TMJ

Question 1

Muscle actions:

1. Masseter
2. Temporalis
3. Medial Pterygoid
4. Lateral Pterygoid
5. Supra hyoid
6. Infrahyoid

Answer 1

1. B contraction is mandible elevation; unilateral is lateral excursion to same side
2. B elevates and retracts mandible; unilateral lateral excursion same side
3. B elevation and protrusion; unilateral Contralateral excursion
4. B protrusion; unilateral Contralateral excursion
5. Depression and retrusion of mandible
6. Stabilizes hyoid bone

Question 2

What are normal ROM for TMJ?

Answer 2

Depression: 40-45mm males, 45-50 females
Functional range: 35mm
Lateral excursion = 1/4 of opening
Protrusion: 6-9mm
Retrusion: 3mm

Question 3

What are the arthrokinematics of the TMJ during

1. Depression
2. Protrusion
3. Retrusion
4. Lateral excursion

Answer 3

1. Early phase posterior rotation of condyle dominates, late phase anterior translation dominates
2. Condyle and disk translate anterior and inferior
3. Disk translates posterior
4. Rotation of ipsilateral condyle and horizontal translation of Contralateral condyle

Question 4

What is the cotton roll test?

Answer 4

Bite on cotton roll on side of pain
If increased sxs, muscular
If decreased sxs, joint or disk

Question 5

What is temporal arteritis and what are signs/sxs?

Answer 5

Inflammation of vertebral and temporal artery, need ophthalmic referral
B or U HA, jaw claudication with pain and stiffness with chewing

Question 6

What is trismus?

What is treatment?

Answer 6

Closed-lock of jaw because B Masseter
Decreased opening (<25mm) TTP Masseter
Treatment: relax 1st with AROM with heat, resisted mouth opening can decrease spasms

Question 7

When does the ADDwD disk displace and reduce?

What is a good exercise for ROM

Answer 7

Reduces with opening

Open (click), protrude, close (no click), retrude (no click), repeat

Question 8

What are signs and sxs of myofascial pain syndrom of TMJ?

Answer 8

Multiple complaints of face pain, jaw pain, HA, joint noises, decreased opening, tinnitus, dizziness, earache, difficulty swallowing and speech
Affected by stress

Question 9

If TMJ is affected by posture, what type of mobility do we expect it to have?

Answer 9

Hypermobility >50mm

Question 10

What are signs of capsular involvement of TMJ?

Answer 10

C curve pattern with limited opening. C goes toward side of involvement
Lateral excursion limited to Contralateral side
Protrusion deviates to ipsilateral side