Term
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Definition
Auricular pain (ear ache)
Head ache
Neck pain
Clicking, grinding, popping
Change in voice
Sinus
Tight throat
Difficulty swallowing |
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Term
| Name the 3 parts of boney articulation of TMJ |
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Definition
Temporal Bone
Mandible
Maxilla |
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Term
| If you do not have good articular eminence then your mandible will dislocate ___ |
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Definition
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Term
| What makes up the anterior portion of the articular disc? |
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Definition
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Term
| What makes up the posterior portion of the articular disc? |
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Definition
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Term
| What makes up the intermediate portion of the articular disc? |
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Definition
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Term
| The articular disc roles to line up with the intermediate and THEN slides anteriorly, what happens if it slides anteriorly first? |
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Definition
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Term
| If TMJ is hypomobile on the R, then its tight on the ___ and there is a __ deviation |
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Definition
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Term
| A tight __ will change the biomechanics of the TMJ. You can have capsular adhesions that need to be treated with TMJ mobs |
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Definition
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Term
| Name the 3 ligaments of the TMJ |
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Definition
Temporomandibular
Stylomandibular
Sphenomandibular |
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Term
| These 2 ligaments are important with maximal opening |
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Definition
| Spheno and stylomandibular |
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Term
| This ligament forms the lateral wall |
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Definition
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Term
| If you open your mouth maximally, how many fingers should you be able to fit in? |
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Definition
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Term
| Is elevation of the TMJ opening or closing? |
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Definition
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Term
| Is depression of the TMJ opening or closing? |
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Definition
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Term
| Name 5 movements of the TMJ. |
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Definition
Elevation
Depression
Protrusion
Retraction
Lateral Deviation |
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Term
| This muscle serves to close the mouth and elevate the mandible. It also helps with retraction. |
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Definition
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Term
| This muscle protracts and elevates the mandible. |
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Definition
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Term
| This muscle elevates the mandible |
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Definition
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Term
| This muscle bilaterally protrudes and elevates the mandible |
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Definition
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Term
| This muscle helps keep the disc in place when opening and closing |
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Definition
| Superior Lateral Pterygoid |
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Term
| Name the 4 muscles that elevate the mandible. |
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Definition
Temporalis
Masseter
Medial pterygoid
Lateral pterygoid |
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Term
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Definition
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Term
| Name 3 muscles that depress the mandible |
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Definition
Digastric
Mylohyoid
Geniohyoid |
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Term
| Name 2 muscles that protrude |
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Definition
Lateral Pterygoid
Masseter |
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Term
| What muscle does retraction? |
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Definition
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Term
| What muscle does lateral deviation? |
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Definition
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Term
| Should you have roll then glide or glide then roll? |
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Definition
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Term
| 2/3 of the movement lower joint (roll) |
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Definition
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Term
| 1/3 of movement upper joint (glide) |
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Definition
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Term
| Is hyper or hypo mobility easier to treat? |
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Definition
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Term
| Defined as less than 20-25mm of opening |
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Definition
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Term
| What is the most common cause of hypomobility? |
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Definition
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Term
| Name 3 causes of hypomobility |
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Definition
Immobilization (sx wire jaw shut)
Trauma to mandible
Post TMJ sx |
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Term
| Name 3 treatment techniques for hypomobility |
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Definition
Restore accessory motion
Mobilization
Modalities to enhance |
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Term
Distraction
Distraction w/lat dev
Distract and ant. glide
Add protrusion after 11mm of opening |
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Definition
| Hypomobility mobilization |
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Term
| Name 3 aspects of the HEP for hypomobility |
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Definition
Tongue on palate
Open/close
Lat dev to L and R |
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Term
| Greater than 40mm of opening |
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Definition
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Term
| With this, anterior dislocation may or may not reduce. |
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Definition
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Term
| How do you treat subluxation? |
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Definition
Strengthen
Isometrics
Elevate, depress, lat dev
Do not strengthen protrusion b/c that enhances anterior translation |
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Term
| What is the protocol for isometrics to treat hypermobility? |
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Definition
-5 second holds
-30 times/session (3 min/day)
-4 times/day (10 min/day)
-4 weeks minimum
-Even if symptoms stop prior to 4 wks |
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|
Term
-May use mouth splint at night
-Tongue on palate as open mouth
-Difficult to protrude jaw with tongue on palate
-Eliminate glide; all roll |
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Definition
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|
Term
-With teeth together - disc sits anterior to condyle
-Clicks during opening (relocation of disc)
-More subtle click during closing (disc dislocates)
-May avoid click by lateral movement
-"s" curve
-If keep jaw in midline - will click |
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Definition
| Anterior Dislocation -Reduces |
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Term
| How do you treat anterior dislocation reduces? |
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Definition
-Intra-oral mouth appliance
-Reposition mandible to a more forward position
-Muscle re-education - tongue on palate (roll only)
-Progress to no tongue on palate - learn to control anterior translation |
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|
Term
-No joint noise
-Restricted opening - disc blocks translation
-May report - "used to pop" (chornic problems now acute) |
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Definition
| Anterior Disc Dislocation - NO reduction |
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Term
| Hypomobility vs. Anterior Disc Dislocation |
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Definition
-Differential Dx based on hx
-Capsule - trauma; no previous click
-Disc - previous click; no trauma |
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Term
| How do you treat anterior disc dislocation? |
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Definition
-Attempt manual distraction and anterior glide to reduce
-May use modalities to relax ms
-Injection to relax
-Acute lock - 90% can be unlocked manually
-Then intra oral mouth appliance, etc
-Acute lock - 10% need sx
-Chronic lock - 60% will unlock with 6 wks of mobs
-Then intra oral mouth appliance, etc
-Chronic lock - 40% will need sx |
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