Plane Joint Plane joints Plane joints Articular surfaces are essentially flat Articular surfaces are...
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Transcript of Plane Joint Plane joints Plane joints Articular surfaces are essentially flat Articular surfaces are...
Plane JointPlane Joint
Plane jointsPlane joints Articular surfaces are Articular surfaces are
essentially flatessentially flat Allow only slipping or Allow only slipping or
gliding movementsgliding movements Only examples of Only examples of
nonaxial jointsnonaxial joints
Figure 8.7a
Types of Synovial JointsTypes of Synovial Joints
Hinge jointsHinge joints Cylindrical projections of one bone fits into a Cylindrical projections of one bone fits into a
trough-shaped surface on anothertrough-shaped surface on another Motion is along a single planeMotion is along a single plane Uniaxial joints permit flexion and extension onlyUniaxial joints permit flexion and extension only Examples: elbow and interphalangeal jointsExamples: elbow and interphalangeal joints
Hinge JointsHinge Joints
Figure 8.7b
Pivot JointsPivot Joints
Rounded end of one bone protrudes into a Rounded end of one bone protrudes into a “sleeve,” or ring, composed of bone (and “sleeve,” or ring, composed of bone (and possibly ligaments) of anotherpossibly ligaments) of another
Only uniaxial movement allowedOnly uniaxial movement allowed Examples: joint between the axis and the dens, Examples: joint between the axis and the dens,
and the proximal radioulnar jointand the proximal radioulnar joint
Pivot JointsPivot Joints
Figure 8.7c
Condyloid or Ellipsoidal JointsCondyloid or Ellipsoidal Joints
Oval articular surface of one bone fits into a Oval articular surface of one bone fits into a complementary depression in anothercomplementary depression in another
Both articular surfaces are ovalBoth articular surfaces are oval Biaxial joints permit all angular motionsBiaxial joints permit all angular motions Examples: radiocarpal (wrist) joints, and Examples: radiocarpal (wrist) joints, and
metacarpophalangeal (knuckle) jointsmetacarpophalangeal (knuckle) joints
Condyloid or Ellipsoidal JointsCondyloid or Ellipsoidal Joints
Figure 8.7d
Saddle JointsSaddle Joints
Similar to condyloid joints but allow greater Similar to condyloid joints but allow greater movementmovement
Each articular surface has both a concave and Each articular surface has both a concave and a convex surfacea convex surface
Example: carpometacarpal joint of the thumbExample: carpometacarpal joint of the thumb
Saddle JointsSaddle Joints
Figure 8.7e
Ball-and-Socket JointsBall-and-Socket Joints
A spherical or hemispherical head of one bone A spherical or hemispherical head of one bone articulates with a cuplike socket of anotherarticulates with a cuplike socket of another
Multiaxial joints permit the most freely Multiaxial joints permit the most freely moving synovial jointsmoving synovial joints
Examples: shoulder and hip jointsExamples: shoulder and hip joints
Ball-and-Socket JointsBall-and-Socket Joints
Figure 8.7f
Synovial Joints: KneeSynovial Joints: Knee
Largest and most complex joint of the bodyLargest and most complex joint of the body Allows flexion, extension, and some rotationAllows flexion, extension, and some rotation Three joints in one surrounded by a single Three joints in one surrounded by a single
joint cavityjoint cavity Femoropatellar jointFemoropatellar joint Lateral and medial tibiofemoral jointsLateral and medial tibiofemoral joints
Synovial Joints: Knee Ligaments Synovial Joints: Knee Ligaments and Tendons – Anterior Viewand Tendons – Anterior View
Tendon of the Tendon of the quadriceps femoris quadriceps femoris musclemuscle
Lateral and medial Lateral and medial patellar retinaculapatellar retinacula
Fibular and tibial Fibular and tibial collateral ligamentscollateral ligaments
Patellar ligamentPatellar ligament
Figure 8.8c
Synovial Joints: Knee – Synovial Joints: Knee – Other Supporting StructuresOther Supporting Structures
Anterior cruciate ligamentAnterior cruciate ligament Posterior cruciate ligamentPosterior cruciate ligament Medial meniscus (semilunar cartilage)Medial meniscus (semilunar cartilage) Lateral meniscusLateral meniscus
Synovial Joints: Knee – Synovial Joints: Knee – Other Supporting StructuresOther Supporting Structures
Figure 8.8b
Synovial Joints: Knee – Synovial Joints: Knee – Posterior Superficial ViewPosterior Superficial View
Adductor magnus Adductor magnus tendontendon
Articular capsuleArticular capsule Oblique popliteal Oblique popliteal
ligamentligament Arcuate popliteal Arcuate popliteal
ligamentligament Semimembranosus Semimembranosus
tendontendon
Figure 8.8e
Synovial Joints: Shoulder Synovial Joints: Shoulder (Glenohumeral)(Glenohumeral)
Ball-and-socket joint in which stability is Ball-and-socket joint in which stability is sacrificed to obtain greater freedom of sacrificed to obtain greater freedom of movementmovement
Head of humerus articulates with the glenoid Head of humerus articulates with the glenoid fossa of the scapulafossa of the scapula
Synovial Joints: ElbowSynovial Joints: Elbow
Hinge joint that allows flexion and extension Hinge joint that allows flexion and extension onlyonly
