Download Synovial Joints

9Lecture
Articulations
PowerPoint® Lecture Presentations prepared by
Jason LaPres
Lone Star College—North Harris
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© 2012 Pearson Education, Inc.
An Introduction to Articulations
• Learning Outcomes
• 9-1 Contrast the major categories of joints, and
explain the relationship between structure and
function for each category.
• 9-2 Describe the basic structure of a synovial joint,
and describe common synovial joint accessory
structures and their functions.
• 9-3 Describe how the anatomical and functional
properties of synovial joints permit movements of
the skeleton.
• 9-4 Describe the articulations between the vertebrae
of the vertebral column.
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© 2012 Pearson Education, Inc.
An Introduction to Articulations
• Learning Outcomes
• 9-5 Describe the structure and function of the
shoulder joint and the elbow joint.
• 9-6 Describe the structure and function of the hip joint
and the knee joint.
• 9-7 Describe the effects of aging on articulations, and
discuss the most common age-related clinical
problems for articulations.
• 9-8 Explain the functional relationships between the
skeletal system and other body systems.
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© 2012 Pearson Education, Inc.
An Introduction to Articulations
• Articulations
• Body movement occurs at joints (articulations) where
two bones connect
• Joint Structure
• Determines direction and distance of movement
(range of motion or ROM)
• Joint strength decreases as mobility increases
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9-1 Classification of Joints
• Two Methods of Classification
1. Functional classification is based on range of motion
of the joint
2. Structural classification relies on the anatomical
organization of the joint
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9-1 Classification of Joints
• Functional Classifications
• Synarthrosis (immovable joint)
• Amphiarthrosis (slightly movable joint)
• Diarthrosis (freely movable joint)
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9-1 Classification of Joints
• Structural Classifications
• Bony
• Fibrous
• Cartilaginous
• Synovial
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Table 9-1 Functional and Structural Classifications of Articulations
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Table 9-1 Functional and Structural Classifications of Articulations
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© 2012 Pearson Education, Inc.
Table 9-1 Functional and Structural Classifications of Articulations
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© 2012 Pearson Education, Inc.
9-1 Classification of Joints
• Synarthroses (Immovable Joints)
•
Are very strong
•
Edges of bones may touch or interlock
•
Four types of synarthrotic joints
1. Suture
2. Gomphosis
3. Synchondrosis
4. Synostosis
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9-1 Classification of Joints
• Suture
• Bones interlocked
• Are bound by dense fibrous connective tissue
• Are found only in skull
• Gomphosis
• Fibrous connection (periodontal ligament)
• Binds teeth to sockets
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9-1 Classification of Joints
• Synchondrosis
• Is a rigid cartilaginous bridge between two bones
• Epiphyseal cartilage of long bones
• Between vertebrosternal ribs and sternum
• Synostosis
• Fused bones, immovable
• Metopic suture of skull
• Epiphyseal lines of long bones
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9-1 Classification of Joints
• Amphiarthroses
•
More movable than synarthrosis
•
Stronger than freely movable joint
•
Two types of amphiarthroses
1. Syndesmosis
•
Bones connected by ligaments
2. Symphysis
•
Bones separated by fibrocartilage
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9-1 Classification of Joints
• Synovial Joints (Diarthroses)
• Also called movable joints
• At ends of long bones
• Within articular capsules
• Lined with synovial membrane
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9-2 Synovial Joints
• Articular Cartilages
• Pad articulating surfaces within articular capsules
• Prevent bones from touching
• Smooth surfaces lubricated by synovial fluid
• Reduce friction
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9-2 Synovial Joints
• Synovial Fluid
• Contains slippery proteoglycans secreted by
fibroblasts
• Functions of synovial fluid
1. Lubrication
2. Nutrient distribution
3. Shock absorption
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9-2 Synovial Joints
• Accessory Structures
• Cartilages
• Fat pads
• Ligaments
• Tendons
• Bursae
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9-2 Synovial Joints
• Cartilages
• Cushion the joint
• Fibrocartilage pad called a meniscus (or articular disc;
plural, menisci)
• Fat Pads
• Superficial to the joint capsule
• Protect articular cartilages
• Ligaments
• Support, strengthen joints
• Sprain – ligaments with torn collagen fibers
© 2012 Pearson Education, Inc.
