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CD2203- Mod 5 > TMJ Pathologies > Flashcards

TMJ Pathologies Flashcards

1
Q

What does manual/manipulative approaches to TMJ improve

A
  • Increases aROM
  • mma decreases pain during active mouth opening
  • mma more effective than other conservative treatment methods for tx of TMD
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2
Q

Persistent TMD lasting 3-6 months is associated with what

A

associated with behavioural, psychological and psychosocial factors (depressive symptoms etc)

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3
Q

ratio of w:m seeking care for TMD problems

A

W:M 3:1-9:1

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4
Q

If a pt has pain with bitting vs full opening where is the pain likely to be

A

with bitting- likely intraarticular

full opening- likely extraarticular

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5
Q

What is the close packed pos, centric occlusion and median occlusion pos.

A

close packed- teeth slightly clenched, heads of condyle in post aspect of TMJ

Centric occlusion- max contact of teeth (pos where u are swallowing)

Median occlusion- Pos where teeth fully interdigitated

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6
Q

What is orthognathic, retrognathic, prognathic

A

orthognathic- straight line from bipupil line to tip of chin

Retroprognathic- Chin lies behind vert line

Prognathic- Strong chin

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7
Q

What is TMJ clicking due to

A

Clicking usually de to ant disc displacement

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8
Q

what are the 4 stages of TMD

A
  1. Incoordination phase
  2. ant disc displacement w/ reduction
  3. ant disc displacement w/o reduction
  4. disc adhesion
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9
Q

What occurs during the incoordination phase

A

Earliest indication of internal derangement

-no noise but a catching sensation is present

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10
Q

What occurs during ant disc displacement with reduction

A

Disc has slipped forward and click is heard during opening when condyle slips onto disc and reciprocal click when slips off the back condyle during closing

(1st click will be more audible)

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11
Q

What occurs during ant disc displacement w/o reduction

A

Disc is even further forward ant and condyle is unable to pass over it during opening
-local pain

-condyle rotates but does not translate

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12
Q

What is opening limited to in ant disc displacement w/o reduction

A

25mm (only rotates)

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13
Q

What is the most valid tool to ID disc positions

A

MRI

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14
Q

What is the most reliable tools for TMD dx

A

ROM (opening)
Dental stick test
Joint sounds test

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15
Q

What occus in stage 4, disc adhesion

A

limited opening due to adhesion of disc to articular eminence so only condylar rotation can occur
NO pain

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16
Q

When does closed lock occur

A

ant disc displacement w/o reduction

17
Q

What occurs in open lock

A

After the condyle moves over the posterior rim of the disc with opening, the disc moves posterior to the condyle and it may not allow the condyle to slide back.(stuck open)

18
Q

What is the normal lateral deviation measurement

A

normal is 10-15mm

19
Q

What part of the disc is more likely to undergo arthritis and what is some indicators of it

A

Inf surface is 3x more likely than sup

Females more likely, use auscultation (grating)

20
Q

What are some signs and symptoms of osteoarthritis

A

females beyond 40

  • unilat
  • Pain/tender jts + mm, fatigue, stiff, decreased ROM, no morning stiffness
21
Q

What proportion of people with rheumatoid arthritis have TMJ involvement

A

50-75% of pts w RA have tmj involvement

22
Q

S/S of rheumatoid arthritis of TMJ

A

deep, dull aching pain w/ limited ROM

-morning stiffness

23
Q

myofasical pain mc symptom and secondary symptoms

A

MC= pain

Secondary- chewing difficulties/ decreased ROM

24
Q

How to tell a muscular issue with ROM testing

A

compare max unassisted opening and maximum assisted (even if there is pain). If larger with assisted: suggests muscle limitation, if not greater think intracapsular.

25
Q

What all must be present to diagnose myofacial pain (3)

A
  1. Regional dull, aching pain (aggrevated by mandibular function)
  2. Hyperirratable sites (trigger points)
  3. Greater than 50% reduction in pain with vapocooant spray or local anesthetic injection
26
Q

What is synovitis

A

Inflammation of TMJ synovial lining

27
Q

What is capsulitis

A

inflammation of capsul-cant ddx from synovitis

28
Q

What is the diagnosistic criteria for synovitis and capsulitis (2)

A
  1. Localized TMJ pain exagerabated by function

2. No extensive OA changes with imaging

CD2203- Mod 5 (11 decks)

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