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

Kines: TMJ, Respiration, Posture, Anthropometric Test Flashcards

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
Q

Quiet expiration

A

mostly passive; external intercostals relax, gravity pulls ribcage down, recoil of thoracic wall and lung tissue

			essentially no muscle activity
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26
Q

Forced expiration

A

internal intercostals (T1-T11 intercostal nerves)

accessory muscles: all four abdominals; quadratus lumborum; serratus posterior inferior

27
Q

Ideal Posture in (transverse/frontal/sagittal)

A

transverse: not twisted or rotated in either direction
frontal: neutral, symmetrical, no difference between the sides
sagittal: spine has normal curves

28
Q

Ideal head/neck

A

Held erect in position of good balance

Cervical lordosis

29
Q

Ideal Shoulder posture

A

Scapulae lay flat against rib cage
~4 inches width between vertebral borders
*not uncommon for dominant hand shoulder to be slightly lower

30
Q

Ideal spine posture

A

Normal spinal curves

*cervical lordosis, thoracic kyphosis, lumbar lordosis

31
Q

Ideal abdomen posture

A

not protruding

32
Q

Ideal Pelvis posture

A

Neutral
Iliac crest level
*not uncommon for dominant hand hip to be slightly higher
Pelvis and thighs in straight line

33
Q

Ideal hip posture

A

Body weight evenly distributed through both legs

34
Q

Ideal knee posture

A

Patellae face forward

Straight with minimal flexion (not locked)

35
Q

Ideal ankle/foot posture

A

Subtalar neutral
Normal medial longitudinal arch
Feet slightly out-toed

36
Q

Ideal toe posture

A

straight, not curled downward or extended upward

37
Q

Sagittal Plumb line: (9)

A

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
Q

Postural Pain Syndrome:

A

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
Q

Postural Dysfunction:

A

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
Q

Factors Affecting Posture: INTRINSIC

A 
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
Q

Factors affecting posture: EXTRINSIC

A 
Footwear
Seating (office chair, couch, wheelchair, etc.)
Work/study station set-up
Height/weight, related to situation
Environment
42
Q

Posture: Mobility impairment=

A

tight muscles

43
Q

Posture: Impaired muscle performance =

A

Weak/overstretched muscles

44
Q

Rounded Back with Forward Head

A 
↑ 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
Q

Causes: Rounded Back with Forward Head

A 
Causes
slouching
poor ergonomics
poor lumbar spine postures
overemphasis on flexion programs
46
Q

Consequences: Rounded Back with Forward Head

A

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
Q

Describe: Flat Upper Back and Neck Posture (Military Posture)

A

↓ thoracic and cervical curves (flattening)
depressed scapulae and clavicles
↑ capital flexion

48
Q

Consequences: Military Posture

A

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
Q

Causes: MIlitary Posture

A

this is not a common postural fault, usually related to exaggeration of military posture

50
Q

Lordotic Posture

A

↑ lumbosacral angle = ↑ lumbar lordosis = ↑ anterior pelvic tilt

51
Q

Causes of: Lordotic Posture

A

sustained faulty posture
pregnancy
obesity
weak Hamstrings, abdominals, Glute muscles

52
Q

Consequences: Lordotic Posture

A

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
Q

Swayback (Kypholordotic) Posture

A

relaxed or slouched posture
pelvis shifted anteriorly → hip extension
↑ lumbar lordosis with ↑ thoracic kyphosis with forward head

54
Q

Causes: Swayback- Kypholordotic

A 
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
Q

Consequences: Swayback-kypholordotic

A

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
Q

Flat Low Back Posture

A

↓ lumbosacral angle = ↓ lumbar lordosis = posterior pelvic tilt

57
Q

Causes: Flat low back posture

A

habitual slouching in flexion when sitting or standing

overemphasis on flexion program

58
Q

Consequences: Flat low back posture

A

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
Q

Scoliosis:

A

lateral curvature and/or rotation in spine

60
Q

Structural scoliosis:

A

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
Q

Scoliosis causes:

A 
neuromuscular disease (ex. CP)
osteopathic disorders (ex. hemivertebrae)
idiopathic- most common. Don’t know why
62
Q

Scoliosis Consequences

A

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
Q

Nonstructural scoliosis (functional/postural scoliosis)

A

reversible and can be changed with flexion or lateral flexion or with positional changes

64
Q

Causes of Nonstructural Scoliosis

A

LLD
muscle guarding or spasm
habit

PTA (4 decks)

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