Functional Disorders of the Masticatory Muscles Flashcards
what produces pain sensations?
vasoconstriction of the relevant nutrient arteries and the accumulation of metabolic waste products in the muscle tissues. within the ischemic area of the muscle, certain algogenic substances (bradykinins, prostaglandins) are released, causing muscle pain.
T or F:
pain is far more complex than simple overuse and fatigue
true
muscle pain can be greatly influenced by ___
central mechanisms
dysfunction of the TMJ can manifest in what 3 ways?
- decrease in the range of mandibular movement
- acute malocclusion (premature contact on new restoration)
- change in the resting length of a muscle that controls jaw position (inferior lateral pterygoid muscle spasm)
T or F:
pain and dysfunction are clinically the same
false
what are 2 CNS influences muscle pain disorders?
myofascial (trigger point) pain and myospasm
how is chronic centrally mediated myalgia treated?
often very difficult to resolve and treatment strategies are other than for acute myalgic disorders
___ is a widespread global musculoskeletal pain disorder in which tenderness is found in 11 or more of 18 specific tender-point sites throughout the body
fibromyalgia
when myogenous pain persists, more chronic and often complex muscle pain disorders can develop. chronic pain is considered to be pain that has been present for ___ months or longer
6 months
the dentist must recognize that as myalgic complaints progress from an acute to a chronic disorder, the effectiveness of ___ is greatly reduced
local treatment
what are the 4 types of perpetuating factors?
local perpetuating factors, protracted cause (clinician fails to eliminate cause), recurrent cause, therapeutic mismanagement (often as a result of improper diagnosis)
what are 6 types of systemic perpetuating factors?
continued emotional stress, downregulation of the descending inhibitory system, sleep disturbances, learned behavior, secondary gain, depression
___ is a chronic, continuous muscle pain disorder originating predominantly from CNS effects that are felt peripherally in the muscle tissues
centrally mediated myalgia (chronic myositis)
myositis = ___
neurogenic inflammation
what is the antidromic effect?
neurons that normally only carry information from the periphery into the CNS can now be reversed to carry information from the CNS out to the peripheral tissues. when this occurs, the afferent neurons in the periphery can release nociceptive neurotransmitters (substance P, bradykinins), which in turn causes peripheral tissue pain. this process is called neurogenic inflammation.