Joints

Classification of Joints Structural Classification – Presence or absence of a space (synovial cavity)/ – Type of Connective Tisssue/ Functional Classification – Relates to the degree of movement they permit.

Structural Classification of Joints Fibrous Joints – Fibrous CT – Lack a synovial cavity Cartilaginous Joints – Cartilage – Lack a synovial cavity Synovial Joints – Have a synovial cavity – Dense irregular CT – Often associated with accessory ligaments

Functional Classification of Joints Synarthrosis (syn = together) – Immovable joint Amphiarthrosis (amphi = on both sides) – A slightly moveable joint Diarthrosis (moveable joint) – A freely moveable joint – Synovial joints

Fibrous Joints Lacks a synovial cavity Little or no movement

Fibrous Joints Sutures – Immovable – Synostosis – suture that is replaced by bone in the adult Syndesmoses – Slightly moveable (amphiarthrosis) – Ligament – Interosseous membrane Gomphoses – Dentoalveolar joint

Cartilaginous Joints Lacks a synovial cavity Allows little or no movement Synchondroses – Epiphyseal plate Symphyses – Pubic symphisis – Intervertebral discs

Synovial Joints Synovial (Joint) Cavity – space btwn. Bones Freely moveable The bones are covered by hyaline cartilage Contains the following: – Articular capsule – Synovial fluid – Accsessory ligaments and articular discs

Arthroscopy Observaion of the interior of a joint Utilizes a lighted, pencil-thin instrument Assists in surgery and assessment of the joint space

Sprain & Strain Sprain – a forcible wrenching or twisting of the joint that stretches or tears its ligaments, but does not dislocate the bones. – The ankle joint is the most often sprained. – The lumbar spine is another prominent location of sprain. Strain – a stretched or partially torn muscle.

Bursae & Tendon Sheaths Bursae – Saclike structures – Reduce friction in some synovial joints Tendon sheaths – Tubelike bursae that wrap around tendons – Occurs where tendons pass through synovial cavities – Reduce friction

Bursitis An acute or chronic inflammation of a bursa Caused by trauma or infection Repeated excessive exertion Symptoms – Pain, swelling, inflammation & limited movement Treatment – Oral anti-inflammatory agents (herbal, O.T.C. And prescription), corticosteroid injections

Types of Synovial Joints Plantar Joints Hinge Joints Pivot Joints Condyloid Joints Saddle Joints Ball & Socket Joints

Types of Movements at Synovial Joints Gliding – Simple back and forth movement, limited in range, planar joints Angular Movements – Increase or decrease in the angle btwn. bones Rotation – Bone revolves around a longitudinal axis Special Movements

Angular Movements Flexion, extension, lateral flexion, hyperextension Abduction, adduction, and circumduction

Rotation Medial (internal) rotation Lateral (external) rotation

Special Movements Elevation Depression Protraction Retraction Inversion

Special Movements Eversion Dorsiflexion Plantar flexion Supination Pronation Opposition

Dislocation Luxation – displacement of a bone from a joint – Causes tearing or ligaments, tendons, and articular capsules Subluxation – Incomplete dislocation

Rotator Cuff Injury Supraspinatous Infraspinatous Teres Minor Subscapularis Common injury among pitchers and volleyball players due to excessive circumduction

Separated Shoulder Injury of the acromioclavicular joint Due to forceful trauma such as when the shoulder strikes the ground in a fall

Tennis Elbow Lateral epicondylitis Little-league elbow

Golfer’s Elbow Medial Epicondylitis

Dislocation of the Radial Head The most common upper limb dislocation in children Occurs with a strong pull to the forearm while it is extended and supinated Swinging a child around with outstretched arms

Swollen Knee Immediate swelling is due to blood loss Delayed swelling is due to excessive production of synovial fluid “water on the knee”

Dislocated Knee Displacement of the tibia relative to the femur Most commonly dislocates anteriorly

Rheumatism Any painful disorder of the supporting structures of the body – bones, ligaments, tendons, or muscles – that is not caused by infection or injury.

Arthritis A form of rheumatism in which the joints are swollen, stiff, and painful.

Types of Arthritis Rheumatoid arthritis (RA) – Autoimmune disease – the body attacks its own tissues Osteoarthritis (OA) – Degenerative joint disease Gouty arthritis – A person with gout produces excessive uric acid or is unable to excrete it properly

Lyme Disease First reported in Lyme, CT Bacteria transported by deer ticks The rash often resembles a bull’s eye target, although some people never develop a rash Symptoms – Joint stiffness, fever, chills, headache, stiff neck, nausea

Terminology Arthralgia – pain in a joint Bursectomy – removal of a bursa Chondritis – inflammation of cartilage Synovitis – inflammation of a synovial membrane in a joint