Ch 9 Articulations

8/2/2019 Ch 9 Articulations

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Chapter 9:Articulations


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Functional Classifications

Synarthrosis:

no movement

Amphiarthrosis:

little movement

Diarthrosis:

more movement


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Functional Classification

Table 91


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Structural Classifications

Bony

Fibrous

Cartilaginous Synovial


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Structural Classification

Table 92


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4 Types of Synarthrotic Joints

Sutures - bound by dense fibrous connective

tissue; found only in skull

Gomphosis - binds teeth to sockets (periodontal

ligament)

Synchondrosis - epiphyseal cartilage of long

bones & b/t vertebrosternal ribs and sternum

Synostosis - fused bones, epiphyseal lines of long bones


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2 Types of Amphiarthroses

Syndesmosis:

bones connected by ligaments

Symphysis:

bones separated by fibrocartilage


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Synovial Joints (Diarthroses)

Also calledfreely moveable joints

Lined with synovial membrane

Articular cartilages (hyaline) pad articulatingsurfaces within articular capsules & prevent

bones from touching

Smooth surfaces lubricated by synovial fluid


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Functions of Synovial Fluid

1. Lubrication

2. Nutrient distribution

3. Shock absorption


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Synovial Joints: Accessory Structures

Cartilages - cushion the joint: fibrocartilage meniscus (articular disc)

Fat pads - superficial to the joint capsule;

protect articular cartilages Ligaments - support, strengthen joints

Sprain - ligaments with torn collagen fibers

Tendons - attach to muscles around joint

Bursae - Pockets of synovial fluid that cushionareas where tendons or ligaments rub


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Synovial Joints: Range of Motion

Nonaxial slipping movements only

Uniaxial movement in one plane

Biaxial movement in two planes

Multiaxial movement in or around allthree planes

Joint movements

To be read for labDO NOT FORGET!


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Linear Motion

Also called gliding

2 surfaces slide past each other:

between carpal or tarsal bones


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Flexion/Extension

Figure 93a

Angular motion in A/P planeFlexion reduces angle

between elements

Extension Increases angle

between elements


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Abduction/Adduction

Figure 93b, c

Angular motion in frontal planeAbduction moves away from

longitudinal axis

Adduction moves toward

longitudinal axis


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Circumduction

Circular motion

without rotation

Angular motion

Figure 93d


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Rotation

Left or right rotation Medial rotation (inward rotation):

rotates toward axis

Lateral rotation (outward rotation):

rotates away from axis


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Pronation and Supination

Pronation:

rotates forearm, radius over ulna

Supination:

forearm in anatomical position


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Inversion and Eversion

Figure 95a

Inversion:

twists sole of

foot medially

Eversion:

twists sole of

foot laterally


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Dorsiflexion and Plantar Flexion

Figure 95b

Dorsiflexion:

flexion at ankle

(lifting toes) Plantar flexion:

extension at ankle

(pointing toes)


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Opposition

Thumb movement toward

fingers or palm (grasping)

Figure 95c


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Protraction and Retraction

Figure 95d

Protraction:

moves anteriorly

in the horizontal plane

(pushing forward) Retraction:

opposite of protraction

moving anteriorly (pullingback)


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Elevation and Depression

Elevation: moves in superior direction (up)

Depression:

moves in inferior direction (down)


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Lateral Flexion

Bends vertebral

column from side

to side

Figure 95f


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6 subtypes of synovial joints

Gliding intercarpals, SI

Pivot atlas/axis, radioulnar

Hinge elbow, knee, TMJ, interphalangeal Ellipsoidal Occ/C1, radius to carpals

Saddle trapezium to 1st metacarpal

Ball & socket shoulder/hip


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Plane joints

Articular surfaces areessentially flat

Allow only slipping or glidingmovements

Only examples of nonaxialjoints

Hinge joints Cylindrical projections of one bone fits into

a trough-shaped surface on another

Motion is along a single plane

Uniaxial joints permit flexion and extension

only Examples: elbow and interphalangeal

joints


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Pivot joints

bone protrudes into a sleeve,or ring, composed of bone (and

possibly ligaments) of another Only uniaxial movement allowed

Examples: joint between the axisand the dens, and the proximalradioulnar joint

Condyloid joints Oval articular surface of one bone fits

into a complementary depression inanother

Both articular surfaces are oval

Biaxial joints permit all angularmotions

Examples: radiocarpal (wrist) joints,and metacarpophalangeal (knuckle)

joints


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Saddle Joints

Similar to condyloid joints but

allow greater movement

Each articular surface has both aconcave and a convex surface

Example: carpometacarpal joint

of the thumb

Ball-and-Socket Joints A spherical or hemispherical head of one

bone articulates with a cuplike socket ofanother

Multiaxial joints permit the most freelymoving synovial joints

Examples: shoulder and hip joints


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Intervertebral Articulations

