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Chapter 9:

Articulations

Functional Classifications

Synarthrosis:

no movement

Amphiarthrosis:

little movement

Diarthrosis:

more movement

Functional Classification

Functional Classification Table 9 – 1

Table 91

Structural Classifications

Bony

Fibrous Cartilaginous Synovial

Structural Classification

Structural Classification Table 9 – 2

Table 92

4 Types of Synarthrotic Joints

Sutures - bound by dense fibrous connective tissue; found only in skull

Gomphosis - binds teeth to sockets (periodontal ligament)

Synchondrosis - epiphyseal cartilage of long bones & b/t vertebrosternal ribs and sternum

Synostosis - fused bones, epiphyseal lines of long bones

2 Types of Amphiarthroses

Syndesmosis:

bones connected by ligaments

Symphysis:

bones separated by fibrocartilage

Synovial Joints (Diarthroses)

Also called freely moveable joints Lined with synovial membrane Articular cartilages (hyaline) pad articulating surfaces within articular capsules & prevent bones from touching Smooth surfaces lubricated by synovial fluid

Functions of Synovial Fluid

  • 1. Lubrication

  • 2. Nutrient distribution

  • 3. Shock absorption

Synovial Joints: Accessory Structures

Cartilages - cushion the joint:

fibrocartilage meniscus (articular disc)

Fat pads - superficial to the joint capsule; protect articular cartilages

Ligaments - support, strengthen joints

Sprain - ligaments with torn collagen fibers

Tendons - attach to muscles around joint

Bursae - Pockets of synovial fluid that cushion areas where tendons or ligaments rub

Synovial Joints: Range of Motion

Nonaxial slipping movements only Uniaxial movement in one plane Biaxial movement in two planes Multiaxial movement in or around all

three planes

Joint movements To be read for lab…DO NOT FORGET!

Linear Motion

Also called gliding 2 surfaces slide past each other:

between carpal or tarsal bones

Flexion/Extension

Angular motion in A/P plane Flexion reduces angle between elements Extension Increases angle between elements

Flexion/Extension • Angular motion in A/P plane • Flexion reduces angle between elements • Extension Increases
Flexion/Extension • Angular motion in A/P plane • Flexion reduces angle between elements • Extension Increases

Figure 93a

Abduction/Adduction

Angular motion in frontal plane Abduction moves away from longitudinal axis Adduction moves toward longitudinal axis

Abduction/Adduction • Angular motion in frontal plane • Abduction moves away from longitudinal axis • Adduction
Abduction/Adduction • Angular motion in frontal plane • Abduction moves away from longitudinal axis • Adduction

Figure 93b, c

Circumduction

Circumduction • Circular motion without rotation • Angular motion Figure 9 – 3d

Circular motion without rotation Angular motion

Figure 93d

Rotation

Rotation • Left or right rotation – rotates toward axis • Medial rotation ( inward rotation

Left or right rotation

rotates toward axis

Medial rotation (inward rotation):

Lateral rotation (outward rotation):

rotates away from axis

Pronation and Supination

Pronation:

rotates forearm, radius over ulna

Supination:

forearm in anatomical position

Inversion and Eversion

Inversion:

twists sole of foot medially

Eversion:

twists sole of foot laterally

Inversion and Eversion • Inversion: – twists sole of foot medially • Eversion: – twists sole

Figure 95a

Dorsiflexion and Plantar Flexion

Dorsiflexion:

flexion at ankle (lifting toes)

Plantar flexion:

extension at ankle (pointing toes)

Dorsiflexion and Plantar Flexion • Dorsiflexion: – flexion at ankle (lifting toes) • Plantar flexion: –

Figure 95b

Opposition • Thumb movement toward fingers or palm (grasping) Figure 9 – 5c

Opposition

Thumb movement toward fingers or palm (grasping)

Figure 95c

Protraction and Retraction

Protraction:

moves anteriorly

in the horizontal plane (pushing forward)

Retraction:

opposite of protraction moving anteriorly (pulling back)

Protraction and Retraction • Protraction : – moves anteriorly – in the horizontal plane (pushing forward)

Figure 95d

Elevation and Depression

Elevation and Depression • Elevation: – moves in superior direction (up) • Depression: – moves in

Elevation:

moves in superior direction (up)

Depression:

moves in inferior direction (down)

Lateral Flexion

Lateral Flexion • Bends vertebral column from side to side Figure 9 – 5f

Bends vertebral column from side to side

Figure 95f

6 subtypes of synovial joints

Gliding intercarpals, SI Pivot atlas/axis, radioulnar Hinge elbow, knee, TMJ, interphalangeal Ellipsoidal Occ/C1, radius to carpals Saddle trapezium to 1 st metacarpal Ball & socket shoulder/hip

Plane joints

Articular surfaces are essentially flat

Allow only slipping or gliding movements

Only examples of nonaxial joints

Hinge joints

Cylindrical projections of one bone fits into

a trough-shaped surface on another Motion is along a single plane

Uniaxial joints permit flexion and extension only

Examples: elbow and interphalangeal joints

• Plane joints – Articular surfaces are essentially flat – Allow only slipping or gliding movements
• Plane joints – Articular surfaces are essentially flat – Allow only slipping or gliding movements

