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TMJ, NECK/TRUNK, AND RESPIRATORYSYSTEM
JASON GLASNAPP, PT, DPT
CHAPTERS 14-16
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CHAPTER 14
TMJ
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STRUCTURES
Mandible: Lower part of jaw. Holds the lower teeth. Mates withtemporal bone to make the TMJ.
Angle, Body, Ramus, Condyle, Coronoid Process
Temporal bone: Mates with mandible to form TMJ.
Styloid, Mastoid, and Zygomatic process
Maxilla: Upper portion of jaw. Connects with nasal bone andholds upper teeth.
Hyoidbone: Horse-shoe shaped bone at C3 level that providesmuscle attachments for the tongue. It does not articulate with anybone. Helps protect the vocal cords or voice box.
Joint Capsule: Envelops the TMJ by attaching superiorly andinferiorly
Articular Disk :connected to the capsule and tendon of lateralpterygoid
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MOVEMENTS
Talking, chewing, biting, swallowing, and yawning.
http://www.youtube.com/watch?v=umnnA50IDIY&NR=1
Mandible depression: Mouth opens or chins moves down.
Mandible elevation: Returns to normal position.
Mandible lateral deviation: Chin moves to either side.
Mandible protrusion/retraction: Chin moves out with protrusion
and comes back to make double chin.
http://www.youtube.com/watch?v=umnnA50IDIY&NR=1http://www.youtube.com/watch?v=umnnA50IDIY&NR=1http://www.youtube.com/watch?v=umnnA50IDIY&NR=17/31/2019 Kines Anatomy Ch. 14-16
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MUSCLES
Temporalis
Masseter
Lateral Pterygoid
Medial Pterygoid
Mylohyoid
Geniogyoid
Stylohyoid
Digastric
Sternohyoid
Sternothyroid
Thyrohyoid
Omohyoid
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TEMPORALIS
O: Temporal Fossa
I: Coronoid process andramus of mandible
A: Elevation, retrusion,ipsilateral lateral deviation
N: Trigeminal
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MASSETER
O: Zygomatic arch oftemporal bone andzygomatic process ofmaxilla
I: Angle of ramus andcoronoid process ofmandible
A: Elevation and ipsilaterallateral deviation
N: Trigeminal
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MEDIAL PTERYGOID
O: Lateral pteyrgoid plateof sphenoid bone andtuberosity of maxilla
I: ramus and angel of themandible
A: Elevation, protrusion,
unilaterally: contralaterallateral deviation
N: Trigeminal
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LATERAL PTERYGOID
O: Latera pteryogid plateand greater wing ofsphenoid
I: Mandibular condyle andarticular disk
A: depression andprotrusion: unilateral
causes contralateral lateraldeviation
N: Trigeminal
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THE REST.
Assist with depression
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THE REST (CONT.)
Digastric
Stylohyoid
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THE REST (CONT.)
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NECK &TRUNK
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SPINAL COLUMN
Cervical: 7 vertebrae Normal curvature - Lordosis
Thoracic: 12 vertebrae Normal to have some Kyphosis
Lumbar: 5 vertebrae Normal to have Lordosis
Sacral: 5 vertebrae that are fused together.
Coccyx: End of sacrum that is our tail bone.
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BONES &
LANDMARKS
Vertebrae:
Body: Major weight bearing structure. The anterior portion ofvertebrae.
Vertebral foramen: Where the spinal cord passes through.
Transverse process: Lateral projections of vertabrae that arefor muscle/ligament attachments.
Spinous process: Posterior projection of vertabrae.Muscles/ligaments also attach to these.
Supraspinous ligament turns into nuchal ligament Nuchal ligament Fig 15-15 page 219
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BONES/LANDMARK
S (CONT.)
Intervetebral Discs:
23 total discs.
Shock absorbers of the spine.
Made up of annulus fibrosus & nucleus pulposus.
Annulus Fibrosus: Outer portion of the discs. Made up offibrocartilaginous rings.
Nucleus Pulposus: Gelatin center that is made up of appox.80% of water. Will dry as we age, thus causing shrinkage andlosing height.
Facets: On the inferior and superior sides of the thoracicvertebrae that the ribs articulate with, sometimes called costalfacets.
