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Flashcards in TMJ Deck (46)
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1
Q

What are the 3 ligaments of the TMJ

A
  1. Temporomandibular Ligament
  2. Sphenomandibular ligament
  3. Stylomandibular ligament
2
Q

Identify features, functions, and locations of the following anatomical components of the TMJ: Condyle

A

articulating head on the mandible

3
Q

Identify features, functions, and locations of the following anatomical components of the TMJ: Articular eminence

A

protuberance on the inferior aspect of zygomatic process of temporal bone, anterior to glenoid (articular) fossa

4
Q

Identify features, functions, and locations of the following anatomical components of the TMJ: Glenoid/articular/mandibular fossa

A

aka: Articular fossa or mandibular fossa)-posterior to the articular eminence, depression on temporal bone

5
Q

Identify features, functions, and locations of the following anatomical components of the TMJ: Articular disc

A

Made of fibrous connective tissue
Moves with the mandibular condyle to accommodate for smooth movement
The disc divides the TMJ into two synovial cavities: Upper Synovial Cavity and Lower Synovial Cavity

6
Q

Identify features, functions, and locations of the following anatomical components of the TMJ: Synovial function

A

The membranes that line the inside of the joint capsule secrete synovial fluid that aids in lubricating the joint and fills the synovial cavities.

7
Q

Identify features, functions, and locations of the following anatomical components of the TMJ: Fibrous capsule

A

completely encloses the TMJ, keeping the synovial fluid confined to the joint

8
Q

Identify features, functions, and locations of the following anatomical components of the TMJ: Ligaments: TMJ

A

Function: Prevents the condyle from being displaced too far inferiorly (downward) and posteriorly (retraction) and provides some resistance to lateral displacement.

Location: Lateral to joint, forms reinforcement of TMJ capsule

9
Q

Identify features, functions, and locations of the following anatomical components of the TMJ: Retrodiscal tissues

A

posterior to the disc, loose CT where the blood supply (external carotid artery) and nerve supply (V-trigeminal) innervate

10
Q

Identify features, functions, and locations of the following anatomical components of the TMJ: Ligaments: Sphenomandibular ligament

A

Function: Becomes taut when mandible is protruded; helps to control movement
Location: NOT PART of TMJ; Lies on medial side of mandible

11
Q

Identify features, functions, and locations of the following anatomical components of the TMJ: Ligaments: Stylomandibular Ligament

A

Function: Becomes taut when mandible is protruded; helps to control movement

Location: NOT PART of TMJ; connects styloid process of temporal bone to angle of mandible

12
Q

Describe each mandibular excursion and the muscles involved

A

Notability

13
Q

2 types of movement of TMJ

A

Gliding and rotational

14
Q

allows the mandible to move forward and backward (protraction and retraction)
Forward movement = protraction of the mandible
Backward movement = retraction of the mandible

A

gliding TMJ

15
Q

Occurs mainly between the disc and the condyle of the mandible in the lower synovial joint.
Allows for depression and elevation of the mandible.

A

Rotational Movement TMJ

16
Q

Hinge means

A

rotation

17
Q

Gliding means

A

translation

18
Q

Identify CN V (trigeminal nerve) and external carotid artery as the nerve and blood supply to the TMJ (to be elaborated on in additional lectures)

A

Innervation: Mandibular Branch (V3) of Trigeminal Nerve (CN V)

Blood supply: various branches of external carotid artery

19
Q

Recognize symptoms of TMD.

A
  • Patients may present with problems in one or both of the TMJs (tempromandibular disorder = TMD)
  • Symptoms may include:
    Chronic joint tenderness
    Swelling
    Popping and clicking in joint
    Limitation of opening, closing, lateral excursive movements, may or may not be with pain
    Headaches, most often frontal and temporal
    Fullness or stuffiness feeling within ears
    Sudden occlusal discrepancies including tooth mobility (no periodontal involvement) with wear facets
    Pain or spasm of muscles
20
Q

Recognize signs of TMD.

A

Clicking, popping, or grating sounds in the joint (crepitus)—should not rely on noise alone to diagnose TMD!
Deviation of joint when opening
Pt may report pain on opening or closing

21
Q

Describe the role of the dental hygienist in the examination, evaluation, and care of the TMD patient.

A

In your role as clinician, you will be called upon by patients to advise them regarding their TMJ issues. The dentist will need a solid review of the patient’s symptoms in order to advise them properly. A thorough extra-oral exam will give you some insight as to the extent of their problems: for instance, are both sides involved? Is it a distinct popping or clicking such as you would find with crepitus? Does the patient experience symptoms continually or intermittently? Does pain accompany the noise?

