國立台灣大學物理治療學系九十三學年度/ 肌動學
JOINT STRUCTURE AND FUNCTION
教學目標: 修習本課後, 學生應可
1. 了解人體關節的種類
2. 描述滑囊關節的特性
3. 描述人體的關節面的動作
必讀書籍
1. Neumann, DA (2002)： Getting Started. in Neumann DA (ed)： Kinesiology of the
Musculoskeletal System - Foundations for Physical Rehabilitation. Philadelphia ：
Mosby. pp.4-11
2. Threlkeld AJ (2002). Basic Structure and Function of the Joints. In Neumann DA:
Kinesiology of the Musculoskeletal System: Foundations for Physical Rehabilitation.
Philadelphia: Mosby. Chapter 2, pp. 25-40
3. Smith et al., 1997: pp. 11-17
Structural Classification of the Joints
A. Diarthrosis: presence of a joint cavity
1. plane (arthrodial; irregular; planar): non-axial; 1 degree of freedom motion
2. hinge (ginglymus): uniaxial; 1 degree of freedom motion
3. pivot (trochoid; screw): uniaxial; 1 degree of freedom motion
4. condyloid (ellipsoidal; ovoid): biaxial; 2 degrees of freedom motions
5. saddle (sellar; reciprocal reception): biaxial; 2 degrees of freedom motions
6. ball-and-socket (spherical; enarthrodial): triaxial; 3 degrees of freedom motions
B. Synarthrosis: no joint cavity
1. cartilaginous (synchondrosis): fibrocartilage; bending and twisting
2. fibrous (suture): fibrous tissue; no movement
3. ligamentous (syndesmosis): ligaments; limited or no movement
HC\Kines04\kJoint04.doc
10
Sept 21, 2004
國立台灣大學物理治療學系九十三學年度/ 肌動學
JOINT STRUCTURE AND FUNCTION
C. Amphiarthrosis： an articulation between bones that is formed primarily by fibrocartilage and/or
hyaline cartilage, e.g. intervertebral disc
Synovial Joint
A. Components
1. intra-articular
a. articular cartilage (hyaline cartilage)
b. joint capsule and capsular ligament
c. synovial membrane
-- synovial cavity
-- rheumatoid arthritis (RA)
d. synovial fluid： to provide nutrition and lubrication for the articular cartilage
2. extra-articular
a. ligament
b. muscle tendon
c. meniscus or disc
d. bursa
e. labrum
f. fat pads
g. synovial plica
B. Functions
1. to provide motions (mobility)
2. to maintain stability (stability)
C. Factors affecting structure and function of synovial joint
1. aging
2. immobilization
3. trauma
4. disease
5. habit
6. psychological status
HC\Kines04\kJoint04.doc
11
Sept 21, 2004
國立台灣大學物理治療學系九十三學年度/ 肌動學
JOINT STRUCTURE AND FUNCTION
Joint Mobility
A. Osteokinematic movements
1. synonym: physiological movements
2. movements between two bony segments
3. types
a. swing: rotary motion about a fixed axis at the proximal segment e.g. knee flexion
b. spin: axial rotation about a longitudinal axis of the distal segment e.g. forearm pronation
4. description of osteokinematic movements
a. plane of motion
b. axis of rotation
c. degree of freedom
d. range of motion
e. open vs. closed kinematic chain
f. concentric vs. eccentric contraction
B. Arthrokinematic movements
1. synonym: accessory movements, joint play
2. movements between articular surfaces
3. types
a. distraction (traction): separation of two articular surfaces along
the longitudinal axis of the distal segment
b. compression: meeting together of two articular surfaces along the
longitudinal axis of the distal segment
c. gliding: a combination of roll and slide between two incongruent joint surfaces
-- rolling
-- sliding
Rolling:
Sliding:
new points on one surface meet new
same point on one surface meet new
points on the opposite surface
points on the opposite surface
HC\Kines04\kJoint04.doc
12
Sept 21, 2004
國立台灣大學物理治療學系九十三學年度/ 肌動學
JOINT STRUCTURE AND FUNCTION
4. description of arthrokinematic movements
a. joint morphology to establish concave-convex rule
b. plane of motion
c. direction of motion
d. amplitude of motion
C. Convex-Concave rule
1. concave surface moving on convex surface
-- The concave articular surface moves in the same direction as the moving bone
-- Glide occurs in the same direction as the physiological movement
e.g. tibia on femur motion: knee flexion with posterior glide
2. convex surface moving on concave surface
-- The convex articular surface moves in the opposite direction of the moving bone
-- Glide occurs in the direction opposite to the physiological movement
e.g. humerus on scapula motion: shoulder abduction with inferior glide
Joint Stability
A. Position of joint
1. resting position
2. close-packed position
a. the position that both of the articular surfaces are in the maximum congruency status for a
joint, resulting in the greatest mechanical stability for that joint
b. In the close-packed position, most ligaments and capsules surrounding to the joint are taut
HC\Kines04\kJoint04.doc
13
Sept 21, 2004
國立台灣大學物理治療學系九十三學年度/ 肌動學
JOINT STRUCTURE AND FUNCTION
c. for the glenohumeral joint the close-packed position is abduction of 90º and full external
rotation
3. loose-packed position: all positions other than close-packed position
B. Factors affecting joint stability
1. Configuration of the bone
2. type of the ligament
a. collagen fibers： for strength
-- 94% of the anterior cruciate ligament of the knee is composed of collagen fibers
-- 60% of the ligamentum of flavum are elastin fibers
b. elastin fibers： for flexibility
c. rectin fibers： for mass
3. muscular arrangement
4. fascia and skin
5. atmospheric pressure
HC\Kines04\kJoint04.doc
14
Sept 21, 2004