Exam 2: TMJ Flashcards
what is the function of the lateral temporal mandibular ligament
prevent excessive A and P, and lateral movement of the jaw
what is the supsension quality of the lateral mandibular ligament
this is the main supension ligament during opening of the jaw
what kind of joint is the jaw
hinge joint
what are the medial ligaments
sphenomandibular ligament and stylomandibular ligament
function of the sphenomandibular ligament
suspends the mouth during wide opening
function of the stylomandibular
acts a stop to extreme opening
what is the mouth disc made out of
fibrocartilage
Does the disc have nerve or art
no it is avascular and aneural
what is the retrodiscal tissue attached ant and post
the post capsule and the ant tympatic plate
- this prevents the disc from going to far anterior
what is the disc attached to medially and laterally
the condyle view the medial and lateral ligament
what are disc issue normally due to
stretching of retrodiscal tissue
what happens when we open the mouth
the disc moves forward with the condyle and creates stress on the retrodiscal tissue
what happens when we close the mouth
the retrodiscal tissue pulls the disc back to move with the condyle
where is the upper compartment
disk and mandibualr fossa
where is the lower compartment
disc and the condyle of the mandicular bone
what plane does the mouth move in for opening and closing
cornal
- plane passes through the condyles
phase 1 of opening
rot of the condyle in the lower compartment
pahse 2 of opening
translation of the disc and the condyle together in the upper compartment
closing and opening phases
close is the same as opening but opp
who much movement do we see with opening
40-50 mm
what kind of movement are mandibular protrusion and retrusion
translation movement
what comp does protrusion and retrusion occur in
upper comp
how much movement do we see with protrusion
6-9 mm
manible juts forward
how much movement do we see with retrusion
3 mm
mandible pulls back
mandibular lateral deviation axises
vertical and horizontal axis
AP axis
vertical axis for mandibular lateral deviation
spin around the isp condyle
translation of contra condyle
how much movement do we see with mandibular lateral deviation
8 mm
A-P axis mandibular lateral deviation
spin in the frontal plane of isp condyle
depression of contra condyle
what motions are see in chewing and griinding
all of the motions
what do we use to open our mouth
grvaity, inf lateral pyertiod, ant epigastric
mouth closers
temporalis, masseter, medial pyterygoid,
sup lat pyertiod - keeps disc sligtly forward during closing
right laterl deviator muslces
left medial and lat ptyeriod
right post temporilis muscle
left lat deviators
right medial and lat ptyeriod
left post temporilis muscle
protruders
bilat infer ptyeroids
assisted by medial ptyeroids
retruders
post temporalis muscle
post diagastric
deep masseter
DDWOR
history of jaw locking or catching
DDWR
opening or closing clicks
- disc displacement with reduction
lateral pyter what is the cheif complaint if you see this issue
lateral face pain
- pain reproduced with resisted protrusion
power stroke
forced closing of the mouth
macrotrama TMD
fracture dislocation
diseas and TMD
OA RA infections
reffered pain TMD
referred pain around the eyes, ears, zygomatic arch, temple areas
ear problem with TMD
tinnitus - ringing of the ears
where do we palpate
lateral pole
behind lateral poles
along the lateral ligamament
unilateral loading with gauze
gauze - distraction
non gauze - closing down
what does no pain mean with compression
release means reliefs of compression
what does pain with comrpession mean
the capsule is irritated from tensile loads
anterior disc location that reduces - openeing
loud clicking during opening - this means the disc has relocated
anterior disc location that reduces - closing
the disc has been displaced ant, condyles behind the disc
anterior disc location that does not reduce general
no clicking - there are restriction during opening
may have a past history of clicking but this is gone now
anterior disc location that does not reduce - what is the issue
restriction due to disc blocking translation
TMJ capsular restrictions
deviation to the right with less opening
deviation to the right with protrusion
decrease L lat movements
there is not history of clicking
there is not snapping on the distraction of the joint
TMJ subluxation
excessive opening
palpate lateral pole to see with they move to far forward
may hear a nosie at the start of close or end of large open
may be due to muscle imbalances
what do we see with unilateral sublux
might see quick deviation to the contralateral side at the end of openeing
translation occurs to soon with opening
jutting of the jaw forward with opening
may be due to muscle imbalances
what to do with translation occuring to soon
focus on neuromuscluar reducation
what does head posture have to do with TMD
forawrd head can effect the position of the manibles
may result in a bad bite pattern
treatment for capsular restriction
aim to stretch the capsule
manually distract - joint play techniques
self distract techniques - gauze on molars
