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?

Ankylosing Spondylitis 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?

Liver and Gallbladder Signup and view all the answers

What symptom is commonly associated with Ankylosing Spondylitis?

Alternating butt pain Signup and view all the answers

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

Shaking or poor controlled motion Signup and view all the answers

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

To improve overall body alignment and movement mechanics Signup and view all the answers

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

Positive cranial cervical flexion test Signup and view all the answers

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

Manual therapy and exercise Signup and view all the answers

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

C-spine ROM limited - upper c-spine hypomobility Signup and view all the answers

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

Manage symptoms and improve neurological function Signup and view all the answers

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

Systemic symptoms of infection Signup and view all the answers

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

Decreased overall physical activity Signup and view all the answers

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

To improve mobility and reduce pain Signup and view all the answers

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

Cranial cervical flexion test Signup and view all the answers

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

Shoulder impingement signs Signup and view all the answers

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

Passive Intervertebral Movement Signup and view all the answers

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

Self-mobilization techniques Signup and view all the answers

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

Stiff T-spine with thoracolumbar AROM Signup and view all the answers

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

Restricted range of motion Signup and view all the answers

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

Mobility exercises Signup and view all the answers

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

Tenderness with palpation Signup and view all the answers

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

Lumbar stabilization exercises Signup and view all the answers

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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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.