Test #5 - Class 8: Articulations; Class 9: Articulations, Movements and Ligaments Flashcards
How many ways can joints (articulations) be classified?
2 ways to classify
What are the 2 ways joints (articulations) can be classified?
- By function; and 2. By structure
What does it mean to classify a joint (articulation) by function?
“How much movement is possible”
What does it mean to classify a joint (articulation) by structure?
“What holds the bones together”
How many functional joint classifications are there?
3 functional joint classifications
What are the 3 functional joint classifications to describe how much movement is possible?
- Synarthroses; 2. Amphiarthroses; and 3. Diarthroses
Functional Joint Classification: Synarthroses
A synarthrotic joint is an immoveable joint
e.g. sutures, sternum + 1st rib, distal tibia + fibula
Functional Joint Classification: Amphiarthroses
An amphiarthrotic joint is a slightly moveable joint.
e.g. sacroiliac joint [SI joint], pubic symphysis, intervertebral [between bodies]
Functional Joint Classification: Diarthroses
A diarthrotic joint is a freely moveable joint.
e.g. All other joints in the body
How many structural joint classifications are there?
3 structural joint classifications
What are the 3 structure joint classifications to describe what holds bones together?
- Fibrous; 2. Cartilaginous; and 3. Synovial
Structural Joint Classification: Fibrous
Dense, strong connective tissue.
No space between bones.
(e.g. sutures)
Structural Joint Classification: Cartilaginous
Cartilage.
No space between bones.
(e.g. intervertebral, pubic symphysis)
Structural Joint Classification: Synovial
Joint capsule (Articular capsule)
There is a space between the bones.
(e.g. All other joints in the body)
What are the most important joints in Massage Therapy?
- Diarthroses (diarthrotic); and 2. Synovial
Freely moveable with a joint capsule and a space between the bones.
How many structures make up a typical synovial joint?
5 structures or parts
What are the 5 structures or parts that make up a typical synovial joint?
- Articulating bones; 2. Articular cartilage; 3. Fibrous capsule; 4. Synovial membrane; and 5. Joint cavity
Structure of a Synovial Joint: Articular Cartilage
Hyaline cartilage which covers the ends of bones where they come together to form a joint. This reduces friction and allows for some shock absorbency.
What is osteoarthritis?
When articular cartilage fragments or wears away through repetitive movement where the bones are rubbing together.
Structure of a Synovial Joint: Articular Capsule
A sleeve of connective tissue which is attached to articulating bones to surround the joint to protect the joint and bathe the joint in synovial fluid.
How many layers make up the articular capsule?
2 layers
What are the 2 layers that make up the articular capsule?
- Fibrous capsule; and 2. Synovial membrane
Structure of a Synovial Joint: Fibrous Capsule
The outer layer of the joint capsule. It’s dense and helps to hold bones together and protects the joint. It “weaves” into the periosteum.
Structure of a Synovial Joint: Synovial Membrane
The inner lining of the joint capsule. Made up of fatty connective tissue and elastic fibers. It produces synovial fluid.
What is rheumatoid arthritis?
An autoimmune disease of the synovial membrane that causes too little or too much synovial fluid.
Structure of a Synovial Joint: Synovial Fluid
A byproduct of blood. A clear fluid, made up of mostly water, electrolytes (salts), proteins (helps with thickening), nutrients, waste product, and hormones. Has the consistency of uncooked egg whites.
How many functions does synovial fluid have?
2 functions
What are the 2 functions of synovial fluid?
- Bathes the joint. Supplies it with nutrients and removes metabolic waste.
- Reduces friction and allows for articulating bones to move within this friction free environment.
Structure of a Synovial Joint: Reinforcing Ligaments
Along with holding bones together they reinforce or strengthen the joint capsule.
Structure of a Synovial Joint: Ligament
Parallel arranged collagen and elastic fibers which attach bone to bone. Ligaments weave into the periosteum.
Collagen for strength. Elastic for flexibility.
How many functions of ligaments?
4 functions
What are the 4 functions of ligaments?
- Joint stability; 2. Maintain postural stability; 3. Guide movement of a joint; and 4. Prevent muscles from being overstretched
What is ligament laxity?
Overstretched ligaments.
Structure of a Synovial Joint: Articular Discs (Menisci)
Are present in some synovial joints.
