TMJ Classifications and Symptoms
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Questions and Answers

What does a loose end-feel in PIVM testing typically indicate?

  • Hypomobility of the thoracic spine
  • Hypermobility or instability of the thoracic spine (correct)
  • Weakness in lower extremity muscles
  • Normal movement coordination
  • Which of the following is NOT a proposed intervention for addressing thoracic clinical instability?

  • Thoracic stabilization exercises
  • Lumbar rehabilitation program (correct)
  • Parascapular exercises
  • Postural education
  • Which exercise is most effective for improving mobility in the thoracic spine?

  • T-spine and rib mobilization/manipulation (correct)
  • Postural exercises
  • Thoracic stabilization exercises
  • Lateral flexion exercises
  • What condition is characterized by a progressive inflammatory disease affecting the thoracic spine and rib joints?

    <p>Ankylosing Spondylitis (A)</p> Signup and view all the answers

    Which visceral organ is likely to refer pain to the right ribs and below the right inferior angle of scapula?

    <p>Liver and Gallbladder (C)</p> Signup and view all the answers

    What symptom is commonly associated with Ankylosing Spondylitis?

    <p>Alternating butt pain (B)</p> Signup and view all the answers

    Which of the following is a key movement feature observed during examination for thoracic clinical instability?

    <p>Shaking or poor controlled motion (C)</p> Signup and view all the answers

    What is the primary purpose of performing postural education as an intervention?

    <p>To improve overall body alignment and movement mechanics (A)</p> Signup and view all the answers

    Which of the following is NOT an exam finding for neck pain with mobility deficits?

    <p>Positive cranial cervical flexion test (B)</p> Signup and view all the answers

    Which treatment is indicated for acute neck pain with movement coordination deficits?

    <p>Manual therapy and exercise (C)</p> Signup and view all the answers

    What specific exam finding indicates neck pain with headache due to cervicogenic issues?

    <p>C-spine ROM limited - upper c-spine hypomobility (D)</p> Signup and view all the answers

    In the treatment of neck pain with radiating pain, what is the primary focus of the intervention?

    <p>Manage symptoms and improve neurological function (A)</p> Signup and view all the answers

    Which of these findings would most likely correlate with fatigue and chills in a patient?

    <p>Systemic symptoms of infection (A)</p> Signup and view all the answers

    What is a common outcome of restricted range of motion in neck pain with mobility deficits?

    <p>Decreased overall physical activity (C)</p> Signup and view all the answers

    What is the main goal of manual therapy in the acute phase of neck pain treatment?

    <p>To improve mobility and reduce pain (B)</p> Signup and view all the answers

    Which test reflects a weakness in neck muscle endurance among patients with movement coordination deficits?

    <p>Cranial cervical flexion test (A)</p> Signup and view all the answers

    Which of the following findings is NOT associated with T4 Syndrome?

    <p>Shoulder impingement signs (D)</p> Signup and view all the answers

    What does PIVM stand for in the context of examination findings?

    <p>Passive Intervertebral Movement (D)</p> Signup and view all the answers

    What is one of the proposed interventions for treating thoracic mobility deficits with neck pain?

    <p>Self-mobilization techniques (C)</p> Signup and view all the answers

    Which examination finding best indicates thoracic mobility deficits with low back pain?

    <p>Stiff T-spine with thoracolumbar AROM (D)</p> Signup and view all the answers

    In the context of thoracic mobility deficits, what symptom commonly accompanies muscle imbalances?

    <p>Restricted range of motion (D)</p> Signup and view all the answers

    What type of exercises are suggested as part of mobility interventions in thoracic mobility deficits?

    <p>Mobility exercises (D)</p> Signup and view all the answers

    What is a common feature of restricted PIVM in the thoracic spine?

    <p>Tenderness with palpation (A)</p> Signup and view all the answers

    Which of the following is NOT a proposed intervention for mobility deficits with shoulder impairments?

    <p>Lumbar stabilization exercises (C)</p> Signup and view all the answers

    Flashcards

    Thoracic Hypomobility

    Limited movement in the thoracic spine, often causing referred pain to the upper extremities.

    UE symptoms in T-spine

    Pain or paresthesia (tingling) in the upper extremities, originating from thoracic spine issues.

    Positive ULTT

    A diagnostic test indicating possible thoracic dysfunction, showing positive results of Upper Limb Tension Tests.

    T4 Syndrome

    A type of thoracic hypomobility with upper extremity referred pain, upper T-spine pain, and other potential associated symptoms.

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    T-spine and rib mobilization

    Manual therapy techniques to improve movement and reduce restrictions in the thoracic spine and ribs.

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    Mobility exercises

    Specific exercises to increase movement and flexibility in the T-spine region for improved posture and reduced pain.

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    Thoracic Mobility Deficits with Neck Pain

    Neck pain stemming from restricted movement in the thoracic spine, often accompanied by cervical issues.

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    Shoulder Impairments from Thoracic Mobility

    Thoracic limitations leading thoracic stiffness and shoulder impingement problems and pain.

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    Thoracic Clinical Instability

    A condition characterized by symptoms provoked by sustained weight-bearing postures, relieved by non-weight-bearing postures, and often associated with hypermobility and weakness in thoracic muscles.

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    Thoracic Spine Interventions

    Interventions for thoracic spine problems may include postural education, stabilization exercises, exercises for parascapular muscles, mobilization/manipulation, and ergonomic adjustments.

