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Chapter 9 Joints Lecture Presentation by Lee Ann Frederick University of Texas at Arlington © 2015 Pearson Education, Inc. An Introduction to Joints • 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 © 2015 Pearson Education, Inc. 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 © 2015 Pearson Education, Inc. 9-1 Classification of Joints • Functional Classifications • Synarthrosis (immovable joint) • Amphiarthrosis (slightly movable joint) • Diarthrosis (freely movable joint) © 2015 Pearson Education, Inc. 9-1 Classification of Joints • Structural Classifications • Bony • Fibrous • Cartilaginous • Synovial © 2015 Pearson Education, Inc. Table 9-1 Functional and Structural Classifications of Joints (Part 1 of 3). © 2015 Pearson Education, Inc. Table 9-1 Functional and Structural Classifications of Joints (Part 2 of 3). © 2015 Pearson Education, Inc. Table 9-1 Functional and Structural Classifications of Joints (Part 3 of 3). © 2015 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. 2. 3. 4. © 2015 Pearson Education, Inc. Suture Gomphosis Synchondrosis Synostosis 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 © 2015 Pearson Education, Inc. 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 © 2015 Pearson Education, Inc. 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 © 2015 Pearson Education, Inc. 9-1 Classification of Joints • Synovial Joints (Diarthroses) • Also called movable joints • At ends of long bones • Within articular capsules • Lined with synovial membrane © 2015 Pearson Education, Inc. 9-2 Synovial Joints • Articular Cartilages • Pad articulating surfaces within articular capsules • Prevent bones from touching • Smooth surfaces lubricated by synovial fluid • Reduce friction © 2015 Pearson Education, Inc. 9-2 Synovial Joints • Synovial Fluid • Contains slippery proteoglycans secreted by fibroblasts • Functions of synovial fluid 1. Lubrication 2. Nutrient distribution 3. Shock absorption © 2015 Pearson Education, Inc. 9-2 Synovial Joints • Accessory Structures • Cartilages • Fat pads • Ligaments • Tendons • Bursae © 2015 Pearson Education, Inc. 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 © 2015 Pearson Education, Inc. 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 © 2015 Pearson Education, Inc. 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 © 2015 Pearson Education, Inc. Figure 9-1a The Structure of a Synovial Joint. Medullary cavity Spongy bone Periosteum Components of Synovial Joints Joint capsule Synovial membrane Articular cartilages Joint cavity containing synovial fluid Metaphysis Compact bone a Synovial joint, sagittal section © 2015 Pearson Education, Inc. Figure 9-1b The Structure of a Synovial Joint. Quadriceps tendon Patella Joint capsule Femur Synovial membrane Accessory Structures of a Knee Joint Bursa Fat pad Joint cavity Articular cartilage Meniscus Tibia Ligaments Extracapsular ligament (patellar) Intracapsular ligament (cruciate) b Knee joint, sagittal section © 2015 Pearson Education, Inc. 9-2 Synovial Joints • Injuries • Dislocation (luxation) • Articulating surfaces forced out of position • Damages articular cartilage, ligaments, joint capsule • Subluxation • A partial dislocation © 2015 Pearson Education, Inc. 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) © 2015 Pearson Education, Inc. Figure 9-2 Joint Movement. © 2015 Pearson Education, Inc. Figure 9-3a Angular Movements. Extension Flexion Hyperextension Flexion Flexion Extension Extension Flexion Hyperextension Extension a © 2015 Pearson Education, Inc. Flexion/extension Hyperextension Figure 9-3b Angular Movements. Abduction Abduction Adduction Adduction Abduction Adduction Abduction Adduction b © 2015 Pearson Education, Inc. Abduction/adduction Figure 9-3c Angular Movements. Adduction Abduction c Adduction/abduction © 2015 Pearson Education, Inc. Figure 9-3d Angular Movements. d Circumduction © 2015 Pearson Education, Inc. Figure 9-4a Rotational Movements. Head rotation Right rotation Lateral (external) rotation Left rotation Medial (internal) rotation a © 2015 Pearson Education, Inc. Figure 9-4b Rotational Movements. Pronation Supination b Supination Pronation © 2015 Pearson Education, Inc. Figure 9-5 Special Movements (Part 1 of 6). Eversion © 2015 Pearson Education, Inc. Inversion Figure 9-5 Special Movements (Part 2 of 6). Dorsiflexion (ankle flexion) Plantar flexion (ankle extension) © 2015 Pearson