1. Anatomy and Physiology
Articulations
Anatomy and Physiology

2. I. Classification of joints
Articulation – point where 2 bones meet (joint)
Joints are classified according to amount and type of movements
3 general types of joints
Immovable (synarthrosis)
Slightly immovable ( amphiarthrosis)
Freely movable (diarthrosis)

3. II. Immovable joints (synarthrosis)
Joints fused together
4 types
Sutures
Gomphoses
Synchondroses
synostoses

4. a. Sutures Between bones of skulls Interlocked
Bound together by dense connective tissue

5. b. gomphoses teeth to bony sockets
held into socket by periodontal ligament

6. c. Synchondroses cartilage bridge between 2 articulating bones
ex. Ends of vertebrosternal rib and sternum

7. d. synostosis rigid immovable
bones fused together with no line of demarcation as to where it starts or ends.
Ex. Hip, coccyx

8. III. Slightly movable (amphiarthrosis)
Permits more movement than syntarthrosis, but stronger than freely movable joints
2 types
1. syndesmosis
2. symphysis

9. a. Syndesmosis (sin-dez-MO-sis)
bones connected by a ligament
ex. Tibia and fibula

10. b,. symphysis bones separated by wedge or pad of fibrocartilage
ex. Vertebrae – vertebral disks
pubic bones – pubic symphysis

11. IV. Freely Movable (diarthroses)
a. Aka – synovial joints
Allow large range of motion
Synovial joint surrounded by capsule and synovial membrane lines the cavity
Found end of long bones
Surface slippery and smooth which decreases friction
Contains synovial fluid

13. b. 3 functions of synovial fluid
i. lubricant
the viscous fluid acts to lubricate the joints
ii. nutrient distribution
circulates to provide nutrients and rids waste products
moves every time joint moves
iii. shock absorption
cushions
distributes pressure across the joint which lessens shock on the
surfaces of joint

14. c. arthritis affects syovial joints damages to articulating cartilages
caused by injury, virus, bacteria, physical stress
2 types arthritis
i. Osteoarthritis –
Degenerative
Results from cumulative wear and tear of joint surfaces
Genetic factors
60 + older
ii. Rheumatoid arthritis
Inflammation
Due to immune system mistakenly attacking joint tissue
Allergies, bacteria, virus, and genetics contribute to triggering

16. iii. Treatment of arthritis
Exercises
Physical therapy
Meds (anti-inflamatory)
Replacement of joint

17. V. Accessory Structures of synovial joints
Fat pads
Cartilage pads
Ligaments
Tendons
bursea

19. a. Fat pads
structure:
adipose tissue covered by layer of synovial membrane
superficial to joint capsule
function –
protect articulating cartilage
act as packing material for joint by filling in spaces created as joint cavity moves.

20. b. Cartilage pads structure:
fibrocartilage pad situated between bones within synovial joint
ex. Meniscus
function :
channel synovial fluid flow
absorb shock
subdivide synovial cavity

21. c. ligaments i. Accessory: thickenings of capsule
reinforces and strengthens capsule
limits rotation at joint
ii. extracapsular
connect articulating bones
passes across outside of capsule
support wall of joint
ex. Lateral collateral and medial collateral ligaments of knee
iii. Intracapsular
inside capsule
prevents extreme movements that could hurt joint
ex. ACL , PCL
iv. other (ligaments of knee)
popliteal
patellar 

22. d. tendons Connect muscle to bone
Across and around joints to provide strength to joints
Tendonitis – inflammation of tendon

23. e. bursea structure Small fluid filled sacs in connective tissue
Contain synovial fluid and lined by synovial membrane
Found where tendons and ligaments rub against other tissues
Function –
Decrease friction
Absorb shock
Bursitis – inflammation of bursae
Pain when move tendon or ligament
Associated with repetitive motion
Golfers, swimmers, pitchers, tennis

24. VI. Types of Movements
Gliding
Angular
Rotation
Special movements

25. a. gliding Sliding past one another Carpal bones B/t tarsal bones
b/t clavicle and sternum
movement in any direction – but very slight
Ex:
touch process on clavicle and turn shoulders in – feel sliding

26. b. angular Change in angle between shaft and joint
Flexion – decrease in angle
ex. Chin to chest, touch toes, bend wrist
Extension – increase in angle
Ex. Straightening leg or arm
Hyperextension – extension beyond anatomical position
ex. Look at ceiling (hyperextend neck)

27. ex. Moving arm away from body, spreading fingers
Abduction – movement of appendage AWAY from long axis of body (along frontal plane)
ex. Moving arm away from body, spreading fingers
Adduction – movement appendages TOWARD long axis of body (along frontal plane)
Ex. Moving arm toward body, fingers together
Circumduction –
Distal end of appendage moves in circle
Ex. Baseball wind up

28. c. Rotation in referent to anatomical position depends on part moving
ex. Head rotation – move chin to right or left (say NO)
ex. Limb rotation – medial – inward
lateral – outward  
Lower arm rotation
pronation – move palm toward back
supinate – move palm from back toward front

