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Joint s Chapter 14
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Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Jan 01, 2016

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Page 1: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

JointsChapter 14

Page 2: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Joints

• aka articulations• Point at which two bones join together

– Allow movement– Transmit forces

• Anatomy – Capsule or ligaments– Synovial membrane– Articular cartilage– Joint space filled with

synovial fluid

Page 3: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Classifications• Structural Categories:

– Fibrous– Cartilaginous– Synovial

• Functional Categories:– Synarthroses—

immoveable – Amphiarthroses—slightly

moveable– Diarthroses—freely

moveable

Page 4: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synarthroses

• Immoveable joints• Lack synovial cavity• Held together by

fibrous connective tissue

• Structural types:– Sutures– Syndesmoses– Gomphoses

Page 5: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synarthroses

• Sutures– Thin layer of dense fibrous connective tissue– Unites bones of skull

• Syndesmosis– Joints where bones connected by ligaments– i.e. fibula/tibia and radius/ulna

• Gomphosis – Conical process fits into socket and is held in place by

ligaments– i.e. tooth in alveolus (socket), held in place by

peridontal ligament

Page 6: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Amphiarthroses

• Slightly moveable• Connected by hyaline cartilage or fibrocartilage• i.e. ribs to sternum or vertebrae

Page 7: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Diarthroses

• aka synovial joints• Freely moveable• Ends of opposing

bones are covered with articular cartilage

• Separated by joint cavity

• Components of joints enclosed in dense fibrous joint capsule

Page 9: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovial Joint Anatomy

• Articular capsule– Aka Joint capsule

– Consists of bundles of collagen and functions to maintain a relative joint position

Page 10: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovial Joint Anatomy

• Ligaments– Bundles of collagen fibers forming a

connection between bones

Page 11: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovial Joint Anatomy

– Intrinsic ligaments: found where the articular capsule has become thickened in places

• Shoulder, Hip

– Extrinsic ligaments: separate from the capsular thickening

• ACL

Page 12: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovial Joint Anatomy

• Ligaments are strongest in the middle and weakest at the ends

• Constant compression and tension will cause ligaments to deteriorate

• Intermittent compression and tension will increase strength and growth

Page 13: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovial Joint Anatomy

• Synovial Membrane and Synovial Fluid– Lines the synovial joint(articular) capsule– Made of connective tissue with flattened cells – Synovial fluid acts as a lubricant. – Able to vary its viscosity (thicker with slower

movements and it thins with faster movements)

Page 14: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovial Joint Anatomy

• Articular Cartilage– Hyaline cartilage: Found on the articular ends

of our long bones

– Fibrocartilage: cushioning type of cartilage• Found in the menisci in our knees, intervertebral

disks, pubic symphysis

• Elastic cartilage: found in the external ear and eustachian tube

Page 15: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovial Joint Stabilization

• Muscle tension is important in limiting unwanted joint movement

• If joint capsule is overstretched, reflex contraction of muscles in the area prevent overstretching (Hilton’s Law)

Page 16: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovial Joint Stabilization

• Joints that are shallow and fit poorly must depend on capsular structures or muscles for support

Page 17: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovial Joint Stabilization

• Capsular and ligamentous tissue help to maintain anatomical integrity and structural alignment of synovial joints

Page 18: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovial Joints

• 6 Types Synovial Joints:– Pivot joint– Gliding joint– Hinge joint– Condyloid joint– Ball-and-Socket joint– Saddle joint

Page 19: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Pivot Joint

• Radius, ulna• Freely moveable joint in which bone moves around central axis, creating rotational movement

Page 20: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Gliding Joint

• Allows bones to make sliding motion

• Carpals and tarsals• Between vertebrae

and spine

Page 21: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Hinge Joint

• Allows only flexion and extension• Convex surface of one bone fits concave surface of

other

• Knee, elbow, phalanges

Page 22: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Condyloid Joint• aka ellipsoidal joint• Bones can move

about one another in many directions, but cannot rotate

• Named for condyle-containing bone

• Metacarpals, phalanges

Page 23: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Ball & Socket Joint

• One bone has rounded end that fits into concave cavity on another bone

• Widest range of movement possible

• Hips, shoulders

Page 24: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Saddle Joint

• Two bones have both concave and convex regions, shape of two bones complementing one another

• Wide range of movement

• Thumb = only saddle joint in body

Page 25: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Movements of Diarthroses

• Flexion• Extension• Hyperextension• Abduction• Adduction• Rotation• Circumduction • Elevation• Depression

• Supination• Pronation• Plantar flexion• Dorsiflexion• Inversion• Eversion• Protraction• Retraction• Opposition

Page 26: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Flexion/Extension

Page 27: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.
Page 28: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Abduction/Adduction

