Anatomy & Physiology 34A Lecture Chapter 8 - Joints I. Overview A. Classifications of Joints B. Fibrous Joints C. Cartilaginous Joints D. Synovial Joints E. Movements at Synovial Joints F. Specific Body Joints G. Joint Disorders II. Classifications of Joints A. _______________ (joints) are the unions between bones; they hold bones together and allow some flexibility to the skeletal system B. _____ology is the study of joints, whereas _____ology is the study of human motion – the interactions of the bones, joints and muscles C. Joints may be classified either structurally or functionally 1. ___________ classification focuses on the amount of ________ allowed at the joint. Functions include: 2. a. _____arthroses are ________________ joints (e.g.: most fibrous joints and all bony joints) b. c. ______arthroses are __________ movable joints (e.g.: most cartilagenous joints) ___arthroses are _________ moving joints (e.g.: most synovial joints) ______________ classification is based on whether there is connective tissue fiber, cartilage, or a joint cavity between the articulating bones. Structures include _________, __________, and ____________ joints III. _________ Joints - fibrous CT holds the articulating bones together; joints lack cavities. Three types of these joints include: A. _______ - synarthrotic joints found only in the ____; dense regular CT binds the articulating bones. Three types of sutures are: 1. ___________ suture - has interlocking saw-like articulations (e.g., coronal, sagittal, and lambdoid sutures) 2. ____________ (lap) suture - edge of one bone overlaps the articulating bone (e.g., squamous suture) 3. _________ (butt) suture - edges of the articulating bones are smooth and do not overlap (e.g., palatine bones and maxillae) B. ___________ - joints held together by collagenous fibers or sheets of fibrous tissue called _____________ ligament (e.g.: bet. distal tibia & fibula); may allow slight movement but are synarthrotic 2 C. _____________ (dentoalveolar joint) - where a tooth root attaches to the ____________ ligament of the dental alveolus (tooth socket) in the jaw IV. ____________ Joints – bones connected by cartilage; allow limited movement (_______arthrotic) or no movement (_____arthrotic). A. _____________ - adjoining bones are interconnected by a disk of _______cartilage (e.g.: pubic symphysis and intervertebral joints) B. ________________ - cartilaginous joints with _________ cartilage between the articulating bones (e.g.: epiphyseal plate and costochondral articulations bet. ribs & sternum) V. Bony Joints (______________) – two bones fused into one bone by osseous tissue during childhood (e.g., frontal bones, mandible) VI. ____________ Joints - freely movable joints (___arthrotic) enclosed by joint __________ containing synovial fluid. The most common body joints, they are categorized by their shapes –gliding, hinge, pivot, condyloid, saddle, ball & socket – and type of movement they permit – monaxial, biaxial, and multiaxial. A. A synovial joint’s range of motion (__) is determined by 3 factors: 1. Structure of the articulating ______ 2. Strength of the joint capsule and associated ________ & ______ 3. Size, arrangement, and action of ___________ around the joint B. Synovial Joint Structure 1. Joint surfaces are enclosed by a 2-layered articular ________ (sleeve of fibrous CT), creating a joint (synovial) cavity a. The outer layer is a ________ capsule of dense irregular CT, continuous with the bone periosteum b. The interior of the capsule is lined with a ___________ membrane of areolar CT, which produces _________ fluid, composed mostly of hyaluronic acid, nutrients, and albumin, that reduces friction and nourishes surrounding tissues 2. 3. Articulating surfaces of the bones are covered with articular (__________) cartilage 4. Fibrocartilage pads (articular discs) may be present within the capsule (e.g., knee _________) to act as shock absorbers and further stabilize the joint 5. Each synovial joint is served by major ______ & blood ______. The articular capsule is usually reinforced with _________ and _________ and may contain a. _________ – synovial fluid-filled sacs that reduce friction between muscles or where tendons cross the bone b. Tendon __________ – bursal sacs that surround and cushion certain tendons (numerous in hands and feet) C. Types of Synovial Joints 1. _______ (gliding) - articular surfaces are flat or slightly curved, allowing sliding movements in one (________) or two (______) planes (e.g.: intercarpal & intertarsal joints) 3 2. _________ - rounded process of one bone fits into the concave