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Chapter 9Chapter 9

Lecture OutlineLecture Outline

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22

JointsJoints

Joints and their classificationJoints and their classification bony jointsbony joints fibrous jointsfibrous joints cartilaginous jointscartilaginous joints

Synovial jointsSynovial joints

33

Joints and Their ClassificationJoints and Their Classification

Arthrology = study of the jointsArthrology = study of the joints Kinesiology = study of musculoskeletal Kinesiology = study of musculoskeletal

movementmovement Classified by freedom of movementClassified by freedom of movement

diarthrosis (freely movable)diarthrosis (freely movable) amphiarthrosis (slightly movable)amphiarthrosis (slightly movable) synarthrosis (little or no movement)synarthrosis (little or no movement)

Classified how adjacent bones are joined Classified how adjacent bones are joined fibrous, cartilaginous, bony or synovialfibrous, cartilaginous, bony or synovial

44

Bony Joint (Synostosis)Bony Joint (Synostosis)

Gap between two bones ossifiesGap between two bones ossifies frontal and mandibular bones in infantsfrontal and mandibular bones in infants cranial sutures in elderlycranial sutures in elderly attachment of first rib and sternumattachment of first rib and sternum

Can occur in either fibrous or cartilaginous Can occur in either fibrous or cartilaginous jointjoint

55

Fibrous Joints (Synarthrosis)Fibrous Joints (Synarthrosis)

Collagen fibers span the space Collagen fibers span the space between bonesbetween bones sutures, gomphoses and syndesmosessutures, gomphoses and syndesmoses

66

Immovable fibrous jointsImmovable fibrous joints bind skull bones togetherbind skull bones together

Lap - overlapping beveled edgesLap - overlapping beveled edges

Plane - straight, nonoverlapping Plane - straight, nonoverlapping edgesedges palatine processes of the maxillaepalatine processes of the maxillae

Fibrous Joint -- SuturesFibrous Joint -- Sutures

77

Types of SuturesTypes of Sutures

88

Fibrous Joint -- GomphosesFibrous Joint -- Gomphoses

Attachment of a tooth to its Attachment of a tooth to its socket socket

Held in place by fibrous Held in place by fibrous periodontal ligamentperiodontal ligament collagen fibers attach collagen fibers attach

tooth to jawbonetooth to jawbone Some movement while Some movement while

chewingchewing

99

Two bones bound Two bones bound by ligament onlyby ligament only interosseus interosseus

membranemembrane Most movable of fibrous jointsMost movable of fibrous joints Interosseus membranes unite radius to ulna Interosseus membranes unite radius to ulna

and tibia to fibulaand tibia to fibula

Fibrous Joint -- SyndesmosisFibrous Joint -- Syndesmosis

1010

Cartilaginous Joint -- SynchondrosisCartilaginous Joint -- Synchondrosis

Bones are joined by Bones are joined by hyaline cartilagehyaline cartilage rib attachment to rib attachment to

sternumsternum epiphyseal plate in epiphyseal plate in

children binds children binds epiphysis and epiphysis and diaphysisdiaphysis

1111

Cartilaginous Joint -- SymphysisCartilaginous Joint -- Symphysis

2 bones joined by 2 bones joined by fibrocartilagefibrocartilage pubic symphysis pubic symphysis

and intervertebral and intervertebral discsdiscs

Only slight amount Only slight amount of movement is of movement is possiblepossible

1212

Synovial JointSynovial Joint

Joint in which two bones are separated by a space called a joint Joint in which two bones are separated by a space called a joint cavitycavity

Most are freely movableMost are freely movable

1313

General AnatomyGeneral Anatomy

Articular capsule encloses joint cavityArticular capsule encloses joint cavity continuous with periosteumcontinuous with periosteum lined by synovial membranelined by synovial membrane

Synovial fluid = slippery fluid; feeds cartilagesSynovial fluid = slippery fluid; feeds cartilages Articular cartilage = hyaline cartilage covering the joint Articular cartilage = hyaline cartilage covering the joint

surfacessurfaces Articular discs and menisciArticular discs and menisci

jaw, wrist, sternoclavicular and knee jointsjaw, wrist, sternoclavicular and knee joints absorbs shock, guides bone movements and distributes forcesabsorbs shock, guides bone movements and distributes forces

Tendon attaches muscle to boneTendon attaches muscle to bone Ligament attaches bone to boneLigament attaches bone to bone

1414

Tendon Sheaths and BursaeTendon Sheaths and Bursae

Bursa = saclike extension of joint capsule Bursa = saclike extension of joint capsule between nearby structures so slide more easily past each other between nearby structures so slide more easily past each other

Tendon sheaths = cylinders of connective tissue lined with Tendon sheaths = cylinders of connective tissue lined with synovial membrane and wrapped around a tendonsynovial membrane and wrapped around a tendon