Education, Inc. Figure 9-5 Special Movements (Part 3 of 6). Opposition © 2015 Pearson Education, Inc. Figure 9-5 Special Movements (Part 4 of 6). Retraction © 2015 Pearson Education, Inc. Protraction Figure 9-5 Special Movements (Part 5 of 6). Depression © 2015 Pearson Education, Inc. Elevation Figure 9-5 Special Movements (Part 6 of 6). Lateral flexion © 2015 Pearson Education, Inc. Figure 9-2 Joint Movement (Part 7 of 12). Gliding joint Gliding joints, or plane joints, have flattened or slightly curved surfaces that slide across one another, but the amount of movement is very slight. © 2015 Pearson Education, Inc. Movement: Gliding. Slight nonaxial or multiaxial Clav Manubrium icle Figure 9-2 Joint Movement (Part 8 of 12). Hinge joint Hinge joints permit angular motion in a single plane, like the opening and closing of a door. © 2015 Pearson Education, Inc. Movement: Angular. Monaxial Humerus Ulna Examples: • Elbow joint • Knee joint • Ankle joint • Interphalangeal joint Figure 9-2 Joint Movement (Part 9 of 12). Condylar joint Condylar joints, or ellipsoidal joints, have an oval articular face nestled within a depression on the opposing surface. © 2015 Pearson Education, Inc. Movement: Angular. Biaxial Scaphoid bone Radius Ulna Examples: • Radiocarpal joint • Metacarpophalangeal joints 2–5 • Metatarsophalangeal joint Figure 9-2 Joint Movement (Part 10 of 12). Saddle joint Saddle joints have complex articular faces and fit together like a rider in a saddle. Each face is concave along one axis and convex along the other. Examples: • First carpometacarpal joint Movement: Angular. Biaxial III II Metacarpal bone of thumb Trapezium © 2015 Pearson Education, Inc. Figure 9-2 Joint Movement (Part 11 of 12). Pivot joint Pivot joints only permit rotation. Movement: Rotation. Monaxial Atlas Axis © 2015 Pearson Education, Inc. Examples: • Atlantoaxial joint • Proximal radioulnar joint Figure 9-2 Joint Movement (Part 12 of 12). Ball-and-socket joint In a ball-and-socket joint, the round head of one bone rests within a cup-shaped depression in another. © 2015 Pearson Education, Inc. Movement: Angular, circumduction, and rotation. Triaxial Scapula Humerus Examples: • Shoulder joint • Hip joint 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 © 2015 Pearson Education, Inc. Figure 9-6a Intervertebral joints. Superior articular process Intervertebral Ligaments Ligamentum flavum Posterior longitudinal ligament Anterior longitudinal ligament a Anterior view © 2015 Pearson Education, Inc. Figure 9-6b Intervertebral joints. Superior articular facet Intervertebral Disc Intervertebral foramen Vertebral end plate Intervertebral Ligaments Anulus fibrosus Ligamentum flavum Nucleus pulposus Spinal cord Posterior longitudinal ligament Spinal nerve Interspinous ligament Supraspinous ligament Anterior longitudinal ligament Lateral and sectional view © 2015 Pearson Education, Inc. 9-4 Intervertebral Joints • 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 © 2015 Pearson Education, Inc. 9-4 Intervertebral Joints • Six Intervertebral Ligaments 1. Anterior longitudinal ligament • Connects anterior bodies 2. Posterior longitudinal ligament • Connects posterior bodies 3. Ligamentum flavum • Connects laminae © 2015 Pearson Education, Inc. 9-4 Intervertebral Joints • 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) © 2015 Pearson Education, Inc. 9-4 Intervertebral Joints • 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 © 2015 Pearson Education, Inc. Clinical Note 9-1a Damage to Intervertebral Discs. T12 Normal intervertebral disc L1 Bulging disc L2 a A lateral view of the lumbar region of the spinal column, showing a bulging intervertebral disc © 2015 Pearson Education, Inc. Clinical Note 9-1b Damage to Intervertebral Discs. Compressed area of spinal nerve Spinal nerve Spinal cord Nucleus pulposus of herniated disc Anulus fibrosus b 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 © 2015 Pearson Education, Inc. 9-4 Intervertebral Joints • Movements of the Vertebral Column 1. 2. 3. 4. Flexion Extension Lateral flexion Rotation © 2015 Pearson Education, Inc. 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 © 2015 Pearson Education, Inc. 9-5 The Shoulder Joint • Socket of the Shoulder Joint • Glenoid labrum • Deepens socket of glenoid cavity • Fibrocartilage lining • Extends past the bone © 2015 Pearson Education, Inc. 