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9-2 Synovial Joints
• Tendons
• Attach to muscles around joint
• Help support joint
• Bursae
• Singular, bursa, a pouch
• Pockets of synovial fluid
• Cushion areas where tendons or ligaments rub
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9-2 Synovial Joints
• Factors That Stabilize Synovial Joints
• Prevent injury by limiting range of motion
• Collagen fibers (joint capsule, ligaments)
• Articulating surfaces and menisci
• Other bones, muscles, or fat pads
• Tendons of articulating bones
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Figure 9-1a The Structure of a Synovial Joint
Medullary cavity
Spongy bone
Periosteum
Fibrous joint capsule
Synovial membrane
Articular cartilages
Joint cavity
(containing
synovial fluid)
Compact bone
Synovial joint, sagittal section
© 2012 Pearson Education, Inc.
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Figure 9-1b The Structure of a Synovial Joint
Bursa
Joint capsule
Quadriceps tendon
Femur
Synovial
membrane
Meniscus
Intracapsular
ligament
Patella
Articular cartilage
Fat pad
Patellar ligament
Tibia
Joint cavity
Meniscus
Knee joint, sagittal section
© 2012 Pearson Education, Inc.
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9-2 Synovial Joints
• Injuries
• Dislocation (luxation)
• Articulating surfaces forced out of position
• Subluxation
• A partial dislocation
• Sprain
• Tear in a ligament due to joint being carried through
ROM greater than normal but without dislocation or
fracture
• Strain
• Tear in a muscle
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9-3 Movements
• Three Types of Dynamic Motion
1. Linear movement (gliding)
2. Angular movement
3. Rotation
• Planes (Axes) of Dynamic Motion
•
Monaxial (1 axis)
•
Biaxial (2 axes)
•
Triaxial (3 axes)
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Figure 9-2 A Simple Model of Articular Movement
Initial position
Gliding movement
Angular movement
Circumduction
Rotation
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9-3 Movements
• Types of Movement at Synovial Joints
• Terms describe:
• Plane or direction of motion
• Relationship between structures
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9-3 Movements
• Types of Movement at Synovial Joints
• Gliding Movement
• Two surfaces slide past each other
• Between carpal or tarsal bones
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9-3 Movements
• Angular Movement
• Flexion
• Angular motion
• Anterior–posterior plane
• Reduces angle between elements
• Extension
• Angular motion
• Anterior–posterior plane
• Increases angle between elements
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9-3 Movements
• Angular Movement
• Hyperextension
• Angular motion
• Extension past anatomical position
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Figure 9-3a Angular Movements
Extension
Flexion
Hyperextension
Flexion
Flexion
Extension
Hyperextension
Extension
Flexion
Hyperextension
Extension
Flexion/extension
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9-3 Movements
• Angular Movement
• Abduction
• Angular motion
• Frontal plane
• Moves away from longitudinal axis
• Adduction
• Angular motion
• Frontal plane
• Moves toward longitudinal axis
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Figure 9-3b Angular Movements
Abduction
Abduction
Adduction
Adduction
Abduction
Adduction
Abduction
Adduction
Abduction/adduction
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Figure 9-3c Angular Movements
Adduction
Abduction
Adduction/abduction
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9-3 Movements
• Angular Movement
• Circumduction
• Circular motion
without rotation
• Angular motion
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9-3 Movements
• Types of Movement at Synovial Joints
• Rotation
• Direction of rotation from anatomical position
• Relative to longitudinal axis of body
• Left or right rotation
• Medial rotation (inward rotation)
• Rotates toward axis
• Lateral rotation (outward rotation)
• Rotates away from axis
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Figure 9-4a Rotational Movements
Head rotation
Right
rotation
Lateral
(external)
rotation
Left
rotation
Medial
(internal)
rotation
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9-3 Movements
• Rotation
• Pronation
• Rotates forearm, radius
over ulna
• Supination
• Forearm in anatomical
position
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9-3 Movements
• Special Movements
• Inversion
• Twists sole of foot medially
• Eversion
• Twists sole of foot laterally
Dorsiflexion
(ankle flexion)
• Dorsiflexion
• Flexion at ankle (lifting toes)
• Plantar flexion
• Extension at ankle (pointing
toes)
