TMJ

Question 1

what muscle is very important for guiding the disc via eccentric control?

Answer 1

lateral pterygoids (superior head)

Question 2

describe how the condyle moves on both sides during lateral deviation

Answer 2

ipsi condyle: rotation
contra condyle: translation

Question 3

normal opening ROM

Answer 3

40-60 mm

Question 4

function opening ROM

Answer 4

35 mm

Question 5

normal lateral deviation ROM

Answer 5

1/4 of opening
10 mm

Question 6

normal protrusion ROM

Answer 6

5-10 mm

Question 7

normal retrusion ROM

Answer 7

3 mm

Question 8

how many fingers wide should normal opening be?

Answer 8

4

Question 9

what is occulsion?

Answer 9

functional relationship between maxillary and mandibular teeth (close)

Question 10

what is grinding of the teeth called?

Answer 10

bruxism

Question 11

what muscles are overactive with clenching?

Answer 11

masseter and temporalis

Question 12

what is freeway space?

Answer 12

space b/w occluding surfaces of teeth when mandible is in physiologic resting position

Question 13

normal freeway space

Answer 13

2-4 mm

Question 14

overbite vs over jet

Answer 14

bite - vertical
jet - horizontal

Question 15

what is it called when a portion of the mandibular center incisor is covered by the maxillary center incisor?

Answer 15

overbite

Question 16

how is over jet measured?

Answer 16

horizontal distance b/w the maxillary arch and the mandibular arch in full occlusion
normal: 3-6 mm

Question 17

the TMJ is a _____ joint with ____cartilage covering the surface

Answer 17

synovial
FIBROcartilage

Question 18

what 2 structures keep the TMJ in place?

Answer 18

post-glenoid spine
articular tubercle

Question 19

where does rotation vs translation occur?

Answer 19

inferior cavity - rotation
superior - translation

Question 20

disc attaches posteriorly to ___ and anteriorly to ____ & _____

Answer 20

post - retrodiscal tissue
ant - superior lateral pterygoid & joint capsule

Question 21

which part of the disc is avascular and aneural?

Answer 21

intermediate

Question 22

retrodiscal tissue is _____ & ____ (nerve and blood supply)

Answer 22

vascular and nociceptive

Question 23

what is the main pain generator for TMJ?

Answer 23

retrodiscal lamina (highly vascularized and innervated)

Question 24

what structure is the switch b/w rotation and translation?

Answer 24

tempomandibular ligament

Question 25

what is the only muscle action the lateral pterygoid does not do?

Answer 25

retrusion

Question 26

what motions does the suprahyoids do?

Answer 26

depression retrusion

Question 27

what actions does the infrahyoids do?

Answer 27

stabilize the hyoid bone speech, swallow, tongue movements

Question 28

T/F: lateral pterygoids are the only contractile tissue that attaches to the disc

Answer 28

T

Question 29

generally, the TMJ issues will be ____ in closing and ____ in opening

Answer 29

tight closing weak opening

Question 30

in resting position, the disc should sit ____ to the condyle

Answer 30

slightly anterior

Question 31

convex/concave rule for TMJ

Answer 31

convex condyle moving on concave disc

Question 32

when does rotation occur during opening?

Answer 32

1st 20-25 mm of motion

Question 33

condyles roll ___ and glide ___ during opening

Answer 33

roll anterior glide inferior

Question 34

condyles roll ___ and glide ___ during closing

Answer 34

roll posterior glide superior

Question 35

the mandible slides slightly ____ during protrusion and ___ during retrusion

Answer 35

protrusion - down retrusion - up

Question 36

what other segment should be assessed when pt complains of TMJ pain?

Answer 36

C spine

Question 37

possible issues with anterior disc displacement with reduction

Answer 37

stretched temporomandicular ligament overactive superior lateral pterygoid issue or morphology of retrodiscal lamina

Question 38

_____ and _____ act as guide wires in position of the disc

Answer 38

superior lateral pterygoids retrodiscal lamina

Question 39

for ADDwR, treat muscles that affect the ______ pressure

Answer 39

interarticular

Question 40

diff dx? no clicking decreased ROM

Answer 40

anterior disc displacement w/o reduction

Question 41

______ is lost in the posterior ligaments and retrodiscal tissue in ADDwoR

Answer 41

elasticity

Question 42

if there is limited opening in ADDwoR, what is occuring?

Answer 42

disc is blocking condylar head

Question 43

if there is no limitation in opening in ADDwoR, what is occuring?

Answer 43

disc is completely displaced anteriorly (2/2 continuous stretching)

Question 44

what are 2 main sx to ask about with TMD?

Answer 44

HAs neck pain

Question 45

C shape jaw opening indicates?

Answer 45

capsular pattern

Question 46

S shape jaw opening indicates?

Answer 46

lack of motor control

Question 47

deflection w/ jaw opening indicates?

Answer 47

anterior disc displacement

Question 48

to which side is the disc displaced if the jaw deflects to the R during opening?

Answer 48

R

Question 49

if pain increases during cotton roll test, what is the issue?

Answer 49

muscular origin

Question 50

if pain decreases during cotton roll test, what is the issue?

Answer 50

joint origin

Question 51

how to confirm joint prob with cotton roll test?

Answer 51

perform test on non painful side and pain is still reproduced

Question 52

what muscle lengths should be checked for TMJ issues?

Answer 52

pec major (T) pec minor (Y) lats (full overhead flex)

Question 53

order of the mandibular neurodynamic test

Answer 53

capital flexion laterally flex upper C spine contralaterally lateral glide of mandible contralaterally

Question 54

how to palpate medial and lateral pterygoid

Answer 54

medial - posterior to back molar along mandibular teeth lateral - inside of external auditory meatus

Question 55

where is the force for the centric relation provocation test?

Answer 55

anterior-superior

Question 56

which MET is used to increase opening?

Answer 56

resisted closing

Question 57

where should PT stand for mobs?

Answer 57

contra side

Question 58

which mob should be done 1st?

Answer 58

distraction

Question 59

what mob helps with anterior disc displacement?

Answer 59

anteriomedial mob with rotation

Question 60

How many patients with neck pain also present w/ temporo-mandibular dysfunction?

Answer 60

1/3