L5: Joints Pt. 2 Flashcards
Proximal radioulnar joint between head of radius and radial notch of ulna; distal radioulnar joint between ulnar notch of radius and head of ulna.
radioulnar
What are the articular components of the radioulnar joint?
Proximal radioulnar joint between head of radius and radial notch of ulna; distal radioulnar joint between ulnar notch of radius and head of ulna.
What is the classification of the radioulnar joint?
Synovial (pivot).
What are the movements of the radioulnar joint?
Rotation of forearm.
What are the articular components of the wrist (radiocarpal) joint?
Between distal end of radius and scaphoid, lunate, and triquetrum of carpus.
What is the classification of the wrist (radiocarpal) joint?
Synovial (ellipsoid).
What are the movements of the wrist (radiocarpal) joint?
Flexion, extension, abduction, adduction, circumduction, and slight hyperextension of wrist.
What are the articular components of the intercarpal joint?
Between proximal row of carpal bones, distal row of carpal bones, and between both rows of carpal bones (midcarpal joints).
What is the classification of the intercarpal joint?
Synovial (plane), except for hamate, scaphoid, and lunate (midcarpal) joint, which is synovial (saddle).
What are the movements of the intercarpal joint?
Gliding plus flexion, extension, abduction, adduction, and slight rotation at midcarpal joints.
What are the articular components of the carpometacarpal joint?
Carpometacarpal joint of thumb between trapezium of carpus and first metacarpal; carpometacarpal joints of remaining digits formed between carpus and second through fifth metacarpals.
What is the classification of the carpometacarpal joint?
Synovial (saddle) at thumb; synovial (plane) at remaining digits.
What are the movements of the carpometacarpal joint?
Flexion, extension, abduction, adduction, and circumduction at thumb; gliding at remaining digits.
What are the articular components of the metacarpophalangeal and metatarsophalangeal joints?
Between heads of metacarpals (or metatarsals) and bases of proximal phalanges.
What is the classification of the metacarpophalangeal and metatarsophalangeal joints?
Synovial (ellipsoid).
What are the movements of the metacarpophalangeal and metatarsophalangeal joints?
Flexion, extension, abduction, adduction, and circumduction of phalanges.
What are the articular components of the interphalangeal joint?
Between heads of phalanges and bases of more distal phalanges.
What is the classification of the interphalangeal joint?
Synovial (hinge).
What are the movements of the interphalangeal joint?
Flexion and extension of phalanges.
What are the articular components of the sacroiliac joint?
Between auricular surfaces of sacrum and ilia of hip bones.
What is the classification of the sacroiliac joint?
Synovial (plane).
What are the movements of the sacroiliac joint?
Slight gliding (even more so during pregnancy).
What are the articular components of the pubic symphysis joint?
Between anterior surfaces of hip bones.
What is the classification of the pubic symphysis joint?
Cartilaginous (symphysis).
What are the movements of the pubic symphysis joint?
Slight movements (even more so during pregnancy).
What are the articular components of the tibiofibular joint?
Proximal tibiofibular joint between lateral condyle of tibia and head of fibula; distal tibiofibular joint between distal end of fibula and fibular notch of tibia.
What is the classification of the tibiofibular joint?
Synovial (plane) at proximal joint; fibrous (syndesmosis) at distal joint.
What are the movements of the tibiofibular joint?
Slight gliding at proximal joint; slight rotation of fibula during dorsiflexion of foot.
What are the articular components of the ankle (talocrural) joint?
(1) Between distal end of tibia and its medial malleolus and talus; (2) between lateral malleolus of fibula and talus.
What is the classification of the ankle (talocrural) joint?
Synovial (hinge).
What are the movements of the ankle (talocrural) joint?
Dorsiflexion and plantar flexion of foot.
What are the articular components of the intertarsal joint?
Subtalar joint between talus and calcaneus of tarsus; talocalcaneonavicular joint between talus and calcaneus and navicular of tarsus; calcaneocuboid joint between calcaneus and cuboid of tarsus.
What is the classification of the intertarsal joint?
Synovial (plane) at subtalar and calcaneocuboid joints; synovial (saddle) at talocalcaneonavicular joint.
What are the movements of the intertarsal joint?
Inversion and eversion of foot.
What are the articular components of the tarsometatarsal joint?
Between three cuneiforms of tarsus and bases of five metatarsal bones.
What is the classification of the tarsometatarsal joint?
Synovial (plane).
What are the movements of the tarsometatarsal joint?
Slight gliding.
What is the temporomandibular joint (TMJ)?
A combined hinge and plane joint formed by the condylar process of the mandible and the mandibular fossa and articular tubercle of the temporal bone.
What is the only freely movable joint between skull bones?
The temporomandibular joint (TMJ).
What type of joints are all other skull joints (except the TMJ and ear ossicles)?
