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Joints and Bone Injuries
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Articular System Series of joints that allow for movement of the human body Joint articulation Two bones come into contact May be immoveable, slightly moveable, or freely moveable Arthrology is the study of joint structure and function Types of joints Synarthroses – immovable Amphiarthroses – slightly moveable Diarthroses – freely moveable
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Synarthroses Lack a synovial cavity
Held together by fibrous connective tissue Sutures Ex. Joints between skull bones Fuse together after birth
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Syndesmoses Connected by ligaments are very slightly moveable
Ex. between the tibia and the fibula
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Gomphoses Joint which a conical process fits into a socket and is held by ligaments ex. teeth held to the jaw bones
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Amphiarthroses Connected by hyaline cartilage or fibrocartilage
Ex. Ribs connected to sternum Ex. Between pubic bones
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Diarthroses (synovial joints)
Ends of bones are covered with articular cartilage and separated by the joint cavity Within joint is a capsule Outer layer is made of ligaments Inner layer is a synovial membrane that secretes synovial fluid for lubrication
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Types of Diarthroses joints
Pivot joint Bone moves around a central axis Ex. joint between the radius and ulna of the lower arm
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Gliding joint Bones move in a sliding motion
Ex. between the carpals in the hand
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Hinge joint Allows only flexion and extension Ex. the knee and elbow
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Condyloid or ellipsoidal joint
Bones can move in many directions but cannot rotate Ex. between the metatarsals and the phalanges
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Saddle joint Two bones have both concave and convex regions
Allows the thumb to touch each of the fingertips Ex. the thumb
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Ball – and – socket joint
Bone’s rounded end fits into a concave cavity on another bone Provides the widest range of motion possible Ex. femur connecting to the hip bones
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Joint Injuries Subluxation
Occurs when bone displaces, then returns to normal position Dislocation Occurs when significant force displaces bone so that the two bone ends in a joint no longer add up
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Joint Movements
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Movements of Diarthroses
Flexion Extension Hyperextension Abduction Adduction Rotation Circumduction Supination Pronation Plantar flexion Dorsiflexion Inversion Eversion Protraction Retraction Elevation Depression Internal Rotation External Rotation Radial Deviation Ulnar Deviation Opposition
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Flexion/Extension Flexion Extension
Decreases the angle between 2 bones Extension Increases the angle between two bones
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Hyperextension Movement that increases the angle between two bones extends beyond the normal range of motion
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Abduction/Adduction Abduction Describes movements of the limbs only
The limb moves away from the midline of the body Adduction Describes movements of the limbs only The limb moves toward from the midline of the body
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Abduction/Adduction
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Rotation Movement that occurs when a bone turns on its axis toward or away from the midline of the body, in the limbs, or between the 1st and 2nd vertebrae of the spine Circumduction The ability of a limb to move in a circular path around an axis
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Supination The action of turning the palm upward Performed by lateral rotation of the forearm Pronation The action of turning the palm downward Performed by medial rotation of the forearm
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Supination/Pronation
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Foot: Dorsal/Plantar
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Plantar Flexion/Dorsiflexion
Movement that extends the foot Pointing toes downwards Dorsiflexion Movement that flexes the foot Brings toes up toward the lower leg
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Plantar Flexion/Dorsiflexion
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Inversion Movement that turns the sole of the foot medially Eversion Movement that turns the sole of the foot laterally
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Inversion/Eversion
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Protraction/Retraction
Moving the body part forward Retraction Moving the body part backward Both movements occur in the transverse plane Only performed with the shoulder and mandible
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Protraction/Retraction
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Elevation/Depression
Movement that lifts the body part superiorly Depression Movement of the body part inferiorly Elevation and Depression occur in the frontal plane
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Elevation/Depression
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Internal/External Rotation
Internal rotation Movement that occurs when the anterior surface moves toward the midline aka medial rotation External rotation Movement that occurs when the anterior surface moves away from the midline aka lateral rotation
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Internal/External Rotation
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Hip Internal Rotation
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Hand Movements Radial Deviation
Hand moves laterally towards the thumb side Ulnar Deviation Hand moves medially toward the little finger Opposition Moves the thumb to touch the tips of the other fingers
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Hand Movements
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Joints of Upper Extremity
Shoulder Joint Glenohumeral Sternoclavicular Acromioclavicular Elbow Joint Radiohumeral Humeroulnar Radioulnar Wrist Radiocarpal Intercarpal Carpalmetacarpal Hand Intermetacarpal Metacarpalphalangeal Interphalangeal
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Shoulder Glenohumeral Sternoclavicular Acromioclavicular
Glenohumeral joint
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shoulder
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Elbow Radiohumeral Humeroulnar Radioulnar
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Wrist Radiocarpal Intercarpal Carpalmetacarpal
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Hand Intermetacarpal Metacarpalphalangeal Interphalangeal
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Joints of Lower Extremity
Sacroiliac Acetabulofemoral Patellofemoral Tibiofemoral Tibiofibular Ankle/Foot Talocural Subtalar Intertarsal Tarsometatarsal Intermetatarsal Metatasophalangel Interphalangeal
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Sacroiliac joint
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TIBIOFIBULAR JOINT Tibiofemoral joint
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Foot/Ankle
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Synovial Joint Injuries
Acute Sprains Synovitis Subluxations Dislocations Chronic Osteochondrosis Arthritis Bursitis Capsulitis/synovitis
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Sprains General Symptoms: Injury to ligamentous and capsular tissue
Joint swelling Local temperature increase Pain Point tenderness Skin discoloration Injury to ligamentous and capsular tissue Traumatic joint twist that results in stretching of total tearing of the stabilizing connective tissue One of most common & disabling sports injuries
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Sprains Grade 3 Severe sprain Extremely painful initially LOF
Severe instability Tenderness Swelling May represent subluxation that reduced spontaneously Grade 1 Some pain Minimum LOF Mild point tenderness Little or not swelling No abnormal motion Grade 2 Pain Moderate LOF Swelling Slight to moderate instability
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Synovitis Irritation of synovial membrane
Causes increase in fluid production, swelling Joint pain during motion, skin sensitivity from pressure Diminish in few days
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Acute Joint Injuries Subluxation Dislocation
Occurs when bone displaces, then returns to normal position Dislocation Occurs when significant force displaces bone so that the two bone ends in a joint no longer add up
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Osteochondrosis Degenerative changes in the ossification centers of the epiphysis of bones During periods of rapid growth in children Osteochondritis dissecans Suggested causes— aseptic necrosis: circulation to epiphysis disrupted Trauma causes particles of articular cartilage to fx, resulting in fissures that penetrate to subchondral bone
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Arthritis Inflammation of an entire joint
Usually involves all tissues of the joint Most often in WB joints 100 varieties of arthritis 10% population No cure
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Rheumatoid Arthritis Connective tissue disorder resulting in severe inflammation of small joints Cause unknown Severely debilitating Synovial membranes of joint and connective tissues grow abnormally to form layer in joint capsules destroys cartilage and fuses bones of joint
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Osteoarthritis
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Osteoarthritis
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Bursitis Inflammation of the synovial cavity caused by excessive stress or tension
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Open & Closed Kinematic Chains
Open Kinematic Chain Sequence of action in which the body part farthest from the trunk is free during movement i.e. Seated leg extension Closed Kinematic Chain Sequence of action in which the body part farthest from the trunk is fixed during movement i.e. In a squat, feet are fixed and the rest of leg chain moves
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