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S3- Musculoskeletal > TMJ Common Clinical Presentations > Flashcards

TMJ Common Clinical Presentations Flashcards

1
Q

DIFFERENTIAL

A

DIFFERENTIAL

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2
Q

What MSK conditions should we consider with the TMJ?

A
  • myofacial, internal derangement, degenerative arthropathy
  • intra-oral (dental)
  • c-spinie referral
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3
Q

What neurological condition should we consider with the TMJ?

A

Peripheral neuralgia

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4
Q

What vascular conditions should we consider with the TMJ?

A
  • cardiac referral (angina, MI)

- HA

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5
Q

What other conditions should we consider with the TMJ?

A
  • psychiatric
  • neoplasm
  • RA, inflammatory arthritis
  • developmental defect
  • infection
  • synovial disease
  • ankylosis
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6
Q

What are the 3 groups of TMJ disorders?

A

Group I (Masticatory Muscle Disorders)

  • Ia- with normal opening
  • Ib- with limited opening

Group II (Disc Displacements)

  • IIa- disc displacement with reduction
  • IIb- disc displacement without reduction and limited opening
  • IIc- disc displacement without reduction without limited opening

Group III (Joint Dysfunction)

  • IIIa- arthralgia
  • IIIb- osteoarthritis
  • IIIc- osteoarthrosis
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7
Q

In short, what are the 3 categories of TMD?

A
  • myofacial
  • disc displacement
  • degenerative/ inflammatory
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8
Q

GROUP 1 (MASTICATORY MUSCLE DISORDERS0

A

GROUP 1 (MASTICATORY MUSCLE DISORDERS)

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9
Q

What are the mechanisms of masticatory muscle disorders?

A
  • strain
  • overuse injury
  • centrally mediated pain
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10
Q

Strain is ______ and can be caused by ____________.

A
  • acute

- direct trauma

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11
Q

Overuse injury is ________ and can happen via __________ and ___________.

A
  • chronic
  • parafunctions (unconscious habitual)
  • guarding
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12
Q
  • Masticatory Muscle Disorders can result in reduced _______ and alter _________.
  • They can also result in _______ ________ with pain referral to the face, teeth, auricular area, temporal area, periocular area, and upper cervical area.
A
  • motion, occlusion

- trigger points

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13
Q

How will someone with Masticatory Muscle Disorder present during a physical examination?

A
  • Tenderness and increased turgor of muscles of mastication.
  • Aberrant motion pattern with AROM testing.
  • Limited ROM when stretching involved structure (painful at end-range).
  • Pain with resistance testing.
  • Pain with tongue depressor biting on ipsilateral side.
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14
Q

JOINT DYSFUNCTIONS (DISC AND ARTHROPATHY)

A

JOINT DYSFUNCTIONS (DISC AND ARTHROPATHY)

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15
Q

Category II = ___________

  • DDWR = ______________
  • DDWOR = ______________
A

Disc Displacements

  • Disc Displacement With Reduction
  • Disc Displacement Without Reduction
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16
Q

Category III = ________________

  • ___________
  • ___________
  • ___________
A

Joint Dysfunctions

  • arthralgia
  • osteoarthritis
  • osteoarthrosis
17
Q

What structures can be affected with Joint Dysfunction?

A

Disc, joint surfaces, capsule, ligaments, retrodiscal tissue, synovium.

18
Q

Joint Dysfunction mechanisms can be either _____ or ______trauma.

A
  • macrotrauma (acute)

- microtrauma (chronic)

19
Q

Joint Dysfunction can lead to muscle __________.

A

guarding

20
Q

What are the general findings with Group II (Disc Displacements) and Group III (Joint Dysfunctions)?

A
  • Preauricular pain commonly primary complaint.
  • Painful palpation of joint line.
  • Pain with tests that place compressive load on joint structures.
21
Q

DDWR

  • Audible and/or palpable ____________ (1/3 trials)
  • Is joint motion typically intact?

DDWOR

  • Report of ________ sensation with opening/closing?
  • Are there ROM limitations?
A
  • clicking
  • Yes, motion is typically intact.
  • catching
  • Yes, limitations in opening ROM.
22
Q

What are 2 pathomechanic deviations seen?

A
  • C-type curve

- S-type curve

23
Q

C-type Curve:

  • __________ displacement of a disc (ipsilaterally) without reduction or unilateral muscle hypomobility
  • Hypomobility of __________ joint.
A
  • Anterior

- Ipsilateral

24
Q

S-type Curve:

  • ________ imbalance or ________ displacement.
  • Condyle “______ ________ the disc”
A
  • muscular, medial

- walks around the disc

25
Q
  • Early deviation = _________

- Late deviation = ________/ tight __________

A
  • spasm

- capsulitis/tight capsule

26
Q

DDWR AND DDWOR

A

DDWR AND DDWOR

27
Q

Describe DDWR clicking and reciprocal clicking.

A

Clicking

  • Partial anterior displacement or dislocation of the disc in resting position.
  • Opening click indicates reduction of the disc as the mandibular condyle passes over the posterior border.

Reciprocal Clicking

  • Clicking occurs with closing
  • Condyle slips posteriorly over the anteriorly displaced disc.
28
Q

Describe DDWOR.

A
  • Disc is still anteriorly displaced like in DDWR, but the disc no longer reduces.
  • This can limit opening motion of the mouth.
  • Causes compression loading on retrodiscal lamina.
29
Q

OPEN LOCK, CLOSED LOCK, ARTHROPATHY

A

OPEN LOCK, CLOSED LOCK, ARTHROPATHY

30
Q

Describe an Open Lock at the TMJ.

A
  • The condyle moves over the anterior rim of the disc at max opening.
  • The condyle cannot move back past the disc and gets “stuck” in the open position.
31
Q

What muscles guard during an Open Lock?

A
  • Masseter

- Temporalis

32
Q

Describe a Closed Lock at the TMJ.

A
  • Involves a DDWOR.
  • Partial anterior displacement or dislocation of the disc.
  • Condyle unable to pass over the posterior border of the disc.
  • Cannot open mouth fully.
33
Q
  • Category III (Joint Dysfunctions) involve ____________ of the capsule, ligaments, retrodiscal tissue, and synovium.
  • What are the structural changes that can occur with Group III (Joint Dysfunction)?
A
  • inflammation

- degeneration, osteoarthritis, osteoarthrosis

34
Q

Does osteoarthrosis or osteoarthritis have an active inflammatory process?

A

Osteoarthritis

S3- Musculoskeletal (27 decks)

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