Brainscape's Knowledge GenomeTM

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


See full index

MSPT II > The Temporomandibular Joint > Flashcards

The Temporomandibular Joint Flashcards

1
Q

What is orofacial pain?

A

Pain perceived in the face and/or oral cavity. May occur with neck and headache pain.

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

The 1-year prevalence of orofacial pain has been estimated to be over ___ % in the adult population.

A

16%

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

List 5 questions that the PT should ask a patient experiencing TMJ pain.

A
  1. Does the jaw grate, click pop, snap or lock?
  2. Does the patient have headaches or ear problems?
  3. Is the patient’s pain worse upon awakening?
  4. Does the patient have any habits such as gum chewing, smoking, or clenching or grinding that could cause an overuse of the TMJ?
  5. What is the patient’s dental history - has the patient had any dental surgery, or braces or other appliances?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The presence of grating can indicate _______ changes.

A

osteoarthritic

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

What 3 symptoms can indicate displacement of the TMJ disc?

A
  1. Clicking
  2. Popping
  3. Snapping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What 2 symptoms indicate subluxation or dislocation caused by TMJ hypermobility?

A
  1. Clicking

2. Locking

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

Locking of the jaw in the full open position is called ______ or the full closed position which is called ______.

A
  1. Open lock: locking in full open position

2. Closed lock: locking in full closed position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What activities usually precede locking of the jaw in a full open position?

A
  1. Yawning

2. Opening the mouth wide to eat

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

What may be indicated if a patient’s pain is worse upon waking?

A

May indicate that the patient is clenching or grinding their teeth while asleep

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

In relation to dental work, what is a common cause of TMJ?

A

Prolonged mouth opening with dental surgery

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

What is malocclusion?

A

Manner in which the teeth fit together during biting or clenching

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

Aside from the usual items, what 4 items should be observed in patients with TMJ?

A
  1. Posture (forward head/protracted scapulae)
  2. Facial structure (asymmetry, under/overdeveloped lip)
  3. Jaw position (overjet)
  4. Resting position of the mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is an overjet?

A

An occlusal impairment, with the teeth together, greater than a 2 mm horizontal distance between the back of the upper teeth and the front of the lower teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the normal resting position of the lips, teeth and tongue?

A
  1. Teeth should be between 2 and 5 mm apart
  2. Lips should be together
  3. Tongue should be resting on the roof of the mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What pressure exists in the mouth in resting position? What is the advantage of this?

A
  1. Slight negative intraoral pressure

2. Advantage: position can be maintained with minimal muscle contraction

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

If the mouth is open, the jaw muscles must ______ to keep the lower jaw from dropping downward. This can be a cause of_____ of the jaw muscles.

A

contract

overuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What condition can cause TMJ pain if the tongue is not on the roof of the mouth in the resting position?

A

Tongue thrust

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If the teeth are clenched together, the jaw muscles are _____.

A

Overworking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What position should the jaw be in?

A

Centric position: mandibular condyle positioned in the center of the temporal fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

A mandible that is positioned too far ____as well as one positioned too far _____ can cause TMJ pain.

A

anterior

posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What can be used to hear TMJ joint noises?

A

Stethescope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

List 6 muscles that should be palpated for tenderness and spasm in patients with TMJ pain.

A
  1. masseter
  2. Temporalis
  3. Medial pterygoid
  4. Lateral pterygoid
  5. Anterior/lateral/posterior neck muscles
  6. Posterior suboccipital muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is normal ROM into opening? How is this measured?

A

40 mm or 3 fingers

Measured with a tape measure from the tip of the front upper and lower teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What movement should also be assessed with opening of the mouth?

A

Anterior translation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What 3 ROM limitations will a patient with a hypomobile left TMJ?

A
  1. Decrease in range of motion with deviation to the left when opening,
  2. Decrease in range of motion with deviation to the left with protrusion, and
  3. Decrease in range of motion with side gliding to the right.
26
Q

What 3 ROM limitations will a patient with a hypermobile left TMJ?

A
  1. Increase in range of motion into opening with a deviation to the right (less mobile side),
  2. Increase in range of motion into protrusion with a deviation to the right (less mobile side), and
  3. More range of motion with side gliding to the right than side gliding to the left
27
Q

How does one assess PROM at the TMJ?

A

Placing fingers inside the patient’s mouth (wear gloves)

28
Q

MMT of the jaw muscles is typically performed _____.

A

Isometrically

29
Q

What 2 muscles act as a force couple to open the mouth?

A
  1. Lateral Pterygoid (protrudes jaw)

2. Suprahyoid (opens the jaw)

30
Q

What will happen if the lateral pterygoid over pulls?

A

Patient will translate too much anteriorly when opening the jaw

31
Q

What 3 muscles are responsible for closing the jaw?

A

Masseter
Medial Pterygoid
Temporalis

32
Q

What 2 muscles are responsible for side gliding (lateral deviation)?

A

Ipsilateral lateral pterygoid

Contralateral medial pterygoid

33
Q

What 2 muscles are responsible for protrusion?

A

Medial Pterygoid

Lateral Pterygoid

34
Q

What muscle is responsible for pretrusion?

A

Suprahyoids

35
Q

How is the integrity of the trigeminal nerve (CNV) assessed?

A

Jaw jerk

36
Q

List 6 common causes of TMJ pain.