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 © 2015 Pearson Education, Inc. Figure 9-7a The Shoulder Joint. Acromioclavicular Coracoacromial Coracoclavicular ligament ligaments ligament Tendon of supraspinatus muscle Acromion Clavicle Articular capsule Subdeltoid bursa Coracoid process Scapula Synovial membrane Articular cartilages Humerus Joint cavity Glenoid labrum Articular capsule Anterior view, frontal section © 2015 Pearson Education, Inc. Figure 9-7b The Shoulder Joint. Ligaments Stabilizing the Shoulder Joint Subcoracoid bursa Clavicle Tendon of biceps brachii muscle Subacromial bursa Acromioclavicular ligament Coracoclavicular ligaments Muscles and Tendons of the Rotator Cuff Coracoacromial ligament Coracohumeral ligament (cut) Tendon of supraspinatus muscle Glenohumeral ligaments Tendon of infraspinatus muscle Subscapular bursa Glenoid cavity Teres minor muscle Glenoid labrum Subscapularis muscle Articular capsule Scapula b Lateral view of pectoral girdle © 2015 Pearson Education, Inc. Figure 9-8a 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) a Lateral view © 2015 Pearson Education, Inc. 9-5 The Elbow Joint • Supporting Structures of the Elbow • Biceps brachii muscle • Attached to radial tuberosity • Controls elbow motion • Elbow ligaments • Radial collateral • Annular • Ulnar collateral © 2015 Pearson Education, Inc. Figure 9-8b The Right Elbow Joint Showing Stabilizing Ligaments. Tendon of biceps brachii muscle Annular ligament Articular capsule Antebrachial interosseous membrane Medial epicondyle Ulnar collateral ligament Radius Ulna Olecranon of ulna b Medial view © 2015 Pearson Education, Inc. Humerus Figure 9-9a The Right Hip Joint. Iliofemoral ligament Articular cartilage Acetabular labrum Ligament of the femoral head Acetabulum Transverse acetabular ligament (spanning acetabular notch) Fat pad in acetabular fossa a A lateral view with the femur removed © 2015 Pearson Education, Inc. Figure 9-9b The Right Hip Joint. Pubofemoral ligament Greater trochanter Iliofemoral ligament Lesser trochanter b An anterior view © 2015 Pearson Education, Inc. Figure 9-9c The Right Hip Joint. Iliofemoral ligament Ischiofemoral ligament Greater trochanter Lesser trochanter Ischial tuberosity c A posterior view, showing additional ligaments that add strength to the capsule © 2015 Pearson Education, Inc. Figure 9-10a The Right Knee Joint. Quadriceps tendon Joint capsule Patella Patellar retinaculae Tibial collateral ligament Patellar ligament Fibula Tibia a Anterior view, superficial layer © 2015 Pearson Education, Inc. Ligaments that Stabilize the Knee Joint Fibular collateral ligament Figure 9-10b The Right Knee Joint. Patellar surface Ligaments that Stabilize the Knee Joint Posterior cruciate ligament Anterior cruciate ligament Lateral condyle Medial condyle Tibial collateral ligament Menisci Medial Fibular collateral ligament Tibia Cut tendon of biceps femoris muscle Fibula b Deep anterior view, flexed © 2015 Pearson Education, Inc. Lateral Figure 9-10c The Right Knee Joint. Plantaris muscle Gastrocnemius muscle, lateral head Gastrocnemius muscle, medial head Femur Ligaments that Stabilize the Knee Joint Bursa Tibial collateral ligament Joint capsule Fibular collateral ligament Popliteal ligaments Popliteus muscle Tibia Cut tendon of biceps femoris muscle Fibula c Posterior view, superficial layer © 2015 Pearson Education, Inc. Figure 9-10d The Right Knee Joint. Femur Ligaments that Stabilize the Knee Joint Anterior cruciate ligament Fibular collateral ligament Posterior cruciate ligament Medial condyle Lateral condyle Menisci Lateral Medial Cut tendon Tibia Fibula d Deep posterior view, extended © 2015 Pearson Education, Inc. 9-7 Effects of Aging on Joints • 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 © 2015 Pearson Education, Inc. 9-7 Effects of Aging on Joints • 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 © 2015 Pearson Education, Inc. 9-7 Effects of Aging on Joints • 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 © 2015 Pearson Education, Inc. 9-8 Integration with Other Systems • Bone Recycling • Living bones maintain equilibrium between: • Bone building (osteoblasts) • And breakdown (osteoclasts) © 2015 Pearson Education, Inc. 9-8 Integration with Other Systems • Factors Affecting Bone Strength 1. 2. 3. 4. 5. Age Physical stress Hormone levels Calcium and phosphorus uptake and excretion Genetic and environmental factors © 2015 Pearson Education, Inc. 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) © 2015 Pearson Education, Inc.