Tmj Disorder

Front 1

What are some signs and symptoms of Temperomandibular joint disorder? (TMJ)

Back 1

pain
Impaired jaw function
malocclusion
Deviation or deflection
Limited range of motion, Joint noise
Locking

Front 2

Can other symptoms of TMJ be observed as well?

Back 2

Yes. headache, tinnitus and visual changes may be observed as well.

Front 3

TMJD can be divided into two categories. What are they?

Back 3

Muscular and articular categories.

Front 4

What is included in some of the myogenic disorders?

Back 4

Myalgia(myofacial pain, Fibromyalgia, myospasm, splinting and fibrosis/contracture.

Front 5

What do some of the articular disorders include?

Back 5

Synovitis/capsulitis, joint effusion, trauma/fracture, internal derangement, arthritis and neoplasm.

Front 6

Why is the temperomandibular joint considered a compound articulation?

Back 6

It is formed from the articular surfaces of the temporal bone and the mandibular condyle. Both surfaces are covered by dense articular fibrocartilage.

Front 7

Each condyle articulates with a large surface of temporal bone. true/False

Back 7

True.The three structures noted here are the articular fossa, articular eminence and preglenoid plane.

Front 8

Why is the function of the TMJ considered somewhat unique?

Back 8

The condyle both rotates within the fossa and translates anteriorly along the articular eminence.

Front 9

What is gynglimodiarthrodial?

Back 9

The TMJ is considered this type of joint.
Ginglymoid is rotation and arthrodial is translation.

Front 10

A ______________________ disc resides between the articular surface of the temporal bone and mandibular condyle.

Back 10

Cartilaginous.

Front 11

The TMJ is stabilized by three ligaments. What are they?

Back 11

1. Collateral(discal)
2.Capsular
3. Temperomandibular

Front 12

What is the function of the capsular ligament?

Back 12

It surrounds the joint space and disc and acts to contain the synovial fluid within the joint space.

Front 13

The synovial tissue is highly innervated and vascularized and has regulatory phagocytic and secretory functions. True/False

Back 13

True.

Front 14

What are the four major muscles of mastication?

Back 14

Masseter
Medial Pterygoid
Lateral Pterygoid
Temporalis

Front 15

Which major muscles are responsible for mandibular closure and bite force?

Back 15

Masseter
medial Pterygoid
Temporalis

Front 16

Which major muscles are responsible for mandibular opening?

Back 16

Lateral Pterygoid
Infrahyoid

Front 17

Mandibular movement is also influenced by which other muscle groups?

Back 17

Digastric
Geniohyoid
Mylohyoid
Stylohyoid
Sternohyoid
Omohyoid
Thyrohyoid

Front 18

The TMJ receives its vascular supply from which vessels?

Back 18

Superficial temporal
Maxillary
Masseteric arteries

Front 19

The synovial fluid is also under a certain amount of neuronal control. True/False

Back 19

True.

Front 20

What is MFP and MPD?

Back 20

MFP-Mylofacial pain
MPD-Mylofacial pain and disfunction.

Front 21

What are some other related muscular disorders?

Back 21

Myositis
Fibrosis
Tendonitis
Whiplash injury
Fibromyalgia

Front 22

Patients suffering from MFP will have tenderness to palpation of two or more muscles sites. True/False

Back 22

True.

Front 23

MFP escalates to myofacial dysfunction when there is concomitant limitation of jaw opening. True/False

Back 23

True.

Front 24

Why has there been some consideration of female patients afflicted with TMJ?

Back 24

Many researches have examined the role of estrogen in the etiology of masticatory myalgias. It is estmated that 50% of TMJD are masticatory myalgias or painful masticatory muscle disorders.

Front 25

MFP of the masticatory muscles is more frequently induced by what?

Back 25

Stress related parafunctional habits(clenching and grinding) and rarely by mechanical causes such as occlusal prematurity or high dental restoration.

Front 26

What is guarding or splinting?

Back 26

TMJ pain from an articular disorder may lead to MFP. This is thought to occur due to reflex muscle contractions in the muscles of mastication. This is considered a self protective reflex and is called guarding or splinting.

Front 27

What is the treatment of masticatory MFP?

Back 27

May include pharmacologic therapy(NSAIDS, muscle relaxants, tricyclic antidepressants, anxiolytics ), occlusal appliance/splint therapy, trigger point therapy(spray and stretch, injections, and physical therapy(mandibular exercises).

Front 28

What is Anterior disc displacement?

Back 28

This is the most frequently encountered articular disorder. This is a disturbance in the normal anatomic relationship between the disc and condyle that interferes with smooth movement of the joint that causes momentary catching, clicking, popping or locking.

Front 29

What is capsulitis?

Back 29

Inflammation of the capsular ligament may manifest with swelling and continuous pain localized to the joint. Joint fluid volume may increase. When this happens one may see an ipsilateral posterior open bite(lack of contact between maxillary and mandibular teeth).

Front 30

Inflammation of the synovial membrane is an early sign of DJD. Inflammatory and pain mediators have been identified in TMJ synovial fluid. True/false

Back 30

True. prostaglandin E2 and leukotriene B4 attracts inflammatory cells. Their presence causes acute synovitis pain and stimulates further damage from cytokines and proteases.

Front 31

Regarding the arthritides, arthritis of the TMJ has many etiologies. name several.

Back 31

OA and Rheumatoid arthritis(RA) and less often infectious, metabolic gout or immunologic(ankylosing spondylitis), Lupus.

Front 32

primary OA symptoms usually begin in the 5th or 6th decade. True/false

Back 32

True. It is thought that repeated stress related microtrauma(bruxism) eventually overloads the joints articular cartilages leading to compression and shearing of cartilage.
Chondrocyte injury stimulates release of proteolytic enzymes and other collagenases.

Front 33

What are the 4 stages of TMJ OA based on?

Back 33

On the amount of cartilage degeneration and the grade of synovitis

Front 34

Panaramic radiography is an excellent screening tool for the presence of bony degenerative changes. True/false

Back 34

True. Arthroscopy is considered to be the gold standard in the diagnosis of OA.

Front 35

Of the patients who test positive for RA, 50-75% will develop TMJ involvement. True/false

Back 35

True.

Front 36

What are some neoplasms of TMJ?

Back 36

Neoplasms of the condyle and joint space may be benign(osteoma, chondroma, synovial chondromatosis, giant cell lesions or maliganant(chondrosarcoma, osteosarcoma, synovial sarcoma or multiple myeloma.

Front 37

What are the most common TMJ neoplasms?

Back 37

osteoma and osteochondroma.

Front 38

How can osteoma and osteochondroma be distinguished from condylar hyperplasia?

Back 38

By the presence of a normal condylar neck length.