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Kinesio > TMJ Biomechanics > Flashcards

TMJ Biomechanics Flashcards

1
Q

How many joints comprise the TMJ

A

4

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2
Q

What are the 4 joints of the TMJ

A

2 rolling glide joints and 2 planar joints

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3
Q

What are the 2 rolling glide joints

A

Lower joints

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4
Q

What are the 2 planar joints

A

Upper joints

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5
Q

What does each TMJ consist of (3)

A
  1. Mandibular condyle
  2. Articular eminence of temporal bone
  3. Articular disc
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6
Q

What forms the hinge joint of the TMJ

A

Mandibular condyle and the inferior surface of the disc

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7
Q

What forms the plane/gliding joint of the TMJ

A

Articular eminence and superior surface of disc

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8
Q

What type of joint is the TMJ

A

Synovial joint

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9
Q

What type of cartilage does the TMJ have

A

Fibrocartilage

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10
Q

What does fibrocartilage allow for

A

Healing properties

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11
Q

True or False:

The TMJ is capable of being very strong and powerful, but very delicate and precise at the same time

A

True

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12
Q

True or False:

You will see lots of TMJ problems in the clinic

A

False

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13
Q

Is the articular disc of the TMJ free floating

A

Nope

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14
Q

What holds the disc in place

A

Anterior side: Lateral pterygoid superior head

Posterior side: Retrodiscal bilaminar tissue

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15
Q

How many layers of laminar rings does the retrodiscal tissue have

A

2

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16
Q

What is the thickness of the disc in the TMJ

A

Thick, thin, thick

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17
Q

Where is the thinnest portion always located

A

The middle of the disc

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18
Q

How do you palpate the coronoid process and temporalis

A

With the mouth open

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19
Q

Where is the coronoid process located when the mouth is closed

A

Under zygomatic arch

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20
Q

Is the mandibular fossa thin and translucent or thick and opague

A

Thin and translucent

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21
Q

Why is the mandibular fossa thin and translucent

A

Because no compression occurs there (Wolff’s Law)

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22
Q

What type of bone is the articular eminence

A

Trabecular

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23
Q

What orientation does the mandible and articular eminence have

A

Convex on convex

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24
Q

Where is the most fibrocartilage found in the TMJ disc

A

Articular eminence and anterosuperior condyle

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25
Q

How are the deep fibers aligned in the disc

A

Perpendicular

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26
Q

How are the superficial fibers if the disc aligned

A

Parallel

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27
Q

What is the shape of the articular disc of the TMJ

A

Biconcave

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28
Q

What is the configuration of the TMJ joint

A

Convex condyle on concave inferior disk and concave superior disc on convex articular eminence

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29
Q

Is the disc firmly attached to the capsule medial and lateral

A

No

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30
Q

What does the disc not being attached firmly to the capsule allow

A

Free rotation of disc with condyle

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31
Q

What does the lateral pterygoid restrict

A

Posterior translation

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32
Q

What does the bilaminar retrodiscal tissue restrict

A

Too much anterior translation of the disc

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33
Q

Are the bilaminar retrodiscal tissues or lateral pterygoids tense when the TMJ is at rest

A

Negative

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34
Q

What happens to the disc when you close your mouth

A

It shifts ever so subtly anteriorly or posteriorly

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35
Q

Why does the disc shift at rest

A

For repair

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36
Q

What is the thickness of the disc anteriorly, posteriorly, and middle

A

Anterior: 2mm
Posterior: 3mm
Middle: 1mm

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37
Q

True or False:

The anterior and posterior portions are vascular and neural

A

True

38
Q

True or False:

The middle portion is avascular and aneural

A

True

39
Q

What are the 3 functions of the articular disc

A
  1. Increased congruency of joint surfaces
  2. Shape allows for greater flexibility of disc
  3. Thick, thin, thick provides self centering mechanism
40
Q

What does greater flexibility of the disc allow for

A

To conform to the bony surfaces with rotation and translation arthrokinematics

41
Q

If you increase pressure how does the disc rotate

A

So the thin portion is between the articulating surfaces

42
Q

If you decrease the pressure how does the disc rotate

A

To either wider portion

43
Q

What are the muscles that act on the TMJ (6)

A
  1. Anterior digastric
  2. Posterior digastric
  3. Medial pterygoid
  4. Lateral pterygoid
  5. Temporalis
  6. Masseter
44
Q

What are the muscles that cause mandibular depression (3)

