TMD

Question 1

What type of joint is the TMJ?

Answer 1

synovial, condylar, hinge-type

Question 2

The fibrocartilage of the mandibular fossa is

a. nociceptive
b. avascular
c. neural
d. aneural
e. b and d

Answer 2

avascular and aneural

Question 3

What shapes can the mandibular condyle have?

Answer 3

convex
flat
angular
rounded

Question 4

The articular disc is

a. innervated in the center
b. avascular
c. aneural
d. vascularized and innervated in the periphery

Answer 4

vascularized and innervated in the periphery

Question 5

What is the function of the articular disc?

Answer 5

increases lubrication
decreases wear
increases congruity
space filler

Question 6

The disc can adapt to incongruent shapes of the mandibular head (true/false)

Answer 6

true

Question 7

The disc can be a source of pain due to

Answer 7

displacement or deform

Question 8

The superior TM joint (rotates/glides and translates)

Answer 8

glides and translates

Question 9

The inferior TM joint (rotates/glides and translates)

Answer 9

rotates

Question 10

This structure is loose connective tissue attached to the posterior aspect of the disc, it is highly innervated and vascularized

a. condylar fossa
b. temporomandibular ligament
c. retrodiscal tissue
d. articular disc

Answer 10

retrodiscal tissue

Question 11

The retrodiscal tissue is

a. avascular and innervated
b. innervated and vascular
c. avascular
d. aneural

Answer 11

innervated and vascular

Question 12

This supporting structure limits distraction and downward movements of the condyle, and stabilizes the meniscus

a. joint capsule
b. posterior ligaments
c. medial collateral ligaments
d. temporomandibular ligament

Answer 12

joint capsule

Question 13

This supporting structure limits excessive movement by the mandible as the mouth opens, limited anterior translation of the condyle

a. joint capsule
b. posterior ligaments
c. medial collateral ligaments
d. temporomandibular ligament

Answer 13

temporomandibular ligament

Question 14

This supporting structure limits medial translation of the condyle and prevents lateral disc placement

a. joint capsule
b. posterior ligaments
c. medial collateral ligaments
d. temporomandibular ligament

Answer 14

medial collateral ligament

Question 15

This supporting structure limits posterior condyle disc displacement and anterior disc

a. joint capsule
b. posterior ligaments
c. medial collateral ligaments
d. temporomandibular ligament

Answer 15

posterior ligaments

Question 16

Which muscle guides the biting motion

a. masseter
b. lateral pterygoid
c. medial pterygoid
d. temporalis

Answer 16

temporalis

Question 17

This muscle has 2 layers and contributes to clenching and grinding

a. masseter
b. lateral pterygoid
c. medial pterygoid
d. temporalis

Answer 17

masseter

Question 18

This muscle attaches to the disc which may cause problems if it becomes tight

a. masseter
b. lateral pterygoid
c. medial pterygoid
d. temporalis

Answer 18

lateral pterygoid

Question 19

What is the TMJ innervated by?

Answer 19

trigeminal

Question 20

This position is with the mouth open, teeth not in contact, and movement of the mandible starts and end here

a. occulsal position
b. open pack

Answer 20

open pack

Question 21

Teeth are in full contact, clenched, and heads of condyles are in posterior aspect of the joint

a. open pack
b. occulsal position

Answer 21

ossulsal position

Question 22

This motion occurs between the articular disc and condyle

a. elevation
b. rotation/hinge
c. translation
d. depression

Answer 22

rotation/hinge

Question 23

This motion is when the condyle slides forward and runs out of movement the disc cushions the upper condyle

a. elevation
b. rotation/hinge
c. translation
d. depression

Answer 23

translation

Question 24

What are red flags to be aware of?

Answer 24

upper cervical red flags
drop attacks
nystagmus with C/S ROM 
limb paresthesia, ataxia, weakness
lip paresthesia with C/S ROM

Question 25

What are typical symptoms with TMD?

Answer 25

pain in TMJ and masticatory muscles restricted mouth opening joint noises

Question 26

It is irrelevant to check the cervical spine or treat it (true/false)

Answer 26

false

Question 27

What are you looking for with MMT?

