Outline 6

Joints

Joints and their Classification – Joints are classified according to the manner in which the adjacent bones are ______to each other

·  ______Joint (also called synostosis)

o  Immovable joint formed when the gap between two bones ossifies and the bones become, in effect, a single bone

§  An infant is born with right and left mandibular bones and ______bones, but these fuse into a single mandible and frontal bone

·  Fibrous Joint (also called synarthrosis)

o  It is a point at which adjacent bones are bound by ______fibers that emerge from the matrix of one bone, cross the space between them, and penetrate into the matrix of the other bone

o  Three kinds of fibrous joints

§  Sutures –

·  ______sutures – appear as wavy lines along the adjoining bones, firmly interlocking them

o  Example: Sagittal suture

·  ______sutures (squamous sutures) – occur where two flat bones have overlapping edges

o  Example: squamous suture

·  ______sutures – occur where two bones have straight, non-overlapping edges

o  Example: suture between right and left palatine processes of the maxilla

§  Gomphoses –

·  The attachment of a tooth to its socket

o  The tooth is held in place by a periodontal ______

§  The ligament allows the tooth to move a little under the stress of chewing

§  Syndesmoses –

·  Fibrous joints in which the bones are bound by longer collagenous fibers than in a suture or gomphosis, giving the bones more mobility

o  Example: the shafts of the ulna and radius are connected by an interosseous membrane which allows the forearm to ______

·  Cartilaginous Joint (also called amphiarthroses)

o  Bones are linked by ______

o  Kinds of cartilaginous joints:

§  Synchondroses – joints in which the bones are bound by hyaline cartilage

·  Example 1: temporary joint between the epiphysis and diaphysis of a long bone in a child, formed by the ______plate

·  Example 2: Attachment of a rib to the sternum by a hyaline costal cartilage

§  Symphyses – joints in which bones are joined by fibrocartilage

·  Example 1: pubic symphysis that connects the right and left ______bones

·  Example 2: cartilage between the bodies of two vertebrae

Synovial Joints (also called diarthroses) – freely movable joints

·  General Anatomy

o  Articular cartilage – a thin layer of ______cartilage covering the connecting surface of a bone at a synovial joint, serving to reduce friction and ease joint movement

o  Joint cavity – narrow space between the ______in a synovial joint

o  Synovial fluid – a lubricating fluid similar to eggwhite in consistency, found in the synovial joint cavities and bursae

o  Joint capsule – capsule of connective tissue that encloses the joint cavity and retains fluid

§  Fibrous capsule – outer portion of the joint capsule ______with the periosteum of the bones

§  Synovial membrane – inner portion with fibroblast-like cells that secrete ______fluid and macrophages that remove debris from the joint cavity

o  Articular disc – fibrocartilage that grows inward from the joint capsule to form a pad between the articular bones

o  Meniscus – crescent-shaped cartilages in the knee that absorb shock and guide bones across each other

o  Tendon – a collagenous band or cord associated with a muscle, usually attaching it to a ______and transferring muscular tension to it

o  Ligament – a cord or band of tough collagenous tissue binding one organ to another, especially one bone to another, and serving to hold organs in place

o  Bursa – a sac filled with synovial fluid at a synovial joint, serving to facilitate muscle or joint action

o  Tendon sheath – bursae that are elongated cylinders wrapped around a ______

o  Bursitis – Inflammation of a bursae, usually due to overexertions of a joint

o  Tendinitis – inflammation of a tendon ______

·  Types of Synovial Joints

o  Hinge joint – joints that can move only in one plane, like a door hinge

§  One bone has a convex surface that fits into a concave depression of the other

§  Examples: ______, knee, interphalangeal joints (within finger or toe)

o  Gliding joint – joints that slide over each other with limited twisting

§  Articular surfaces are flat or only slightly concave and convex

§  Examples: ______and ankle bones, sternoclavicular joint

o  ______joint – joints in which the first bone rotates on its longitudinal axis relative to the other

§  Example 1: the atlas bone rotates on the dens of the axis bone, so the head can rotate to gesture “no”

§  Example 2: a ligament on the ulna wraps around the head of the radius, which allows the radius to rotate as the forearm is turned

o  Saddle joint – joints that allow movement in two axes (providing a wide range of movement)

§  the articular surface of each bone is shaped like a ______(concave in one direction and convex in the other)

§  Example: attachment of the thumb to the hand

o  Condyloid joint – joints that allow movement in two axes (but more limited than in the saddle joint)

§  The articular surface of one bone is oval and convex, while the other bone is a similarly shaped depression

§  Example: attachment of the index finger to the hand (metacarpophalangeal joint)

o  Ball-and-socket joint – joints that provide the greatest range of movement (they are multiaxial)

§  A smooth hemispherical head of one bone fits into a cuplike depression on another

§  Examples: humerus into ______, femur into os coxae

·  Movement of Synovial Joints

o  Flexion – movement that decreases the angle of a joint on an anterior-posterior plane

§  Examples: bending the elbow or knee, bending the neck to look down at the floor

o  Extension – movement that ______a joint and generally returns a body part to anatomical position

§  Examples: straightening the elbow or knee, raising the head to look directly forward

o  ______extension – extension of a joint beyond 180O.

