1. Chapter 9 Articulations

2. Joint Functional Classification Synarthroses: immovable Amphiarthroses: slightly movable Diarthroses: freely movable

4. Fibrous Joints (Synarthroses) Syndesmoses Fibrous bands connect 2 bones Joints between distal and radial end of ulna Sutures Teethlike projection interlock Found in the skull Gomphoses Occurs between the root of tooth and alveolar process

5. Cartilaginous Joints (Amphiarthroses) Synchondroses Has hyaline cartilage between articulating bones Articulation between first rib and sternum Also during growth years between epiphysis and diaphysis Symphysis Pad of disk of fibrocartilage connects 2 bones Vertebral disc

6. Synovial Joints (Diarthroses) Majority of joints between bones in the appendicular skeleton are synovial joints

7. Structure of Synovial Joints Sleeve-like extension of periosteum of articulating bones. Forms casing around bone end Moist membrane that lines inner surface of joint capsule Thin layer of hyaline cartilage cushioning articulating surface of bone Ligament Cords of dense fibrous tissue. Lash bones firmly together Pillow-like structure filled with synovial fluid. Function to cushion joint at bony prominances

8. Types of Synovial Joints Uniaxial permit movement around only one axis and in only one plane –Hinge joint –Pivot joints Biaxial permit around 2 perpendicular axes and planes –Saddle joints –Condyloid joints Multiaxial permit movement around 3 or more axes and planes –Ball and socket joints –Gliding joints

10. Types of Synovial Joints Hinge Joint: distal bone can move only in one plane, flexion and extension (forward and backward). pivot joint´s movement is limited to rotation. Ball and Socket Distal bone can move around a center in an indefinite number of axes. Condyloid Distal bone has an ovoid articular surface and is received into an elliptical cavit, which makes it impossible for the bones to perform axial rotation. Gliding The main movements are flexion-extension and rotation. saddle joint consists of two opposing surfaces that are reciprocally concave-convex, wich allows flexion, extension, adduction, abduction, and circumduction, but no axial rotation.

11. Types of Synovial Joints

13. Humeroscapular Joint / Shoulder Joint

15. Elbow Joint

16. Helps cushion joint Medially cubital vein Ulnar nerve

17. Forearm and Wrist Joints Proximal radioulnar: pivot joint between the circumference of the head of the radius and the ring formed by the radial notch of the ulna and the annular ligament. Distal radioulnar:pivot-joint formed between the head of the ulna and the ulnar notch on the distal radius. Proximal radioulnar: pivot joint between the circumference of the head of the radius and the ring formed by the radial notch of the ulna and the annular ligament. Distal radioulnar:pivot-joint formed between the head of the ulna and the ulnar notch on the distal radius. Proximal radioulnar: pivot joint between the circumference of the head of the radius and the ring formed by the radial notch of the ulna and the annular ligament. Distal radioulnar:pivot-joint formed between the head of the ulna and the ulnar notch on the distal radius.

18. Forearm and Wrist Joints Radiocarpal (wrist): Condyloid joint formed by the radius and the articular disk proximally and the proximal row of carpal bones distally.

19. Hand and Finger Joints

20. Hand Joints Intercarpal: Articulations between the individual carpal bones. They are plane synovial joints. The small amount of movement between the carpal bones at these joints contributes to total wrist mobility.

21. Hand and Finger Joints Synovial Joints Interphalageal

22. Hip Joint synovial joint formed by the articulation of the rounded head of the femur and the cup-like acetabulum of the pelvis. It forms the primary connection between the bones of the lower limb and the axial skeleton of the trunk and pelvis. surfaces are covered with a strong but lubricated layer called articular hyaline cartilage.

23. Hip Joint

25. Knee Joint (tibiofemoral) Hinge Concavity of tibia forms a shallow socket for condyle of femur Has several ligaments

26. Knee Joint

27. Ankle Joint synovial hinge joint that connects the distal ends of the tibia and fibula in the lower limb with the proximal end of the talus bone in the foot synovial hinge joint that connects the distal ends of the tibia and fibula in the lower limb with the proximal end of the talus bone in the foot Most common injury sprained ankle is caused by internal rotation to anterior talofibular ligament

28. Vertebral Joints

29. Caliginous joints between bodies of adjacent vertebra classified symphyses Permit only slight movement Synovial joints between articulating surfaces of vertebral processes are classified as gliding

30. ROM

31. Measuring ROM ROM is measured with a goniometer

32. Measuring ROM

33. Types of Movement Synovial joints permit one or more of the following movements: –Angular: change the size of angle between articulating bones –Circular: results in arclike rotation around axis –Gliding: moves over articulating surfaces without angular or circular movement –Special: Don’t fit in any movement category

34. Angular Movements Flexion: Decrease angle, bends or folds one part to another Extension: Increase angle between bones Hyperextension: Stretching part beyond anatomical position Flexion: Decrease angle, bends or

36. Angular Movements Plantar Flexion: foot is stretched down and back. Increases angle between top of foot and front of leg Dorsiflexion: foot is tilted upward decreasing angle

37. Angular Movements Abduction: moves part away from median body plane Adduction: Moves toward median body plane

38. Circular Movement Rotation: pivoting bone on own axis. Moving head side to side (NO) Circumduction: distal ends move in circle. Such as pitching Supination: turns palms side up Pronation: turns palms side down

40. Special Movement Inversion: turn sole of foot inward Eversion: Turn sole of foot outward Protraction: moves part forward Retraction: Moves part back

41. Special Movement Elevation: moves part up Depression: Moves part down

42. Bursitis

43. Joint Disorders Noninflammatory: –Does not involve inflammation of synovial membrane. –Doesn’t produce systemic signs or symptoms such as fever or damage other organs Inflammatory

44. Noninflammatory Osteoarthritis/degenerative joint disease. –Most common noninflammatory disorder –Wear and tear degeneration –Fracturing of articulating cartilage –Abnormal formation of new bone such as bone spurs –Cause unknown but attributed to obesity, aging and wear and tear –Symptoms are treated with NSAIDS, glucosamine, chondriton or injections of gelatinous type lubricating fluid, and surgery

45. Osteoarthritis

46. Swelling deformities of the distal interphalangeal joints

47. Noninflammatory Dislocation (subluxation) –Usually resulting from trauma –Can be an emergency due to association with blood vessels and nerves –Articulating surfaces no longer in proper contact

49. Arthroscopy Surgical procedure orthopaedic surgeons use to visualize, diagnose, and treat problems inside a joint.

52. Inflammatory Joint Diseases

53. Arthritis General term for many different inflammatory joint diseases Can be caused by variety of factors such as infection, injury, genetics and autoimmunity

54. Rheumatoid Arthritis (RA)

55. Systemic autoimmune disease Involves chronic inflammation of many tissues and organs, generally starting with the joints Pannus is granulation tissue that is formed within the synovium by proliferating fibroblasts and inflammatory cells Pannus adheres to cartilage, destroying it and eventually fusing bones

56. Rheumatoid Arthritis Deformity of the fingers known as ulnar deviation is common Treated with NSAIDs, corticosteroids, and other antirheumatic meds New drugs that alter immune response such as TNF blockers are showing promise

57. Juvenile Rheumatoid Arthritis appears between the ages of 6 months and 16 years. first signs often are joint pain or swelling and reddened or warm joints

58. Gouty arthritis Metabolic disorder Excess blood levels of uric acid are deposited as sodium urate crystals within synovial fluid of joints (tophi) Can lead to very swollen and painful joints Treated with Allopurinol (inhibits synthesis of uric acid)