Lecture 6: Temporomandibular Dysfunction Flashcards Preview

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Flashcards in Lecture 6: Temporomandibular Dysfunction Deck (36)
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1

Describe the 2 separate motions involved in opening the jaw and which axis each is on?

Rotation about a RT/LF (transverse axis)

Anterior glide (over the articular disc)

2

Which 3 muscles of mastification close the jaw tightly?

- Temporalis m.

- Masseter m.

- Medial ptergoid m. 

3

Which muscle of the mouth approximates and compresses lips?

Orbicularis oris m.

4

Which muscles of the mouth raise the lateral angle of the mouth (smile)?

Zygomaticus major

5

Which muscle of the mouth approximates lips and draws lips and corners of mouth lateral (grimace)

Risorius

6

What are some of the common signs/sx's someone with TMJ issues may complain about?

- CC of Cephalgia (HA)

- May or may not mention jaw problems

- May describe as dull ache ---> worse w/ chewing

- Tinnitus

7

The audible click associated with TMJ dysfunction is almost always do due?

Disc displacement after disc thin/stretched

8

A person with osteoarthritis is more likly to have what sound associated with the jaw?

Crepitus

9

A direct blow to a pt with a closed mouth results in what type of injury to the TMJ?

Posterior capsule injury

10

What are 4 types of trauma which may be etiologies for TMJ dysfunciton?

1. Direct blow

2. Whiplash injury

3. 3rd molar extraction

4. Intubation

11

What is a class 1 malocclusion of the jaw?

1st molars normal, problem elsewhere

12

What is a class 2a vs. class 2b malocclusion of jaw?

2a = lower 1st molar posterior to upper mandibular retrustion (overbite)

2b = lower 1st molar posterior to upper to greater degree (larger overbite)

13

What is a class 3 malocclusion of the jaw?

Lower 1st molar anterior to upper mandibular protrusion (underbite)

14

What devleopmental abnormality is associated with TMJ dysfunction?

Condylar hypoplasia/agenesis

15

Which mood disorders may be associated with TMJ dysfunction?

What have some studies showed?

- Anxiety

- Depression

- PTSD

- Hx of Abuse

- Some studies show association btw chronic TMD and these mood disorders

16

What are 2 metabolic causes of TMJ dysfunction?

- Endocrine abnormalities

- Hypocalcemia

17

What are 6 pathologies of intracapsular TMJ dysfunction?

- Infection

- RA

- Ostoarthritis

- Gout

- Metastatic CA

- Articular disc displacements

18

Extracapsular cause of TMJ dysfunction?

Myofascial pain of masticatory muscles

19

What are some of the risk factors associated with TMJ dysfunction?

- Hyperlaxity (controversial)

- Neck trauma (i.e., whiplash)

- Femal hormones

- Bruxism and clenching

- Pyschological abnormalities

20

Which country has the highest prevalence of TMJ dysfunction?

Germany > Netherlands

21

Which age/sex is TMJ dysfunction more common in?

Young women

22

What should be evaluated during the OSE of someone with TMJ pain/dysfunction?

- Cranial

- C-spine

Scoliosis

Leg length ---> Innominate, Sacrum, SI joint

23

Normal functional opening (ROM) of TMJ is how many mm?

Suspect TMJ dysfunction if

- Normal = 35-55 mm

- Susepct TMJ dysfunction if <25 mm and very often associated w/ pain

24

What is a PE finding associated with Bruxism?

Signs of wear and tear on teeth

25

What are 8 differential diagnoses for TMJ dysfunction?

1. Migraine related disorder --> Carotodynia

2. Inflammatory Dz --> local infection, RA, giant cell arteritis

3. Dental problems --> posterior teeth support loss

4. Neuralgias --> Trigeminal or Glossopharyngeal

5. Parotid gland disorders

6. Lymphoproliferative disorders

7. Medication SE's

8. Eagle's Syndrome (stylohyoid syndrome)

26

C. tetani is associated w/ what TMJ dysfunction?

Lockjaw

27

What are 2 medications which may be associated with SE's related to TMJ dyfunction?

1) Steroids --> Avascular necrosis

2) Bisphosphonates --> Osteonecrosis of jaw

28

What is Eagle's Syndrome?

Elongated Styloid Process

29

When should radiological examination be used for TMJ dysfunction?

- Usually NOT helpful

- Use when you suspect dental problems or concern for alternative cause

- Pt with severe sx's that don't improve w/ conservative tx tactics

- Recent, severe trauma

 

30

What imaging modality is the procedure of choice for TMJ dysfunction?

Why?

MRI - allows to see position and shape of disc