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Plantar
flexion
(ankle extension)
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9-3 Movements
Opposition
• Opposition
• Thumb movement toward
fingers or palm (grasping)
• Reposition
• Opposite of opposition
• Protraction
• Moves anteriorly
• In the horizontal plane
(pushing forward)
• Retraction
• Opposite of protraction
• Moving anteriorly (pulling
back)
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Retraction
Protraction
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9-3 Movements
• Special Movements
• Elevation
• Moves in superior direction (up)
• Depression
• Moves in inferior direction (down)
• Lateral flexion
• Bends vertebral column from side to side
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Figure 9-5 Synovial Joints
Depression
Elevation
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Figure 9-5 Synovial Joints
Lateral flexion
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9-3 Movements
• Classification of Synovial Joints by Shape
• Gliding
• Hinge
• Pivot
• Condylar
• Saddle
• Ball-and-socket
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9-3 Movements
• Gliding Joints
• Flattened or slightly curved faces
• Limited motion (nonaxial)
• Hinge Joints
• Angular motion in a single plane (monaxial)
• Pivot Joints
• Rotation only (monaxial)
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Figure 9-6 Synovial Joints
Gliding joint
Movement: slight nonaxial or multiaxial
Examples:
Manubrium
• Acromioclavicular and claviculosternal joints
• Intercarpal and intertarsal joints
• Vertebrocostal joints
• Sacro-iliac joints
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Figure 9-6 Synovial Joints
Hinge joint
Humerus
Ulna
Movement: monaxial
Examples:
• Elbow joint
• Knee joint
• Ankle joint
• Interphalangeal joint
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Figure 9-6 Synovial Joints
Pivot joint
Movement: monaxial (rotation)
Examples:
Atlas
• Atlanto-axial joint
• Proximal radio-ulnar joint
Axis
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9-3 Movements
• Condylar Joints
• Oval articular face within a depression
• Motion in two planes (biaxial)
• Saddle Joints
• Two concave, straddled (biaxial)
• Ball-and-socket Joints
• Round articular face in a depression (triaxial)
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Figure 9-6 Synovial Joints
Condylar joint
Movement: biaxial
Examples:
Scaphoid
bone
Ulna
• Radiocarpal joint
• Metacarpophalangeal joints 2–5
• Metatarsophalangeal joints
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Figure 9-6 Synovial Joints
Saddle joint
Movement: biaxial
Examples:
III II
Metacarpal
bone of thumb
• First carpometacarpal joint
Trapezium
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Figure 9-6 Synovial Joints
Ball-and-socket joint
Scapula
Movement: triaxial
Examples:
• Shoulder joint
• Hip joint
Humerus
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9-3 Movements
• Joints
• A joint cannot be both mobile and strong
• The greater the mobility, the weaker the joint
• Mobile joints are supported by muscles and
ligaments, not bone-to-bone connections
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9-4 Intervertebral Articulations
• Intervertebral Articulations
• C2 to L5 spinal vertebrae articulate:
• At inferior and superior articular processes (gliding
joints)
• Between adjacent vertebral bodies (symphyseal joints)
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9-4 Intervertebral Articulations
• Intervertebral Discs
• Pads of fibrocartilage
• Separate vertebral bodies
• Anulus fibrosus
• Tough outer layer
• Attaches disc to vertebrae
• Nucleus pulposus
• Elastic, gelatinous core
• Absorbs shocks
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Figure 9-7 Intervertebral Articulations
Superior
articular
facet
Intervertebral
Disc
Vertebral end plate
Intervertebral
foramen
Ligamentum
flavum
Anulus fibrosus
Nucleus pulposus
Spinal cord
Posterior
longitudinal
ligament
Spinal nerve
Interspinous
ligament
Supraspinous
ligament
Anterior
longitudinal
ligament
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9-4 Intervertebral Articulations
• Vertebral Joints
• Also called symphyseal joints
• As vertebral column moves:
• Nucleus pulposus shifts
• Disc shape conforms to motion
• Intervertebral Ligaments
• Bind vertebrae together
• Stabilize the vertebral column
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9-4 Intervertebral Articulations
• Six Intervertebral Ligaments
1. Anterior longitudinal ligament
•
Connects anterior bodies
2. Posterior longitudinal ligament
•
Connects posterior bodies
3. Ligamentum flavum
•
Connects laminae
