TMJ Flashcards
__-__% of the general population present with at least one sign of TMD
60-70
Only _% of people with signs of TMD will seek treatment
5%
Females seek care from TMD _ times more often than males
4
What are a few common complaints of TMD?
- hearing changes
- headache
- orofascial pain
- earache
- neck pain
What type of joint is the TMJ?
Modified oviod bicondylar joint
Describe the TMJ joint structre
Consists of the temporal bone, biconcave intra-articular disk, and the head of the mandible
What kind of cartilage does the intra-articular disc consist of?
fibrocartilage
What aspects of the joint does the intra-articular disc attach to?
- medial and lateral collateral ligaments
- post mandibular fossa
- lateral pterygoid muscle
What provides ligamentous stability to the TMJ?
The capsular ligament and lateral ligament
What is the origin and insertion of the temporalis muscle?
Origin: temporal floor
Insertion: coronoid process and mandible
What actions does the temporalis muscle do?
Mouth closing and side to side teeth grinding
What is the origin and insertion of the masseter muscle?
Origin: zygomatic arch
Insertion: mandible
What actions does the masseter muscle do?
Elevates the mandible
What is the origin and insertion of the medial pterygoid muscle?
Origin: ramus of the mandible
Insertion: angle of the mandible
What actions does the medial ptyergoid muscle do?
Assist mouth closing and deviating to opposite side
What is the origin and insertion of the lateral pterygoid muscle?
Origin: sphenoid bone and pterygoid plate
Insertion: capsule and neck of mandible
What actions does the lateral ptyergoid muscle do?
Anteriorly rotates disk on the condyle during closing, jaw protrusion, opening and deviation to the opposite side
What cranial nerve supplies all muscles of mastication?
CN V - Trigeminal Nerve
The arthorkinematics of the TMJ involve rotation and _____ translation in the sagittal, horizontal, and frontal planes
anterior
Protusion and retrusion are _____ glides
planar
Describe the arthrokinematics of the TMJ during mouth opening
The condyles begin to rotate anteriorly and translate inferiorly and laterally during first the 25 degrees. Then during the last 15 degrees the collateral ligaments tighten and rotation ceases which allows for translation of the disc and condyle to occur together
Decreased mouth-opening due to masseter stiffness (clinching) can lead to what?
Over-recruitment of the upper cervical extensors, which leads to associated cervicogenic headaches and compressive TMJ pain
What does centric relation test for?
Identification of pain caused by malpositioning
What is indicated if there is pain associated with the centric relation test?
That the cause of malpositioning could possibly be due to structural problems
What is indicated if there is no pain associated with the centric relation test?
That the cause of malpositioning is functional
What is considered normal maximal opening of the mouth?
50 mm
What is considered funtional opening of the mouth?
40 mm
How do you elicit the TMJ reflex?
The patient’s mouth is relaxed and opened in the resting position. Clinician places their thumb on the mandible and lightly taps thumb with hammer. The mouth should close.
Which 2 cranial nerves should be tested on all TMD patients?
CN V and VII
True or False
HVLA manipulations (grade 5 mobilizations) can be used on the TMJ
False
What is the goal of PIR?
The goal of post-isometric relaxation is relaxation of hypertonic or overactive muscles