1515

Components of a LeverComponents of a Lever A lever is a rigid object that rotates around a A lever is a rigid object that rotates around a

fixed point called a fulcrumfixed point called a fulcrum Rotation occurs when effort overcomes Rotation occurs when effort overcomes

resistanceresistance resistance arm and effort arm are described resistance arm and effort arm are described

relative to fulcrumrelative to fulcrum

1616

Mechanical Advantage of a LeverMechanical Advantage of a Lever

Two kinds of leversTwo kinds of levers lever that helps increase output of forcelever that helps increase output of force

• human moving a heavy object with help of crowbarhuman moving a heavy object with help of crowbar lever move object further and fasterlever move object further and faster

• movement of row boat with paddlemovement of row boat with paddle

Types of levers produce either increase in Types of levers produce either increase in speed or forcespeed or force

1717

First-Class LeverFirst-Class Lever

Has fulcrum in the middle between effort and resistanceHas fulcrum in the middle between effort and resistance Atlantooccipital joint lies between the muscles on the back of Atlantooccipital joint lies between the muscles on the back of

the neck and the weight of the facethe neck and the weight of the face loss of muscle tone occurs when you nod off in classloss of muscle tone occurs when you nod off in class

1818

Second-Class LeverSecond-Class Lever

Resistance between fulcrum and effortResistance between fulcrum and effort Resistance from the muscle tone of the temporalis Resistance from the muscle tone of the temporalis

muscle lies between the jaw joint and the pull of the muscle lies between the jaw joint and the pull of the diagastric muscle on the chin as it opens the mouth diagastric muscle on the chin as it opens the mouth quicklyquickly

1919

Third-Class LeverThird-Class Lever

Effort between the resistance and the fulcrumEffort between the resistance and the fulcrum most joints of the bodymost joints of the body

The effort applied by the biceps muscle is applied to the The effort applied by the biceps muscle is applied to the forearm between the elbow joint and the weight of the forearm between the elbow joint and the weight of the hand and the forearmhand and the forearm

2020

Range of MotionRange of Motion

Degrees through which a joint can moveDegrees through which a joint can move Determined byDetermined by

structure of the articular surfacesstructure of the articular surfaces strength and tautness of ligaments, tendons and strength and tautness of ligaments, tendons and

capsulecapsule• stretching of ligaments increases range of motionstretching of ligaments increases range of motion• double-jointed people have long or slack ligamentsdouble-jointed people have long or slack ligaments

action of the muscles and tendonsaction of the muscles and tendons• nervous system monitors joint position and muscle nervous system monitors joint position and muscle

tonetone

2121

Axes of RotationAxes of Rotation

Shoulder joint has 3 degrees of freedom = Shoulder joint has 3 degrees of freedom = multiaxial jointmultiaxial joint

Other joints – monoaxial or biaxialOther joints – monoaxial or biaxial

2222

Types of Synovial JointsTypes of Synovial Joints

2323

Ball-and-Socket JointsBall-and-Socket Joints

Smooth hemispherical head fits within a Smooth hemispherical head fits within a cuplike depressioncuplike depression head of humerus into glenoid cavity of head of humerus into glenoid cavity of

scapulascapula head of femur into acetabulum of hip bonehead of femur into acetabulum of hip bone

Multiaxial jointMultiaxial joint

2424

Condyloid (ellipsoid) JointsCondyloid (ellipsoid) Joints

Oval convex surface on one bone fits into Oval convex surface on one bone fits into a similarly shaped depression on the nexta similarly shaped depression on the next radiocarpal joint of the wrist radiocarpal joint of the wrist metacarpophalangeal joints at the bases of metacarpophalangeal joints at the bases of

the fingersthe fingers Biaxial jointsBiaxial joints

2525

Saddle JointsSaddle Joints

Each articular surface is shaped like a saddle, Each articular surface is shaped like a saddle, concave in one direction and convex in the otherconcave in one direction and convex in the other trapeziometacarpal joint at the base of the thumbtrapeziometacarpal joint at the base of the thumb

Biaxial jointBiaxial joint more movable than a condyloid or hinge joint forming more movable than a condyloid or hinge joint forming

the primate opposable thumbthe primate opposable thumb

2626

Gliding JointsGliding Joints

Flat articular surfaces in which bones slide Flat articular surfaces in which bones slide over each otherover each other

Limited monoaxial jointLimited monoaxial joint Considered amphiarthrosesConsidered amphiarthroses

2727

Hinge JointsHinge Joints

One bone with convex surface that fits into One bone with convex surface that fits into a concave depression on other bonea concave depression on other bone ulna and humerus at elbow jointulna and humerus at elbow joint femur and tibia at knee jointfemur and tibia at knee joint finger and toe jointsfinger and toe joints

