TMJ

Question 1

what are the two way a TMJ condition can occur

Answer 1

1. extraarticular involvement

2. intraarticular involvement

Question 2

what is extraarticular involvement

Answer 2

cervical involvement including myofascial, postural, or subluxation-related dysfunction, and dental abnormalities or pathologies

Question 3

what is intraarticular involvement

Answer 3

synovitis, and capsulitis with the focus on the disc which is considered displaced or degenerated

Question 4

how many people will develop some TMJ related symptom in their lifetime

Answer 4

85-90%

Question 5

who is affected more: men or women?

Answer 5

women

Question 6

TMJ problems are primary referrals from

Answer 6

neck and ear pain

Question 7

where can TMJ also refer to

Answer 7

the head as in H/A’s, and into the eyes (focusing problems)

Question 8

determine the cmoplaint

Answer 8

is it pain, clicking/popping, crepitus, inability to open fully, or close, or fatigue when chewing

Question 9

note any history

Answer 9

of direct trauma, episodes of jaw locking, whiplash injuries, past diagnosis of arthritis, or dental pathologies

Question 10

when taking history make sure to note any other signs and symptoms of

Answer 10

arthrtides

Question 11

during elevation attempt to distinguish between

Answer 11

intraarticular and extraarticular

Question 12

during elevation also determine

Answer 12

dental status

Question 13

during elevation perform provocative maneuvers

Answer 13

1. stretch= capsulitis
2. compression = synovitis
3. contraction= myofascial

Question 14

what is the anatomy of the TMJ

Answer 14

a biconcave disc consisting of dense fibrous connective tissue which is not vascularized or pain sensitive, this sits on top of the condyle or head of the mandible, which sits into the gleaned fossa of the temporal bone

Question 15

what is the retrodiscal tissue

Answer 15

located behind the disc and consists of a venous plexus covered with a synovial membrane
source of pain and synovial effusion

Question 16

what stabilizes the disc

Answer 16

collateral ligaments and capsular ligaments which can elongate or damage allowing the displacement of the disc

Question 17

what is one of the most common functional problems with TMJ

Answer 17

anterior displacement of the articular disc, which is posterior/superior condyle

Question 18

what occurs with anterior displacement

Answer 18

the condyles starting position is behind the disc, with opening if the condyle can override the disc then the pop is often heard

Question 19

what is occurring when the pop is heard or felt close to full opening

Answer 19

then anterior displacement of the disc with posterior ligament degeneration is commonly found

Question 20

what is thought if grinding/crepitation is throughout the opening or closing

Answer 20

thought to be adhesions surrounding the capsule

Question 21

what is one of the most common complaints of TMJ

Answer 21

overstitching of the capsule and ligaments which leads to distended join

Question 22

what if TMJ becomes a chronic problem

Answer 22

the capsule and ligaments may poorly function leading to hyper mobility of the TMJ

Question 23

what is the retordiscal area susceptible to

Answer 23

compression, both compassion and the resulting synovial fluid reaction increases pressure int he joint and this can cause pain

Question 24

condylar compression due to anterior disc displacement can cause

Answer 24

retrodiscal tissues to compress

Question 25

hypertonic temporalis muscle can

Answer 25

pull the condyle posterior

Question 26

vertical height of the teeth (diminished, or loss) can lead to

Answer 26

superior/posterior displacement of the condyle

Question 27

trauma in a superior/posterior direction may

Answer 27

jam the condyle into the retrodiscal tissue

Question 28

was the blow direct/indirect? | what occurs with direct blows

Answer 28

stretch or compress the same side TMJ, anterior blow can cause a compressive type of injury with reactive synovitis, lateral blow stretches the joint capsule, resulting in capsulitis or disc deragement

Question 29

micro trauma may be a result of

Answer 29

buxism

Question 30

if pt has had diagnosis of inflammatory arthritis, RA, lupus, psoriatic, retirees, then the TMJ pain=

Answer 30

the inflammatory process of the disease

Question 31

provocative maneuvers may help with narrowing the thourht process

Answer 31

clicking and popping= jaw clicks on opening=disc displacement with weakened posterior ligament

Question 32

pt complains of locking= can't open fully is called a

Answer 32

closed lock= the disc is anterior to the condyle during jaw opening

Question 33

if the pt unable to close the mouth is called a

Answer 33

open lock=the anterior condyle has dislocated and may be a result of excessive joint laxity or blunt trauma

Question 34

pain with excessive opening

Answer 34

capsulitis usually accompanied by pain with contralateral chewing and protrusion or lateral excursion of the mandible

Question 35

pain with chewing=

Answer 35

dental disorder=TMJ involved=synovitis may be due to atypical chewing habits, chronic gum chewing, or impact injury (referral may be necessary)