ARTICULATIONS Chapter 9

Immovable VS Movable

Functional Classification Synarthrosis - fibrous– immovable - suture Amphiarthrosis - cartilaginous – slightly movable - vertebra Diarthrosis - synovial – freely movable – shoulder, hip

Fibrous joints Syndemosis – ligaments connect two bones – radioulnar interosseous ligament – some movement due to ligamentous movement Sutures – skull only Gomphoses – tooth root and maxilla/mandibular junction – gotta chew!

Cartilaginous joints Synchondroses – hyaline cartilage between bones – true rib and sternum Symphyses – pad/disk connecting bones – symphysis pubis and intervertebral disks

Synovial joints Most moveable and numerous Uniaxial – hinge and piviot – flex/extension Pivot – C-2, radius Biaxial – movement in two perpendicular planes - saddle (thumb/opposition), condyloid/ellipsoidal (occipital to atlas) Multiaxial – three or more axis – ball and socket joints (hip/shoulder), gliding vertebrae (least moveable)

Examples of synovial joints Humeroscapular - bursa (cushion sacs providing ease of movement), rotator cuff (muscles and tendons form protective pad) Hip – stability (shape of ball and socket) mobility (flexion, extension, abduction, adduction, circumduction) iliofemoral ligament strongest in body Knee – meniscus – cartilage (medial/lateral) creates socket for femur

5 ligaments holding knee stable Anterior cruciate Posterior cruciate Wrisberg Transverse Fibular/tibial collateral

Knee questions What protects the knee? Is it harder or easier to injure in comparison to the hip? What range of motion movements can the knee perform? What does weight have to do with knee health? How long does a knee replacement usually help a patient?

Vertebral joints Slight movement/flexible ROM – flex, extend, circumduct Intervertebral disks pad between vertebrae

Types of movement Angular Circular Gliding Special

Range of Motion Measures level of wellness Measures level of damage/injury Determines mode of treatment Measured by the use of a goniometer

Angular movements Changes size of angle between two bones Includes:  Flexion  Extension  Abduction  Adduction  Abnormal - hyperextension

Circular movements Rotation on axis Include:  Rotation  Circumduction  Supination  Pronation

Gliding movements Simplest of all movements Surface of one bone moves over another without any angular or circular movement Example – carpals/tarsals/vertebrae

Special movements Inversion Eversion Protraction Retraction Elevation depression

Pathophysiology - noninflammatory: Osteoarthritis (degenerative joint disease) – elders from normal ADL’s – TMT – nonsteroidal antiinflammatory drugs (NSAID’s) Aspirin, advil, Celebrex, vioxx Trauma – dislocation (subluxation) Arthroscopy used to determine extent of injury Sprain Whiplash

Pathophysiology - Inflammatory Arthritis - age vs traumatic injury Rheumatoid arthritis – chronic/systemic Juvenile RA – more severe than adult/more prevalent in female patients Gout – metabolic – deposits of uric acid – TMT - Allopurianol

Complete case study pg 275 and CTQ pg 277