Chapter 9 Lecture Outline See PowerPoint Image Slides for all figures and tables pre-inserted into PowerPoint without notes. 9-1 Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Joints • Joints and their classification – bony joints – fibrous joints – cartilaginous joints • Synovial joints • Anatomy of selected diarthroses – humeroscapular joint – elbow joint – coxal joint – knee joint 9-2 Joints and Their Classification • Arthrology = study of the joints • Kinesiology = study of musculoskeletal movement • Classified by freedom of movement – diarthrosis (freely movable) – amphiarthrosis (slightly movable) – synarthrosis (little or no movement) • Classified how adjacent bones are joined – fibrous, cartilaginous, bony or synovial 9-3 Bony Joint (Synostosis) • Gap between two bones ossifies – frontal and mandibular bones in infants – cranial sutures in elderly – attachment of first rib and sternum • Can occur in either fibrous or cartilaginous joint 9-4 Fibrous Joints (Synarthrosis) • Collagen fibers span the space between bones – sutures, gomphoses and syndesmoses 9-5 Fibrous Joint -- Sutures • Immovable fibrous joints – bind skull bones together • Serrate - interlocking lines – coronal, sagittal and lambdoid sutures • Lap - overlapping beveled edges – temporal and parietal bones • Plane - straight, nonoverlapping edges – palatine processes of the maxillae 9-6 Types of Sutures 9-7 Fibrous Joint -- Gomphoses • Attachment of a tooth to its socket • Held in place by fibrous periodontal ligament – collagen fibers attach tooth to jawbone • Some movement while chewing 9-8 Fibrous Joint -- Syndesmosis • Two bones bound by ligament only – interosseus membrane • Most movable of fibrous joints • Interosseus membranes unite radius to ulna and tibia to fibula 9-9 Cartilaginous Joint -- Synchondrosis • Bones are joined by hyaline cartilage – rib attachment to sternum – epiphyseal plate in children binds epiphysis and diaphysis 9-10 Cartilaginous Joint -- Symphysis • 2 bones joined by fibrocartilage – pubic symphysis and intervertebral discs • Only slight amount of movement is possible 9-11 Synovial Joint • Joint in which two bones are separated by a space called a joint cavity • Most are freely movable 9-12 General Anatomy • Articular capsule encloses joint cavity – continuous with periosteum – lined by synovial membrane • Synovial fluid = slippery fluid; feeds cartilages • Articular cartilage = hyaline cartilage covering the joint surfaces • Articular discs and menisci – jaw, wrist, sternoclavicular and knee joints – absorbs shock, guides bone movements and distributes forces • Tendon attaches muscle to bone • Ligament attaches bone to bone 9-13 Tendon Sheaths and Bursae • Bursa = saclike extension of joint capsule – between nearby structures so slide more easily past each other • Tendon sheaths = cylinders of connective tissue lined with synovial membrane and wrapped around a tendon 9-14 Components of a Lever • A lever is a rigid object that rotates around a fixed point called a fulcrum • Rotation occurs when effort overcomes resistance – resistance arm and effort arm are described relative to fulcrum 9-15 Mechanical Advantage of a Lever • Two kinds of levers – lever that helps increase output of force • human moving a heavy object with help of crowbar – lever move object further and faster • movement of row boat with paddle • Types of levers produce either increase in speed or force 9-16 Mechanical Advantage • Mechanical advantage is calculated from the length of the effort arm divided by the length of the resistance arm • Contraction of the biceps muscle causes the 9-17 hand to move fast and further (MA <1.0) First-Class Lever • Has fulcrum in the middle between effort and resistance • Atlantooccipital joint lies between the muscles on the back of the neck and the weight of the face – loss of muscle tone occurs when you nod off in class 9-18 Second-Class Lever • Resistance between fulcrum and effort • Resistance from the muscle tone of the temporalis muscle lies between the jaw joint and the pull of the diagastric muscle on the chin as it opens the mouth quickly 9-19 Third-Class Lever • Effort between the resistance and the fulcrum – most joints of the body • The effort applied by the biceps muscle is applied to the forearm between the elbow joint and the weight of the hand and the forearm 9-20 Range of Motion • Degrees through which a joint can move • Determined by – structure of the articular surfaces – strength and tautness of ligaments, tendons and capsule • stretching of ligaments increases range of motion • double-jointed people have long or slack ligaments – action of the muscles and tendons • nervous system monitors joint position and muscle tone 9-21 Axes of Rotation • Shoulder joint has 3 degrees of freedom = multiaxial joint • Other joints – monoaxial or biaxial 9-22 Types of Synovial Joints 9-23 Ball-and-Socket Joints • Smooth hemispherical head fits within a cuplike depression – head of humerus into glenoid cavity of scapula – head of femur into acetabulum of hip bone • Multiaxial joint 9-24 Condyloid (ellipsoid) Joints • Oval convex surface on one bone fits into a similarly shaped depression on the next – radiocarpal joint of the wrist – metacarpophalangeal joints at the bases of the fingers • Biaxial joints 9-25 Saddle Joints • Each articular surface is shaped like a saddle, concave in one direction and convex in the other – trapeziometacarpal joint at the base of the thumb • Biaxial joint – more movable than a condyloid or hinge joint forming the primate opposable thumb 9-26 Gliding Joints • Flat articular surfaces in which