Joints and Joint Tissue Flashcards
Why is the skull jaggered at young age
jagged interlocking of skull provides stability. Disappear as we age.
whats a suture?
Example
Bone – Fibrous tissue – Bone
Fibula- interosseous membrane- tibia
What are Intervertebral Articulations?
Example Spine
Bone – Cartilage – Fibrous tissue – Cartilage - Bone
Intervertebral disc disease:
- risk factor
- what happens to annulus fibrosis, nucleus pulposis etc
- treatment
Aging is biggest risk factor
NP becomes more stiff, more collagen, less proteoglycans
forces are spread to AF and this weakens overtime with additional stresses. Leads to ruptured or buldging disk and possibly sciatica. Disturbance can affect the above discs above and below as well.
different ways to manage
-Always non surgical
-can fuse the bones - can try to remove them and hope it repairs
-can get disc replacements
What is Synovial Joint?
Benefit/drawback of this joint?
Found where?
Example
- Bone ends are no longer directly attached to each other by solid tissue.
- Permit a wider range of movement
- Mostly found in the appendicular skeleton - Typically weaker than other joints
Eg, finger joint
Joint capsule layers
- OUTER Fibrous capsule
- tough outer layer of collagen fibres
- resists over extension of synovial joint
- perforated by nerves and blood vessels - INNER synovial membrane
- lines joint capsule
- secretes synovial fluid
Articular cartilage
Purpose?
Lacks?
- Protects bones
- Smooth surface for joint articulation
-
No blood supply or nerve supply
SO theres no immune rejection, no pain with damage, cant repair itself
Synovial fluid
What is it?
3 main Functions?
An ultra-filtrate of blood plasma
Functions
1. A source of NUTRITION for articular cartilage
- LUBRICATES articular cartilage and all the surfaces inside joints to reduce friction
- DISTRIBUTES load during compression
OSTEOARTHRITIS:
type of disease progress?
What does it look like on Xray/changes inside the joint
Symptoms?
not a wear tear disease, active, slow, chronic, inflammatory condition, really complex
Loss of joint space on XRAY.
Erosion of articular cartilage, changes in synvoium (some thickening and inflammation), bony ingrowths called osteophytes
Symptoms: Stiffness and pain particualry in the morning
Risk factors for OSTEOARTHRITIS Causes for primary and secondary OA and risk factors for each
Primary OA–no known cause
Risks: age, obesity, genetics, mechanics and others
Secondary OA
* Occupation
Injury/trauma (ACL rupture leads to post-traumatic osteaorthritis
Key features in ostearthritis knee
Bone remodelling and scleorosis
Cartiloage breaking down
Meniscal damage
Synvoial hypertrophy
Osteophytes
Management and Treatment of Knee OA (or treatment of the person)
NSAIDs/painrelief
* Weight management
* Cortisone injections in the joint (not favoured so
much anymore)
-Exercise (PT programmes, mindfullness)
- Cartiliage repair techniques (microfracture)
-Arthroplasty (hemi or full)
Therapies not recommended for OA
Viscosupplementation
* Injection of hyaluronan or other lubricant/supplemens into the joints
Joint supplements such as:
* Glucosamine/ chondroitin sulphate
* Deer Antler Velvet
* Collagen
Other tissues that get wear and tear
- Menisci – fibrocartilage pads for knee
* Common to tear with sports
2.Fat pad – padding for protection
- Bursa – can become inflammed - overuse.
- Tendons and ligaments (Achilles/ ACL/ Tendonitis)
* Collagen structures with limited blood supply
* Stabilise joints
* Very strong in tension
* Poor healing capacity
Define joint
where 2 bones meet. The two bones may be in direct contact with each other or have additional tissues such as cartilage, fibrous tissue or synovial flui
Typical movement (limited or wide range) in appendicular and axial skeleton
limiting movement (which is commonly found in the axial skeleton)
wide range of movement (more commonly found in the appendicular skeleton).
Functional classification of joints
Joints can be classified functionally, according to their range of movement.
- SYNARTHROSIS: Immovable joints. Sometimes bones are interlocked or have a fibrous or cartilaginous connection to prevent movement. E.g. suture in the skull or epiphyseal growth plate
- AMPHIARHTROSIS: Slightly moveable joints. Limited movement but provides stability. Joint between tibia and fibula contains the fibrous interosseous membrane. Cartilaginous amphiarthroses
include the pubis symphysis and the vertebral body and intervertebral disc articulation - DIARTHOSIS: Freely moveable, synovial joints. Bones not in contact as usually covered with
articular cartilage, bound by a joint capsule and contains synovial fluid. Can be further classified as mono-, bi- or tri- axial.
Rank fibrious, cartilingious and synvovial joints in term of free movement
No free movement: fibrious
Some
cartilingious
Complete free movement: Synvoial
Joint classification types
Functional or structural
Structural classification of Joints
Based onthe structural characteristics and can fibrous, cartilaginous or synovial (ie what materials are between bones in joint)
Elements of Synvoial joint
- joint space - need space to move
- articular cartilage - cushion
- Joint capsule
- Outer fibrious (Tough outer casting -inner synvioum (Thin membrane) - Synvoial fluid (made by synvoium for lubrication and nutrition to cartiliage which is avascualr)
Hinge Joint:
Description, functional classification and example
Convex surface fits into concave surface
Uniaxial diarthrosis: Flexion and extension
Eg: Knee, elbow, ankle
Ball and Socket:
Description, functional classification and example
Ball like surface fits into cuplike depression
Triaxial diathrosis: Flexion, extension, abduction, adduction, rotation
Shoulder and hips
Suture
Syndesmosis
Interossesous membrane
Sycnhondrosis
Symphysis
Pivot
Condyloid
Saddle
Suture: Coronal suture
Syndesmosis: Distal tibiofibular joint
Interossesous membrane: Between tibila and fibila
Sycnhondrosis: Epiphyseal plate of long bone
Symphysis: Pubic symphysis
Pivot: Radioulnar joints
Condyloid: Radiocarpal
Saddle: Carpometacarpal
What is Osteoarthritis
Why doesnt it repair well?
Osteoarthritis is a disease affecting the articular cartilage of synovial joints.
Articular cartilage does not repair well because it lacks 2 important things:
1. blood supply 2.nerve supply
Overall progress of OA
So with repetitive use of the joints over the years, the water content of the cartilage increases and the protein components such as collagen start to break down. This irritates and inflames the cartilage, causing joint pain and swelling. Eventually, cartilage begins to degenerate by flaking or forming tiny crevasses. In advanced cases, there is a total loss of the cartilage cushion between the bones of the joints. Loss of cartilage cushion causes friction between the bones, leading to pain and limitation of joint mobility.
Gout:
Cause:
Timing Progression:
Symptoms:
Who does it affect
Most common sites of gout
Gout is caused by high level of uric acid in the blood.
It occurs as an acute attack, often coming on overnight
Within 12-24 hours there is
- severe pain
- swelling in the affected joint.
The skin over the joint may also become red and shiny.
Gout affects more men than women, in women it occurs after the menopause
Gout usually affects only one or two joints at a time – most often the big toe; feet, ankles, knees, wrists, fingers
Gout risk factors
- genetic (i.e. it runs in the family)
- being overweight
- high alcohol intake, especially beer
- high intake of foods that produce a lot of uric acid e.g. some seafood
- some drugs for the treatment of high blood pressure
- long standing kidney disease
- high intake of fructose rich drinks.