Radius and ulna articulate with the humerusRadius and ulna articulate with the humerus
Synovial Joints: ElbowSynovial Joints: Elbow
Annular ligamentAnnular ligament Ulnar collateral Ulnar collateral
ligamentligament Radial collateral Radial collateral
ligamentligament
Figure 8.10a
Synovial Joints: ElbowSynovial Joints: Elbow
Figure 8.10b
Synovial Joints: ElbowSynovial Joints: Elbow
Figure 8.10d
Synovial Joints: Shoulder Synovial Joints: Shoulder StabilityStability
Weak stability is maintained by:Weak stability is maintained by: Thin, loose joint capsuleThin, loose joint capsule Four ligaments – coracohumeral, and three Four ligaments – coracohumeral, and three
glenohumeralglenohumeral Tendon of the long head of biceps, which travels Tendon of the long head of biceps, which travels
through the intertubercular groove and secures the through the intertubercular groove and secures the humerus to the glenoid cavityhumerus to the glenoid cavity
Rotator cuff (four tendons) that encircles the Rotator cuff (four tendons) that encircles the shoulder joint and blends with the articular capsuleshoulder joint and blends with the articular capsule
Synovial Joints: Shoulder StabilitySynovial Joints: Shoulder Stability
Figure 8.11a
Synovial Joints: Shoulder StabilitySynovial Joints: Shoulder Stability
Figure 8.11b
Synovial Joints: Hip (Coxal) Synovial Joints: Hip (Coxal) JointJoint
Ball-and-socket jointBall-and-socket joint Head of the femur articulates with the Head of the femur articulates with the
acetabulumacetabulum Good range of motion, but limited by the deep Good range of motion, but limited by the deep
socket and strong ligamentssocket and strong ligaments
Synovial Joints: Hip StabilitySynovial Joints: Hip Stability
Acetabular labrumAcetabular labrum Iliofemoral Iliofemoral
ligamentligament Pubofemoral Pubofemoral
ligamentligament Ischiofemoral Ischiofemoral
ligamentligament Ligamentum teresLigamentum teres
Figure 8.12a
Synovial Joints: Hip StabilitySynovial Joints: Hip Stability
Figure 8.12c, d
Temporomandibular Joint Temporomandibular Joint (TMJ)(TMJ)
Mandibular condyle articulate with the Mandibular condyle articulate with the temporal bonetemporal bone
Two types of movementTwo types of movement Hinge – depression and elevation of mandibleHinge – depression and elevation of mandible Side to side – (lateral excursion) grinding of teethSide to side – (lateral excursion) grinding of teeth
Temporomandibular JointTemporomandibular Joint
Figure 8.13a, b
SprainsSprains
The ligaments reinforcing a joint are stretched The ligaments reinforcing a joint are stretched or tornor torn
Partially torn ligaments slowly repair Partially torn ligaments slowly repair themselvesthemselves
Completely torn ligaments require prompt Completely torn ligaments require prompt surgical repairsurgical repair
Cartilage InjuriesCartilage Injuries
The snap and pop of overstressed cartilageThe snap and pop of overstressed cartilage Common aerobics injuryCommon aerobics injury Repaired with arthroscopic surgeryRepaired with arthroscopic surgery
DislocationsDislocations
Occur when bones are forced out of alignmentOccur when bones are forced out of alignment Usually accompanied by sprains, Usually accompanied by sprains,
inflammation, and joint immobilizationinflammation, and joint immobilization Caused by serious falls and are common sports Caused by serious falls and are common sports
injuriesinjuries Subluxation – partial dislocation of a jointSubluxation – partial dislocation of a joint
Inflammatory and Degenerative Inflammatory and Degenerative ConditionsConditions
BursitisBursitis An inflammation of a bursa, usually caused by a An inflammation of a bursa, usually caused by a
blow or frictionblow or friction Symptoms are pain and swellingSymptoms are pain and swelling Treated with anti-inflammatory drugs; excessive Treated with anti-inflammatory drugs; excessive
fluid may be aspirated, ultimately surgery will be fluid may be aspirated, ultimately surgery will be neededneeded
Inflammatory and Degenerative Inflammatory and Degenerative ConditionsConditions
TendonitisTendonitis Inflammation of tendon sheaths typically caused Inflammation of tendon sheaths typically caused
by overuseby overuse Symptoms and treatment are similar to bursitisSymptoms and treatment are similar to bursitis
ArthritisArthritis
More than 100 different types of inflammatory More than 100 different types of inflammatory or degenerative diseases that damage the jointsor degenerative diseases that damage the joints
Most widespread crippling disease in the U.S.Most widespread crippling disease in the U.S. Symptoms – pain, stiffness, and swelling of a Symptoms – pain, stiffness, and swelling of a
jointjoint Acute forms are caused by bacteria and are Acute forms are caused by bacteria and are
treated with antibioticstreated with antibiotics Chronic forms include osteoarthritis, rheumatoid Chronic forms include osteoarthritis, rheumatoid
arthritis, and gouty arthritisarthritis, and gouty arthritis
Osteoarthritis (OA)Osteoarthritis (OA)
Most common chronic arthritis; often called Most common chronic arthritis; often called “wear-and-tear” arthritis“wear-and-tear” arthritis