Fibrocartilaginous discs which sit between the bones of some synovial joints.
e.g. knee, TMJ, distal ulna
How many functions of articular discs (menisci)?
2 functions
What are the 2 functions of articular discs (menisci)?
- Helps oddly shaped bones to fit more snugly; and 2. Shock absorbency
Structure of a Synovial Joint: Bursae
Are often found surrounding synovial joints.
A connective tissue sac filled with synovial fluid in places where soft tissue rubs against bone.
What is bursitis?
Inflammation of a bursa.
What is a bunion?
Calcified bursitis.
How many different movements are possible at synovial joints?
22 movements
What are the 22 movements possible at synovial joints?
1-2. Flexion/Extension; 3. Lateral flexion at neck or waist; 4-5. ABduction/ADduction; 6. Rotation; 7-8. Medial (Internal) Rotation/Lateral (External) Rotation at the hip or shoulder; 9. Circumduction; 10-11. Inversion (Supination)/Eversion (Pronation) of the foot at the ankle; 12-13. Plantarflexion/Dorsiflexion of the foot at the ankle; 14-15. Protraction (ABduction)/Retraction (ADduction) of the scapula/mandible; 16-17. Elevation/Depression of the scapula/mandible; 18-19. Supination/Pronation of the forearm at the elbow; 20-21. Radial Deviation/Ulnar Deviation of the hand at the wrist; 22. Opposition of the thumb
Movement: Flexion
Occurs when the angle between articulating surfaces is decreased. In the fetal position, the body is in flexion.
Movement: Lateral Flexion
Occurs when the angle between articulating surfaces decreases in a lateral plane. This only occurs at the neck and waist.
Movement: Extension
Occurs when the angle between articulating surfaces is increased. In anatomical position, the body is in extension. Extension may occur when the body returns to anatomic position from a flexed position.
Hyperextension is used to describe a joint position which is past anatomic position. The movement is still considered extension but the position is considered hyperextension.
Movement: ABduction
Is the movement of the body part away from the midline.
“ABduct away”
Movement: ADduction
Is the movement of the body part towards the midline.
“ADd toward”
Movement: Rotation
Is movement of a body part around its own linear axis (imagine putting a string through the length of bone and then rotating the bone around the string).
Movement: Medial (Internal) Rotation
Is when the anterior surface of the body part moves towards the midline. Occurs only at the hip and shoulder.
Movement: Lateral (External) Rotation
Is when the anterior surface of the body part moves away from the midline. Occurs only at the hip and shoulder.
Movement: Circumduction
Occurs when the proximal end of the body part remains stable and the distal end makes a circular movement. Circumduction is the combination of flexion, extension, aBduction and aDduction.
How many special movements of the thigh at the hip and the arm at the shoulder shoulder are there?
2 movements
What are the 2 special movements of the thigh at the hip and the arm at the shoulder?
Medial and Lateral Rotation
How many special movements of the foot at the ankle?
4 movements
What are the 4 special movements of the foot at the ankle?
- Inversion (Supination); 2. Eversion (Pronation); 3. Plantarflexion; and 5. Dorsiflexion
Movement: Inversion (Supination)
Occurs when the sole of the foot faces inward, toward the midline of the body.
Movement: Eversion (Pronation)
Occurs when the sole of the foot faces outward, away from the midline of the body.
Movement: Plantarflexion
Occurs when the foot moves downward, toes pointing away from the head.
“Plant your foot on the gas pedal.”
Movement: Dorsiflexion
Occurs when the foot moves upward, toes pointing toward the head.
How many special movements of the scapula and mandible at the TMJ?
4 movements
What are the 4 special movements of the scapula and mandible at the TMJ?
- Protraction (ABduction); 2. Retraction (ADduction); 3. Elevation; and 4. Depression
Movement: Protraction (ABduction)
Occurs when the scapula moves away from the midline of the body or when the mandible is jutted forward away from the body.
Movement: Retraction (ADduction)
Occurs when the scapula moves toward the midline of the body or when the mandible is in anatomical position.
Movement: Elevation
Occurs when the scapula is moved toward the ears or when the mandible is closed.
Movement: Depression
Occurs when the scapula moves downward away from the head or when the mandible is open.
How many special movements of the forearm at the elbow?