bones slide over each other • Limited monoaxial joint • Considered amphiarthroses 9-27 Hinge Joints • One bone with convex surface that fits into a concave depression on other bone – ulna and humerus at elbow joint – femur and tibia at knee joint – finger and toe joints • Monoaxial joint 9-28 Pivot Joints • One bone has a projection that fits into a ringlike ligament of another • First bone rotates on its longitudinal axis relative to the other – atlantoaxial joint (dens and atlas) – proximal radioulnar joint allows the radius during pronation and supination 9-29 Flexion, Extension and Hyperextension • Flexion decreases the angle of a joint • Extension straightens and returns to the anatomical position • Hyperextension = extension beyond 180 degrees 9-30 Flexion, Extension and Hyperextension 9-31 Abduction and Adduction • Abduction is movement of a part away from the midline – hyperabduction – raise arm over back or front of head • Adduction is movement towards the midline – hyperadduction – crossing fingers 9-32 Elevation and Depression • Elevation is a movement that raises a bone vertically – mandibles are elevated during biting and clavicles during a shrug • Depression is lowering the mandible or the shoulders 9-33 Protraction and Retraction • Protraction = movement anteriorly on horizontal plane – thrusting the jaw forward, shoulders or pelvis forward • Retraction is movement posteriorly 9-34 Circumduction • Movement in which one end of an appendage remains stationary while the other end makes a circular motion • Sequence of flexion, abduction, extension and adduction movements – baseball player winding up for a pitch 9-35 Rotation • Movement on longitudinal axis – rotation of trunk, thigh, head or arm • Medial rotation turns the bone inwards • Lateral rotation turns the bone outwards 9-36 Supination and Pronation • In the forearm and foot • Supination – rotation of forearm so that the palm faces forward – inversion and abduction of foot (raising the medial edge of the foot) • Pronation – rotation of forearm so the palm faces to the rear – eversion and abduction of foot (raising the lateral edge of the 9-37 foot) Movements of Head and Trunk • Flexion, hyperextension and lateral flexion of 9-38 vertebral column Rotation of Trunk and Head • Right rotation of trunk; rotation of head 9-39 Movements of Mandible • Lateral excursion = sideways movement • Medial excursion = movement back to the midline – side-to-side grinding during chewing • Protraction – retraction of mandible 9-40 Movement of Hand and Digits • Radial and ulnar flexion • Abduction of fingers and thumb • Opposition is movement of the thumb to approach or touch the fingertips • Reposition is movement back to the anatomical position 9-41 Movements of the Foot • Dorsiflexion is raising of the toes as when you swing the foot forward to take a step (heel strike) • Plantarflexion is extension of the foot so that the toes point downward as in standing on tiptoe • Inversion is a movement in which the soles are turned medially 9-42 • Eversion is a turning of the soles to face laterally The Humeroscapular Joint • Most freely movable joint in the body – shallowness and looseness – deepened by glenoid labrum • Supported by ligaments and tendons – 3 glenohumeral, coracohumeral, transverse humeral and biceps tendon are important joint stabilizer • Supported by rotator cuff musculature – tendons fuse to joint capsule and strengthens it – supraspinatus, infraspinatus, teres minor and subscapularis, • 4 Bursae associated with shoulder joint 9-43 Stabilizers of the Shoulder Joint 9-44 Tendons of Rotator Cuff Muscles 9-45 Dissection of Shoulder Joint 9-46 The Elbow Joint • Single joint capsule enclosing the humeroulnar and humeroradial joints • Humeroulnar joint is supported by collateral ligaments. • Radioulnar joint is head of radius held in place by the anular ligament encircling the head 9-47 Elbow Joint 9-48 The Coaxal (hip) Joint • Head of femur articulates with acetabulum • Socket deepened by acetabular labrum • Blood supply to head of femur found in ligament of the head of the femur Joint capsule strengthened by ligaments 9-49 Hip Joint • Joint capsule strengthened by ligaments – pubofemoral – ischiofemoral – iliofemoral 9-50 Dissection of Hip Joint 9-51 The Knee Joint • Most complex diarthrosis – patellofemoral = gliding joint – tibiofemoral = gliding with slight rotation and gliding possible in flexed position • Joint capsule anteriorly consists of patella and extensions of quadriceps femoris tendon • Capsule strengthened by extracapsular and intracapsular ligaments 9-52 Knee Joint – Sagittal Section 9-53 Knee Joint – Anterior and Posterior Views • Anterior and lateral cruciate ligaments limit anterior and posterior sliding movements • Medial and lateral collateral ligaments prevent rotation of extended knee 9-54 Knee Joint – Superior View • Medial and lateral meniscus absorb shock and shape joint 9-55 Dissection of Knee Joint 9-56 Arthritis • Arthritis is a broad term for pain and inflammation • Osteoarthritis results from years of joint wear – articular cartilage softens and degenerates – accompanied by crackling sounds called crepitus – bone spurs develop on exposed bone tissue causing pain 9-57 Arthritis and Artificial Joints • Rheumatoid arthritis is autoimmune attack on joint – antibodies attack synovial membrane, enzymes in synovial fluid degrade the cartilage, bones ossify – remissions occur, steroids and aspirin control inflammation • Arthroplasty is replacement of diseased joint with artificial device called prosthesis 9-58 Rheumatoid Arthritis 9-59 Joint Prostheses 9-60