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MSK 2 Summer 2024 > Week 3 TMJ > Flashcards

Week 3 TMJ Flashcards

1
Q

TMD

A

Temporomandibular Dysfunction
- 20-40 y/o
- woman 4x more commonO

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2
Q

orofacial Pain

A

pain in the face and jaw/mouth region

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3
Q

Temporomandibular Dysfunction Contributing Factors

A
  • Microtrauma
  • Malocclusion
  • Cervical spine
  • hypermobility
  • Bad habits- bruxism (grinding teeth), mouth breathing, nail biting
  • Psychosocial factors- stress, anxiety, anger, depression
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4
Q

TMJ Anatomy review

A
  • 2 joint compartment superior/inferior
  • Inferior Joint space is where the roll and slide arthrokinematics happen
  • Superior Joint space is where the movement of translation happens
  • retro discal lamina (restraining ligaments) superior head of the later pterygoid attaches to it which helps give it stability during interior translation of the mandible
    Lateral ligaments give lateral stability to the joint
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5
Q

Arthrokinematics TMJ Protrusion

A

protrusion: condyle and disc translate anteriorly following the slope of the articular eminence.

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6
Q

Arthrokinematics TMJ Retrusion

A

retrusion: condyle and disc translate posteriorly following the slope of the articular eminence.

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7
Q

Arthrokinematics TMJ Lateral excursion

A

Lateral excursion: side to side translation of disc and condyle in fossa; occurs with slight rotation in horizontal plane

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8
Q

Arthrokinematics TMJ Depression

A

depression: when the mouth begins to open the condyle rolls in the fossa anteriorly; then the disc moves and the condyle slides anteriorly; limited by the superior retrodiscal laminae

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9
Q

Arthrokinematics TMJ Elevation

A

elevation: reversal of depression.

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10
Q

Muscles used in Protrusion

A

protrusion: masseter, temporalis, medial and lateral pterygoids

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11
Q

Muscles used for Retrusion

A

retrusion: temporalis; suprahyoids

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12
Q

Muscles used for depression of TMj

A

depression: lateral pterygoid; suprahyoid
elevation: masseter, temporalis, medial pterygoid

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13
Q

During elevation of the mandible….
(a) the superior retrodiscal laminae does what ?
(b) The superior head of the lateral pterygoid does what ?

A

a) pull on the TMJ disc to bring it back into the fossa
(b) controls the tension in the disc and it’s position during resisted closure of the jaw.

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14
Q

TMJ Norms
1. Opening
2. Lateral Excursion
3. Protrusion

A
  1. opening 43mm
  2. lateral excursion 9mm
  3. protrusion 7mm
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15
Q

DDwR
Disc Dislocation with Reduction

A
  1. Starts with a disc that is anteriorly positioned with respect to the condyle
  2. person is resting in a dislocated position and when the person begins to open their mouth and at some point the opening disc reduces and goes back into its normal position which is the top of the condyle YOU WILL HEAR A CLICK
  3. Person will continue to open their mouth normally with the disc reduced in its proper position on the condyle
  4. when the condyle is receding back toward the fossa right before maximal closing the disc slips anteriorly again
  5. YOU WILL HEAR ANOTHER CLICK BEFORE CLOSING FULLY where it goes back into the dislocated position
  • ROM grossly WNL
  • History of Hypermobility
  • Reciprocal Click
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16
Q

DDwoR
Disc Dislocation without Reduction

A
  • Disc remains anteriorly dislocated
  • NO CLICK
  • Hypomobile stage
  • 25-35mm opening
  • Decrease laterotrusion (doesn’t really cause ROM restriction)
  • deflected mandible with opening
17
Q

TMJ Hypermobility/Subluxation

A
  • Loud clunking/Popping/ pronounced sound
  • ” out of place feeling”
  • Excessive motion of lateral pole (palpable)
  • Unilateral - deviation to the contralateral side
  • opening greater than 50 mm
  • open locking
18
Q

TMJ Inflammatory Conditions

A
  • Capsulitis
  • Retrodiscitis
  • Arthritis
  • Prearticular pain without referral elsewhere
  • Tender lateral pole/posterior pole: can signal capsular involvement or retrodiscitis or posterior retrodiscal lamina inflammation if its posterior where the tenderness is
  • Positive TMJ loading- retrusive overpressure/contralateral pain with force biting
  • Mandibular mobility normal or slightly limited
  • No deflection or deviation
19
Q

Myofascial Disorders

A
  • Trigger points
  • positive ipsilateral forced biting test
  • Deviations in mandibular movements
  • Mild limitation of joint mobility
  • No clicking
20
Q

Overbite =

A

Is how far overlapping the top teeth are over the bottom teeth
- 3rd of the mandibular incisors height which is the bottom of the bottom of the teeth should be visible
- Is how far in the frontal plane

21
Q

Overjet=

A

When the top teeth are lined up further anteriorly than the bottome teeth- 3-6mm of overjet is acceptable
- More than 3-6 mm you should start to worry about malocclusion/ malalignment that could cause dysfunction in the joint

22
Q

C-Curve TMJ Deviation

A
  • Thought ot represent that there is some hypomobility
  • Internal derangement within the joint with reduction of the disc
  • more like an anterior dislocation with reduction scenario
23
Q

S-Curve TMJ Deviation

A

Thought to be a result of muscle imbalance or momentary disc locking that corrects and then finishes in a neutral position

24
Q

Deflection TMJ Deviation

A

Sign that the mandible is deviating towards the less mobile side because the side its deviating towards is not able to complete the rotation/translation it needs to
- The side that’s moving normally shows its shifts the whole mandible to the restricted side

25
Q

TMJ Rhythm

A
26
Q

What is the only measurement for TMJ to discriminate between those with and without TMD

A

Opening

27
Q

Rocabado 6x6 Exercise

A
  1. nasal Breathing- tongue to roof of mouth take 6 deep breaths
  2. controlled TMJ rotation on opening- opening with tongue on hard plate this limits protrusion
  3. Mandibular Rhythmic stabilization
  4. Upper cervical distraction: OA nodding
  5. Axial Extension of Cervical Spine (Chin tuck)
  6. shoulder girdle retraction (w/thor exten.)
28
Q

what is the Theory of Condylar “Remodeling”

A
  • idea is to normalize forces between disc and musculature
  • Co-contraction enhances stabilization
  • contralateral lateral deviation will gap and glide the condyle anteriorly on the eminence while the disc remains position correctly
  • Biting in this position creates a co-contraction of the musculature acting on the disc and facilitates stabilization

Activates these muscles:
- posterior temporalis
- deep masseter
- Superior lateral pterygoid

MSK 2 Summer 2024 (5 decks)

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