Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oral Surgery 2 > Initial Evaluation of TMJ Patient > Flashcards

Initial Evaluation of TMJ Patient Flashcards

1
Q

steps to evaluating TMJ patient

A
  1. hx
  2. clinical exam
  3. studies (imaging)
  4. assessment
  5. plan (with discussion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the most important part of workup of TMJ patient?

A

hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

critical elements of hx of TMJ patient

A
  1. pain hx
  2. previous tx and outcome
  3. joint sounds
  4. functional limitations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

LIQORAAA of pain hx

A

L - location
I - intensity
Q - quality of symptom
O - onset of symptom and precipitating factors
R - radiation of symptom
A - associated symptoms (joint sounds, other neurological oddities)
A - alleviating factors (avoid jaw fxn, etc.)
A - aggravating factors (chew, sing, talk a long time)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

previous tx of TMJ

A
  1. splint therapy
  2. physical therapy
  3. medications (NSAIDs, muscle relaxers)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what should be asked of TMJ patient who had previous occlusal splint therapy?

A
  1. type
  2. start and duration of tx
  3. wear
  4. outcome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what should you especially note of TMJ patient who had previous occlusal splint therapy?

A

change in symptoms on awakening, change in distribution of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what should be asked of TMJ patient who had previous physical therapy?

A
  1. duration, number/frequency of visits
  2. modalities used
  3. outcome
  4. home care instructions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what should be asked of TMJ patient who had previously taken medication to tx issue?

A
  1. which one(s)
  2. duration of therapy
  3. scheduled vs prn
  4. result
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what should you also note of TMJ patient who had previously taken medication?

A

other concurrent meds that may be helping (or worsening) the symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F: it is important to distinguish between pop, click, or snap sound when tx’ing TMJ patient

A

false, no relevant distinction, just sound different

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what should be documented with crepitus/grinding/”bone-on-bone”?

A
  1. onset

2. subsequent change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when examining functional limitations, what should you be able to distinguish?

A

between general stiffness (muscular) from mechanical obstruction (internal derangement, arthropathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

stiffness

A

can stretch more (with pain) vs moves okay then hits a brick wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

catching

A

opens easily part way but gets caught at 1-2 finger-widths of opening, then opens the rest of the way

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

closed lock

A

like a catch, but stays that way for minutes, hours, days, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

extremely limited, unchanging ROM may indicate what?

A

ankylosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

functional limitations

A
  1. limited/impaired movement
  2. limited diet
  3. malocclusion
  4. other neurological problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

T/F: to check for malocclusion, you should try to retrude the chin

A

false, don’t

use tongue trick to establish CR position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

TMJ patients have a high incidence of what?

A
  1. depression/anxiety

2. fibromyalgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

inspection of TMJ patient includes what?

A
  1. facial asymmetry
  2. swelling
  3. asymmetric facial movements
  4. masticatory muscle hyperplasia, hyperactivity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

palpation of moderate pressure over masticatory muscles

A

10 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

palpation of light pressure over lateral capsules

A

5 lbs

24
Q

T/F: pterygoid muscles are directly palpable

A

false, not directly

25
Q

preauricular tenderness may be what type of finding?

A

either joint or muscle finding

26
Q

what should be considered in highly sensitive TMJ patients?

A

neuropathic pain (e.g. tactile allodynia, hyperalgesia)

27
Q

muscle palpation should be worked from top down starting at what?

A

temporalis crest

28
Q

what should you look for with muscle palpation?

A
  1. tenderness
  2. increased tone
  3. taught bands
  4. trigger points
29
Q

what should be noted when you press upward from pterygomandibular sling during muscle palpation?

A

radiation or distant site of pain

30
Q

what should be palpated during joint palpation?

A

lateral capsule area

31
Q

how much pressure should there be with endaural palpation?

A

with light anterior pressure

32
Q

T/F: pressure on posterior border of mandible should always be done during joint palpation

A

false, always painful so avoid it

33
Q

what is involved in clinical exam?

A
  1. inspection
  2. muscle palpation
  3. joint palpation
  4. functional examination
34
Q

functional examination

A

open wide as possible without pain (or without worsening pain), measure

35
Q

T/F: overbite amount should not be included in measurements when performing functional exam

A

false, always include

36
Q

what should be noted during functional exam?

A
  1. location and severity of pain separately for each movement
  2. abnormal movement of jaw
37
Q

T/F: during the functional exam, you should gently keep fingers over lateral capsules during movements

A

true

38
Q

palpate posterior maxillary vestibule… if lateral/posterior

A

masseter origin

39
Q

palpate posterior maxillary vestibule… if posterior on ascending ramus

A

temporalis insertion

40
Q

how to check indirect load to lateral pterygoids

A

press chin area posteriorly and/or superiorly against resistance with mouth half open (half of patient’s best opening)

41
Q

how to know if there is indirect load to lateral pterygoids

A

presence of pain in preauricular area (TMJs) or deep under cheekbone (lateral pterygoid)

42
Q

functional load

A

bite tongue blade between most posterior teeth bilaterally and incisors

43
Q

what should be noted during functional load exam?

A

location and severity of pain to determine muscle vs joint area

44
Q

intraoral examination

A
  1. measure overbite, overjet
  2. angle classification
  3. absence of posterior stops
45
Q

guarding

A

excessive limitation of ROM

46
Q

tricks to detect guarding

A
  1. observe during interview, note interincisal ROM

2. look for tonsillar hypertrophy with tongue blade

47
Q

a few minutes after the physical exam, why should you ask the patient if her jaw hurts now, record positive response and pain detains?

A

to look for induced pain

48
Q

panoramic film screens for what?

A

gross joint pathology and other potential problems

49
Q

T/F: on a pano, it’ll demonstrate joint space reliably

A

false, NOT

50
Q

what type of radiograph is best for suspected bony abnormality (i.e. ankylosis, severe arthritis)?

A

CT

51
Q

what type of radiograph is best for internal derangement and effusion?

A

MR

52
Q

T/F: most radiographic findings have weak or no correlation with clinical findings or symptoms

A

true

53
Q

what is frequently found in asymptomatic control populations?

A

ADD (12-45%)

54
Q

condylar changes may be what?

A

arthritic or adaptive

55
Q

T/F: systematic review find little if any literature support for a link between findings and clinical relevance

A

true

56
Q

effusions are strongly associated with what?

A

ADD (+/- reduction) and pain

Oral Surgery 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions