Download File

10/30/14
PowerPoint® Lecture Slides
prepared by
Janice Meeking,
Mount Royal College
CHAPTER
8
Classification of Synovial Joints
•  Six types, based on shape of articular
surfaces:
•  Plane
•  Hinge
•  Pivot
Joints: Part B
•  Condyloid
•  Saddle
•  Ball and socket
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
Plane Joints
f
•  Nonaxial joints
Nonaxial
Uniaxial
Biaxial
Multiaxial
•  Flat articular surfaces
•  Short gliding movements
c
b
a Plane joint (intercarpal joint)
a
e
d
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
Figure 8.7a
1
10/30/14
Hinge Joints
f
•  Uniaxial joints
Nonaxial
Uniaxial
Biaxial
Multiaxial
•  Motion along a single plane
•  Flexion and extension only
c
b Hinge joint (elbow joint)
b
a
e
d
Copyright © 2010 Pearson Education, Inc.
Figure 8.7b
Copyright © 2010 Pearson Education, Inc.
Pivot Joints
f
•  Rounded end of one bone conforms to a
“sleeve,” or ring of another bone
Nonaxial
Uniaxial
Biaxial
Multiaxial
•  Uniaxial movement only
c
b
c Pivot joint (proximal radioulnar joint)
a
e
d
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
Figure 8.7c
2
10/30/14
Condyloid (Ellipsoidal) Joints
f
•  Biaxial joints
Nonaxial
Uniaxial
Biaxial
Multiaxial
•  Both articular surfaces are oval
•  Permit all angular movements
c
d Condyloid joint
(metacarpophalangeal joint)
b
a
e
d
Copyright © 2010 Pearson Education, Inc.
Figure 8.7d
Copyright © 2010 Pearson Education, Inc.
Saddle Joints
f
•  Biaxial
Nonaxial
Uniaxial
Biaxial
Multiaxial
•  Allow greater freedom of movement than
condyloid joints
•  Each articular surface has both concave and
convex areas
c
e Saddle joint (carpometacarpal joint
of thumb)
b
a
e
d
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
Figure 8.7e
3
10/30/14
Ball-and-Socket Joints
f
•  Multiaxial joints
Nonaxial
Uniaxial
Biaxial
Multiaxial
•  The most freely moving synovial joints
c
b
f Ball-and-socket joint (shoulder joint)
a
e
d
Copyright © 2010 Pearson Education, Inc.
Knee Joint
•  Largest, most complex joint of body
•  Three joints surrounded by a single joint cavity:
•  Femoropatellar joint:
•  Plane joint
•  Allows gliding motion during knee flexion
•  Lateral and medial tibiofemoral joints between the
femoral condyles and the C-shaped lateral and medial
menisci (semilunar cartilages) of the tibia
•  Allow flexion, extension, and some rotation when
knee is partly flexed
PLAY
A&P Flix™: Movement at the knee joint
Copyright © 2010 Pearson Education, Inc.
Figure 8.7f
Copyright © 2010 Pearson Education, Inc.
Femur
Articular
capsule
Posterior
cruciate
ligament
Lateral
meniscus
Anterior
cruciate
ligament
Tibia
Tendon of
quadriceps
femoris
Suprapatellar
bursa
Patella
Subcutaneous
prepatellar bursa
Synovial cavity
Lateral meniscus
Infrapatellar
fat pad
Deep infrapatellar
bursa
Patellar ligament
(a) Sagittal section through the right knee joint
Copyright © 2010 Pearson Education, Inc.
Figure 8.8a
4
10/30/14
Knee Joint
Anterior
Anterior
cruciate
ligament
Articular
cartilage on
lateral tibial
condyle
Articular
cartilage
on medial
tibial
condyle
•  At least 12 associated bursae
•  Capsule is reinforced by muscle tendons:
•  E.g., quadriceps and semimembranosus tendons
•  Joint capsule is thin and absent anteriorly
•  Anteriorly, the quadriceps tendon gives rise to:
Medial
meniscus
Lateral
meniscus
•  Lateral and medial patellar retinacula
•  Patellar ligament
Posterior
cruciate
ligament
(b) Superior view of the right tibia in the knee joint, showing
the menisci and cruciate ligaments
Figure 8.8b
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
Knee Joint
Quadriceps
femoris muscle
Tendon of
quadriceps
femoris muscle
Patella
•  Capsular and extracapsular ligaments
•  Help prevent hyperextension
•  Intracapsular ligaments:
Fibular
collateral
ligament
Medial patellar
retinaculum
Tibial collateral
ligament
Patellar ligament
Fibula
Tibia
Lateral patellar
retinaculum
•  Anterior and posterior cruciate ligaments
•  Prevent anterior-posterior displacement
•  Reside outside the synovial cavity
(c) Anterior view of right knee
Copyright © 2010 Pearson Education, Inc.
Figure 8.8c
Copyright © 2010 Pearson Education, Inc.
5
10/30/14
Femur
Articular capsule
Oblique popliteal
ligament
Lateral head of
gastrocnemius
muscle
Bursa
Fibular collateral
ligament
Tendon of
adductor magnus
Medial head of
gastrocnemius
muscle
Popliteus
muscle (cut)
Tibial collateral
ligament
Tibia
Patella
Fibula
(d) Posterior view of the joint capsule,
including ligaments
PLAY
Figure 8.8d
Lateral
Quadriceps tendon
(e) Anterior view of flexed knee, showing the cruciate
ligaments (articular capsule removed, and quadriceps
tendon cut and reflected distally)
Tibia
Copyright © 2010 Pearson Education, Inc.
Posterior cruciate
ligament
Medial condyle
Tibial collateral
ligament
Anterior cruciate
ligament
Medial meniscus
Patellar ligament
Arcuate popliteal
ligament
Tendon of
semimembranosus
muscle
Hockey puck
Fibular
collateral
ligament
Lateral condyle
of femur
Lateral
meniscus
Animation: Rotatable knee
Copyright © 2010 Pearson Education, Inc.
Figure 8.8e
Shoulder (Glenohumeral) Joint
Medial
Patella
(outline)
•  Ball-and-socket joint: head of humerus and
glenoid fossa of the scapula
Tibial collateral
ligament
(torn)
•  Stability is sacrificed for greater freedom of
movement
Medial
meniscus (torn)
Anterior
cruciate
ligament (torn)
Copyright © 2010 Pearson Education, Inc.
Figure 8.9
Copyright © 2010 Pearson Education, Inc.
6
10/30/14
Acromion
of scapula
Coracoacromial
ligament
Subacromial
bursa
Fibrous
articular capsule
Tendon
sheath
Shoulder Joint
Synovial cavity
of the glenoid
cavity containing
synovial fluid
Hyaline
cartilage
Synovial membrane
Fibrous capsule
Tendon of
long head
of biceps
brachii muscle
•  Reinforcing ligaments:
•  Coracohumeral ligament—helps support the
weight of the upper limb
•  Three glenohumeral ligaments—somewhat
weak anterior reinforcements
Humerus
(a) Frontal section through right shoulder joint
PLAY
Animation: Rotatable shoulder
Copyright © 2010 Pearson Education, Inc.
Shoulder joint
•  Reinforcing muscle tendons:
•  Tendon of the long head of biceps:
•  Travels through the intertubercular groove
•  Secures the humerus to the glenoid cavity
•  Four rotator cuff tendons encircle the shoulder joint:
•  Subscapularis
•  Supraspinatus
•  Infraspinatus
•  Teres minor
PLAY
A&P Flix™: Rotator cuff muscles: An overview (a)
PLAY
A&P Flix™: Rotator cuff muscles: An overview (b)
Copyright © 2010 Pearson Education, Inc.
Figure 8.10a
Copyright © 2010 Pearson Education, Inc.
Acromion
Coracoacromial
ligament
Subacromial
bursa
Coracohumeral
ligament
Coracoid
process
Articular
capsule
reinforced by
glenohumeral
ligaments
Greater
tubercle
of humerus
Transverse
humeral
ligament
Tendon sheath
Tendon of long
head of biceps
brachii muscle
Subscapular
bursa
Tendon of the
subscapularis
muscle
Scapula
(c) Anterior view of right shoulder joint capsule
Copyright © 2010 Pearson Education, Inc.
Figure 8.10c
7
10/30/14
Elbow Joint
Acromion
Coracoid process
Articular capsule
•  Radius and ulna articulate with the humerus
Glenoid cavity
Glenoid labrum
•  Hinge joint formed mainly by trochlear notch
of ulna and trochlea of humerus
Tendon of long head
of biceps brachii muscle
Glenohumeral ligaments
•  Flexion and extension only
PLAY
Tendon of the
subscapularis muscle
Scapula
A&P Flix™: Movement at the elbow joint
Posterior
Anterior
(d) Lateral view of socket of right shoulder joint,
humerus removed
Figure 8.10d
Copyright © 2010 Pearson Education, Inc.
Elbow Joint
Articular
capsule
Synovial
membrane
Humerus
Fat pad
Tendon of
triceps
muscle
Bursa
Copyright © 2010 Pearson Education, Inc.
Synovial cavity
Articular cartilage
Coronoid process
•  Anular ligament—surrounds head of radius
•  Two capsular ligaments restrict side-to-side
movement:
Tendon of
brachialis muscle
•  Ulnar collateral ligament
Ulna
•  Radial collateral ligament
Trochlea
Articular cartilage
of the trochlear
notch
(a) Median sagittal section through right elbow (lateral view)
Copyright © 2010 Pearson Education, Inc.
Figure 8.11a
Copyright © 2010 Pearson Education, Inc.
8
10/30/14
Articular
capsule
Anular
ligament
Humerus
Anular
ligament
Lateral
epicondyle
Humerus
Coronoid
process
Radius
Articular
capsule
Medial
epicondyle
Ulnar
collateral
ligament
Radius
Radial
collateral
ligament
Olecranon
process
Ulna
Ulna
(d) Medial view of right elbow
(b) Lateral view of right elbow joint
PLAY
Copyright © 2010 Pearson Education, Inc.
Figure 8.11b
Animation: Rotatable elbow
Hip (Coxal) Joint
•  Ball-and-socket joint
•  Head of the femur articulates with the
acetabulum
Figure 8.11d
Copyright © 2010 Pearson Education, Inc.
Articular cartilage
Acetabular
labrum
Femur
Coxal (hip) bone
Ligament of
the head of
the femur
(ligamentum
teres)
•  Good range of motion, but limited by the deep
socket
•  Acetabular labrum—enhances depth of socket
Synovial cavity
PLAY
A&P Flix™: Movement at the hip joint: An overview
Copyright © 2010 Pearson Education, Inc.
Articular capsule
(a) Frontal section through the right hip joint
Copyright © 2010 Pearson Education, Inc.
Figure 8.12a
9
10/30/14
Hip Joint
Ischium
Reinforcing ligaments:
•  Iliofemoral ligament
Iliofemoral
ligament
Ischiofemoral
ligament
Greater
trochanter
of femur
•  Pubofemoral ligament
•  Ischiofemoral ligament
•  Ligamentum teres
(c) Posterior view of right hip joint, capsule in place
PLAY
Copyright © 2010 Pearson Education, Inc.
Anterior inferior
iliac spine
Animation: Rotatable hip
Copyright © 2010 Pearson Education, Inc.
Iliofemoral
ligament
Pubofemoral
ligament
Greater
trochanter
Figure 8.12c
Temporomandibular Joint (TMJ)
•  Mandibular condyle articulates with the
temporal bone
•  Two types of movement
•  Hinge—depression and elevation of mandible
•  Gliding—e.g. side-to-side (lateral excursion)
grinding of teeth
•  Most easily dislocated joint in the body
(d) Anterior view of right hip joint, capsule in place
Copyright © 2010 Pearson Education, Inc.
