Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Temporomandibular Disorders (TMJ) > Flashcards

Temporomandibular Disorders (TMJ) Flashcards

1
Q

Applied Anatomy: Joint

(3)

A
  1. Mandibular Condyle
  2. Articular Disc - Mandibular Disc
    Helps w/ congrunency of the joint
    Acts like the meniscus
  3. Glenoid Fosse (temporal bone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Applied Anatomy: Ligaments

(3)

A

Lateral Ligament - helps restrain the mvmts of the joint
- Strongest lig in the TMJ
- Thickening the joint capsule
- Restrains mvmt of lower jaw
- Prevents compression of tissue posterior to the condyle
- Also known as Collateral or Temporomandibular ligaments

Stylomandibular Ligaments (medial)
Sphenomandibular Ligaments (medial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Applied Anatomy: Muscles

Movement (5) + MM Responsible

A
  1. Opening: Lateral pterygoid
  2. Closing: Massester, medial pteygoid, temporalis
  3. Protrusion: Lateral pterygoid (primary), medial pterygoid
  4. Retrusion: Temporalis
  5. Lateral Deviation: Ipsilateral temporalis & contralateral masseter, medial pterygoid, and lateral pterygoid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Applied Anatomy: Nerve

A

Trigeminal Nerve (CN V)
- Mandibular Branch: innervates most of mastication

Trigeminal Neuralgia
- Chronic pain disorder that involves sudden severe facial pain
- DDx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Applied Anatomy: Vascular

A

Secondary arteries from external carotid artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Temporomandibular Disorders (TMD):
Cardinal Signs

A
  1. Orofacial
  2. Restricted Jaw Movements
  3. Joint noise

Based on structural Dx/ Pathoanatomical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

TMD: OA

(6)

A
  1. Degenerative changes
  2. Diffuse pain (INC w/ biting firm foods)
  3. DEC ROM
    Stiffness on waking with pain on function that dissapears as the day goes on suggests OA
  4. Atrophy of mm of mastication
  5. Weakness of mm of mastication
  6. Crepitus - HALLMARK Sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

TMD: Disc Displacement w/ Reduction

(3)

A
  1. Clicking w/ movement
  2. Double click:
    Click 1: reduction of disc (opening of mouth)
    Click 2: dislocation of disc (closing mouth)
  3. ANTERIOR disc dislocation most common

Reduced = hops under the condyle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

TMD: Disc Displacement w/o Reduction

2 Types

A

LockingL

Closed Lock: mouth won’t open
- Locking on opening (jaw cannot fully open < 30mm)
- ANTERIOR displacement of disc (infront of condyle - blocking the condyle from moving)
Cannot jump from past posterior edge of disc

Open Lock:
- Locking on closing (jaw cannot close)
- POSTERIOR displacement of disc (behind condyle)
Disc is blocking condyle from returning into Glenoid fossa
- Much less common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

TMD: HypOmobility Syndrome

(6)

A
  1. DEC ROM
  2. Localized pain at end range
  3. Signs of contractures
  4. History of trauma - Sx
  5. Deviation towards affected side (IPSILATERAL)
  6. May have secondary myofascial syndrome

Wheelchair analogy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

TMD: HypERmobility Syndrome

(6)

A
  1. Excessive anterior translation
  2. INC ROM (> 50 mm opening)
  3. May have generalized laxity
  4. Pain w/ opening
  5. Deviation towards unaffected side (CONTRALATERAL)
    Pain on LT but jaw deviated to RT = hyper
  6. May have joint noise at end of range

Wheelchair analogy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

TMD: Myofascial Pain

(5)

A
  1. Pain: INC pain in full open position (contracting/on stretch)
  2. No joint noise (different)
  3. Traumatic (MVA, ounch) or insidious (grinding, postural dysfunction - FHP)
  4. Trigger points may result in referred pain to other areas
  5. May result in DEC ROM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

TMD: Observation (Examination)

(5)

A
  1. Cervical spine & posture
  2. Asymmetry of the face
  3. Occulusion
    Normal
    Cross Bite
    Overbite
    Underbite
  4. Facial Pain
  5. Teeth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

TMD: Physical Examination

(5)

A
  1. Active movements
    C/S AROM
    TMJ ROM
    Mandibular measurement
    Swallowing & tounge position - gloves (touching mucusol layers)
    Cranial Nerve Testing
  2. Passive Movements - not used often unless need ENd-FEEL
  3. Resisted Isometric mvmts
  4. Functional Assessment
  5. Special Tests - talk, chew, blow, swallow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

TMD: Physical Examination: Active Movements

(6)

A

TMJ AROM
1. Quality
Smooth & unbroken
Lack of asymmetry/ deviation during opening, closing, protrusion, retrusion
2. Quality: measured (use a ruler)
3. Pain
4. Clicking Sensation
5. Opening
- Lateral deviation due to hypomobility - towards the side of deviation & hypermobility - on the contralateral side of deviation (unaffected side)
- If clicking is present during opening, re-test w/ jaw retrusion & protrusion
If clicking is more prominent with retrusion & absent with protrusion, the problem is likely an ANTERIOR disc displacement w/ reduction

Click w/ retrusion
No click 2/ protusion
= Anterior disc displacement w/ reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

TMJ AROM NORMAL VALUES

(5)

A
  1. Function opening = 40 mm
    25 mm rotation (anterior roll) & 15 mm translation
  2. Maximal opening = 50 mm
  3. Lateral Deviation = 9 mm
  4. Protusion = 9 mm
  5. Retusion = 1-2 mm
17
Q

Special Tests

(2)

A

Auscultation
- Clicking is more likely to occur in a hypermobile TMJ
Late clicking on opening is usually indicative of anteriorly displaced disc
- Crepitus is usually indicative joint disease or perforations in the disc
Painful crepitus could indicate rubbing between mandibular condyle & the glenoid fossa of the temporal bone d/t eroded disc

Functional Opening “Knuckle Test”
- Patient is instructed to place 2 flexed PIP joints w/in thier mouth
(+): Inability to fit 2 PIP joints w/in their open mouth

Functional Opening = 2 PIP w/in mouth
Maximal Opening = 3 PIP w/in mouth

18
Q

TMD: Interventions

(7)

A
  1. Education - posture, habits (gum & biting things), stress management
  2. Fascial mm relaxation
  3. Tongue proprioception & control - draw letters
  4. Jaw proprioception & control - open jaw slowly in mirror
  5. Strengthening
  6. Manual Therapy: passive stretching, soft tissue techniques (mm of mastication - less indicated for ppl w/ hypermobility), mobilization, joint manipulation techniques
  7. Modalities

MSK (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions