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The temporalis muscle is a large, thin, fan-shaped muscle that occupies the temporal fossa of the skull. It is responsible for the movements of the mandible at the temporomandibular joint, facilitating the act of mastication. The temporalis muscle is innervated by the anterior, middle, and posterior deep temporal branches of the anterior trunk of the mandibular nerve (V3). It receives its blood supply from the deep temporal branches of the maxillary artery and the middle temporal branches of the superficial temporal artery. To test the temporalis muscle, one can perform a muscle tenderness exam, palpating the muscle to identify taut bands and assess relative tenderness. Another method is to examine the trigeminal nerve by asking the patient to clench their jaw and feeling for a muscle contraction.
| Characteristics | Values |
|---|---|
| Muscle Group | Masticatory muscles |
| Muscle Type | Bipennate muscle |
| Muscle Shape | Thin, fan-shaped |
| Muscle Function | Controls the jaw, produces movements of the mandible at the temporomandibular joint, facilitates mastication and side-to-side movements of the jaw |
| Muscle Origin | Temporal fossa of the skull, lateral surface of the skull |
| Muscle Insertion | Inner surface of the coronoid process, upper anterior border and medial border of ramus of mandible |
| Muscle Innervation | Anterior, middle and posterior deep temporal branches of the anterior trunk of the mandibular nerve (V3) |
| Muscle Blood Supply | Deep temporal branches of the maxillary artery, middle temporal branches of the superficial temporal artery |
| Muscle Thickness | 15 mm at the level of the zygomatic arch, 5 mm at its peripheral boundary |
| Muscle Tenderness Assessment | Palpate the muscle to identify taut bands and rate tenderness as none, mild, moderate or severe |
| Muscle Reconstruction | Used in the reconstruction of the paralyzed face, defects involving the skull base, orbit, midface, and oropharynx |
| Muscle Growth | TMT (temporalis muscle thickness) growth accelerates around the onset of puberty in males and then plateaus in the early 20s |
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What You'll Learn
Palpate the anterior temporalis for tenderness
The temporalis muscle is a thin, fan-shaped muscle that sits within the temporal fossa of the skull. It is divided into anterior and posterior parts. The anterior temporalis muscle is best palpated at the hairline and opposite the eyebrow.
Palpating the anterior temporalis for tenderness involves applying pressure to the muscle and asking the patient to rate the pressure as none, mild, moderate, or severe. This is known as a relative tenderness assessment. The pressure to be used is 2kg of pressure with one finger for 2 seconds.
To palpate the anterior temporalis for tenderness, start by locating the muscle at the hairline and opposite the eyebrow. Using one finger, apply 2kg of pressure for 2 seconds. Ask the patient to rate the pressure as none, mild, moderate, or severe. Move your finger up and down the muscle, applying firm pressure, and ask the patient to report the most tender point. Once found, compress this point for 5 seconds to see if the pain radiates or refers.
It is important to note that tension in the temporal muscle can induce pain in the temporal area. Common causes of temporal muscle tension include injection-induced myositis, myofascial taut band, trigger point, hypertrophy, and spasms. Clinically, it is important to rule out inflammation of the superficial temporal artery, which can cause swelling and pain in the temporal area.
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Identify abnormalities
The temporalis muscle is a thin, fan-shaped muscle that sits within the temporal fossa of the skull. It is divided into anterior and posterior parts. The anterior portion moves the mandible dorsocranially (elevation), while the posterior fibres pull the mandible posteriorly (retrusion). The temporalis muscle is the strongest muscle of the temporomandibular joint and the primary retractor of the mandible.
To identify abnormalities, a medical professional will palpate the temporalis muscle for tenderness using a none, mild, moderate, or severe scale. The anterior temporalis muscle is best palpated at the hairline and opposite the eyebrow. The posterior temporalis is palpated just above the pinna or the ear.
The temporalis muscle can be tested by asking the patient to clench their jaw. The examiner will feel for a muscle contraction. If the patient is unable to contract the muscle, this may indicate an abnormality.
Common abnormalities of the masticatory muscle include injection-induced myositis, myofascial taut band, trigger point, hypertrophy, and spasms. Tension of the temporal muscle can induce pain in the temporal area. Clinicians must rule out inflammation of the superficial temporal artery, which can cause swelling and pain in the temporal area. A temporal artery biopsy can confirm this diagnosis.
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Understand the anatomy
The temporalis muscle, also known as the temporal muscle, is a thin, broad, and powerful fan-shaped convergent muscle on each side of the head. It is situated within the temporal fossa of the skull, superior to the zygomatic arch, and covers much of the temporal bone. The origin point of the temporalis muscle spans the entire surface of the fossa below the temporal line, with some fibres also originating from the temporal fascia.
