Cervical Spine and TMJ Flashcards
Objectives
9: Differentiate among ROM, AAROM, AROM and FROM
11: Perform PROM on the trunk, UEs and Cspine
12: Measure functional, active, and passive ROM with a goniometer and accurately record
13: Discuss manual muscle testing principles
14: Recognize a variety of muscle strength scales used in PT
15: Demonstrate accurate technique for performing manual muscle tests
16: Interpret results from a manual muscle test
fyi
shaped like a horseshoe and it articulates with the temporal bone.
The mandible or mandibular bone
located between the body and the ramus, it is the joining point of these two landmarks
Angle
- the horizontal portion of the mandible,
- the superior surface holds on to the lower teeth.
Body
it is the posterior projection on the ramus and directly articulates with the temporal bone
Condyle
also called the condylar process
located on the interior side (inside) of the mandible near the midline and is the attachment of the geniohyoid muscle
Mental spine
just inferior to the condylar process.
Neck
located between the condyle and coronoid process on the ramus
Notch
the vertical portion of the mandible from the angle to the condyle
Ramus
located on the side of the skull posterior to the zygomatic bone and is inferior to the parietal bone, posterior to the greater wing of the sphenoid bone and anterior to the occipital bone
- Has both convex and concave joint articulations
The middle is concave and the anterior and posterior tubercles are convex
Temporal bone
- makes up the anterior portion of the articulating temporal bone
- it connects with the zygomtic process to make the bridge.
Articular tubercle
lies anteriolyr to the external auditory meatus and articulates with the condyle of the mandible
Articular fossa
aka, the mandibular fossa
a slender projection positioned downward and forward from the temporal bone on the inferior, slightly interior surface
Styloid process
bony prominence posterior and inferior to the ear
Mastoid process
the external opening to the ear, posterior to the TMJ
External auditory meatus
Makes up the posterior portion of the zygomatic arch
Zygomatic process
- this attaches on the neck of the mandible condyle and disk, and then runs speriorly to the articular tubercle of the temporal bone
- limits downward, posterior and lateral motions of the mandible
Lateral ligament or temporomandibular ligament
The ligament that attaches to the spine of the sphenoid bone and runs to the middle of the ramus on the internal surface of the mandible. I suspends the mandible and limits excessive anterior motion.
Sphenomandibular ligament
This ligament limits excessive anterior motion of the mandible.
Stylomandibular ligament
almost parallel to the digastric muscle. (k we don’t know what muscle that is but it runs parallel to it )
It attaches to the styloid process of the temporal bone and goes to the hyoid bone. helps hold the hyoid bone in place.
Stylohyoid ligament
envelops the TMJ
Joint capsule
similar to articular disks every where in the body. It is connected circumferentially to the capsule and tendon of the lateral pterygoid.
Articular disk
This joint will be tested as convex on concave when the lower jaw is moving.
What are the 5 motions ?
- Elevation of the mandible
- Depression of the mandible
- Deviation of the mandible
- Protrusion of the mandible
- Retrusion of the mandible
YOU WILL BE RESPONSIBLE FOR THE FOLLOWING MUSCLES AND THEIR OIAN’S
- Temporalis
- Masseter
- Medial/Lateral Pterygoids
dorsal -Curvatures of the spine
Please note, this is NOT arthrokinematic movement of the spine
- Cervical – Concave
- Thoracic – Convex
- Lumbar – Concave
- Sacral – Convex
a small, smooth, flat surface on the bone
- they are found in the thoracic spine at the point of contact at a rib
Facets
The curves of the spine provide stability as if the spine were a straight rod, the spine would not be stable at all
- In fact, the strength is _______times what it would be if the spine were straight
10x
this is the articulation between the superior articular process with the inferior articulate process of the vertebra above
A facet joint
Motions occur in all three planes of motion in the spine
Flexion/extension
Abduction/adduction (side bending)
Rotation
Motion at the Occiput and C1 is called?
the atlanto-occipital joint
- Main motion is flexion and extension
Most of the lateral flexion and rotation in the spine occurs where?
at C1 and C2 or the atlanto-axial joint
Muscles that have the most influence on O/C1 and C1/C2 are what ?
