Exam 2 Week 5

Question 1

what is the most frequently used joint in the body

Answer 1

the TMJ, and there are two of them don’t forget

Question 2

what is the average TMJ movement per day

Answer 2

1500-6000x a day

Question 3

what are the components of the TMJ

Answer 3

mandible, temporal bone, and C spine, muscles of mastication, teeth and vessels and nerves

Question 4

what are the TMJ osseous structures

Answer 4

the condyle of the mandible, the mandibular fossa of the temporal bone and the articular eminence (also on the temporal bone)

Question 5

what are the three ligaments of the TMJ joint

Answer 5

the collateral ligaments, stylomandibular and sphenomandibular ligaments.

Question 6

where are the medial and lateral collateral ligaments attached

Answer 6

the medial is from the medial pole of the condyle to the disc, and the lateral is from the disc to the lateral pole.

Question 7

what is the primary function of the stylomandibular ligament

Answer 7

the limit excessive protrusion

Question 8

what effect does the sphenomandibular ligament have on the jaw?

Answer 8

no effects. but it protects the nerve

Question 9

what is the function of the TMJ articular disc

Answer 9

to divide the joint into the superior and inferior compartments.

Question 10

what are the attachments of the disc, anteriorly and posteriorly

Answer 10

anteriorly, attaches to the capsule and the superior lateral pterygoid muscle.
posteriorly, attaches to the temporal bone through the loos retrodiscal tissue

Question 11

what muscle contracts and pulls the disc anteriorly

Answer 11

the lateral pterygoid (superior)

Question 12

what muscles are responsible for opening the TMP

Answer 12

the inferior lateral pterygoid, and the digastric, and the stylohyoid, geniohyoid and mylohyoid.

Question 13

what muscles close the mandible

Answer 13

the temporalis, the masseter and the medial pterygoid.

Question 14

what muscles control lateral movements of the mandible, and in what directions.

Answer 14

the temporalis (ipsilateral), and the medial and lateral pterygoid (contralateral).

Question 15

what muscles protrude the mandible

Answer 15

the masseter, medial and superior lateral pterygoid muscles

Question 16

what muscles do TMJ retrusion?

Answer 16

temporalis, the digastric and the suprahyoid (stylohyoid, geniohyoid, and mylohyoid)

Question 17

what is the innervation of the TMJ

Answer 17

the mandibular nerve, the n. to mylohyoid, the lingual nerve (ant 2/3 tongue), buccal nerve (gums and cheeks), inferior alveolar (mandibular teeth, and eventually the mental nerve) and auriculotemporal nerve (parotid gland)

Question 18

when talking about opening the TMJ, there are two movement components what are they

Answer 18

rotation: the condyle on the disc

and translation: condyle and disc on mandibular fossa.

Question 19

what happens in the initial phase of opening

Answer 19

rotation, 20-25 mm

Question 20

what is the second phase of TMJ opening

Answer 20

translation; the condyle moves anteriorly and inferiorly, and the anterior surface of the mandible moves anteriorly and inferiorly.

Question 21

what is the acceptable functional opening of the TMJ

Answer 21

36-44mm

Question 22

what are the arthrokinematics of the jaw closing

Answer 22

eccentric contraction of the superior lateral pterygoid. and release of the passive tension posteriorly from the retrodiscal tissue.

Question 23

which muscle controls the disc movement

Answer 23

the lateral pterygoid.

Question 24

what are the arthrokinematics of lateral movement of the mandible

Answer 24

unilateral rotation of the ipsilateral condyle and unilateral translation of the contralateral condyle.

Question 25

what is the force couple action of the TMJ lateral movements

Answer 25

ipsilateral temporalis, and contralateral inferior lateral pterygoid.

Question 26

what is the normal lateral movement of the mandible

Answer 26

5-10mm

Question 27

what is the arthrokinematics of protrusion

Answer 27

paired contraction of the inferior pterygoid muscles.

Question 28

what is normal protrusion for the mandible

Answer 28

5-10mm

Question 29

what is CMD

Answer 29

craniomandibular disorder. it affects the mastication muscles, TMJ and other structures.

Question 30

with CMD, where is pain commonly reported

Answer 30

in the TMJ, around the ear, head and neck.

Question 31

TMD is considered an MSK disorder of the ___ system

Answer 31

masticatory.

Question 32

how many people are affected by TMD

Answer 32

25%

Question 33

what are some symptoms of TMD

Answer 33

face or jaw pain, joint sounds, limited movement, muscle tenderness, TMJ tenderness, HA, ear symptoms, and C-spine disorders.

Question 34

who is more likely to get TMD, females or males, and what age

Answer 34

females, 10-86

Question 35

what percent of the population over the age of 18 have experiences orofacial pain in the past 6 months.

Answer 35

22% (even up to 58%)

Question 36

what are some etiological factors of TMD

Answer 36

genetic, development, physiological, traumatic, pathological, and environmental or behavioral

Question 37

what is the regional involvement of the TMD

Answer 37

must check the surrounding areas. Must eval neck, shoulder and C-spine too

Question 38

there are 3 groups when considering classification of the TMD

Answer 38

muscle disorders, (Myofascial pain, and with limitations), disc displacement (with reduction or without, and Mayne with limitations in opening), and arthralgia, arthritis and arthritis (OA)

Question 39

what are the articular structures of the TMJ

Answer 39

condyle, disc, superior lateral pterygoid and retrodiscal tissue.

Question 40

describe disc displacement with reduction

Answer 40

elongated ligaments. the disc lies anterior at rest, and the condyle is posterior to the posterior region of the disc. When you open, the condyle reduces back over the posterior region of the disc, and normal function can happen.

Question 41

describe disc displacement without reduction

Answer 41

elasticity of the ligaments and retrodiscal material is lost, so the condyles cannot glide over the posterior region onto the disc. The disc isn't reduced, translation of the condyle stops and the discs can be forced anteriorly, which can lead to the jaw being stuck open.

Question 42

what is a condylar subluxation

Answer 42

hyper mobility, the condyle and the disc translate over the articular eminence, appearing to jump forward into the maximum opening position

Question 43

what are some general intervention guidelines for hyper-mobility. GOAL

Answer 43

``` GOAL: stabilize teach them to not open wide limit opening, and in tongue out position teach lateral pole palpation isometrics address weak muscles mandibular muscle relaxation ```

Question 44

what are some general intervention guidelines for HYPO-mobile. GOAL

Answer 44

``` GOAL: mobilize manual mobs self-mob intraoral appliance, mobilization splints. stretching. ```

Question 45

how do you eval the TMJ

Answer 45

postural screen, palpation of jaw and C-spine, motion assessment

Question 46

what are the normal opening, lateral devotion and protrusion values

Answer 46

opening: 40-45mm deviation: 8-10mm protrusion: 8-10mm

Question 47

what is the functional opening value

Answer 47

35mm (2 knuckle rule)

Question 48

what happens in the C-spine with a forward head, and what does that do to the suprahyoid muscles

Answer 48

upper C flexion and lower extension. it stretches those muscles, which pulls the jaw back?