1. Articulations and Movement

2. Articulations or Joints Articulation or Joint –Place where two bones come together –Freely movable to limited to no apparent movement –Structure correlated with movement Named –According to bones or parts united at joint –According to only one of articulating bones –By Latin equivalent of common name

3. Classes of Joints Structural: Based on major connective tissue type that binds bones –Fibrous –Cartilaginous –Synovial Functional: Based on degree of motion –Synarthrosis: Nonmovable –Amphiarthrosis: Slightly movable –Diarthrosis: Freely movable

4. Fibrous Joints Characteristics –United by fibrous connective tissue –Have no joint cavity –Move little or none Types –Sutures –Syndesmoses –Gomphoses

5. Syndesmoses Bones farther apart than suture and joined by ligaments Some movement may occur

6. Gomphoses Specialized joints Pegs that fit into sockets Inflammations –Gingivitis –Periodontal disease

7. Cartilaginous Joints Unite two bones by means of cartilage Types –Synchondroses Joined by hyaline Little or no movement –Symphyses Fibrocartilage uniting two bones

8. Synchondroses

9. Synovial Joints Most common joints in body Most mobile joints Have –Articular surfaces on bone with hyaline cartilage –Completely enclosed joint capsule formed from ligamentous connective tissue –Synovial fluid within capsule lubricates joint –Some have meniscus or articular disc(e.g. knee, jaw joint)

10. Synovial Joints Allow considerable movement Most joints that unite bone of appendicular skeleton Complex –Articular cartilage and disks –Joint cavity and capsule –Synovial membrane and fluid Bursae –Pockets of synovial fluid –Bursitis

11. Synovial Joint Shape Types Plane joints--intercarpal joints Hinge joints--elbow,ankle, interj-phalangeal Pivot joints--radio-ulnar joint Condyloid joints (egg into oval)--metacarpo- phalangeal Saddle joints--carpo-metacarpal joint of thumb Ball-and-socket--hip, shoulder The type of joint, in part, determines the range and direction of movement

12. Types of Synovial Joints Plane or gliding Saddle Hinge Pivot Ball-and-socket Ellipsoid

13. Plane and Pivot Joints Plane or Gliding joints –Monoaxial –Example:Articular processes between vertebrae Pivot joints –Monoaxial –Example: Articulation between dens of axis and atlas

14. Saddle and Hinge Joints Saddle Joints –Biaxial –Example: Thumb Hinge Joints –Monoaxial –Example: elbow, knee

15. Ellipsoid and Ball-and-Socket Joints Ellipsoid –Modified ball-and- socket –Biaxial –Example: Atlantooccipital joint Ball-and-socket –Multiaxial –Examples: shoulder and hip joints

16. Also see Fig. 9.3, M&M

19. Types of Movement Gliding Angular –Flexion and Extension Hyperextension Plantar and Dorsiflexion –Abduction and Adduction Circular –Rotation –Pronation and Supination –Circumduction

20. Flexion and Extension

21. Dorsiflexion and Plantar Flexion

22. Abduction and Adduction

23. Rotation and Pronation and Supination

24. Circumduction

25. Special Movements Unique to only one or two joints Types –Elevation and Depression –Protraction and Retraction –Opposition and Reposition –Inversion and Eversion

26. Elevation and Depression

27. Protraction and Retraction

28. Excursion

29. Opposition and Reposition

30. Inversion and Eversion

31. Range of Motion Amount of mobility demonstrated at a given joint Types –Active –Passive Influenced by –Shape of articular surfaces forming joint –Amount and shape of cartilage covering surfaces –Strength and location of ligaments and tendons –Location of muscles associated with joint –Amount of fluid in and around joint –Amount of use/disuse of joint –Amount of pain in and around joint

32. Temporomandibular Joint TMJ Combination plane and ellipsoid joint TMJ Disorders –Cause most chronic orofacial pain

33. Shoulder Joint

34. Elbow Joint

35. Hip Joint

36. Knee Joint Modified hinge joint Menisi: Fibrocartilage articular disks Cruciate ligaments: ACL and PCL Collateral ligaments: Fibular and tibial

37. Knee Injuries and Disorders Football injuries Bursitis Chondromalacia –Softening of cartilage Hemarthrosis: –Acute “Water on the knee” –Slower accumulation

38. Ankle Joint Highly modified hinge joint Ligaments of arch –Hold bones in proper relationship –Transfer weight

39. Effects of Aging on Joints Tissue repair slows Production of synovial fluid declines Ligaments and tendons become less flexible Decrease in ROM

40. Joint Disorders Arthritis –Osteoarthritis: Wear and tear –Rheumatoid: Caused by transient infection or autoimmune disease Joint infections –Lyme disease: Tick vector Gout –Metabolic disorders of unknown cause (idiopathic)