resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Functional Impingement of the Hip (Part 2): Rehab Exercises
I find functionally impinged hips that don't move properly on so many of my patients. (See part 1 of this article for a description of the condition.)
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Applauding a Legacy of Leadership
Founding Palmer West President, John Miller, DC, HCD (Hon.), FICA (Hon.), a 1954 graduate of Palmer College of Chiropractic, passed away March 8, 2015 at age 83.
Make Every Day Mother's Day
May is a special month for many reasons. After a long, harsh winter, spring is at last in full swing. Memorial Day helps us honor those who have fought and fallen in the name of freedom.
If Your Pro-Chiropractic Governor Resigned, Would You Be Prepared?
John Kitzhaber, MD, recently re-elected to a historic fourth term as Oregon governor, has resigned among alleged ethics violations by his fiancée' and first lady, Cylvia Hayes. I developed a personal friendship with John and consider him a good friend.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Talking to Patients About Medial Branch Neurotomy (Part 2)
Even when lumbar facet denervation (medial branch neurotomy) is successful, relief is rarely complete or permanent. Smuck, et al., reviewed 16 articles and found the average duration of >50 percent pain relief for an initial procedure was nine months.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Teach Your Patients About External Healing Applications
Since the skin is the body's largest organ, and is able to respond to both internal and external stimulations, communicate sensations to the brain, protect the body, breathe and even excrete toxins, it can be an excellent source of healing.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Trouble in the Wellness Waters?
Call me old-fashioned, paranoid or just old, but I do remember graduating from chiropractic college in the late '70s in the midst of the Wilk v AMA lawsuit.
News in Brief
Dr. Frank Nicchi Receives Award at ACC-RAC; Sherman College Expands International Influence.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
May, 2001, Vol. 01, Issue 05
Snap, Crackle and Pop, Part I
By Neal Cross, PhD, NCTMB
The human temporomandibular joint (TMJ) is involved in the etiology of several clinical complaints, including jaw pain, tongue pain and headache. Although small, this joint has a rather complex structure and function.By placing your middle finger over the TMJ (just inferior and slightly anterior to the external auditory meatus) and slowly opening and closing your mandible, you should feel a nice smooth motion bilaterally. This motion will start as a jaw opening (depression); at the end of the movement ( at the point just prior to fully opening the jaw), you should feel the joint glide anteriorly. Some will feel one side move out of synch with the other; others may feel one or both sides suddenly "snap" anteriorly. A few may feel a "crackle" (crepitus) on one or both sides; still others may feel and/or hear a "pop" as the articular disc releases.
Let's consider some of the underlying anatomical and functional aspects of the TMJ. The TMJ is formed by parts of two bones: the temporal bone and the mandible. More specifically, the condyloid process of the mandibular ramus fits into the mandibular (glenoid) fossa of the zygomatic process of the temporal bone. This mandibular fossa is bounded posteriorly by the retroarticular process and anteriorly by the articular tubercle. There is a well-defined articular disc within the joint cavity and an articular capsule enveloping the joint. (Author's note: For more information, please refer to one of the atlas pictures listed below.) Interestingly, the disc separates the joint cavity into two functionally separate compartments: one inferior and one superior. Another unique feature of this joint is that the articular surfaces are covered by dense fibrous connective tissue instead of hyaline cartilage, as is usual in synovial joints. This type of connective tissue allows for joint remodeling. The disc attaches to bone medially, laterally and posteriorly, but blends with the articular capsule anteriorly. The articular capsule and the lateral ligament further stabilize this joint. Medially, the sphenomandibular ligament assists in TMJ stabilization. Posteriorly, the stylomandibular ligament assists in joint stabilization.
The TMJ is considered a compound joint, because it operates as two separate but related functional units. The articular disc and the mandibular condyle form the first functional unit. These two act together in most hinge-type movements. This is when the jaw is depressed. The condyle and the disc together move (glide) on the articular eminence for full mandibular opening. The jaw may also be protracted (protruding the mandible) or retracted. In addition, there is lateral displacement about the TMJ. The primary muscles producing these mandibular movements are: depression-lateral pterygoids with help from the digastric, mylohyoid and geniohyoid muscles; elevation-masseter, temporalis and medial pterygoids; retraction-posterior temporalis; protraction-lateral pterygoids; and lateral displacement-contralateral lateral pterygoid. Earlier descriptions of a separate "superior pterygoid" muscle acting solely upon the articular disc seem to have been unfounded.1
The innervation of the TMJ is derived from branches of the mandibular division of the trigeminal nerve; specifically, the masseteric and auriculotemporal branches. The blood supply is derived from the superficial temporal and maxillary branches of the external carotid artery. Lymphatic drainage is primarily into the deep cervical nodes.
Next month, I will discuss various TMJ dysfunctions as they relate specifically to the underlying anatomical features. It will then become clear why so many clinicians of various types treat TMJ dysfunction.
Click here for previous articles by Neal Cross, PhD, NCTMB.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.