TMJ + posture Flashcards

1
Q

where do the condyles sit

A

mandibular fossa

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2
Q

what 2 structures surround the mandibular fossa

A

postglenoid tubercle
articular eminence

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3
Q

why is TMJ an ‘atypical’ synovial

A

surfaces are covered in fibrocartilage

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4
Q

deep layer fibers of fibrocartilage go __(parallel/perpendicular)___ to bony surface

A

perpendicular
(helps withstand stress)

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5
Q

superficial layer fibers of fibrocartilage go __(parallel/perpendicular)___ to bony surface

A

parallel
(helps with sliding)

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6
Q

where does the temporalis muscle attach

A

coronoid process

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7
Q

inferior TMJ function vs superior TMJ function

A

inf = hinge joint (rolling posterior during opening)

sup = plane joint (sliding anterior during opening)

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8
Q

which part of the disc is not innervated and not vascularized

A

anterior band
intermediate zone

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9
Q

what is the “open-packed” position of the TMJ?

A

mouth slightly opened, at rest

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10
Q

articular disc is made up of 3 things

A

collagen
proteoglycans
elastin

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11
Q

3 structures the articular disc of TMJ attaches to

A

medial/lateral poles of mandible condyle
lateral pterygoid anteriorly
bilaminar retorodiscal pad posteriorly

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12
Q

which part of the disc is vascularized and innervated

A

posterior band

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13
Q

3 ligaments of TMJ

A

TM joint
stylomandibular ligament
sphenomandibular ligament

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14
Q

which direction is the TMJ strongest

A

lateral

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15
Q

TM ligament resists (oblique/horizontal parts)….

A

oblique = limits downward + posterior motion/rotation

horizontal (inner) = resist posterior motion of condyle

MOST IMPORTANT FOR STABILITY

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16
Q

stylomandibular ligament resists….

A

protrusion (weakest tho)

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17
Q

sphenomandibular ligament resists …

A

forward translation (protrusion?)

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18
Q

osteokinematic motions of TMJ (6)

A

depression
elevation
protrusion
retrusion
L lateral deviation
R lateral deviation

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19
Q

arthrokinematic movements of TMJ

A

rolling
anterior slide
distraction
lateral glide

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20
Q

normal depression ROM in TMJ (fingers test and mm value)

A

40-50mm
2 fingers = functional
3 fingers = normal

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21
Q

2 movements of TMJ

A
  1. posterior roll of mandible
  2. anterior slide of condyle
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22
Q

t/f: there is no active contraction of the superior lateral pterygoid in TMJ depression