29. d. Special movements FOOT: inversion
twisting motion of foot that turns sole inward
eversion
twisting motion of foot that turns sole outward
dorsiflexion
flexion of ankle and elevation of sole of foot (dig heel into ground)
plantar flexion
extend ankle and elevate heel (stand on tip toes)

30. Special mvmts. cont…. opposition thumb to fingers protraction
moving body part anteriorly in horizontal plane
ex. Sticking out tongue
retraction
opposite of protraction
elevation
structure moves superiorly
ex. Shrug shoulders, close mouth,
depression
structure move inferior
open mouth
lateral flexion
vertebral column bends to one side
ex. Side stiches, move ear toward shoulder

31. VII. Types of Synovial Joints
Each synovial joint permits different type and range of motion
Gliding
Hinge
Pivot
Ellipsoidal
Saddle
Ball and socket

32. a. Gliding Aka planar joints Flattened or slightly curved faces
Flat articulating surfaces
Slight movement
Ex. Clavicle, carpals, tarsals, between vertebrae

33. b. Hinge joint Angular movement in single plane (monaxial joint)
Monaxial joint (only flexes or extends in one plane)
Ex. Occipital condyle and atlas
Elbow, knee, interphalangeal joints , wrist

34. c. Pivot Monaxial Permits rotation only
Ex. Atlanto-axial joint (atlas and axis)
Radioulnar joint

35. d. Ellipsoidal Aka condyloid joint Nestles with in a depression
Angular motion in 2 planes – biaxial
(flexion/extension and abduction/adduction
ex. Metacarpal phalangeal joint
metatarsalphalangeal joint
wrist – radiocarpal joint

36. e. Saddle Aka sellaris joint Articulating faces look like saddles
Angular motion – biaxial
Circumduction and angular motion (flexion /extension, etc)
Ex. Carpometacarpal joint (base of thumb – twiddle thumbs)

37. f. Ball and socket
round head of bone fits in cup shaped depression of another bone
multiaxial – rotate, circumduction, angular movements)
ex. Shoulder , hip

38. VIII. Major Joints in Human Body
Shoulder joint:
greatest range of motion
also most frequently dislocated
most stability provided by ligaments and muscles around joint
contain bursae to decrease friction between tissue

39. Shoulder joint cont… rotator cuff: supraspinatus infraspinatus
subscapularis
teres minor
primary support for shoulder joint and limits range of motion.
Injury to rotator cuff usually due to severe stress on shoulder, repetition
(pitchers, swimmers, quarterbacks , etc..)

40. b. elbow olecranon joint hinge (flexion and extension) diarthrosis
muscles that extend elbow attach at olecranon process (triceps)
muscles that flex elbow – attach at radial tuberosity
stable joint due to the fact that humerus and ulna interlock
has thick articular capsule and ligament reinforcement

41. c. hip
diarthrosis
flexsion / extension, abduction/adduction, circumduction and rotation
contains large muscles to help with stability of joint
ligaments around the hip include
iliofemoral
pubofemoral
ischiofemoral
transverse acetabular ligament
ligamentum teres

42. d. knee Hinge joint Flexion / extension (monaxial) Limited rotation
Medial and lateral menisci lie between femoral and tibial surface
Cushions, gives lateral stability,

43. Knee cont. Ligaments of knee Patellar ligament
Patella is within patellar tendon, continuation of this tendon = patellar ligament which attaches to anterior surface of tibia (tuberosity)
Popliteal ligaments (2)
Between femur and heads of tibia and fibula
Supports posterior surface
Anterior and Posterior Cruciate
Inside joint capsule
Criss cross inside capsule
Limit anterior and posterior movement of femur and maintain alignment of femoral and tiaeal condyles.
Tibial (medial ) collateral (MCL)
Reinforces medial surface of knee
Fubular (lateral) collateral (LCL)
Reinforces lateral surface of knee

44. IX. Male vs. Female Skeleton
General differences:
Males bones larger than female
Males have larger muscle attachment surfaces
Males have larger Joint surfaces
Skull :
Males have shorter forehead
Males mandible and maxillae larger
Males facial area is more pronounced
Pelvis:
Males pelvis narrower
Males pelvis deeper
Males pelvic outlet smaller
Males subpubic angle less than 90 degrees

47. X. Common Disorders of Skeletal System
1. Arthritis – inflammation of joint, pain stiffness
Osteoarthritis – wear and tear
Rheumatoid -
2. Bunion
Bony bump that forms on the joint at the base of your great toe.
Wearing tight or narrow shoes can form bunions. Sometimes just inherent structural defect.
3. Bursitis
Inflammation of fluid filled sac
Overuse or repetitive movement
4. Gout
Missing enzyme causes uric acid build up in joints
Common in toe, knee
5. Herniated disc
When vertebral disk “pops” out from between vertebrae

48. Disorders cont….. 6. Luxation 7. Subluxation 8. Sprain 9. Strain
Full dislocation of a joint
Usually from fall or unusual movement
Shoulder, knees, shoulder, fingers, jaw
7. Subluxation
Partial dislocation of a joint
8. Sprain
Overstretching or tearing of connective tissue, ligaments and tendons
9. Strain
Overstretching or over use of muscle