TMD: Final Flashcards
what is the anatomy of the TMJ
anterior to tragus
temporal and mandible bones
complex synovial joint
describe the disc of the TMJ
avascular except on periphery
bears load with closing mouth
guides motion, resists compression, and provides stability
what all is the disc of the TMJ attached to
muscles (masseter and lateral pterygoid)
capsule
condyle
post. elastic ligament
TMJ mostly innervated by
trigeminal N
what does the capsule attach to
disc and muslce
describe ligaments of synovial joints
blend with capsule
condyle relationship of tmj
convex on concave fossa
follows Kaltenborn’s rule
normal opening for tmj
~3 knuckles
less than 1 = urgent referral
condyles flide anteriorly
bilateral clicking is normal
muscles that open jaw
digastric
lateral pterygoid
hyoids
muscles that swallow
hyoids
digastric
closing muscles
temporalis
masseter
medial pterygoid
lateral pterygoid
S&S of TMD
oral habit hx: thumb sucking, nail biting. excessive teeth grinding , gum/smokeless tobacco chewer
FHP
localized pain/crepitus
trigeminal n sensation
impaired motion/function
what will you see wearlier deviation with loss of functional opening
due to recent or past trauma
capsular patter of acute TMD with trauma
deviation toward painful TMJ due to inflammation and unwillingness to move
capsular pattern of chronic with fibrotic TMJ due to past trauma
deviation awat from hypermobile TMJ
accessory motion limited on side of deviation
when will you see earlier deviation without loss of functional opening
Hx of past trauma resulting in greater laxity
minimal to no pain
dev away from unilateral hypermobile side
click at end range on hypermobile side indicates larger displacement
ONE SIDE MOVES TOO MUCH
when will you see end range deviation without loss of functional opening
no hx of trauma
minimal to no pain
gradual and less hypermobility developed bilaterally due to FHP
click at end range indicates larger displacement
BOTH SIDES MOVING TOO MUCH
influence of FHP on TMD
laxity from prolonged positioning
increased tension/lengthening of some muscles
displaced anterior mandibular condyle to disc
impaired length tension of muscles
what should you assess in and out of FHP
opening in neutral and FHP should be the same
swallowing in FHP and neutral should be the same
how is displacement described
condyle in relation to disc
how does anterior displacement occur
condyle is anterior to disc
hx of prolonged opening, trauma with sudden opening, or excessive opening
S&S = full opening with no deviation, and likely pain/limits with closing
Rx for anterior displacement
dstx with post glide to reposition condule posteriorly
hope to reverse creep of capsule and ligament
MET stabilization of TMJ and neck
lifestyle changes with anterior displacement issue
avoid wide opening with diet or yawn
correct posture
sleep with neck flexed and chin tucked
other clicks/signs of hypermobility
early clicking upon opening- small displacement
inconsistent click
reciprocal clicking - condyle moves ahead of disc on opening and behind disc on closing
