09 Articulations Selected Articulations In Depth

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Specific articulations. Synovial joints of various categories

Transcript of 09 Articulations Selected Articulations In Depth

  • 1. Temporomandibular Joint (TMJ)
    • Combination of ahinge and glidingjoint
  • Reinforced by 3 major extrinsic ligaments
  • Only synovial joint in skull
  • Depression/elevation
  • Protraction/retraction
  • Lateral movements

2. 3. Thetemporomandibular jointis formed by the mandibular condyle and the mandibular fossa of the temporal bone. It is supported by ligaments. 4. 5. Anarticular discseparates the bones within the joint capsule.The movement of this disc may create clicking or popping sounds. 6. The TMJ allows depression/elevation, protraction/retraction, and lateral rotary movements. 7. Mouth splints can prevent teeth grinding which can lead to TMJ syndrome 8. Close-up of mouth splint used to prevent TMJ syndrome 9. ACCORDING TO THE CLINICAL VIEW IN YOUR TEXT, TMJ DISORDER CAN CAUSEWIDESPREADDISTRIBUTION OF PAIN IN THE HEAD.WHY? A SPREAD OF INFLAMMATORY CHEMICALS VIATHE LYMPHATIC SYSTEM B AVASCULAR NECROSIS C AUTOIMMUNE DISEASE D PSYCHOSOMATIC PAIN FROM OCCIPITAL LOBEOF THE CEREBRUM E IRRITATION OF THE TRIGEMINAL NERVE 10. The intervertebral discs form an amphiarthroticsymphysisbetween one vertebral body and the next. The articulation between the articular processes form amphiarthotic synovialgliding(planar)joints . 11. The combined effect of slight movement between all the gliding joints is considerable movement of the spine. 12. Palpation of theligamentum nuchae 13. Thesternoclavicular jointis formed where the clavicle articulates with the manubrium.Depending on the reference source it is a either adiarthrotic synovial gliding joint OR a diarthrotic synovial saddle joint . 14. Sternoclavicular joint has anarticular disc . 15. Mike Bond putting great stress on his sternoclavicular joints 16. Dislocation of the sternoclavicular joint 17. Partial dislocation of both sternoclavicular joints with bleeding 18. 19. 20. X ray ofacromioclavicular separation 21. Glenohumeral Joint 22. Theglenohumeral jointis formed by the head of the humerus articulating with the glenoid cavity of the scapula 23. Master Long preparing to dislocate an opponents glenohumeral joint Readclinical viewin the text 24. U. S. soldier learning how to dislocate opponents shoulder Green arrow shows direction of force 25. Dislocation(luxation)of the right shoulder(glenohumeral joint) with subsequent anterior displacement of the head of the humerus. 26. Glenohumeral dislocation 27. Doctors foot 28. Theglenoid labrumdeepens the concavity of the shoulder joint 29. Lateral view of scapula 30. Rotator cuff(musculotendinous cuff) is formed by tendons of the infraspinatus, subscapularis, supraspinatus, and teres major.It is weak inferiorly. 31. Thecoracohumeral ligament, glenohumeral ligaments, and the transverse humeral ligamentall help stabilize the glenohumeral joint. 32. There are numerousbursaeandtendon sheathsassociated with the shoulder (glenohumeral) joint. 33. WHICH OF THE FOLLOWING IS ACORRECTSTATEMENT? A GLENOHUMERAL DISLOCATIONS (LUXATIONS)INITIALLY OCCUR SUPERIORLY AND THEN THEHUMERAL HEAD SHIFTS POSTERIORLY. B THE LIGAMENTUM NUCHAE CONNECTS TO THEVERTEBRA PROMINENS C THE FIBROCARTILAGE PADS BETWEENVERTEBRAL BODIES FORM SYNCHONDROSES D THE ARTICULATION BETWEEN VERTEBRALARTICULAR PROCESSES ARE BIAXIAL SYMPHYSES E. THE MUSCULOTENDINOUS CUFF IS FORMED BYINTEROSSEOUS MEMBRANE 34. Elbow joint 35. Thehumeroulnar joint ( between trochlea and trochlear notch) is a hinge joint.Thehumeroradial joint ( between capitulum and radial head) is considered by some to be a gliding joint. Anterior view 36. Elbow joint 37. 38. Theelbow jointis supported by itsarticular capsuleand by multiple strong ligaments:the radial (lateral) collateral ligament, the ulnar (medial) collateral ligament, and the annular ligament. 39. Elbow joint : noteradial (lateral) collateral ligamentandanular ligament 40. Elbow joint : note theulnar (medial) collateral ligamentand theanular ligament . 41. Readclinical viewabout subluxation of the head of the radius in your text 42. Subluxation of the head of the radius 43. Dislocation (luxation) of the elbowcan damage the associated ligaments 44. Theradiocarpal (wrist) articulationdoes NOT include the distal end of the ulna because the ulna is separated from the carpal bones by anarticular disc. 45. Metacarpophalangeal and interphalangeal joints 46. Hinge joints Condyloid joint No ligamentous support posteriorly! 