temporomandibular disorders

Question 1

What is TMD

Answer 1

Group of MSK disorders causing pain in the facial and perauricular regions

Question 2

What are risk factors of TMD

Answer 2

middle age females (20 - 50y/o) , headaches, depression/anxiety,trauma, hyperlaxity, hormone, pain conditions, BRUXISM

Question 3

What is Bruxism

Answer 3

abnormal habitual mouth activity of which increases jaw muscle activity.

CLENCHING OR GRINDING

Question 4

Epidemiology

Answer 4

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

Question 5

TMJ anatomy

Answer 5

synovial joint (synovial membrane, filled with synovium and covered in fibrocartilage. highly innervated and highly vascularized.

Question 6

TMJ anatomy: the articular disc

Answer 6

improves joint stability and congruency

Shaped like an hourglass, fibrocartilage, non-innervated and a-vascular

Question 7

What muscles help to close and ipsilaterally deviate the jaw

Answer 7

masseters, temporalis, medial pterygoid

Question 8

What muscles help open the jaw

Answer 8

hyoid muscles, lateral pterygoid

Question 9

What muscle contralaterally deviates

Answer 9

medial pterygoid

Question 10

What protudes the jaw

Answer 10

lateral pterygoid

Question 11

What does it mean when there is pain in the cheek

Answer 11

muscle

Question 12

What does it mean when there is pain at the joint

Answer 12

problem at the joint

Question 13

What is the physio treatment for elongated upper traps (muscle disorders)

Answer 13

Strengthen, stretch, shorten, massage, pressure release, practice slow controlled movements, isometrics, add speed etc…

Question 14

How many fingers is a normal opening

Answer 14

3

Question 15

What is the difference between TMJ disorders and masticatory muscle disorders

Answer 15

TMJ - joint disorders
Masticatory - Muscle disorders

Question 16

What goes into a TMJ evaluation

Answer 16

history,subjective, AROM/PROM, neuro exam, palpation (joint + muscle), muscle iso + flexibility, function, chewing, talking

Question 17

What are the S & Sx of jaw dysfunction

Answer 17

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

Question 18

what is the treatment for acute TMJ

Answer 18

limit mouth opening to a pain-free range, soft foods, small bites, avoid FHP, cold on joint, heat on muscles

Question 19

Treatment for joint disorders

Answer 19

hyopmobile - mobilize
hypermobile - isometrics and control through range
internal derangement - mobilize as lng as not acute and painful

Question 20

Treatment for muscle disorders

Answer 20

trigger point release, restore muscle length (stretch or strengthen), change habits, muscle retraining, chewing retraining, dry needling for trigger pointa

Question 21

Scope of practice

Answer 21

t phys cannot insert into orifices but can educate and provide exercisesq