surface of another to allow movement in one plane (________), usually flexion and extension (e.g.: ______, ____, & phalanges) 3. ________ - rounded or conical surface on one bone articulates with a depression in another bone; permits ________ (monaxial) about a central axis (e.g.: _____ & _____ joint, proximal joint of ulna & radius) 4. _____________ (ellipsoid) - oval convex of one bone fits into a concave depression of another bone; permits angular movement in two (biaxial) planes (e.g.: wrist joint and metacarpophalangeal = ___________) 5. ____________ (modified condyloid) - articulating surfaces are saddle shaped: one bone has a concave surface, the other a convex surface; allows biaxial movement (e.g.: carpometacarpal joint of the _______) 6. _____ & __________ - ball shaped head of one bone fits into a cuplike depression of another; allows movement in all 3 planes (_________) with pivotal rotation (e.g.: ___ & _______ joints) VII. Movements at Synovial Joints A. Body movement occurs when muscles contract across diarthrotic synovial joints. Common body motions include: 1. 2. ___________ movements - increase or decrease the joint angle produced by articulating bones a. __________ - decreases the joint angle on an anteroposterior plane; this is typical of _______ joints (e.g.: bending the knee or elbow). Two ______ flexions are 1) _________flexion occurs as the top surface of the foot is elevated 2) _________flexion occurs as the foot is pointed downward b. ______________ - increases the joint angle and the distance between two bones or parts of the body (e.g.: straightening the elbow or knee). If the extension is greater than 180, it is called ________extension c. ____________ - movement of a limb _____ from the body’s midline in a lateral direction d. ____________ - movement of a limb __________ the body’s midline (the opposite of abduction) ______________ Movements - a bone with a rounded or oval surface articulates with a depression on another bone a. ____________ - bone movement around its longitudinal axis, without lateral or medial displacement; common in _____ & __________ joints and rotation of atlas around the axis dens 1) ____________ - movement of the palm from a posterior (or facing down) to an anterior (or facing up) position 2) ____________ - opposite of supination b. _____________ - circular movement of a body part in a cone shape; combines flexion, ________, abduction, & ________; common in ball & socket joints 4 3. Special movements a. b. _______ - movement of the sole of the foot inward (medially) c. d. e. f. ____________ - movement of part of the body forward (e.g.: jutting out the jaw) _________ - opposite of inversion; movement of the sole of the foot outward (laterally) ____________ - pulling back the protracted part _____________ - raises a body part (e.g.: shrugging the shoulders) _____________ - opposite of elevation VIII. Specific Joints of the Body A. Temporomandibular (jaw) joint - formed by the ____________ condyle and the mandibular fossa of the ____________ bone 1. This joint is a combination ______ and _____________ joint; movements include: a. b. c. 2. 3. 4. depression and ___________ of the mandible as a hinge joint protraction and ____________ as a gliding joint lateral ________ movements Three ____________ support and reinforce the TM joint An articular disk (_________) separates the joint cavity into superior and inferior compartments Temporomandibular joint (___) ________ is a misalignment of one or both TM joints. Symptoms range from moderate facial pain to intense pain in the head, neck, shoulders, and back B. Glenohumeral (__________) joint - formed by the head of the humerus and the shallow scapular _________ cavity 1. This is a ball & socket joint and the most _____________ joint of the body, but also easily dislocated; allows _______________ and rotation of the arm 2. Five ____________ pass around the shoulder rim, between the corocoid process & greater tubercle, and between the greater & lesser tubercles 3. Several ________ and tendon ________ are associated with the shoulder 4. The stability of the shoulder is provided mainly by the _______ of the subscapularis, infraspinatus, supraspinatus, and teres minor muscles, which form the _________ cuff, as well as the biceps brachii C. ________ joint - a hinge joint composed of two articulations: 1. The humeroulnar joint, formed by the _______ of the humerus & trochlear notch of the _______ 2. The humeroradial joint, formed by the ____________ of the humerus and the head of the _________ 3. 4. 