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Chapter 9
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- 1Joints and Their Classification Joint (articulationany point where two bones meet, whether or not the bones are movable at that interface
- 2Arthrologyscience of joint structure, function, and dysfunction
- 3Kinesiologythe study of musculoskeletal movement
A branch of biomechanics, which deals with a broad variety of movements and mechanical processes - 4Joint nametypically derived from the names of the bones involved (example: radioulnar joint)
Joints classified according to the manner in which the bones are bound to each other - 5Four major joint categoriesBony joints
Fibrous joints
Cartilaginous joints
Synovial joints - 6Bony joint, or synostosisan immobile joint formed when the gap between two bones ossifies, and the bones become, in effect, a single bone
- 7Fibrous joint, or synarthrosisadjacent bones are bound by collagen fibers that emerge from one bone and penetrate into the other
- 8Three kinds of fibrous jointsSutures (ex. Skull)
Gomphosis (ex. Tooth)
Syndesmosis (ex. Fibula/tibia or radius/ulna - 9Fibrous Joints - SuturesSutures—immobile or slightly mobile fibrous joints in which short collagen fibers bind the bones of the skull to each other
- 10Sutures can be classified as:Serrate: interlocking wavy lines
Coronal, sagittal (between parietal bones), and lambdoid sutures
Lap (squamous): overlapping beveled edges
Temporal and parietal bones
Plane (butt): straight, non-overlapping edges
Palatine processes of the maxillae - 11Fibrous Joints - GomphosisGomphosis (fibrous joint)—attachment of a tooth to its socket. Only joint not joining two bones
- 12Syndesmosis—a fibrous joint at which two bones are bound by long collagen fibers
- 13Two types of cartilaginous jointsSynchondroses
Symphyses (pl) Symphysis (s) - 14Cartilaginous - SynchondrosesSynchrondrosis—bones joined by hyaline cartilage
Temporary joints in the epiphyseal plates in children
Bind epiphysis to diaphysis
First rib attachment to sternum- synchondrosis
Other costal cartilages joined to sternum by synovial joints - 15Cartilaginous - SymphysisSymphysis—two bones joined by fibrocartilage
Pubic symphysis joins right and left pubic bones with interpubic disc
Bodies of vertebrae joined by intervertebral discs
Collective effect of all 23 discs gives spine considerable flexibility - 16Synovial JointsSynovial joint, or diarthrosis—joint in which two bones are separated by a joint cavity
Most familiar type of joint
Most moveable joint
Most structurally complex type of joint
Most likely to develop painful dysfunction
Most important joints for physical and occupational therapists, athletic coaches, nurses, and fitness trainers - 17General Anatomy of Synovial JointsArticular cartilage —layer of smooth, hyaline cartilage that covers the facing surfaces of two bones
- 18Synovial fluidviscous, slippery lubricant in joint cavity
Nourishes cartilage and removes waste
Makes movement of synovial joints almost friction free - 19Joint (articular) capsuleconnective tissue that encloses the cavity and retains the fluid
Outer fibrous capsule: continuous with periosteum of adjoining bones
Inner, cellular, synovial membrane: composed cells that secrete synovial fluid and macrophages that remove debris - 20Meniscusmoon-shaped cartilage in knee; in each knee, menisci extend inward from the left and right
These cartilages absorb shock and pressure
Guide bones across each other and improve their fit together
Stabilize the joints, reducing the chance of dislocation - 21Tendonstrip of collagenous tissue attaching muscle to bone
- 22Ligament:strip of collagenous tissue attaching one bone to another
- 23Bursafibrous sac filled with synovial fluid, located between muscles, where tendons pass over bone, or between bone and skin
Cushions muscles, helps tendons slide more easily over joints, modifies direction of tendon pull - 24Tendon sheathelongated cylindrical bursa wrapped around a tendon found in hand and foot
- 25Exercise and Articular CartilageExercise warms synovial fluid
Becomes less viscous, more easily absorbed by cartilage
Cartilage then swells
Warm-up period before vigorous exercise helps protect cartilage from undue wear and tear
Repetitive compression of nonvascular cartilage during exercise squeezes fluid and metabolic waste out of the cartilage - 26Leverany elongated, rigid object that rotates around a fixed point called a fulcrum. Effort is applied to the lever to overcome the resistance (load).
- 27The Basic Components of a LeverIn skeletal anatomy, the fulcrum is the joint; the effort is applied by a muscle; and the resistance can be an object being lifted, the weight of the limb, or the opposing muscle.
