Cervical Spine and TMJ Flashcards by natalie brown

Objectives

9: Differentiate among ROM, AAROM, AROM and FROM
11: Perform PROM on the trunk, UEs and Cspine
12: Measure functional, active, and passive ROM with a goniometer and accurately record
13: Discuss manual muscle testing principles
14: Recognize a variety of muscle strength scales used in PT
15: Demonstrate accurate technique for performing manual muscle tests
16: Interpret results from a manual muscle test

fyi

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shaped like a horseshoe and it articulates with the temporal bone.

The mandible or mandibular bone

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located between the body and the ramus, it is the joining point of these two landmarks

Angle

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the horizontal portion of the mandible,
the superior surface holds on to the lower teeth.

Body

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it is the posterior projection on the ramus and directly articulates with the temporal bone

Condyle

also called the condylar process

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located on the interior side (inside) of the mandible near the midline and is the attachment of the geniohyoid muscle

Mental spine

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just inferior to the condylar process.

Neck

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located between the condyle and coronoid process on the ramus

Notch

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the vertical portion of the mandible from the angle to the condyle

Ramus

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located on the side of the skull posterior to the zygomatic bone and is inferior to the parietal bone, posterior to the greater wing of the sphenoid bone and anterior to the occipital bone

Has both convex and concave joint articulations

The middle is concave and the anterior and posterior tubercles are convex

Temporal bone

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makes up the anterior portion of the articulating temporal bone
it connects with the zygomtic process to make the bridge.

Articular tubercle

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lies anteriolyr to the external auditory meatus and articulates with the condyle of the mandible

Articular fossa

aka, the mandibular fossa

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a slender projection positioned downward and forward from the temporal bone on the inferior, slightly interior surface

Styloid process

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bony prominence posterior and inferior to the ear

Mastoid process

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the external opening to the ear, posterior to the TMJ

External auditory meatus

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Makes up the posterior portion of the zygomatic arch

Zygomatic process

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this attaches on the neck of the mandible condyle and disk, and then runs speriorly to the articular tubercle of the temporal bone
limits downward, posterior and lateral motions of the mandible

Lateral ligament or temporomandibular ligament

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The ligament that attaches to the spine of the sphenoid bone and runs to the middle of the ramus on the internal surface of the mandible. I suspends the mandible and limits excessive anterior motion.

Sphenomandibular ligament

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This ligament limits excessive anterior motion of the mandible.

Stylomandibular ligament

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almost parallel to the digastric muscle. (k we don’t know what muscle that is but it runs parallel to it )

It attaches to the styloid process of the temporal bone and goes to the hyoid bone. helps hold the hyoid bone in place.

Stylohyoid ligament

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envelops the TMJ

Joint capsule

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similar to articular disks every where in the body. It is connected circumferentially to the capsule and tendon of the lateral pterygoid.

Articular disk

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This joint will be tested as convex on concave when the lower jaw is moving.

What are the 5 motions ?

Elevation of the mandible
Depression of the mandible
Deviation of the mandible
Protrusion of the mandible
Retrusion of the mandible

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YOU WILL BE RESPONSIBLE FOR THE FOLLOWING MUSCLES AND THEIR OIAN’S

Temporalis
Masseter
Medial/Lateral Pterygoids

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dorsal -Curvatures of the spine Please note, this is NOT arthrokinematic movement of the spine

1. Cervical – Concave 2. Thoracic – Convex 3. Lumbar – Concave 4. Sacral – Convex

a small, smooth, flat surface on the bone * they are found in the thoracic spine at the point of contact at a rib

Facets

The curves of the spine provide stability as if the spine were a straight rod, the spine would not be stable at all * In fact, the strength is \_\_\_\_\_\_\_times what it would be if the spine were straight

10x

this is the articulation between the superior articular process with the inferior articulate process of the vertebra above

A facet joint

Motions occur in all three planes of motion in the spine

Flexion/extension Abduction/adduction (side bending) Rotation

Motion at the Occiput and C1 is called?

the atlanto-occipital joint * Main motion is flexion and extension

Most of the lateral flexion and rotation in the spine occurs where?

at C1 and C2 or the atlanto-axial joint

Muscles that have the most influence on O/C1 and C1/C2 are what ?

* prevertebral muscles anteriorly * suboccipitals posteriorly

Tucking your chin and neck extension is cervical ?

retraction

Extending your head and flexing your head is cervical what? It’s the pigeon bob – forward is protraction, backwards is retraction

protraction

The skull is made up of how many bones? luckily, we will only be talking about the ones that articulate with the spine

posterior inferior part of the cranium

Occipital bone

small prominance in the center of the occiput Wisdom notch

Occipital protuberance

ridge running horizontally along the back of the head from the occipital protuberance to the mastoid process

Nuchal line

base or inferior portion of the occiput Remember the basilar artery?

Basilar area

opening in the occipital bone?

Foramen magnum

located laterally to the foramen condyle, bumps that provide articulation with C1

Occipital condyles

forms part of the base and lateral inferior sides of the cranium

Temporal bone

cylindrical mass of cancellous bone, the anterior portion of the vertebra and the major weight bearing portion of the column

Body

the vertebral arch

Neural arch

opening formed by joining the body and neural arch

Vertebral foramen

portion of the neural arch just posterior to the body and anterior to the lamina

Pedicle

formed at the union of the lamina and pedicle, these are the lateral projections of the arch

Transverse process

depressions located on the superior and inferior surfaces of the pedicle

Vertebral notches

opening formed by the superior vertebral notch of foramen, vertebra below and the inferior vertebral notch of the vertebra above

Intervertebral foramen

projecting superiorly and inferiorly off of the posterior surface of each lamina

Articular process

the most posterior projection on the neural arch

Spinous process

an Intervertebral disk outer portion of the disk that serve to contain the nucleus pulposus

Annulus fibrosis

Intervertebral disk pulpy, gelatinous substance with a high water content in the center of the disk * Birth 80% decreasing to 70% by age 60

Nucleus pulposus

the cranium rests here, ring shaped and has no body or spinous process. Anterior arch – anterior portion of C1

Atlas – C1

the second cervical vertebra, has a pivot that supports the head Odontoid process/Dens – vertical projection that articulates with C1

Axis – C2

long and prominent spinous process, resembles a thoracic verteba

Joints to familiarize yourself with fyi * Atlanto-occipital joint * Atlantoaxial joint – synovial articulation between the odontoid and the anterior arch of C1 * Lateral atlantoaxial joints * Facet joints Limit/allow the amount of movement at any given vertebral joint In the lumbar area, they are in the sagittal plane In the thoracic area, they are in the frontal plane

fyi

runs down the vertebral column on the anterior surface of the bodies and limits hyperextension

Anterior longitudinal ligament

runs along the vertebral bodies posteriorly inside of the vertebral foramen preventing hyperflexion

Posterior longitudinal ligament

extends from C7 distally to the sacrum posteriorly along the tips of the spinous process

Supraspinal ligament

connects adjacent laminae anteriorly

Ligamentum flavum

Fun Facts * The lumbar spine is the region of the body most often injured due to its mobility and the location of the center of gravity * The thoracic spine has much less ROM due to the attachments of the rib cage * The cervical spine is freely mobile – allows for freedom of motion, allows for entrance and exit of the blood vessels in the skull

fun

You will be responsible for the following muscles and all the OIAN’s that go along with them: of the spine

* Sternocleidomastoid * Scalene muscles * Splenius capitis * Splenius cervicis * Rectus abdominus * External oblique * Internal oblique * Transverse abdominus * Erector spinae * Transversospinalis * Interspinalis * Intertransversarii * Quadratus lumborum