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Manual II > TEMPOROMANDIBULAR JOINT > Flashcards

TEMPOROMANDIBULAR JOINT Flashcards

1
Q

What are symptoms of Costen’s syndrome?

A

pain in or near the ear, tinnitis, dizziness, fullness in the ear, and difficulty swallowing

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2
Q

What is Eagle syndrome?

A

Ossification of the stylomandibular joint

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3
Q

What does the Malleomandibular or Discomalleolar or Pinto’s ligament do?

A

Connects malleus of the

middle ear to the posterior TMJ capsule, lateral pterygoid, and disc. Link between TMJ and ear.

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4
Q

The TMJ is richly supplied by the external carotid artery through the …

A

superficial temporal, deep auricular, anterior tympanic, ascending pharyngeal, and maxillary branches

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5
Q

Nerve supply to the TMJ is supplied through the…

A

auriculotemporal and messeteric branches of the mandibular division of the Trigeminal Nerve CN(V).

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6
Q

Which area of the intra-articular disc is avascular and aneural?

A

Intermediate zone

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7
Q

Where does the anterior TMJ disc connect?

A

Superior head of lateral

pterygoid

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8
Q

Where is the posterior-bilaminar zone attachment of the TMJ disc?

A
  • Upper lamina-elastic fibers

* Lower Lamina-collagenous fibers

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9
Q

What are the medial and lateral attachments of the TMJ disc?

A

Collateral ligaments

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10
Q

In terms of Maxillomandibular Relationships, what is an over bite?

A

Vertical overlap

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11
Q

In terms of Maxillomandibular Relationships, what is an over jet?

A

Horizontal overlap

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12
Q

In terms of Maxillomandibular Relationships, what is an orthognathic?

A

Normal

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13
Q

In terms of Maxillomandibular Relationships, what is a retrognathic?

A

Posterior mandible/ micro-gnathic

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14
Q

In terms of Maxillomandibular Relationships, what is a prognathic?

A

Anterior mandible/ Norwegian jaw

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15
Q

If I extend my neck and head, what happens to my freeway space and mandible?

A

◼ Increases freeway space

◼ Retrudes mandible

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16
Q

If I flex my head and neck, what happens to my freeway space and mandible?

A

◼ Decreases freeway space

◼ Protrudes mandible

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17
Q

What does forward head posture do to freeway space and the mandible?

A

◼ Decreases freeway space

◼ Elevates/Retrudes mandible

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18
Q

A forward head posture _________s the tongue

A

Depresses

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19
Q

What is the classification of the TMJ?

A

◼ Synovial, complex, modified ovoid

◼ Ginglymus/Sliding-Hinge

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20
Q

What is the capsular pattern of the TMJ?

A

Depression

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21
Q

What is the resting position of the TMJ?

A

Rests in loose packed

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22
Q

How does the TMJ rotate?

A

Posterior- anterior

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23
Q

How does the TMJ glide?

A

Anterior- posterior

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24
Q

What is the elevation (MIP) of the TMJ?

A

Fully elevated

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25
Q

What is the depression (MIO) of the TMJ?

A

40-50mm

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26
Q

What is the lateral excursion of the TMJ?

A

8mm

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27
Q

What is the protrusion of the TMJ?

A

8mm

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28
Q

What is the retrusion of the TMJ?

A

4mm

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29
Q

Does the TMJ follow the convex or concave rule?

A

Convex

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30
Q

What actions does the masseter perform?

A

◼ Elevator
◼ Protrusion
◼ Clenching

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31
Q

What innervates the masseter?

A

CN V

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32
Q

What actions does the temporalis perform?

A

◼ Elevator
◼ Retrusion
• Posterior fibers
◼ Clenching

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33
Q

What innervates the temporalis?

A

CN V

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34
Q

Which actions does the medial pterygoid perform?

A

◼ Elevator
◼ Lateral Excursion
• Contra-lateral side
◼ Clenching

35
Q

What innervated the medial pterygoid?

A

CNV

36
Q

Which actions do the lateral pterygoid perform?

A

◼ Superior Head
• Disc control and repositioning on elevation

Inferior Head
• Protrusion
• Lateral Excursion
--Contra-lateral 
--• Depression
37
Q

What innervates the lateral pterygoid?

A

CN V

38
Q

Which actions do the digastrics perform?

A

Anterior
-depression

Posterior
- recursion

Works bilaterally to also elevate the hyoid during swallowing

39
Q

What innervates the anterior digastrics?

A

CN V

40
Q

What innervated the posterior digastrics?

A

CN VII

41
Q

What are the arthrokinematics of opening and closing the TMJ?

A

⦿ Phase 1
◼ opening = rotation only. This involves a posterior mandibular rotation around the X-axis. Estimated range is between 10 – 15 mm.

⦿ Phase 2
◼ opening (15 - 40 mm) = rot/translation of the disc/condyle complex. This involves a posterior X-axis rotation with anterior translation along the Z-axis.

⦿ Phase 3
◼ opening (40-50 mm) = further anterior translation of the disc/condyle complex, along the Z-axis. Range of normal opening as measured between the anterior incisors of the mandibular and maxillary teeth (MIO) is 40 – 50 mm.

42
Q

Jaw protrusion is

associated with …

A

bilateral anterior translation of the TMJ disc/condyle complex.

