TMJ Flashcards

1
Q

what sort of cartilage are the TMJ and disk covered in?

A

fibrocartilage

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2
Q

in which cavities do rotation and translation occur in?

A

rotation occurs in inferior cavity; translation occurs in superior cavity

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3
Q

which portion of the disc is aneural?

A

the intermediate (middle)

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4
Q

what are the unilateral and bilateral contraction results of the masseter?

A

uni: slight lateral deviation to same side
bi: elevation of mandible

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5
Q

unil and bil contraction results of temporalis?

A

unil: deviation to same side
bi: elevate and retract mandible

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6
Q

unil and bil contraction results of lat pterygoid?

A

unil: contralateral excursion
bil: protrusion

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7
Q

action of suprahyoid muscles?

A

depression and retrusion of the mandible during closing

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8
Q

infrahyoid muscle action?

A

stabilize hyoid bone to form a firm base for the suprahyoids

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9
Q

unil and bil function of medial pterygoid

A

unil: contralateral deviation
bil: elevation and protrusion

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10
Q

normal ROM for depresion is…

A

between 40-45 mm for males and 45-50 mm for females

approx 4 fingers width of the nondominant hand

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11
Q

functional ROM for depression is…

A

~35 mm or 3 fingers width

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12
Q

normal lateral excursion is…

A

1/4 of opening range

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13
Q

normal protrustion and retrusion are…..

A

6-9 mm protrusion; 3 mm retrusion

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14
Q

key findings in ADDwoR

A

no clicking noise during opening/closing with possible limited opening (disc blocking condylar head) or no limitation opening (disc completely displaced anteriorly)

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15
Q

key findings in ADDwR

A

click on both opening and closing (clicks on to the disk in opening and off the disc in closing)

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16
Q

diff between overbite and overjet?

A

overbite: how much overlap there is between the top teeth and bottom teeth (top to bottom measurement)
overjet: how the top teeth are in front of the bottom teeth (front to back measurement)

17
Q

what do a C curve and S curve usually represent?

A

C curve = capsular pattern, S curve = lack of motor control

18
Q

what is deflection?

A

mandible deflects to one side without returning to center at end range (usually occurs when a disk is anteriorly displaced)

19
Q

what are the 3 classes of occlusion?

A

1: normal
2: excessive overjet (over 6mm) - the layman’s “overbite”
3: underbite

20
Q

what is the most prevalent cause of TMD?

A

myofascial pain disorder (complete with trigger point referral patterns)

21
Q

conditions that can be associated with TMD?

A

HAs, Ear sx, Vertigo, swallowing/speech difficulty, psychological affect, trigeminal neuralgia, temporal arteritis, atypical odontalgia (phantom tooth pain), post-herpetic neuralgia (herpez zoster), meniere disease

22
Q

what is temporal arteritis?

A

subacute inflammation of the superficial temporal artery and the vertebral artery - causes severe unilat or bilat headache or scalp-temporal artery region; jaw claudication with pain/stiffness during chewing is indicative of this - must refer for ophthalmologic eval

23
Q

what clinical findings may indicate nocturnal bruxism?

A

scalloping of the tongue or irregularity on the buccal tissues

24
Q

which muscle of mastication is not palpable?

A

lateral pterygoid

25
Q

describe the cotton roll test

A

the pt bites down on a cotton roll with back molars on the side of the complaint; if pain increases, the cause of sx may be muscular in origin - if pain decreases, the cause may be joint related; then have them bite on the cotton roll with the opposite molars - if it is joint pain; then the pain will increase

26
Q

what is trismus?

A

an acute closed lock (usually caused by spasm of masseter after prolonged jaw opening such as is needed after a dental procedure)

27
Q

how can myofasical pain disorder be dx’d?

A

palpation of trigger points, pt sx, and release of sx with the spray and stretch technique

28
Q

how often is the rocobado 6x6 program supposed to be carried out?

A

every 2 hrs regardless of sx

29
Q

describe the spray and stretch technique

A

put the irritated muscle on stretch - spray ethyl-chloride or fluori-methane vapo coolant spray from 24 cm away at a rate of 10 cm/sec about 4 times; then warm the muscle with your hands and apply further stretching

30
Q

specific interventions for Ant disc displacement

A

pt education about proper head/neck/jaw position, avoidance of parafunction and clicking/popping of the joint, modalities, exercises (condylar remodeling, practicing closing the mouth along a protruded path once the disk is reduced); mobilization

31
Q

describe the condylar remodeling exercise program

A

surgical tubing b/w incisors - deviate laterally to contralateral side of symptomatic joint; many phases of progression including adding a bite, then adding protrustion, then rhythmic stabilization

32
Q

what is a good joint mob for restoring an anteriorly displaced disc?

A

longitudinal distraction, add ulnar deviation of the hand then go into anterior translation

33
Q

when would you recommend a stabilization splint vs an anterior repositioning splint?

A

stabilization splint: intended to relax masticatory muscles (appropriate for ADDwoR); anterior repositioning splint: for ADDwR and is required to be worn 24 hours a day