Articulations

(Joints)

Articulation = joint = point of contact between bones

Joint ClassificationFunctional Name Structural Name Movement Example Description

Synarthroses Fibrous Immovable Syndesmoses ligaments

Sutures skull

Gomphoses Teeth to jaw

Amphiarthroses Cartilaginous (hyaline, fibrocartilage)

Slightly movable

Synchrondosis Ribs, epiphyseal plate

Symphyses Pubis, vertebral discs

Diarthroses Synovial Freely movable Uniaxial Hinge, pivot

Biaxial Saddle, ellipsoidal

Multiaxial Ball and socket, gliding

SynarthrosesFibrous Joints

AmphiarthosesCartilaginous

DiarthrosesSynovial

• Most numerous• Most complex• Structures

– joint capsule • sleevelike encasing around bone ends

to bind them together– synovial membrane

• membrane lining capsule to secrete synovial fluid

– bursae • cushions joints and helps tendons

move– joint cavity

• small space between bones– articular cartilage

• hyaline cartilage covering bone ends– menisci

• pads of fibrocartilage between bones– Ligaments

• strong, dense, white fibrous tissue that hold bones firmly together

bursae

Types of Joints

ellipsoidal

Uniaxial Joints permits movement around one axis and one plane

• allows only flexion and extension– examples – elbow, knee

• knee joint – largest joint, most complex, most frequently injured

• projection of one bone articulating with a ring/notch of another bone– examples - between vertebrate

Biaxial Jointspermits movement around two perpendicular axes and planes

• Example– thumb

• only saddle joint in the body

• condyle fits into an elliptical socket

• Example– between radius

and carpals

ellipsoidal

Multiaxial Joints permits movement around three or more axes and planes

• most moveable joints• ball shaped head fits into concave depression• example - shoulder, hip

– humeroscapular joint• most mobile joint

– sacroiliac joint• hip joint

• relatively flat articulating surface that allows gliding movement

• example – between carpals– between tarsals– between vertebrate

Multiaxial

Ball and socket

Multiaxial

Ball and socketMultiaxial

Ball and socket

Multiaxial

Gliding

Herniated Discs

Multiaxial

Ball and socket

Uniaxial

HingeMultiaxial

Ball and socket

Meniscus

Normal Tear of medial meniscus

• __________________– Used to determine extent of injury

and progress of rehabilitation– measures range of motion

(degree of angle)

ROM(Range of Motion)

____________ ROM• flexion – decreases angle,

movement towards body• extension – increase angle,

movement away from body• hyperextension – stretching or

extending beyond anatomical position

• plantar flexion – increase angle between top of foot and front of leg (point up/flex)

• dorsiflexion – decrease angle between top of foot and front of leg (point down)

• ABduction – move AWAY from medial plane

• ADduction – move TOWARDS medial plane

• rotation – pivoting a bone on its axis

• circumduction – distal end of a body part moves in a circle

• supination – hand palm side up

• pronation – hand palm side down

____________ROM

Special Movements• inversion – turn foot inward• eversion – turn foot outward• protraction – move part forward• retraction – move part backward• elevation – move part up• depression – move part down

Joint Disorders

• _________________(NIJD)– Osteoarthritis– Tramatic Injuries

• Dislocation• Meniscus tear• Sprain• Ligament tear• Herniated disc

• _________________(IJD)– Rheumatoid arthritis– Gout

Joint Disorders

• Osteoarthritis– Most ____________ NIJD– Wear and tear deterioration– Atrophy of ____________ cartilage– Formation of new _______ at joint surface– Most common in weight-bearing joints– Stiffness, pain, limited movement– Treat symptoms with NSAIDS

Joint Disorders• ________________

– Articular surfaces not in proper contact– Torn vessels, nerves, ligaments, muscles– Pain and swelling– Treat with realignment (reduction)

Joint Disorders

• Meniscus Tear– One of most common athletic injuries– Swelling, pain, instability, limited motion– Treat with arthroscopic surgery

Joint Disorders• ___________

– Stretching of ligaments surrounding joint– Due to twisting motion– Hematoma, limited motion– Treatment: R.I.C.E.

Degree of Sprains•   ______ degree ankle sprain 

– Some stretching or perhaps tearing may have occurred– No loss of function– Mild pain, little bruising– Little or no swelling– Some joint stiffness or difficulty walking

• ______ degree ankle sprain– Difficulty walking– Moderate to severe pain– Swelling and tenderness in the ankle joint– Bruising may start after 3 to 4 days

• ______ degree ankle sprain– most serious– Total rupture of a ligament– Walking may not be possible– Severe pain initially and substantial swelling– May require surgery

• Ligament Tears (___ degree Sprain)• Bruising, pain, swelling, instability• Physical therapy• Partial tear vs. complete tear

– Partial Tear – boot/brace, crutches– Complete Tear - Surgery after most swelling subsides

Joint Disorders

Knee Injuries

____________________ surgery

• 3-4 very small incisions ¼ in. – fiber-optic light

source – video camera – terile saline solution

is continuously pumped through the knee via a cannula

Video of surgery

Joint Disorders

• Rheumatoid arthritis– Chronic and systemic– Inflammation of ___________ membrane– ______________ destroyed, bone erosion– Progressive crippling and _____________– Pain, inflammation, decreased mobility,

aching, stiffness– Treat with corticosteroid drugs and NSAIDS

Joint Disorders

• Gouty arthritis– Also referred to as just _________– Excessive _______ ________ in blood– Crystals get deposited in _____________fluid– Chronic inflammation and tissue damage– Swelling, tenderness– Pin in wrists, fingers, ankles, knees, elbows– Treat with Allopurinol (inhibits uric acid

synthesis)

Joint Disorders

Osteoarthritis

Rheumatoid arthritis Gout

NIJDC

IJD IJD