A
  1. Disc dislocation
  2. Joint dislocation / hypermobility
  3. Joint hypo mobility
  4. Muscle weakness
  5. Muscle spasm
  6. Decreased muscle length
37
Q

What is an occasionally dislocating disc?

A

Characterized by a soft opening click, which occurs intermittently.

Click when opening an no closing click occurs when the disc relocates with opening and not with closing.

38
Q

What is a reducible disc?

A

Characterized by a soft opening click and a soft closing click that occurs at different parts of the range of motion as the mandible moves onto and back off of the disc.

39
Q

What is a irreducible disc? What will this present as?

A

Characterized by a jaw that used to click but no longer clicks, and a decrease in jaw range of motion. The disc is now taking up space in the anterior aspect of the temporomandibular joint.

Presents as joint hypomobility

40
Q

What is hypermobility with joint dislocation?

A

Characterized by a hard opening and a hard closing click. The hard click is caused by the two bones dislocating and relocating.

41
Q

True or False: Disc dislocation are rarely the direct cause of pain at the TMJ.

A

TRUE

42
Q

What 4 impairments should be treated in patients with dislocating discs and reducible discs?

A
  1. Impaired posture
  2. Excessive anterior translation with opening
  3. Muscle imbalance (esp. excessive contraction of the lateral pterygoid)
  4. Joint hypo/hypermobility
43
Q

What intervention may be used to treat irreducible discs?

A

Surgery

44
Q

List 4 interventions used to treat joint hypermobility at the TMJ.

A
  1. Stabilization exercises
  2. Instructions to avoid end range positions
  3. Joint mobilizations
  4. Stretching
45
Q

List 6 general intervention considerations used to treat TMJ pain.

A
  1. Correct postural abnormalities (including sleeping posture)
  2. Instruct the patient to maintain good oral posture; lips together, teeth apart, tongue in the roof of the mouth
  3. Instruct the patient to eat soft foods, don’t eat bulky foods, take small bites
  4. Instruct the patient to yawn
  5. Refer patient for intraoral device
  6. Instruct patient not to smoke, chew gum, or grind/clench teeth
46
Q

How often should the patient perform the Rocabado’s 6 exercises?

A

6 times each, 6 times a day

47
Q

List the 6 Rocabado exercises.

A
  1. Clucking
  2. Tongue positioning
  3. Rhythmic stabilization
  4. Nodding
  5. Axial extension
  6. Shoulder positioning
48
Q

What is the purpose of clucking for TMJ pain?

A

Provides proprioceptive input regarding the correct location of the tongue

49
Q

Describe Rocabado’s tongue positioning exercise. What is the purpose of this exercise?

A
  1. Place your tongue flat on the roof of your mouth. Keep your tongue in this position, and open and close your mouth while breathing through your nose
  2. Purpose is to train the patient to minimize mandible protrusion with opening
50
Q

Describe Rocabado’s rhythmic stabilization exercise. What is the purpose of this exercise?

A
  1. Start by assuming the start position described under “tongue positioning”. Place your index finger on your chin. Very gently, push against your chin in an upward direction, in a downward direction, and to each side, without allowing your chin to move in any direction
  2. Purpose is to strengthen TMJ muscles and stabilize the TMJ
51
Q

Describe Rocabado’s nodding exercise. What is the purpose of this exercise?

A
  1. Start with both hands holding the back of your neck with your eyes horizontal. Gently nod your head slowly in approximately a 15 degree arc of motion.
  2. Purpose is to increase suboccipital mobility
52
Q

Describe Rocabado’s axial extension exercise. What is the purpose of this exercise?

A
  1. Start with your face vertical and eyes horizontal. Press one finger gently over the base of your nose. Allow your finger to guide your head back, keeping your face and eyes aligned horizontal
  2. Purpose is to increase suboccipital mobility, to train the patient to maintain correct posture
53
Q

Describe Rocabado’s shoulder positioning exercise. What is the purpose of this exercise?

A
  1. Start by assuming the start position described under “tongue positioning”, and the end position described under “axial extension”. Grasp your hands together behind your back. Slowly raise your arms up and pinch your shoulder blades together.
  2. Purpose is to train patient to maintain correct posture
54
Q

True or False: No evidence exists to direct clinicians toward which exercises, if any, may be useful in the conservative management of TMD.

A

TRUE

55
Q

List 2 patient education recommendations when treating patients with TMD.

A
  1. Reducing parafunctional habits

2. Providing pain science education

56
Q

______ and ______ have been shown to produce a temporary analgesic effect, potentially lasting as little as 30 minutes.

A
  1. Interferential current

2. TENS

57
Q

What is the indication for using biofeedback with patient with TMD? Is biofeedback effective?

A

To teach the patient to discriminate between muscles in spasm and those not in spasm, and to teach them to relax these muscles

YES, very effective in 70% of patients

58
Q

This is abundant evidence to suggest that _____ is not warranted to treat TMD.

A

Ultrasound

59
Q

_____ is not mentioned in relation to orofacial pain in any review article.

A

Laser

60
Q

True or False: Myofascial release and massage techniques applied on the masticatory muscles are more effective than Botox injections in treating TMD.

A

FALSE

Myofascial release and massage are AS EFFECTIVE as Botox injections

61
Q

______ approaches are effective for treating TMD/

A

Musculoskeletal manual approaches

MSPT II (13 decks)

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