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1Copyright 2009, John Wiley & Sons, Inc. Chapter 9: JointsCopyright 2009, John Wiley & Sons, Inc.
2Copyright 2009, John Wiley & Sons, Inc. Joints Chapter 9Joint ClassificationsFibrous JointsCartilaginous JointsSynovial JointsTypes of Movements at Synovial JointsTypes of Synovial JointsFactors Affecting Contact and Range of Motion at Synovial JointsSelected Joints of the BodyAging and JointsArthroplastyCopyright 2009, John Wiley & Sons, Inc.
3Copyright 2009 John Wiley & Sons, Inc. What is a ‘joint’?The terms joint, articulation, and arthrosis are synonyms that refer to points of contact between two bones.Arthrology refers to the scientific study of joints.Emphasize that it is important to learn the location of each bone (and its surface features) relative to the location of other bones (and their surface features) in order to understand the three-dimensional relationship between bones.Use of directional terms (e.g., lateral, superior, etc.) while studying will facilitate this task.Copyright 2009 John Wiley & Sons, Inc.
4Joints (Joint Classification) The structural classification of jointsFibrous joints (bones held together by dense collagen fibers)Cartilaginous joints (bones held together by cartilage)Synovial joints (bones held together by ligaments)The functional classification of jointsSynarthrosis (an immovable joint)Amphiarthrosis(a slightly movable joint)Diarthrosis (a freely movable joint)Copyright 2009, John Wiley & Sons, Inc.
5Joints (Fibrous Joints) Lack a synovial cavityThe articulating bones are held very closely together by dense irregular connective tissueFibrous joints permit little or no movementThree types of fibrous jointsSuturesInterosseousmembranesGomphoses
6Joints (Fibrous Joints) SuturesOccur only between bones of the skullInterosseous membranesPermits slight movementInterosseous membraneBetween the tibia and fibula in the legGomphosesImmovable jointJoint in which a cone-shaped peg fits into a socketArticulations of the teeth with the sockets of the maxillae and mandible
7Joints (Cartilaginous Joints) Lacks a synovial cavityLittle or no movementJoint is tightly connected by either hyaline or fibrocartilageTwo types :SynchondrosesConnecting tissue is hyaline cartilageEpiphyseal (growth) plateSymphysesSlightly movable jointEnds of the articulating bones are covered with hyaline cartilage, but a disc of fibrocartilage connects the bonesPubic symphysisBetween the anterior surfaces of the hip bonesIntervertebral joints between the vertebrae
8Joints (Synovial Joints) Synovial cavity allows a joint to be freely movableLigaments hold bones together in a synovial jointArticular CapsuleA sleeve-like capsule encloses the synovial cavityThe articular capsule is composed of two layersan outer fibrous capsulean inner synovial membraneSynovial FluidThe synovial membrane secretes synovial fluidFunctions to reduce friction by:lubricating the jointabsorbing shockssupplying oxygen and nutrients to the cartilageremoving carbon dioxide and metabolic wastes from the cartilageCopyright 2009, John Wiley & Sons, Inc.
9Copyright 2009, John Wiley & Sons, Inc. Synovial JointsCopyright 2009, John Wiley & Sons, Inc.
10Joints (Synovial Joints) Bursae and Tendon SheathsBursaeSac-like structures containing fluid similar to synovial fluidLocated between tendons, ligaments and bonesCushion the movement of these body partsTendon sheathsWrap around tendonsReduce friction at jointsCopyright 2009, John Wiley & Sons, Inc.
11Joints (Types of Movements at Synovial Joints) Specific terminology is used to designate the movements that occur at jointsFour main categories:1) Gliding2) Angular movements3) Rotation4) Special movements
12Joints (Types of Movements at Synovial Joints) GlidingSimple movement back-and-forth and from side-to-sideThere is no significant alteration of the angle between the bonesLimited in rangeIntercarpal jointsAngular MovementsIncrease or a decrease in the angle between articulating bonesAngular movements includeFlexionExtensionLateral flexionHyperextensionAbductionAdductionCircumductionCopyright 2009, John Wiley & Sons, Inc.
13Joints (Types of Movements at Synovial Joints) FlexionDecrease in the angle between articulating bonesBending the trunk forwardExtensionIncrease in the angle between articulating bonesFlexion and extension are opposite movementsLateral flexionMovement of the trunk sideways to the right or left at the waistHyperextensionContinuation of extension beyond the normal extensionBending the trunk backwardAbductionMovement of a bone away from the midlineMoving the humerus laterally at the shoulder jointAdductionMovement of a bone toward the midlineMovement that returns body parts to normal position from abductionCopyright 2009, John Wiley & Sons, Inc.
14Copyright 2009, John Wiley & Sons, Inc. CircumductionMovement of a body part in a circleMoving the humerus in a circle at the shoulder jointRotationA bone revolves around its own longitudinal axisTurning the head from side to side as when you shake your head “no”Copyright 2009, John Wiley & Sons, Inc.
17Joints (Types of Movements at Synovial Joints) ElevationUpward movement of a part of the bodyClosing the mouthIts opposing movement is depressionDepressionDownward movement of a part of the bodyOpening the mouthProtractionMovement of a part of the body anteriorlyThrusting the mandible outwardIts opposing movement is retractionRetractionMovement of a protracted part of the body back to normalCopyright 2009, John Wiley & Sons, Inc.