Fibrous joints and therefore immovable or slightly movable.
What is the articular disc (meniscus)?
A fibrous cartilage disc that separates the articular cavity into superior and inferior cavities, each with a synovial membrane.
What is the articular capsule?
A thin, fairly loose envelope around the circumference of the joint.
What is the lateral ligament, and what is its function?
Two short bands on the lateral surface of the articular capsule that extend inferiorly and posteriorly from the inferior border and tubercle of the zygomatic process of the temporal bone to the lateral and posterior aspect of the neck of the mandible. It helps strengthen the joint laterally and prevent displacement of the mandible.
What covers the lateral ligament?
The parotid gland.
What is the sphenomandibular ligament?
A thin band that extends inferiorly and anteriorly from the spine of the sphenoid bone to the ramus of the mandible.
Does the sphenomandibular ligament significantly contribute to the strength of the joint?
No, it does not contribute significantly to the strength of the joint.
What is the stylomandibular ligament?
A thickened band of deep cervical fascia that extends from the styloid process of the temporal bone to the inferior and posterior border of the ramus of the mandible.
What does the stylomandibular ligament separate?
The parotid gland from the submandibular gland.
What is the function of the stylomandibular ligament?
It limits movement of the mandible at the TMJ.
is the only movable joint between skull bones.
TMJ
In the temporomandibular joint, which bone moves?
Only the mandible moves.
Why does only the mandible move in the temporomandibular joint?
Because the temporal bone is firmly anchored to other bones of the skull by sutures.
What are the functions of the mandible in the inferior compartment of the temporomandibular joint?
Depression (jaw opening) and elevation (jaw closing).
What are the functions of the mandible in the superior compartment of the temporomandibular joint?
Protraction, retraction, lateral displacement, and slight rotation.
is a ball- and- socket joint formed by the head of the humerus and the glenoid cavity of the scapula.
glenohumeral (shoulder) joint
In the temporomandibular joint, which bone moves?
Only the mandible moves.
Why does only the mandible move in the temporomandibular joint?
Because the temporal bone is firmly anchored to other bones of the skull by sutures.
What are the functions of the mandible in the inferior compartment of the temporomandibular joint?
Depression (jaw opening) and elevation (jaw closing).
What are the functions of the mandible in the superior compartment of the temporomandibular joint?
Protraction, retraction, lateral displacement, and slight rotation.
Most of the stability of the glenohumeral joint results from the arrangement of the
rotator cuff muscles.
What is the articular capsule?
A thin, loose sac that completely envelops the joint and extends from the glenoid cavity to the anatomical neck of the humerus.
Which part of the articular capsule is the weakest?
The inferior part.
What is the function of the coracohumeral ligament?
It strengthens the superior part of the articular capsule and reinforces the anterior aspect of the articular capsule.
Where does the coracohumeral ligament extend from and to?
From the coracoid process of the scapula to the greater tubercle of the humerus.
What are the glenohumeral ligaments?
Three thickenings of the articular capsule over the anterior surface of the joint.
Where do the glenohumeral ligaments extend from and to?
From the glenoid cavity to the lesser tubercle and anatomical neck of the humerus.
What is the role of the glenohumeral ligaments?
They provide minimal strength but help stabilize the joint when the humerus approaches or exceeds its limits of motion.
What is the transverse humeral ligament?
A narrow sheet extending from the greater tubercle to the lesser tubercle of the humerus.
What is the function of the transverse humeral ligament?
It functions as a retinaculum to hold the long head of the biceps brachii muscle.
What is the glenoid labrum?
A narrow rim of fibrous cartilage around the edge of the glenoid cavity.
What is the function of the glenoid labrum?
It slightly deepens and enlarges the glenoid cavity.
How many bursae are associated with the shoulder joint?
Four.
What are the names of the bursae associated with the shoulder joint?
Subacromial bursa, subdeltoid bursa, subscapular bursa, and subcoracoid bursa.
What is the acromioclavicular joint?
A joint formed by articulations between the scapula and clavicle.
What are the ligaments involved in the acromioclavicular joint?
The acromioclavicular ligament and the coracoclavicular ligament.
Where is the acromioclavicular ligament located?
Between the acromion of the scapula and the acromial end of the clavicle.
Where is the coracoclavicular ligament located?
Between the coracoid process of the scapula and the clavicle.
What joint is involved in a separated shoulder?
The acromioclavicular joint.
What movements does the glenohumeral joint allow?
Flexion, extension, hyperextension, abduction, adduction, medial rotation, lateral rotation, and circumduction of the arm.
Which joint has more freedom of movement than any other joint of the body?
The glenohumeral joint.
What allows the glenohumeral joint to have more freedom of movement?
The looseness of the articular capsule and the shallowness of the glenoid cavity in relation to the large size of the head of the humerus.
