TMJ And Headaches

Question 1

Benign headaches

Answer 1

Migraines

Tension headaches

Cluster headaches

Post traumatic headaches

Question 2

Life threatening headache causes

Answer 2

Meningitis and abscesses

Mastoiditis

Hydrocephalus

Malignant HTN

AVM malformation

Hematomas

Giant cell arteritis

Venous thrombosis

Subarachnoid hemorrhage

Question 3

Tension type headache

Answer 3

Can be 3 subtypes:

1) infrequent = episodes less than 1 day a month
2) frequent = episodes 2-14 days a month
3) chronic = episodes 15+ days a month

86% of people are 12-41 yrs old

Symptoms:
- bilateral “headband” non throbbing pain
- no Aura and no N/V
(+/-) photophobia (more common in migraines)
- not aggravated by physical exertion
- upper C-spine is most involved

Question 4

What innervates the TMJ?

Answer 4

CN 5 V3 (mandibular nerve)

Question 5

What are the motions at the TMJ?

Answer 5

Depression of the mandible

• opens mouth
• mandibular head glides anteriorly
• muscles = lateral pterygoid

Elevation of the mandible

• closes mouth
• mandibular head glides posteriorly
• muscles = masseter/temporalis/medial pterygoid

Protraction and retraction

• muscles for protraction = masseter and lateral pterygoid
• muscles for retraction = temporalis

Lateral glide
- muscles = lateral and medial pterygoids

Question 6

TMJ masseter counterstrain

Answer 6

1) patient supine with physician seated at head of table
2) tenderpoint is found on the side of which the jaw diabetes towards slightly when opening slowly. Anterior to the ascending Ramus of that wight and slightly superior to the upper molars
3) with jaw slightly open push toward the side of deviation

Question 7

TMJ jaw angle counterstrain

Answer 7

Location of tender point = posterior to the ascending Ramus of the mandible less than 2cm above the angle of the mandible

Treatment = force is applied to the point of the chin to rotate the jaw away from the tenderpoint