2 movements
What are the 2 special movements of the forearm at the elbow?
- Supination; and 2. Pronation
Only occurs during flexion.
Movement: Supination
Occurs when the palm is facing upward or anteriorly.
Movement: Pronation
Occurs when the palm is facing downward or posteriorly.
How many special movements of the hand at the wrist?
2 movements
What are the 2 special movements of the hand at the wrist?
- Radial Deviation; and 2. Ulnar Deviation
Movement: Radial Deviation
Hand deviates at the wrist with the thumb leading laterally.
Movement: Ulnar Deviation
Hand deviates at the wrist with the small finger leading medially.
How many special movements of the thumb?
1 movement
What is the special movement of the thumb?
Opposition
Movement: Opposition
Occurs when the thumb moves toward the small finger.
How many types of synovial joints?
6 types
What are the 6 types of synovial joints?
- Plane or gliding joints; 2. Hinge joints; 3. Pivot joints; 4. Condylar (ellipsoidal) joints; 5. Saddle joint (modified ellipsoidal); and 6. Ball and socket joint
Synovial Joint: Plane or Gliding
Permits the simplest kind of movement: side to side, and back and forth
e.g. carpals, tarsals and ribs/vertebrae
Synovial Joint: Hinge
Permits movement similar to a hinged door; flexion and extension
e.g. elbow (ulna & humerus)
Synovial Joint: Pivot
Permit rotation
e.g. atlantoaxial (C1-C2), radioulnar
Synovial Joint: Condylar (Ellipsoidal)
Permit flexion and extension, radial deviation (aBduction), ulnar deviation (aDduction) and circumduction.
e.g. wrist (distal radius with scaphoid & lunate)
Synovial Joint: Saddle (modified ellipsoidal)
Permit flexion, extension, aDduction, ABduction, circumduciton and opposition
e.g. thumb (trapezium and 1st metacarpal)
Synovial Joint: Ball and Socket
Permits the most movement: flexion, extension, aBduction, aDduction, medial and lateral rotation and circumduction
e.g. hip joint (femur & acetabulum of coxal), shoulder (humerus into glenoid cavity of scapula)
Neck Joint: Bones
Occiput (occipital) of skull + C1-C7 cervical vertebrae
Neck Joint: Movements Possible
Flexion/Extension
Lateral Flexion
Rotation
Circumduction
Neck Joint: Proper Terms
Head at neck
Neck Joint: Type(s) of Joint
Plane or gliding joint
Shoulder Joint: Bones
Head of humerus + glenoid cavity of scapula
Shoulder Joint: Movements Possible
Flexion/Extension
Medial/Lateral Rotation
ABduction/ADduction
Circumduction
Shoulder Joint: Proper Terms
Arm at shoulder
Shoulder Joint: Type(s) of Joint
Ball & Socket
Elbow Joint: Bones
Distal humerus + proximal ulna + proximal radius
Elbow Joint: Movements Possible
Flexion/Extension
Pronation/Supination
Elbow Joint: Proper terms
Forearm at elbow
Elbow Joint: Type(s) of Joint
Hinge (flexion/extension)
Pivot (pronation/supination)
Wrist Joint: Bones
Distal radius + scaphoid & lunate carpals
Wrist Joint: Movements Possible
Flexion/Extension
Radial/Ulnar Deviation
Circumduction
Wrist Joint: Proper Terms
Hand at wrist
Wrist Joint: Type(s) of Joint
Condylar
Finger (Hand/Finger) Joint: Bones
Metacarpals + phalanges
Finger (Hand/Finger) Joint: Movements Possible
Flexion/Extension
ABduction/ADduction
Circumduction
Finger (Hand/Finger) Joint: Proper Terms
Phalanges or digits
Finger (Hand/Finger) Joint: Type(s) of Joint
Condylar
Finger (Finger/Finger) Joint: Bones
Phalanges to phalanges
Finger (Finger/Finger) Joint: Movements Possible
Flexion/Extension
Finger (Finger/Finger) Joint: Proper Terms
Phalanges or digits
Finger (Finger/Finger) Joint: Type(s) of Joint
???
Waist Joint: Bones
L1-L5 lumbar vertebrae
Waist Joint: Movements Possible
Flexion/Extension
Lateral Flexion
Rotation
Circumduction
Same as neck but less range of motion.
