颞下颌关节紊乱病现代物理治疗演示文稿.ppt

Lateral ?excursion ?occurs ?when ?the ?condyle and ?disc ?of ?the ?contralateral side ?are ?pulled ?forward, ?downward, ?and ?medially ?along ?the ?articular eminence. ? ??The ?condyle on ?the ?ipsilateralside ?performs ?minimal ?rotation ?around ?a ?vertical ?axis ?and ?a ?slight ?lateral ?shift.12 ??These ?motions ?take ?place ?primarily ?in ?the ?upper ?joint ?space. ? ?? * Lateral ?excursion ?is ?created ?by ?contraction ?of ?the ?lateral ?pterygoid muscles ?on ?the ?contralateral side ?of ?the ?direction ?of ?the ?motion ?combined ?with ?the ?ipsilateral side ?temporalis muscle ?contracting ?to ?hold ?the ?rest ?position ?of ?the ?condyle to ?prevent ?the ?mandile ?from ?deviating ?anteriorly.12 * Protusionof ?the ?mandible ?is ?created ?with ?symmetrical ?anterior ?translation ?of ?both ?condyle/disc ?complexes ?on ?the ?articulareminence ??The ?motion ?occurs ?at ?the ?superior ?joint ?space. ? ??Protrusion ?is ?created ?by ?contraction ?of ?the ?inferior ?head ?of ?the ?lateral ?pterygoidand ?holding ?action ?of ?the ?masseterand ?medial ?terygoidmuscles.12The ?lateral ?pterygoidpulls ?the ?condyleand ?disc ?forward ?and ?down ?along ?the ?articulareminence ?while ?the ?elevator ?and ?depressor ?muscles ?maintain ?the ?mandibularposition.12 ??Retrusionis ?the ?return ?to ?rest ?position ?from ?the ?protrusion ?position ?and ?is ?created ?by ?the ?contraction ?of ?the ?middle ?and ?posteror ?fibers ?of ?both ?temporalismuscles ?while ?the ?depressors ?and ?elevators ?maintain ?a ?slight ?opening ?of ?the ?mouth.12 * * 11 咀嚼肌紊乱疾病: ①肌筋膜痛; ②肌炎; ③肌 痉挛; ④不能分类的局部性肌痛; ⑤肌纤维变性性挛 缩。 21 结构紊乱疾病: ①可复性盘前移位; ②不可复性盘前移位; ③其他类型的关节盘移位(关节盘内、外及旋转移位等) 。 结构紊乱类各种疾病中均可伴有关节囊松弛、扩张、关节盘附丽松弛或撕脱等。在关节囊扩张、松弛、关节盘附丽松弛或撕脱的病例中,常伴有颞下颌关节半脱位。在由可复性盘前移位发展为不可复性盘前移位的过程中,常存在一个中间状态,临床表现为开口过程中反复发生暂时性锁结,关节盘不能恢复正常位置。 31 炎性疾病:滑膜炎和(或) 关节囊炎:急性,慢 性。 41 骨关节病:可分为原发性骨关节病、继发性 骨关节病两类。 * 在由可复性盘前移位发展为不可复性盘前移位的过程中,常存在一个中间状态,临床表现为开口过程中反复发生暂时性锁结,关节盘不能恢复正常位置。 * 吃甘蔗、大闸蟹、骨头、吃安利咀嚼钙片、中风病人吞咽言语障碍过多说话咀嚼、玉米上市 鼻炎 * A disc di