The temporalis muscle is divided into two functional parts: the anterior and posterior. The anterior fibres run inferiorly in an almost vertical direction, while the posterior fibres are directed almost horizontally. Both sets of fibres converge onto a narrow tendon that runs medial to the zygomatic arch. The tendon inserts onto the coronoid process of the mandible. The temporalis muscle covers the temporal fossa with its deep surface, and is covered itself by the temporal fascia, masseter muscle, subcutaneous tissue, and skin.
The auriculotemporal, facial, and zygomaticotemporal nerves run across the superficial aspect of the temporalis muscle. The muscle receives its innervation from the anterior, middle, and posterior deep temporal branches of the anterior trunk of the mandibular nerve (V3). It receives its blood supply from the deep temporal branches of the maxillary artery and middle temporal branches of the superficial temporal artery.
The main function of the temporalis muscle is to produce movements of the mandible at the temporomandibular joint, thus facilitating the act of mastication (chewing). The contraction of the anterior fibres moves the mandible dorsocranially (elevation), while the contraction of the posterior fibres pulls the mandible posteriorly (retrusion). The middle portion, which has fibres running in an oblique direction towards the inferior and anterior, is used for both elevation and retraction of the mandible. The unilateral contraction of the middle portion provokes a lateral movement of the mandible.
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Assess muscle contractions
The temporalis muscle is a thin, fan-shaped muscle that sits within the temporal fossa of the skull. It is divided into anterior and posterior parts, with the anterior portion moving the mandible dorsocranially (elevation) and the posterior fibres pulling the mandible posteriorly (retrusion). The temporalis muscle is the strongest muscle of the temporomandibular joint and is responsible for the mandible's backward movement.
To assess muscle contractions, you can perform a trigeminal nerve function test. This nerve controls the muscles used for biting and chewing and carries sensory information about touch and pain from the face. It also controls the temporalis, masseter, and pterygoid muscles that manipulate the jaw.
- Inform the patient that you are about to test their jaw.
- Place one hand on each temple of the patient's head.
- Ask the patient to clench their jaw and feel for a muscle contraction. This is the temporalis muscle.
- Ask the patient to release their clenched jaw.
- Move your hands close to the ears on each of the patient's cheeks.
- Ask the patient to clench their jaw again and feel for a muscle contraction. This is the masseter muscle, which also helps control the jaw.
- Ask the patient to release their clenched jaw.
- Remove your hands. If you did not feel any muscle contraction, continue with the examination.
You can also assess muscle tenderness and pain by palpating the muscles and identifying taut bands. The anterior temporalis muscle is palpated at the hairline and opposite the eyebrow, while the posterior temporalis is palpated just above the ear. Use a scale of none, mild, moderate, or severe to rate the tenderness.
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Confirm diagnosis with a biopsy
A temporal artery biopsy is required to confirm a diagnosis of vasculitides, such as giant cell arteritis, which frequently involves the superficial temporal artery and causes swelling and pain in the temporal area. The anterior temporalis muscle is best palpated at the hairline and opposite the eyebrow. The posterior temporalis muscle is palpated just above the pinna or the ear, and its direction is posterior from the coronoid process. The temporalis muscle is a thin, fan-shaped muscle situated within the temporal fossa of the skull. It is divided into anterior and posterior parts. The anterior fibres run inferiorly in a near-vertical direction, while the posterior fibres are directed almost horizontally.
The temporalis muscle is innervated by the anterior, middle, and posterior deep temporal branches of the anterior trunk of the mandibular nerve (V3). It receives its blood supply from the deep temporal branches of the maxillary artery and the middle temporal branches of the superficial temporal artery. The thickness of the muscle varies from 15mm at the level of the zygomatic arch to 5mm at its peripheral boundary. The thin peripheral muscle fibres converge as they descend to form a thick tendon, which passes medial to the arch and inserts onto the anterior border and medial surface of the coronoid process of the mandible.
The temporalis muscle is the strongest muscle of the temporomandibular joint and the primary retractor of the mandible. Its contraction results in the backward movement of the mandible (retrusion). The unilateral contraction of the temporalis muscle plays an important role in the side-to-side movements of the jaw. Contraction of the temporalis muscle can be felt by asking the patient to clench their jaw.
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Frequently asked questions
The temporalis muscle is a large, thin, fan-shaped muscle that occupies the temporal fossa of the skull. It is divided into anterior and posterior parts. The anterior portion moves the mandible upwards, while the posterior fibres pull the mandible backwards.
The temporalis muscle is located within the temporal fossa of the skull. It is covered by the temporal fascia, masseter muscle, subcutaneous tissue and skin.
Ask the patient to clench their jaw. Place your hands on the temples of the patient's head and feel for a muscle contraction. This is the temporalis muscle.
The main function of the temporalis muscle is to produce movements of the mandible at the temporomandibular joint, thus facilitating the act of mastication (chewing).
Tension of the temporal muscle can induce pain in the temporal area. Inflammation of the superficial temporal artery, which runs in front of the ear, can cause swelling and pain.
