Joints Joints and Their Classification - PowerPoint Presentation

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Joints Joints and Their Classification - PPT Presentation

bony joints fibrous joints cartilaginous joints Synovial Joints general anatomy joints and lever systems movements of synovial joints Anatomy of Selected Diarthroses jaw joint shoulder joint ID: 775474

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Slide1

Joints

Joints and Their Classification

bony joints

fibrous joints

cartilaginous joints

Synovial Joints

general anatomy

joints and lever systems

movements of synovial joints

Anatomy of Selected Diarthroses

jaw joint

shoulder joint

elbow joint

hip joint

knee joint

ankle

Slide2

9-2

Joints (Articulations)

joint (articulation)

– any point where two bones meet, whether or not the bones are movable at that interface

arthrology

– science of joint structure, function, and dysfunction

kinesiology

– the study of musculoskeletal movement

a branch of

biomechanics

– deals with a broad variety of movements and mechanical processes in the body, including the physics of blood circulation, respiration, and hearing

Slide3

9-3

Joints and Their Classification

joint name

– typically derived from the names of the bones involved

atlanto-occipital joint, glenohumeral joint, radioulnar joint

joints classified

according to the manner in which the adjacent bones are bound to each other, with differences in how freely the bones can move

four major

joint categories:

bony joints

fibrous joints

catilaginous joints

synovial joints

Slide4

9-4

Bony Joint (Synostosis)

bony joint,

synostosis

–

an immovable joint formed when the gap between two bones ossify, and they become in effect, a single bone

frontal and mandibular bones in infants

cranial sutures in elderly

attachment of first rib and sternum with old age

can occur in either fibrous or cartilaginous joint

Slide5

9-5

Fibrous Joints (Synarthrosis)

fibrous joint, synarthrosis, or synarthrodial joint

– a point at which adjacent bones are bound by collagen fibers that emerge from one bone, cross the space between them, and penetrate into the other

three kinds of fibrous joints

sutures

gomphoses

syndesmoses

Slide6

sutures - immovable or slightly movable fibrous joints that closely bind the bones of the skull to each othersutures can be classified as:serrate – interlocking wavy linescoronal, sagittal and lambdoid sutureslap (squamous)- overlapping beveled edgestemporal and parietal bonesplane (butt)- straight, nonoverlapping edgespalatine processes of the maxillae

Fibrous Joints - Sutures

Fibrous connective tissue

Slide7

Types of Sutures

Wood

Dovetail joint

Miter joint

Butt joint

Bone

Serrate suture

Lap suture

Plane suture

Figure 9.3

Slide8

9-8

Fibrous Joint - Gomphoses

gomphosis - attachment of a tooth to its socket held in place by fibrous periodontal ligamentcollagen fibers attach tooth to jawboneallows the tooth to move a little under the stress of chewing

Fibrous connective tissue

(b) Gomphosis

Figure 9.2b

Slide9

9-9

syndesmosis – a fibrous joint at which two bones are bound by longer collagenous fibers than in a suture or gomphosis giving the bones more mobilityinterosseus membranemost movable syndesmosisinterosseus membranes unite radius to ulna allowing supination and pronation less movable syndesmosis tibia to fibula

Fibrous Joint - Syndesmosis

Fibrous connective tissue

Figure 9.2c

Slide10

9-10

Cartilaginous Joints

cartilaginous joint, amphiarthrosis

amphiarthrodial joint

– two bones are linked by cartilage

two types

of cartilaginous joints

synchondroses

symphyses

Slide11

9-11

Cartilaginous Joint - Synchondrosis

synchrondrosis - bones are bound by hyaline cartilagetemporary joint in the epiphyseal plate in children binds epiphysis and diaphysisfirst rib attachment to sternumother costal cartilages are joined to sternum by synovial joints

Figure 9.4a,b

Pubic symphysis

Clavicle

Rib 1

(a)

(b)

Sternum

Costal

cartilage

Interpubic disc

(fibrocartilage)

Slide12

9-12

Cartilaginous Joint - Symphysis

symphysis - two bones joined by fibrocartilagepubic symphysis in which right and left pubic bones joined by interpubic discbodies of vertebrae and intervertebral discsonly slight amount of movement between adjacent vertebraecollective effect of all 23 discs gives spine considerable flexibility