22
Q

EOE: Palpation of the TMJ
Palpating the joint while having the patient open and close will allow the clinician to tactilely observe popping
Audible popping or clicking (crepitus) may not be present, but you will be able to feel non-smooth movements in your fingertips
Auscultation utilizing stethoscope can provide additional information

A

Extra oral exam of the TMJ

23
Q

Additional tools to examine the TMJ

A
  • Stethoscope (auscultation)

- Flexible ruler (measurement of opening ability)

24
Q

Three basic problems

A

Masticatory muscle disorder
Internal derangements
Combination of the above

25
Q

Not in objectives: ^

Three basic problems

A

Masticatory muscle disorder
Internal derangements
Combination of the above

26
Q

^problem is located outside the fibrous capsule (myo=muscle)

A

Masticatory muscle-problem

27
Q

^Disc derangement- damage and displacement to the articular disc
Dislocation (Subluxation)-partial or full dislocation of joint
Hypomobility (Ankylosis)
Hypermobility

A

Internal derangements

28
Q

^change or constriction of CT which leads to atrophy

A

Myofibrosis

29
Q

^Muscle pain

A

Myalgia

30
Q

^Spasm of muscles

A

Myospasm

31
Q

^Inflammation of muscles

A

Myositis

32
Q

^Etiology of TMD

A
  • Spasms in neck muscles, the muscles of mastication, as well as malocclusion may cause pain in the TMJ
  • Disk derangement may produce clicking and popping sounds in the TMJ, limit movement, and cause pain on opening and closing
  • A hole or perforation in the disk my produce crepitus (grinding noise)
  • Some conditions, such as trauma or rheumatoid arthritis may be severe enough to cause fusion within the joint and prevent movement (ankylosis)
33
Q

^2 types of TMJ surgery

A

Arthroscopic surgery

direct surgical approach

34
Q

^Treatment Options

A

Dependent upon etiology, and can range from conservative care to complex surgery
Treatment may include:
Short-term non-steroidal anti-inflammatory drugs for pain and muscle relaxation
Occlusal/bite guards (splint)
Occupational Therapy/Physical therapy
Stress management counseling, yoga, etc.
Chiropractic treatment
If non-surgical treatment is unsuccessful, or there is clearly joint damage, surgery may be indicated

35
Q
Chew on the affected side
Limit opening to width of the thumb
Moist heat
Try not to sleep with the jaw deviated
TMJ splint/occlusal guard
Avoid clenching and grinding
No chewing gum
Avoid chewy or hard foods
A

^Pain relief suggestiions for patients

36
Q

Take frequent breaks (body position and comfort)
Limited opening
OHI with electric or children’s toothbrush, floss aids
Limit duration of appointments
Frequent appointments limits time in chair
Night guards (slightly open is easiest on joint)
Exercises (recommend OT/PT consultation)
Medications pre and post (NSAIDS if med hx allows)
Occlusal adjustments
Orthodontics
Surgery
*Mouth prop can make it worse

A

^Clinical Care of Patients/Recommendations

37
Q

A site of function or union between 2 or more bones

A

Joint

38
Q

joint on each side of the head that allows the movement of the mandible faciliting speech and mastication

A

Temporomandibular joint

39
Q

Mandibular condyle and temporal bone are separted by the ____ ____ or miniscus

A

articular disc

40
Q

TMJ allows the condyle of the ___ to articulate with the glenoid fossa of the __ __

A

mandible

temporal bone

41
Q

Glenoid fossa aka

A

mandibular fossa

Articular fossa

42
Q

THE bony articulating surfaces of the TMJ are covered with a dense fibrous CT that has ___ ___ ___ ___ ___

A

no blood or nerve supply

43
Q

what movement occurs mainly between the disc and the condyle of the mandible in the lower synovial joint

A

rotational movement

44
Q

Innervation to TMJ

Blood supply to TMJ

A

Innervation Mandibular branch V3 of Trigeminal Nerve CN V

45
Q

A condition in which the patient opens his/her mouth too wide and is unable to close again; or in which closing the mouth causes a popping back into place

Condyle glides too far forward and moves too far anterior to the height of the articular eminence (area of the temporal bone in front of the mandibular fossa)

The patient is unable to close because the muscles are tyring to pull up and back which prevents the condyle from moving posterioralyu

A

Subluxation

46
Q

What is a long term treatment of subluxation

A

surgically decreasing the height of the articular eminence