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HD 4 - dental relevance > TMD > Flashcards

TMD Flashcards

(58 cards)

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1
Q

when does pain become chronic?

A

> /=3month

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2
Q

4 main orgins of orofacial pain

A
  1. musculoskeletal - TMD
  2. neuropathic - TN, BMS, phantom tooth pain
  3. neurovascular - migraine, trigeminal autonomic cephagiaas
  4. odontogenic
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3
Q

what is dysesthesia

A

partial/comlete loss of sensation with pain

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4
Q

3 types of provocation testing

A
  1. tooth sleuth
  2. TTP
  3. palpation of area of discomfort
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5
Q

5 ENT red flags

A
  1. recurrent epistaxis
  2. anosmia
  3. perisitant nasal obstruction/discharge
  4. objective hearing loss
  5. lymphaenopathy
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6
Q

OMFS red flags

A
  1. near absolute trismus
  2. erythroplakia, leukoplakia, frank ulceration, oral mucosa
  3. cranial nerve dysfunction
  4. previous carcinoma of head/neck
  5. preauricular mass
  6. young onset trigeminal neuralgia
  7. numbness in trigeminal dermatome
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7
Q

most common musculoskeletal facial pain

A

TMD

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8
Q

symptoms of temporal (giant cell) arteritis

A
  1. temporal headache
  2. > 50yrs
  3. visual disturbances
  4. claudication/tiredness when eating
  5. palpably tener
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9
Q

what is temporal (giant cell) arteritis

A

localised temporal headache
systemic inflammatory vasculitits
transmural inflammation of intimal + mural hyperplasia –> lumen narrow

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10
Q

3 investigations for temporal arteritis

A

ESR, CRP, temporal artery biopsy

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11
Q

management for temporal arteritis

A

urgen systemic steroids

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12
Q

what is a common comorbidity of TMD

A

migraine

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13
Q

most common neurovascular orofacial pain

A

migraine

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14
Q

symptoms of migraine

A

persisitent throbbing for up to 72hrs
nausea, vomiting, photo + photophobia
aggravated by everyday function
+/- aura

most common women 35-45

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15
Q

examples of neuropathic pain

A

burning mouth syndrome
post SR wisdom teeth
phantom tooth pain
neuralgia

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16
Q

what type of pain is TN

A

episodic

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17
Q

what type of pain is BMS

A

continuous

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18
Q

symptoms of trigeminal neuralgia

A

paroxysmal, stabbing
electric like, hot needle like pain
usually unilateral
talking, chewing, touch, temp change causes pain

TN affect >/= trigeminal nerve dermatomes

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19
Q

investigation for trigeminal neuralgia

A

MRI - must exclude pathology like MS/tumour

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20
Q

management of trigeminal neuralgia

A

carbamazepine on titrating dose - profound sodium channel blocker

second line = other anticonvulsants

neurosurgery

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21
Q

what is burning mouth syndrome

A

persistent burning sensation affecting oral mucosa

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22
Q

what is primary BMS?

A

+ve history of procedure taking longer than normal

central sensitisation - non-noxious stimuli perceived so they are noxious

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23
Q

possible causes of secondary BMS

A 
drug reaction - ACE inhibitors
candidiasis
anaemia 
diabetes
xerostomia
thyroid dysfunction
inadequate tongue space -/C
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24
Q

treatment for primary BMS

Study These Flashcards
A

top or systemic - TCA, anxiolytics, anticonvulsant

25
what is phantom tooth pain?
pain following extraction or RCT >/=3 months - injury to primary afferent
26
do analgesics relieve neuropathic pain?
no
27
how to tell difference between peripheral + central neuropathic pain
peripheral lockable by LA | central isn't
28
symptoms of TMD
``` pain tenderness to palpation jaw movement limited/deviated//uncoordinated joint sounds evidence of parafunction headaches ```
29
how does COMT affect TMD
low COMT - increased pain sensitivity - increased TMD
30
diagnostic system used for TMD
DC TMD 2014
31
what is myogenous + arthrogenous pain
``` myogenous = from muscle arthrogenous = from joint or disc ```
32
4 type of TMD
1. myalgia 2. head attributed to TMD 3. arthralgia 4. intra-articular disorders
33
how to examine myalgia
familiar pain - palpate masseter + temporalis
34
types of myalgai
local myalgia myofascial pain myofascial pain with referral
35
what happens in disc displacement with reduction
snap/pop cause by disc moving forwards infront of condyle
36
what is the parotid gland relationship with master + buccinator
parotid duct pirerces buccinator | overlies masseter
37
is buccinator or master deeper?
buccinator
38
which branch of trigeminal innervates MOM
v3
39
what nerve is transmitted through fo. ovale
v3
40
components of anterior branch of V3
``` mainly motor (MOM) long buccal sensory ```
41
components of posterior branch of V3
mainly sensory - general sensation ant 2/3 + mandibular teeth (IAN) nerve to mylohyoid motor
42
what is the chorda tympani nerve?
branch of VII | hitchhiker along lingual nerve - ant 2/3 taste
43
what nerves are in infratemporal fossa?
5, 7, 9
44
4 muscles of mastication
later + medial pterygoid masseter temporalis
45
what is MMA a branch of?
maxilla artery
46
what skull bone does the mandibular condyle fit into?
temporal bone - articular fossa + eminence
47
nerve sensation of TMJ
auriculotemporal nere + masseteric nerve
48
which pharyngeal arch does the mandible, V and mystical muscles originate?
arch 1
49
3 ligaments reinforcing TMJ
lateral sphenomandibular stylomandibular restrict movement in certain directions
50
2 movements of TMJ
hinge - lower compartment, condyle moves, disc stationary | translation - upper compartment, condyle + disc move together
51
which muscles are used for lateral excursion of mandible
contralateral to working side pterygoids | ipsilateral to working side temporals
52
action of temporalis
elevation + retraction of mandible
53
action of med pterygoid
elevation + lateral movement of mandble
54
action of masseter
elevation of mandible
55
action of lat pterygoid
protrusion + lateral
56
3 main muscles involved in elevation/closing
temporalis med pterygoid masseter
57
what is lining of TMJ made from
fibrocartilage
58
what is arthrocentesis of TMJ?
degenerative change/calcified material can be treated this way upper TMJ compartment rinsed with saliva or ringers +/- anti-inflammatory drugs

HD 4 - dental relevance (12 decks)

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