TMJ

Question 1

TMJ prevalence

Answer 1

Females
25-44 yr
W or w/o trauma
Bruxing
Iatrogenic

Question 2

TMJ closing muscles

Answer 2

Masseter
Temporalis
medial pterygoid

Question 3

TMJ opening muscles

Answer 3

Initially gravity followed by digastric for forceful

Question 4

TMJ retrusion muscles

Answer 4

Post temporalis

Assisted by deep masseter

Question 5

TMJ protrusion muscles

Answer 5

Bilateral heads of lateral pterygoid

Assisted by medial pterygoid

Question 6

TMJ laterotrusion muscles

Answer 6

Contralateral contraction of lateral and medial pterygoid

Ipsi contraction of temporalis and masseter

Question 7

Masseter

Answer 7

Elevation of mandible to close mouth and chew

Question 8

Temporalis

Answer 8

Chewing: elevating and returning

Question 9

Medial pterygoid

Answer 9

Mastication

Mandibular elevator and protrudes w/ mastication and active in speech

Question 10

Digastric

Answer 10

Depresses mandible and raises hyoid bone
Part of suprahyoid bone
Fixate or depress hyoid bone and thyroid cartilage for swallowing

Question 11

Lateral pterygoid

Answer 11

Mastication
Active in mouth opening
Near final closure
Espy during transition from true hinge movement to combined rotation and translation

Question 12

TMJ opening - rotation occurs

Answer 12

0-26 mm

Question 13

TMJ opening - ant translation occurs

Answer 13

After 26 mm

Question 14

Laterotrusion

Answer 14

Ipsilateral condyles rotates and contralateral condyle translates

Question 15

Protrusion

Answer 15

Both condyles translate

Question 16

Occlusion

Answer 16

Bringing of opposing surfaces of teeth into contact

Question 17

Occlusion class 1

Answer 17

Normal
2mm overbite
2mm overjet
Medial buccaneers 1st molar

Question 18

Occlusion class 2

Answer 18

Overbite
>2mm overbite and overreact
Cusp contact lies in front of groove

Question 19

Occlusion class 3

Answer 19

Underbite
>2mm overjet
Cusp is behind of groove

Question 20

Anterior open bite

Answer 20

RA

Split induced

Question 21

Posterior open bite

Answer 21

Splint induced

Question 22

Cross bite

Answer 22

Asymmetrical mandibular growth

Question 23

Bite stick

Answer 23

Contra pain - joint

Ipsi or bilateral pain = muscles

Question 24

Myofascial pain criteria

Answer 24

Taut band
Tender nodule
Recognition of pain
Local twitch response
Referred sensory sign 
Limited ROM
Painful contraction and weakness

Question 25

Indication for splint

Answer 25

Myofascial Pain when wakes up with pain and PT has not helped Severe OA pain Biofeedback to stop clenching

Question 26

Best tests for TMJ

Answer 26

Palpation Pain during movement Maximal mouth opening deficit/asymmetrical Active widest opening

Question 27

TMJ exercises

Answer 27

Isometrics in neutral - proprio and strength Hold/relax - ROM, tension Painful/catch clicking avoided

Question 28

TMJ disc classification

Answer 28

“Anterior disc displacement w/“ Reduction - click Incoordination - click/lock Without reduction - lock

Question 29

TRISMUS

Answer 29

Lock jaw/ cant open wide

Question 30

TMJ inflammation

Answer 30

``` Ice and later heat Massage - MLD Gentle exercise NSAIDS Injection ```

Question 31

TMJ DJD

Answer 31

``` Exercises: hinge. Midline open Joint protection: diet, sleep position NSAIDS Stabilization splint Injection ```

Question 32

TMJ acute myalgia

Answer 32

Ice, massage to tx pain, inflammation Rest Gradual mobilization exercises

Question 33

TMJ trismus and splinting

Answer 33

Modalities Vigorous mobes Stretching exercises The rabbits or easy flex

Question 34

TMJ dyskinesia

Answer 34

``` Coordation excersie AROM w/ and w/o cutes Isometrics Mild resistance Mirror, palpation, etc ```

Question 35

TMJ hypermoblility

Answer 35

Avoidance Limited ROM - hinge axis, Madeline open Resistive/isometric w/in restricted range

Question 36

TMJ hypomobility

Answer 36

Modalities increase tissue ext. vigorous mobes A and PROM

Question 37

TMJ functional ranges

Answer 37

Open 36mm | Laterotrusion and protrusion 6mm

Question 38

TMJ opening range

Answer 38

>40 mm or 3 fingers at DIP

Question 39

TMJ norm laterotrusion

Answer 39

6-8mm or about one tooth width

Question 40

TMJ norm protrusion

Answer 40

6-8 mm

Question 41

Deviation vs deflection

Answer 41

Deviation S curve | Deflection stays to side