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OCS Exam > TMD and miscellaneous > Flashcards

TMD and miscellaneous Flashcards

1
Q

The jaw is controlled directly by the muscles of mastication and indirectly by?

A

The cervical muscles

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2
Q

The cartilage of the TMJ is made of?

A

Fibrocartilage

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3
Q

What is significant about knowing what kind of cartilage the TMJ is made of?

A

Fibrocartilage is easier to repair

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4
Q

Whast are the ligaments of the TMJ?

A

-Medial collateral
-Lateral Collateral
-Stylomandibular
-Sphenomandibular

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5
Q

What is the only structure that can pull the jaw posteriorly into the joint space?

A

Superior band of the retrodiscal tissue

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6
Q

What are mandibular opening muscles?

A

Primary:
-Inferior lateral pterygoid
-Digastric

Secondary:
-Stylohyoid
-Geniohyoid
-Mylohyoid

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7
Q

What are the mandibular closing muscles?

A

-Temporalis
-Masseter
-Medial Pterygoid

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8
Q

How does lateral movement of the jaw occur?

A

Combination of:
Same side temporalis
Opposite Pterygoids

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9
Q

What is the average amount of lateral movement of the jaw?

A

5-10 mm

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10
Q

What muscles perform mandibular protrusion?

A

-Masseter (superficial head)
-Medial Pterygoid
-Lateral Pterygoid (superior head)

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11
Q

What muscles perform mandibular retrusion?

A

-Temporalis
-Digastric
-Suprahyoid muscles including Stylohyoid, geniohyoid, and mylohyoid

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12
Q

What innervates the muscles of mastication?

A

Trigeminal nerve

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13
Q

What cervical levels refer to the TMJ?

A

C2 and C3

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14
Q

What are the two components of TMJ opening?

A

Rotation and translation

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15
Q

What is the normal amount of jaw opening?

A

40-60 mm

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16
Q

The rotational part of jaw opening is what amount of the opening?

A

The first 20-25 mm

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17
Q

What is the force couple of jaw closing?

A

The eccentric contraction of the superior lateral pterygoid and the release of passive tension in the retrodiscal tissue

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18
Q

TMD is also called?

A

Craniomandibular disorder

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19
Q

What are symptoms of craniomandibular disorder?

A

-Face or jaw pain
-Joint Sounds (29-66%)
-Limitation of jaw movement
-Muscle tenderness
-TMJ joint tenderness
-Headache
-Ear Symptoms
-Cervical spine disorders

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20
Q

What other systems are included in regional involvement of CMD?

A

-Stomatognathic
-Cervical Spine
-Shoulder Girdle

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21
Q

TMJ related issues can refer pain where?

A

Structures of:
-Facial
-Auditory
-Dental

22
Q

What are the categories of TMD?

A

-Myofascial Pain
-Myofascial Pain with limitations in aperture
-Disc Displacement with reduction
-Disc Displacement without reduction and no limitation in aperture
-Disc Displacement without reduction and with limitation in aperture
-Arthralgia
-Osteoarthritis of the TMJ
-Osteoarthrosis of the TMJ

23
Q

What is occuring with disc displacement with reduction TMD?

A

At rest, the dist lies anterior and when the mouth opens the condyle reduces back over the posterior region of the disc

24
Q

What is characteristic of a unilateral disc displacement with reduction?

A

-One side of the TMJ will breifly be restricted upon opening
-Makes an “S” shape, -Deviating toward the involved side
-May hear a click upon opening and closing

25
Q

What is going on with disc displacement without reduction in TMD?

A

The condyle is unable to move forward of the anteriorly placed disc due to the lost elasticity of the collateral ligaments and retrodiscal tissue.

26
Q

What is characteristic of disc displacement without reproduction?

A

-No click since it’s blocked
-Jaw deviates toward the involved side
-Moves in a “C” shape

27
Q

What is happening with condylar subluxation?

A

Hypermobility of the joint capsule causes the condyle and disc to translate over the articular eminence

28
Q

What is characteristed of condylar subluxation?