18Joints (Types of Movements at Synovial Joints) InversionMovement of the foot mediallyIts opposing movement is eversionEversionMovement of the sole laterallyDorsiflexionBending of the foot at the ankle in an upward directionIts opposing movement is plantar flexionPlantar flexionBending of the foot at the ankle in a downward directionSupinationMovement of the forearm so that the palm is turned upwardIts opposing movement is pronationPronationMovement of the forearm so that the palm is turned downwardOppositionMovement of the thumb in which the thumb moves across the palm to touch the tips of the fingers on the same handCopyright 2009, John Wiley & Sons, Inc.
20Joints (Types of Synovial Joints) Synovial joints are classified based on type of movementPlanarHingePivotCondyloidSaddleBall-and-socketCopyright 2009, John Wiley & Sons, Inc.
21Copyright 2009, John Wiley & Sons, Inc. Planar JointsPrimarily permit back-and-forth and side-to-side movementsIntercarpal jointsHinge JointsProduce an opening and closing motion like that of a hinged doorPermit only flexion and extensionKnee and elbowCopyright 2009, John Wiley & Sons, Inc.
22Copyright 2009, John Wiley & Sons, Inc. Pivot JointsSurface of one bone articulates with a ring formed partly by another boneJoints that enable the palms to turn anteriorly and posteriorlyCondyloid JointsThe projection of one bone fits into the oval-shaped depression of another boneWristCopyright 2009, John Wiley & Sons, Inc.
23Joints (Types of Synovial Joints) Saddle JointsArticular surface of one bone is saddle-shaped, and the articular surface of the other bone fits into the “saddle”ThumbBall-and-Socket JointsBall-like surface of one bone fitting into a cuplike depression of another boneShoulder and hipCopyright 2009, John Wiley & Sons, Inc.
25Copyright 2009, John Wiley & Sons, Inc. Joints (Factors Affecting Contact and Range for Motion at Synovial Joints)Range of motion (ROM)Refers to the range, measured in degrees of a circle, through which the bones of a joint can be movedFactors contribute to keeping the articular surfaces in contact and affect range of motion:Structure or shape of the articulating bonesShape of bones determines how closely they fit togetherStrength and tension of the joint ligamentsLigaments are tense when the joint is in certain positionsTense ligaments restrict the range of motionCopyright 2009, John Wiley & Sons, Inc.
26Copyright 2009, John Wiley & Sons, Inc. Joints (Factors Affecting Contact and Range for Motion at Synovial Joints)Arrangement and tension of the musclesMuscle tension reinforces the restraint placed on a joint by its ligaments , and thus restricts movementContact of soft partsThe point at which one body surface contacts another may limit mobilityMovement be restricted by the presence of adipose tissueHormonesFlexibility may also be affected by hormonesRelaxin increases the flexibility of the pubic symphysis and loosens the ligaments between the sacrum and hip bone toward the end of pregnancyDisuseMovement may be restricted if a joint has not been used for an extended periodCopyright 2009, John Wiley & Sons, Inc.
27Joints (Selected Joints of the Body) The selected joints described are:Temporomandibular jointShoulder jointElbow jointHip jointKnee jointCopyright 2009, John Wiley & Sons, Inc.
28Copyright 2009, John Wiley & Sons, Inc. Temporo-mandibular JointCombined hinge and planar joint formed by the mandible and the temporal boneOnly movable joint between skull bonesOnly the mandible movesCopyright 2009, John Wiley & Sons, Inc.
29Shoulder JointBall-and-socket joint formed by the head of the humerus and the scapulaMore freedom of movement than any other joint of the body
30Copyright 2009, John Wiley & Sons, Inc. Elbow JointHinge joint formed by the humerus, the ulna, and the radiusCopyright 2009, John Wiley & Sons, Inc.
31Copyright 2009, John Wiley & Sons, Inc. Hip JointBall-and-socket joint formed by the femur and the hip boneCopyright 2009, John Wiley & Sons, Inc.
32Copyright 2009, John Wiley & Sons, Inc. Knee JointLargest and most complex joint of the bodyModified hinge jointCopyright 2009, John Wiley & Sons, Inc.
33Copyright 2009, John Wiley & Sons, Inc. Knee JointCopyright 2009, John Wiley & Sons, Inc.
36Joints (Aging and Joints) May result in decreased production of synovial fluidThe articular cartilage becomes thinnerLigaments shorten and lose some of their flexibilityOsteoarthritis is partially age-relatedStretching and aerobic exercises are helpful in minimizing the effects of agingHelp to maintain the effective functioning of ligaments, tendons, muscles, synovial fluid, and articular cartilageCopyright 2009, John Wiley & Sons, Inc.
37Joints (Arthroplasty) Joints may be replaced surgically with artificial jointsMost commonly replaced are the hips, knees, and shouldersHip ReplacementsPartial hip replacements involve only the femurTotal hip replacements involve both the acetabulum and head of the femurKnee ReplacementsActually a resurfacing of cartilage and may be partial or totalPotential complications of arthroplasty include infection, blood clots, loosening or dislocation of the replacement components, and nerve injuryCopyright 2009, John Wiley & Sons, Inc.
38Joints (Arthroplasty) Copyright 2009, John Wiley & Sons, Inc.
39Joints (Arthroplasty) Copyright 2009, John Wiley & Sons, Inc.
40Copyright 2009, John Wiley & Sons, Inc. End of Chapter 9 Copyright 2009 John Wiley & Sons, Inc. All rights reserved. Reproduction or translation of this work beyond that permitted in section 117 of the 1976 United States Copyright Act without express permission of the copyright owner is unlawful. Request for further information should be addressed to the Permission Department, John Wiley & Sons, Inc. The purchaser may make back-up copies for his/her own use only and not for distribution or resale. The Publishers assumes no responsibility for errors, omissions, or damages caused by the use of theses programs or from the use of the information herein.Copyright 2009, John Wiley & Sons, Inc.