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    Ankylosing Spondylitis

    A progressive inflammatory disease primarily affecting the T-spine and ribs, causing stiffness and pain, worsened by inactivity but better by exercise

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    Visceral Referral Pain

    Pain originating in an internal organ that is perceived as coming from a different area in the body (thoracic wall in this case).

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    Forward Bend Arthrokinematics

    In a forward bend, facet joints open and the transverse process moves in a posterior-anterior direction.

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    Backward Bend Arthrokinematics

    In a backward bend, facet joints close and the spinous process moves in a central posterior-anterior direction.

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    Compression Fracture MOI

    A compression fracture is caused by a significant force or trauma affecting the thoracic vertebra.

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    Thoracic Spine Examination

    Assessing for injuries (e.g., trauma, surgery), how pain is affected by movement (standing vs not), muscle strength, and range of motion of the thoracic spine.

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    Neck pain with mobility deficits

    Neck pain characterized by restricted range of motion (ROM), pain at end ROM, and segmental mobility deficits in the cervical and thoracic spine. It can also involve subacute or chronic cervicoscapulothoracic strength and motor control issues.

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    Neck pain with movement coordination deficits

    Neck pain with difficulty coordinating neck movements, typically showing up as weakness or lack of endurance in neck muscles. Pain is more present mid-range of movement.

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    Cervicogenic headache

    Headache caused by problems in the neck, often accompanied by limited upper cervical spine mobility and neck muscle weakness or coordination issues.

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    Radicular pain

    Neck pain that radiates down an arm, which is typical of a problem affecting the nerve roots.

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    ADDWOR

    Anterior disk displacement without reduction. A joint issue affecting the spine.

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    Acute Pain (12 weeks)

    Pain that has been present for up to 12 weeks. Acute pain is often part of a clinical classification for treatment.

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    Limited ROM

    Restriction of the range of motion or movement of a joint or body part. This is often seen with neck pain.

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    Segmental mobility deficits

    Problems with how different parts of a spine segment move relative to each other in the cervical and thoracic spine.

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    Study Notes

    TMD

    • TMJ classifications and associated signs/symptoms
      • Capsulitis/Synovitis and Fibrosis:
        • Tender to palpation at the TMJ lateral condyle or posterior compartment
        • Pain with biting/chewing on the opposite side
        • Pain with retrusive overpressure
        • Pain with accessory motion testing
        • Capsular pattern deviation toward the limited side with opening and protrusion
        • Limited contralateral lateral excursion
        • Limited AROM mandibular dynamics
        • Limited mobility with TMJ accessory motion tests
        • No joint sounds
        • History of trauma or surgery
      • Ankylosis:
        • Limited joint play mobility and mandibular ROM opening, protrusion, and contralateral excursion
        • Deflection of mandible toward restricted side during opening and protrusion
        • Bony ankylosis- No TMJ mobility
        • Capsular and fibrosis ankylosis- some mobility
        • Usually results from joint inflammatory response related to trauma or systemic conditions
      • Mobility:
        • Hypomobility:
          • Decrease in opening (less than 30 mm)
          • Limited joint play during mobility testing
          • Pain may be present or absent
          • Etiology: trauma, surgical procedure, internal derangement (IKD), ankylosis, advanced OA
        • Hypermobility:
          • Excessive jaw opening (greater than 55 mm)
          • Poor movement control ("S" pattern observed during opening)
          • Unilateral: jaw deviates to contralateral side at end of opening and protrusion
          • Etiology: joint laxity, systemic hypermobility, anatomic variability, masticatory muscle dystonia
        • End range click with deviation away from hypermobile side that clicks
        • Hypermobility with accessory motion testing
      • Disk-Condyle Incoordination/IKD:
        • ADDWR: anterior disk displacement with reduction
        • Reciprocal joint sound with opening and closing
        • "S" curve with opening
        • Full AROM

    C-Spine

    • Coupled motion in cervical spine
      • Upper cervical spine: sidebending and rotation in opposite directions (contralateral)
      • Lower cervical spine (C3-T4): sidebending and rotation in same direction (ipsilateral)
      • Thoracic and lumbar (T5 and below): sidebending and rotation in opposite directions (contralateral)
    • Special tests for cervical spine, including rationale and positive test results
      • Transverse ligament stability tests
      • Alar ligament stability tests
      • Vertebral artery tests

    Cervical Myelopathy vs. Cervical Spine Radiculopathy

    • Myelopathy:
      • Multilevel/bilateral UE/LE weakness
      • Usually no sensory deficits
      • Hyperreflexia
      • Positive UMN tests
      • Positive Romberg
      • Early signs: gait disturbances, clumsy hand, Ihermitte's sign, spastic paresis
    • Radiculopathy:
      • Unilateral, single-level weakness
      • Unilateral dermatomal sensation deficit
      • Unilateral positive ULTT
      • Diminished reflexes (single level)
      • Early signs: pain + sensory deficits followed by strength

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    MSK 2: Final Exam PDF

    Description

    Explore the classifications of temporomandibular joint (TMJ) disorders, including capsulitis, synovitis, and ankylosis. This quiz delves into the signs and symptoms associated with each condition, focusing on their impact on mandibular mobility. Test your knowledge on TMJ-related symptoms and classifications.

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