S2_L5: Cervical Spine & TMJ Flashcards by Mind Med

This is a chronic regional pain syndrome that affects the muscle and is characterized by the presence of
myofascial trigger points

Myofascial Pain Syndrome (MPS)

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Which cervical spine is most commonly affected in cervical RA?

C1 and C2

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What is the intervention scenario for TMJ Dysfunction?

to restore

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Branches to TMJ are from?

A. Maxillary division of trigeminal nerve
B. Mandibular division of trigeminal
C. Both
D. None

B. Mandibular division of trigeminal

Source: Temporomandibular Joint Dysfunction Quiz Questions (ProPorfs Quizzes)

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TRUE OR FALSE: Arthritis may affect the disc or the bony part of the TMJ.

True

Source: Trivia Quiz on Temporomandibular Joint (ProPorfs Quizzes)

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Subject: TMJ

The upper posterior lamina is collagenous and prevents the disc from being pulled too far _____

backward

Source: Trivia Quiz on Temporomandibular Joint (ProPorfs Quizzes)

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Subject: TMJ

TRUE OR FALSE: The articular disc is tightly attached to the medial and lateral poles of the condyle.

True

Source: Trivia Quiz on Temporomandibular Joint (ProPorfs Quizzes)

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Which of the following is true about lateral excursions of the jaw?

A. They are controlled by the lower head of the lateral pterygoid
B. The jaw moves toward the side on which the lateral pterygoid contracts
C. If the jaw moves to the right, the condyle on the other side moves posteriorly
D. None of the above

A. They are controlled by the lower head of the lateral pterygoid

Source: Trivia Quiz on Temporomandibular Joint (ProPorfs Quizzes)

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Subject: TMJ

TRUE OR FALSE: The anterior band of the discs is its thickest region.

False.

The posterior is the thickest.

Source: Trivia Quiz on Temporomandibular Joint (ProPorfs Quizzes)

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TRUE OR FALSE: In the chewing motion, the mandible moves downward, then shifts toward the non-chewing side.

False

Source: Trivia Quiz on Temporomandibular Joint (ProPorfs Quizzes)

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Subject: TMJ

TRUE OR FALSE: Irregular movements of the disc may make popping sounds.

True

Source: Trivia Quiz on Temporomandibular Joint (ProPorfs Quizzes)

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Subject: TMJ

TRUE OR FALSE: There are synovial cavities above and below the articular disc.

True

Source: Trivia Quiz on Temporomandibular Joint (ProPorfs Quizzes)

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Subject: TMJ

TRUE OR FALSE: The central portion of the disc has numerous pain fibers.

False.

There are no fibers.

Source: Trivia Quiz on Temporomandibular Joint (ProPorfs Quizzes)

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Pain in the TMJ coming from other areas is known as ___________ pain.

Referred

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Dislocation of the TMJ is referred to as ____

Subluxation

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When the disc of the TMJ is deranged it is usually ___

Displaced anteriorly

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_____ is defined as “consistent association of one motion about an axis with another motion around a different axis”

Coupled motion

Source: Kisner & Colby 7th ed., page 419

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The craniovertebral region is composed of the (1)____, (2)____, and (3)____ of the axis.

occiput
atlas
superior facets

Source: Kisner & Colby 7th ed., page 419

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The occipito-atlanto (OA) joint is considered a ____ joint.

ball and socket

Source: Kisner & Colby 7th ed., page 419

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These are bony projections that provide lateral stability to the spine and reinforce the vertebral disc posterolaterally.

Joints of Luschka

Source: Kisner & Colby 7th ed., page 419

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The annulus fibrosus is the outer portion of the disc is made up of dense layers of ____ fibers.

type I collagen

Source: Kisner & Colby 7th ed., page 420

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The annulus fibrosus is supported by the (1)____ and (2)____ ligaments.

anterior longitudinal
posterior longitudinal

Source: Kisner & Colby 7th ed., page 421

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TRUE OR FALSE: The nucleus pulposus generally does not move in a healthy disc.

