Download - Manual Functional Analysis
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Manual Functional Analysis Lecture 4
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Manual Functional Analysis
2. Extended Examinations
Manipulation Techniques
Dynamic Tests
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Manipulation Techniques
Traction
Translation
Passive Compression
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Manipulation Techniques
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Manipulation Techniques
Passive Compression
✤Superior✤Posterosuperior✤Posterior
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Manipulation Techniques
Passive Compression
✤Superior
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Manipulation Techniques
Passive Compression
✤Posterior
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Manipulation Techniques
Passive Compression
✤Posterosuperior
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Superior
Passive Compression
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Passive Compression
Posterior
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Passive Compression
Posterior
Affected Structure๏Inferior stratum ๏Superior stratum๏The genu vasculosum ๏Horizontal part of the lateral ligament
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Passive Compression
Posterosuperior
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Affected Structure๏Inferior stratum ๏Superior stratum๏The genu vasculosum ๏Horizontal part of the lateral ligament
Posterosuperior
Passive Compression
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Lateral Condyle position
Passive Compression
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Passive Compression
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posterosuperior PainfulPosterior Non
Posterosuperior NonPosterior Painful
Superior Stratum
Inferior Stratum
Superior StratumInferior Stratum
Posterosuperior PainfulPosterior Painful
Passive Compression
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Inferior Traction
Manipulation Techniques
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Manipulation Techniques
Inferior Traction
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Affected Structure
The medial wall of the joint capsule The lateral wall of the joint capsule The posterior wall of the joint capsule
Inferior Traction
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Affected StructureThe posterior wall of the joint capsule
Inferior Traction
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Differential Diagnosis
✤ Anterior Translation ✤ Joint Surface Tests✤ Passive Compression
No Painful Response
Inferior Traction
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Painful Response
Joint Capsule
Medial TranslationMedial Wall of Capsule
Lateral TranslationLateral Wall of Capsule
Differential Diagnosis
Inferior TractionInferior Traction
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Translation
Manipulation Techniques
Anterior Translation Medial TranslationLateral Translation
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Medial Translation
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Medial Wall of Capsule
Affected Structure
Medial Translation
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Lateral Translation
Affected Structure
Lateral Wall of Capsule
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Lateral Translation
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Anterior Translation
Pain
Capsule Posetior Wall ExaminationJoint Surface Tests
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Anterior Translation
Pain
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Capsule Posetior Wall and Ligaments
Anterior Translation
Affected Structures
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Endfeel
Muscle shortening Too Soft(with limitation)
Too Soft(with limitation)
CapsuleshrinkageToo Hard Too Hard
Capsule expansionToo Soft(without limitation)
Anterior disk displacement
Too Soft (with limitation)
Rebounding
Protrusion Traction Anterior Translation
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Dynamic Compression
Dynamic Translation
Extended Examinations
Dynamic Tests
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Dynamic Compression
Dynamic Compression during Active Movements
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Joint Surface Tests
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Joint Surface Tests
Pain
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Pain
Joint Surface Tests
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Pain
Joint Surface Tests
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–Johnny Appleseed
Joint Surface Tests
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Degenerative Changes
Joint Surface Tests
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Dynamic Compression during Active Movements
Dynamic compression during jaw-opening
movement
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Dynamic Compression
Dynamic compression during protrusive
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Dynamic Translation
Maximal jaw opening during manual translation
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Lateral manual translation with compression for the right joint
Dynamic Translation
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• Osteoarthosis vs. osteoarthritis: the tests either proceed painlessly or they elicit pain • Temporal vs. condylar: symptoms appear either during protrusion or during jaw opening • Lateral vs. medial: symptoms appear either during lateral or during medial translation.
Joint Surface Tests
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Isometric ContractionPassive Movement
Pain Dignosis
Joint CapsuleArticular Surfaces
Inferior Traction
Isometric Contraction Neg Passive Movement Pos
Joint
PainNo Pain
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Inferior Traction
Medial Wall ofCapsule
Anterior Translation Lateral Translation Medial Translation
Lateral Wall ofCapsule
Bilaminar Zone Articular Surfaces
Joint CapsuleArticular SurfacesBilaminar Zone
PainNo Pain
initial / intermediate
Pain Final Pain
Passive Compression
Extended Examinations
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posterosuperior PainfulPosterior Non
Posterosuperior NonPosterior Painful
Superior Stratum
Inferior Stratum
Superior StratumInferior Stratum
Anterior Translation
Bilaminar Zone
Final Pain
Posterosuperior PainfulPosterior Painful
Passive Compression
Extended Examinations
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Active protrusion or jaw opening
Timing of clicking sound
Initial or intermediate Terminal
G1 G2 G3 G4
Lateral ligamentDisk hypermobility
Partial disk displacement
Total disk displacement
Cartilage hypertrophy Disk displacement with adhesion
Disk displacement with terminal repositioning
Condyle hypermobility
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Disk Hypermobility 21
2
1
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Dynamic Copression
Disk Hypermobility
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Disk Hypermobility
Manual Translation
Medial Direction Lateral Direction
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Disk Hypermobility
Manual Translation with Compression
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Manual compression
Lateral ligament
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Lateral ligament Differential Diagnosis
Lateral manual translation Medial manual translation
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Lateral Translation with Compression
Lateral ligament
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Differential Diagnosis
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Partial Disk Displacement
2
1
12
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Partial Disk Displacement
Differential Diagnosis
Manual Compression
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Lateral Manual Translation Medial Translation
Partial Disk Displacement
Differential Diagnosis
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Total Disk Displacement
Differential Diagnosis
2
1
1 2
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Total Disk Displacement
Differential Diagnosis
Manual compression
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Total Disk Displacement
Differential Diagnosis
Medial And Lateral Manual Translation
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Cartilage Hypertrophy
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Cartilage Hypertrophy
Differential Diagnosis
DynamicCompression
Jaw Opening
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Disk displacement with adhesion
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Differential Diagnosis
Disk displacement with adhesion
DynamicCompressionJaw Opening
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Differential Diagnosis
Disk displacement with adhesion
Medial And Lateral Manual Translation
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Anterior Disk Displacement with Terminal Repositioning
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Anterior Hypermobility of The Condyle
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Ant
erio
r Dis
k D
ispl
acem
ent w
ith T
erm
inal
Rep
ositi
onin
gGuided Retrusive Movement
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Guided Retrusive Movement A
nter
ior D
isk
Dis
plac
emen
t with
Ter
min
al R
epos
ition
ing
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Manual Translation to
The lateralThe lateral with Dynamic
compression The Medial
Cartilage hypertrophy
Disk displacement with adhesion
Lateral Ligament
Disk hypermobility
Partial disk displacement
Total disk displacement
- + - + Ø - Ø +