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S3- Musculoskeletal > TMJ Examination > Flashcards

TMJ Examination Flashcards

1
Q

INTRODUCTION (PATIENT INTERVIEW)

A

INTRODUCTION (PATIENT INTERVIEW)

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2
Q

What common functional limitations may be present with TMJ dysfunction?

A
  • Chewing
  • Eating
  • Talking
  • Sleeping
  • Work Tasks
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3
Q

With the History of Present Illness (HPI) what do we want to consider?

A
  • Anatomical Location
  • Onset
  • Timing
  • Status
  • Irritability
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4
Q

What are some associated symptoms with TMJ dysfunction?

A
  • Headaches
  • Dizziness/Nausea
  • Paresthesia/Anesthesia of face/scalp/body
  • Tinnitus
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5
Q

What are some special questions to ask patients with TMJ dysfunction?

A
  • Joint noises
  • Parafunction
  • Locking
  • Catching
  • Hx of Open Lock
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6
Q

With the patient interview we want to consider any previous interventions and the ________ to it. What are some examples?

A

-response

  • PT
  • other disciplines (dentistry, oral surgery, ENT, neurology, etc.)
  • Imaging/Testing (US, radiograph, MR/CT)
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7
Q

What are some outcome measures that can be useful in this population?

A
  • PSFS
  • Tampa Scale of Kinesiphobia for TMD
  • TMD Pain Disorder Screening Instrument
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8
Q

VISUAL INSPECTION

A

VISUAL INSPECTION

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9
Q

What are some things to consider when performing a visual inspection?

A
  • Posture
  • Craniofacial-Specific Observations
  • Intro-oral Inspection
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10
Q

What are the 3 planes we look at during visual inspection to check and see if they are parallel to each other?

A
  • bipupital plane
  • otic plane
  • occlusal plane
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11
Q

We divide the face into __ vertical divisions of the face.

A

3

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12
Q

What are some contributing factors related to posture abnormalities?

A
  • Forward head posture

- Malocclusions

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13
Q

What are some different types of malocclusions?

A 
Open Bite
-space between front teeth when mouth is closed
Retrognathism
-retracted position
Prognathism
-protracted position
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14
Q

Retrognathism and Prognathism can relate to both the _______ or the __________.

A

mandible or maxilla

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15
Q

What is the proposed mechanism for forward head posture present with TMJ dysfunction?

A
  • Passive tension by the supra/infrahyoid muscles alter resting position of the mandible
  • Mandible pulled inferiorly and posteriorly, changing the position of the mandibular condyle on the cranium
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16
Q

ELIMINATION TESTING

A

ELIMINATION TESTING

17
Q

What thing should be performed during elimination testing?

A
  • UQS (including C-spine and UE)
  • Initial TMJ Screening
  • Neuro Screening (CN, UMN, LMN)
  • Special Tests
18
Q

When looking at gross TMJ AROM we want to look at:

  • Motions including _______, _______, and __________.
  • Symptoms that produce _________ pain.
  • Signs such as joint _________, ____________ and gross ___________.
A
  • opening, clenching, and protrusion
  • concordant
  • noises, deviations/correction, and gross quantity
19
Q

What one elimination test can be helpful to rule out cervicogenic HA?-

A

-Cervical Flexion Rotation Test

20
Q

STRUCTURAL STRESS TESTING

A

STRUCTURAL STRESS TESTING

21
Q

What motions do we want to look at with the TMJ?

A
  • opening/closing
  • protraction/retraction
  • lateral deviation
22
Q

What 4 things are we assessing for with AROM?

A
  • Quantity
  • Quality
  • Provocation
  • Willingness to move
23
Q
  • With quantity we can use a ______/____________.
  • With quality we want to note _________, _________ and __________.
  • With provocation we want to note the point in movement of provocation.
A
  • ruler/tape measure

- coordination, symmetry, compensations

24
Q
  • How should we position ourselves when assessing AROM?

- We want to observe for deviations such as what?

A
  • eye level at pt’s level of the TMJ

- c-shaped or s-shaped curves and correction back to midline

25
Q

Why do we want to look at PROM as well?

A

To compare to AROM/resistive to look for patterns consistent with contractile or joint lesion.

26
Q

With resistive testing we want to look for _______ and ______.

A 
Symptoms
-provocation of concordant pain
Signs
-quality of contraction
-quantity (strong v weak)
27
Q

PALPATION AND JOINT MOBILITY TESTING

A

PALPATION AND JOINT MOBILITY TESTING

28
Q

What extra-oral structures can we palpate at the TMJ?

A
  • Temporalis
  • Masseter
  • Medial Pterygoid
  • TMJ joint line
  • Suprahyoids
  • SCM
  • Cervical paraspinals
  • Zygomatic Arch
29
Q

What intro-oral structures can we palpate at the TMJ?

A
  • Lateral Pterygoid
  • Medial Pterygoid
  • Temporalis tendon
  • Masseter
  • Teeth
  • Gum line
30
Q

What joint mobility tests can be performed at the TMJ?

A
  • Caudal Glide
  • Ventral Glide
  • Medial Glide
  • Lateral Glide
31
Q
  • What is the resting position of the TMJ?

- What is the closed position?

A
  • slight opening

- fully closed

32
Q

CONFIRMATION TESTS

A

CONFIRMATION TESTS

33
Q

What are the few confirmation tests that we have for the TMJ?

A
  • Auscultation of TMJ with stethoscope during AROM
  • Provocation Test: Retrodiscal Material
  • Unilateral tongue depressor biting

S3- Musculoskeletal (27 decks)

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