True

Source: Kisner & Colby 7th ed., page 421

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The curve present in the cervical spine is known as a ____ or ____ curve

anterior or compensatory

Source: Kisner & Colby 7th ed., page 421

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(1)____ is a term used to denote a posterior curve, while (2)____ is a term also used to denote an anterior curve.

1. Kyphosis 2. Lordosis Source: Kisner & Colby 7th ed., page 421

TRUE OR FALSE: Gravity places stress on the structures responsible for maintaining the body upright and therefore provides a continual challenge to stability and efficient movement.

True Source: Kisner & Colby 7th ed., page 421

The center of gravity of the head falls anterior to the _____.

atlanto-occipital joints Source: Kisner & Colby 7th ed., page 422

The _____ muscles keep the head balanced.

posterior cervical Source: Kisner & Colby 7th ed., page 422

This structure helps restrain the various spinal motions as a complex ligament.

Collagen Fibers Source: Kisner & Colby 7th ed., page 420

TRUE OR FALSE: The facet joint capsule is a pain sensitive structure in the cervical spine.

True

Enumerate the 2 causes of MPS.

1. Poor posture 2. Chronic repetitive minor strain on the posterior cervical muscles

3 Cardinal signs of TMJ dysfunction

1. Pain 2. Joint Noise 3. LOM of jaw

Mechanical stress to pain-sensitive structures, such as sustained stretch to ligaments or joint capsules or compression of blood vessels, causes (1)____ or (2)____ of the nerve endings, which leads to the experience of pain.

1. distention 2. compression Source: Kisner & Colby 7th ed., page 429

Match the following terms with its correct descriptions: 1. adaptive shortening of soft tissues and muscle weakness 2. important to avoid abnormal stresses on growing bones and adaptive changes in muscle and soft tissue 3. posture that deviates from normal alignment but has no structural impairments. 4. pain that results from mechanical stress when a person maintains a faulty posture for a prolonged period A. Postural fault B. Postural pain syndrome C. Postural habits D. Postural dysfunction E. None

1. D 2. C 3. A 4. B Source: Kisner & Colby 7th ed., page 429-430

This is is characterized by a decrease in the thoracic curve, depressed scapulae, depressed clavicles, and decreased cervical lordosis with increased flexion of the occiput on atlas.

flat upper back and neck posture Source: Kisner & Colby 7th ed., page 432

Name the muscles of mastication.

1. medial and lateral pterygoid 2. masseter 3. temporalis muscles

Name the 4 muscle relaxation technique for the cervical region and the patient's position.

Position: sitting c arm on lap or standing 1. Bend the neck forward and backward 2. Side bend and rotation of head in each direction 3. Roll the shoulders (protract, elevate, retract, and relax) 4. Circle the arms (clockwise and counterclockwise) Source: Kisner & Colby 7th ed., page 438

Irritation of the ______ is a major cause of headaches.

greater occipital nerve Additional Information: This is the sensory branch of C2 that provides innervation to posterior scalp. Source: Kisner & Colby 7th ed., page 476

TRUE OR FALSE: Musculoskeletal headaches are a common complaint with impaired posture.

True Source: Kisner & Colby 7th ed., page 477

This condition results from degeneration or stenosis of the central spinal canal.

Cervical Myelopathy Source: Kisner & Colby 7th ed., page 479

Mouth opening is primarily facilitated by (1)____ with minimal assistance from the (2)____ and the (3)____ muscles.

1. gravity 2. anterior digastric 3. lateral pterygoid Source: Kisner & Colby 7th ed., page 480

TRUE OR FALSE: Both protrusion and lateral excursion are needed when grinding small foods.

True Source: Kisner & Colby 7th ed., page 480

Pain from TMJ dysfunction may come from:

1. richly vascularized and highly innervated retrodiscal pad 2. muscle spasm or myofascial pain 3. tension in the muscles of the cervical spine 4. irritation of the greater occipital nerve Source: Kisner & Colby 7th ed., page 480

TRUE OR FALSE: Aggressive and irreversible treatments is done when treating TMJ dysfunctions.

False. It must be avoided. Source: Kisner & Colby 7th ed., page 481

Name 3 soft tissue techniques to reduce muscle tension and improve mobility in the TMJ region.