A

true, the inferior fibers may help but gravity does most of the work

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23
Q

is the depression of TMJ more passive or active

A

passive due to gravity

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24
Q

what structures help elevation of TMJ passively

A

elasticity of superior retrodisc lamina
sphenomandibular ligament

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25
what muscle eccentrically contracts to control posterior gliding and rotation of condyle in TMJ elevation
superior lateral pterygoid
26
what 3 muscles are involved in TMJ elevation
superior lateral pterygoid masseter temporalis
27
in jaw protrusion, is the superior joint or inferior joint more involved
SUPERIOR
28
retrusion is limited by which ligament
TM ligament
29
functional screen of lateral excursion
see if mandible can move full width of one of central incisors (one of the front 2 teeth)
30
in lateral excursion... ipsilateral mandibular condyle spins around a ____ axis vs contralateral mandibular condyle translates _____
ipsi = vertical contra = anteriorly
31
S vs C curve indications
C = one joint is not moving enough S = poor muscle movement control
32
cranial nerves involved with jaw movement
CN5, 7, 12
33
deflection
mandible moves away from midline during depression or protrusion
34
muscles of TMJ depression
digastric + suprahyoids lower lateral pterygoid GRAVITY is the biggest depressor
35
muscles of TMJ elevation
temporalis masseter medial pterygoid superior lateral pterygoid
36
muscles of TMJ protrusion
bilateral action of.. masseter medial pterygoid lateral pterygoid
37
muscles of TMJ retrusion
bilateral action of... temporalis assisted by anterior digastric
38
muscles of TMJ lateral deviation
unilateral, contralateral contraction of medial and lateral pterygoids temporalis ipsilateral
39
secondary muscles of TMJ (4)
digastric muscle (anterior belly) mylohyoid stylohyoid geniohyoid
40
2 deep cervical flexors
longus colli longus capitus
41
longus colli functions bi/unilaterally
bi = neck flexion uni = side bend with contralateral rotation
42
longus capitus funciton bi/unilaterally
bi = neck flexion uni = side bend with ipsilateral rotation
43
omohyoid links hyoid to which boney structure
scapula
44
which joint in the upper cervical spine is involved with TMJ
OA joint
45
Maximal Intercuspation
teeth are approximated occlusion position
46
what is a normal 'freeway space' in resting position between upper and lower teeth
1.5-5mm
47
what is the most common cause of capsulitis and synovitis in TMJ
rheumatoid arthritis
48
capsular fibrosis
overproduction of connective tissue leads to loss of tissue function + elicitation of pain
49
articular disc displacement with reduction
clicking during depression and elevation later the click --> more severe the dislocation
50
articular disc displacement without reduction
no clicking pain with chewing, talking, yawning posterior attachments overstretches + unable to relocate
51
where is COM when sitting
just below axilla
52
vision helps regulate what type of postural adjustment
anticipatory postural adjustment (APA)
53
3 main senses for balance and posture
vision vestibular somatosensory
54
most sway is observed in ___ direction
AP (anterior posterior)
55
anticipatory synergy adjustments (ASA) occur how many ms before planned movement
~250-300ms
56
ground reaction force (GRF)
force produced by ground in stance or during gate
57
joint reaction force (JRF)
occur at the joint as result of combined internal and external forces
58
center of pressure
represents a sum of all contact pressures in a single point of application
59
______ is used as a predictor for motor and cognitive development in infants/children
postural control
60
optimal posture defined in internal/external moment arms
internal moments are MINIMIZED by having external moments as SMALL as possible
61
optimal posture varies based on (4 things)
height age weight gender
62
line of gravity posture through the body
anterior to ear anterior to acromion midline of ilium middle of greater troch anterior to knee joint (posterior to patella) anterior to lateral malleoli
63
pelvic incidence
line from hip axis to midpoint of sacral endplate
64
sacral slope
angle creased by a line drawn parallel to sacral endplate (SI region) from the horizontal plane line
65
pelvic tilt
angle between horizontal plane line and line drawn between PSIS and ASIS
66
line of gravity in head
ear in line with clavicle just anterior to C2
67
alignment of eyes to ears
angled slightly above the ear
68
line of gravity through the hip
anterior to sacrum posterior to femoral head
69
forward headed posture ___(increases/decreases)___ freeway space
decreases!! the jaw protrudes more
70
line of gravity through the knee
anterior to condyle posterior to patella
71
line of gravity through the ankle
anterior to lateral malleolus
72
what muscle in the lower leg is considered a key postural stabilizer
soleus
73
4 common sitting postures
active erect sitting relaxed erect posture slumped sitting slouched sitting
74
meaning of "positive effects" from altered postures
protective; acute injuries
75
meaning of "detrimental" effects from altered postures
compensatory; chronic conditions
76
how is scoliosis named
direction and location of convexity
77
how is scoliosis three-dimensional
lateral bend with a rotation!!
78
hyperkyphosis is associated with
vertebral compression fractures
79
spondylosis
reduction of intervertebral disc heights and hypertrophy of facets/capsules/ligaments
80
spondylolistesis
superior vertebral body slips anterior to vertebra below it
81
forward head posture
upper cervical extension lower cervical flexion forward shoulders
82
hyperkyphosis
very rounded thoracic spine
83
swayback posture
increased lumbar lordosis and thoracic kyphosis
84
genu valgum
knock knees
85
genu varum
bow legs
86
genu recurvatum
hyperextension of knee over 10 degrees
87
pes planus
pronated/flat foot
88
pes cavus
supinated/high arch
89
hemiparesis
weakness or paralysis on one side of the body
90
Talipes Calcaneovalgus
their foot and ankle excessively bent up, where the toes are usually touching the shin
91
Talipes Equinovarus
"club foot" foot is twisted inward and downward
92
metatarsus adductus
the front half of the foot (forefoot) turns inward
93
claw toe
the toes curl downward
94
mallet toe
DIP is hanging down
95
hammer toe
PIP hyperflexion DIP hyperextension
96
what are the 2 movements the TMJ needs to do to open the jaw?
1. mandibular condyle rolls POSTERIOR in the inferior TMJ disc 2. it then slides ANTERIORLY with with the help of the superior TMJ disc
97
c curve movement
mandible moves away from midline when opening and then DOES NOT COME BACK TO CENTER
98
s curve movement
mandible moves away from midline when opening BUT THEN COMES BACK TO CENTER BY END ROM