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Pathology Exam 3 > Chapter 10 > Flashcards

Chapter 10 Flashcards

1
Q

What is characterized by an unexplained and usually continuous burning sensation of the oral soft tissues?

A

Burning Mouth Disorder

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2
Q

What usually causes burning mouth disorder?

A

a neuropathic etiology or systemic condition

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3
Q

Burning Mouth Syndrome

A
  • Onset is usually spontaneous
  • Evaluation involves a careful work up
  • Laboratory testing may identify undiagnosed systemic diseases such as anemia and diabetes mellitus.
  • Treatment:Neuropathic Pain Meds.
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4
Q

What is a pathologic condition involving the fifth cranial nerve (Trigeminal Nerve)?

A

Trigeminal Neuralgia

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5
Q

How is Trigeminal Neuralgia characterized?

A

Unilateral sharp, shooting, knifelike, or electric shock-type pain.

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6
Q

Trigeminal Neuralgia

A
  • Etiology unknown
  • Diagnosis is based on history and onset of pain, and associated clinical symptoms.
  • One of the newest procedures (gamma radio surgery) has shown promising results.
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7
Q

What is Bell’s Palsy?

A

An acute, self-limiting loss of muscle control on one side of the face.

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8
Q

When is the clinical diagnosis of Bell’s Palsy made?

A

after excluding other causes of facial paralysis.

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9
Q

When does Bell’s Palsy usually occur?

A

in people of all ages; mostly between ages 14 and 45

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10
Q

Treatment of Bell’s Palsy?

A

Variety of treatments used in management

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11
Q

Bell’s Palsy

A
  • Inability to wrinkle eyebrow
  • Drooping eyelid: inability to close eye
  • Inability to puff cheeks: no muscle tone
  • Drooping mouth: inability to smile or pucker.
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12
Q

Disorders of the TMJ include what?

A
  • Myofascial pain (Muscle and fascia)
  • Dysfunction
  • Internal derangement syndrome
  • osteoarthritis
  • rheumatoid arthritis
  • Benign and malignant tumors.
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13
Q

The TMJ is a articulation between what?

A

the condyle of the mandible and the glenoid fossa of the temporal bone.

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14
Q

What covers the bony articulating surfaces?

A

Fibrocartilage

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15
Q

What type of movement is in the TMJ?

A

Ginglymoarthrodial movement

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16
Q

What divides the spaces in the the TMJ?

A

An articular disk

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17
Q

Nerve Fiber of TMJ

A

Avascular and devoid

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18
Q

What provides nourishment and lubrication for the TMJ?

A

Synovial fluid

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19
Q

Muscles of Mastication

A
  • Masseter
  • Temporalis
  • Medial Pterygoid
  • Lateral Pterygoid
  • Anterior Digastric
  • Mylohyoid
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20
Q

Evaluation of the muscles of mastication may be done to determine what?

A

Whether muscle pain or dysfunctional muscle activity is occurring.

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21
Q

In the position of maximal occlusal contact, the mandibular condyle rests within what?

A

the glenoid fossa

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22
Q

TMDs are caused by what?

A

abnormalities in the function of either the joint itself or associated structures.

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23
Q

TMDs (Temporomandibular Disorders)

A
  • More common in females.
  • Female sex hormones play a role
  • Depression
  • Rheumatoid Arthritis
  • Chronic Fatigue Syndrome
  • Chronic Headache
  • Fibromyalgia
  • Sleep Disturbance
  • Irritable bowel syndrome
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24
Q

Pathophysiology of TMDs

A
  • Trauma
  • Psychosocial factors
  • Dentofacial deformities
  • May be associated with disorders in growth and development as in condylar hyperplasia or hypoplasia
  • Abnormalities are associated with systemic diseases
  • Female sec hormones
  • Iatrogenic cause
25
Q

Dysfunction may be caused by what?

A

disorders of muscles of mastication or by internal derangements of components of the joints.

26
Q

Evaluation involves a comprehensive history and thorough clinical examination by doing what?

A
  • Chief complaint
  • History: Chief complaint, medical, dental
  • Examination
  • Imaging
27
Q

How can you manage TMDs?

A
  • Reduce mouth opening
  • Shorter appointments
  • Pain control
28
Q

What are the three cardinal features on TMDs?

