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Musculoskeletal Rehab PT 514 > TMJ > Flashcards

TMJ Flashcards

1
Q

TMJ Anatomy

A

Diarthrodial joint
Fibrocartilagenous disc, ligaments, and capsules
Articular disk is biconcave
Anterior and Posterior portions of disc are innervated and vascular
Capsule is firm medial to lateral and loose anterior to posterior

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2
Q

TMJ Arthrokinematics

A

Rotation and Translation of the condylar-disk complex during open and close
Translation anterior and posterior during protrusion retrusion
Lateral movement is ipsilateral rotation and translation contralaterally

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3
Q

Mouth locked closed

A

Anterior disc derangement

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4
Q

Mouth locked open

A

Post disc derangement

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5
Q

TMJ red flags

A

Ringing in the ears (Too much aspirin)
Dizziness/light headed (Orthostatic hypotension)
5 D’s (Vertebral artery dissection)
Headaches

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6
Q

Link between cervical spine and TMJ

A

Link between C1-C3 and TMJ through trigeminocervical nucleus
Neck pain associated with TMD
Tinnitus and Vertigo in TMD

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7
Q

TMJ Exam

A

Head alignment
Dental exam
Facial alignment
Tongue position at rest

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8
Q

TMD Incidence

A

50-75%
All ages and genders
Symptoms fluctuate and may be self limiting

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9
Q

Specific TMJ Questions

A 
Pain opening or closing?
Pain chewing, biting, yawning?
Clicking, popping, snapping?
Morning tightness/stiffness?
Bad habits?
Painful or sensitive teeth?
Missing teeth?
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10
Q

Bruxism

A

Teeth grinding

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11
Q

Treatment differences w/ neck pain versus without

A

Cervical Screen before TMJ treatment

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12
Q

Number of teeth

A

32 (28 without wisdom teeth)

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13
Q

Signs of clenching

A 
Linea alba (white line on cheek inside)
Tongue Scalloping
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14
Q

AROM TMJ

A 
Mouth opening (35-50 mm)
Quality of movement
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15
Q

S shaped curve opening

A

Muscle imbalance

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16
Q

C shaped curve opening

A

Capsular pattern

17
Q

Deflection during opening

A

Anterior disk displacement

18
Q

AROM Lateral excursion

A

10-15 mm

19
Q

AROM Protrusion

A

6-9 mm

20
Q

AROM Retrusion

A

3-4 mm

21
Q

Functional opening

A

25-35 mm

2-3 PIPs between incisors

22
Q

TMJ PROM

A 
Examiner takes Pt through:
opening
protrusion/retrusion
Lateral excursion
End feel and Pt response
23
Q

Passive Accessory Motion Testing TMJ

A

Pt Supine
Externally (A/P, P/A, Medial glide)
Internally (Longitudinal distraction, w/ ant glide, w/ post glide)

24
Q

Muscle Performance Testing TMJ

A

Resisted Isometrics

Deep Neck Flexors

25
Q

Resisted Isometric Testing TMJ

A

Mandibular Depression
Mandibular elevation
Lateral Deviation

26
Q

TMJ Neurological screen

A

DTR (Tapping chin)
Myotomes
Sensation
CN Testing

27
Q

TMJ Special Test

A

Auscultate (Listening for click)

Bite maneuver

28
Q

Bite Maneuver

A

Pt bites with cotton ball on one side
Determine which side, then…
Distraction Pain on bite side: Extracapsular
Distraction Pain on opposite side: Intracapsular

29
Q

TMJ Palpation

A 
TMJ through external auditory meatus
Condyle anterior to ear open/closed
Coronoid Process
Muscles (Tone, symptom reproduction)
Bony Structures
Cervical Spine
30
Q

Disk Displacement

A

Acute
Joint sounds
Limited opening or closing
Deviation C shape towards painful side

31
Q

Myofacial TMD

A

Chronic
Limited opening
Deviation noted later in range J shape
Poor posture

32
Q

Interventions for reduced derangement

A 
Manual therapy for arthrokinematics
Motor learning activity
Stabilization
Pt education
Referral to specialist
33
Q

Interventions for non-reduced derangement

A 
Manual therapy to recapture the disc
Motor learning activity
Stabilization exercise
Pt education
Referral to a specialist
34
Q

Interventions for Hypomobility

A 
Pt education
PROM and Joint mobes
Soft tissue mobes and stretching of Connective tissue
AROM 
Posture
Cervical spine mobes
Motor learning
35
Q

Interventions for hypermobility

A 
Pt Education
Local Modalities
Motor learning
Stabilization activities
Postural strength/endurance
36
Q

Interventions for inflammatory conditions

A 
Local Modalities
Education
Joint moves Gr I and II
AROM in pain free range
Mobility classification when improved
37
Q

Interventions for Myofacial Conditions

A

Pt Education
Postural Training
Cervical Spine treatment
Deep neck flexor and scapular muscle strengthening

Musculoskeletal Rehab PT 514 (11 decks)

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