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35 Cards in this Set
- Front
- Back
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What is special about the anatomy of the TMJ
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the only synovial joint in the cranium
- mandible is bi-convex |
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The temporal bone at the TMJ is _____ shaped
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saddle
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The meniscus is innervated at the _____. What is the movement? Describe its vasculature at force bearing zones ...
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- periphery
- translates anteriorly during depression of the mandible - aneural & avascular at force bearing zones |
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Infection, arthritis, gout, cancer & articular disc displacements are all examples of ...
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intracapsular dysfunctions
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What are some examples of extracapsular problems?
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myofascial pain of masticatory muscles - TMJD
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What are some common co-occuring problems with TMJD?
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nocturnal bruxism
subconscious jaw clenching w/anxiety/stress |
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T/F
TMJD can be caused by trauma |
true
can be direct (posterior capsule injury) or indirect - whiplash |
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What are malocclusions?
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deviation from normal contact of maxillary & mandibular teeth (overbite, underbite) - can cause TMJ
- 4 classes 1, 2a, 2b, 3 |
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What is a facial sign of hypocalcemia? Of the hand?
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Chvostek's sign - face spasm in rxn to dr touching facial nerve
Trousseau's sign (extnesion of interphalangeal joints/flexion of metacarpophalangeal joints) |
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What kind of developmental abnormalities can cause TMJD? Somatic?
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D- condylar hypoplasia/agenesis
S- temporal dysfunction & compensatory changes |
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T/F
TMJD is more common in men |
false
more common in young women - #2 cause of facial pain (HA #1) |
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Which muscles depress the mandible?
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digastric & suprahyoid
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Which muscles would move the mandible lateral & forward to the right?
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Left lateral & medial pterygoids
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Which muscles close the jaw tightly?
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temporalis, masseter, medial pterygoid
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Which muscle is necessary for a good blow job?
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buccinator
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1. This muscle protrudes the lower lip
2. draws down corner of the mouth 3. draws tip of chin upward |
1. depressor labii inferior
2. depressor anguli oris 3. mentalis |
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What do the following muscles do?
- orbicularis oris - zygomatic minor - levator anguli oris |
- approximates & compresses lips
- pretrudes upper lip - lifts upper border of lip on one side w/o raising later angle (snarl) |
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This muscle raises the lateral angle of the mouth
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zygomatic major
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Risorius muscle does this ...
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approximates lips & draws lips & corners lateral (grimace)
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A jaw click is almost always caused by ...
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disc displacement after it is stretched thin
also can be caused by adhesions, uncoordinated muscle movements, tears/perfs, osteoarthritis or occlusion imbalance |
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What are the symptoms of TMJD?
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cephalgia, otalgia, neck/eye/shoulder/back pain
jaw ache worse with chewing dizziness or tinnitus |
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T/F
50% of TMJD patients have nocturnal bruxism |
false
78% do |
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What is associated with a severely disturbed capacity for interpersonal relationships & poor prognosis in the TMJD patient?
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jaw clenching due to anxiety & psychosocial stress
high levels of disability, prolonged/excessive use of drugs & pre-existing psych disorders also ass with poor prognosis |
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What is the ROM for the TMJ?
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active -3-6 cm open, laterally 1-2 cm
passive -compare bilaterally - should be the same |
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Radiological examination is especially helpful for pts with TMJD - T/F?
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false
use when you suspect dental problems or severe sx that dont respond to conservative tx For TMJD MRI is the exam of choice - see disc shape (not pathognomonic) |
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What % of people with TMJD will have displaced discs?
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84% - however, 33% of people with displaced discs have no sx of TMJD
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What is the research diagnostic criteria for Group I, II & III?
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I - muscle disorders
II- disc displacement III- arthralgia OA, |
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Name some of the differential dx for TMJD
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inflammatory diseases, dental problems, lymphoproliferative disorders, migraine related disorders (carotodynia), neuralgias, parotid gland disorders
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What is Eagle's syndrome?
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an elongated styloid process
- a diff dx for TMJD |
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What are some of the tx for TMJD?
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- eliminate jaw stress (dental care, bite appliance, d/c chewing)
- correct structural imbalances (OMT to correct compensatory changes) - heat for muscles spasms - isometric jaw exercises - decrease stress (avoid stimulants, TENS unit, biofeedback, relaxation techniques) |
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Which TMJD treatment should be avoided in folks with sleep apnea?
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night time oral devices
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What medications are commonly prescribed for TMJD?
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- muscle relaxants
- NSAIDs (usually dont work) - narcotics (not indicated x/c severe trauma) - steroids (injection) - Botox injection |
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low level laser therapy is an effective treatment for TMJD
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False - no proven benefit
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Consider surgical correction as ..
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a last resort in cases of
- inflammatory arthritis, recurrent fibrosis, bony ankylosis, trauma, dev. abnormality, pathological lesion |
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Which surgical method is the most effective,
total meniscectomy, partial meniscectomy or arthroscopic lysis of adhesions |
all three are = effective
can also do total joint implantation - rare |