Monoaxial jointMonoaxial joint

2828

Pivot JointsPivot Joints

One bone has a projection that fits into a One bone has a projection that fits into a ringlike ligament of anotherringlike ligament of another

First bone rotates on its longitudinal axis First bone rotates on its longitudinal axis relative to the otherrelative to the other atlantoaxial joint (dens and atlas)atlantoaxial joint (dens and atlas) proximal radioulnar joint allows the radius during proximal radioulnar joint allows the radius during

pronation and supinationpronation and supination

2929

Flexion, Extension and HyperextensionFlexion, Extension and Hyperextension

Flexion decreases the Flexion decreases the angle of a jointangle of a joint

Extension straightens Extension straightens and returns to the and returns to the anatomical positionanatomical position

Hyperextension = Hyperextension = extension beyond 180 extension beyond 180 degreesdegrees

3030

Flexion, Extension and HyperextensionFlexion, Extension and Hyperextension

3131

Abduction and AdductionAbduction and Adduction

Abduction is movement of a part away from the Abduction is movement of a part away from the midline midline hyperabduction – raise arm over back or front of headhyperabduction – raise arm over back or front of head

Adduction is movement towards the midlineAdduction is movement towards the midline hyperadduction – crossing fingershyperadduction – crossing fingers

3232

Elevation and DepressionElevation and Depression

Elevation is a movement that raises a bone verticallyElevation is a movement that raises a bone vertically mandibles are elevated during biting and clavicles during a mandibles are elevated during biting and clavicles during a

shrugshrug

Depression is lowering the mandible or the Depression is lowering the mandible or the shouldersshoulders

3333

Protraction and RetractionProtraction and Retraction

Protraction = movement Protraction = movement anteriorly on horizontal anteriorly on horizontal planeplane thrusting the jaw thrusting the jaw

forward, shoulders or forward, shoulders or pelvis forwardpelvis forward

Retraction is movement Retraction is movement posteriorlyposteriorly

3434

CircumductionCircumduction

Movement in which one end Movement in which one end of an appendage remains of an appendage remains stationary while the other end stationary while the other end makes a circular motionmakes a circular motion

Sequence of flexion, Sequence of flexion, abduction, extension and abduction, extension and adduction movementsadduction movements baseball player winding up for baseball player winding up for

a pitcha pitch

3535

RotationRotation Movement on Movement on

longitudinal axislongitudinal axis rotation of trunk, rotation of trunk,

thigh, head or armthigh, head or arm Medial rotation Medial rotation

turns the bone turns the bone inwardsinwards

Lateral rotation Lateral rotation turns the bone turns the bone outwardsoutwards

3636

Supination and PronationSupination and Pronation In the forearm and footIn the forearm and foot Supination Supination

rotation of forearm so that the palm rotation of forearm so that the palm faces forwardfaces forward

inversion and abduction of foot inversion and abduction of foot (raising the medial edge of the foot)(raising the medial edge of the foot)

PronationPronation rotation of forearm so the palm rotation of forearm so the palm

faces to the rearfaces to the rear eversion and abduction of foot eversion and abduction of foot

(raising the lateral edge of the foot) (raising the lateral edge of the foot)

3737

Movements of Head and TrunkMovements of Head and Trunk

Flexion, hyperextension and lateral flexion of Flexion, hyperextension and lateral flexion of vertebral columnvertebral column

3838

Rotation of Trunk and HeadRotation of Trunk and Head

Right rotation of trunk; rotation of headRight rotation of trunk; rotation of head

3939

Movements of MandibleMovements of Mandible

Lateral excursion = sideways movement Lateral excursion = sideways movement Medial excursion = movement back to the midlineMedial excursion = movement back to the midline

side-to-side grinding during chewingside-to-side grinding during chewing

Protraction – retraction of mandibleProtraction – retraction of mandible

4040

Movement of Hand and DigitsMovement of Hand and Digits

Radial and ulnar Radial and ulnar flexionflexion

Abduction of fingers Abduction of fingers and thumband thumb

Opposition is Opposition is movement of the movement of the thumb to approach thumb to approach or touch the or touch the fingertipsfingertips

Reposition is Reposition is movement back to movement back to the anatomical the anatomical positionposition

4141

Movements of the FootMovements of the Foot

Dorsiflexion is raising of the toes as when you swing the foot Dorsiflexion is raising of the toes as when you swing the foot forward to take a step (heel strike)forward to take a step (heel strike)

Plantarflexion is extension of the foot so that the toes point Plantarflexion is extension of the foot so that the toes point downward as in standing on tiptoedownward as in standing on tiptoe

Inversion is a movement in which the soles are turned mediallyInversion is a movement in which the soles are turned medially Eversion is a turning of the soles to face laterallyEversion is a turning of the soles to face laterally

