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Tim's Cards > TMD OMFG > Flashcards

TMD OMFG Flashcards

1
Q

What kind of device moves the Jaw Forward?

A

Upper Splint with a Flange

*aka Anterior Positioning Device

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2
Q

NTI alleviates what?

A

Myalgia

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3
Q

Whiplash can cause TMD

A

True

*cause

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4
Q

Nerve pain is never alleviated by what class of drug?

A

Beta blockers

*anything LOL

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5
Q

Carbamazapine/Tegretol can treat Migraine

A

False

  • this is an Anti-convulsant
  • the only anti-convulsants that Tx Migraine are Topomax and Depicote
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6
Q

Highest standard of TMJ imagery:

Minimum standard:

Not diagnostic:

A

Conebeam CT

Tomography

Pano

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7
Q

Imaging that shows disc position:

A

MRI

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8
Q

What are the master cells for Pain in the brain?

A

Glial Cells

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9
Q

Superior Capsulitis will feel better if you bite on what side?

Lateral Capsulitis will feel bette if you bite on what side?

A

Same side

Opposite side

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10
Q

Most common cause of Trigeminal Neuralgia

A

Vessel impingement in the brain

*happens more in older people

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11
Q

% population w/ at least 1 sign of TMD dysfunction:

% population w/ at least 1 symptom:

% population that need Tx

Ratio Females:Males

A

75%

33%

5-7%

4:1

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12
Q

If TMD, % internal derangement:

% arthritis

% masticatory muscle disorder

A

31%

39%

30%

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13
Q

There is no specific cause to TMD, but there are contributing factors

Predisposing factors

Initiating factors

Perpetuating factors

A

True

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14
Q

5 Predisposing factors for TMD:

A

Systemic hypermobility (needs more evidence)

Psychosocial factors

Hx of injury

Oral habits

Dental occlusion (rare, 15%)

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15
Q

2 Initiating factors TMD

A

Direct trauma

Repetitive micro trauma (clenching, grinding, fingernail biting)

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16
Q

3 Perpetuating Facors TMD:

A

Psychosocial factors (stress)

Oral habits

Poor Occlusion

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17
Q

6 Contributing Factors TMD:

A

Direct extrinsic trauma

Hyperfunction

Psychosocial factors

Anatomic factors

Systemic disease

Hyperextension

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18
Q

What is the best image for seeing the disc?

What is the best image for imaging bone?

What is the best for arthritis/bone?

A

MRI

X-ray

X-ray

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19
Q

When a jaw deflects to one side, is this muscle or joint?

A

Joint

*ADD w/o reduction

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20
Q

Poor occlusion is a common cause of TMD

A

False

*15%

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21
Q

NTI is used for what?

A

Myalgia (muscle pain)

*anterior bite has less muscle contraction, but it will still put pressure on the condyles

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22
Q

If the occlusion on a stabilization splint is balanced by a splint, but the pain is locking/knocking/popping and painful what is the correct option?

A

Reposition Forward with a Flange (anterior repositioning device)

*listed for other info

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23
Q

Are bite changes usually necessary for TMD Tx?

A

No

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24
Q

What is the most important part of the Exam?

A

Hx

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25
Q

What is the main function of the Lateral Pterygoid?

A

Protrusion

Lateral excursions

*also depressor

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26
Q

Does Anterior disc displacement w/ reduction limit opening?

A

No

*only w/o

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27
Q

If you have a joint problem can you also have a muscle problem?

A

Of course

*most pts have 4-5

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28
Q

If you have a limited opening with a soft infeel you have a…

A

Muscle problem

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29
Q

When you have referred pain, what is the name for what’s going on in the brain?

What nucleus?

A

Convergence

Trigeminal nucleus adelas

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30
Q

Know the anatomy of where the mm. are on a diagram

A

Fo sho

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31
Q

Tissue covering the superior surface of the condyle

Tissue making up the disc

A

Fibrocartilage

Dense fibrous CT

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32
Q

Which mm. are elevators?

Which are depressors?

A

Temporalis, masseter, medial pterygoid

Infrahyoid, suprahyoid, lateral pterygoid

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33
Q

What is the 1st Tx for severe muscle pain?

A

Home instructions (moist heat, relaxation, stretching, etc)

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34
Q

Sharp pain can be what?

A

Nerve or joint

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35
Q

Which type of pain is electric shock?

What pain can be sharp?

Muscle pain is normally…

A

Nerve only

Nerve or Joint

Dull

36
Q

Migraine/neurovascular pain is usually perpetuated by what?

A

Pounding/heartbeat

37
Q

Myofascial pain

Myalgia

Myositis

Spasm

A

Referred

Muscle (not referred)

Trauma

Intense

38
Q

Tooth w/ pain post-RCT, what should you do?

extraction, refer, topical…

A

Topical anesthetic

39
Q 
If the occlusion on a stabilization splint is balanced but the pain has recently increased w/ popping/locking, the next treatment:
Balance the splint
Add pivot
Make the splint thinner
Reposition forward with a flange
A

Reposition forward with a Flange

*this is an Anterior Repositioning Device

40
Q

How far forward do you bring an Anterior Repositioning Device?

(forward w/ flange)

A

enough to where they aren’t popping

41
Q

A splint that tries to distract the condyle bilaterally but is not effective b/c of the position of the Masseter muscle is what?

A

Bilateral Pivot

*never use

42
Q

A splint that repositions the Mandible forward to relieve pressure on the posterior attachment

A

Anterior Positioning Appliance

*for some reason referred to as the forward w/ flange

43
Q

A splint that has been shown to successfully reduce clenching pressure and masseter pain but is NOT appropriate for relieving joint pain

A

Anterior Bite Appliance/NTI

*also relieves headaches

44
Q

A splint that creates even contact, covers all the teeth, and relieves both joint and muscle conditions?