C2 to L5 spinal vertebrae

articulate:

at inferior and superior

articular processes (gliding

joints)

between adjacent vertebral

bodies (symphyseal joints)

Figure 97


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Intervertebral Discs

Intervertebral discs:

pads of fibrocartilage that separate vertebral bodies

Anulus fibrosus:

tough outer layer that attaches disc to vertebrae

Nucleus pulposus:

elastic, gelatinous core that absorbs shocks


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6 Intervertebral Ligaments

1. Anterior longitudinal ligament: connects anterior bodies

2. Posterior longitudinal ligament: connects posterior bodies

3. Ligamentum flavum: connects laminae

4. Interspinous ligament: connects spinous processes

5. Supraspinous ligament: connects tips of spinous processes (C7 to sacrum)6. Ligamentum nuchae:

continues supraspinous ligament (C7 to skull)


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Damage to Intervertebral Discs

Slipped disc: bulge in anulus fibrosus

invades vertebral canal

Herniated disc: nucleuspulposus breaks through anulus fibrosus

presses on spinal cord or nerves


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The Knee Joint

Figure 912a, b


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The Knee Joint

2 femurtibia articulations: 1 at medial and lateral condyles

1 between patella and patellar surface of femur


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7 Ligaments of the Knee Joint

Patellar ligament (anterior)

2 popliteal ligaments (posterior)

Anterior and posterior cruciate ligaments (insidejoint capsule)

Tibial collateral ligament (medial)

Fibular collateral ligament (lateral)

Medialandlateral menisci: fibrocartilage pads at femurtibia articulations to cushion and stabilize joint

& give lateral support

S i


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Sprains

The ligamentsreinforcing a joint are stretched or

torn Partially torn ligaments slowly repair themselves

Completely torn ligaments require prompt surgicalrepair

StrainsThe muscles or tendonsare stretched or torn

Healing generally better than with a sprain,however it depends on the location of the strainwith relationship of the joint


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Inflammatory and Degenerative

Conditions

Bursitis

An inflammation of a bursa, usually caused by ablow or friction

Symptoms are pain and swelling Treated with anti-inflammatory drugs; excessive

fluid may be aspirated

Tendonitis

Inflammation of tendon sheaths typically caused byoveruse

Symptoms and treatment are similar to bursitis


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Arthritis

More than 100 different types of inflammatory

or degenerative diseases that damage the joints

Most widespread crippling disease in the U.S.

Symptoms pain, stiffness, and joint swelling

Acute forms are caused by bacteria and are

treated with antibiotics

Chronic forms include osteoarthritis, rheumatoid

arthritis, and gouty arthritis

O h i i (OA)


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Osteoarthritis (OA)

Most commonchronic arthritis; often called wear-and-

tear arthritis AKA: Degenerative Joint Disease (DJD)

Affects women more than men

85% of all Americans develop OA

More prevalent in the aged, and is probably related tothe normal aging process

As one ages, cartilage is destroyed more quickly than itis replaced

The exposed bone ends thicken, enlarge, form bonespurs, and restrict movement

Joints most affected are the cervical and lumbar spine,fingers, knuckles, knees, and hips


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Rheumatoid Arthritis (RA)

Chronic, inflammatory,

autoimmune disease ofunknown cause, with an

insidious onset

Usually arises between the

ages of 40 to 50, but mayoccur at any age

Signs and symptoms include

joint tenderness, anemia,

osteoporosis, muscle atrophy,

and cardiovascular problems

The course of RA is marked with

exacerbations and remissions


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Gouty Arthritis

Deposition of uric acid crystals in joints andsoft tissues, followed by an inflammationresponse

Typically, gouty arthritis affects the joint at thebase of the great toe

In untreated gouty arthritis, the bone endsfuse and immobilize the joint

Treatment colchicine, nonsteroidal anti-inflammatory drugs, and glucocorticoids

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