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9-4 Intervertebral Articulations
• Six Intervertebral Ligaments
4. Interspinous ligament
•
Connects spinous processes
5. Supraspinous ligament
•
Connects tips of spinous processes (C7 to sacrum)
6. Ligamentum nuchae
•
Continues supraspinous ligament (C7 to skull)
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9-4 Intervertebral Articulations
• Damage to Intervertebral Discs
• Slipped disc
• Bulge in anulus fibrosus
• Invades vertebral canal
• Herniated disc
• Nucleus pulposus breaks through anulus fibrosus
• Presses on spinal cord or nerves
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Figure 9-8a Damage to the Intervertebral Discs
T12
Normal
intervertebral
disc
L1
Slipped
disc
L2
A lateral view of the
lumbar region of the
spinal column, showing a
distorted intervertebral
disc (a “slipped” disc)
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Figure 9-8b Damage to the Intervertebral Discs
Compressed area
of spinal nerve
Nucleus pulposus
of herniated disc
Spinal nerve
Spinal cord
Anulus
fibrosus
A sectional view through
a herniated disc, showing
the release of the nucleus
pulposus and its effect
on the spinal cord and
adjacent spinal nerves
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9-4 Intervertebral Articulations
• Movements of the Vertebral Column
1. Flexion
2. Extension
3. Lateral flexion
4. Rotation
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9-5 The Shoulder Joint
• The Shoulder Joint
• Also called the glenohumeral joint
• Allows more motion than any other joint
• Is the least stable
• Supported by skeletal muscles, tendons, ligaments
• Ball-and-socket diarthrosis
• Between head of humerus and glenoid cavity of scapula
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9-5 The Shoulder Joint
• Socket of the Shoulder Joint
• Glenoid labrum
• Deepens socket of glenoid cavity
• Fibrocartilage lining
• Extends past the bone
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9-5 The Shoulder Joint
• Processes of the Shoulder Joint
• Acromion (clavicle) and coracoid process (scapula)
• Project laterally, superior to the humerus
• Help stabilize the joint
• Shoulder Separation
• Dislocation of the shoulder joint
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9-5 The Shoulder Joint
• Shoulder Muscles
(Rotator Cuff)
• Shoulder Bursae
• Subacromial
• Supraspinatus
• Subcoracoid
• Infraspinatus
• Subdeltoid
• Subscapularis
• Subscapular
• Teres minor
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Figure 9-9a The Shoulder Joint
Acromioclavicular Coracoclavicular
ligaments
ligament
Tendon of
supraspinatus
muscle
Clavicle
Acromion
Articular
capsule
Subdeltoid
bursa
Synovial
membrane
Scapula
Humerus
Glenoid labrum
Articular
capsule
Anterior view, frontal section
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Coraco-acromial
ligament
Coracoid
process
Articular
cartilages
Joint cavity
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Figure 9-9b The Shoulder Joint
Acromioclavicular
ligament
Coraco-acromial
ligament
Tendon of
supraspinatus
muscle
Clavicle
Coracoclavicular
ligaments
Tendon of biceps
brachii muscle
Coracohumeral
ligament (cut)
Coracoid
process
Subcoracoid
bursa
Subscapular
bursa
Subscapularis
muscle
Acromion
Subacromial
bursa
Tendon of
infraspinatus
muscle
Teres minor
muscle
Glenohumeral
ligaments
Articular
capsule
Glenoid cavity
Scapula
Glenoid labrum
Lateral view of pectoral girdle
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9-5 The Elbow Joint
• The Elbow Joint
• A stable hinge joint
• Humero-ulnar joint
• Humeroradial joint
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Figure 9-10a The Right Elbow Joint Showing Stabilizing Ligaments
Humerus Radial
collateral
ligament
Radial
tuberosity
Antebrachial
interosseous
membrane
Radius
Ulna
Capitulum
Annular ligament (covering
head and neck of radius)
Lateral view
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Figure 9-10b The Right Elbow Joint Showing Stabilizing Ligaments
Tendon of biceps
brachii muscle
Annular
ligament
Humerus
Articular
capsule
Antebrachial
interosseous
membrane
Medial
epicondyle
Ulnar
collateral
ligament
Radius
Ulna
Olecranon
of ulna
Medial view
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9-6 The Hip Joint
• The Hip Joint
• Also called coxal joint
• Strong ball-and-socket diarthrosis
• Wide range of motion
• Head of femur fits into socket of acetabulum
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Figure 9-11a The Right Hip Joint
Iliofemoral ligament
Fibrocartilage pad
Acetabular labrum
Ligament of the
femoral head
Acetabulum
Transverse acetabular
ligament (spanning
acetabular notch)
Fat pad
in acetabular
fossa
A lateral view with the femur removed
