Docstoc

ppt Joint Classification arthritis

Document Sample
ppt Joint Classification arthritis Powered By Docstoc
					                                                              Chapter 9
                                                               Lecture
                                                               Outline
                                                           See PowerPoint Image Slides
                                                   for all figures and tables pre-inserted into
                                                             PowerPoint without notes.




                                                                                                 9-1
Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
              Joints
• Joints and their classification
  – bony joints
  – fibrous joints
  – cartilaginous joints
• Synovial joints
• Anatomy of selected diarthroses
  – humeroscapular joint
  – elbow joint
  – coxal joint
  – knee joint
                                    9-2
Joints and Their Classification
• Arthrology = study of the joints
• Kinesiology = study of musculoskeletal
  movement
• Classified by freedom of movement
  – diarthrosis (freely movable)
  – amphiarthrosis (slightly movable)
  – synarthrosis (little or no movement)
• Classified how adjacent bones are joined
  – fibrous, cartilaginous, bony or synovial
                                               9-3
    Bony Joint (Synostosis)

• Gap between two bones ossifies
  – frontal and mandibular bones in infants
  – cranial sutures in elderly
  – attachment of first rib and sternum
• Can occur in either fibrous or
  cartilaginous joint


                                              9-4
Fibrous Joints (Synarthrosis)

• Collagen fibers span the space
  between bones
  – sutures, gomphoses and
    syndesmoses




                                   9-5
      Fibrous Joint -- Sutures
• Immovable fibrous joints
  – bind skull bones together
• Serrate - interlocking lines
  – coronal, sagittal and lambdoid
    sutures
• Lap - overlapping beveled
  edges
  – temporal and parietal bones
• Plane - straight,
  nonoverlapping edges
  – palatine processes of the
    maxillae
                                     9-6
Types of Sutures




                   9-7
  Fibrous Joint -- Gomphoses
• Attachment of a tooth to
  its socket
• Held in place by fibrous
  periodontal ligament
  – collagen fibers attach
    tooth to jawbone
• Some movement while
  chewing


                               9-8
 Fibrous Joint -- Syndesmosis


• Two bones bound
  by ligament only
  – interosseus
    membrane
• Most movable of fibrous joints
• Interosseus membranes unite radius to
  ulna and tibia to fibula
                                          9-9
Cartilaginous Joint -- Synchondrosis

• Bones are joined
  by hyaline
  cartilage
  – rib attachment to
    sternum
  – epiphyseal plate in
    children binds
    epiphysis and
    diaphysis
                                 9-10
Cartilaginous Joint -- Symphysis

• 2 bones joined by
  fibrocartilage
  – pubic symphysis
    and intervertebral
    discs
• Only slight
  amount of
  movement is
  possible
                              9-11
            Synovial Joint




• Joint in which two bones are separated by a
  space called a joint cavity
• Most are freely movable                       9-12
             General Anatomy

• Articular capsule encloses joint cavity
   – continuous with periosteum
   – lined by synovial membrane
• Synovial fluid = slippery fluid; feeds cartilages
• Articular cartilage = hyaline cartilage covering the joint
  surfaces
• Articular discs and menisci
   – jaw, wrist, sternoclavicular and knee joints
   – absorbs shock, guides bone movements and distributes forces
• Tendon attaches muscle to bone
• Ligament attaches bone to bone
                                                             9-13
  Tendon Sheaths and Bursae




• Bursa = saclike extension of joint capsule
   – between nearby structures so slide more easily past each other
• Tendon sheaths = cylinders of connective tissue lined
  with synovial membrane and wrapped around a tendon
                                                                9-14
      Components of a Lever
• A lever is a rigid object that rotates around
  a fixed point called a fulcrum
• Rotation occurs when effort overcomes
  resistance
  – resistance arm and effort arm are described
    relative to fulcrum




                                                  9-15
Mechanical Advantage of a Lever
 • Two kinds of levers
   – lever that helps increase output of force
     • human moving a heavy object with help of
       crowbar
   – lever move object further and faster
     • movement of row boat with paddle
 • Types of levers produce either increase
   in speed or force

                                                  9-16
        Mechanical Advantage




• Mechanical advantage is calculated from the
  length of the effort arm divided by the length of
  the resistance arm
• Contraction of the biceps muscle causes the
                                                  9-17
  hand to move fast and further (MA <1.0)
               First-Class Lever