Waist Joint: Proper Terms
Trunk or torso at waist
Waist Joint: Type(s) of Joint
Plane or gliding
Hip Joint: Bones
Head of femur + acetabulum of coxal
Hip Joint: Movements Possible
Flexion/Extension
Medial/Lateral Rotation
ABduction/ADduction
Circumduction
Same as shoulder but less range of motion.
Hip Joint: Proper Terms
Thigh at the hip
Hip Joint: Type(s) of Joint
Ball & Socket
Knee Joint: Bones
Distal femur + proximal tibia + patella
Knee Joint: Movements Possible
Flexion/Extension
Knee Joint: Proper Terms
Leg at knee
Ankle Joint: Bones
Distal tibia + distal fibula + talus tarsal
Ankle Joint: Movements Possible
Dorsiflexion/Plantarflexion
Eversion/Inversion
Circumduction
Ankle Joint: Proper Terms
Foot at ankle
Toe (Foot/Toe) Joint: Bones
Metatarsals to Phalanges
Toe (Foot/Toe) Joint: Movements Possible
Flexion/Extension
ABduction/ADduction
Circumduction
Same as fingers.
Toe (Foot/Toe) Joint: Proper Terms
Phalanges or digits
Toe (Toe/Toe) Joint: Bones
Phalanges to Phalanges
Toe (Foot/Toe) Joint: Movements Possible
Flexion/Extension
Same as fingers.
Toe (Foot/Toe) Joint: Proper Terms
Phalanges or digits
How many major ligaments in the neck joint?
1 major ligament
What is the 1 major ligament in the neck joint?
Ligamentum Nuchae (Nuchal Ligament)
Major Ligament: Ligamentum Nuchae (Nuchal Ligament)
Runs from the External Occipital Protuberance (EOP) of the occipital bone to the spinous process of the thoracic vertebra T1. Attachment point for muscles.
How many major ligaments in the shoulder joint?
4 major ligaments
What are the 4 major ligaments of the shoulder joint?
- Acromioclavicular ligament; 2. Coracoclavicular ligament; 3. Coracoacromial ligament; and 4. Transverse humeral ligament
Major Ligament: Acromioclavicular Ligament
(AC ligament) Runs from the acromion of the scapula to the clavicle. This is the location of injury with a shoulder separation.
Major Ligament: Coracoclavicular Ligament
Runs from the coracoid process of the scapula to the clavicle.
Major Ligament: Coracoacromial Ligament
Runs from the scapula’s coracoid process to the acromion.
Major Ligament: Transverse Humeral Ligament
Runs over the bicipital groove from the greater to the lesser tubercle on the humerus.
What is the function of the transverse humeral ligament?
To hold the bicep tendon in place.
Shoulder Joint
Ball & Socket Joint
Sacrificed stability for greater range of motion.
Allows all ranges of motion.
It is less stable because the glenoid cavity is shallow (dislocations can happen more easily).
Most of the shoulder ligaments are anteriorly located.
Major Ligament: Inguinal Ligament
Runs from the coxal’s ASIS (ilium) to the pubic symphysis (pubis). Attachment site for abdominal muscle. Forms the roof of the femoral triangle. Also, lymph nodes are located here. Precautionary area for massage therapy.
Major Ligament: Sacrotuberous Ligament
Runs from the sacrum to the ischial tuberosity. Deep to gluteus maximus. Stabilizes the pelvis.
Major Ligament: Posterior Sacroiliac Ligament
Located on the posterior sacrum. Attaches the sacrum to the ilium of the coxal bone. Lies superficial to SI joint.
How many major ligaments of the hip joint?
3 major ligaments
What are the 3 major ligaments of the hip joint?
- Iliofemoral ligament; 2. Ischiofemoral ligament; and 3. pubofemoral ligament
Major Ligament: Iliofemoral Ligament
Runs from the ilium to the femur.
Major Ligament: Ischiofemoral Ligament
Runs from the ischium to the femur.
Major Ligament: Pubofemoral Ligament
Runs from the pubis to the femur.
Hip Joint
Ball & Socket joint.
Allows for greater range of motion, but not as much as the shoulder.
