Chapter 9: Joints Flashcards

1
Q

What is a joint and how does it get its name?

A
  • A joint (AKA articulation) is any point where two bones meet, whether or not the bones are moveable at that interface
  • Joint name: typically derived from the names of the bones / bone marking involved
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2
Q

What are the 3 major joint (functional) categories?

A
  • Synarthrotic
    • immoveable
  • Amphiarthrotic
    • amphiarthrotic
  • Diarthrotic
    • freely moveable
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3
Q

What are the 4 major (structural) joint categories?

A
  • Bony joints
    • between them is bone
  • Fibrous joints
    • Bones are bound by collagen fibers that emerge from one bone and penetrate into the other
  • Cartilaginous joints
    • between them is cartilage
  • Synovial joints
    • freely moving
    • between them is space (capsule and cavity)
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4
Q

WHat are the different types of bony joints?

A
  • Synostosis
    • immobile
    • gap between two joints ossifies and becomes one bone
    • E.g. light and right mandibular bones in infants, cranial sutures in elderly, attachment of rib to sternum in old age
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5
Q

What are the different types of fibrous joints?

A
  • Sutures
    • immobile or slightly mobile
    • short collagen fibers
    • Serrate (interlocking way lines)
      • coronal, sagittal, lambdoid sutures
    • Lap (squamos): overlapping beveled edges
      • temporal and parietal sutures
    • Plane (butt): straight
      • palatine process of the maxillae
  • Gomphoses
    • attachment of a tooth to its socket
    • Held in place by periodontal ligament (collagen made)
    • Allows tooth to move a lit under stress of chewing
  • Syndesmoses
    • two bones bound by long collagen fibers
    • mobile syndesmoses: interosseous membrane between radius and ulna
    • less mobile syndesmoses: between tibia to fibula
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6
Q

What are the types of cartilaginous joints?

A
  • Synchondroses
    • bones held together by hyaline
    • Epiphysial plates (temporary joints)
    • E.g. first rib attachment to sternum
  • Symphyses
    • bones held together by fibrocartilage
    • e.g. pubic symphysis, bodies of vertebrae joined by intervertebral discs
      • only slight movement between adjacent vertebrae
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7
Q

What are some characteristics of synovial joints?

A
  • These are often known as diarthrosis or diathrodial joints
  • Two bones are separated by a joint (articular cavity) containing the lubricant synovial fluid (like an egg white)
  • Most are free moveable
  • Most are structurally complex
  • They are most likely to develop painful disfunction
  • They are most important joints for health professionals to understand
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8
Q

What is the general anatomy of a synovial joint?

A
  • Articular cartilage (very thin coating)
    • reduces friction and absorbs shock
  • Joint (articular) cavity
  • Synovial fluid
    • slippery lubricant in joint cavity
  • Joint (articular) capsule
    • outer fibrous capsule, contains periosteum
    • Inner, cellular, synovial membrane
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9
Q

What are accesory structures of a synovial joint?

A
  • Fibrocartilage
    • articular disc between bones (e.g. temporomandibular joint)
    • Meniscus in knee
    • absorbs shock and pressure
    • improves fit together
    • stabilizes joints, reducing the chance of dislocation
  • Tendon
  • Ligament
  • Bursa
    • fibrous sack filled with synovial fluid
    • located between muscles where tendons pass over bone or between bone and skin
    • cushion muscles, help tendons slide over joints, modifies direction of tendon pull
  • tendon sheath
    • elongated cylindrical bursa wrapped around a tendon
    • in hand and foot
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10
Q

How does exercise work with articular cartilage?

A
  • Exercise warms synovial fluid
    • presses it like a sponge, in and out
    • synovial fluid is like blood replacement
  • Cartilage then swells and provides a more effective cushion
  • Repetitive compression exhanges fluid in and out of cartilage
    • exhange metabolic waste and nutrients/oxygen (like blood)
    • helps maintain health of cartilage longer
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11
Q

What is range of motion (ROM) and what affects it?

A
  • ROM is the degrees through which a joint can move
    • aspect of joint performance
    • physical assessment of a patient’s joint flexibility
  • Determined by…. shape of articular surfaces
    • olecranon ulna fits into olecranon fossa of humerus
  • Strength and tautness of ligaments and joint capsules
    • stretching of ligaments increases ROM
  • Action of the muscles and tendons
    • nervous system monitors joint position and muscle tone
      • muscle tone: state of tension maintained in resting muscles
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12
Q

What are the 6 classes of synovial joints and their general characteristics?

A
  • Ball and socket joints
    • only multiaxial joints
    • hips, shoulder
  • Condylar (ellipsoid) joints
    • oval convex surface of one bone fits into a complementary shaped depression on the other
    • biaxial (flexsion/extension and abduction/adduction usually)
    • radiocarpal joint, metacarpophalangeal joint, atlanto-occipital joint
  • Saddle joints
    • both bones have articular surface shaped like a saddle, one is concave and the other convex
    • Biaxial
    • Trapeziometacarpal (opposeable thumb)
  • Plane (gliding) joints
    • flat articular surfaces slide over each other
    • usually biaxial
    • intercarpal/tarsal, between articular processes of vertebrae
  • Hinge joints
    • one bone with convex surface fits into concave depression of another bone
    • monoaxial
    • elbow, knee, joints within fingers and toes
  • Pivot joints
    • a bone spins on its longitudinal axis
    • monoaxial
    • atlantoaxial joint (shaking head), radioulnar joint
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13
Q

What is zero position?

