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Kines Exam 1 > TMJ > Flashcards

TMJ Flashcards

1
Q

What bones make up the TMJ?

A

Articulation of mandibular condyle and mandibular fossa of temporal bone

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2
Q

What is the purpose of the articular disc at the TMJ?

A
  1. Disc is biconcave allow convex surfaces to remain congruent throughout ROM
  2. Increases stability
  3. Minimizes loss of mobility
  4. Reduces Friction
  5. Decreases biomechanical stress
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3
Q

What kind of joint is the inferior TMJ?

A

Simple hinge joint

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4
Q

What kind of joint is the superior TMJ?

A

Functions as a gliding joint

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5
Q

What attaches to the articular disc?

A
  1. Medial/lateral poles of condyle
  2. Anteriorly - Joint capsule and lateral pterygoid
  3. Posteriorly - bilaminar retrodiscal pad
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6
Q

What does the superior lamina assist the disc with?

A

Assists the disc in translating anteriorly with mandibular depression

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7
Q

What does the inferior lamina do?

A

Limits forward translation

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8
Q

What is the make up of the joint capsule of the TMJ? Where is it strong? Where is it weak? How does those strength and weaknesses influence dislocations?

A
  1. Firm medially/laterally
  2. Thin and loose anterior/posterior
    - Allows for ant translation when mouth is open
    - Predisposes TMJ to ant dislocation due to lack of strength of ant capsule and the incongruence of articular surfaces
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9
Q

What are the ligaments of the TMJ? What purpose do they serve?

A
  1. Lateral lig - stabilize lateral portion of capsule
  2. Stylomandibular lig - weakest of 3
  3. Sphenomandibular lig - swinging hinge that suspends manidle
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10
Q

What is the normal resting position of the TMJ?

A
  • Lips closed and teeth several mm a part

- Maintained by temporalis muscle

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11
Q

]What are the different movements osteokinematically?

A
  • Depression/elevation
  • Protrusion/Retrusion
  • Left & Right lateral excursion
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12
Q

How and at which part of the joint does the first part of mouth opening occur?

A

Roll posterior in lower joint

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13
Q

How and at which part of the joint does the second part of mouth opening occur?

A

Glide ant in upper joint

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14
Q

How and at which part of the joint does the first part of mouth closing occur?

A

Glide post in upper joint

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15
Q

How and at which part of the joint does the second part of closing opening occur?

A

Roll posterior in lower joint

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16
Q

What happens with the articular disc during mouth opening and closing?

A

50% rolling in lower joint = disc remains stationary

50% gliding in upper joint = disc slides along with condyle

17
Q

How and at which part of the joint does protraction and retraction occur?

A

Protraction - anterior/slight inferior glide of condyle/disc

Retraction - post/slight superior glide of condylde/disc

18
Q

What happens with the articular disc during protraction and retraction?

A

Same as condyle

19
Q

What occurs on the ipsilateral side during lateral excursion?

A

Glide posterior (retrude)

20
Q

What occurs on the contralateral side during lateral excursion?

A

Glide anterior (protrude)

21
Q

What muscles and forces act on the TMJ during opening?

A
  • Primarily gravity
  • Digastric
  • Suprahyoids
  • Inferior lateral pterygoid
22
Q

What muscles and forces act on the TMJ during Closing?

A
  • Temporalis
  • Masseter
  • Medial pterygoids
  • Control of disc via superior lateral pterygoids
23
Q

What muscles and forces act on the TMJ during Protrusion?

A
  • Superior masseters
  • Medial Pterygoids
  • Lateral Pterygoids
24
Q

What muscles and forces act on the TMJ during Retrusion?

A
  • Post. Fibers: Temporalis
  • Deep Fibers: Masseter
  • Ant. Digastric (some help)
25
Q

What muscles and forces act on the TMJ during Lateral excursion?

A
  • Contralateral Med/Lat Pterygoid (pull condyle forward)

- Ipsilateral Temporalis (pull condyle posterior)

26
Q

What is the normal ROM for the different motions of the TMJ?

A
  1. Opening: 35-50 mm
    -(25-35 mm: needed for everyday activity)
    -Functional screen of mandibular depression
    2 knuckles=functional
    3 knuckles=normal
  2. Lateral deviation: 10-15mm
  3. Protrusion: 3-9 mm
  4. Retrusion: about 3 mm
27
Q

What is TMD?

A
  • Broad/vague term used to describe dysfunctions associated with TMJ
  • Includes pain, popping, reduced bite force, reduced ROM with mouth opening, headaches, tinnitus trigger points
28
Q

What factors are associated with TMD?

A
  • Stress/emotional disturbance
  • Daily oral parafunctional habits
  • Asymmetric muscle activity
  • Sleep bruxism
  • Chronic forward head posture
  • C-spine pathology
  • Sensitization of the CNS
29
Q

What is deviation of TMJ?

A

Motion that produces “S” curve with depression or protrusion

30
Q

What is deflection of TMJ?

A

Motion that produces “C” curve with depression or protrusion

31
Q

Describe what is occurring during mouth opening/closing when there is a disc displacement with reduction? Why is there a click? What is a reciprocal click?

A
  • Full opening
  • Disc sits anterior
  • Reciprocal Click: opening click as disc relocates, closing click as disc gets squeezed abnormally & subluxes anteriorly
32
Q

Describe what is occurring during mouth opening/closing when there is a disc displacement without reduction? Why is there not a click?

A
  • Closed lock/no clicking
  • Partial anterior displacement or dislocation
  • Mandibular condyle unable to pass over the posterior border of the disc with opening (disc remains bunched anterior to the mandibular condyle)
  • Disc does not relocate: Blocks translation and limits motion
  • Deviation toward painful side during opening
33
Q

How does posture and the cervical spine impact the TMJ?

A
  • may affect tension in cervical muscles which can influence the function of the mandible
  • Forward head = posterior/superior position -> greater stress on TMJ, lateral pterygoid contracture, anterior disk displacement

Kines Exam 1 (15 decks)

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