Pivot joints

bone protrudes into a “sleeve,”

or ring, composed of bone (and

possibly ligaments) of another Only uniaxial movement allowed

Examples: joint between the axis and the dens, and the proximal radioulnar joint

Condyloid joints

Oval articular surface of one bone fits into a complementary depression in another

Both articular surfaces are oval

Biaxial joints permit all angular motions

Examples: radiocarpal (wrist) joints, and metacarpophalangeal (knuckle)

joints

• Pivot joints – bone protrudes into a “sleeve,” or ring, composed of bone (and possibly
• Pivot joints – bone protrudes into a “sleeve,” or ring, composed of bone (and possibly

Saddle Joints

Similar to condyloid joints but allow greater movement

Each articular surface has both a concave and a convex surface

Example: carpometacarpal joint of the thumb

Ball-and-Socket Joints

A spherical or hemispherical head of one bone articulates with a cuplike socket of another

Multiaxial joints permit the most freely

moving synovial joints Examples: shoulder and hip joints

• Saddle Joints – Similar to condyloid joints but allow greater movement – Each articular surface
• Saddle Joints – Similar to condyloid joints but allow greater movement – Each articular surface

Intervertebral Articulations

C 2 to L 5 spinal vertebrae articulate:

at inferior and superior articular processes (gliding joints)

between adjacent vertebral bodies (symphyseal joints)

Intervertebral Articulations • C to L spinal vertebrae articulate: – at inferior and superior articular processes

Figure 97

Intervertebral Discs

Intervertebral discs:

pads of fibrocartilage that separate vertebral bodies

Anulus fibrosus:

tough outer layer that attaches disc to vertebrae

Nucleus pulposus:

elastic, gelatinous core that absorbs shocks

6 Intervertebral Ligaments

  • 1. Anterior longitudinal ligament:

connects anterior bodies

  • 2. Posterior longitudinal ligament:

connects posterior bodies

  • 3. Ligamentum flavum:

connects laminae

  • 4. Interspinous ligament:

connects spinous processes

  • 5. Supraspinous ligament:

connects tips of spinous processes (C 7 to sacrum)

  • 6. Ligamentum nuchae:

continues supraspinous ligament (C 7 to skull)

Damage to Intervertebral Discs

Slipped disc:

bulge in anulus fibrosus invades vertebral canal

Herniated disc:

nucleus pulposus breaks through anulus fibrosus presses on spinal cord or nerves

Damage to Intervertebral Discs • Slipped disc: – bulge in anulus fibrosus – invades vertebral canal

The Knee Joint

The Knee Joint Figure 9 – 12a, b

Figure 912a, b

The Knee Joint

The Knee Joint • 2 femur – tibia articulations: – 1 at medial and lateral condyles

2 femurtibia articulations:

1 at medial and lateral condyles 1 between patella and patellar surface of femur

7 Ligaments of the Knee Joint

Patellar ligament (anterior) 2 popliteal ligaments (posterior)

Anterior and posterior cruciate ligaments (inside joint capsule)

Tibial collateral ligament (medial) Fibular collateral ligament (lateral)

Medial and lateral menisci: fibrocartilage pads

at femurtibia articulations to cushion and stabilize joint & give lateral support

Sprains

The ligaments reinforcing a joint are stretched or torn

Partially torn ligaments slowly repair themselves Completely torn ligaments require prompt surgical repair

Strains

The muscles or tendons are stretched or torn

Healing generally better than with a sprain, however it depends on the location of the strain with relationship of the joint

Inflammatory and Degenerative Conditions

Bursitis

An inflammation of a bursa, usually caused by a blow or friction

Symptoms are pain and swelling Treated with anti-inflammatory drugs; excessive fluid may be aspirated

Tendonitis

Inflammation of tendon sheaths typically caused by overuse Symptoms and treatment are similar to bursitis

Arthritis

More than 100 different types of inflammatory or degenerative diseases that damage the joints

Most widespread crippling disease in the U.S. Symptoms pain, stiffness, and joint swelling

Acute forms are caused by bacteria and are treated with antibiotics

Chronic forms include osteoarthritis, rheumatoid arthritis, and gouty arthritis

Osteoarthritis (OA)

Most common chronic arthritis; often called “wear-and- tear” arthritis

AKA: Degenerative Joint Disease (DJD)

Affects women more than men

85% of all Americans develop OA

More prevalent in the aged, and is probably related to

the normal aging process

As one ages, cartilage is destroyed more quickly than it is replaced

The exposed bone ends thicken, enlarge, form bone

spurs, and restrict movement

Joints most affected are the cervical and lumbar spine, fingers, knuckles, knees, and hips

Rheumatoid Arthritis (RA)

Chronic, inflammatory, autoimmune disease of

unknown cause, with an

insidious onset

Usually arises between the ages of 40 to 50, but may

occur at any age

Signs and symptoms include joint tenderness, anemia,

osteoporosis, muscle atrophy,

and cardiovascular problems

The course of RA is marked with exacerbations and remissions

Rheumatoid Arthritis (RA) • Chronic, inflammatory, autoimmune disease of unknown cause, with an insidious onset •

Gouty Arthritis

Deposition of uric acid crystals in joints and soft tissues, followed by an inflammation

response

Typically, gouty arthritis affects the joint at the base of the great toe

In untreated gouty arthritis, the bone ends fuse and immobilize the joint

Treatment colchicine, nonsteroidal anti- inflammatory drugs, and glucocorticoids