What contributes some strength to the glenohumeral joint?
The ligaments of the glenohumeral joint.
What provides most of the strength to the glenohumeral joint?
The muscles that surround the joint, especially the rotator cuff muscles.
What are the rotator cuff muscles?
Supraspinatus, infraspinatus, teres minor, and subscapularis.
What is the function of the rotator cuff muscles?
They anchor the humerus to the scapula.
What do the tendons of the rotator cuff muscles encircle?
They encircle the joint (except for the inferior portion) and intimately surround the articular capsule.
What do the rotator cuff muscles do as a group?
They work together to anchor the head of the humerus in the glenoid cavity.
What is the most common shoulder injury?
Rotator cuff injury.
What is a rotator cuff injury?
A strain or tear in the rotator cuff muscles.
Who are commonly affected by rotator cuff injury?
Baseball pitchers, volleyball players, racket sports players, swimmers, and violinists.
What type of shoulder movements can cause rotator cuff injury?
Movements that involve vigorous circumduction.
What are some causes of rotator cuff injury?
Wear and tear, aging, trauma, poor posture, improper lifting, and repetitive motions in certain jobs.
Which tendon is most often torn in a rotator cuff injury?
Supraspinatus muscle tendon.
Why is the supraspinatus muscle tendon predisposed to wear and tear?
Because of its location between the head of the humerus and acromion of the scapula, which compresses the tendon during shoulder movements.
What increases compression of the supraspinatus muscle tendon?
Poor posture and poor body mechanics.
Which joint is the most commonly dislocated in adults?
The glenohumeral joint.
Why is the glenohumeral joint commonly dislocated?
Because its socket is quite shallow and the bones are held together by supporting muscles.
What happens in a dislocated shoulder?
The head of the humerus becomes displaced from the glenoid cavity of the scapula with significant damage to the surrounding ligaments, tendons, and muscles.
How are shoulder dislocations treated?
With rest, ice, pain relievers, manual manipulation, or surgery followed by use of a sling and physical therapy.
What does a separated shoulder refer to?
An injury to the acromioclavicular joint.
What causes a separated shoulder?
A partial or complete tearing of the acromioclavicular ligament and sometimes the coracoclavicular ligament.
What usually causes a separated shoulder?
Forceful trauma to the joint, such as when the shoulder strikes the ground in a fall.
How is a separated shoulder treated?
Similar to a dislocated shoulder, although surgery is rarely needed.
What happens in a torn glenoid labrum?
The fibrous cartilage labrum may tear away from the glenoid cavity.
What are symptoms of a torn glenoid labrum?
The joint may catch or feel like it’s slipping out of place.
What can happen as a result of a torn glenoid labrum?
The shoulder may become dislocated.
How is a torn labrum treated?
It is reattached to the glenoid surgically with anchors and sutures.
What is the benefit of surgically repairing a torn glenoid labrum?
The repaired joint is more stable.
is a hinge joint formed by the trochlea and capitulum of the humerus, the trochlear notch of the ulna, and the head of the radius (humeroulnar and humeroradial joints) and a pivot joint formed between the head of the radius and the radial notch of the ulna (proximal radrocular joint).
elbow joint
is formed by parts of three bones: humerus, ulna, and radius.
elbow joint
What does the anterior part of the articular capsule cover?
The anterior part of the elbow joint, from the radial and coronoid fossae of the humerus to the coronoid process of the ulna and the annular ligament of the radius.
Where does the posterior part of the articular capsule extend from and to?
From the capitulum, olecranon fossa, and lateral epicondyle of the humerus to the annular ligament of the radius, the olecranon of the ulna, and the ulna posterior to the radial notch.
What is the ulnar collateral ligament?
A thick, triangular ligament that extends from the medial epicondyle of the humerus to the coronoid process and olecranon of the ulna.
What does part of the ulnar collateral ligament do?
It deepens the socket for the trochlea of the humerus.
What is the radial collateral ligament?
A strong, triangular ligament that extends from the lateral epicondyle of the humerus to the annular ligament of the radius and the radial notch of the ulna.
What is the annular ligament of the radius?
A strong band that encircles the head of the radius.
What does the annular ligament of the radius do?
It holds the head of the radius in the radial notch of the ulna.
it allows flexion and extension of the forearm
elbow joint
What does tennis elbow most commonly refer to?
Pain at or near the lateral epicondyle of the humerus, usually caused by an improperly executed backhand.
What causes tennis elbow?
Strain or sprain of the extensor muscles, resulting in pain.
What is Little League elbow?
Inflammation of the medial epicondyle.
What typically causes Little League elbow?
A heavy pitching schedule and/or throwing curveballs, especially among youngsters.
What can happen to the elbow joint in Little League elbow?
The elbow joint may enlarge, fragment, or separate.
