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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
Recommended