temporomandibular disorders Flashcards
What is TMD
Group of MSK disorders causing pain in the facial and perauricular regions
What are risk factors of TMD
middle age females (20 - 50y/o) , headaches, depression/anxiety,trauma, hyperlaxity, hormone, pain conditions, BRUXISM
What is Bruxism
abnormal habitual mouth activity of which increases jaw muscle activity.
CLENCHING OR GRINDING
Epidemiology
2nd most common chronic condition after chronic LBP
40 - 75% have signs of dysfunction
33% have at lest one symptom
5 - 10% deek professional help
3 - 7% have tx
TMJ anatomy
synovial joint (synovial membrane, filled with synovium and covered in fibrocartilage. highly innervated and highly vascularized.
TMJ anatomy: the articular disc
improves joint stability and congruency
Shaped like an hourglass, fibrocartilage, non-innervated and a-vascular
What muscles help to close and ipsilaterally deviate the jaw
masseters, temporalis, medial pterygoid
What muscles help open the jaw
hyoid muscles, lateral pterygoid
What muscle contralaterally deviates
medial pterygoid
What protudes the jaw
lateral pterygoid
What does it mean when there is pain in the cheek
muscle
What does it mean when there is pain at the joint
problem at the joint
What is the physio treatment for elongated upper traps (muscle disorders)
Strengthen, stretch, shorten, massage, pressure release, practice slow controlled movements, isometrics, add speed etc…
How many fingers is a normal opening
3
What is the difference between TMJ disorders and masticatory muscle disorders
TMJ - joint disorders
Masticatory - Muscle disorders
What goes into a TMJ evaluation
history,subjective, AROM/PROM, neuro exam, palpation (joint + muscle), muscle iso + flexibility, function, chewing, talking
What are the S & Sx of jaw dysfunction
Pain, clicking, tooth pain, locked jaw, headaches, painful chewing or trouble chewing d/t fatigue, ear pain, sinus pain
Limiting mouth movement, uneven mouth opening, clicking, popping, clunking, malocclusion, stiffness, muscle tension poor control
what is the treatment for acute TMJ
limit mouth opening to a pain-free range, soft foods, small bites, avoid FHP, cold on joint, heat on muscles
Treatment for joint disorders
hyopmobile - mobilize
hypermobile - isometrics and control through range
internal derangement - mobilize as lng as not acute and painful
Treatment for muscle disorders
trigger point release, restore muscle length (stretch or strengthen), change habits, muscle retraining, chewing retraining, dry needling for trigger pointa
Scope of practice
t phys cannot insert into orifices but can educate and provide exercisesq