What is the most common upper limb dislocation in children?
A dislocation of the radial head.
What happens in a dislocation of the radial head?
The head of the radius slides past or ruptures the radial annular ligament.
What does the radial annular ligament do?
It forms a collar around the head of the radius at the proximal radioulnar joint.
When is dislocation of the radial head most likely to occur?
When a strong pull is applied to the forearm while it is extended and supinated, such as when swinging a child around with outstretched arms.
Which player on the field makes the most active throws?
Baseball pitchers.
What injury is becoming increasingly common in baseball pitchers?
Damage to the ulnar collateral ligament.
Since 1974, how has the damaged ulnar collateral ligament been replaced?
With a tendon taken from the palmaris longus muscle in the wrist or a graft taken from a cadaver.
What is the reconstructive surgery for the ulnar collateral ligament called?
Tommy John surgery.
Who was Tommy John surgery named after?
A professional baseball pitcher who first underwent the procedure.
is a ball- and- socket joint formed by the head of the femur and the acetabulum of the hip bone.
hip joint
What is the articular capsule?
Very dense and strong capsule that extends from the rim of the acetabulum to the neck of the femur.
What makes the articular capsule one of the strongest structures of the body?
Its accessory ligaments.
What are the two types of fibers in the articular capsule?
Circular and longitudinal fibers.
What are the circular fibers of the articular capsule called?
Zona orbicularis.
What do the circular fibers (zona orbicularis) form around the femur?
A collar around the neck of the femur.
What are the accessory ligaments that reinforce the longitudinal fibers of the articular capsule?
Iliofemoral ligament, pubofemoral ligament, and ischiofemoral ligament.
What is the iliofemoral ligament?
Thickened portion of the articular capsule that extends from the anterior inferior iliac spine of the hip bone to the intertrochanteric line of the femur.
What is said to be the body’s strongest ligament?
Iliofemoral ligament.
What does the iliofemoral ligament prevent?
Hyperextension of the femur at the hip joint during standing.
What is the pubofemoral ligament?
Thickened portion of the articular capsule that extends from the pubic part of the rim of the acetabulum to the neck of the femur.
What does the pubofemoral ligament prevent?
Overabduction of the femur at the hip joint.
What does the pubofemoral ligament strengthen?
The articular capsule.
What is the ischiofemoral ligament?
Thickened portion of the articular capsule that extends from the ischial wall bordering the acetabulum to the neck of the femur.
What happens to the ischiofemoral ligament during adduction?
It slackens.
What happens to the ischiofemoral ligament during abduction?
It tenses.
What does the ischiofemoral ligament strengthen?
The articular capsule.
What is the ligament of the head of the femur?
Flat, triangular band (primarily a synovial fold) that extends from the fossa of the acetabulum to the fovea capitis of the head of the femur.
What does the ligament of the head of the femur usually contain?
A small artery that supplies the head of the femur.
What is the acetabular labrum?
Fibrous cartilage rim attached to the margin of the acetabulum that enhances the acetabular ligament depth of the acetabulum.
What does the acetabular labrum help prevent?
Dislocation of the femur.
What is the transverse acetabular ligament?
Strong ligament that crosses over the acetabular notch.
What does the transverse acetabular ligament support?
Part of the acetabular labrum.
What is the transverse acetabular ligament connected with?
The ligament of the head of the femur and the articular capsule.
What movements does the hip joint allow?
Flexion, extension, abduction, adduction, lateral rotation, medial rotation, and circumduction of the thigh.
What contributes to the extreme stability of the hip joint?
The very strong articular capsule and its accessory ligaments, the manner in which the femur fits into the acetabulum, and the muscles surrounding the joint.
How do the shoulder and hip joints differ in terms of movement?
Although both are ball-and-socket joints, the hip joints do not have as wide a range of motion.
What limits flexion of the hip joint when the knee is flexed?
The anterior surface of the thigh coming into contact with the anterior abdominal wall.
What limits flexion of the hip joint when the knee is extended?
Tension of the hamstring muscles.
What limits extension of the hip joint?
Tension of the iliofemoral, pubofemoral, and ischiofemoral ligaments.
What limits abduction of the hip joint?
Tension of the pubofemoral ligament.
What limits adduction of the hip joint?
Contact with the opposite limb and tension in the ligament of the head of the femur.
What limits medial rotation of the hip joint?
Tension in the ischiofemoral ligament.
What limits lateral rotation of the hip joint?
Tension in the iliofemoral and pubofemoral ligaments.
is one of the strongest structures in the body.
articular capsule of the hip joint
What is the largest and most complex joint of the body?
The knee joint.
What type of joint is the knee joint?
A modified hinge joint.
Why is the knee joint considered a modified hinge joint?
Because its primary movement is a uniaxial hinge movement.
How many joints are within the single synovial cavity of the knee joint?
