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1 Chapter 9 Joints Joints hold bones together but permit movement Joints hold bones together but permit movement Point of contact Point of contact between.

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Presentation on theme: "1 Chapter 9 Joints Joints hold bones together but permit movement Joints hold bones together but permit movement Point of contact Point of contact between."— Presentation transcript:

1 1 Chapter 9 Joints Joints hold bones together but permit movement Joints hold bones together but permit movement Point of contact Point of contact between 2 bones between 2 bones between cartilage and bone between cartilage and bone between teeth and bones between teeth and bones Arthrology = study of joints Arthrology = study of joints Kinesiology = study of motion Kinesiology = study of motion

2 2 Classification of Joints Structural classification based upon: Structural classification based upon: presence of space between bones presence of space between bones type of connective tissue holding bones together type of connective tissue holding bones together collagen fibers collagen fibers cartilage cartilage joint capsule & accessory ligaments joint capsule & accessory ligaments Functional classification based upon movement: Functional classification based upon movement: immovable = synarthrosis immovable = synarthrosis slightly movable = amphiarthrosis slightly movable = amphiarthrosis freely movable = diarthrosis freely movable = diarthrosis

3 3 Fibrous Joints Lack a synovial cavity Lack a synovial cavity Bones held closely together by fibrous connective tissue Bones held closely together by fibrous connective tissue Little or no movement (synarthroses or amphiarthroses) Little or no movement (synarthroses or amphiarthroses) structural type structural type sutures sutures syndesmoses syndesmoses gomphoses gomphoses

4 4 Sutures Thin layer of dense fibrous connective tissue unites bones of the skull Thin layer of dense fibrous connective tissue unites bones of the skull Immovable (synarthrosis) Immovable (synarthrosis) If fuse completely in adults is synostosis If fuse completely in adults is synostosis

5 5 Syndesmosis Fibrous joint bones united by ligament Slightly movable (amphiarthrosis) Anterior tibiofibular joint and Interosseous membrane

6 6 Gomphosis Ligament holds cone-shaped peg in bony socket Ligament holds cone-shaped peg in bony socket Immovable (amphiarthrosis) Immovable (amphiarthrosis) Teeth in alveolar processes Teeth in alveolar processes

7 7 Cartilaginous Joints Lacks a synovial cavity Lacks a synovial cavity Allows little or no movement Allows little or no movement Bones tightly connected by fibrocartilage or hyaline cartilage Bones tightly connected by fibrocartilage or hyaline cartilage 2 types 2 types synchondroses synchondroses symphyses symphyses

8 8 Synchondrosis Connecting material is hyaline cartilage Immovable (synarthrosis) Epiphyseal plate or joints between ribs and sternum

9 9 Symphysis Fibrocartilage is connecting material Fibrocartilage is connecting material Slightly movable (amphiarthroses) Slightly movable (amphiarthroses) Intervertebral discs and pubic symphysis Intervertebral discs and pubic symphysis

10 10 Synovial Joints Synovial cavity separates articulating bones Synovial cavity separates articulating bones Freely moveable (diarthroses) Freely moveable (diarthroses) Articular cartilage Articular cartilage reduces friction reduces friction absorbs shock absorbs shock Articular capsule Articular capsule surrounds joint surrounds joint thickenings in fibrous capsule called ligaments thickenings in fibrous capsule called ligaments Synovial membrane Synovial membrane inner lining of capsule inner lining of capsule secretes synovial fluid containing hyaluronic acid slippery) secretes synovial fluid containing hyaluronic acid slippery) brings nutrients to articular cartilage brings nutrients to articular cartilage

11 11 Example of Synovial Joint Joint space is synovial joint cavity Articular cartilage covering ends of bones Articular capsule

12 12 Other Special Features Accessory ligaments Accessory ligaments extracapsular ligaments extracapsular ligaments outside joint capsule outside joint capsule intracapsular ligaments intracapsular ligaments within capsule within capsule Articular discs or menisci Articular discs or menisci attached around edges to capsule attached around edges to capsule allow 2 bones of different shape to fit tightly allow 2 bones of different shape to fit tightly increase stability of knee - torn cartilage increase stability of knee - torn cartilage Bursae = saclike structures between structures Bursae = saclike structures between structures skin/bone or tendon/bone or ligament/bone skin/bone or tendon/bone or ligament/bone

13 13 Arthroscopy & Arthroplasty Arthroscopy = examination of joint Arthroscopy = examination of joint instrument size of pencil instrument size of pencil remove torn knee cartilages & repair ligaments remove torn knee cartilages & repair ligaments small incision only small incision only Arthroplasty = replacement of joints Arthroplasty = replacement of joints total hip replaces acetabulum & head of femur total hip replaces acetabulum & head of femur plastic socket & metal head plastic socket & metal head knee replacement common knee replacement common

