ARTICULATIONS

Chapter 9

Immovable VS Movable

Functional Classification

Synarthrosis - fibrous– immovable - suture

Amphiarthrosis - cartilaginous – slightly movable -vertebra

Diarthrosis - synovial – freely movable – shoulder, hip

Fibrous joints

Syndemosis – ligaments connect two bones – radioulnar interosseous ligament – some movement due to ligamentous movement

Sutures – skull only

Gomphoses – tooth root and maxilla/mandibular junction – gotta chew!

Cartilaginous joints

Synchondroses – hyaline cartilage between bones – true rib and sternum

Symphyses – pad/disk connecting bones – symphysis pubis and intervertebral disks

Synovial joints

Most moveable and numerousUniaxial – hinge and piviot – flex/extensionPivot – C-2, radiusBiaxial – movement in two perpendicular

planes - saddle (thumb/opposition), condyloid/ellipsoidal (occipital to atlas)

Multiaxial – three or more axis – ball and socket joints (hip/shoulder), gliding vertebrae (least moveable)

Examples of synovial joints

Humeroscapular - bursa (cushion sacs providing ease of movement), rotator cuff (muscles and tendons form protective pad)

Hip – stability (shape of ball and socket) mobility (flexion, extension, abduction, adduction, circumduction) iliofemoral ligament strongest in body

Knee – meniscus – cartilage (medial/lateral) creates socket for femur

5 ligaments holding knee stable

Anterior cruciate Posterior cruciate WrisbergTransverse Fibular/tibial collateral

Knee questions

What protects the knee?Is it harder or easier to injure in comparison

to the hip?What range of motion movements can the

knee perform?What does weight have to do with knee

health?How long does a knee replacement usually

help a patient?

Vertebral joints

Slight movement/flexibleROM – flex, extend, circumductIntervertebral disks pad between vertebrae

Types of movement

Angular

Circular

Gliding

Special

Range of Motion

Measures level of wellnessMeasures level of damage/injuryDetermines mode of treatment

Measured by the use of a goniometer

Angular movements

Changes size of angle between two bonesIncludes:

Flexion Extension Abduction Adduction

Abnormal - hyperextension

Circular movements

Rotation on axisInclude:

Rotation Circumduction Supination Pronation

Gliding movements

Simplest of all movementsSurface of one bone moves over another

without any angular or circular movement

Example – carpals/tarsals/vertebrae

Special movements

Inversion Eversion ProtractionRetraction Elevationdepression

Pathophysiology - noninflammatory:

Osteoarthritis (degenerative joint disease) – elders from normal ADL’s –

TMT – nonsteroidal antiinflammatory drugs (NSAID’s)

Aspirin, advil, Celebrex, vioxx

Trauma – dislocation (subluxation)Arthroscopy used to determine extent of injurySprainWhiplash

Pathophysiology - Inflammatory

Arthritis - age vs traumatic injuryRheumatoid arthritis – chronic/systemicJuvenile RA – more severe than adult/more

prevalent in female patientsGout – metabolic – deposits of uric acid –

TMT - Allopurianol

Complete case study pg 275 and CTQ pg 277