4242

The Humeroscapular JointThe Humeroscapular Joint Most freely movable joint in the bodyMost freely movable joint in the body

shallowness and looseness shallowness and looseness deepened by glenoid labrumdeepened by glenoid labrum

Supported by ligaments and tendonsSupported by ligaments and tendons 3 glenohumeral, coracohumeral,3 glenohumeral, coracohumeral,

transverse humeral and biceps tendon transverse humeral and biceps tendon areareimportant joint stabilizerimportant joint stabilizer

Supported by rotator cuff musculatureSupported by rotator cuff musculature tendons fuse to joint capsule and tendons fuse to joint capsule and

strengthens itstrengthens it supraspinatus, infraspinatus, teres supraspinatus, infraspinatus, teres

minor and subscapularis, minor and subscapularis, 4 Bursae associated with shoulder joint4 Bursae associated with shoulder joint

4343

Stabilizers of the Shoulder JointStabilizers of the Shoulder Joint

4444

Tendons of Rotator Cuff Tendons of Rotator Cuff MusclesMuscles

4545

The Elbow JointThe Elbow Joint Single joint capsule Single joint capsule

enclosing the enclosing the humeroulnar and humeroulnar and humeroradial jointshumeroradial joints

Humeroulnar joint is Humeroulnar joint is supported by collateral supported by collateral ligaments.ligaments.

Radioulnar joint is head Radioulnar joint is head of radius held in place of radius held in place by the anular ligament by the anular ligament encircling the headencircling the head

4646

Elbow JointElbow Joint

4747

The Coaxal (hip) JointThe Coaxal (hip) Joint

Head of femur articulates with acetabulumHead of femur articulates with acetabulum Socket deepened by acetabular labrumSocket deepened by acetabular labrum Blood supply to head of femur found in ligament of Blood supply to head of femur found in ligament of

the head of the femur Joint capsule strengthened by the head of the femur Joint capsule strengthened by ligamentsligaments

4848

Hip JointHip Joint

Joint capsule Joint capsule strengthened by strengthened by ligamentsligaments

pubofemoralpubofemoral ischiofemoralischiofemoral iliofemoraliliofemoral

4949

Dissection of Hip JointDissection of Hip Joint

5050

The Knee JointThe Knee Joint Most complex diarthrosis Most complex diarthrosis

patellofemoral = gliding jointpatellofemoral = gliding joint tibiofemoral = gliding with slight tibiofemoral = gliding with slight

rotation and gliding possible in rotation and gliding possible in flexed positionflexed position

Joint capsule anteriorly consists Joint capsule anteriorly consists of patella and extensions of of patella and extensions of quadriceps quadriceps femoris tendonfemoris tendon

Capsule strengthened by Capsule strengthened by extracapsular and intracapsular extracapsular and intracapsular ligamentsligaments

5151

Knee Joint – Sagittal SectionKnee Joint – Sagittal Section

5252

Knee Joint – Anterior and Posterior Knee Joint – Anterior and Posterior ViewsViews

Anterior and lateral cruciate ligaments limit Anterior and lateral cruciate ligaments limit anterior and posterior sliding movementsanterior and posterior sliding movements

Medial and lateral collateral ligaments prevent Medial and lateral collateral ligaments prevent rotation of extended kneerotation of extended knee

5353

Knee Joint – Superior ViewKnee Joint – Superior View

Medial and lateral meniscus absorb shock and shape jointMedial and lateral meniscus absorb shock and shape joint

5454

Dissection of Knee JointDissection of Knee Joint

5555

ArthritisArthritis

Arthritis is a broad term for pain and Arthritis is a broad term for pain and inflammationinflammation

Osteoarthritis results from years of joint wearOsteoarthritis results from years of joint wear articular cartilage softens and degeneratesarticular cartilage softens and degenerates accompanied by crackling sounds called accompanied by crackling sounds called

crepituscrepitus bone spurs develop on exposed bone tissue bone spurs develop on exposed bone tissue

causing paincausing pain

5656

Arthritis and Artificial JointsArthritis and Artificial Joints

Rheumatoid arthritis is autoimmune attack Rheumatoid arthritis is autoimmune attack on jointon joint antibodies attack synovial membrane, antibodies attack synovial membrane,

enzymes in synovial fluid degrade the enzymes in synovial fluid degrade the cartilage, bones ossifycartilage, bones ossify

remissions occur, steroids and aspirin control remissions occur, steroids and aspirin control inflammationinflammation

Arthroplasty is replacement of diseased Arthroplasty is replacement of diseased joint with artificial device called prosthesisjoint with artificial device called prosthesis

5757

Rheumatoid ArthritisRheumatoid Arthritis

5858

Joint ProsthesesJoint Prostheses