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JOINT MOTIONS
Flexion
Extension
Lateral bendingRotation
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MUSCLES
Anterior:
SCM(Sternocleidomastoid)
Scalene (3 of them) Prevertebral group (4 of
them)
Rectus Abdominis
External Oblique
Internal Oblique
Transverse Abdominis
Posterior:
Splenius Capitis
Splenius Cervicis
Erector Spinae group(3 of them)
Paraspinals
Quadratus Lumborum
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STERNOCLEIDOMASTOID -
SCM
O: Sternum and clavical
I: Mastoid process
A Bilaterally flexes neck and
hyperextends head.Unilaterally, lateral bending ofneck and rotates face inopposite direction
N: Accessory Nerve (CranialXI) and second and thirdcervical nerves
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SCALENES
O: Transverse processesof cervical vertebrae
I: First and second ribs
A: Bilaterally assists inneck flexion; unilaterallywith lateral bending
N: Lower cervical nerves
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PREVERTEBRAL
GROUP
Rectus Capitis lateralis
Rectus Capitis AnteriorLongus Capitus
Longus Colli
Known as deepflexors andimportant for
cervical spinerehabilitation
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SPLENIUS CAPITUS
O: Lower half of nuchalligamentSPs of C7-T3
I: Lateral occipital bone;
mastoid processA: Bilaterally extend headand neck; unilaterallyrotates and lateral bends
neck at same timeN: middle and lowercervical nerves
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SPLENIUS CERVICIS
O: Spinous processes T3T6
I: Transverse processes of
C1-3A: Bilaterally extendsneck; unilaterally rotateand laterally bend neck to
same sideN: middle and lowercervical nerves
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RECTUS ABDOMINUS
O: Pubis
I: Xiphoid process andcostal cartilages of fifth,
sixth, and seventh ribs
A: Trunk flexion;compression of abdomen
N: 7-12 intercoastal nerves
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EXTERNAL OBLIQUE
O: lower eight ribs
I: iliac crest and linea alba
A Bilaterally trunk flexion;unilaterally, lateralbending to same side; androtation to opposite side
N: 8th 12th intercoastal,iliohypogastric, andilioinguinal
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INTERNAL OBLIQUE
O: Inguinal ligament, iliaccrest, throacolumbar fascia
I: 10th, 11th, and 12th ribs;abdominal aponeurosis
A: bilaterally trunk flexion;compression of abdominal;unilaterally lateral bending;rotation to same side
N: 8-12th intercoastal,iliohypogastric, andilioinguinal nerves
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TRANSVERSUS
ABDOMINUS
O: Inguinal ligament, iliaccrest, thoracolumbarfascia, and last 6 ribs
I: Abdominal aponeurosisand linea alba
A: Compression ofabdominal contents
N: 7th -12th intercoastal,iliohypogastric, andilioinguinal
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ERECTOR SPINAE
O: Spinous processes,transverse processes, andposterior ribs from theocciput to sacrum and ilium
I: Spinous processes,transverse processes, andposterior ribs from occiputto sacrum and ilium
A: bilaterally: extend neck
and trunk, unilaterally bendneck and trunk
N: Spinal nerves
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QUADRATUS
LUMBORUM
O: Iliac Crest
I: Twelfth rib, transverseprocesses of all five
lumbar vertebrae
A: trunk lateral bending
N: 12th thoracic and first
lumbar nerves
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RESPIRATORY SYSTEM
CHAPTER 16
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BONES &
LANDMARKS
Rib cage attaches vertebral column posteriorly to the sternumanteriorly
Protects chest organs (heart, lungs, aorta, thymus gland, trachea,espoghagus, lymph nymph nodes, and important nerves
12 sets of ribs (24 total)
Upper seven are true ribs;attached to the sternum.
#8-10 ribs are false ribs;attach indirectly to the sternum via thecostal cartilage.
#11th & 12th are floating ribs; they have no anterior attachment.
All ribs attach to thoracic vertebrae via the facets forming thecostovertebral joint.
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MUSCLES AND
INSPIRATION
Diaphragm muscle: (Big muscle)
Inspiration taking air in and out
Intercostals Muscles:
External: Elevate the ribs.
Internal: Depress the ribs.
Quiet Inspiration sitting or resting quietly
Deep Inspiration Diaphragm and/or external intercostals activate(being up and down actively involved will be at deep inspiration)
Forced InspirationPerson is state of air hunger
Quiet Expirationmostly passive with relaxation of diaphragm andexternal intercoastals
Forced Expiration pull down on rib cage and compress abdomenforcing diaphragm upward (i.e.p. 239 Heimlich)
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BREATHING
Diaphragmatic
Most efficient and requires least amount of energy
Diaphragm normally lowers when in contracts
Causes abdomen to move out, lungs to expand, and air to flow outof lungs
Diaphragm can become dysfunctional with pathology
Chest
Greater effort and much less efficient
Rig cage moves up and out (medial/lateral and A/P)
Valsalva Maneuver
Holding breath with attempting to exhale (forcing respiration) i.e.clearing ears
This thoracic pressure traps blood in veins and prevents it entering heart
With exhalation blood rushes into heart with dramatic HR and BPIncrease
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PATHOLOGIES
URI (upper respiratory infection) nose, throught, larynx
LRI (lower respiratory infection) -Pneumonia: (Trachea andbelow) -Bacterial or viral infection of the alveoli of the lungs.
Pnuemothorax: Collapsed lung.Hiccups: Spasms of the diaphragmBronchitis: Inflammation ofthe bronchi of the lung.
Asthma: Spasms of bronchial walls and makes a person have ahard time to exhale.
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THE
END!!!!!