Pubic symphysis

Body of vertebra

(c)

(b)

Interpubic disc

(fibrocartilage)

Intervertebral

disc (fibrocartilage)

Figure 9.4b,c

Slide13

9-13

Synovial Joint

synovial joint, diarthrosis or diarthrodial joint – joint in which two bones are separated by a space called a joint cavitymost familiar type of jointmost are freely movablemost structurally complex type of jointmost likely to develop painful dysfunctionmost important joints for physical and occupational therapists, athletic coaches, nurses, and fitness trainerstheir mobility make them important to quality of life

Periosteum

Ligament

Bone

Proximal

phalanx

Joint cavity

containing

synovial fluid

Fibrous

capsule

Articular

cartilages

Joint

capsule

Middle

phalanx

Synovial

membrane

Figure 9.5

Slide14

9-14

General Anatomy

articular cartilage

– layer of hyaline cartilage that covers the facing surfaces of two bones

usually 2 or 3 mm thick

joint (articular) cavity

– separates articular surfaces

synovial fluid

– slippery lubricant in joint cavity

rich in albumin and hyaluronic acid

gives it a viscous, slippery texture like raw egg whites

nourishes articular cartilage and removes waste

makes movement of synovial joints almost friction free

joint (articular) capsule

– connective tissue that encloses the cavity and retains the fluid

outer fibrous capsule

– continuous with periosteum of adjoining bones

inner, cellular, synovial membrane

– composed mainly of

fibroblast-like cells

that secrete synovial fluid and

macrophages

that remove debris from the joint cavity

Slide15

9-15

General Anatomy

in a few synovial joints,

fibrocartilage

grows inward from the joint capsule

articular disc

forms a pad between articulating bones that crosses the entire joint capsule

temporomandibular joint, distal radioulnar joints, sternoclavicular and acromioclavicular joints

meniscus

– in the knee, two cartilages extend inward from the left and right but do not entirely cross the joint

these cartilages absorb shock and pressure

guide bones across each other

improve the fit between bones

stabilize the joints, reducing the chance of dislocation

accessory structures

associated with synovial joints

tendon

– a strip or sheet of tough collagenous connective tissue that attaches muscle to bone

the most important structures in stabilizing a joint

ligament

–

similar tissue that attaches one bone to another

bursa

– a fibrous sac filled with synovial fluid, located between adjacent muscles, where tendon passes over bone, or between bone and skin

cushion muscles, helps tendons slide more easily over joints, modify direction of tendon pull

tendon sheaths

–

elongated cylindrical bursae wrapped around a tendon

in hand and foot

Slide16

9-16

Tendon Sheaths and Bursae

Tendon of flexor pollicis longus

Radial bursa (cut)

Flexor retinaculum (cut)

Ulnar bursa (cut)

Lumbrical muscles

Tendon of flexor carpi radialis

Tendon sheaths

Tendon sheath (opened)

Tendon of flexor digitorum

superficialis

Tendon of flexor digitorum

profundus

Tendons of flexor digitorum superficialis

and flexor digitorum profundus

Tendons of flexor digitorum

superficialis

Figure 9.6

Slide17

Exercise and Articular Cartilage

exercise warms synovial fluidbecomes less viscous and more easily absorbed by articular cartilagecartilage then swells and provides a more effective cushion against compressionwarm-up period before vigorous exercise helps protect cartilage from undue wear and tearrepetitive compression of nonvascular cartilage during exercise squeezes fluid and metabolic waste out of the cartilagewhen weight removed, cartilage absorbs synovial fluid like a sponge taking in oxygen and nutrients to the chondrocyteswithout exercise, cartilage deteriorates more rapidly from inadequate nutrition and waste removal

Slide18

9-18

Joints and Lever Systems

long bones act as levers to enhance the speed or power of limb movementslever – any elongated, rigid object that rotates around a fixed point called a fulcrumrotation occurs when an effort applied overcomes resistance (load) at some other pointresistance arm and effort arm are described relative to fulcrum

Resistance arm

Effort arm

Fulcrum

Effort

Resistance

(load)