Three.
What is the lateral joint in the knee?
The tibiofemoral joint, between the lateral condyle of the femur, lateral meniscus, and lateral condyle of the tibia.
What is the medial joint in the knee?
Another tibiofemoral joint, between the medial condyle of the femur, medial meniscus, and medial condyle of the tibia.
What is the intermediate joint in the knee?
The patellofemoral joint, between the patella and the patellar surface of the femur.
allows flexion, extension, slight medial rotation, and lateral rotation of the leg in the flexed position
Knee joint
What is the structure that has no complete, independent capsule uniting the bones of the knee joint?
Articular capsule
What consists mostly of muscle tendons or their expansions and surrounds the knee joint?
Ligamentous sheath
What are the fused tendons of insertion of the quadriceps femoris muscle and the fascia lata that strengthen the anterior surface of the joint?
Medial and lateral patellar retinacula
What is the continuation of the common tendon of insertion of the quadriceps femoris muscle that extends from the patella to the tibial tuberosity?
Patellotibial ligament
What separates the posterior surface of the patellotibial ligament from the synovial membrane of the joint?
Infrapatellar fat pad
What is the broad, flat ligament that extends from the intercondylar fossa and lateral condyle of the femur to the head and medial condyle of the tibia?
Oblique popliteal ligament
What strengthens the posterior surface of the knee joint?
Oblique popliteal ligament
What extends from the lateral condyle of the femur to the styloid process of the head of the fibula?
Arcuate popliteal ligament
What strengthens the lower lateral part of the posterior surface of the knee joint?
Arcuate popliteal ligament
What is the broad, flat ligament on the medial surface of the knee joint that extends from the medial condyle of the femur to the medial condyle of the tibia?
Tibial collateral ligament
What three tendons cross the tibial collateral ligament and strengthen the medial aspect of the joint?
Sartorius, gracilis, and semitendinosus muscles
What is the strong, rounded ligament on the lateral surface of the knee joint that extends from the lateral condyle of the femur to the lateral side of the head of the fibula?
Fibular collateral ligament
What ligament is covered by the tendon of the biceps femoris muscle?
Fibular collateral ligament
What two ligaments within the fibrous layer of the articular capsule connect the tibia and femur?
Intracapsular ligaments
What are the names of the two intracapsular ligaments?
Anterior cruciate ligament (ACL) and Posterior cruciate ligament (PCL)
What ligament extends posteriorly and laterally from a point anterior to the intercondylar area of the tibia to the posterior part of the medial surface of the lateral condyle of the femur?
Anterior cruciate ligament (ACL)
What ligament limits hyperextension of the knee and prevents the anterior sliding of the tibia on the femur?
Anterior cruciate ligament (ACL)
What ligament is stretched or torn in about 70% of all serious knee injuries?
Anterior cruciate ligament (ACL)
Which gender is more prone to ACL injuries?
Females
What are possible reasons why females are more prone to ACL injuries?
Less space between femoral condyles, wider pelvis, hormonal factors, and lesser muscle strength
What ligament extends anteriorly and medially from a depression on the posterior intercondylar area of the tibia and lateral meniscus to the anterior part of the lateral surface of the medial condyle of the femur?
Posterior cruciate ligament (PCL)
What prevents the posterior sliding of the tibia and anterior sliding of the femur when the knee is flexed?
Posterior cruciate ligament (PCL)
What function of the PCL is crucial when walking down stairs or a steep incline?
Prevents posterior sliding of the tibia
What are the two fibrous cartilage discs between the tibial and femoral condyles?
Articular discs (menisci)
What helps compensate for the irregular shapes of the knee bones and circulates synovial fluid?
Articular discs (menisci)
What is the semicircular piece of fibrous cartilage attached to the anterior intercondylar fossa of the tibia?
Medial meniscus
What is the nearly circular piece of fibrous cartilage that approaches an incomplete O in shape?
Lateral meniscus
What ligament connects the anterior surfaces of the medial and lateral menisci?
Transverse ligament of the knee
What are the important bursae of the knee?
Prepatellar bursa, infrapatellar bursa, suprapatellar bursa
Where is the prepatellar bursa located?
Between the patella and skin
Where is the infrapatellar bursa located?
Between the superior part of the tibia and the patellar ligament
Where is the suprapatellar bursa located?
Between the inferior part of the femur and deep surface of the quadriceps femoris muscle
What is the joint most vulnerable to damage due to its mobility, weight-bearing function, and reliance on ligaments and muscles for stability?
Knee joint
Why is the knee joint particularly vulnerable to damage?
It is a mobile, weight-bearing joint, and its stability depends on ligaments and muscles.
What is lacking between the articulating bones of the knee joint that contributes to its vulnerability?
Complementary fit between the surfaces
What are some causes of a swollen knee?