1. extra-oral massage. 2. intra-oral trigger point release 3. petrous sinus release Source: Kisner & Colby 7th ed., page 483

How do you perform unilateral distraction of the TMJ?

1. Use the hand opposite the side on which you are working. 2. Place your thumb in the patient’s mouth on the back molars; the fingers are outside and wrapped around the jaw. 3. Apply force in a downward (caudal) direction Source: Kisner & Colby 7th ed., page 482

When gliding the TMJ, what must be the direction of pull?

Anterior / forward Source: Kisner & Colby 7th ed., page 482

(1)____ are defined as exercises or skills that all patients with spinal impairments should learn regardless of their functional level at the time of examination and initial treatment. The interventions include basic (2)____ training, basic (3)____ training, and functional training of basic body mechanics.

1. Fundamental interventions 2. kinesthetic 3. spinal stabilization Source: Kisner & Colby 7th ed., page 492

To increase cervical flexion, what must be the patient position, the landmark noted, and direction of force?

1. Prone 2. spinous process of the superior restricted segment of the three-joint complex 3.cephalad-anterior Source: Kisner & Colby 7th ed., page 500

TRUE OR FALSE: The shoulder girdle is indirectly related to the cervical posture

False. It is directly related Source: Kisner & Colby 7th ed.

TRUE OR FALSE: Neck pain with headache is usually found in patients with hypertension

True

Enumerate the 3 types of joint mobilization for TMJ dysfunction.

1. Unilateral 2. Unilateral with glide 3. Bilateral

TRUE OR FALSE: Neck pain is because of pathological cause.

False, it is of mechanical cause.

TRUE OR FALSE: The C4 ligament when injured can cause pain in the neck, scapula, upper arm, and chest.

False Source: ProProfs Quizzes

TRUE OR FALSE: Pain on active neck testing will help you tell the difference between a muscle injury and a ligament injury

False Source: ProProfs Quizzes

_____ is the alignment of the body parts whether upright, sitting, or recumbent.

Posture Source: Kisner & Colby 7th ed., page 417

How many cervical vertebrae are there?

Identify is the statements below are true or false. I. A functional unit is defined by what is occurring with the posterior portion of the body of the superior vertebra II. The functional unit of the cervical region is comprised of two vertebrae and the joints in between III. The functional unit is typically two zygapophyseal facet joints and one intervertebral disc IV. Generally, the axis of motion for each unit is in the vertebral canal

only II and III are correct Additional Information: I is incorrect as it is defined by what is occurring in the anterior portion IV is incorrect as the axis of motion is in the nucleus pulposus. Source: Kisner & Colby 7th ed., page 418

TRUE OR FALSE: The periosteum of the vertebrae is a pain sensitive structure, while facet capsules are not.

False Both are pain sensitive structures

Enumerate the 4 other names of cervical headache

1. Cervicogenic headache 2. Occipital neuralgia 3. Tension headache 4. Cephalalgia

Causes of cervical radiculopathy

1. Cervical arthritis/ spondylosis 2. Herniated nucleus pulposus

This condition results from the suddenly acceleration- deceleration of the head in space

Whiplash

This is a kind of weakness seen in muscles that are habitually in a shortened position

Tight weakness

Where is the load shifted to when a muscle fatigues?

Inert tissues

The following can be seen in FHP, EXCEPT: A. Increased flexion of lower cervical region B. Decreased extension of upper cervical region C. Extension of occiput on C1 D. Increased flexion of upper thoracic region

B. Decreased extension of upper cervical region Note: extension increases.

What kind of joint is the TMJ?

Ginglymoarthrodial joint Note: it is a hinge + plane joint

What comprises the TMJ?

1. Mandibular condyle 2. Articular disc 3. Glenoid fossa of temporal bone

TRUE OR FALSE: Breathing with the mouth open may cause TMJ dysfunction

True

TRUE OR FALSE: MPS may also be seen in the low back and thigh

True

This is the most comfortable position where there are no tension in the muscles and ligaments

Neutral spine