Figure 9.7

Slide19

9-19

Mechanical Advantage

advantage conferred by a lever can be of two kinds:

to exert more force against a resisting object than the force applied to the lever

human moving a heavy object with help of crowbar

to move the resisting object farther or faster than the effort arm is moved

movement of rowing a boat

a single lever cannot confer both advantages

as one increases, the other decreases

mechanical advantage

(MA) of a lever – the ratio of its output force to its input force

Slide20

9-20

Mechanical Advantage

mechanical advantage is calculated from the length of the effort arm divided by the length of the resistance armMA > 1.0 – the lever produces more force, but less speed and distance, than the force exerted on itMA < 1.0 – the lever produces more speed or distance, but less force, than the inputcontraction of the biceps brachii muscle puts more power into the lever than we get out of it, but the hand to move faster and further (MA <1.0)

Figure 9.8

Biceps brachii

50 mm

0.15

330 mm

Low mechanical advantage

Low power

High speed

(a)

(b)

Radius

High mechanical advantage

High power

Low speed

Coronoid process

Condyloid process

Resistance arm (L

= 35 mm)

Effort arm (L

= 95 mm)

Digastric muscle

Resistance arm (L

= 330 mm)

Effort arm (L

= 50 mm)

95 mm

2.7

35 mm

Temporalis muscle

Slide21

9-21

First-Class Lever

has fulcrum in the middle between effort and resistance (RFE)atlanto-occipital joint lies between the muscles on the back of the neck and the weight of the faceloss of muscle tone occurs when you nod off in class

Fulcrum

Resistance

Effort

(a) First-class lever

Fulcrum

Effort

Resistance

Effort

Figure 9.9a

Slide22

9-22

Second-Class Lever

resistance between fulcrum and effort (FRE)resistance from the muscle tone of the temporalis muscle lies between the jaw joint and the pull of the digastric muscle on the chin as it opens the mouth quickly

Effort

Fulcrum

Resistance

(b) Second-class lever

Resistance

Effort

Resistance

Figure 9.9b

Slide23

9-23

Third-Class Lever

effort between the resistance and the fulcrum (REF)most joints of the bodythe effort applied by the biceps muscle is applied to the forearm between the elbow joint and the weight of the hand and the forearm

Figure 9.9c

Effort

Fulcrum

Resistance

Effort

Fulcrum

Resistance

Effort

Resistance

Slide24

9-24

Range of Motion

range of motion

(ROM) –the degrees through which a joint can move

an aspect of joint performance

physical assessment of a patient’s joint flexibility

range of motion determined by:

structure of the articular surfaces

elbow – olecranon of ulna fits into olecranon fossa of humerus

strength and tautness of ligaments and joint capsules

stretching of ligaments increases range of motion

double-jointed people have long or slack ligaments

action of the muscles and tendons

nervous system monitors joint position and muscle tone

muscle tone

– state of tension maintained in resting muscles

Slide25

9-25

Axes of Rotation

a moving bone has a relatively stationary axis of rotation that passes through the bone in a direction perpendicular to the plane of movementmultiaxial joint - shoulder joint has three degrees of freedom or axes of rotationother joints – monoaxial or biaxial

(b) Flexion of arm

(a) Abduction of arm

of arm

Figure 9.10

Slide26

9-26

Classes of Synovial Joints

Head of humerus

Scapula

Carpal bone

Metacarpal bone

Phalanx

Metacarpal

bone

Humerus

Ulna

Carpal bones

Radius

Ulna

Ball-and-socket joint

(humeroscapular)

Pivot joint

(radioulnar)

Saddle joint

(trapeziometacarpal)

Hinge joint

(humeroulnar)

Plane joint

(intercarpal)

Condylar joint

(metacarpophalangeal)

Figure 9.11

Slide27

9-27

Ball-and-Socket Joints

smooth, hemispherical head fits within a cuplike socket

shoulder joint

- head of humerus into glenoid cavity of scapula

hip joint

- head of femur into acetabulum of hip bone

the

only multiaxial joints

in the body

Slide28

9-28

Condyloid (ellipsoid) Joints

oval convex surface on one bone fits into a complementary shaped depression on the other

radiocarpal joint

of the wrist

metacarpophalangeal joints

at the bases of the fingers

biaxial joints

– movement in two planes

Slide29

9-29

Saddle Joints

both bones have an articular surface that is shaped like a saddle, concave in one direction and convex in the other

trapeziometacarpal

joint at the base of the thumb

sternoclavicular joint

– clavicle articulates with sternum

biaxial joint

more movable than a condyloid or hinge joint forming the primate

opposable thumb

Slide30

9-30

Plane (gliding) Joints

flat articular surfaces in which bones slide over each other with relatively limited movement

usually

biaxial

joint

carpal bones of wrist

tarsal bones of ankle

articular processes of vertebrae

although any one joint moves only slightly, the combined action of the many joints in wrist, ankle, and vertebral column allows for considerable movement

