TMJ examination Flashcards
(18 cards)
What are 2 good questions to ask for TMD?
1) Have you had pain or stiffness in the face, jaw, temple, in front of the ear, or in the ear in the past month?
- if yes, are symptoms altered by chewing, talking, singing, yawning, kissing, moving the jaw?
2) Have you ever had your jaw catch or lock so that it would not open all the way?
- if yes, was this limitation in jaw opening severe enough to interfere w/ your ability to eat?
- have you ever noticed clicking, popping, or other sounds in your joint?
What kind of posture should you look for when examining for the TMJ?
- Forward head posture
- rounded shoulders
What level of the c-spine can refer pain to the TMJ?
C2-3
What muscles are affected with FHP?
- tight suboccipitals
- lengthened masseter and temporalis
What are ways to check for symmetry of the face?
- corner of eye w/ corner of mouth
- corner mouth in relation to center chin
What should overbite and over jet be?
Overbite: 1/3 mandibular incisor height
Overjet: 3-6mm
What should you look out for with palpation?
- clicking or popping
- crepitus & cracking
- normal
also listen for sounds while moving
What are some major muscles to palpate during an exam for the TMJ?
- masseter
- temporalis
- lateral pterygoid
- trapezius
- SCM
What is functional opening in the TMJ?
3 knuckles in the mouth is normal
opening to lateral excursion should be 4:1
What is responsible for the first 11mm of opening?
condylar rotation
What is the difference between deflection and deviations?
Deflection: moves straight down toward less mobile side
Deviations: make some sort of curve (c or s) dependent upon the issue
What does a C or S curve deviation tell us?
C:
- hypomobility
- anterior disc dislocation w/ reduction
S:
- muscle imbalance OR momentary disc locking that corrects itself
What is usually used to measure TMJ ROM?
TheraBite
What does asymmetry w/ lateral excursion indicate?
internal derangement
What are the 6 joint glides of the TMJ?
- distraction
- compression
- ant glide
- post glide
- lateral glide
- medial glide
each side
What is the forced bite provocation test and what does it tell us?
- bite down on cotton ball with molars and looking for provocation of symptoms
Ipsilateral pain = muscle/tendon irritation (joint isn’t compressed)
Contralateral pain = joint issue (joint can compress)
What does the retrusive overpressure test assess?
- posterior joint structures
- (+) indicates impingement of retrodiscal structures
What muscles should be tested in an exam for the TMJ?
- muscles of the face, mandible, and tongue
