JOINTS AND BONE
INJURIES
Articular System
Series of joints that allow for movement of the
human body
Joint articulation
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


Two bones come into contact
May be immoveable, slightly moveable, or freely
moveable
Arthrology is the study of joint structure and
function
Types of joints
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Synarthroses – immovable
Amphiarthroses – slightly moveable
Diarthroses – freely moveable
Synarthroses
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
Lack a synovial cavity
Held together by fibrous connective tissue
Sutures


Ex. Joints between skull bones
Fuse together after birth

Syndesmoses


Connected by
ligaments are
very slightly
moveable
Ex. between the
tibia and the
fibula
Gomphoses



Joint which a
conical process
fits into a socket
and is held by
ligaments
ex. teeth held to
the jaw bones
Amphiarthroses

Connected by
hyaline cartilage
or fibrocartilage


Ex. Ribs
connected to
sternum
Ex. Between
pubic bones
Diarthroses
(synovial joints)
 Ends
of bones are covered with articular cartilage
and separated by the joint cavity
 Within joint is a capsule
 Outer
layer is made of ligaments
 Inner layer is a synovial membrane that secretes
synovial fluid for lubrication
Types of
Diarthroses joints
Pivot joint



Bone moves around
a central axis
Ex. joint between
the radius and ulna
of the lower arm

Gliding joint
Bones move in a
sliding motion
 Ex. between the
carpals in the hand


Hinge joint
Allows only flexion and
extension
 Ex. the knee and elbow


Condyloid or
ellipsoidal joint
Bones can move in
many directions but
cannot rotate
 Ex. between the
metatarsals and the
phalanges

Saddle joint




Two bones have
both concave and
convex regions
Allows the thumb to
touch each of the
fingertips
Ex. the thumb

Ball – and – socket
joint
Bone’s rounded end fits
into a concave cavity
on another bone
 Provides the widest
range of motion
possible
 Ex. femur connecting to
the hip bones

Joint Injuries
Subluxation
 Occurs when bone
displaces, then
returns to normal
position
Dislocation
 Occurs when
significant force
displaces bone so
that the two bone
ends in a joint no
longer add up
JOINT
MOVEMENTS
Movements of Diarthroses
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Flexion
Extension
Hyperextension
Abduction
Adduction
Rotation
Circumduction
Supination
Pronation
Plantar flexion
Dorsiflexion
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Inversion
Eversion
Protraction
Retraction
Elevation
Depression
Internal Rotation
External Rotation
Radial Deviation
Ulnar Deviation
Opposition
Flexion/Extension

Flexion
 Decreases

the angle between 2 bones
Extension
 Increases
the angle between two bones

Hyperextension
 Movement that increases the angle between two
bones extends beyond the normal range of motion
Abduction/Adduction

Abduction
 Describes movements
of the limbs only
 The limb moves away
from the midline of the
body

Adduction
 Describes movements
of the limbs only
 The limb moves
toward from the
midline of the body
Abduction/Adduction
Rotation
Movement that occurs when a bone turns
on its axis toward or away from the
midline of the body, in the limbs, or
between the 1st and 2nd vertebrae of
the spine
 Circumduction
The ability of a limb to move in a
circular path around an axis

Supination
The action of turning the palm upward
Performed by lateral rotation of the
forearm
 Pronation
The action of turning the palm
downward
Performed by medial rotation of the
forearm

Supination/Pronation
Foot: Dorsal/Plantar
Plantar
Flexion/Dorsiflexion
Plantar Flexion
Movement that extends the foot
Pointing toes downwards
 Dorsiflexion
Movement that flexes the foot
Brings toes up toward the lower leg

Plantar
Flexion/Dorsiflexion
Inversion
Movement that turns the sole of the foot
medially
 Eversion
Movement that turns the sole of the foot
laterally

Inversion/Eversion
Protraction/Retraction
Protraction
Moving the body part forward
 Retraction
Moving the body part backward
 Both movements occur in the transverse
plane
 Only performed with the shoulder and
mandible

Protraction/Retraction
Elevation/Depression
Elevation
Movement that lifts the body part
superiorly
 Depression
Movement of the body part inferiorly
 Elevation and Depression occur in the
frontal plane

