TMJ

Question 1

Explain a arthroplasty procedure

Answer 1

Draw a line long holmlund-hellsing(tragus to canthus). 10 and 2 and 20 and 10 mm. Apply local anesthesia without epinephrine. Then insufflate superior joint space with saline. Angel 18 gauge need 15 degrees anterior and superior and walk the needle down into joint space. Irrigate with minimum 100cc saline. Take out anterior port. Administer Kenalog 2mg into joint space. Manipulate joint thoroughly

Question 2

what is Kenalog and MOA

Answer 2

Triamcinolone-glucocorticoid, inhibts NFKB and cox

Question 3

Go layer by layer down to joint space for arthroplasty

Answer 3

skin, subq, TP fascia, Temporalis fascia. Capsular ligament/joint capsule.

Question 4

Treatment for otitis externa

Answer 4

Floroquinolone, if perforated can place abx patch. Possible tubes for drainage.

Question 5

Explain MRI. what is disk position

Answer 5

Normal disk position

Question 6

Question 7

Question 8

Cyclobenzaprine MOA

Answer 8

5HT receptor antagonist

Question 9

What is the classification system for Ankylosis

Answer 9

Topazian
1. condyle only
2. down to sigmoid notch
3. down to coronoid

Question 10

Explain a costochondral graft procedure

Answer 10

mark 6th rib ideally in inframammary crease. Dissection completed between pec major and rectus abdominis. Strattle the rib with fingers. Sharp dissection through periosteum and reflection of tissue. Can harvest 7-10 mm in children and up to ~15 in adults. IF cap falls off then go to 4th rib and harvest. Use right rib due to chest pain.

Close periosteum of rib. Check pleura. close.