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PTA > Kines: TMJ, Respiration, Posture, Anthropometric Test > Flashcards

Kines: TMJ, Respiration, Posture, Anthropometric Test Flashcards

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1
Q

What makes up the TMJ

A

Left and right temporal bones

mandible: only moving bone of the skull
hyoid: ligament and muscle attachment
sphenoid: ligament and muscle attachment
maxilla: upper jaw; muscle attachment

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2
Q

articular disk:

A

divides each joint into upper and lower joints

attached firmly to mandibular condyle

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3
Q

upper joint: (TMJ)

A

convex articular eminence of temporal bone
concave superior surface of disk
gliding joint (amphiarthrodial)

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4
Q

lower joint: TMJ

A

superior/anterior convex articular surface of mandibular condyle
concave inferior surface of the disk
hinge joint (diarthrodial)

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5
Q

functionally: (TMJ)

A

hinge with a movable socket

motion in all 3 planes

one capsule

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6
Q

articular surfaces (TMJ)

A

no hyaline cartilage
covered with fibrocartilage with more potential for self-repair
disk is vascular around the edges, avascular in the center

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7
Q

capsule (TMJ)

A

thin and loose above the disk
thick and strong laterally
encloses the entire mandibular condyle

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8
Q

Open packed (TMJ)

A

mouth slightly open

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9
Q

Closed pack (TMJ)

A

Teeth clenched

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10
Q

rest position (TMJ)

A

rest position–1.5 to 5.0 mm between teeth

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11
Q

TMJ Sagittal plane:

A 
mandibular depression (mouth opening)
* measured in mm between central incisors

 mandibular elevation (mouth closing)
* closed is closed; not measured
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12
Q

TMJ Frontal plane:

A

lateral deviation–movement of jaw laterally

*10 mm each way is normal

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13
Q

TMJ Transverse plane:

A

protrusion (jaw forward)
retrusion (jaw backward)
*can be measured

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14
Q

Mandibular elevation prime movers:

A

masseters
temporalis
medial pterygoids

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15
Q

Lateral deviation prime movers:

A

Prime: right lateral & medial pterygoids

		left masseter and left temporalis
  • to R, it’s left lateral and medial pterygoids, right masseter & temporalis
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16
Q

Protrusion/protraction prime movers:

A

All lateral and medial pterygoids

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17
Q

Retrusion/Retraction prime movers:

A

Prime:
Temporalis (posterior)
Tongue Motions/Prime Movers (extrinsic muscles)
(CN XII, hypoglossal nerve)

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18
Q

Costovertebral joints:

A

synovial; nonaxial, amphiarthrodial, gliding joints

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19
Q

Sternocostal joints:

A

cartilaginous; nonaxial, amphiarthrodial joints

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20
Q

Elevation of the rib cage

A

rib cage as a whole moves superior and lateral (up and out)

sternum moves anterior

dimensions of thorax increase (along with vertical increase)

creates negative pressure, drawing air in

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21
Q

Depression of the rib cage

A

rib cage moves down and in, back to rest position

sternum returns to resting position

dimensions of thorax decrease

pressure increases in thorax, pushing air out.

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22
Q

Quiet inspiration:

A 
diaphragm (phrenic nerve, C3, C4, C5 [mostly C4])
external intercostals (T1-T11 intercostal nerves)
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23
Q

Deep inspiration:

A

more forceful action of diaphragm and external intercostals

accessory muscles: SCM, pec major, all scalenes, levator costarum, serratus posterior superior

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24
Q

Forced inspiration:

A

even more forceful action of diaphragm and external intercostals
more forceful work of accessory muscles of deep inspiration, plus, levator scapulae, upper traps, rhomboids, pec min