Slide31

9-31

Hinge Joints

one bone with convex surface that fits into a concave depression on other bone

elbow joint - ulna and humerus

knee joint - femur and tibia

finger and toe joints

monoaxial

joint – move freely in one plane

Slide32

9-32

Pivot Joints

one bone has a projection that is held in place by a ring-like ligament

bone spins on its longitudinal axis

atlantoaxial joint (dens of axis and atlas)

transverse ligament

proximal radioulnar joint allows the radius to rotate during pronation and supination

anular ligament

monoaxial

joint

Slide33

9-33

Movement of Synovial Joints

vocabulary of movements

of synovial joints used in kinesiology, physical therapy, and other medical fields

many presented in pairs with opposite or contrasting meanings

need to understand anatomical planes and directional terms

zero position

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

joint movement are described as deviating from the zero position or returning to it

Slide34

9-34

Flexion, Extension and Hyperextension

flexion – movement that decreases the a joint anglecommon in hinge joints extension – movement that straightens a joint and generally returns a body part to the zero positionhyperextension – further extension of a joint beyond the zero positionflexion and extension occur at nearly all diarthroses, hyperextension is limited to a few

Figure 9.12a

(a)

Extension

Flexion

(b)

Extension

Flexion

Hyperextension

Figure

9.12b

Slide35

9-35

Flexion, Extension and Hyperextension

Figure 9.12c

Figure 9.12d

(c)

Flexion

Hyperextension

(d)

Hip

flexion

Knee

flexion

Extension

Slide36

9-36

Abduction and Adduction

abduction - movement of a body part in the frontal plane away from the midline of the bodyhyperabduction – raise arm over back or front of headadduction - movement in the frontal plane back toward the midlinehyperadduction – crossing fingers, crossing ankles

Figure 9.13a,b

(a) Abduction

(b) Adduction

Slide37

9-37

Elevation and Depression

elevation - a movement that raises a body part vertically in the frontal planedepression – lowers a body part in the same plane

Figure 9.14a,b

(a) Elevation

(b) Depression

Slide38

9-38

Protraction and Retraction

protraction – the anterior movement of a body part in the transverse (horizontal) planeretraction – posterior movement

(a) Protraction

(b) Retraction

Figure 9.15a,b

Slide39

9-39

Circumduction

circumduction - one end of an appendage remains stationary while the other end makes a circular motion sequence of flexion, abduction, extension and adduction movementsbaseball player winding up for a pitch

Figure 9.16

Slide40

9-40

Rotation

rotation – movement in which a bone spins on its longitudinal axisrotation of trunk, thigh, head or armmedial (internal) rotation turns the bone inwardslateral (external) rotation turns the bone outwards

Figure 9.17a,b

(b) Lateral (external) rotation

(a) Medial (internal) rotation

Slide41

9-41

Supination and Pronation

primarily forearm movementssupination – forearm movement that turns the palm to face anteriorly or upwardforearm supinated in anatomical positionradius is parallel to the ulnapronation – forearm movement that turns the palm to face posteriorly or downwardradius spins on the capitulum of the humerusdisc spins in the radial notch of ulnaradius crosses stationary ulna like an X

(a) Supination

(b) Pronation

Slide42

9-42

Movements of Head and Trunk

flexion, hyperextension, and lateral flexion of vertebral column

(a) Flexion

(b) Hyperextension

Slide43

Rotation of Trunk and Head

right and left rotation of trunk

right and left rotation of head

Slide44

9-44

Special Movements of Mandible

lateral excursion – right or left movement from the zero positionmedial excursion - movement back to the median, zero position side-to-side grinding during chewingprotraction – retraction elevation - depression

