is larger ; the upper joint cavity or the lower joint cavity??

Answer: upper

-the upper joint cavity is responsible for the ........................movement , while the lower
joint cavity is responsible for the ................................movement.

Answer: translatory ( glinding ) – hinge

-the cavity of the TMJ is filled with a fluid called.................

Answer : Synovial fluid

-synovial fluid is produced from..................................

Answer: cellular intima of the synovial membrane

Is composed of..................................

Answer : viscous fluid : plasma + protein + mucin + monocytes+ lymphocytes+

macrophage.

Has the following functions(3)...................

Answer: 1-Provides a liquid environment to lubricate the joint surfaces. 

2-As a source of nutrition 

3-To remove material (debris) from joint - this is done by macrophages present
-the TMJ permits....................movement & ...........movement

Answer: hinge - translatory

-the Hinge movement takes place in ...............................cavity

Answer: lower joint cavity

-the translatory movements takes place in the..................cavity.

Answer: upper joint cavity

II) give scientific term:

-bilateral movable joint of modified hinge type between the condyle and the temporal
bone.

Answer: TMJ

-a layer of 1-2 u thick separating the superficial layer of the condyle from the joint cavity.

Answer: lamina splendens

-the fibrous sac of the TMJ that is attached superiorly to temporal bone and inferiorly to
the condylar neck.

Answer: capsule

-the liquid present inside the TMJ and produced by the synovial membrane.

Answer: synovial fluid

-the structure of the TMJ that divides the joint cavity into 2 compartments; uuper & lower

Answer: disc

-a ligament formed as a result of thickening of lateral part of the TMJ capsule.

Answer: temporomandibular ligament

-the bone that forms the roof of the TMJ and formed of articular fossa & eminence

Answer : temporal bone

III) give reasons:
-the bone trabeculae of the spongy bane of the condyle reach the outer surface at
right angles.

To give maximum strength for the condyle

-the articular surfaces of the TMJ is covered by a " fibrocartiligenous layer".

To protect the opposing articulating bony surfaces from erosion during TMJ function

-there is a layer of hyaline cartilage under the fibrous covering of the condyle under
the age of 20 years.

To act as a growth centre for the condyle

-disappearance of hyaline cartilage in the condyle at old age.

Because it acts as a growth centre ONLY till the age of 20 years then it disappears and
replaced by bone

-the only part of the articular disc that contains blood vessels is its upper posterior
lamellae.

Because the upper posterior lamellae of the disc BLENDS with the capsule that contains
BLOOD VESSELS.

-synovial fluid is viscous .

To help in lubrication of different joint surfaces

-synovial fluid is very important in the TMJ.

Write the 3 functions of the synovial fluid ( in complete)

-one of the functions of the synovial fluis is " debris removal" HOW?

By the help of the macrophages are present in great amount in the synovial fluid.

IV)MCQ:

1- The TMJ does not contain:

A. Articular disc.

B. Capsular ligament.

C. Synovial membrane.

D. Blood vessels in its covering fibrocatilagenous tissue.

2- Which is true of the T.M.J?

A.an epithelium lines the synovial membrane.

B.It has a highly vascular articulator disc.

C.The articular surfaces are covered by a dense fibrous C.T.

D.The articular disc is attached to the roof of the glenoid fossa.

3- The head of the mandibular condyle:

A. Articulates with the roof of the glenoid fossa.

B.Develops from the secondary cartilage.

C.Lacks hyaline cartilage.

D.Consists of spongy bone only

4- The condylar head shows cartilage :

A.after the age of 20 years

B.till the age of 20 years

C.never has a cartilage

D.non of the above

IV)ESSAY:

Q1)Histology of the articulating

disc?
Answer:
Define :"dense avascular fibrous tissue"
Formed histologically of :
Dense packed collagen fibers , few elastic fibers , fiboblast , chondrocytes
(with aging).

Top view............................
Upper surface................
Lower surface................
Divided into 3 zones:
Anterior==========divided into......??

Intermediate======thinneest zone.

Posterior =========divided into.....+contain........???.

N.B: the only part of the disc that is containg blood vessels is
the posterior zone
 Q2)Histology of the TMJ capsule ?
Answer:
Define attached superiorly to.....and inferiorly to.....

Its lateral part is thickened to form...............

Consist of 2 layers:
Outer fibrous layer

Inner synovial membrane... vascular subintima: contain???

Cellular intima: contain?

Produce synovial fluid

-content

-function
 Q3)Histology of the joint
cavity?(Synovial cavity)?
Answer:
-Divided by the disc into.................................
-Lined by synovial membrane : discuss " boss fo2"
-Filled with SYNOVIAL FLUID:
produced from..........
Contents................
Functions............(3)

-Upper joint cavity for glinding movement

-Lower joint cavity for hinge movement

GOOD LUCK...Ezz 