§  Examples: raising the back of your hand “as if admiring a new ring” or bending the neck to look upward

o  Abduction – movement of a body part ______the median plane

§  Examples: raising the arm to one side of the body, or moving the feet away from each other while standing; also spreading the ______apart on one hand

o  Adduction – movement of a body part toward the median plane

§  Examples: bringing the arms to the sides or sliding the feet closer together while standing; also putting the fingers close together on one hand

o  Elevation – movement of a body part to ______it vertically

§  Example: shrugging the shoulders to raise the scapulae and clavicles

o  Depression – movement of a body part downward

§  Example: lowering the shoulders

o  Protraction – movement of a body part ______on plane parallel with the ground

§  Example: moving the mandible forward, or moving the shoulders forward

o  Retraction – movement of a body part posteriorly on a plane parallel with the ground

§  Example: moving the mandible ______, or moving the shoulders backward

o  Lateral excursion – sideways movement to the right or left

§  Example: movement of the jaw away from midline

o  Medial excursion – movement back to midline

§  Example: movement of the jaw back to midline

o  Circumduction – movement in which one end of an appendage remains relatively stationary while the other end makes a circular motion

§  Example – winding up for a pitch in baseball, making “big arm circles” in gym class

o  Rotation - movement in which a bone turns on its ______axis

§  Examples: twisting the thigh at the femur to os coxae joint, or twisting the arm at the glenohumeral joint.

o  Supination – movement of the forearm so that the palm faces forward or upward

o  Pronation – movement of the forearm so that the palm faces ______or downward

o  Opposition – movement of the thumb to approach or touch the ______

o  Reposition – movement of the thumb to anatomical position, parallel to the index finger

o  Dorsiflexion – movement in which the toes are raised

o  Plantar flexion – movement in which the toes are pointed ______

o  Inversion – movement that lifts the medial border of the foot to turn the soles of the feet medially (inward)

o  Eversion – movement that lifts the lateral border of the foot to turn the soles of the foot away from each other

·  Range of Motion

o  Structure and action of the muscles

§  Tendons, ligaments, and muscles have proprioceptors that monitor joint angle and muscle tension.

§  When the ______receives this information, it sends signals back to the muscles to increase or decrease their state of contraction

§  This adjusts the position of the joint and the tautness of tendons

o  Structure of the articular surfaces of the ______

§  Some joints cannot be hyperextended

·  The olecranon of the ulna fits into the olecranon fossa of the humerus, and prevents further movement in that direction

o  Strength and tautness of ______, tendons, and joint capsule

§  The knee cannot be hyperextended because its cruciate ligament is pulled tight as the knee is extended

Anatomy of Selected Synovial Joints

·  The Jaw Joint

o  Type: condyloid, hinge, and gliding

o  Movements: elevation, depression, protraction, retraction, excursion

·  The Shoulder Joint

o  Type: ball-and-socket

o  Movements: adduction, abduction, flexion, ______, circumduction, medial and lateral rotation

·  The Elbow Joint

o  Type: hinge and pivot

o  Movements: flexion, extension, pronation, supination, ______

·  The Hip (Coxal) Joint

o  Type: ball-and-socket

o  Movements: adduction, abduction, ______, extension, circumduction, medial and lateral rotation

·  The Knee Joint

o  Type: primarily hinge

o  Movements: flexion, extension, slight rotation

·  The Ankle Joint

o  Type: hinge

o  Movements: dorsiflexion, plantar flexion, extension

Clinical Perspectives

·  ______– inflammation of a joint

o  Osteoarthritis (wear-and-tear arthritis)

§  As joints age, the articular cartilage softens and degenerates

§  As cartilage becomes roughened by wear, joint movement may be accompanied by crunching or crackling sounds

§  As the articular cartilage wears away, exposed bone tissue often develops ______that grow into the cavity, restricting movement and causing pain

o  Rheumatoid arthritis

§  Results from autoimmune attack against the joint tissues

§  Misguided antibodies attack the synovial membrane.

§  Inflammatory cells accumulate in the synovial fluid and produce enzymes that degrade the articular cartilage

§  The synovial membrane thickens, fluid accumulates in the capsule, and the capsule is invaded by fibrous connective tissue

§  As the cartilage degenerates, the bones become solidly ______