• Has fulcrum in the middle between effort and resistance
• Atlantooccipital joint lies between the muscles on the
  back of the neck and the weight of the face
   – loss of muscle tone occurs when you nod off in class

                                                            9-18
         Second-Class Lever




• Resistance between fulcrum and effort
• Resistance from the muscle tone of the
  temporalis muscle lies between the jaw joint and
  the pull of the diagastric muscle on the chin as it
  opens the mouth quickly
                                                  9-19
             Third-Class Lever




• Effort between the resistance and the fulcrum
  – most joints of the body
• The effort applied by the biceps muscle is applied
  to the forearm between the elbow joint and the
  weight of the hand and the forearm
                                                  9-20
           Range of Motion
• Degrees through which a joint can move
• Determined by
  – structure of the articular surfaces
  – strength and tautness of ligaments, tendons
    and capsule
    • stretching of ligaments increases range of motion
    • double-jointed people have long or slack
      ligaments
  – action of the muscles and tendons
    • nervous system monitors joint position and
      muscle tone                                   9-21
        Axes of Rotation




• Shoulder joint has 3 degrees of freedom =
  multiaxial joint
• Other joints – monoaxial or biaxial         9-22
Types of Synovial Joints




                           9-23
     Ball-and-Socket Joints
• Smooth hemispherical head fits within
  a cuplike depression
  – head of humerus into glenoid cavity of
    scapula
  – head of femur into acetabulum of hip bone
• Multiaxial joint



                                            9-24
  Condyloid (ellipsoid) Joints
• Oval convex surface on one bone fits
  into a similarly shaped depression on
  the next
  – radiocarpal joint of the wrist
  – metacarpophalangeal joints at the bases
    of the fingers
• Biaxial joints


                                              9-25
             Saddle Joints
• Each articular surface is shaped like a
  saddle, concave in one direction and
  convex in the other
  – trapeziometacarpal joint at the base of the
    thumb
• Biaxial joint
  – more movable than a condyloid or hinge
    joint forming the primate opposable thumb

                                                  9-26
           Gliding Joints

• Flat articular surfaces in which bones
  slide over each other
• Limited monoaxial joint
• Considered amphiarthroses




                                           9-27
            Hinge Joints
• One bone with convex surface that fits
  into a concave depression on other
  bone
  – ulna and humerus at elbow joint
  – femur and tibia at knee joint
  – finger and toe joints
• Monoaxial joint


                                           9-28
              Pivot Joints
• One bone has a projection that fits into a
  ringlike ligament of another
• First bone rotates on its longitudinal axis
  relative to the other
  – atlantoaxial joint (dens and atlas)
  – proximal radioulnar joint allows the radius
    during pronation and supination


                                                  9-29
       Flexion, Extension and
          Hyperextension

• Flexion decreases the
  angle of a joint
• Extension straightens
  and returns to the
  anatomical position
• Hyperextension =
  extension beyond 180
  degrees
                                9-30
Flexion, Extension and
   Hyperextension




                         9-31
    Abduction and Adduction




• Abduction is movement of a part away from the
  midline
  – hyperabduction – raise arm over back or front of head
• Adduction is movement towards the midline
  – hyperadduction – crossing fingers                 9-32
    Elevation and Depression




• Elevation is a movement that raises a bone
  vertically
  – mandibles are elevated during biting and clavicles
    during a shrug
• Depression is lowering the mandible or the
  shoulders                                              9-33
   Protraction and Retraction

• Protraction =
  movement anteriorly
  on horizontal plane
  – thrusting the jaw
    forward, shoulders or
    pelvis forward
• Retraction is
  movement posteriorly
                                9-34
             Circumduction
• Movement in which one
  end of an appendage
  remains stationary while
  the other end makes a
  circular motion
• Sequence of flexion,
  abduction, extension and
  adduction movements
  – baseball player winding up
    for a pitch
                                 9-35
                  Rotation
• Movement on
  longitudinal axis
  – rotation of trunk,
    thigh, head or arm
• Medial rotation
  turns the bone
  inwards
• Lateral rotation
  turns the bone
  outwards                   9-36
Supination and Pronation
        • In the forearm and foot
        • Supination
          – rotation of forearm so that the
            palm faces forward
          – inversion and abduction of foot
            (raising the medial edge of the
            foot)
        • Pronation
          – rotation of forearm so the palm
            faces to the rear
          – eversion and abduction of foot
            (raising the lateral edge of the
                                          9-37
            foot)
      Movements of Head and
             Trunk




