History and Exam for TMD

Question 1

can you palpate the lateral pterygoid?

Answer 1

yes! proven now!

Question 2

can you palpate the lateral pterygoid?

Answer 2

yes! proven now!

Question 3

what can you do if the lateral pterygoid spasms?

Answer 3

functional manipulation.

If they are thrown into a spasm, what do you do?! Lidocaine anesthesia without epi Like a gow gates…

Question 4

how do you check the SCM?

Answer 4

look to see if it’s like a TENDON? is it stress from holding up the head.

Splenius captius and trapezius- talk about posture

Question 5

Can you palpate the splines captious?

Answer 5

if you push hard enough. Posterior to the attachment from the SCM

Question 6

normal range of mouth opening?

Answer 6

53-58 mm

Question 7

limited range of mouth opening?

Question 8

what can you do if the lateral pterygoid spasms?

Answer 8

functional manipulation.

If they are thrown into a spasm, what do you do?! Lidocaine anesthesia. Like a gow gates…

Question 9

do we use transpharyngeal?

Answer 9

no

Question 10

Can you palpate the splines captious?

Answer 10

if you push hard enough. Posterior to the attachment from the SCM

Question 11

any lateral movement

Answer 11

8 mm- about the size of your central incisor

Question 12

T/F? If the condition becomes chronic, the posterior zone continues to thin, which perpetuates the anterior movement, causing a second click

Answer 12

true

Question 13

Can you use pano for joint?

Answer 13

not really the best!

Question 14

what is a lateral transcranial film used for?

Answer 14

put film on one side and have the patient open and close.

OPEN lock?? reduce it one at a time- not in occlusion with the non drilling

Question 15

do we use transpharyngeal?

Answer 15

no

Question 16

what is reciprocal clicking?

Answer 16

when a click is heard upon opening AND closing

Question 17

what is the 2nd click on reciprocal clicking caused by?

Answer 17

result of the lengthening of the retrodiscal lamina; during the final stages of closing, the lamina decreases its pull and the disc once again slips anteriorly
**so second click- from lengthening of the retrodiscal lamina during final stages of closing!!!*

Question 18

what is costen’s syndrome?

Answer 18

the TMJ is referred to the ears

Question 19

what can you visualize with panoramic TMD ?

Answer 19

it’s ideal because you have minimal superimposition of the structures over condyles.

Question 20

when might you use AP transmaxillary?

Answer 20

viewing the superior subarticular bone and fractures of the neck and condyle. Patient has to have mouth wide open, so this might not be ideal for patients with TMD

Question 21

what is the gold standard for TMJ soft tissue imaging?

Answer 21

MRI