Rupture of the anterior cruciate ligament, damage to synovial membranes, torn menisci, fractures, or collateral ligament sprains
What causes initial swelling in a knee injury?
Escape of blood from damaged blood vessels
What causes delayed swelling in a knee injury?
Excessive production of synovial fluid (water on the knee)
Why is the firm attachment of the tibial collateral ligament to the medial meniscus clinically significant?
Tearing of the ligament typically also results in tearing of the meniscus.
What sports are commonly associated with injuries to the tibial collateral ligament and medial meniscus?
Football and rugby
What type of force may tear the anterior cruciate ligament?
A blow from the lateral side while the foot is fixed on the ground
What is the term for a knee injury that involves damage to the tibial collateral ligament, medial meniscus, and anterior cruciate ligament?
Unhappy triad
What is a dislocated knee?
Displacement of the tibia relative to the femur
What is the most common type of knee dislocation?
Anterior dislocation due to hyperextension of the knee
What is a frequent consequence of a dislocated knee?
Damage to the popliteal artery
What does PRICE stand for in the treatment of knee injuries?
Protection, Rest, Ice, Compression, and Elevation
What additional treatments may be required for knee injuries besides PRICE?
Strengthening exercises and physical therapy
What usually results in decreased production of synovial fluid in joints?
Aging
What happens to articular cartilage with age?
It becomes thinner.
What changes occur in ligaments due to aging?
They shorten and lose some flexibility.
What factors influence the effects of aging on joints?
Genetic factors and wear and tear
At what age may degenerative changes in joints begin?
As early as age 20
By what age do almost all individuals develop some type of joint degeneration?
Age 80
Which joints commonly experience degeneration due to aging?
Knees, elbows, hips, and shoulders
What degenerative changes in the vertebral column are common in elderly individuals?
Hunched-over posture and pressure on nerve roots
What type of arthritis is at least partially age-related?
Osteoarthritis
By what age does nearly everyone show evidence of osteoarthritic changes?
Over age 70
What types of exercises help minimize the effects of aging on joints?
Stretching and aerobic exercises
What aspects of joint function do stretching and aerobic exercises help maintain?
Ligaments, tendons, muscles, synovial fluid, and articular cartilage
What is the surgical procedure for replacing severely damaged joints with artificial joints?
Arthroplasty
What conditions can lead to the need for arthroplasty?
Arthritis or injury
What does the term ‘arthroplasty’ mean?
Plastic repair of a joint
Which joints are most commonly replaced through arthroplasty?
Hips, knees, and shoulders
How many hip replacements are performed annually in the United States?
About 400,000
How many knee replacements are performed annually in the United States?
About 300,000
What materials are used to replace the ends of damaged bones in arthroplasty?
Metal, ceramic, or plastic
What are the two main goals of arthroplasty?
To relieve pain and increase range of motion
What do partial hip replacements involve?
Only the femur
What do total hip replacements involve?
Both the acetabulum and head of the femur
What are the damaged portions of the hip replaced with during hip replacement surgery?
Prefabricated prostheses (artificial devices)
What steps are involved in a total hip replacement?
The acetabulum is shaped to accept the new socket, the head of the femur is removed, and the center of the femur is shaped to fit the femoral component.
What material is the acetabular component made of?
Plastic such as polyethylene
What material is the femoral component made of?
Metal such as cobalt-chrome, titanium alloys, or stainless steel
Why are the materials used in hip replacements specifically chosen?
To withstand a high degree of stress and to prevent a response by the immune system
How are the acetabular and femoral components attached to the bone?
With acrylic cement, which forms an interlocking mechanical bond
What does a knee replacement actually resurface?
Cartilage
What are the two types of knee replacements?
Partial and total
What parts are removed in a total knee replacement?
Damaged cartilage from the distal end of the femur, proximal end of the tibia, and back surface of the patella (if badly damaged)
What is the femur fitted with in a total knee replacement?
A metal femoral component cemented in place
What is the tibia fitted with in a total knee replacement?
A plastic tibial component cemented in place
When is a plastic patellar implant used in a total knee replacement?
If the back surface of the patella is badly damaged
What is another name for a partial knee replacement?
Unicompartmental knee replacement
What parts are replaced in a partial knee replacement?
Only one side of the knee joint
What is the tibia fitted with in a partial knee replacement?
A plastic tibial component cemented in place
What are researchers seeking to improve in knee replacements?
Strength of cement and ways to stimulate bone growth around the implanted area
What are potential complications of arthroplasty?
Infection, blood clots, loosening or dislocation of components, and nerve injury
What might happen due to increased sensitivity of metal detectors?
Metal joint replacements may activate metal detectors
damaged portions of the acetabulum and the head of the femur are replaced by prostheses.
total hip replacement
What is rheumatism?