Elevation/Depression
Internal/External Rotation


Internal rotation
 Movement that occurs when
the anterior surface moves
toward the midline
 aka medial rotation
External rotation
 Movement that occurs when
the anterior surface moves
away from the midline
 aka lateral rotation
Internal/External Rotation
Hip Internal Rotation
Hand Movements
Radial Deviation
 Hand moves laterally towards the thumb
side
 Ulnar Deviation
 Hand moves medially toward the little
finger
 Opposition
 Moves the thumb to touch the tips of the
other fingers

Hand Movements
Joints of Upper Extremity


Shoulder Joint

Wrist
 Glenohumeral
 Radiocarpal
 Sternoclavicular
 Intercarpal
 Acromioclavicular
 Carpalmetacarpal
Elbow Joint

Hand
 Radiohumeral
 Intermetacarpal
 Humeroulnar
 Metacarpalphalangeal
 Radioulnar
 Interphalangeal
Shoulder



Glenohumeral
Sternoclavicular
Acromioclavicular
Glenohumeral
joint
shoulder
Elbow



Radiohumeral
Humeroulnar
Radioulnar
Wrist



Radiocarpal
Intercarpal
Carpalmetacarpal
Hand
 Intermetacarpal
 Metacarpalphalangeal
 Interphalangeal
Joints of Lower Extremity
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Sacroiliac
Acetabulofemoral
Patellofemoral
Tibiofemoral
Tibiofibular

Ankle/Foot
 Talocural
 Subtalar
 Intertarsal
 Tarsometatarsal
 Intermetatarsal
 Metatasophalangel
 Interphalangeal
Sacroiliac joint
Tibiofemoral
joint
TIBIOFIBULAR
JOINT
Foot/Ankle
Synovial Joint Injuries

Acute

Chronic
 Sprains
 Osteochondrosis
 Synovitis
 Arthritis
 Subluxations
 Bursitis
 Dislocations
 Capsulitis/synovitis
Sprains



Injury to ligamentous
and capsular tissue
Traumatic joint twist
that results in
stretching of total
tearing of the
stabilizing connective
tissue
One of most common
& disabling sports
injuries

General Symptoms:
Joint swelling
 Local temperature
increase
 Pain
 Point tenderness
 Skin discoloration

Sprains

Grade 1
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Some pain
Minimum LOF
Mild point tenderness
Little or not swelling
No abnormal motion
Grade 2
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Pain
Moderate LOF
Swelling
Slight to moderate instability

Grade 3
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Severe sprain
Extremely painful initially
LOF
Severe instability
Tenderness
Swelling

May represent
subluxation that
reduced
spontaneously
Synovitis




Irritation of synovial
membrane
Causes increase in fluid
production, swelling
Joint pain during motion,
skin sensitivity from
pressure
Diminish in few days
Acute Joint Injuries
Subluxation
 Occurs when bone
displaces, then returns
to normal position
Dislocation
 Occurs when
significant force
displaces bone so
that the two bone
ends in a joint no
longer add up
Osteochondrosis


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Degenerative changes in the ossification centers of
the epiphysis of bones
During periods of rapid growth in children
Osteochondritis dissecans
Suggested causes—
aseptic necrosis: circulation to epiphysis disrupted
 Trauma causes particles of articular cartilage to fx, resulting
in fissures that penetrate to subchondral bone

Arthritis
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Inflammation of an
entire joint
Usually involves all
tissues of the joint
Most often in WB joints
100 varieties of arthritis
10% population
No cure
Rheumatoid Arthritis




Connective tissue disorder
resulting in severe
inflammation of small joints
Cause unknown
Severely debilitating
Synovial membranes of joint
and connective tissues grow
abnormally to form layer in
joint capsules destroys
cartilage and fuses bones of
joint
Osteoarthritis
Osteoarthritis
Bursitis

Inflammation of the synovial cavity caused by
excessive stress or
tension
Open & Closed
Kinematic Chains

Open Kinematic Chain
Sequence of action in which the body part farthest from the
trunk is free during movement
 i.e. Seated leg extension


Closed Kinematic Chain
Sequence of action in which the body part farthest from the
trunk is fixed during movement
 i.e. In a squat, feet are fixed and the rest of leg chain
moves
