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Ortho Review > C-Spine and TMJ > Flashcards

C-Spine and TMJ Flashcards

PT

1
Q

The Cervical Spine is broken into:

A

Upper Cervical:
C0-C1 (atlanto occipital joint)
C1-C2 (atlanto axial joint)

Lower Cervical:
C2-C3 to C7-T1

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2
Q

How much does the upper C spine contribute to the motion of the neck

A

50%

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3
Q

What is the primary movement of C0-C1?

A

C0-C1 Atlanto Occipital Joint performing flexion and extension (30% total)

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4
Q

What is the primary movement of C1-C2?

A

C1-C2 Atlanto-Axial Joint performing rotation (45% each side)

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5
Q

What are the deep ligaments of the c spine?

A

Transverse Ligament of Atlas
Alar Ligaments (holds Dens)

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6
Q

What type of motion happens in the lower c spine?

A

Primarily Type II
rotation and side-bending happen on the same side

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7
Q

Actions of upper trap

A

Extension
SB
Contra Rotation

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8
Q

Action of Levator Scapula

A

Extension
SB
Ipsi Rotation (to C spine, not scapula)

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9
Q

Action of Scalenes

A

SB
Contra Rotation

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10
Q

Action of SCM

A

Bilateral Flexion of the Neck with extension of Upper C Spine
Unilateral SB
Contra Rotation

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11
Q

Action Sub-Occipital Group

A

Extend the Occiput on the cervical spine

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12
Q

Muscles of Deep Cervical Flexors

A

Longus Colli, Longus Capitus

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13
Q

What is TMJ

A

Articulation between condyle of the mandible and the temporal bone
(disc attached to lateral pterygoid)

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14
Q

Muscles and Motion of Opening/Closing TMJ

A

Opening: Lateral Pterygoid
Closing: Temporalis, Masseter, Medial Pterygoid

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15
Q

Muscles and Motion of Lateral Deviation TMJ

A

Ipsilateral temporalis and masseter
Contralateral Pterygoids

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16
Q

Muscles and Motion of Protrusion/Retrusion of TMJ

A

Protrusion: pterygoids (jaw forward)
Retrusion: Posterior fibers of temporalis and anterior fibers of the neck

17
Q

Resting Position of the mouth

A

mandible slightly retracted and teeth slightly apart

18
Q

Acute Phase of Cervical Sprains and Strains

A

Protecting healing tissue, decrease inflammation and pain, minimize loss of ability
Modalities: E Stim, Cold Pack, Non-Thermal US, Laser
Manual: STM
Therex: AROM in pain-free ROM
PT Education: Posture Ed, Activity Modifications

19
Q

Types of Cervical Collars

A

Soft
Tynor Hard Collar
Miami J Collar

20
Q

Sub Acute Phase of Cervical Sprains and Strains

A

decrease inflammation and pain
regaining mobility
Modalities: CP/HP E Stim, US, Laser, Intermittent Traction
Manual: STM, gentle manual cervical traction
Therex: AROM, light stretching, postural exercise, gentle ISO strengthening in pain free position
Education: Posture Ed, HEP

21
Q

Chronic Phase of Cervical Sprains and Strains

A

restore full mobility, posture re-ed, regaining full strength, training postural muscle endurance
Modalities: HP/CP
Manual: STM to restore full mobility, sub occipital release, manual cervical traction, manual stretching, joint mob
Therex: stretching spinal stabilization, upper extremity strengthening, ISO exercises for cervical strength, re-ed of deep cervical flexor
Education: HEP, slow return to pre-injury activity

22
Q

What is cervical Spondylosis?

A

chronic degenerative condition that involves either
Disc (DDD), Joints (DJD), or BOTH
(theres no space)

23
Q

What tissues can cervical spondylosis possibly have an impact?

A

Neural tissues in spinal canal or intervetebral foreamen

24
Q

What are the symptoms of Cervical Spondylosis?

A

Stiffness
Pain
Loss of Mobility
Crepitus
Radiculopathy
Myelopathy leading to weakness

25
Q

What is the chronic long term adaptations of cervical spondylosis?

A

Connective Tissue shortening
Chronic Muscle Tightness
Joint OA
Capsular Tightness restricting segmental mobility

26
Q

What can you use to decrease pressure on joint/disc/connective tissue by decreasing tightness of c spine?

A

STM
Traction
Stretching

27
Q

What is Cervical Disc Disease

A

a result of wear and tear or trauma

28
Q

What should treatment be focused on for radiculopathy?

A

decreasing neural compression and patient education to avoid movements that close on the IV foreamen
*because of nerve damage treatment should not go for extended periods without signs and symptoms improving
(May require surgery)

29
Q

Thoracic Outlet Syndrome

A

Condition where there is compression of the artery, nerve, or vein in the thoracic outlet
A result of trauma, overuse, or mechanical dysfunction

30
Q

What are common areas of compression in thoracic outlet syndrome?

A

Scalenes
Between the clavicle and 1st Rib
Under Pec Minor

31
Q

What is the goal when treating TOS?

A

decrease tightness in the anterior lateral cervical musculature and the axilla, and ensure there are normal mechanics for the upper quarter

32
Q

What is Cervical Facet Joint Dysfunction

A

“crick in the neck” (somatic or segmental)
Overfacilitation of the nervous system at a particular cervical segment which leads to local muscle guarding and impaired mobility

33
Q

What is an acute episode of Cervical Facet Joint Dysfunction

A

sleeping wrong, moving too quickly, trauma

34
Q

Cervical Posture Dysfunction

A

Chronic adaptations (long periods) of poor posture on in response to previous trauma that was not rehabilitated properly
Requires restoration of proper length to tight structures and strengthening to inhibited muscle groups

35
Q

What is the typical presentation of Cervical Posture Dysfunction

A

tight sub-occipital muscles, SCM, scalenes, pectoral muscles, hypertonic levator scap and/or upper trap
Weakness in deep neck flexors and interscap muscles

36
Q

What is TMJ dysfunction?

A

Develops due to muscle imbalance from grinding, chewing on one side, chewing gum, sleeping position, or compensation for cervical spine dysfunction

37
Q

What are signs and symptoms of TMJ dysfunction?

A

pain (usually one sided)
worse with opening
popping, limited ability to open mouth, difficulty chewing

Ortho Review (8 decks)

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