1. INTRODUCTION
Part 1
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2. structural classification of joints
Structurally, there are fibrous, cartilaginous, and synovial joints.
In general, fibrous joints are immovable, and synovial joints are
freely movable.
However, cartilaginous joints have both rigid and slightly movable examples
In fibrous joints, the bones are joined by fibrous tissue, namely dense fibrous connective tissue, and no joint cavity is present.
Types of fibrous joints are sutures and syndesmoses.

3. Sutures occur only between bones of the skull.

4. Syndesmos is a fibrous joint at which two bones are bound by
long collagen fibers, the bones are connected by ligaments
cords or bands of fibrous tissue.

5. Cartilaginous Joints:
In cartilaginous joints the articulating bones are united by cartilage. Like fibrous joints, they lack a joint cavity and are not highly movable. The two types of cartilaginous joints are synchondroses and symphyses.
Synchrondrosis: bones joined by hyaline cartilage (e.g. between the first rib and manubrium)

6. Symphyses: two bones joined by fibrocartilage

7. Synovial Joints
Most joints are synovial joints.
They have 5 distinguishing features
1. Articular cartilage
2. Joint cavity space that is filled with Synovial fluid. Synovial
membrane covers the entire surface within the joint capsule
and secretes synovial fluid.
3. Articular capsule the joint cavity is enclosed by articular
capsule.
4. Synovial fluid a slippery fluid that occupies all free spaces
within the joint capsule.
5. Reinforcing ligaments are reinforced by a number of
ligaments.

9. There are 6 types of synovial joints:
Synovial joints can be classified into six major categories: plane,
hinge, pivot, condyloid, saddle and ball-and-socket joints.
Plane Joints:
Gliding movement: allows back and forth movement (e.g. carpals sliding onto one another during wrist movements), Gliding does not involve rotation around any axis

10. Hinge Joints:
allows folding movement (bending and straightening) (e.g. elbow
and interphalangeal joints)

11. Pivot Joints:
allows rotation around an axis (e.g. between atlas and axis at the odontoid process, proximal radioulnar joint)

12. Condyloid Joints
In condyloid joints or ellipsoidal joints, the oval articular surface of one bone fits into a complementary depression in another.
The important characteristic is that both articulating surfaces are
oval. The biaxial condyloid joints permits flexion and extension,
abduction and adduction except rotation (e.g. between metacarpals and proximal phalanges).

13. Saddle Joints
resemble condyloid joints, but they allow greater freedom of
movement. Each articular surface has both concave and convex, it
is shaped like a saddle. The articular surfaces then fit
together, concave to convex surfaces (e.g. carpometacarpal joints
of the thumbs).

14. Ball-and-Socket Joints
the spherical or hemispherical head of one bone articulates with
the cuplike socket of another. These joints are multiaxial and the most freely moving synovial joints. All movement is allowed (in all axes and planes, including rotation). The shoulder and hip joints
are the only examples.

15. Palpation: soft tissue palpation and bony palpation
Assessment is done by:
Inspection: by sight
Palpation: soft tissue palpation and bony palpation
Examination: range of motion (ROM) for joints, muscle test and
special tests.
Kinematics
is the study of motion without regard for the forces that are
creating the motion.
Subdivisions of kinematics are: arthrokinematics and osteokinematics.
In arthrokinematics, the focus is on how joint surfaces move and
interact, whereas in osteokinematics, the focus is on movements of
the shafts of bones.

16. Arthrokinematics is the term used to refer to the movement of
joint surfaces. The movements of joint surfaces are described as
slides (or glides), spins, and rolls.
A slide (glide), which is a translatory motion, is the sliding of one
joint surface over another, as when a braked wheel skids

17. A spin is a rotary motion, similar to the spinning of a toy top
A spin is a rotary motion, similar to the spinning of a toy top. All points on the moving joint surface rotate around a fixed axis of
motion

18. A roll is also a rotary motion, similar to the rolling of the bottom of a rocking chair on the floor or the rolling of a tire on the road

19. The ranges of arthrokinematic motions are very small and cannot be measured with a goniometer or standard ruler.
These motions are also called accessory or joint play motions.
Osteokinematics refers to the gross movement of the shafts of
bony segments rather than the movement of joint surfaces. The
movements of the shafts of bones are usually described in terms of the rotary or angular motion produced, as if the movement
occurs around a fixed axis of motion. Goniometry measures the
angles created by the rotary motion of the shafts of the bones.

20. Planes and Axes
Osteokinematic motions are classically described as taking place in one of the three cardinal planes of the body (sagittal, frontal,
transverse) around three corresponding axes (medial–lateral,
anterior–posterior, vertical). The three planes lie at right angles to one another, whereas the three axes lie at right angles both to
one another and to their corresponding planes.
The median sagittal plane divides the body into right and left
halves. The motions of flexion and extension occur in the sagittal plane.

21. The axis around which the motions of flexion and extension occur may be envisioned as a line that is perpendicular to the sagittal
plane and proceeds from one side of the body to the other. This axis is called a medial–lateral axis. All motions in the sagittal
plane take place around a medial–lateral axis.

23. The frontal plane proceeds from one side of the body to the other and divides the body into front and back halves. The motions that occur in the frontal plane are abduction and adduction.
The axis around which the motions of abduction and adduction
take place is an anterior–posterior axis. This axis lies at right angles to the frontal plane and proceeds from the anterior to the
posterior aspect of the body. Therefore, the anterior–posterior axis lies in the sagittal plane.

25. The transverse plane is horizontal and divides the body into upper and lower portions. The motion of rotation occurs in the transverse plane around a vertical axis. The vertical axis lies at right angles to the transverse plane and proceeds in a cranial to caudal direction.

26. Range of motion (ROM) is the arc of motion in degrees between
the beginning and the end of a motion in a specific plane. The arc of motion may occur either at a single joint or at a series of joints.
The starting position for measuring all ROM is either the
anatomical or neutral position.

27. Active ROM is the arc of motion produced by the individual’s
voluntary unassisted muscle contraction.
Passive ROM is the arc of motion produced by the application of an external force by the examiner. The individual remains relaxed
and plays no active role in producing the motion.
Normally, passive ROM is slightly greater than active ROM
because each joint has a small amount of motion that is not
under voluntary control.