A

-May have a “clunk”
-Deviation will be away from the affected side

29
Q

What are general interventions for hypermobile TMD?

A

-Teach not to open wide
-Use tongue-up position
-Palpate at the lateral pole
-Isometric exercises
-Address muscle weakness
-Mandibular muscle relaxation / biofeedback

30
Q

What are general interventions for hypomobile TMD?

A

-Manual mobilization
-Self-Mobilization
-Intraoral appliance/mobilizing splints
-Stretching

31
Q

What factors are incorporated in the musculoskeletal response?

A

-Musculoskeltal
-Biopsychosocial
-Somatovisceral
-Neurophysiological

32
Q

What does regional interdependence emphasize?

A

The need to evaluate joints above and below the area of symptoms - 2 joint rule

33
Q

What is perceived with vertigo?

A

Either the world is moving and they are standing still or they are still and the world is moving

34
Q

What is “dizziness?”

A

Feeling of being light-headed, foggy, unsteady, or off-balance sometimes associated with nausea, vomiting, or fainting

35
Q

What are causes of dizziness?

A

-Blood pressure drop
-Cardiac disease: acute or chronic
-Hypovolemia
-Anemia
-Hypoglycemia
-Some anxiety disorders
-Endurance events in a high heat environment

36
Q

What is the definition of orthostatic hypotension?

A

20 mmHg drop in systolic or 10 mmHg drop in diastolic withing 3 minutes of standing

37
Q

What are findings along with dizziness that might clue you into a cardiac origin?

A

-Brady or tachy cardia
-Arrythmias
-Chest Pain
-Sweating
-Other symptomatic cardiac findings

38
Q

What are symptoms of hypovolemia?

A

-Anxiety/agitation
-Cool/clammy skin
-Confusion
-Decreased or no urine output
-General weakness
-Pale Skin
-Rapid Breathing
-Low blood pressure regardless of position
-Rapid, weak, thready pulse

39
Q

What are symptoms of anemia?

A

-Fatigue
-Weakness
-Pale/yellowish skin
-Irregular heartbeat
-SOB
-Chest Pain
-Cold hands/feet
-Headaches

40
Q

When is a person in hypoglycemia?

A

Blood sugar below 70 mg/dL

41
Q

What are symptoms of hypoglycemia?

A

-Sweating, chills, clammy skin
-Irritability and confusion
-Tachycardia
-Hunger
-Sleepy/weak/no energy
-Tingling of lips, tongue, cheeks
-Headaches
-Coordination issues

42
Q

What are conditions included in central vertigo?

A

-Head Injuries
-Illness/Infection
-MS
-Migraines
-Brain Tumors
-Stroke/TIA

43
Q

What are examples of peripheral vertigo?

A

-BPPV
-Vestibular Neuronitis
-Meniere’s Disease
-Labyrinthitis
-Perilymph Fistula
-Superior Semicircular canal dehiscence syndrome

44
Q

What causes vestibular neuritis?

A

Most often a viral infection

45
Q

What are characteristics of vestibular neuritis?

A

Sudden and severe:
-Nausea/vomiting
-Ear drum normal
-Horizontal nystagmus
-Neuro exam/hearing unremarkable
-Fully Resolves in 7 days

46
Q

What are characteristics of Meniere’s Disease?

A

-Symptoms are unilateral and last minutes to hours
-Vertigo, hearing loss, and tinnitus
-Usually resolves within 24 hours

47
Q

What differentiates Meneire’s Disease from BPPV?

A

BPPV does not have ear ringing or unilateral hearing loss

48
Q

What is the most common type of BPPV?

A

Posterior canal

49
Q

If a person is going to shift from one type of BBPV to another, what would it be?

A

From lateral to posterior

50
Q

What should be recommeneded post BPPV treatment?

A

-Should NOT recommend postural restrictions
-May offer vestibular rehab
-Should NOT treat BPPV with vestibular suppressant medications such as antihistamines or benzos
-Educate on BPPV and their safety, potential for recurrence, and importance of follow up
-Encourage AWAY from Meclazine (suppresses vestibular system and does not fix crystals)

OCS Exam (12 decks)

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