14 14 Torn Cartilage and Arthroscopy Damage to menisci of the knee joint Damage to menisci of the knee joint Visualization of the inside of a joint Visualization of the inside of a joint arthroscope arthroscope requires only small incisions requires only small incisions Repair may include removal of torn cartilage Repair may include removal of torn cartilage

15 15 Nerve and Blood Supply Nerves to joints are branches of nerves to nearby muscles Nerves to joints are branches of nerves to nearby muscles Joint capsule and ligaments contain pain fibers and sensory receptors Joint capsule and ligaments contain pain fibers and sensory receptors Blood supply to the structures of a joint are branches from nearby structures Blood supply to the structures of a joint are branches from nearby structures supply nutrients to all joint tissues except the articular cartilage which is supplied from the synovial fluid supply nutrients to all joint tissues except the articular cartilage which is supplied from the synovial fluid

16 16 Sprain versus Strain Sprain Sprain twisting of joint that stretches or tears ligaments twisting of joint that stretches or tears ligaments no dislocation of the bones no dislocation of the bones may damage nearby blood vessels, muscles or tendons may damage nearby blood vessels, muscles or tendons swelling & hemorrhage from blood vessels swelling & hemorrhage from blood vessels ankle if frequently sprained ankle if frequently sprained Strain Strain less serious injury less serious injury overstretched or partially torn muscle overstretched or partially torn muscle

17 17 Planar Joint Bone surfaces are flat or slightly curved Bone surfaces are flat or slightly curved Side to side movement only Side to side movement only Rotation prevented by ligaments Rotation prevented by ligaments Examples Examples intercarpal or intertarsal joints intercarpal or intertarsal joints sternoclavicular joint sternoclavicular joint vertebrocostal joints vertebrocostal joints

18 18 Hinge Joint Convex surface of one bones fits into concave surface of 2nd bone Uniaxial like a door hinge Examples Knee, elbow, ankle, interphalangeal joints Movements produced flexion = decreasing the joint angle extension = increasing the angle hyperextension = opening the joint beyond the anatomical position

19 19 Flexion, Extension & Hyperextension

20 20 Pivot Joint Rounded surface of bone articulates with ring formed by 2nd bone & ligament Monoaxial since it allows only rotation around longitudinal axis Examples Proximal radioulnar joint supination pronation Atlanto-axial joint turning head side to side “no”

21 21 Condyloid or Ellipsoidal Joint Oval-shaped projection fits into oval depression Biaxial = flex/extend or abduct/adduct is possible Examples wrist and metacarpophalangeal joints for digits 2 to 5

22 22 Abduction and Adduction Condyloid joints Ball and Socket joints

23 23 Saddle Joint One bone saddled-shaped; other bone fits as a person would sitting in that saddle Biaxial Circumduction allows tip of thumb travel in circle Opposition allows tip of thumb to touch tip of other fingers Example trapezium of carpus and metacarpal of the thumb

24 24 Ball and Socket Joint Ball fitting into a cuplike depression Multiaxial flexion/extension abduction/adduction rotation Examples shoulder joint hip joint

25 25 Bursae and Tendon Sheaths Bursae Bursae fluid-filled saclike extensions of the joint capsule fluid-filled saclike extensions of the joint capsule reduce friction between moving structures reduce friction between moving structures skin rubs over bone skin rubs over bone tendon rubs over bone tendon rubs over bone Tendon sheaths Tendon sheaths tubelike bursae that wrap around tendons at wrist and ankle where many tendons come together in a confined space tubelike bursae that wrap around tendons at wrist and ankle where many tendons come together in a confined space Bursitis Bursitis chronic inflammation of a bursa chronic inflammation of a bursa

26 26 Summary of Movements at Synovial Joints Gliding Gliding no change in angle of joint no change in angle of joint Angular movements Angular movements increase or decrease in angle between articulating bones increase or decrease in angle between articulating bones flexion, extension, hyperextension flexion, extension, hyperextension adduction, abduction adduction, abduction circumduction is a combination of above movements circumduction is a combination of above movements Rotation Rotation bone revolves around its own axis bone revolves around its own axis Special movements Special movements uniquely named movements for jaw, hand and foot uniquely named movements for jaw, hand and foot

27 27 Circumduction Movement of a distal end of a body part in a circle Movement of a distal end of a body part in a circle Combination of flexion, extension, adduction and abduction Combination of flexion, extension, adduction and abduction Occurs at ball and socket, saddle and condyloid joints Occurs at ball and socket, saddle and condyloid joints

28 28 Rotation Bone revolves around its own longitudinal axis Bone revolves around its own longitudinal axis medial rotation is turning of anterior surface in towards the midline medial rotation is turning of anterior surface in towards the midline lateral rotation is turning of anterior surface away from the midline lateral rotation is turning of anterior surface away from the midline At ball & socket and pivot type joints At ball & socket and pivot type joints

