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4th year > OS- TMD > Flashcards

OS- TMD Flashcards

1
Q

What provides blood supply to muscles surrounding the TMJ?

A

Deep auricular artery

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2
Q

Describe the movements of the TMJ?

A

Rotational movement- in the mandibular fossa
Translational movement-past the articular eminence.

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3
Q

Label the muscles associated with the TMJ

A
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4
Q

Name the general nerve supply to the muscles associated with the TMJ?

A

Mandibular branch of the trigeminal nerve.

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5
Q

Why do patients with tmj problems also feel pain in the ear?

A

Because a branch of the mandibular nerve supplies the ear (auricular temporal)

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6
Q

What causes TMJ dysfunction?

A

Physiological
Macrotrauma (a sudden incident)
Microtrauma (repetitive chronic overload of TMJ)

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7
Q

What is the myofascial pain that a patient with tmj problems presents with ?

A

Inflammation of the muscles of mastication or the TMJ

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8
Q

How do parafunctional habits cause myofacial pain?

A

Parafunctional habits cause repetitive chronic overload of the TMJ. This causes excessive spasm of the lateral pterygoid.

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9
Q

How does articular disc displacement occur?

A
  1. Increased pressure in the joint causes the articular disc to slip in front of the condyle (while mouth is closed)
  2. Disc blocks the movement of the condyle when the patient tries to open their mouth.
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10
Q

Why does the patient feel pain when the articular disc slips forward?

A

Because the bilaminar zone is stretched forward (has nerve innervation) to be crushed by the condyle.

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11
Q

Compare the two types of anterior displacement of the TMJ?

A

Anterior displacement with reduction- The condyle pops onto the disc to open and will pop back onto it to close.
The bilaminar zone is still pulling the disc back into place.

Anterior displacement without reduction- When we don’t adress the problem early enough. The bilaminar zone is no longer pulling the disc back (it stays infront of the condyle)

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12
Q

What are signs of anterior disc displacement with reduction?

A
  • A clicking noise.
  • Jaw tightness and jaw locking (impairement of movement for a short period of time)
  • Initial deviation of the mandible before returning to the midline.
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13
Q

What is crepitus?

A

A crunchier/grating sound that can be indictive of a degenerative joint change.
The sound is caused by the degnerated disc/joint rubbing against each other.

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14
Q

What is chronic recurrent dislocation of the joint

A

This is when the TMJ joint regularily dislocates (condyle is infront of the articular eminence and cannot move back)

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15
Q

How can akylosis of the tmj cause dysfunction?

A

The Condyle is fused to the skull so cannot move.

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16
Q

How can hyperplasia of the tmj cause dysfunction?

A

One condyle has grown more than the other- causing facial asymetry & the jaw pointing more to one side.

17
Q

What does the time of jaw pain indicate?

A

If pain is in the morning- bruxism.
If pain is throughout the day- it is a habit.

18
Q

List some intra-oral signs of parafunctional habits.

A

Linea alba
Tongue scalloping
Cheek biting
Occlusal non-carious tooth surface loss.

19
Q

Compare clenching and grinding

A

Clenching- bringing the teeth together
Grinding- bringing teeth together and movement

20
Q

List some differential diagnoses for tmj problems.

A

Dental pain
Sinusitis
Ear pathology
salivary gland pathology
Headache
referred neck pain
Atypical facial pain
Trigeminal neuralgia.
Condylar fracture.

21
Q

How do we treat patients with TMJ dysfunction?

A

Education
Physical therapy
Splint
Medications

22
Q

How do we educate the patient on TMJ dysfunction?

A

Cause
How to prevent pain:
Soft diet
Masticate bilaterally
No chewing gum
Don’t incise foods
Cut food into small peices
Stop parafunctional habits
No wide opening
Support mouth on opening (e.g. yawning)

23
Q

How can TMJ dysfunction be treated using physical therapy?

A

Physiotherapy
Massage/heat
Acupuncture
Hypotherapy
Relaxation

24
Q

How can splints help with tmj dysfunction?

A
  • They eliminate occlusal interferences (stabilise).
  • Act as a habit breaker
  • Reduce the load on the TMJ and relax it.
  • Improve the function of the mastigatory muscles.
  • Decrease abnormal activity
  • Protect the teeth in case of tooth grinding.
25
Q

What medications can be used for treatment of TMJ dysfunction?

A

NSAIDs
Muscle relaxants
Tricyclics
Antidepressants
Botox (paralysis reduces clenching habits)
Steroids.

26
Q

How do we treat patients with trismus due to trauma?

A

If there is no resolution after acute phase- Rehabilitate to allow patient to open their jaw again. We want to stretch the muscles open.
Jaw screw
Therabite.

27
Q

What is a closed lock?

A

When the jaw is locked closed. This can be due to anterior displacement without reduction or other problems limiting mouth opening e.g. severe trismus.

28
Q

Describe anterior movement of the articular disc.

A

The front part of the articular disc is attached to the lateral pterygoid muscle. Everytime the lateral pterygoid contracts the articular disc is pulled anteriorly.

29
Q

How does the articular disc move posteirorly?

A

The bilaminar zone is the anterior part of the articular disc.
It is attached to the posterior of the condyle and the posterior of the eminence.
It is formed of collagen fibres & is elastic to bring the disc back.

30
Q

How do you palpate the Lateral pterygoid

A

You palpate the pterygoid plate (This is one of the attachments of the lateral pterygoid muscle)
It is found behind the maxillary tuberosity.

31
Q

What is an anthrogram?

A

A type of imaging test to look at joints where we inject radiographic material into the inferior and superior compartments of the TMJ

32
Q

What is an arthroscopy of the TMJ

A

Use of a microscope to investigate the superior compartment for any perforations or damage.

33
Q

What is athrocentesis of the TMJ?

A

When you inject into the superior compartment to wash the joint & increase lubrication.

Used for patients with anterior dislocation without reduction.

34
Q

What surgical treatments can be used for TMJ dysfunction?

A

Disc plication- moving the articular disc to the correct position.
Eminectomy- removal of the eminence
Menisectomy- removal of the disc completely.

4th year (51 decks)

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