- 28Range of Motionthe degrees through which a joint can move
Aspect of joint performance
Physical assessment of a patient’s joint flexibility - 29Factors which determine ROMStructure of the articular surfaces- can be limited by the shape of the bones
Strength and stiffness (tautness) of ligaments and joint capsules. Double-jointed people have long or slack ligaments - 30Action of the muscles and tendons in range of motionNervous system monitors joint position and muscle tone
Muscle tone—state of tension maintained in resting muscles - 31Axes of RotationA moving bone has a relatively stationary axis of rotation that passes through the bone in a direction perpendicular to the plane of movement
- 32Multiaxial joint—Rotationshoulder joint (humeroscapular) has three degrees of freedom or axes of rotation
- 33Six classes of synovial jointsball-and-socket, condylar, saddle, plane, hinge, pivot
- 34Ball-and-socket jointsSmooth, hemispherical head fits within cup-like socket
Only multiaxial joints in body
Examples: shoulder, hip - 35Condylar (ellipsoid) jointsOval convex surface of one bone fits into a complementary-shaped depression on the other
Biaxial joints—movement in two planes
Examples: radiocarpal joint, metacarpophalangeal joints - 36Saddle jointsBoth bones have an articular surface that is shaped like a saddle, one concave, the other convex
Biaxial joints
Examples: trapeziometacarpal (opposable thumb), sternoclavicular joint - 37Plane (gliding) jointsFlat articular surfaces, bones slide over each other
Usually biaxial joints
Examples: between carpal bones of wrist; between tarsal bones of ankle; also between articular processes of vertebrae - 38Hinge jointsOne bone with convex surface fits into a concave depression of another bone
Monoaxial joints—move freely in one plane
Examples: elbow (humeroulnar), knee, joints within fingers (proximal and middle phalanges), toes - 39Pivot jointsA bone spins on its longitudinal axis
Monoaxial joints
Examples: atlantoaxial joint (C1 and C2), proximal radioulnar joint at the elbow - 40Zero positionthe position of a joint when a person is in the standard anatomical position
Joint movements described as deviating from the zero position or returning to it - 41Flexionmovement that decreases joint angle
Common in hinge joints (ex. bending the elbow)
Ex. Holding your hands with the palms up , flexing your wrists will tip your palms toward you. - 42Extension—movement that straightens a joint and returns a body part to the zero position
Ex. In stair climbing,, both the hip and knee joints extend to lift your body weight. - 43Hyperextensionextension of a joint beyond the zero position
Ex. While standing, looking up at the stars hyperextends the neck - 44Hyperabduction:raise arm over back or front of head
- 45Abductionmovement of a body part in the frontal plane away from the midline of the body (when signaling a taxi to stop)
- 46Adductionmovement in the frontal plane back toward the midline- Hyperadduction: crossing fingers, crossing ankles
- 47Elevationmovement that raises a body part vertically in the frontal plane
- 48Depressionmovement that lowers a body part in the same plane
- 49Protractionthe anterior movement of a body part in the transverse (horizontal) plane
- 50Retractionposterior movement
- 51Circumductionone end of an appendage remains stationary while other end makes a circular motion
Example: an artist circumducts upper limb when painting a circle on a canvas - 52Rotationmovement in which a bone spins on its longitudinal axis
Rotation of trunk, thigh, head, or arm - 53Medial(internal) rotation turns the bone inward
- 54Lateral(external) rotation turns the bone outward
- 55Supinationforearm movement that turns palm to face anteriorly or upward
Forearm supinated in anatomical position
Radius is parallel to the ulna - 56Pronationforearm movement that turns palm to face either posteriorly or downward
Head of radius spins
Radius crosses stationary ulna like an X - 57Flexionforward-bending movements at the waist or neck
- 58Extension—straightens trunk or neck
- 59Hyperextensionbending over backward
- 60Lateral flexiontilting the head or trunk to the right or left at the midline
- 61Lateral excursionright or left movement from the zero position
- 62Medial excursionmovement back to the median, zero position
Side-to-side grinding during chewing - 63Protractionretraction
- 64Elevationdepression
- 65Radial flexiontilting hand toward thumb
- 66Ulnar flexiontilting hand toward little finger
- 67Abduction vs. adduction of the fingersspreading them apart vs. bringing them together (cupping water)
- 68Flexion vs. extension of fingerscurling vs. straightening them
- 69Palmar abductionmoving thumb away from hand and pointing it anteriorly
- 70Radial abductionmoving thumb away from index finger (90°)
- 71Flexion of thumb Extension of thumb Opposition Repositiontip of thumb directed toward palm
straightening the thumb
moving thumb to touch tip of a finger
returning thumb to the zero position - 72Dorsiflexionelevating toes as you do while swinging foot forward to take a step (heel strike)
- 73Plantar flexionextending foot so that toes point downward as in standing on tiptoe (toe-off