Any painful disorder of the supporting structures of the body—bones, ligaments, tendons, or muscles—that is not caused by infection or injury
What is arthritis?
A form of rheumatism in which the joints are swollen, stiff, and painful
How many people in the United States are afflicted by arthritis?
About 54 million
What is the leading cause of physical disability among adults over age 65?
Arthritis
What is osteoarthritis (OA)?
A degenerative joint disease in which joint cartilage is gradually lost
What causes osteoarthritis?
Aging, obesity, irritation of the joints, muscle weakness, and wear and abrasion
What is another name for osteoarthritis?
Wear-and-tear arthritis
What is the most common type of arthritis?
Osteoarthritis
What type of joints does osteoarthritis primarily affect?
Synovial joints, particularly weight-bearing joints
What happens to articular cartilage in osteoarthritis?
It deteriorates, and new bone forms in the subchondral areas and at the margins of the joint
What are spurs in osteoarthritis?
Small bumps of new osseous tissue deposited on bone ends
How do spurs affect joint movement?
They decrease the space of the articular cavity and restrict movement
What is a key difference between osteoarthritis and rheumatoid arthritis?
Osteoarthritis affects larger joints (knees, hips) and is due to wear and tear, while rheumatoid arthritis first affects smaller joints (hands, feet) and actively attacks cartilage
What is the most common reason for hip- and knee-replacement surgery?
Osteoarthritis
What is rheumatoid arthritis (RA)?
Rheumatoid arthritis (RA) is an autoimmune disease in which the immune system of the body attacks its own tissues— in this case, its own cartilage and joint linings.
What characterizes RA?
RA is characterized by inflammation of the joint, which causes swelling, pain, and loss of function.
How does RA usually occur?
RA usually occurs bilaterally: If one hand is affected, the other is also likely to be affected, although they are often not affected to the same degree.
What is the primary symptom of RA?
The primary symptom of RA is inflammation of the synovial membrane.
What happens if RA is untreated?
If RA is untreated, the synovial membrane thickens, and synovial fluid accumulates. The resulting pressure causes pain and tenderness.
What abnormal granulation tissue does the synovial membrane produce?
The synovial membrane produces an abnormal granulation tissue called pannus, that adheres to the surface of the articular cartilage and sometimes erodes the cartilage completely.
What happens when the cartilage is destroyed in RA?
When the cartilage is destroyed, fibrous tissue joins the exposed bone ends.
What does the fibrous tissue do over time in RA?
The fibrous tissue ossifies and fuses the joint so that it becomes immovable— the ultimate crippling effect of RA.
What causes the distortion of fingers in RA sufferers?
Growth of the granulation tissue causes the distortion of the fingers that characterizes the hands of RA sufferers.
What is uric acid?
Uric acid is a waste product produced during the metabolism of nucleic acid (DNA and RNA) subunits.
What does a person who suffers from gout experience?
A person who suffers from gout either produces excessive amounts of uric acid or is not able to excrete as much as normal.
What is the result of excessive uric acid in the blood?
The result is a buildup of uric acid in the blood.
With what does uric acid react to form a salt?
Uric acid reacts with sodium to form a salt called sodium urate.
Where do sodium urate crystals accumulate?
Sodium urate crystals accumulate in soft tissues such as the kidneys and in the cartilage of the ears and joints.
What is gouty arthritis?
Gouty arthritis is when sodium urate crystals are deposited in the soft tissues of the joints.
Which joints are most often affected by gout?
Gout most often affects the joints of the feet, especially at the base of the great (big) toe.
What do sodium urate crystals do to the cartilage?
Sodium urate crystals irritate and erode the cartilage, causing inflammation, swelling, and acute pain.
What happens to the joint if gout is untreated?
If gout is untreated, the ends of the articulating bones fuse, and the joint becomes immovable.
What is the first step in the treatment of gout?
The first step in the treatment of gout consists of pain relief using ibuprofen, naproxen, colchicine, and cortisone.
What medication is used to keep uric acid levels low?
Allopurinol is administered to keep uric acid levels low so that crystals do not form.
What is the spiral-shaped bacterium that causes Lyme disease?
Borrelia burgdorferi causes Lyme disease.
Why is Lyme disease named as such?
Lyme disease is named for the town of Lyme, Connecticut, where it was first reported in 1975.
How is Borrelia burgdorferi transmitted to humans?
Borrelia burgdorferi is transmitted to humans mainly by deer ticks (Ixodes dammini).
Why do deer tick bites often go unnoticed?
Deer ticks are so small that their bites often go unnoticed.
What may appear within a few weeks of a tick bite?
Within a few weeks of a tick bite, a rash may appear at the site.
What does the rash associated with Lyme disease often resemble?
The rash often resembles a bull’s-eye target, but there are many variations, and some people never develop a rash.
What are some other symptoms of Lyme disease?