Affects women more than menAffects women more than men 85% of all Americans develop OA85% of all Americans develop OA More prevalent in the aged, and is probably More prevalent in the aged, and is probably
related to the normal aging processrelated to the normal aging process
Osteoarthritis: CourseOsteoarthritis: Course
OA reflects the years of abrasion and OA reflects the years of abrasion and compression causing increased production of compression causing increased production of metalloproteinase enzymes that break down metalloproteinase enzymes that break down cartilagecartilage
As one ages, cartilage is destroyed more As one ages, cartilage is destroyed more quickly than it is replacedquickly than it is replaced
The exposed bone ends thicken, enlarge, form The exposed bone ends thicken, enlarge, form bone spurs, and restrict movementbone spurs, and restrict movement
Joints most affected are the cervical and lumbar Joints most affected are the cervical and lumbar spine, fingers, knuckles, knees, and hipsspine, fingers, knuckles, knees, and hips
Osteoarthritis: TreatmentsOsteoarthritis: Treatments
OA is slow and irreversibleOA is slow and irreversible Treatments include:Treatments include:
Mild pain relievers, along with moderate activityMild pain relievers, along with moderate activity Magnetic therapy Magnetic therapy Glucosamine sulfate decreases pain and Glucosamine sulfate decreases pain and
inflammationinflammation
Rheumatoid Arthritis (RA)Rheumatoid Arthritis (RA)
Chronic, inflammatory, autoimmune disease of Chronic, inflammatory, autoimmune disease of unknown cause, with an insidious onsetunknown cause, with an insidious onset
Usually arises between the ages of 40 to 50, Usually arises between the ages of 40 to 50, but may occur at any agebut may occur at any age
Signs and symptoms include joint tenderness, Signs and symptoms include joint tenderness, anemia, osteoporosis, muscle atrophy, and anemia, osteoporosis, muscle atrophy, and cardiovascular problemscardiovascular problems The course of RA is marked with exacerbations The course of RA is marked with exacerbations
and remissionsand remissions
Rheumatoid Arthritis: CourseRheumatoid Arthritis: Course
RA begins with synovitis of the affected jointRA begins with synovitis of the affected joint Inflammatory chemicals are inappropriately Inflammatory chemicals are inappropriately
releasedreleased Inflammatory blood cells migrate to the joint, Inflammatory blood cells migrate to the joint,
causing swellingcausing swelling
Rheumatoid Arthritis: CourseRheumatoid Arthritis: Course
Inflamed synovial membrane thickens into a Inflamed synovial membrane thickens into a pannuspannus
Pannus erodes cartilage, scar tissue forms, Pannus erodes cartilage, scar tissue forms, articulating bone ends connectarticulating bone ends connect
The end result, ankylosis, produces bent, The end result, ankylosis, produces bent, deformed fingersdeformed fingers
Rheumatoid Arthritis: Rheumatoid Arthritis: TreatmentTreatment
Conservative therapy – aspirin, long-term use Conservative therapy – aspirin, long-term use of antibiotics, and physical therapyof antibiotics, and physical therapy
Progressive treatment – anti-inflammatory Progressive treatment – anti-inflammatory drugs or immunosuppressants drugs or immunosuppressants
The drug Enbrel, a biological response The drug Enbrel, a biological response modifier, neutralizes the harmful properties of modifier, neutralizes the harmful properties of inflammatory chemicalsinflammatory chemicals
Gouty ArthritisGouty Arthritis
Deposition of uric acid crystals in joints and soft Deposition of uric acid crystals in joints and soft tissues, followed by an inflammation responsetissues, followed by an inflammation response
Typically, gouty arthritis affects the joint at the Typically, gouty arthritis affects the joint at the base of the great toebase of the great toe
In untreated gouty arthritis, the bone ends fuse In untreated gouty arthritis, the bone ends fuse and immobilize the jointand immobilize the joint
Treatment – colchicine, nonsteroidal anti-Treatment – colchicine, nonsteroidal anti-inflammatory drugs, and glucocorticoidsinflammatory drugs, and glucocorticoids
Developmental Aspects of JointsDevelopmental Aspects of Joints
By embryonic week 8, synovial joints By embryonic week 8, synovial joints resemble adult jointsresemble adult joints
Few problems occur until late middle ageFew problems occur until late middle age Advancing years take their toll on joints:Advancing years take their toll on joints:
Ligaments and tendons shorten and weakenLigaments and tendons shorten and weaken Intervertebral discs become more likely to herniateIntervertebral discs become more likely to herniate Most people in their 70s have some degree of OAMost people in their 70s have some degree of OA
Developmental Aspects of JointsDevelopmental Aspects of Joints
Prudent exercise (especially swimming) that Prudent exercise (especially swimming) that coaxes joints through their full range of coaxes joints through their full range of motion is key to postponing joint problemsmotion is key to postponing joint problems