Reasons for less range of motion:
1. Head of femur sits deeply within the acetabulum.
2. Ligaments surround the hip joint in a corkscrew pattern.
How many major ligaments of the knee joint?
5 major ligaments + 2 menisci
What are the 5 major ligaments and 2 menisci of the knee joint?
- Medial Meniscus; 2. Lateral Meniscus; 3. Tibial (or Medial) Collateral Ligament (MCL); 4. Fibular (or Lateral) Collateral Ligament (LCL); 5. Anterior Cruciate Ligament (ACL); 6. Posterior Cruciate Ligament (PCL); and 7. Patellar Ligament.
Major Menisci: Medial Meniscus
Lies between the medial femoral and tibial condyles.
Major Menisci: Lateral Meniscus
Lies between the lateral femoral and tibial condyles.
Major Ligament: Medial (or Tibial) Collateral Ligament
The MCL runs from the medial epicondyle of femur to the medial condyle of the tibia
Major Ligament: Lateral (or Fibular) Collateral Ligament
The LCL runs from the lateral epicondyle of femur to the head of the fibula.
What prevents rotation of the tibia against the femur?
The Medial (or Tibial) Collateral Ligament (MCL) + Lateral (or Fibular) Collateral Ligament (LCL)
Major Ligament: Anterior Cruciate Ligament
The ACL forms an “X” inside the knee joint.
Major Ligament: Posterior Cruciate Ligament
The PCL forms an “X” inside the knee joint.
What prevents displacement of the tibia (forward or backward) against the femur?
Anterior Cruciate Ligament (ALC) + Posterior Cruciate Ligament (PCL)
Major Ligament: Patellar Ligament
Runs from the patella to the tibial tuberosity. Distal attachment for quadriceps.
How many major ligaments of the ankle joint?
2 major ligaments
What are the 2 major ligaments for the ankle joint?
- Medial (or Deltoid) Ligament; and 2. Lateral Ligament
Major Ligament: Deltoid (or Medial) Ligament
Runs from the medial malleolus of the tibia to the tarsal bones.
Major Ligament: Lateral Ligament
Runs from the lateral malleolus of the fibula to the tarsal bones.
Ankle Joint
Most commonly sprained joint in the body.
Of all ankle sprains, 90% involve the lateral ligament.
Deltoid (or Medial) ligament is much more dense and the bone structure prevents inversion; eversion movement is much greater.
Define a ligament
Parallel arranged collagen (for stength) and elastic (for flexibility) fibers which attach bone to bone. Ligaments weave into the periosteum.
Name the parts of a typical synovial joint
- Articulating bones; 2. Articular cartilage; 3. Fibrous capsule; 4. Synovial Membrane; and 5. Joint Cavity filled with synovial fluid
The ligamentum nuchae runs from where to where?
From the EOP to the spinous process of T1
What is the name of the ligament crossing the bicipital groove? What is its function?
Transverse humeral ligament. To hold the bicep tendon in place.
What type of joint is the shoulder? The hip? The knee? The elbow?
Shoulder: Ball & Socket
Hip: Ball & Socket
Knee: Hinge & Plane
Elbow: Hinge & Pivot
Knee Joint: Type(s) of Joint
Hinge (femur + tibia)
Plane or Gliding (patella)
Why is the range of motion greater at the shoulder than at the hip?
Humerus sits in the shallow glenoid cavity; head of femur sits deep in the acetabulum. Most ligaments are anteriorly located on shoulder; ligaments surround the hip in a corkscrew pattern.
What is the name of the ligament running from the ASIS to the Pubis?
Inguinal Ligament
What is the function of the sacrotuberous ligament?
Stabalizes the pelvis.
What is the most commonly sprained joint in the body?
Ankle
What is the name of the ligaments in the knee that resemble an “X” pattern?
Anterior and Posterior Cruciate Ligaments (ACL & PCL)
What is the function of a meniscus?
It helps oddly shaped bones to fit together more snugly and provides shock absorbency.
Name the two ligaments on either side of the knee.
Medial (tibial) and lateral (fibular) collateral ligaments (MCL and LCL)
What is the largest joint in the body?
Knee (by surface area)
What is the name of the ligament on the medial side of the ankle?
Medial (or deltoid) ligament
What is the name of the ligament on the lateral side of the knee?
Lateral (or fibular) collateral ligament (LCL)
