TMJ / Breathing Flashcards
What is the only joint in the body that has equal movement in rotation and translation?
TMJ
What movement occurs in the superior compartment, divided by the disk?
gliding; hinging and rotation occurs in the inferior compartment
What bony parts make up the TMJ?
fossa of temporal bone articulates with the condyle of the mandible
What muscles do retrusion?
temporalis and suprahyoids (pull mandible up)
What are the osteokinematics for protrusion?
anterior translation, some rotation, mandible slightly goes down
How can poor posture affect TMJ?
poor posture tugs forward omohyoid (which is attached to scapula), which tugs on hyoid, affecting TMJ
What osteokinematics occur with L lateral excursion?
- ipsilateral side (L) acts as a pivot (only rotation occurs)
- contralateral side (R) moves in an anteriomedial direction via BOTH translation and rotation
What is the order of translation and rotation for depressing mouth? elevating mouth?
depressing mouth = rotation then translation
elevating mouth = translation then rotation
What must happen to the lungs during inspiration, involving Boyle’s law?
THORACIC CAVITY: P decreases, V increases
- for inspiration, they need to go from high to low pressure (for air to come in)
- to do this, we need to manipulate volume (needs to increase)
How do we expire naturally? Forcefully?
P must increase, V must decrease
- expiration is a passive event: alveoli recoil without much work on our part
- forced expiration involves abs and intercostals to push air out, like during exercise
What happens to the diaphragm during breathing?
- inspiration = diaphragm contracts and lowers, which increases volume
- expiration = diaphragm relaxes and raises, decreasing volume
What two bony articulations make the T-spine so stable?
- tubercle of rib to the transverse process of T-vert
- head of the rib to the vertebral body
What two pieces make up the sternocostal joint? What kind of movement is allowed here?
1) costochondral = rib to cartilage, little to no movement
2) chondrosternal = some gliding here
What is the main issue with COPD?
they can get air in, but they can’t get it back out
- alveoli broken down, won’t passively recoil
- their chest will change shape b/c they’re working so hard to get air out: “barrel-chest”
What happens to the diaphragm over time with COPD?
- the residual volume in the lungs continues to increase (b/c you can’t get it out), which flattens the diaphragm and rearranges the fibers
- now it’s not a good inspiratory muscle b/c it won’t pull as efficiently, so these people have issues breathing IN now, as well as out
What is the normal tidal volume during normal breathing?
~500mL
What is vital capacity?
inspiratory capacity + tidal volume + expiratory capacity
- does NOT include residual capacity
How does total lung capacity differ from vital capacity?
total lung capacity includes everything that vital capacity does, but also includes residual lung capacity (that dead air we can’t get out)
What should we teach low back pain pts with breathing?
teach them proper breathing techniques:
- you want your stomach to expand more than your chest
- breathe in through nose, out through mouth
What pts may demonstrate shallow breathing?
- these pts have no deep breaths
- could be from a pulled intercostal muscle, heart failure, infection
What 3 diameter changes increase the volume for the lungs during inspiration?
1) vertical diameter change via diaphragm lowering
2) pump handle via ribs 2-5, increases ant/post diameter
3) bucket handle via ribs 7-10, increases lateral diameter
How are the ribs able to expand in the bucket and pump handle?
there’s movement at the sternocostal joint by the work of the external and internal intercostals, which move the ribs
What are the muscles of ventilation?
external and internal intercostals, as well as diaphragm
Parasternal and interosseus intercostals are what kind of intercostals? What do they do?
internal intercostals
- parasternal = close in alignment w/ ext. intercostals, aka interchondral; do inspiration
- interosseus = run in a different angle and do forced expiration, depress ribs
What muscles elevate the ribs?
external intercostals, and parasternal intercostals assist
What are the three types of dysfunctional breathing?
1) accessory breathing = using more muscles, especially during expiration
2) chest breathing = using more chest than diaphragm
3) shallow breathing = no deep breaths, can be due to disease or pulled intercostal
What muscles can be used in accessory breathing?
abdominals, sternal head of pec major, scalenes
- bring your arms up behind your head or anchor on knees to allow better breathing via pec
What occurs in paradoxical breathing?
- chest goes in while abdominals go out; not in sync
- some muscles are intact, some not
What is flail chest?
- when the abs and intercostals are moving but the ribs are not; may look like they’re going in
- ribs are likely fractured due to trauma aren’t aren’t working, leaving abs and intercostals to do all the work, which is inefficient
What kind of breathing issue would a SCI cause for a pt?
could cause paradoxical breathing if diaphragm is intact but abs/intercostals aren’t
- this would make the chest go in while abdominals go out