• Abduction—moving a body part away from midline

• Adduction—moving a body part toward the midline

Page 29: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Abduction/Adduction

Page 30: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Internal/External Rotation

• Internal rotation—rotation towards the center of the body – aka medial rotation

• External rotation—rotation away the center of the body – aka lateral rotation

Page 31: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Internal/External Rotation

Page 32: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Hip Internal Rotation

Page 33: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Foot: Dorsal/Plantar

Page 34: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Plantar Flexion/Dorsiflexion

Page 35: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Supination/Pronation

Page 36: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Elevation/Depression

Page 37: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Inversion/Eversion

Page 38: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.
Page 39: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.
Page 40: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.
Page 41: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Joints of Upper Extremity

• Shoulder Joint– Glenohumeral – Sternoclavicular– Acromioclavicular

• Elbow Joint– Radiohumeral– Humeroulnar– Radioulnar

• Wrist– Radiocarpal– Intercarpal– Carpalmetacarpal

• Hand– Intermetacarpal– Metacarpalphalangeal– Interphalangeal

Page 42: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Shoulder

• Glenohumeral• Sternoclavicular• Acromioclavicular

Glenohumeral joint

Page 43: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

shoulder

Page 44: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Elbow

• Radiohumeral• Humeroulnar• Radioulnar

Page 45: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Wrist

• Radiocarpal• Intercarpal• Carpalmetacarpal

Page 46: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Hand

– Intermetacarpal– Metacarpalphalangeal– Interphalangeal

Page 47: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Joints of Lower Extremity

• Sacroiliac• Acetabulofemoral• Patellofemoral• Tibiofemoral• Tibiofibular

• Ankle/Foot– Talocural– Subtalar– Intertarsal– Tarsometatarsal– Intermetatarsal– Metatasophalangel– Interphalangeal

Page 48: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Sacroiliac joint

Page 49: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Tibiofemoral joint

TIBIOFIBULAR JOINT

Page 50: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Foot/Ankle

Page 51: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovial Joint Injuries

Acute– Sprains– Synovitis– Subluxations – Dislocations

Chronic– Osteochondrosis– Arthritis– Bursitis– Capsulitis/synovitis

Page 52: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Sprains

• Injury to ligamentous and capsular tissue

• Traumatic joint twist that results in stretching of total tearing of the stabilizing connective tissue

• One of most common & disabling sports injuries

• General Symptoms:Joint swellingLocal temperature

increasePain Point tendernessSkin discoloration

Page 53: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Sprains Grade 1

Some pain Minimum LOF Mild point tenderness Little or not swelling No abnormal motion

Grade 2 Pain Moderate LOF Swelling Slight to moderate

instability

Grade 3 Severe sprain Extremely painful initially LOF Severe instability Tenderness Swelling

May represent subluxation that reduced spontaneously

Page 54: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Synovitis

• Irritation of synovial membrane

• Causes increase in fluid production, swelling

• Joint pain during motion, skin sensitivity from pressure

• Diminish in few days

Page 55: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Acute Joint Injuries

Subluxation• Occurs when bone

displaces, then returns to normal position

Dislocation• Occurs when

significant force displaces bone so that the two bone ends in a joint no longer add up

Page 56: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Osteochondrosis

• Degenerative changes in the ossification centers of the epiphysis of bones

• During periods of rapid growth in children• Osteochondritis dissecans• Suggested causes—

– aseptic necrosis: circulation to epiphysis disrupted– Trauma causes particles of articular cartilage to fx,

resulting in fissures that penetrate to subchondral bone

Page 57: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Arthritis

• Inflammation of an entire joint

• Usually involves all tissues of the joint

• Most often in WB joints

• 100 varieties of arthritis

• 10% population• No cure

Page 58: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Rheumatoid Arthritis Connective tissue

disorder resulting in severe inflammation of small joints

Cause unknown Severely debilitating Synovial membranes of

joint and connective tissues grow abnormally to form layer in joint capsules destroys cartilage and fuses bones of joint

Page 59: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Osteoarthritis

Page 60: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Osteoarthritis

Page 61: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Bursitis

• Inflammation of the synovial cavity caused by excessive stress or tension

Page 62: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.

Open & Closed Kinematic Chains

• Open Kinematic Chain– Sequence of action in which the body part farthest

from the trunk is free during movement– i.e. Seated leg extension

• Closed Kinematic Chain– Sequence of action in which the body part farthest

from the trunk is fixed during movement– i.e. In a squat, feet are fixed and the rest of leg chain

moves

Page 63: Joints Chapter 14. Joints aka articulations Point at which two bones join together –Allow movement –Transmit forces Anatomy –Capsule or ligaments –Synovial.