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11
Chapter 9Chapter 9
Lecture OutlineLecture Outline
See PowerPoint Image SlidesSee PowerPoint Image Slides
for all figures and tables pre-inserted intofor all figures and tables pre-inserted into
PowerPoint without notes.PowerPoint without notes.
Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
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