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Joints Classification of Joints • Structural Classification – Presence or absence of a space (synovial cavity)/ – Type of Connective Tisssue/ • Functional Classification – Relates to the degree of movement they permit. Structural Classification of Joints • Fibrous Joints – Fibrous CT – Lack a synovial cavity • Cartilaginous Joints – Cartilage – Lack a synovial cavity • Synovial Joints – Have a synovial cavity – Dense irregular CT – Often associated with accessory ligaments Functional Classification of Joints • Synarthrosis (syn = together) – Immovable joint • Amphiarthrosis (amphi = on both sides) – A slightly moveable joint • Diarthrosis (moveable joint) – A freely moveable joint – Synovial joints Fibrous Joints • Lacks a synovial cavity • Little or no movement Fibrous Joints • Sutures – Immovable – Synostosis – suture that is replaced by bone in the adult • Syndesmoses – Slightly moveable (amphiarthrosis) – Ligament – Interosseous membrane • Gomphoses – Dentoalveolar joint Cartilaginous Joints • Lacks a synovial cavity • Allows little or no movement • Synchondroses – Epiphyseal plate • Symphyses – Pubic symphisis – Intervertebral discs Synovial Joints • • • • Synovial (Joint) Cavity – space btwn. Bones Freely moveable The bones are covered by hyaline cartilage Contains the following: – Articular capsule – Synovial fluid – Accsessory ligaments and articular discs Arthroscopy • Observaion of the interior of a joint • Utilizes a lighted, pencil-thin instrument • Assists in surgery and assessment of the joint space Sprain & Strain • Sprain – a forcible wrenching or twisting of the joint that stretches or tears its ligaments, but does not dislocate the bones. – The ankle joint is the most often sprained. – The lumbar spine is another prominent location of sprain. • Strain – a stretched or partially torn muscle. Bursae & Tendon Sheaths • Bursae – Saclike structures – Reduce friction in some synovial joints • Tendon sheaths – Tubelike bursae that wrap around tendons – Occurs where tendons pass through synovial cavities – Reduce friction Bursitis • • • • An acute or chronic inflammation of a bursa Caused by trauma or infection Repeated excessive exertion Symptoms – Pain, swelling, inflammation & limited movement • Treatment – Oral anti-inflammatory agents (herbal, O.T.C. And prescription), corticosteroid injections Types of Synovial Joints • • • • • • Plantar Joints Hinge Joints Pivot Joints Condyloid Joints Saddle Joints Ball & Socket Joints Types of Movements at Synovial Joints • Gliding – Simple back and forth movement, limited in range, planar joints • Angular Movements – Increase or decrease in the angle btwn. bones • Rotation – Bone revolves around a longitudinal axis • Special Movements Angular Movements • Flexion, extension, lateral flexion, hyperextension • Abduction, adduction, and circumduction Rotation • Medial (internal) rotation • Lateral (external) rotation Special Movements • • • • • Elevation Depression Protraction Retraction Inversion Special Movements • • • • • • Eversion Dorsiflexion Plantar flexion Supination Pronation Opposition Dislocation • Luxation – displacement of a bone from a joint – Causes tearing or ligaments, tendons, and articular capsules • Subluxation – Incomplete dislocation Rotator Cuff Injury • • • • • Supraspinatous Infraspinatous Teres Minor Subscapularis Common injury among pitchers and volleyball players due to excessive circumduction Separated Shoulder • Injury of the acromioclavicular joint • Due to forceful trauma such as when the shoulder strikes the ground in a fall Tennis Elbow • Lateral epicondylitis • Little-league elbow Golfer’s Elbow • Medial Epicondylitis Dislocation of the Radial Head • The most common upper limb dislocation in children • Occurs with a strong pull to the forearm while it is extended and supinated • Swinging a child around with outstretched arms Swollen Knee • Immediate swelling is due to blood loss • Delayed swelling is due to excessive production of synovial fluid “water on the knee” Dislocated Knee • Displacement of the tibia relative to the femur • Most commonly dislocates anteriorly Rheumatism • Any painful disorder of the supporting structures of the body – bones, ligaments, tendons, or muscles – that is not caused by infection or injury. Arthritis • A form of rheumatism in which the joints are swollen, stiff, and painful. Types of Arthritis • Rheumatoid arthritis (RA) – Autoimmune disease – the body attacks its own tissues • Osteoarthritis (OA) – Degenerative joint disease • Gouty arthritis – A person with gout produces excessive uric acid or is unable to excrete it properly Lyme Disease • First reported in Lyme, CT • Bacteria transported by deer ticks • The rash often resembles a bull’s eye target, although some people never develop a rash • Symptoms – Joint stiffness, fever, chills, headache, stiff neck, nausea Terminology • • • • Arthralgia – pain in a joint Bursectomy – removal of a bursa Chondritis – inflammation of cartilage Synovitis – inflammation of a synovial membrane in a joint