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TMJ > medsibridge OCS review > Flashcards

medsibridge OCS review Flashcards

1
Q

what is the incidence of TMD

A

up to 35% with 5-10% seeking care

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2
Q

Describe the orientation of the the temporalis insertion on the TMJ

A

it inserts on the coranoid process in front of the condyle of the TMJ

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3
Q

what muscle mirrors the masseter on the inside of the manible

A

medial ptyerigoid

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4
Q

what TMJ muscle has the greater impact on anterior glide of the TMJ

A

lateral ptyerigoid

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5
Q

At what point in opening should the condyle glide forward

A

25mm or 60-90% of opening

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6
Q

what is the power stroke of the mandible

A

biting down against resistance

- occurs even with swallowing (600 swallows per day)

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7
Q

what are parafunction of the mandible

A

clinching
grinding
bruxism

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8
Q

what are the risk factors for developing TMD

A
  • women 2:1 in general population and 8:1 in clinical settings
  • pain in other areas of the body and depression
  • greatest in middle ages (40s)
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9
Q

what is the difference between axis 1 and axis 2 TMD classifications

A

axis 1 - physical, nociceptive

axis 2 - psychosocial disorders

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10
Q

what are the treatment classifications of axis 1 TMD

A

axis 1 - masticatory muscles disorder with or without ROM loss
axis 1 - TM joint disorder of disc derangement and inflammation/arthralgia
Harris 2014

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11
Q

what are the key TMD assessment questions

A
  1. have you had pain or stiffness in the face, jaw, temple, front of hear, or in the ear
  2. are you symptoms altered by
    - functional activities - chewing, talking, singing, yawning, kissing, moving jaw
    - parafunctional activity - clenching, grinding, bruxism
  3. does your jaw lock or catch
  4. are your teeth touch right now (teeth apart is the key)
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12
Q

what is an alarm clock headache

A

headache that goes off at the same time and is a red flag

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13
Q

what self reported indexes are recommended for assessment of TMD

A
  1. graded chronic pain scale
  2. Patient health questionnaire
  3. jaw functional limitation scale
  4. NDI
  5. Tampa scale for kinesiophobia
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14
Q

what is the graded chronic pain scale

A

2 item 0-10 scale

  1. average pain in the last month
  2. pain interference in daily activities
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15
Q

how would you describe face posture

A

symmetry three lines

  • eyes
  • ear lobes
  • mouth
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16
Q

what is a cross bite

A

Crossbite is a form of malocclusion where a tooth (or teeth) has a more buccal or lingual position (that is, the tooth is either closer to the cheek or to the tongue) than its corresponding antagonist tooth in the upper or lower dental arch. In other words, crossbite is a lateral misalignment of the dental arches

17
Q

what is the difference between overbit and over jet

A
  • overbit refers to how far the top goes past the the bottom tooth with closing (vertical)
  • overjet refers to have far the top tooth sits infront of the bottom tooth (horizontal)
18
Q

what is a deflected opening

A

mandible deviates to one side or the other at max opening

19
Q

what is normal lateral deviations

A

1/4 of opening

20
Q

what is normal protrusion

A

4mm

21
Q

How does a bite separator impact the mechanics of the TMJ

A

Keeping the teeth apart with a tongue depressor prevents the joint from compressing while the muscles contract
- can perform unilateral or bilateral

22
Q

what are the International Headache Society classification for headaches

A
  1. primary HA - migrane, trigeminal autonomic cephalagia, tension type
  2. secondary HA - sinus, eyes, ENT, teeth, TMD, cervicogenic
  3. cranial neuralgias - trigeminal neuralgia, neuropathic pain, CNS
23
Q

What is the pathoanatomic source of migraine headache

A
  1. neurologic with a vascular component

2. cortical spending depression that starts at the occipital region (aura source) progressing forward

24
Q

what are the diagnostic criteria for migrane

A
  1. unilateral, but may shift
  2. last 4-72 hours (must have 5 episodes before diagnosis)
  3. at least two of: unilateral, moderate to severe intensity, increased with activity, pulsating quality
  4. at least one: nausea vomiting or photophobia, photophobia
25
Q

what are the diagnosis criteria for tension type headache

A
  1. last 30 minutes to 7 days
  2. at least two of: (B), (B) pressing, mild to moderate intensity, does not increase with activity
  3. no nausea, either one or neither photo- or phono-, pericardial tenderness
26
Q

what are cluster headaches

A

AKA - TAC or trigeminal autonomic cephalgia

  1. around the eye, unilateral
  2. occur in cyclical patterns last 15minutes to 2 hours
  3. men more than women, sudden onset, tearing
27
Q

what is the pathoanatomic source of trigeminal neuralgia

A

paroxysmal attacks of fascial or frontal pain lasting a few seconds to less than two minutes following branch off TN
- sensory ONLY

28
Q

what type of TMD and cerivcal spine pain relationships have been identified

A
  • neck pain and masseter hypertrophy

- TMD pain and cervical extensor fatigue

29
Q

Describe the referral pattern to the lateral and medial pterygoid

A

lateral - maxilla and sphenoid

medial - external auditory canal

30
Q

what percentage of people have clicking the TMJ

A

30-40% of asymptotic population

- clicking with pain is the key to diagnosis disk disorder with displacement

31
Q

describe the role of the TMJ discs in pain production

A
  • it is not innervated, but is can pull on the posterior elements and produce irritation to surrounding structures
32
Q

role of pre auricular palpation in diagnosis of TMD

A
  • Sensitivity .92
  • specificity .21
    IT the joint is not tender it is probably not a joint problem
33
Q

what are the risk factors for BPPV

A
  1. hyper lipediamia
  2. migrane
  3. endolymphatic hydrops
  4. Menier’s disease
  5. prolonged bed rest
  6. otological surgery
  7. prior BPPV

TMJ (5 decks)

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