- prevertebral muscles anteriorly
- suboccipitals posteriorly
Tucking your chin and neck extension is cervical ?
retraction
Extending your head and flexing your head is cervical what?
It’s the pigeon bob – forward is protraction, backwards is retraction
protraction
The skull is made up of how many bones?
luckily, we will only be talking about the ones that articulate with the spine
21
posterior inferior part of the cranium
Occipital bone
small prominance in the center of the occiput
Wisdom notch
Occipital protuberance
ridge running horizontally along the back of the head from the occipital protuberance to the mastoid process
Nuchal line
base or inferior portion of the occiput
Remember the basilar artery?
Basilar area
opening in the occipital bone?
Foramen magnum
located laterally to the foramen condyle, bumps that provide articulation with C1
Occipital condyles
forms part of the base and lateral inferior sides of the cranium
Temporal bone
cylindrical mass of cancellous bone, the anterior portion of the vertebra and the major weight bearing portion of the column
Body
the vertebral arch
Neural arch
opening formed by joining the body and neural arch
Vertebral foramen
portion of the neural arch just posterior to the body and anterior to the lamina
Pedicle
formed at the union of the lamina and pedicle, these are the lateral projections of the arch
Transverse process
depressions located on the superior and inferior surfaces of the pedicle
Vertebral notches
opening formed by the superior vertebral notch of foramen, vertebra below and the inferior vertebral notch of the vertebra above
Intervertebral foramen
projecting superiorly and inferiorly off of the posterior surface of each lamina
Articular process
the most posterior projection on the neural arch
Spinous process
an Intervertebral disk
outer portion of the disk that serve to contain the nucleus pulposus
Annulus fibrosis
Intervertebral disk
pulpy, gelatinous substance with a high water content in the center of the disk
- Birth 80% decreasing to 70% by age 60
Nucleus pulposus
the cranium rests here, ring shaped and has no body or spinous process.
Anterior arch – anterior portion of C1
Atlas – C1
the second cervical vertebra, has a pivot that supports the head
Odontoid process/Dens – vertical projection that articulates with C1
Axis – C2
long and prominent spinous process, resembles a thoracic verteba
C7
Joints to familiarize yourself with fyi
- Atlanto-occipital joint
- Atlantoaxial joint – synovial articulation between the odontoid and the anterior arch of C1
- Lateral atlantoaxial joints
- Facet joints
Limit/allow the amount of movement at any given vertebral joint
In the lumbar area, they are in the sagittal plane
In the thoracic area, they are in the frontal plane
fyi
runs down the vertebral column on the anterior surface of the bodies and limits hyperextension
Anterior longitudinal ligament
runs along the vertebral bodies posteriorly inside of the vertebral foramen preventing hyperflexion
Posterior longitudinal ligament
extends from C7 distally to the sacrum posteriorly along the tips of the spinous process
Supraspinal ligament
connects adjacent laminae anteriorly
Ligamentum flavum
Fun Facts
- The lumbar spine is the region of the body most often injured due to its mobility and the location of the center of gravity
- The thoracic spine has much less ROM due to the attachments of the rib cage
- The cervical spine is freely mobile – allows for freedom of motion, allows for entrance and exit of the blood vessels in the skull
fun
You will be responsible for the following muscles and all the OIAN’s that go along with them: of the spine
- Sternocleidomastoid
- Scalene muscles
- Splenius capitis
- Splenius cervicis
- Rectus abdominus
- External oblique
- Internal oblique
- Transverse abdominus
- Erector spinae
- Transversospinalis
- Interspinalis
- Intertransversarii
- Quadratus lumborum