A

Stabilization Appliance

*aka nightguard, CR appliance

45
Q 
Tx of long term, with normal Tx, w/o response, you should:
put on opioids
re-assess diagnosis
Surgery
Ortho
A

Re-assess

*very difficult, most practitioners take Dx and try different Tx for it

46
Q

What tests diagnose Superior Capsulitis?

A

????? WTF?????

47
Q

What class of meds do we use for joint/tendon pain?

A

Anti-inflammatories

48
Q

Migraine meds can be Beta blockers, ending in…

and which 2 Anticonvulsants?

A

LOL

Topomax, Depicote

49
Q

Powerful Narcotics can be used for ____ days

side effect:

A

3-14 days

Constipation

50
Q

Powerful Narcotics can be used for ____ days

side effect:

A

3-14 days

Constipation

51
Q

Name 5 muscle relaxants to Tx Muscle Pain:

A

Flexeril

Zanaflex

Skelaxin

Baclofen

Robaxan

52
Q

3 meds for Non-blockable/sympathetically blockable Neuropathic Pain

A

Elavil (amitriplyline)

Pamelor (nortryptyline)

Alpha blockers (Clonidine, Prazocin, Hytrin)

53
Q

Neuropathic pain can be treated with Lidocaine

54
Q

6 meds for Blockable Neuropathic pain:

note: combos also used

A

Tegretol (carbamzepine)

Liorisal (Baclofen)

Depakote (Valproate)

Dilantin (Phynytoin)

Konopin (Clonazepam)

Topomax

55
Q

11 meds for Neuropathic Pain:

A

Tegretol

Depakote

TCA’s

Gabapentin (Neurontin)

Baclofen

Hytrin/minipress

Gabatril

Topamax

Trileptal

Lamotrigine

Dilantin

56
Q

11 meds for Neuropathic Pain:

A

Tegretol

Depakote

TCA’s

Gabapentin (Neurontin)

Baclofen

Hytrin/minipress

Gabatril

Topamax

Trileptal

Lamotrigine

Dilantin

57
Q

Abortive migraine meds include what class?

his fave Beta Blocker:

Ca channel blocker:

2 anti-convulsants:

SNRI w/ TCA:

A

Triptans

Inderal (lol)

verapamil

topamax, depakote

pemelor

58
Q

Abortive migraine meds include what class?

his fave Beta Blocker:

Ca channel blocker:

2 anti-convulsants:

SNRI w/ TCA:

A

Triptans

Inderal (lol)

verapamil

topamax, depakote

pemelor

59
Q

What is the best/most specific imaging for disc/TMJ

60
Q

If a jaw deviates to one side, it is joint and…

A

ADD w/o reduction

61
Q

Whiplash causes TMD

62
Q

NTI is for

63
Q

Pt has popping/locking, what splints?

A

Anterior repositioning

Unilateral splint w/ flange

64
Q

CR to CO slide greater than _____, TMJ problem

65
Q

soft end feel:

hard end feel:

A

pry open, goes more (Muscle)

pry open, goes no further (ADD w/o reduction or coronoid locked over zygoma)

66
Q

What kind of pain can refer?

A

Myofascial

67
Q

Temporalis trigger points:

Masseter:

SCM:

Trap/posterior cervicalis:

Lat Pterygoid:

A

Mx ant, PM’s, molars

ear, lower molars, above rt eye

ear, above eye, eye, occiput

temple, ear, eye

zygoma, TMJ, eye

68
Q

Intrinsic TMJ ligament:

2 Extrisics:

A

Temporomandibular

Stylomandibular, Sphenomandibular

69
Q

Stylomandibular:

Sphenomandibular:

Temporomandibular:

A

Styloid process, angle Mn

Spine of sphenoid, Lingula

prevents Mn from being pushed back

70
Q

Condyle articulates in what zone?

A

Intermediate

71
Q

measurements: Posterior zone:

anterior zone:

intermediate zone:

A

3mm

2mm

1mm

72
Q

Most TMD cases are both joint and muscle

73
Q

Stabilization appliances reduce forces by ___%

but do not increase _____

A

70%

joint space

74
Q

Stabilization appliances reduce forces by ___%

but do not increase _____

A

70%

joint space

75
Q

What type of movement pain is Joint?

76
Q

___% of the population has 1 sign

__% has 1 symptom

__% needs Tx

A

75%

33%

5-7%

77
Q

__% pts in office will have non-tooth related pain

78
Q

rotation:

sliding/displacement:

A

inferior

superior

79
Q

Lateral ROM:

Protrusion:

opening:

A

10-12mm

8-10 mm

over 40 mm

80
Q

Use pain meds for migraine

81
Q

use propanolol/beta blockers/inderall for nerve pain

A

False

*migraine only

82
Q

Tegretol/carbmazeinipine is not used for what?

used for?

A

Migraine

trigem neuralgia

*this is an anticonvulsant

83
Q

What splint for Superior Capsullitis?

What splint for Posterior Capsulitis?

Use bilateral pivot for what?

A

unilateral pivot

anterior repositioning splint/unilateral w/ flange

never

84
Q

A lateral slide of more than ___mm is significant

85
Q

Anterior bruxing, anterior open bite, sudden changes in occlusion cause TMD

A

False

*all PREDISPOSE

86
Q

Penny: Best bone image:

best for soft tissue:

A

CT (not x-ray)

MRI

Tim's Cards (140 decks)

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