5. Both of these articulations are enclosed in a single joint ______ The ____________ bursa cushions tendons crossing the elbow Lateral and medial ___________ prevent side to side motion 5 6. Allows flexion and ___________ of the forearm D. ________ - formed by the distal ends of the ______ & ________ and the scaphoid, lunate, and triquetral carpal bones 1. 2. This is a synovial, _____________ joint It allows ________________ E. Coxal (___) joint - formed by the femur head and the __________ of the os coxae 1. The hip is a ___ & ______ joint that is stronger and more stable than the shoulder; allows circumduction and _______ of the leg 2. The hip is secured by a strong fibrous joint capsule, several ligaments, and a number of powerful ___________ F. Tibiofemoral (____) joint - located between the _____ and _____, the knee is the largest, most complex, most vulnerable joint in the body; it is formed by 3 joints 1. Lateral tibiofemoral joint between the ______ condyles of the femur & _________ and the lateral meniscus 2. Intermediate patellofemoral joint between the _________ and patellar surface of the _________ 3. Medial tibiofemoral joint between the _______ condyles of the femur & _______ and the medial meniscus 4. The _______ are fibrocartilage disks on the superior surface of the ________ condyles; they act as shock absorbers and prevent side to side motion of the femur 5. Major knee ____________ include: a. _____________ ligaments (medial & lateral) support medial (______) & and lateral (_________) sides of the knee; both prevent the knee from rotating when extended b. ___________ ligament binds the medial and lateral _______ together c. _____________ ligaments lie deep within the knee, crossing each other between the tibia and femur 1) Anterior cruciate (____) attaches to the ____ of the tibia and back of the femur; prevents knee ______extension 2) Posterior cruciate (___) attaches to the _____ of the tibia and front of the femur; prevents the femur from sliding off the front of the tibia 6. The knee is stabilized mostly by the _____________ tendon in front and the semimembranosus tendon in back 7. 8. Numerous ______ cushion the tendons & ligaments of the knee Knee injuries often involve the 3 C’s - the anterior _________ ligament, _____________ ligaments, and _________ G. Talocrural (_____) joint - the 2 articulations within the ankle are: 1. The medial malleolus of the ______ articulates with the ______ 2. The lateral malleolus of the _______ articulates with the ______ 6 3. Several ligaments and the calcaneal (_________) tendon, which extends from the calf muscles to the calcaneous bone, stablilize the joint 4. This synovial, hinge joint allows dorsiflexion and _____ flexion IX. Joint Disorders A. Joint Injuries 1. A _______ involves excessive _________ of tendons or muscles surrounding a joint; often caused by not “warming up” before exercise 2. A _______ involves the ___________ of ligaments or tendons surrounding a joint; usually takes longer to heal than a strain 3. A ____________ (luxation) is a displacement of the articulating bones in a joint; usually more serious than a sprain B. Inflammatory & Degenerative Conditions 1. Bursitis is the inflammation of the _____ associated with a joint 2. Tendinitis is the inflammation of a __________ sheath 3. ____________ is a designation for joint diseases which have the symptoms of edema, inflammation, and pain. The most common types of arthritis are: 4. a. _________ arthritis - results from autoimmune attack against the joint tissues, results in deterioration of the articular cartilage, joint ossification, and crippling of the joints b. _____arthritis is the softening and disintegration of articular cartilage; it results from _______ and irritation of the joints. This is more common, but usually less damaging than rheumatoid arthritis c. ________ arthritis results when excess ____________ is retained in the blood and crystals are deposited in the joints; the crystals irritate the articular cartilage and synovial membrane, causing swelling, pain, and deterioration. Most commonly occurs in the great ___ joint of males _______ Disease - joint pain and arthritis caused by spirochette bacteria transmitted by _____. Symptoms include skin rash, flu-like symptoms, foggy thinking. Treatable with antibiotics in early stages C. Treatment of Joint Disorders 1. ____________ involves making a small incision into the joint capsule and inserting an arthroscope to view the area 2. ___________ involves the replacement of diseased joints, such as hips and knees, by __________ made of metals such as stainless steel. Joint sockets are made of polyethylene.