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MSK 2 > TMJ > Flashcards

TMJ Flashcards

1
Q

What kind of joint is the TMJ

A

Sliding Hinge Joint (ginglymoarthrodial joint)

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2
Q

What are the Articular surfaces associated with the TMJ?

A

Mandibular condyles and the mandibular fossa

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3
Q

Muscles of Mastication

A

Masseter, Temporalis, Lateral Pterygoid, and Medial Pterygoid

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4
Q

Masseter Movement

A

Elevate and protrusion

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5
Q

Temporalis Movement

A

Elevate and Retraction

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6
Q

Medial Pterygoid Movement

A

Elevate and retraction

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7
Q

Lateral Pterygoid Movement

A

Depress and protrusion

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8
Q

Muscles of mastication Innervation

A

Trigeminal Nerve (CNV), mandibular branch

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9
Q

TMJ Osteokinematics

A

Elevate (Close)
Depress (Open)
Protrusion
Lateral deviation

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10
Q

Depression Normal Values (How many mm is normal to open mouth?)

A

40-50 mm

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11
Q

Lateral Deviation Normal Values (How many mm is normal to open mouth?)

A

10 mm

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12
Q

Medial Deviation Normal Values (How many mm is normal to open mouth?)

A

10 mm

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13
Q

TMJ Arthrokinematics (Depression and Elevation)

A
  • Roll in mandibular fossa first 20 mm
    - Rotation (spin)
  • Slide onto articular eminence
    - Translation
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14
Q

TMJ Arthrokinematics (Lateral Deviation)

A
  • Ipsilateral rotation w/i fossa
  • Contralateral transition
    - anteromedial
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15
Q

TMJ Arthrokinematics (Protrusion)

A
  • Forward slide w/o roll
  • Translation only
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16
Q

Habits Effecting TMJ

A
  • WB on mandibles
  • Smoking
  • Biting nails
  • Chewing gum
  • mouth breathing
  • Snoring
  • Mask Wearing
17
Q

Objective TMJ Measures (Symmetry and Posture)

A
  • Fascial Symmetry
  • Posture
18
Q

Breathing Pattern (Things to look for)

A
  • Accessory muscles
  • Mouth breathing
  • Short upper lip (tendency to snore)
  • Stridor
  • Frenulum restriction (tongue tie)
19
Q

Exterior Palpation

A
  • Cervical Musculature
    - Symmetries
    - Hypertrophies
    - Tenderness
  • Joint opening and Closing
    - Symmetries
    - Feel for any popping /clicking
  • Masseter Palpation
    - Patient will clench and relax
20
Q

Intra-Oral Palpation (Medial Pterygoid)

A
  • Use index finger
  • Slide along inside of bottom teeth all the way back to base of the tongue
  • Have pt bite down gently
21
Q

Intra-Oral Palpation (Lateral Pterygoid)

A
  • Patient will open big
  • slide back of pinky along outside of top teeth
  • Have patient deviate ipsilateral and close slightly
22
Q

Hypermobility Screen (Beighton)

A
  • Do this BEFORE taking ROM measurements!
  • Ask quick screening questions. ex)
    - Can you bend over and place palms of hands on the floor? Can you bend your thumb back to touch forearm
  • Yes to 2 or more questions is 84% sensitivity and 87% specificity
23
Q

TMJ Deviations

A

S- Curve
- lateral movements that return to midline
- Cause: neuromuscular dysfunction

24
Q

TMJ Deflections

A

C- Curve
- Lateral movement that stays lateral when open
- Cause: muscle imbalance or capsular tightness

25
Q

Intra-Oral Mobility Tests (Inferior Glide)

A
  • Patient supine
  • Therapist on Contralateral side
  • Thumb on bottom molars and hand cradles mandible
  • Distract caudally
26
Q

Intra-Oral Mobility Tests (Anterior Glide)

A
  • Patient supine
  • Therapist on Contralateral side
  • Thumb on bottom molars and hand cradles mandible (can try to hook back molar)
  • Distract caudally first and then anteriorly
27
Q

Intra-Oral Mobility Tests (Medial Glide)

A
  • Patient supine
  • Therapist on Contralateral side
  • Thumb on bottom molars and hand cradles mandible
  • Distract caudally then deviate towards therapist
28
Q

Intra-Oral Mobility Tests (Lateral Glide)

A
  • Patient supine
  • Therapist on Contralateral side
  • Thumb on bottom molars and hand cradles mandible
  • Distract caudally then deviate away from therapist
29
Q

TMJ Strength Testing

A

Grading:
* Functional – all available ROM and holds against resistance
* Weak functional – decreased motion and only able to hold minimal resistance
* Nonfunctional – no resistance tolerated
* 0 – no voluntary motion occurs

30
Q

TMJ Other Testing

A
  • Deep Cervical flexors
  • Scapular Stabilizers
  • Jaw Jerk reflex CNV
31
Q

Common TMJ Pathologies

A
  • Muscle Imbalance
  • Disc Derangement
  • Capsular fibrosis
  • Inflammatory conditions
  • Degenerative condition
32
Q

Muscle Imbalance

A

A deflection (C- Curve) will occur towards tight side or away from lax side.

33
Q

Disc Derangement w/ reduction

A
  • 2 clicks (reciprocal)
  • Mandible jumps on/off disc w/ depression/elevation
34
Q

Disc Derangement w/o reduction

A
  • Unable to open (limited by disc)
  • patient will not be able to get past 40 mm of opening because disc does not go back in place
35
Q

Capsular Fibrosis

A
  • Usually w/ hx of long term disc dysfunction and or muscle imbalance
  • usually no pains or joint sounds
  • limited opening
  • Deviation (S-curve) to ipsilateral side w/ depression and protrusion
  • Lateral deviation limited to contralateral side
36
Q

Inflammatory Conditions (Capsulitis)

A
  • Pain w/ protrusion & deviation.
  • Pain to bite on contralateral side
  • pain to open wide
37
Q

Inflammatory Conditions (Synovitis)

A
38
Q

Degenerative Conditions

A

MSK 2 (2 decks)

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