Published on 16/03/2015 by admin
Filed under Orthopaedics
Last modified 16/03/2015
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CHAPTER 3
Selected Movements
Active Movements
Functional Opening (Knuckle) Test
Resisted Isometric Movements
Précis of the Temporomandibular Joint Assessment*
History
Observation
Examination
Active movements
Neck flexion
Neck extension
Neck side flexion (left and right)
Neck rotation (left and right)
Extend neck by opening mouth
Assess functional opening (knuckle test)
Assess freeway space
Open mouth
Closed mouth (occlusion)
Measure protrusion of mandible
Measure retrusion of mandible
Measure lateral deviation of mandible (left and right)
Measure mandibular length
Swallowing and tongue position
Cranial nerve testing (if necessary)
Passive movements (as in active movements, if necessary)
Resisted isometric movements
Lateral deviation of jaw
Special tests
Reflexes and cutaneous distribution
Joint play movements
Palpation
Diagnostic imaging
*The entire assessment usually is done with the patient sitting. After any examination, the patient should be warned that symptoms may be exacerbated as a result of the assessment.
ACTIVE MOVEMENTS1
PURPOSE
These movements assess the mobility and motion of the temporomandibular joint (TMJ).
SUSPECTED INJURY
Temporomandibular joint dysfunction
PATIENT POSITION
The patient is sitting.
EXAMINER POSITION
The examiner stands or sits in front of the patient so as to observe mouth motion and range.
Mouth Opening and Closing
TEST PROCEDURE
The patient is asked to open the mouth as far as possible. The first phase of opening is rotation while maintaining the tongue against the roof (hard palate) of the mouth. The second phase is translation and rotation as the condyles move along the slope of the eminence; this phase begins when the tongue loses contact with the roof of the mouth.
INDICATIONS OF A POSITIVE TEST
Orthopedic Physical Assessment Atlas and Video Selected Special
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