Assessment – Nutrition-Focused Physical Exam to Detect Macronutrient Deficiencies
Jennifer Doley, Mary J. Marian in Adult Malnutrition, 2023
The temporalis muscle is one of the muscles of mastication and is located along the side of the head occupying the temporal fossa. Clenching and unclenching the jaws or teeth contracts this muscle. Standing directly in front of the patient, the examiner should inspect the temporalis muscle for signs of hollowing, scooping, or concave depression. To palpate the temporalis, ask the patient to clench the teeth for muscle engagement. Using the index and middle fingers, palpate the muscle over the temporal bone in a scooping motion forward, backward, and diagonally. In well-nourished patients, there will be ample temporalis muscle and no apparent hollowing or scooping. In severely malnourished patients, inspection will reveal hollowing temples with concave depression. Palpation of the engaged temporalis muscle will feel firm and rigid on well-nourished patients and will feel flaccid and limp in malnourished patients. See Figures 6.2–6.4.
Temporal Region and Lateral Brow
Ali Pirayesh, Dario Bertossi, Izolda Heydenrych in Aesthetic Facial Anatomy Essentials for Injections, 2020
The temporalis muscle (Figure 2.14) is a large, fan- shaped masticatory muscle covering the lateral aspect of the cranium. At its origin, it is tightly adherent to the temporal line, while its tendinous portion passes beneath the zygomatic process to insert into the coronoid process of the mandible. It may be divided into anterior, middle, and posterior regions. As a masticatory muscle, it is capable of generating great contractile strength. The temporalis tendon extends from its insertion at the upper anterior border and inner surface of the coronoid process and mandibular ramus to approximately 45 mm superior to the zygomatic arch. When treating the temporalis muscle with botulinum toxin for headache or bruxism, injections need to be placed into the muscular portion of temporalis for maximal efficacy.
The Gallbladder (GB)
Narda G. Robinson in Interactive Medical Acupuncture Anatomy, 2016
Clinical Relevance: The temporalis muscle, a common source of pain and dysfunction affecting the temporomandibular joint, fills the temporal fossa, overlying the adjoined zygomatic, frontal, parietal, sphenoid, and temporal bones. The temporalis muscle attaches onto the medial and lateral aspects of the coronoid process of the mandible as well as onto the anterior edge of the ramus of the mandible. Its extent almost reaches the last molar tooth. The temporalis muscle fibers fan out in a rostral-caudal direction like spokes of a wheel, collecting onto their mandibular attachment as they would onto a hub. This multi-directional nature of the temporalis muscle allows it to move the mandible in a variety of directions to accommodate the motions required for chewing, speaking, yawning, etc. The rostral/vertical, middle/ oblique, and caudal/horizontal bundles of these fibers form three functionally distinct portions with each group referring a different pain pattern when trigger points develop. That is, attachment trigger points (ATrPs) (i.e., those occurring at the musculotendinous junction) in the anterior division lead to a pain trajectory that arches over the supraorbital ridge, up to the forehead, and down to the ipsilateral nasal ala and upper incisor teeth. ATrPs in the middle and caudal sections refer pain upward toward the midline of the cranium in fingerlike projections aligned with the direction of the spokes, or muscle fibers.
A randomized, double-blinded, placebo-controlled, parallel trial of vitamin D3 supplementation in adult patients with migraine
Published in Current Medical Research and Opinion, 2019
P. Gazerani, R. Fuglsang, J. G. Pedersen, J. Sørensen, J. L. Kjeldsen, H. Yassin, B. S. Nedergaard
PPT and temporal summation were assessed to record hypersensitivity and to determine whether these measures changed during the course of the study, i.e. following treatment. Both tests were performed on each side of the head on the temporal muscle, on both arms, at a point on the belly of the brachioradialis muscle, and on the right leg, at a point located on the belly of the tibialis anterior muscle 5 cm distal to the tibial tuberosity. PPT was performed on a point on the temporal muscle as determined as the most sensitive point for migraine sufferers22. This point is located 1.5 cm above the upper medial edge of the ear and 1 cm anterior from there. For temporal summation, a point on the hairless part of the temple was used. During both tests, the subject was lying comfortably on their side for test points on the head, and on their back for test points on the limbs.
The association between myofascial orofacial pain with and without referral and widespread pain
Published in Acta Odontologica Scandinavica, 2022
Anna Lövgren, Corine M. Visscher, Frank Lobbezoo, Negin Yekkalam, Simon Vallin, Anders Wänman, Birgitta Häggman-Henrikson
In accordance with the DC/TMD and following the International Classification of Orofacial Pain, ICOP [25], myofascial orofacial pain was considered present when the following criteria were fulfilled: self-reported pain within the last 30 days, pain modified by function, and pain confirmed to the masseter or temporal muscles by the examiner together with familiar pain confirmed during jaw movement or muscle palpation during the clinical examination. In a second step, pain referral was considered present in the case of concurrent referred pain outside the muscle border during a 5-second muscle palpation. Based upon these criteria, all individuals were categorized into three groups; no myofascial pain (controls), myofascial pain without referral or myofascial pain with referral, respectively.
Internal maxillary artery to middle cerebral artery bypass for a complex recurrent middle cerebral artery aneurysm: case report and technical considerations
Published in British Journal of Neurosurgery, 2022
Ronan J. Doherty, Daragh Moneley, Paul Brennan, Mohsen Javadpour
Preoperatively the patient underwent computed tomographic angiography (CTA) of the head which was used for intraoperative navigation and localisation of the IMAX (Figure 2). Under general anaesthesia, the patient was positioned supine, with the head in the Mayfield head holder and rotated approximately 45 degrees towards the contralateral side. The previous left frontotemporal incision and pterional craniotomy were reopened. The temporalis muscle was reflected inferiorly and a zygomatic arch osteotomy was performed. Under the operating microscope, a temporal fossa craniectomy was performed consisting of removal of bone of the lateral part of middle cranial fossa floor extending medially as far as a line connecting the foramen rotundum and foramen ovale (Figures 3 and 4). The left IMAX was localised in the infratemporal fossa using a combination of CTA-based neuronavigation and micro-Doppler probe (Mizuho Inc. Tokyo, Japan) (Figure 5). In addition, the deep temporal arteries in the deep aspect of the temporalis muscle were followed proximally to lead to the location of the IMAX.
Related Knowledge Centers
- Anatomy
- Muscles of Mastication
- Temporal Bone
- Temporal Fascia
- Zygomatic Arch
- Skeletal Muscle
- Muscles of Mastication
- Muscle Architecture
- Head
- Temporal Fossa
- Temple