47. Posterior dislocation of interphalangeal joint 48. Open dislocation of interphalangeal joint of finger #1 49. Coxal joint 50. Coxal (hip, acetabulofemoral) joints 51. Afibrocartilage acetabular labrumdeepens the concavity of the acetabulum and helps stabilize the coxal (acetabulofemoral) joint 52. Strong ligaments, a strong joint capsule, and powerful muscles help to stabilize theacetabulofemoral joint 53. Theretinacular fiberssupport the joint capsule and contain arteries thatsupply most of the blood to the neck and head of the femur Theligament of the head of the femur(ligamentum teres) contains a small artery that supplies some of the blood to the head of the femur. 54. Fracture of the neck of the femur Read about fracture of the femoral neck in theclinical viewin the text 55. Tibiofemoral (knee) joint 56. Theknee jointis composed of two separate articulations:the tibiofemoral joint and the patellofemoral joint. 57. Patellofemoral joint of left knee of femur 58. Thequadriceps femoris tendoninserts onto the patella, which is embedded in this tendon Thepatellar ligamentextends inferiorly from the patella and attaches to the tibial tuberosity 59. Thetibiofemoral jointis stabilized by thelateral (fibular) collateral ligamentand by themedial (tibial) collateral ligament .The LCL is NOT attached to the meniscus. Right knee, anterior view 60. Invarusdisplacement of the knee (hyperadduction of the lower leg), the distal segment (lower leg) is abnormally deviated medially.This is normallyprevented by the lateral (fibular) collateral ligament . 61. Thetibiofemoral jointis stabilized by thelateral (fibular) collateral ligamentand by themedial (tibial) collateral ligament .Right knee, anterior view 62. Invalgusdisplacement of the knee (hyperabduction of the lower leg), the knee is driven mediallywhile the lower leg is deviated laterally.This is normally prevented by the medial (tibial) collateral ligament. 63. attached The medial collateral ligamentis attached to the medial meniscus .This means if the MCL tears the medical meniscus also tears. Right knee, anterior view 64. Themedial meniscusand thelateral meniscusare made of fibrocartilage and help stabilize the knee and act as cushions.Note the MCL is attached to the medial meniscus. attached Right knee, anterior view 65. Themeniscihelp to pad and stabilize the knee 66. More deeply thetibiofemoral jointis stabilized by theposterior cruciate ligament and by the anterior cruciate ligament . 67. Note that theposterior cruciate ligament is tight(taut) when the tibiofemoral joint isflexedwhile theanterior cruciate ligament is tight(taut) when the tibiofemoral joint isextended .Most knee injuries occur when the knee is extended (anterior cruciate ligament is tight) so it is commonly ruptured (ruptured ACL) by hyperextension or lateral displacement when leg is extended. ACL tight PCL tight 68. Humans are bipedal animals.An important aspect in walking and standing is the ability tolock the knees .This is possible because at full extension the tibia rotates laterally so as to tighten the ACL and squeeze the meniscus between the tibia and femur.This mechanism permits a person to stand for long periods without using or tiring the muscles of the leg. 69. Thetibiofemoral joint(knee) is very vulnerable to injury.Read theclinical viewin the text. 70. Valgus deviation of the knee(hyperabduction of lower leg)) 71. Valgusstress to the knee (hyperabduction of the lower leg) can rupture the MCL, the medial meniscus, and, if enough displacement occurs, the ACL and the PCL. (medial) 72. 73. 74. Anallograft replacementof the ACL uses materials from another person (cadaver) 75. Anautograft replacementuses your own tissues, such as the middle portion of the patellar ligament 76. Anautograft replacementcan also use a portion of your hamstring tendons.They are removed, braided, and used to replace the ACL. 77. 78. 79. There are numerousbursaeassociated with the knee.Two of them are shown here. 80. WHICH OF THE FOLLOWINGWOULD BE INJUREDIN THE KNEE BY HYPERABDUCTION OF THE LOWER LEG (VALGUS DEVIATION)? A MENISCUS B LATERAL COLLATERAL LIGAMENT C PATELLAR LIGAMENT D RUPTURED RETINACULAR FIBERS E ALL OF THE ABOVE 81. Ankle joint 82. Thetalocrural (ankle) jointis a hinge joint formed by the medial and lateral malleoli and the talus 83. Thetalocrural (ankle) jointis surrounded by an articular capsule 84. Medial view Lateral view 85. The most common sprain of the ankle isexcessive inversionthat ruptures theanterior talofibular ligament and the calcaneofibular ligament 86. Excessive inversion of the ankle in rugby 87. 88. 89. Dislocated right ankle 90. Dislocated ankle joint 91. 92. 93. Excessiveeversion , which is less common, can damage thedeltoid ligamenton the medial side of the ankle 94. High top athletic shoeshave been statistically shown to reduce the incidence of ankle sprains, most likely by making the person more aware of the position of the ankle when leaping or jumping. 95. Results: The high-topshoes were moreeffective in reducingthe amount andrate of inversionthan the low-top shoes 96. Sprainsare often accompanied by bleeding and inflammation of the joint capsule (synovitis). Read about ankle sprains and Pott fractures in theclinical viewin the text. 97. Intertarsal