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TMD > Readings > Flashcards

Readings Flashcards

1
Q

T/F TMDs are often remitting, self-limiting or fluctuating over time and rarely result in disabling conditions.

A

t

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2
Q

Patients with pain-free TMJ clicking need treatment

A

F- only reassurance and education on the begnin condition

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3
Q

T/F Nicotine can influence TMD symptoms

A

t

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4
Q

Management of TMD is similar to what other conditions

A

orthopedic or rheumatologic disorders

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5
Q

Conservative (reversible) tx for TMD includes

A
  • self- management
  • behavior modification
  • pt
  • orthopedic appliances
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6
Q

-% of patients had relief of symptoms after conservative treatment

A

85-90

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7
Q

Success of self-management depends on

A
  • Patient motivation
  • Cooperation
  • Compliance
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8
Q

Successful self-management should include what

A
  • Allows healing and prevents further injury
  • Rest of masticatory system
  • Limitation of mandibular function
  • Habit awareness and modification
  • Home physiotherapy program
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9
Q

Describe what is meant by biobehavioral therapy

A

making the patient aware of their parafunctional habits and modifying overuse

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10
Q

The most widely used pharmacologic agents for managing TMD includes

A
  • Analgesics
  • NSAIDs
  • Corticosteroids
  • benzos
  • muscle relaxants
  • Low dose anti-depressants
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11
Q

T/F administrations of anti-depressants for TMD are associated with depression relief

A

f- treatment of chronic pain and demonstrate pain relief

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12
Q

Mechanism of how anti-depressants relief pain

A
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13
Q

PT helps relieve the musculoskeletal pain and restore normal function by

A
  • Altering sensory input
  • Increases ROM
  • Reduces inflammation
  • Decreases coordinating and strengthening of the muscle
  • Promotes repair and regeneration
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14
Q

Exercise is recommended for patients with tmd because…

A
  • stretches and reloveds cervical and masticatory muscles
  • Mobilize and stabilize TMJ
  • Increases muscle strength
  • Coordination arthrokinematics
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15
Q

Describe how ultrasound works

A

-high frequency oscillations converted to heat when transmitted through tissue- can heat tissues up to 5 cm depth

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16
Q

Stabilization splints are used for (myogenous/arthrogenous) TMDs

A

both

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17
Q

How do splints prevent wear of opposing teeth

A

resin is softer than tooth structure.

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18
Q

Arthrocentesis involves

A

-Intra-articular irrigation or lavage of the TMJ with or without corticosteroids

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19
Q

Which is more effective arthrocentesis or arthroscopy

A

both are the same

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20
Q

What is arthroscopy

A

Allows direct observation and sampling of joint tissues

21
Q

What is an arthrotomy

A

Open surgical intervention of the TMJ usually required for bony or fibrous ankylosis, neoplasia, severe chronic dislocations, and persistent painful disc derangemenet, and severe osteoarthritis

22
Q

What is the model for clinical assessment and pain management

A

biobehavioral

23
Q

Core biobehavioral principles include

A

multifactorial assessment
learning history
interplay between biologic and psychologic factors

24
Q

Biobehavioral risk factors include

A

pain
distress
pain related disability
pain history for red and yellow flags for patient care

25
Q

A comprehensive evaluation of biobehavioral factors includes

A
  • Pain location
  • intensity of pain
  • pain related disability
  • psychologic distress
  • sleep dysfunction
  • PTSD
  • Alcohol/drug use
  • limitation in use and movement
  • parafunction
26
Q

The most common psychiatric disorder in orofacial pain is

A

depression
anxiety (includes PTSD)
somatization
personality disorders

27
Q

What is the standard of care

A

integrated care among health care professionals

28
Q

Nociception travels to what ganglia in the brain

A

thalamocortical basal ganglia

29
Q

Excitatory factors that can amplify pain are

A

-fear
anxiety
attention
pain expectations

30
Q

Conversley factors that decrease pain are

A
  • Self confidence
  • positive emotional state
  • relaxation
  • belief that the pain is manageable
31
Q

What is the instrument used to determine pain intensity

A

Graded chronic pain scale

32
Q

What is the instrument to determine limitation of jaw movement

A

Jaw functional limitation scale

33
Q

What is the instrument to determine pain disability

A

Graded chronic pain scale

34
Q

What is the instrument to determine pain location

A

pain mannikin drawing

35
Q

What is the instrument to determine distress

A

PHQ-4

36
Q

When it comes to first line screening the critical dimensions include

A
  • Means of assessing multiple pain conditions or complains plus the orofacial pain that generated the initial clinical visit
  • Pain intensity and pain-related disability
  • Psychologic distress
37
Q

What is one of the most strongest and consistent predictors of onset of a new orofacial pain condition

A

presence of other ongoing pain complaints, multiple pain conditions

38
Q

common types of distress presenting with orofacial pain are

A

depression and anxiety

39
Q

What screening instrument measures both depression and anxiety

A

PHQ4

40
Q

PHQ4 evaluates the patient over the course of

A

2 weeks

41
Q

Red flags for referal of orofacial pain patients are

A

suicidal thoughts- refer immediately

42
Q

The impact of chronic pain on sleep is described as a

A

vicious cycle (disrupted sleep –> increased pain)

43
Q

Sleep quality is restored with

A

sleep hygiene advice

cognitive behavioral tx

44
Q

what fraction of TMD patients have disrupted sleep

A

1/3

45
Q

What level of the brain regulates sleep patterns

A

hypothalamus suprachiasmatic nucleus

46
Q

NREM sleep is divided into what stages

A

Light sleep and deep sleep (N1/ N2 and N3/N4respectively)

47
Q

REM sleep is also called

A

paradoxical sleep (muscles are in hypotonic state but CNS and autonomic nervous system are highly active

48
Q

_% of bruxism is seen when

A

80… during arousal periods

TMD (13 decks)

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