ArticulationsPoints of contact between bones

(Joints)

Primary Joint Classifications

Functional Name Structural Name Degree of Movement

Example

Synarthroses Fibrous Immovable Sutures of skull

Amphiarthroses Cartilaginous Slightly movable Symphysis Pubis

Diarthroses Synovial Freely movable Shoulder joint

SynarthrosesFibrous Joints

AmphiarthrosesCartilaginous Joints

DiarthrosesSynovial Joints

•Most mobile joints•Most numerous joints•Most complex joints•Structures Joint Capsule – sleevelike casing around ends of bones to bind them together Synovial Membrane – membrane lining capsule; secretes synovial fluid Articular Cartilage – cartilage covering articular

surface of bones Joint Cavity – small space between articulating

surfaces Menisci – pads of fibrocartilage between articulating bones Ligaments – strong dense white fibrous tissue

that hold bones of a synovial joint firmly together

Bursae – synovial membranes filled with synovial fluid; cushions joints and help movement of tendons

Types of Synovial Joints

uniaxial

biaxial

multiaxial

Between C1 & C2

Elbow, knee

Thumb Between radius and carpals

Shoulder, hip

Vertebrate

Shoulder Joint(ball and socket)

Hip Joint(ball and socket)

Knee Joint(hinge)

Vertebral Joints(gliding)

Range of Motion (ROM)•ROM assessment used to determine extent of joint injury

•Goniometer – instrument used to measure ROM

Angular Movements

Hyperextension

Circular MovementsCircumduction

Gliding Movements

Special Movements

Inversion

Eversion

Noninflammatory Joint DiseasesOsteoarthritis

•Degenerative Joint Disease (DJD)•most common NIJD of moveable joints

•Wear and tear deterioration •Atrophy of articular cartilage•Formation of new bone at joint surface•Most common in weight-bearing joints (hips, lumbar spine, knees)•Symptoms: stiffness, pain, limited movement•Cause: unknown•Treatment: none to stop progression•Treatment for symptoms: NSAIDs (nonsteroidal anti-inflammatory drugs)

•aspirin, ibuprofen, Celebrex, Vioxx

Noninflammatory Joint DiseasesTraumatic Injuries - Dislocation

•articular surfaces of bones not in proper contact•can damage blood vessels and nerves•can tear ligaments•pain and swelling•Treatment: realignment

Noninflammatory Joint DiseasesTraumatic Injuries - Dislocation

Noninflammatory Joint DiseasesTraumatic Injuries – Meniscus Tear

•one of most common athletic injuries•severe tears produce: edema, pain,•instability, limited motion•Treatment: arthroscopic surgery

Normal Meniscus Linear Tear of Medial Meniscus

Noninflammatory Joint DiseasesTraumatic Injuries – Sprain

•acute musculoskeletal injury to ligaments surrounding joint•Cause: twisting movement•Symptoms: bruising from rupture of blood vessels, limited motion

Inflammatory Joint DiseasesArthritis - Rheumatoid Arthritis

•chronic and systemic inflammatory connective tissue disease

•Cause: unknown

•Inflammation of synovial membrane, destruction of cartilage, bone erosion, progressive crippling and deformity

•Small joints effected first (hand, wrist, feet) but progresses to larger joints

•Symptoms: pain, inflammation, decreased mobility, aching, stiffness, fever, anemia, weight loss, profound fatigue

•May cause damage to blood vessels, eyes, lungs, heart

•Treatment: Corticosteroid drugs reduce immune activity along with NSAIDs to relieve pain and inflammation

Inflammatory Joint DiseasesArthritis - Rheumatoid Arthritis

•more severe than adult form

•more common in girls

•destroys cartilage growth and stops long bone growth

Inflammatory Joint DiseasesArthritis – Juvenile Rheumatoid Arthritis

•metabolic disorder in which excess uric acid (nitrogenous waste) in blood deposits crystals within synovial fluid and other tissues•chronic inflammation and tissue damage•Symptoms: swelling, tenderness, pain in fingers, wrists, ankles, knees, elbows•Treatment: Allopurinol – drug to inhibit uric acid synthesis

Inflammatory Joint DiseasesArthritis – Gouty Arthritis

Osteoarthritis

Rheumatoid arthritis Gouty arthritis