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Figure 9-11b The Right Hip Joint
Pubofemoral
ligament
Greater
trochanter
Iliofemoral
ligament
Lesser
trochanter
An anterior view
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Figure 9-11c The Right Hip Joint
Iliofemoral
ligament
Ischiofemoral
ligament
Greater
trochanter
Lesser
trochanter
Ischial tuberosity
A posterior view, showing additional ligaments that add strength
to the capsule
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9-6 The Knee Joint
• The Knee Joint
• A complicated hinge joint
• Transfers weight from femur to tibia
• Articulations of the knee joint
• Two femur–tibia articulations
• At medial and lateral condyles
• One between patella and patellar surface of femur
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9-6 The Knee Joint
• The Articular Capsule and Joint Cavity
• Medial and lateral menisci
• Fibrocartilage pads
• At femur–tibia articulations
• Cushion and stabilize joint
• Give lateral support
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9-6 The Knee Joint
• Seven Major Supporting Ligaments
1. Patellar ligament (anterior)
2. & 3. Two popliteal ligaments (posterior)
4. & 5. Anterior and posterior cruciate ligaments (inside
joint capsule)
6. Tibial collateral ligament (medial)
7. Fibular collateral ligament (lateral)
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Figure 9-12a The Right Knee Joint
Quadriceps
tendon
Patella
Patellar
retinaculae
Fibular
collateral
ligament
Joint
capsule
Tibial
collateral
ligament
Patellar
ligament
Tibia
Anterior view, superficial layer
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Figure 9-12b The Right Knee Joint
Femur
Joint
capsule
Plantaris
muscle
Gastrocnemius
muscle,
lateral head
Gastrocnemius
muscle,
medial head
Bursa
Fibular
collateral
ligament
Tibial
collateral
ligament
Cut tendon
of biceps
femoris
muscle
Popliteal
ligaments
Popliteus
muscle
Tibia
Fibula
Posterior view, superficial layer
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Figure 9-12c The Right Knee Joint
Patellar
surface
Fibular
collateral
ligament
Posterior cruciate
ligament
Lateral
condyle
Medial condyle
Tibial collateral
ligament
Lateral
meniscus
Cut
tendon
Medial meniscus
Tibia
Anterior cruciate
ligament
Fibula
Deep anterior view, flexed
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Figure 9-12d The Right Knee Joint
Femur
Posterior cruciate
ligament
Fibular collateral
ligament
Medial condyle
Lateral condyle
Tibial collateral
ligament
Lateral
meniscus
Cut tendon
Medial meniscus
Anterior cruciate
ligament
Fibula
Tibia
Deep posterior view, extended
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9-7 Effects of Aging on Articulations
• Degenerative Changes
• Rheumatism
• A pain and stiffness of skeletal and muscular systems
• Arthritis
• All forms of rheumatism that damage articular
cartilages of synovial joints
• Osteoarthritis
• Caused by wear and tear of joint surfaces, or genetic
factors affecting collagen formation
• Generally in people over age 60
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9-7 Effects of Aging on Articulations
• Rheumatoid Arthritis
• An inflammatory condition
• Caused by infection, allergy, or autoimmune disease
• Involves the immune system
• Gouty Arthritis
• Occurs when crystals (uric acid or calcium salts)
• Form within synovial fluid
• Due to metabolic disorders
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9-7 Effects of Aging on Articulations
• Joint Immobilization
• Reduces flow of synovial fluid
• Can cause arthritis symptoms
• Treated by continuous passive motion or CPM
(therapy)
• Bones and Aging
• Bone mass decreases
• Bones weaken
• Increases risk of hip fracture, hip dislocation, or pelvic
fracture
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9-8 Integration with Other Systems
• Bone Recycling
• Living bones maintain equilibrium between:
• Bone building (osteoblasts)
• And breakdown (osteoclasts)
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9-8 Integration with Other Systems
• Factors Affecting Bone Strength
1. Age
2. Physical stress
3. Hormone levels
4. Calcium and phosphorus uptake and excretion
5. Genetic and environmental factors
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9-8 Integration with Other Systems
• Bones Support Body Systems
• Support and protect other systems
• Store fat, calcium, and phosphorus
• Manufacture cells for immune system
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9-8 Integration with Other Systems
• Bones Support Body Systems
• Disorders in other body systems can cause:
• Bone tumors
• Osteoporosis
• Arthritis
• Rickets (vitamin D deficiency)
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