A

the position of a joint when a person is in the standard anatomical position

(joint movements described as deviation from the zero position or returning to it)

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14
Q

Describe the following movements: flexsion, extension, hyperextension, abduction, and adduction

A
  • flexion: movement that decreases joint angle
    • common in hinge joints
  • extension: movement that straightens a joint and returns the body to the zero position
  • hyperextension: extension of a joint beyond zero position
  • Abduction: movement of a body part in the frontal plane away from the midline of the body
  • Adduction: movement in the frontal plane back toward the midline
    • hyperadduction: crossing fingers, crossing ankles
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15
Q

Describe the following movements: elevation and depression, protraction and retraction, circumduction, rotation, supination and pronation

A
  • elevation: movement that raises a body part vertically in the frontal plane
  • depression: movement that lowers a body part in the same plane
  • protraction: the anterior movement of a body part in the transverse plane
  • retraction: posterior movement in the same plane
  • circumduction: one end of an appendage remains stationary while the other end makes a circular motion
  • rotation: movement in which a bone spins on its longitudinal axis (can be medial/internal or lateral/external)
  • Supination: forearm movement that turns the palm to face anteriorly or upward
  • Pronation: forearm movement that turns palm to face either posteriorly or downward
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16
Q

Describe the following special movements: lateral flexion of the head, radial/ulnar flexion of the hand, opposition / reposition of the thumb, dorsiflexion/plantar flexion of the feet, inversion / eversion of the feet

A
  • Lateral flexion of the head: tilting the head or trunk to the right or left at the midline
  • Radial / ulnar flexion of the hand: tilting hand toward thumb/little finger
  • Opposition/reposition of the thumb: moving thumb to touch tip of a finger, returning thumb to the zero position
  • Dorsiflexion/plantarflexion: elevating toes / extending foot to stand on tip toe
  • Inversion/eversion: soles are turned medially / soles are turned laterally
17
Q

What are the basic elements of the jaw joint (TMJ)?

A
  • Temporomandibular joint (TMJ) is an articulation of the mandibular condyle of the mandible with the mandibular fossa of the temporal bone
  • Synovial cavity is dvided into superior and inferior chambers by an articular disc
  • Deep yawn or strenuous depression can dislocated TMJ
  • Chronic dislocation sydnrome is common
18
Q

What are the basic elements of the shoulder joint?

A
  • Glenhumeral joint–articulation of the glenoid cavity of scapula and the humerus
  • Most freely moveable joint in the body
  • Sacrifices stability for freedom of movement
  • The joint is stabilized by tendons:
    • biceps brachii tendon
    • rotator cuff tendon (fused to joint capsule)
    • stabilized in all directions except inferior, so most dislocations are downward
    • ring of fibrocartilage (labrum) deepens glenoid cavity
19
Q

What are the basic elements of the elbow joint?

A
  • Joint with two articulations:
    • humeroulnar joint (trochlea of humerus and trochlear notch of ulna)
    • Humeroradial joint: capitulum of humerus and head of radius
    • Both articulations closed in one joint capsule
  • Also contains proximal radioulnar joint
    • Functions as a pivor joint, not a hinge
    • Head of radius fits into radial notch of ulna
    • Allows for pronation and supination
20
Q

What are the basic elements of the hip joint?

A
  • The coxal joint: head of femur inserts into acetabulum of coxal bone
  • More stable than shoulder
  • Dislocations are rare
  • ring of fibrocartilage (labrum) deepens acetabulum socket
  • Some infants have congenital dislocation
    • stay in harness until acetabulum is deep enough for femur head
21
Q

What are the basic elements of the knee joint?

A
  • Tibiofemoral joint: largest and most complex diarthrosis of the human body
  • Primarily a hinge joint
    • Patellofemoral joint is a gliding joint
  • Stabilized by quadriceps tendon in front and hamstring tendon (semimembranous muscle) in back
  • Popliteal region is stabilized by extracapsular ligaments and intracapsular ligaments (cross each other to form an X)
    • Anterior cruciate ligament (ACL): prevents hyperextension of knee, common site of knee injury
    • Posterior Cruciate Ligament (PCL): prevents femur from sliding off tibia
  • Has lateral meniscus and medial meniscus
    • C-shaped cartilages within joint capsule
    • absorb shock and prevent side to side rocking
    • joined by transverse ligament
22
Q

What are the most common knee injuries and what is arthroscopic surgery?

A
  • The knee is high vulnerable to rotational and horizontal stress
  • Most common injuries are within the menisci and Anterior Cruciate Ligament
  • Knee heals slowly due to scanty blood flow
  • Arthroscopy is a procedure in which the interior of a joint is viewed with a pencil-thin arthroscope
    • less tissue damage than regular surgery
    • recover more quickly
    • arthoscopic ACL repair: 9 months for full heal
23
Q

What are the basic elements of the ankle joint?

A
  • Talocrural joint
    • Medial articulation: between tibia and talus
    • Lateral joint: between fibula and talus
    • both articulations contained within one joint capsule
  • Malleoli of the tibia/fibula overhang the talus on either side and prevent side to side motion
  • More restricted range of motion than wrist
  • Calcaneal (Achilles) tendon: extends from calf muscles to calcaneas
  • Sprains (torn ligaments and tendons) are common at the ankle
24
Q

What is arthritis and its types / components?

A
  • Arthritis is a broad term for the pain and inflammation of joints
    • It is the most common crippling disease in US
    • Rheumatologists treat it
  • Osteoarthritis: most common form
    • wear and tear (years of joint wear)
    • articular cartilage softens and degenerates
    • Bone crackling sounds called crepitus
    • bone spurs develop on exposed bone tissue (painful)
  • Rheumatoid Arthritis
    • autoimmune attack against joint tissues
    • Misguided antibodies (rheumatoid factor) attack synovial membrane, articular cartilage degrades, joints begin to ossify
    • Remissions occur, steroids and aspirin control inflammation
  • Arthroplasty: replacement of diseased joint with artifical device called prosthesis