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MS 2 Exam 1 > Lecture 9: TMJ > Flashcards

Lecture 9: TMJ Flashcards

1
Q

What type of joint is the TMJ?

A

synovial bi condylar joint, cant work alone if problem at one side will affect other side

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2
Q

What type of cartilage is the TMJ disc comprised of?

A

fibrocartilage

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3
Q

What are three zones of TMJ disc?

A
  1. posterior/bilaminar zone- richly innervated (pain), highly elastic
  2. middle/intermediate- not innervated , weight bearing surface of bones
  3. anterior portion- innervated
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4
Q

What is the only muscle that connects to the tmj disc?

A

lateral pterygoid

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5
Q

What nerve is responsible for supplying sensory and motor innervation to TMJ?

A

trigeminal CN 5

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6
Q

What is the open packed position of the TMJ?

A

tongue on roof of mouth, lips closed but teeth not touching

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7
Q

What is closed packed position of TMJ

A

clenched mouth

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8
Q

What motion occurs during first 1/3 of motion?

A

rotation of inferior compartment approx: 20 mm

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9
Q

What motion occurs at TMJ during last 2/3 of motion?

A

translation of superior compartment of disc and condyle

approx 20-30 mm

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10
Q

If one side of TMJ is hypomobile during opening which side will it deflect to?

A

the side that is hypomobile

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11
Q

What are some subjective questions to ask during a TMJ eval?

A
  • pain with opening or closing?
  • pain with eating or yawning?
  • what side do they eat on?
  • locking or clicking?
  • any CN sx?
  • have you seen a dentist lately
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12
Q

What are red flags during a TMJ eval?

A
  • infection- inability to open or recent surgery
  • fracture- ecchymosis, signifcant pain with clenching
  • bleeding under tongue
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13
Q

What are two major components of an oral health screen?

A

observe face, lips gums, teeth, lateral borders, beneath tongue

palpate neck for glands or lymph nodes, floor of mouth

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14
Q

What areas of TMJ should be palpated during an exam?

A

joint line for edema and symmetry

masseter, temporalis and medial pterygoid

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15
Q

What are the 4 directions of ROM needed to obtain for TMJ?

A
  1. hinge- should account for 1/3 of motion, open with tongue on roof of mouth
  2. depression- 40-50 mm fill opening
  3. lateral deviation- should be 1/4 of depression, approx 10 mm
  4. protrusion- able to put bottom teeth in front of top
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16
Q

What components of neuro assessment should be examined for TMJ?

A

sensation, CN, reflexes

17
Q

What are you looking for during a strength assessment for TMJ?

A

resisted isometric movements, are they symmetrical ?

18
Q

What are three special test for TMJ?

A
  1. bite- bite on left loads right joint
  2. posterior loading- indicates retro discal or extra capsular dysfunction
  3. superior loading- indicates intra articular or discal dysfunction
19
Q

What diagnostic criteria will help rule in internal derangement or within joint?

A

ROM, muscle joint palpation, joint sounds, single test, reciprocal click (disc involvement)

20
Q

What diagnostic criteria will help rule in internal derangement with out reduction or no disc involvement?

A

crepitation, deflection, pain, limited mouth opening (hypomobility)

21
Q

What are 4 types of joint mobs for TMJ?

A

longitudinal, posterior/anterior glide, medial glide, lateral glide

22
Q

What is longitudinal distraction used for?

A

to improve mandibular depression (opening) and inferior compartment rotation

only mob to address rotation

23
Q

What is the posterior/anterior glide used for?

A

improve depression for the superior compartment anterior glide and protraction

24
Q

What interventions can be done for an inflamed TMJ?

A

US- 3mhZ, 0.5 w/cm2, for 5 mins pulsed

5 min ice massage, TENS

25
Q

What interventions can be done for an hypomobile TMJ?

A

joint mobs, MWM, self mobs, AAROM, contract relax PNF, sustained stretches

26
Q

What interventions can be done for an hypermobile TMJ?

A

muscle re-ed, guided motions, visual feedback with mirrors always, isometrics, loaded movement, posture

MS 2 Exam 1 (9 decks)

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