- 74Inversionmovement in which the soles are turned medially
- 75Eversionmovement in which the soles are turned laterally
- 76Pronation of footcomplex combination of dorsiflexion, eversion, and abduction
- 77Supination of footcomplex combination of plantar flexion, inversion, and adduction
- 78Temporomandibular (jaw) jointarticulation of the condyle of the mandible with the mandibular fossa of the temporal bone
Combines elements of condylar, hinge, and plane joints - 79Synovial joint - of the TMJ isdivided into superior and inferior chambers by an articular disc
Two ligaments support joint
Deep yawn or strenuous depression can dislocate the TMJ
Condyles pop out of fossa and slip forward
Relocated by pressing down on molar teeth while pushing the jaw backward - 80Temporomandibular joint (TMJ) syndromeMay affect as many as 75 million Americans
Signs and symptoms
Clicking sounds in the jaw, imitation of jaw movement
Pain radiating from jaw down the neck, shoulders, and back
Can cause moderate intermittent facial pain, or severe headaches, vertigo (dizziness), tinnitus (ringing in the ears) - 81TMJ Syndrome causes/treatmentsCause of syndrome
Caused by combination of psychological tension and malocclusion (misalignment of teeth)
Treatment
Psychological management, physical therapy, analgesic and anti-inflammatory drugs, corrective dental appliances to align teeth properly - 82Glenohumeral (humeroscapular) jointhemispherical head of humerus articulates with glenoid cavity of scapula
Most freely mobile joint in body
Shallow glenoid cavity and loose shoulder joint capsule sacrifice stability for freedom of movement - 83Glenoid labrumfibrocartilage ring that deepens glenoid cavity
- 84Shoulder DislocationVery painful and sometimes causes permanent damage
Downward displacement of the humerus is the most common shoulder dislocation
Rotator cuff protects the joint in all directions but inferiorly
Joint protected from above by coracoid process, acromion, and clavicle
Dislocations most often occur when the arm is abducted and then receives a blow - 85Humeroulnar jointtrochlea of the humerus joins trochlear notch of the ulna
- 86Humeroradial jointcapitulum of humerus meets head of radius
Both articulations enclosed in one joint capsule
Olecranon bursa on posterior side of elbow eases movements of tendons - 87The Elbow JointElbow region also contains proximal radioulnar joint
Functions as a pivot, not a hinge
Head of radius fits into radial notch of ulna
Held in place by anular ligament encircling radial head
Allows for pronation and supination - 88Coxal (hip) jointhead of femur inserts into acetabulum of hip bone
- 89Acetabular labrumhorseshoe-shaped ring of fibrocartilage that deepens socket
Dislocations are rare
Ligaments supporting hip joint
Iliofemoral and pubofemoral— anterior
Ischiofemoral ligament—posterior
When standing, ligaments become twisted and pull head of femur tightly into acetabulum
Round ligament (ligamentum teres)—arises from fovea capitis and attaches to lower margin of acetabulum
Contains artery that supplies blood to head of femur - 90Tibiofemoral (knee) jointlargest and most complex diarthrosis of the body
Primarily a hinge joint
Capable of slight rotation and lateral gliding when knee is flexed - 91Knee stabilized by:Quadriceps tendon in front, tendon of semimembranosus muscle on rear of thigh
Lateral meniscus and medial meniscus—C-shaped cartilages within joint capsule
Absorb shock and prevent side-to-side rocking
Joined by transverse ligament - 92Arthroscopyprocedure in which interior of joint is viewed with a pencil-thin arthroscope inserted through a small incision
Less tissue damage than conventional surgery
Recover more quickly
Arthroscopic ACL repair: about 9 months for healing to be complete - 93Talocrural (ankle) jointincludes two articulations:
Medial joint: between tibia and talus
Lateral joint: between fibula and talus
Both articulations enclosed by one joint capsule
Malleoli of tibia and fibula overhang the talus on either side and prevent side-to-side motion
More restricted range of motion than the wrist - 94Multipart medial (deltoid) ligamentbinds tibia to the foot on the medial side
- 95Multipart lateral (collateral) ligamentbinds fibula to the foot on the lateral side
- 96Calcaneal (Achilles) tendonextends from the calf muscles to the calcaneus
- 97Osteoarthritis (OA)—most common form of arthritisWear-and-tear arthritis”
Results from years of joint wear
Articular cartilage softens and degenerates
Accompanied by crackling sounds called crepitus
Bone spurs develop on exposed bone tissue causing pain - 98Rheumatoid arthritis (RAautoimmune attack against the joint tissues
Misguided antibodies (rheumatoid factor) attack synovial membrane, enzymes in synovial fluid degrade the articular cartilage, joint begins to ossify - 99Ankylosissolidly fused, immobilized joint
- 100Arthroplastyreplacement of diseased joint with artificial device called prosthesis
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- Fichas sobre Chapter 9, creado por erin murphy el 21/10/2022.
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