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25
Quiet expiration
mostly passive; external intercostals relax, gravity pulls ribcage down, recoil of thoracic wall and lung tissue essentially no muscle activity
26
Forced expiration
internal intercostals (T1-T11 intercostal nerves) accessory muscles: all four abdominals; quadratus lumborum; serratus posterior inferior
27
Ideal Posture in (transverse/frontal/sagittal)
transverse: not twisted or rotated in either direction frontal: neutral, symmetrical, no difference between the sides sagittal: spine has normal curves
28
Ideal head/neck
Held erect in position of good balance | Cervical lordosis
29
Ideal Shoulder posture
Scapulae lay flat against rib cage ~4 inches width between vertebral borders *not uncommon for dominant hand shoulder to be slightly lower
30
Ideal spine posture
Normal spinal curves | *cervical lordosis, thoracic kyphosis, lumbar lordosis
31
Ideal abdomen posture
not protruding
32
Ideal Pelvis posture
Neutral Iliac crest level *not uncommon for dominant hand hip to be slightly higher Pelvis and thighs in straight line
33
Ideal hip posture
Body weight evenly distributed through both legs
34
Ideal knee posture
Patellae face forward | Straight with minimal flexion (not locked)
35
Ideal ankle/foot posture
Subtalar neutral Normal medial longitudinal arch Feet slightly out-toed
36
Ideal toe posture
straight, not curled downward or extended upward
37
Sagittal Plumb line: (9)
Sagittal Plumb Line (standing) ``` Slightly posterior to coronal suture ↓ Through external auditory meatus ↓ Through axis of odontoid process ↓ Midway through tip of shoulder (acromion) ↓ Through bodies of lumbar vertebrae ↓ Slightly posterior to hip joint ↓ Slightly posterior to patella (through axis of knee joint) ↓ Slightly anterior to lateral malleolus ↓ Through calcaneocuboid joint ```
38
Postural Pain Syndrome:
pain that results from mechanical stress when a faulty posture is maintained for a prolonged period of time pain often relieved by activity no impairments in functional strength or flexibility, however may progress to these impairments if faulty posture continues
39
Postural Dysfunction:
strength and flexibility impairments shortening of soft tissues limiting ROM muscle weakness may be result of poor prolonged postural habits or adhesions formed during healing after trauma or surgery predisposes area to injury or overuse syndromes (ex. supraspinatus impingement)
40
Factors Affecting Posture: INTRINSIC
``` Structural (fixed deformity) Abnormal muscle tone (we’ll discuss more in neuro) Muscle imbalance or weakness Hyper or hypomobility Impaired sensation, including kinesthesia or proprioception Pain Fatigue Consciousness Attitude ```
41
Factors affecting posture: EXTRINSIC
``` Footwear Seating (office chair, couch, wheelchair, etc.) Work/study station set-up Height/weight, related to situation Environment ```
42
Posture: Mobility impairment=
tight muscles
43
Posture: Impaired muscle performance =
Weak/overstretched muscles
44
Rounded Back with Forward Head
``` ↑ thoracic kyphosis protracted scapulae (rounded shoulders) ``` forward head: ↑ flexion of lower cervical and upper thoracic spine, increased extension of upper cervical spine, and capital extension
45
Causes: Rounded Back with Forward Head
``` Causes slouching poor ergonomics poor lumbar spine postures overemphasis on flexion programs ```
46
Consequences: Rounded Back with Forward Head
Fatigue of thoracic erector spinae and scapular retractors Irritation of facet joints in upper cervical spine Possible impingement on upper cervical spinal nerve roots (What could this lead to?) Thoracic outlet syndrome (TOS) Tension headaches (HA) TMJ dysfunction with protrusion and depression of mandible Lower cervical disc issues
47
Describe: Flat Upper Back and Neck Posture (Military Posture)
↓ thoracic and cervical curves (flattening) depressed scapulae and clavicles ↑ capital flexion
48
Consequences: Military Posture
Fatigue of scapular retractors and depressors Restricted scapular movement limiting shoulder flexion and abduction (Why would these be affected if scapula doesn’t move freely?) TOS ↑ risk of neck injury due ↓ shock-absorbing function of normal spinal curves
49
Causes: MIlitary Posture
this is not a common postural fault, usually related to exaggeration of military posture
50
Lordotic Posture
↑ lumbosacral angle = ↑ lumbar lordosis = ↑ anterior pelvic tilt
51
Causes of: Lordotic Posture
sustained faulty posture pregnancy obesity weak Hamstrings, abdominals, Glute muscles
52
Consequences: Lordotic Posture
low back pain narrowing of posterior disc space and intervertebral foramen → compression of spinal nerve root, dura, or blood vessels (What could this lead to?) approximation of articular facets → synovial irritation and joint inflammation → acceleration of degenerative changes
53
Swayback (Kypholordotic) Posture
relaxed or slouched posture pelvis shifted anteriorly → hip extension ↑ lumbar lordosis with ↑ thoracic kyphosis with forward head
54
Causes: Swayback- Kypholordotic
``` relaxed posture with person using passive structures (ligaments, capsules, bony approximation) at end range to provide stability instead of using muscles to support against gravity attitudinal fatigue poor postural muscle endurance overemphasis on flexion program ```
55
Consequences: Swayback-kypholordotic
pain from stress to iliofemoral, anterior longitudinal, and posterior longitudinal ligaments pain from stress to IT band on elevated hip with asymmetrical single stance posture narrowing of intervertebral foramen → compression of spinal nerve root, dura, or blood vessels approximation of articular facets in lower lumbar spine
56
Flat Low Back Posture
↓ lumbosacral angle = ↓ lumbar lordosis = posterior pelvic tilt
57
Causes: Flat low back posture
habitual slouching in flexion when sitting or standing | overemphasis on flexion program
58
Consequences: Flat low back posture
pain due to ↓ shock-absorbing of normal lumbar curve stress to posterior longitudinal ligament ↑ posterior disc space which allows nucleus pulposus to take in extra fluid which may lead to protrusion with extension
59
Scoliosis:
lateral curvature and/or rotation in spine
60
Structural scoliosis:
irreversible lateral curvature with fixed rotation *rotation is toward convexity of curve ribs will rotate with vertebrae in thoracic spine causing rib hump on side of convexity (ribs go to side of hump) *named for side of convexity
61
Scoliosis causes:
``` neuromuscular disease (ex. CP) osteopathic disorders (ex. hemivertebrae) idiopathic- most common. Don’t know why ```
62
Scoliosis Consequences
muscle fatigue and ligamentous strain on side of convexity nerve root irritation on side of concavity rib expansion with difficulty breathing in advanced cases
63
Nonstructural scoliosis (functional/postural scoliosis)
reversible and can be changed with flexion or lateral flexion or with positional changes
64
Causes of Nonstructural Scoliosis
LLD muscle guarding or spasm habit

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