A
  1. Inferior head of lateral pterygoid
  2. Anterior digastric
  3. Posterior digastric
45
Q

What is the norm for mandibular depression

A

40-55mm

46
Q

What happens to the superior head of the lateral pterygoid during depression

A

Goes on slack

47
Q

How do the anterior and posterior digastrics cause mandibular depression

A

Posterior digastric contracts isometrically and anterior digastric contracts concentrically

48
Q

What muscles cause mandibular protrusion (3)

A
  1. Massester
  2. Medial pterygoids
  3. Lateral pterygoids
49
Q

What muscles cause mandibular retrusion (2)

A
  1. Posterior temporalis

2. Anterior digastric

50
Q

What muscles cause mandibular lateral deviation (3)

A
  1. Ipsilateral temporalis
  2. Ipsilateral lateral pterygoid
  3. Contralateral medial pterygoid
51
Q

What is the axis of rotation during lateral deviation

A

Ipsilateral condylar process

52
Q

What is a force couple

A

Parallel and opposite direction of forces that cause rotation

53
Q

What are the arthrokinematics of mandibular depression

A

Initial anterior roll followed by anterior inferior translation of the disc and condyle

54
Q

During mandibular depression when does the anterior ad inferior translation occur

A

Near full opening

55
Q

How does the ICR shift during mandibular depression

A

Anteriorly

56
Q

How much of the mandibular depression comes from the condyle rotation

A

11-25mm

57
Q

Where does the rest of the mandibular depression come from

A

Disc and condyle translating

58
Q

What does the muscle being adaptively shortened limit

A

Agonist direction

59
Q

What does the muscle being organically weak limit

A

Antagonist direction

60
Q

True or False:

You should have compression loading of tissues

A

False

61
Q

What do we as PTs enhance the roll or the translation

A

The translation

62
Q

What are the arthrokinematics of mandibular elevation

A

Initial posterior and superior translation of disc and condyle followed by posterior roll of condyle

63
Q

How does the ICR shift during mandibular elevation

A

Posteriorly

64
Q

What are the arthrokinematics of mandibular protrusion

A

Bilateral condyle translation anterior and inferior

65
Q

What are the arthrokinematics of mandibular retrusion

A

Bilateral condyle translation posterior and superior

66
Q

What is the norm for mandibular protrusion

A

6-9mm

67
Q

What is the norm for mandibular retrusion

A

3mm

68
Q

What are the arthrokinematics of mandibular retrusion from neutral

A

Posterior translation

69
Q

What is the norm for mandibular lateral deviation

A

8mm

70
Q

What is the normal “freeway” when the mandible is in the resting position

A

1.5-5mm

71
Q

What does firm approximation of the upper and lower teeth equal

A

Occlusal position

72
Q

What is another name for an occlusal position

A

Bruxated position

73
Q

What does the resting position allow for

A

Decreased intra-articular pressure and stress on articular structures

74
Q

What happens with forward head overtime

A

Mandible will depress and retrude

75
Q

What is bruxism

A

Grinding teeth

76
Q

What are 5 ways to injure the TMJ

A
  1. Direct trauma
  2. Poor posture or oral habits
  3. Reciprocal click
  4. Locking
  5. Osteoarthritis
77
Q

What causes a reciprocal click

A

Anteromedial displacement of the disc

78
Q

When do the clicks occur

A

First during opening and second during closing

79
Q

What causes the 1st click

A

Condyle contacting the anteromedially displace disc

80
Q

What causes the 2nd click

A

The condyle leaving the anteromedially displaced disc during closing

81
Q

What does an early click signify

A

Less anteromedially displaced disc

82
Q

What does a late click signify

A

More anteromedially displaced disc

83
Q

What happens during locking

A

Only roll occurs

84
Q

Does anterior or posterior translation occur with locking

A

Not at all

85
Q

Which way is the disc displaced during locking

A

anteriorly

86
Q

What causes close locking

A

Disc is anteriomedial to the condyle

87
Q

What are the symptoms of closed locking

A

Cannot open mouth fully

88
Q

What causes open locking

A

Disc is posterior to the condyle

89
Q

What are the symptoms of open locking

A

Cannot close mouth fully

90
Q

Is OA of the TMJ usually bilateral or unilateral

A

Unilateral

91
Q

Motivation

A

Just keep swimming. Just keep swimming. Just keep swimming swimming swimming

Kinesio (11 decks)

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