• Flexion, hyperextension and lateral flexion of
  vertebral column                               9-38
  Rotation of Trunk and Head




• Right rotation of trunk; rotation of head

                                              9-39
   Movements of Mandible




• Lateral excursion = sideways movement
• Medial excursion = movement back to the
  midline
  – side-to-side grinding during chewing
• Protraction – retraction of mandible      9-40
Movement of Hand and Digits
• Radial and ulnar
  flexion
• Abduction of
  fingers and thumb
• Opposition is
  movement of the
  thumb to approach
  or touch the
  fingertips
• Reposition is
  movement back to
  the anatomical
  position
                          9-41
        Movements of the Foot




• Dorsiflexion is raising of the toes as when you swing
  the foot forward to take a step (heel strike)
• Plantarflexion is extension of the foot so that the toes
  point downward as in standing on tiptoe
• Inversion is a movement in which the soles are turned
  medially
• Eversion is a turning of the soles to face laterally     9-42
    The Humeroscapular Joint
• Most freely movable joint in the body
   – shallowness and looseness
   – deepened by glenoid labrum
• Supported by ligaments and tendons
   – 3 glenohumeral, coracohumeral,
     transverse humeral and biceps
     tendon are
     important joint stabilizer
• Supported by rotator cuff musculature
   – tendons fuse to joint capsule and
     strengthens it
   – supraspinatus, infraspinatus, teres
     minor and subscapularis,
• 4 Bursae associated with shoulder joint
                                            9-43
Stabilizers of the Shoulder
           Joint




                              9-44
Tendons of Rotator Cuff
      Muscles




                          9-45
Dissection of Shoulder Joint




                               9-46
              The Elbow Joint
• Single joint capsule
  enclosing the
  humeroulnar and
  humeroradial joints
• Humeroulnar joint is
  supported by collateral
  ligaments.
• Radioulnar joint is head
  of radius held in place by
  the anular ligament
  encircling the head
                                9-47
Elbow Joint




              9-48
      The Coaxal (hip) Joint




• Head of femur articulates with acetabulum
• Socket deepened by acetabular labrum
• Blood supply to head of femur found in
  ligament of the head of the femur Joint capsule
  strengthened by ligaments
                                               9-49
Hip Joint
        • Joint capsule
          strengthened by
          ligaments
            – pubofemoral
            – ischiofemoral
            – iliofemoral




                              9-50
Dissection of Hip Joint




                          9-51
               The Knee Joint
• Most complex diarthrosis
  – patellofemoral = gliding joint
  – tibiofemoral = gliding with slight
    rotation and gliding possible in
    flexed position
• Joint capsule anteriorly
  consists
  of patella and extensions of
  quadriceps
  femoris tendon
• Capsule strengthened by
  extracapsular and intracapsular
  ligaments
                                         9-52
Knee Joint – Sagittal Section




                                9-53
      Knee Joint – Anterior and
          Posterior Views




• Anterior and lateral cruciate ligaments limit
  anterior and posterior sliding movements
• Medial and lateral collateral ligaments prevent
  rotation of extended knee                     9-54
  Knee Joint – Superior View




• Medial and lateral meniscus absorb shock
  and shape joint
                                             9-55
Dissection of Knee Joint




                           9-56
                 Arthritis

• Arthritis is a broad term for pain and
  inflammation
• Osteoarthritis results from years of joint
  wear
  – articular cartilage softens and degenerates
  – accompanied by crackling sounds called
    crepitus
  – bone spurs develop on exposed bone tissue
    causing pain
                                             9-57
 Arthritis and Artificial Joints
• Rheumatoid arthritis is autoimmune
  attack on joint
  – antibodies attack synovial membrane,
    enzymes in synovial fluid degrade the
    cartilage, bones ossify
  – remissions occur, steroids and aspirin
    control inflammation
• Arthroplasty is replacement of
  diseased joint with artificial device
  called prosthesis
                                             9-58
Rheumatoid Arthritis




                       9-59
Joint Prostheses




                   9-60

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:272
posted:1/16/2011
language:English
pages:60