Figure 8.12d
Copyright © 2010 Pearson Education, Inc.
10
10/30/14
Mandibular fossa
Articular tubercle
Zygomatic process
Infratemporal fossa
Mandibular
fossa
External
acoustic
meatus
Articular disc
Articular
tubercle
Superior
joint
cavity
Articular
capsule
Lateral
ligament
Synovial
membranes
Articular
capsule
Mandibular
condyle
Ramus of
mandible
Ramus of
Inferior joint
mandible
cavity
(b) Enlargement of a sagittal section through the joint
(a) Location of the joint in the skull
Copyright © 2010 Pearson Education, Inc.
Figure 8.13a
Figure 8.13b
Copyright © 2010 Pearson Education, Inc.
Common Joint Injuries
•  Sprains
•  The ligaments are stretched or torn
•  Partial tears slowly repair themselves
•  Complete ruptures require prompt surgical repair
•  Cartilage tears
Torn
meniscus
•  Due to compression and shear stress
•  Fragments may cause joint to lock or bind
•  Cartilage rarely repairs itself
•  Repaired with arthroscopic surgery
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
Figure 8.14
11
10/30/14
Common Joint Injuries
Inflammatory and Degenerative Conditions
•  Dislocations (luxations)
•  Bursitis
•  Occur when bones are forced out of alignment
•  Accompanied by sprains, inflammation, and
joint immobilization
•  Caused by serious falls or playing sports
•  Subluxation—partial dislocation of a joint
•  An inflammation of a bursa, usually caused by
a blow or friction
•  Treated with rest and ice and, if severe, antiinflammatory drugs
•  Tendonitis
•  Inflammation of tendon sheaths typically
caused by overuse
•  Symptoms and treatment similar to bursitis
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
Arthritis
Osteoarthritis (OA)
•  >100 different types of inflammatory or
degenerative diseases that damage joints
•  Common, irreversible, degenerative (“wearand-tear”) arthritis
•  Most widespread crippling disease in the U.S.
•  85% of all Americans develop OA, more
women than men
•  Symptoms; pain, stiffness, and swelling of a
joint
•  Acute forms: caused by bacteria, treated with
antibiotics
•  Probably related to the normal aging process
•  Chronic forms: osteoarthritis, rheumatoid
arthritis, and gouty arthritis
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
12
10/30/14
Osteoarthritis (OA)
Rheumatoid Arthritis (RA)
•  More cartilage is destroyed than replaced in
badly aligned or overworked joints
•  Chronic, inflammatory, autoimmune disease
of unknown cause
•  Exposed bone ends thicken, enlarge, form
bone spurs, and restrict movement
•  Usually arises between age 40 and 50, but
may occur at any age; affects 3 times as
many women as men
•  Treatment: moderate activity, mild pain
relievers, capsaicin creams, glucosamine and
chondroitin sulfate
Copyright © 2010 Pearson Education, Inc.
•  Signs and symptoms include joint pain and
swelling (usually bilateral), anemia,
osteoporosis, muscle weakness, and
cardiovascular problems
Copyright © 2010 Pearson Education, Inc.
Rheumatoid Arthritis
•  RA begins with synovitis of the affected joint
•  Inflammatory blood cells migrate to the joint,
release inflammatory chemicals
•  Inflamed synovial membrane thickens into a
pannus
•  Pannus erodes cartilage, scar tissue forms,
articulating bone ends connect (ankylosis)
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
Figure 8.15
13
10/30/14
Rheumatoid Arthritis: Treatment
•  Conservative therapy: aspirin, long-term use
of antibiotics, and physical therapy
•  Progressive treatment: anti-inflammatory
drugs or immunosuppressants
•  New biological response modifier drugs
neutralize inflammatory chemicals
Copyright © 2010 Pearson Education, Inc.
14