TMJ

Question 1

70% of TMJ disorder involve

Answer 1

mal positioning of the disc (internal derangement)

Question 2

primary pathology of TMJ is

Answer 2

osteoarthritis/osteoarthosis

Question 3

anatomy of TMJ

Answer 3

Modified ball and socket
Synovial joint

Temporal bone
Condyles of Mandible

Loosened capsule for movement
Disc (meniscus)
Attached more to mandible

Question 4

what artery run behind TMJ

Answer 4

middle meningeal artery, supply dura

Question 5

muscle of TMJ

Answer 5

Temporalis
Masseter
Pterygoid
Hyoid muscles

Question 6

which muscle is powerful in biting

Answer 6

temporalis

Question 7

which muscle is the main muscle involve in chewing

Answer 7

masseter

Question 8

role of lateral pterygoid

Answer 8

– When both sides work together they push chin out and/or depress the chin. Unilaterally they produce side to side chin movements.

Question 9

role of medial pterygoid

Answer 9

Helps to elevate and close the jaw. Working together they protrude the mandible, working unilaterally it produces a grinding motion.

Question 10

TMJ biomechanics in opening and closing

Answer 10

Opening
Anterior roll and anterior glide of the condyle

Closing
Posterior roll and posterior glide

Question 11

which joint doesn’t follow convex concave rule

Answer 11

TMJ

Question 12

normal opening of the mouth and normal daily use

Answer 12

Normal opening is 35-55 mm ( 2 or 3 fingers in the mouth)

Normal daily use requires 25-35 mm

Question 13

history question with TMJ

Answer 13

Grinding teeth
Clicking, locking, popping
Pain with functional movement of the jaw
Recent dental work
Surgeries
Medical conditions- lymph node swelling, tonsillitis, sinus infections
Hearing and balance issues
Headaches

Question 14

profil of nose breather

Answer 14

alert eyes
jaw and cheekbone definition
higher CO2
parasympathic relaxation
deeper sleeper
spine support
good tongue posture
lower bp
alpaca whisperer

Question 15

profil of mount breather

Answer 15

tired eyes
restless sleep/snoring
set back jaw
leaning forward
poor head posture
narrow palate
lower CO2/O2
higher blood pressure
stress activation

Question 16

normal anatomical position of TMJ

Answer 16

: Normal anatomical position of articulating disc with respect to condyle and surfaces of articulation

Question 17

ID-reducing of TMJ

Answer 17

Anteriorly displaced disc returning to normal anatomical position upon maximal opening (Wilkes Stage II-early Stage III).

Question 18

ID-Non-reducing TMJ

Answer 18

Anteriorly displaced disc during closed and maximal opening positions with disc thickening present (Wilkes late Stage III-Stage IV).

Question 19

Wilkes stage to classifying ID

Answer 19

Stage I- painless clicking in early opening and late closing with unrestricted motion
Stage II- occasional pain with clicking, intermittent locking, orofacial pain
Stage III- frequent orofacial pain, as locking becomes more frequent and mandibular becomes restricted
Stage IV- contours begin to change, chronic pain and restricted mandibular opening
Stage V- similar to stage 4 but with more severe symptoms (chronic pain, crepitus, significant ROM restrictions)

Question 20

whaat is Bell’s palsy

Answer 20

Damage or inflammation of the CN VII (Fascial)
Sudden paralysis of one side of your face, causing it to droop

Question 21

S/s of bell palsy

Answer 21

Drooling
Eye problems, such as excessive tearing or a dry eye
Loss of ability to taste
Pain in or behind your ear
Numbness in the affected side of your face
Increased sensitivity to sound

Question 22

TMJ functionnal movement

Answer 22

Biting
Chewing
Swallowing
Coughing
Talking

Question 24

what can restricted the opening of TMJ

Answer 24

muscle spasm, disc displacement

Question 25

what does a click with opening mouth means

Answer 25

Click- condyle slips over the disc and then self reduces
Later then click in movement, better chance jaw may get locked

Question 26

what does crepitus of TMJ means

Answer 26

Possible OA
Possible disc displacement

Question 27

what is Chvostek sign

Answer 27

Used to help determine if there is a pathology of the 7th cranial nerve (facial)
Tap the parotid gland overlying the masseter muscle

Positive: facial muscles twitch

Question 28

cervical spine effecting joint what can flexion and extension indicate

Answer 28

Flexion – posterior neck muscles tighten and mandible gets pulled up and forward

Extension – the mandible gets pulled down and backward

Can the patient go through full neck flexion and extension with the mouth closed?