43
Q

Jaw retrusion is associated with …

A

bilateral posterior translation of the TMJ

disc/condyle complex

44
Q

Lateral excursion to

the left is associated with…

A

anterior translation of the right TMJ disc/condyle complex and spin of the left.

45
Q

Lateral excursion to

the right is associated …

A

with anterior translation of the left TMJ with spin on the right.

46
Q

What is the TMJ triad?

A

⦿ Jaw Pain
⦿ Tinnitus (ringing, buzzing, etc.)
⦿ Ear fullness/blockage

47
Q

Which pattern is associated with OA of the TMJ?

A

Depression [(U)-lateral deviation to uninvolved>involved]

48
Q

What are the clinical signs of OA of the TMJ?

A

◼ Crepitus
◼ Painful mastication
◼ Limited depression
◼ Females>Males

49
Q

What do compression and traction of the TMJ do?

A

◼ Compression: ↑ pain ◼ Traction: ↓ pain

50
Q

True or false; an anterior disc displacement with reduction will have a capsular pattern

A

False

51
Q

What are the characteristics of an anterior disc displacement with reduction?

A 
◼ Bilaminar zone laxity ◼ SLP hyper-tonicity 
◼ Reciprocal Clicking 
◼ “Opening Click”-Reduction
• May exhibit brief deviation 
◼ “Closing Click”-Displacement
• Potential for “Close-lock”
• Ending in positional deflection
52
Q

What are the characteristics of an anterior disc displacement without reduction?

A 
◼ Bilaminar zone laxity 
◼ SLP hypertonicity 
◼ Disc thickens/folds 
◼ NO clicking 
◼ “Closed-lock”
53
Q

True or false; deflection of the TMJ will have a sustained position from the midline to the contralateral side of the tight capsule

A

False; same side

54
Q

True or false; deflection is caused by mircotraumas

A

False; macrotrauma

55
Q

What would you expect to see with a subluxed TMJ?

A
  • Deflects to opposite side of hyper-mobile capsule

* Possible “Open-lock”

56
Q

What are the overuse injuries common to the TMJ?

A

Bruxism

Clenching

57
Q

What are the causes of Trismus?

A

AKA LOCK JAW

Myofacial
Bacterial infection
Radiation therapy

58
Q

What do the letters RPTTLB stand for in terms of postural re-education?

A 
Relax
Teeth apart
Tongue up
Lips together
Breathe nasodiaphragmatically
59
Q

What are the causes of condylar/ mandibular hypoplasia?

A

◼ Facial asymmetry
◼ Muscle imbalance
◼ Hyper-/hypomobility

60
Q

What is the cause of Tic Douloureux?

A

Unknown etiology

61
Q

True or false; Tic Douloureux is common in children

A

False; occurs in adults

62
Q

What is the pattern of pain of Tic Douloureux?

A

Facial pain (U)

63
Q

What are the triggers of Tic Douloureux?

A

Touch, sounds, brushing

teeth, chewing, shaving, tumor/swollen vessel

64
Q

What action does the tempromandibular ligament prevent?

A

Downward and backward motion

65
Q

What action does the sphenomandibular ligament prevent?

A

Anterior motion

66
Q

What action does the stylomandibular ligament prevent?

A

Downward motion

67
Q

In the TMJ, the (LCL/MCL) gets more stressed.

A

LCL

68
Q

Which vertebral region may cause the trigeminal nerve to refer pain to the TMJ?

A

C1 C2

69
Q

True or false; the bilaminar zone is avascular and aneural

A

False; highly vascular and innervated

70
Q

What are you doing if you can measure MIP?

A

Clenching your teeth

71
Q

How do you calculate free space?

A

Vertical dimension of rest- vertical dimension of occlusion

72
Q

What is a normal amount of over bite? Over jet?

A

3mm

73
Q

Forward head posture causes the mandible to be ________, which causes __________.

A

Mandible= elevated and retracted

Causes altered rest position of the jaw

74
Q

Forward head posture causes the tongue to become ________, which causes…

A

Tongue= depressed

Causes altered swallow and jaw position

75
Q

Forward head posture causes _________ tone of the ________, which causes …

A

Causes increased tone of the temporalis which causes

TMJ-myofascial pain and tension type headaches

76
Q

When the jaw opens, there is a _____ roll and a ______ glide

A

Posterior roll

Anterior glide

77
Q

When the jaw closes, there is a _____ roll and a ______ glide

A

Anterior roll

Posterior glide

78
Q

True or false; the temporalis is a weak contralateral lateral excursion muscle

A

False; ipsilateral

79
Q

Anterior disc displacement with or without reduction has a click?

A

With

80
Q

What is the difference between derangement and displacement?

A

Derangement involved damage to the disc

81
Q

What is the difference between a deflection and a deviation?

A

Deflections are permanent, deviations are temporary

82
Q

You assess your patient has a RIGHT deflection. Their RIGHT lateral excursion is 8mm, LEFT is 4mm. Which is tight and which is loose?

A

Right is tight, left is loose

83
Q

In the context of condylar/mandibular hypoplasia, a larger ramus will result in…

A

Facial convexity

84
Q

In the context of condylar/mandibular hypoplasia, a smaller ramus will result in…

A

Facial concavity

Manual II (11 decks)

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