Other symptoms include joint stiffness, fever and chills, headache, stiff neck, nausea, and low back pain.
In advanced stages of Lyme disease, what is the main complication?
In advanced stages, arthritis is the main complication.
Which joints are usually affected by arthritis in Lyme disease?
Arthritis in Lyme disease usually afflicts the larger joints such as the knee, ankle, hip, elbow, or wrist.
What is the treatment for Lyme disease?
Antibiotics are generally effective against Lyme disease, especially if they are given promptly.
Can symptoms of Lyme disease persist even after treatment?
Yes, some symptoms may linger for years even after treatment.
What is a sprain?
A sprain is the forcible wrenching or twisting of a joint that stretches or tears its ligaments but does not dislocate the bones.
When does a sprain occur?
A sprain occurs when the ligaments are stressed beyond their normal capacity.
Why are severe sprains so painful?
Severe sprains may be so painful that the joint cannot be moved.
What causes considerable swelling in a sprain?
Swelling results from chemicals released by the damaged cells and hemorrhage of ruptured blood vessels.
Which joint is most often sprained?
The lateral ankle joint is most often sprained.
What is another frequently sprained area besides the lateral ankle joint?
The wrist is another area that is frequently sprained.
What is a strain?
A strain is a stretched or partially torn muscle or muscle and tendon.
When does a strain often occur?
A strain often occurs when a muscle contracts suddenly and powerfully, such as the leg muscles of sprinters when they spring from the blocks.
What is the initial treatment for sprains?
Initially, sprains should be treated with PRICE: Protection, Rest, Ice, Compression, and Elevation.
What other conditions may PRICE therapy be used for?
PRICE therapy may also be used on muscle strains, joint inflammation, suspected fractures, and bruises.
What does Protection mean in PRICE therapy?
Protection means protecting the injury from further damage, such as stopping the activity and using padding, protection, splints, a sling, or crutches if necessary.
Why is Rest important in PRICE therapy?
Rest is needed to avoid further damage to tissues and to allow repair. Exercising before an injury has healed may increase the probability of re-injury.
What is the purpose of Ice in PRICE therapy?
Ice slows blood flow, reduces swelling, and relieves pain.
What is the recommended ice application method?
Ice should be applied for 20 minutes, off for 40 minutes, then back on for 20 minutes.
How does Compression help in PRICE therapy?
Compression by wrap or bandage helps to reduce swelling, but care must be taken not to block blood flow.
Why is Elevation recommended in PRICE therapy?
Elevation of the injured area above the level of the heart helps to reduce potential swelling.
What is tenosynovitis?
Tenosynovitis is an inflammation of the tendons, tendon sheaths, and synovial membranes surrounding certain joints.
Which tendons are most often affected by tenosynovitis?
The tendons most often affected are at the wrists, shoulders, elbows (resulting in tennis elbow), finger joints (resulting in trigger finger), ankles, and feet.
Why do the affected sheaths sometimes become visibly swollen?
The affected sheaths sometimes become visibly swollen because of fluid accumulation.
What symptoms are frequently associated with tenosynovitis?
Tenderness and pain are frequently associated with movement of the body part.
What are common causes of tenosynovitis?
Tenosynovitis often follows trauma, strain, or excessive exercise.
How can tenosynovitis of the dorsum of the foot occur?
Tenosynovitis of the dorsum of the foot may be caused by tying shoelaces too tightly.
Why are gymnasts prone to developing tenosynovitis?
Gymnasts are prone to developing tenosynovitis as a result of chronic, repetitive, and maximum extension at the wrists.
What other repetitive movements can result in tenosynovitis?
Repetitive movements involving activities such as typing, haircutting, carpentry, and assembly line work can also result in tenosynovitis.
What is a dislocation or luxation?
A dislocation or luxation is the displacement of a bone from a joint with tearing of ligaments, tendons, and articular capsules.
What is a dislocated mandible?
A dislocated mandible occurs when the condylar processes of the mandible pass anterior to the articular tubercles.
What is the most common type of mandibular dislocation?
Anterior displacements are the most common type of mandibular dislocation.
What are common causes of anterior displacement of the mandible?
Common causes of anterior displacement are extreme mouth opening, as in yawning or taking a large bite, dental procedures, or general anesthesia.
What can cause a posterior displacement of the mandible?
A posterior displacement can be caused by a direct blow to the chin.
What can cause a superior displacement of the mandible?
A superior displacement is typically caused by a direct blow to a partially opened mouth.
What are lateral dislocations of the mandible usually associated with?
Lateral dislocations are usually associated with mandibular fractures.
Pain in a joint.
arthralgia
Removal of a bursa
Bursectomy
Inflammation of cartilage.
Chondritis
A partial or incomplete dislocation.
Subluxation
Inflammation of a synovial membrane in a joint
Synovitis
