Lab 4: TMJ Dysfunction Lab Flashcards
1
Q
What is the correct setup and technique of MFR/ST for Hypertonic Temporalis M.?
A
- Pt head rotated contralateral to side being tx
- Caudadthumb padsuperiortoipsilateral angle of pt’s jaw of the temporalis being stretched to anchor insertion of muscle
- Cephalad thumb provides stretching force away from origin of muscle by tractioning along superior temporal line
- Apply force gentle/rhythimically (ST) ever 1-2 sec. or hold tissue into RB (direct MFR). Continue 1-2 mins until tissues soften
- Reasses for TART
2
Q
What is the correct setup and technique of MFR/ST for Mandible restricted to Lateral Translation (“C-shaped” deviation)?
A
- Doc seated on side of restriction w/ cephalad hand under pt’s head, elevating it slightly
- Doc’s caudad hand positioned w/ 3rd-5th fingers along posterior border of the ramus of mandible and hypothenar eminence along body of jaw
- Instruct pt to open mouth slightly, while doc exerts force w/ hand on jaw so as to draw the jaw forward at the TMJ and deviate jaw laterally to restricted side
- Traction on jaw applied and released in slow rhytmic pattern for 30 sec to 2 min (ST) –> success is determined by reassessing mandible ROM in lateral translation
3
Q
What is the correct setup and technique of bilateral direct MFR/ST for Muscle of Mastification?
A
- Doc is seated at table head, pt is supine with mouth closed comfortably
- Doc stabilized pt’s jaw w/ thenar eminences on bilateral mandibular angles
- Apply traction to the feather’s edge of barrier, inferiorly and slightly anteriorly corresponding along the long-axis of mandibular ramus
- Maintain traction and monitor w/ thenar eminences for reduced muscle tension and a sense of relaxation
4
Q
What is the correct setup and technique for Medial Pterygoid Counterstrain?
Where is the TP?
A
- Point found at medial aspect of ascending ramus just anterior to the angle of jaw
- Doc at table head; pt supine; monitor TP w/ ipsilateral index finger and instruct pt to allow their mouth to hang open comfortably
- Contralateral hand translates mandible away from TP, fine-tuning amount of translation and opening until pain is reduced by at least 70% (head rotation towards TP may also be helpful
- Hold for 90 secs, slowly return to neutral and reassess
5
Q
What is the correct setup and technique for Masseter TMJ counterstrain?
Where is the TP?
A
- Inferior to zygoma, in the belly of the masseter m.
- Doc at table head w/ pt supine, while monitoring the TP have the pt depress mandible slightly to disengage TMJs
- Place one hand on body of mandible opposite of TP and translate mandible toward side of TP until pain decreased by 70%
- Hold 90 sec, slowly return to neutral and then reasses
6
Q
What is the correct setup and technique for TMJ counterstrain?
Where is the TP?
A
- Posterior aspect of angle of mandible, generally side opposite of mandibular deviation
- Pt supine, Doc at table head monitoring TP
- Doc rotates head and neck to opposite side of TP until pain decreased 70%
- Hold for 90 sec, slowly return to neutral and reassess
7
Q
What is the correct setup and technique of ME for an Adducted Mentum Dysf.?
A
- Doc at table head; Pt supine w/ mouth open as far as they comfortably can
- Doc stabilized pt’s jaw in open position and pt tries to close jaw for 5 secs/
- Upon relaxation the jaw is opened to its next wider comfortable positon and the same technique is repeated x5 or until muscle doesn’t lengthen anymore
8
Q
What is the correct setup and technique of ME for an “C”hin Deviation?
A
- Pt supine w/ mouth open comfortable; Doc stands facing patient
- One hand on body of mandible ipsilateral to side of deviation
- Stabilize head w/ other hand on contralateral side of deviation w/ a wide application w/ MTP joints near the ear
- Engage the RB thru your mandibular placed hand, while pt presses their chin lightly against your counterforce for 5 secs.
- Have pt relax, wait 1-2 secs, and then move to next RB
- Repeat 3-5x or until no RB perceived and the reassess for TART
9
Q
What is the correct setup and technique of TMJ BLT?
A
- Thumbs on anterior ramus, while 1st and 2nd fingers contact posterior ramus
- Medial 3rd and 4th fingers grasp inferior under mandible parallel
- Apply traction inferiorly and anteriorly; follow rotary and lateraly translatory glides towards ease
- Use breath holding to facilitate release
10
Q
What is the correct setup and technique of the Anterior Disc Reduction Technique?
A
- Doc seated at table head; Pt is supine
- Grasp mandible on involved side w/ 4th and 5th fingers on posterior aspect of ramus + 2nd and 3rd fingers on body of mandible
- Other hand contacts body of mandible on opposite side
- 4th and 5th fingers lift mandible anteriorly, while 2nd and 3rd fingers lift cephalad
- Opposite hand applies force to mandible, pushing medially, gliding the mentum around towards dysf. side.
- This attempts to pin the condyle on the disc and reduce it with the motion of mandible and is a temporary fix until tissue have healed or pt has surgery
11
Q
What is the correct setup and technique of Supraclavicular Fascia Release?
A
- Pt seated w/ Doc standing facing the pt; Doc applies downward pressure w/ fingers superior to clavicle
- Abduct pt’s UE to 90° and alternate between IR and ER slowly
- Follow fascial release as fingers sink into post-clavicular area
12
Q
What is the correct setup and technique for Doming the Diaphragm?
A
- Pt is supine w/ hip and knees flexed; Doc on either side of pt
- Doc places thumbs inferior to xiphoid process and pointing cephalad
- Pt takes deep breath and exhales; on exhalation doc presses thumbs posteriorly and superiorly
- Resist on inhalation and push further on exhalation; repeat 3-5x
13
Q
What technique is this?
A
- Submandibular drainage
14
Q
What technique is this?
A
Cervical chain drainage
15
Q
Which lymphatics technique is contraindicated in COPD?
A
Thoracic Pump
