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DPT MSK - fall 22 > TMJ & Disorders > Flashcards

TMJ & Disorders Flashcards

1
Q

What are the 5 components of a synovial joint:

A

-synovial membrane
-fibrous capsule
-synovial fluid
-articular cartilage
-space

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2
Q

Temporal and mandible are _______ bones

A

condyle

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3
Q

TMJ disc is avascular except at ______ like other fibrocartilage

A

periphery

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4
Q

Functions of TMJ disc?

A

resists tension (primary)
resists compression (secondary)

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5
Q

TMJ has multiplanar movements. T or F

A

True

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6
Q

2 main muscles of the TMJ and where do they attach?

A

masseter and lateral pterygoid
attach to disc

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7
Q

The function of the masseter, lateral pterygoid, capsule condyle, and post. elastic ligament?

A

guides motion resists compression and provides stability

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8
Q

TMJ structures are MOSTLY innervated by what nerve?

A

Trigeminal N. branches

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9
Q

TMJ capsule is attached to:

A

mm. and disc

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10
Q

Ligaments that blends w/capsule prevent:

A

excessive motion

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11
Q

Resting or OPP of TMJ:

A

lips closed, teeth not touched, and tongue resting on roof of mouth
2mm overbite
2+mm overjet or overjet beyond overbite

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12
Q

CPP is _____________

A

unknown

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13
Q

Mandibular condyles may move ____________ OR ___________ directions

A

together in the same OR different directions

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14
Q

The condyle is convex-concave or concave-convex

A

convex-concave fossa -allows multiple functions

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15
Q

Motions of the TMJ:

A

depression, elevation, lat. deviation, protrusion, retrusion

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16
Q

Opening norms :

A

3 knuckles width

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17
Q

If only ≤ 1 knuckle, then:

A

urgent referral to dentist/oral surgeon

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18
Q

Opening: mandibular condyles glides_______ as mandible goes ________

A

anterior ; posterior

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19
Q

grinding and bilateral clicking on opening is abnormal. T or F

A

False; normal

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20
Q

Opening mm for TMJ:

A

digastric -main opener
lateral pterygoid
hyoids

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21
Q

Swallowing mm. for TMJ

A

hyoids - main movers
digatric- stabilize

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22
Q

Closing mm. for TMJ

A

temporalis
masseter
medial pterygoid
lateral pterygoid - pulls disc

23
Q

closing: mandibular condyle glide _________ as mandible goes __________

A

posterior ; anterior

24
Q

The Function of Lateral Deviation
mm.?

A

masseter
pterygoid -same side medial and lateral (primarily act to move mandible medial for grinding food)
temporalis

25
Q

S&S of TMJ Disorder:

A

Oral habit hx
Thumb sucking -overbite, change teeth position
Nail/ice biter - excessive compression force
Excessive teeth grinder -AM HA that goes away; if HA from neck it would get worse with ADL
Gum/smokeless tobacco chewer

26
Q

S&S of TMJ Disorder:
-Observation:
-_________ P! and/or __________
-Trigeminal S&S?

A

FHP
localized P!; crepitus
tinnitus, HA, toothache

27
Q

EARLIER deviation WITH loss of functional opening:

of capsular patterns?
acute w/recent trauma:

A

(2)
-deviation toward P!ful TMJ due to inflammation and willingness to move (ACUTE)

28
Q

EARLIER deviation WITH loss of functional opening

-chronic with fibrotic TMJ:

A

due to past trauma
-deviation away from hypermobile TMJ (click may happen @end range)
-accessory motion limited on side of deviation

29
Q

EARLIER deviation WITHOUT loss of functional opening

-hx of _______ resulting in ______
-minimal to no ______ unless ______
-deviation _________from ________ hypermobile side
-______ at end range hypermobile side indicates ____________

A

past trauma ; greater laxity
P! unless irritated
away from UNILATERAL
Click; larger displacement

30
Q

END RANGE deviation WITHOUT loss of functional opening

no ____ of trauma
minimal to no _____ unless irritated
gradual and less _______ developed BILATERALLY due _______

A

hx
P!
hypermobility ; FHP

31
Q

Click @ end range indicates ______________

A

larger displacement
-condyle + displacement has too much motion

32
Q

FHP influence
-increased tension and lengthening of:

A

digastric/hyoid mm. mouth opens
posterior elastic ligament

33
Q

FHP influence
-anterior mandibular condyle displacement to disc

A

excessive glide forward

34
Q

FHP influence:
- impaired ___________ of mm.

A

length tension

35
Q

FHP assessment:

A

opening in neutral and FHP should be the same
swallow in neutral and FHP; no excessive neck motion

36
Q

anterior displacement =

A

condyle ant. to the disc

37
Q

Hx of ant. displacement:

A

prolonged opening (FHP, mouth breather)
trauma w/sudden opening
excessive opening(yawning/dentistry)

38
Q

Ant. Displacement S&S:

A

full opening/nodeviation
likely P! and limitation on closing

39
Q

Ant. Displacement Rx:

A

distx w/ post. glide to reposition mandibular condyle post.

40
Q

Ant. displacement Rx: in hopes of reversing creep of capsule and ligament pt. should:

A

avoid wide opening with diet/yawning
correct posture
sleep with neck flexed and chin tucked

41
Q

TMJ MET focus:

A

stabilization of TMJ and neck

42
Q

Other clicks and signs of hypermobility: (3)

A

early clicking upon opening indicates - a small displacement

inconsistent clicking

reciprocal clicking (consistent) condyle moves ahead of the disc on opening and behind on closing

43
Q

crepitus =

A

TMJ and/or disc damage

44
Q

posterior displacement =

A

condyle posterior to the disc

45
Q

hx of post. displacement:

A

trauma w/ sudden closing

46
Q

S&S of post. displacement:

A

-likely P! and limitation on opening
-full closing

opposite of what creates the problem

47
Q

Posterior displacement Rx:

A

-distx with ant. glide to reposition mandibular condyle ant.
-sleep w/small neck roll for slight neck ext. and opening
-avoid excessive or hard chewing/grinding

48
Q

Possible cervical dysfunction relating to TMJ disorder is greater in the upper or lower cervical?

A

Upper

49
Q

General PT Rx for TMJ Disorder:

A

POLICED
Postural edu.
Oral habit modification
Diaphragmatic breathing training
Activity modifications -diet, motion, sleep)

50
Q

MT for TMJ:

A

JMs and neck hypomobility and displacement reduction

51
Q

MET for TMJ:

A

-typically isometrics, plus neck exercises
-practice resting and talking with cork in btw teeth

52
Q

Dentist and/or MD Rx for TMJ:

A

-Splints
-Orthodontics
-Sx

53
Q

The prognosis for TMJ:

A

very good if proper mechanics posture and breathing patterns restored

DPT MSK - fall 22 (18 decks)

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