29 29 Special Movements of Mandible Elevation = upward Depression = downward Protraction = forward Retraction = backward

30 30 Special Hand & Foot Movements Inversion Eversion Dorsiflexion Plantarflexion Pronation Supination

31 31 Shoulder Joint Head of humerus and glenoid cavity of scapula Ball and socket All types of movement

32 32 Glenohumeral (Shoulder) Joint Articular capsule from glenoid cavity to anatomical neck Glenoid labrum deepens socket Many nearby bursa (subacromial)

33 33 Supporting Structures at Shoulder Associated ligaments strengthen joint capsule Transverse humeral ligament holds biceps tendon in place

34 34 Rotator Cuff Muscles Attach humerus to scapula Encircle the joint supporting the capsule Hold head of humerus in socket

35 35 Elbow Joint Hinge joint Hinge joint trochlea notch of ulna and trochlea of humerus trochlea notch of ulna and trochlea of humerus flexion and extension of elbow flexion and extension of elbow Pivot joint Pivot joint head of radius and capitulum of humerus head of radius and capitulum of humerus supination and pronation of forearm supination and pronation of forearm

36 36 Articular Capsule of the Elbow Joint Radial annular ligament hold head of radius in place Collateral ligaments maintain integrity of joint

37 37 Hip Joint Head of femur and acetabulum of hip bone Ball and socket type of joint All types of movement possible

38 38 Hip Joint Structures Acetabular labrum Ligament of the head of the femur Articular capsule

39 39 Hip Joint Capsule Dense, strong capsule reinforced by ligaments iliofemoral ligament ischiofemoral ligament pubofemoral ligament One of strongest structures in the body

40 40 Tibiofemoral Joint Between femur, tibia and patella Hinge joint between tibia and femur Gliding joint between patella and femur Flexion, extension, and slight rotation of tibia on femur when knee is flexed

41 41 Tibiofemoral Joint Articular capsule mostly ligs & tendons Lateral & medial menisci = articular discs Many bursa Vulnerable joint Knee injuries damage ligaments & tendons since bones do not fit together well

42 42 External Views of Knee Joint Patella is part of joint capsule anteriorly Rest of articular capsule is extracapsular ligaments Fibular and tibial collateral ligaments

43 43 Intracapsular Structures of Knee Medial meniscus C-shaped fibrocartilage Lateral meniscus nearly circular Posterior cruciate ligament Anterior cruciate ligament

44 44 Temporomandibular Joint Synovial joint Articular disc Gliding above disc Hinge below disc Movements depression elevation protraction retraction

45 45 Atlanto-occipital joints Atlas and occipital condyles Condyloid Joint Flexion Extension Slight lateral tilting

46 46 Intervertebral Joints Between bodies and intervertebral discs symphysis Between vertebral articular processes synovial Flexion Extension Lateral flexion

47 47 Elbow Joint Trochlea of humerus, trochlear notch of ulna & head of radius Pivot and hinge types Flexion, extension, pronation & supination

48 48 Radiocarpal Joint Articular disc Condyloid type Flexion, extension, abduction & adduction

49 49 Talocrural Joint Tibia & fibula with talus Hinge Inversion, eversion, plantarflexion & dorsiflexion Strong joint, seldom dislocates

50 50 But it still can dislocate

51 51 Range of Motion in a Synovial Joint Shape of articulating bones Shape of articulating bones Tension & strength of joint ligaments Tension & strength of joint ligaments Arrangement of muscles around joints Arrangement of muscles around joints Apposition (coming together) of soft parts Apposition (coming together) of soft parts Hormones Hormones relaxin from placenta loosens pubic symphysis relaxin from placenta loosens pubic symphysis Disuse Disuse decreased synovial fluid, decreased flexibility of ligaments, reduced size of muscles decreased synovial fluid, decreased flexibility of ligaments, reduced size of muscles

52 52 Rheumatoid Arthritis Autoimmune disorder Cartilage attacked Inflammation, swelling & pain Final step is fusion of joint

53 53 Osteoarthritis Degenerative joint disease Degenerative joint disease aging, wear & tear aging, wear & tear Noninflammatory---no swelling Noninflammatory---no swelling only cartilage is affected not synovial membrane only cartilage is affected not synovial membrane Deterioration of cartilage produces bone spurs Deterioration of cartilage produces bone spurs restrict movement restrict movement Pain upon awakening--disappears with movement Pain upon awakening--disappears with movement

54 54 Gouty Arthritis Urate crystals build up in joints---pain Urate crystals build up in joints---pain waste product of DNA & RNA metabolism waste product of DNA & RNA metabolism builds up in blood builds up in blood deposited in cartilage causing inflammation & swelling deposited in cartilage causing inflammation & swelling Bones fuse Bones fuse Middle-aged men with abnormal gene Middle-aged men with abnormal gene


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