Answer 27

pain provocation

Question 28

Whar areas are the most common sources of referred pain to the craniofacial region a. medial pterygoid, temporalis, masseter b. lateral pterygoid ara, trap, masseter c. masseter, hyoid, temporalis d. lateral pterygoid and masseter

Answer 28

lateral pterygoid ara, trap, masseter

Question 29

This pathology is indicated by clicking and can be the first sign of dysfunction of TMJ a. disc displacement without reduction b. OA c. disc displacement with reduction d. dislocation or sublux

Answer 29

disc displacement with reduction

Question 30

What is the most common type of disc displacement with reduction?

Answer 30

reciprocal clicking

Question 31

This dysfunction is when the disc remains in the displaced position during mandibular movement a. disc displacement without reduction b. OA c. disc displacement with reduction d. dislocation or sublux

Answer 31

disc displacement without reduction

Question 32

Patient with this dysfunction usually says "my jaw used to click and pop, but now it does not" a. disc displacement without reduction b. OA c. disc displacement with reduction d. dislocation or sublux

Answer 32

disc displacement without reduction

Question 33

This dysfunction is characterized by crepitus and patient complains of grating, or grinding symptoms, tender with palpation a. disc displacement without reduction b. OA c. disc displacement with reduction d. dislocation or sublux

Answer 33

OA

Question 34

This patient has a chronic restriction of motion a. disc displacement without reduction b. OA c. disc displacement with reduction d. dislocation or sublux

Answer 34

OA

Question 35

This patient will present with prolonged inability to close the mandible from a max opening position a. disc displacement without reduction b. OA c. disc displacement with reduction d. dislocation or sublux

Answer 35

dislocation or sublux

Question 36

The condyle can be caught in front of the _ _

Answer 36

articular eminence

Question 37

This dysfunction is a localized inflammatory condition of the synovial tissue a. synovitis/retrodiscal irritation b. OA c. disc displacement with reduction d. dislocation or sublux

Answer 37

synovitis/retrodiscal irritation

Question 38

This is secondary to degeneration, trauma or secondary systemic connective tissue disorder a. synovitis/retrodiscal irritation b. OA c. disc displacement with reduction d. dislocation or sublux

Answer 38

synovitis/retrodiscal irritation

Question 39

This patient has increased pain with joint compression and joint movement and relief with distraction a. synovitis/retrodiscal irritation b. OA c. disc displacement with reduction d. dislocation or sublux

Answer 39

synovitis/retrodiscal irritation

Question 40

Pain will occur with outer range opening, distraction of joint or any posterior displacement of the condyle a. trismus b. capsulitis c. synovitis d. OA

Answer 40

capsulitis

Question 41

This dysfunction is restricted active mandibular motion due to tonic contraction of the muscles to mastication a. trismus b. capsulitis c. synovitis d. OA

Answer 41

trismus

Question 42

This restriction of mandibular movement is caused by articular dysfunction or tissue damage a. trismus b. capsulitis c. synovitis d. OA

Answer 42

trismus

Question 43

This injury occurs due to acute, severe psychological stress

Answer 43

hysterical trismus

Question 44

What muscles should be treated with soft tissue mobilization?

Answer 44

``` masseter temporalis pterygoids suprahyoid cervical musculature ```

Question 45

Which directions are good for joint mobilization?

Answer 45

inferior glide/distraction distraction with anterior glide lateral glide upper cervical distraction

Question 46

Exercise options for TMD

Answer 46

``` tongue clucking control rotation mandibular rhythmic stabilization head nods head retraction scapular retraction ```

Question 47

head nods target (upper cervical/lower cervical)

Answer 47

upper cervical

Question 48

retraction targets (upper cervical/lower cervical)

Answer 48

lower cervical

Question 49

Patient presents with dizziness, constant headaches, neck is rigid, has difficulty lying flat and night pain. Should you treat this patient?

Answer 49

no RED FLAGS

Question 50

What is the most common symptom with TMD? a. jaw joint noises b. pain with mouth opening c. jaw locking d. ear/cheek and facial pain

Answer 50

pain with mouth opening