A
  • Pain during mandibular function
  • Joint noise
  • Restricted jaw function
29
Q

History

A
  • Ask Questions
  • Medical/dental history
  • location of pain
  • Precipitating events
  • What makes the pain better or worse
  • Is there any time of the day when the pain is better or worse?
  • Previous treatment
  • Do you have pain in any other joint?
  • Onset and progression of symptoms.
30
Q

Symptoms of TMDs

A
  • Joint symptoms (clicking or popping)
  • Pain
  • Problems with mastication
  • Trismus
  • malocclusion
  • parafunctional habits (bruxin g or clenching)
  • Extensive dental or orthodontic treatment
  • History of surgical treatment of the jaws.
31
Q

Clinical Examination of TMJ

A
  • Includes examination of the joint, muscles of mastication, oral cavity, and cervical spine
  • Auscultation
  • Palpitation
  • Joint Noises
  • Evaluate movement of mandible
  • Measure interincisal opening and note deviations
  • evaluate occlusion
32
Q

Imaging of the TMJ

A
  • Panoramic
  • Magnetic resonance imaging
  • Computed tomography
33
Q

Types of TMDs

A
  • Myalgia, Myofascial Pain Syndrome
  • Internal Derangements
  • Arthritis
34
Q

Myalgia

A

Local muscle tenderness in affected muscles with variable amounts of reduced opening possible.

35
Q

Myalgia comprises of how much of all TMDs?

A

50%

36
Q

Myofascial pain syndrome

A

a chronic pain disorder. In this condition, pressure on sensitive points in your muscles (trigger points or tight bands) cause pain in the muscle and sometimes in seemingly unrelated parts of your body. This is called referred pain.

37
Q

Internal Derangements

A
  • An abnormal positional relationship of the disk relative to the mandibular condyle and the articular eminence
  • Pain may or may not be experienced by jaw movement.
38
Q

Disc Displacement with Reduction

A

The disc may be displaced anteriorly and returns to normal position when the mouth is opened or movement is away from the affected side.

39
Q

Disc Displacement without Reduction

A
  • The disc may act as an obstacle to the sliding condyle
  • Patients may complain of problems such as intermittent locking of the jaw; a sudden onset of limited mouth opening, usually associated with cessation of joint sounds; deflection of the mandible, with a midline correction on opening; and restricted lateral excursive movements away from the affected side.(disc comes out and stays out)
40
Q

Arthritis

A

-Inflammation of the joint

41
Q

Osteoarthritis

A
  • Not Inflammatory
  • Characterized by degenerative changed of the cartilage
  • Pain
  • Limited opeing
  • Muscle Splinting
  • Crepitus
42
Q

Rheumatoid Arthritis

A
  • An inflammatory, immunologic disorder of the joints
  • Limited opening
  • Occlusal changes
  • Preauricular edema
  • Tenderness
43
Q

Hypermobility Disorders

A
  • Dislocation

- Subluxation

44
Q

Dislocation

A

When one or both of the condyles translates anterior to the articular eminence, leading to an open lock the patient cannot reduce.
-Should be reduced immediately by applying downward and posterior pressure on the mandible to relocate the condyle within the glenoid fossa.

45
Q

Subluxation

A

Hypermobility in which the patient can relocate the mandible back into the glenoid fossa.

46
Q

Ankylosis

A
  • Immobility of the condyle caused by fibrous or bony union between articulating surfaces.
  • Joint infection after trauma accounts for 50% of all cases
  • 30% result from trauma without infection
47
Q

Tumors of the TMJ are what?

A

Rare

48
Q

Tumor of the TMJ

A
  • Synovial Chondromatosis

- Osteogenic Sarcoma

49
Q

Synovial Chondromatosis

A

Most common benign neoplasm of the synovium

50
Q

Osteogenic Sarcoma

A

Commonly occurring malignant bone tumor

51
Q

Treatment of TMDs

A
  • Nonsurgical treatment
  • Surgical Treatment
  • Multidisciplinary treatment
52
Q

Non surgical Treatment

A
  • Goals involve improving function and reducing pain
  • Pharmacologic therapy: Pain medication, muscle relaxants, and antianxiety agents
  • Moist heat
  • Physical therapy
  • Soft mechanical diet
  • Jaw stretching
  • Coordination exercises
  • Occlusal adjustments
53
Q

Second Phase of Non surgical Treatment

A

Occlusal appliances which may protect the dentition, stabilize and protect the joint, and provide biofeedback by making patients aware of their bruxing habits.
-OTC appliances are not recommended

54
Q

Surgical Treatment

A
  • Arthrocentesis
  • Open Joint Surgery
  • Eminectomy
55
Q

Arthrocentesis

A

Lavaging the joint through needle

56
Q

Open Joint Surgery

A

Used to perform disc reconstruction with a prosthetic device or autogenous graft.

57
Q

Eminectomy

A

Removal of the articular eminence of the temporal bone.

58
Q

Multidisciplinary Management

A

Patients may require referral to other health care providers such as a oral surgeon, neurologist, physical therapist, rheumatologist, physician

Pathology Exam 3 (6 decks)

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