(a) Protraction

(b) Retraction

(d) Medial excursion

Slide45

9-45

Special Movement of Hand and Digits

ulnar flexion – tilts the hand toward the little fingerradial flexion – tilts the hand toward the thumbflexion of fingers – curling themextension of fingers – straightening themabduction of the fingers – spread them apartadduction of the fingers – bring them together againflexion of thumb – tip of thumb directed toward palmextension of thumb – straightening the thumbradial abduction – move thumb away from index finger 90°palmar abduction – moves thumb away from hand and points it anteriorlyadduction of thumb – moves it to the zero positionopposition – move the thumb to touch the tips of any of the fingersreposition – return the thumb to the zero position

Figure 9.21

(a) Radial flexion

(b) Ulnar flexion

(d) Palmar abduction of thumb

(e) Opposition of thumb

Slide46

Special Movements of the Foot

dorsiflexion – elevation of the toes as you do while swinging the foot forward to take a step (heel strike)plantar flexion - extension of the foot so that the toes point downward as in standing on tiptoe (toe-off)inversion - a movement in which the soles are turned mediallyeversion - a movement in which the soles are turned laterallysupination of foot – complex combination of plantar flexion, inversion, and adductionpronation of foot – complex combination of dorsiflexion, eversion, and abduction

Dorsiflexion

Zeroposition

(b) Inversion

Plantar flexion

(a) Flexion of ankle

Slide47

Temporomandibular Joint

temporomandibular (jaw) joint (TMJ) – articulation of the condyle of the mandible with the mandibular fossa of the temporal bonecombines elements of condylar, hinge, and plane jointssynovial cavity of the TMJ is divided into superior and inferior chambers by an articular disctwo ligaments support jointlateral ligament – prevents posterior displacement of mandiblesphenomandibular ligament – on the medial sidedeep yawn or strenuous depression can dislocate the TMJcondyles pop out of fossa and slip forwardrelocated by pressing down on molar teeth while pushing the jaw backward

Slide48

Temporomandibular Joint

Joint capsule

Styloid process

(a) Lateral view

(b) Medial view

Occipital bone

Sphenoid sinus

Styloid process

Joint capsule

Synovial membrane

Mandibular condyle

Superior joint cavity

Inferior joint cavity

Articular disc

Sphenomandibular

ligament

Lateral

ligament

External

acoustic meatus

Stylomandibular

ligament

Mandibular fossa

of temporal bone

Sphenomandibular

ligament

Stylomandibular

ligament

Figure 9.23

Slide49

9-49

TMJ Syndrome

temporomandibular joint (TMJ) syndrome may affect as many as 75 million Americanssigns and symptomscan cause moderate intermittent facial painclicking sounds in the jawlimitation of jaw movementoften severe headaches, vertigo (dizziness), tinnitus (ringing in the ears)pain radiating from jaw down the neck, shoulders, and backcause of syndromecaused by combination of psychological tension and malocclusion (misalignment of teeth)treatment psychological management, physical therapy, analgesic and anti-inflammatory drugs, corrective dental appliances to align teeth properly

Figure 9.23 a,c

Joint capsule

Styloid process

(a) Lateral view

Sphenomandibular

ligament

Lateral

ligament

External

acoustic meatus

Stylomandibular

ligament

Joint capsule

Synovial membrane

Mandibular condyle

Superior joint cavity

Inferior joint cavity

Articular disc

Mandibular fossa

of temporal bone

Slide50

9-50

The Shoulder Joint

glenohumeral (humeroscapular) joint – the hemispherical head of the humerus articulates with the glenoid cavity of the scapulathe most freely movable joint in the bodyshallow glenoid cavity and loose shoulder joint capsule sacrifice joint stability for freedom of movementglenoid labrum – fibrocartilage ring that deepens glenoid cavityshoulder supported by biceps brachii tendon anteriorly and also the rotator cuff tendonstendons fuse to joint capsule and strengthens itsupraspinatus, infraspinatus, teres minor and subscapularis five principal ligaments support shoulderthree are called the glenohumeral ligamentscoracohumeral ligamenttransverse humeral ligamentfour bursa occur at the shouldersubdeltoid, subacromial, subcoracoid, and subscapular bursae

Figure 9.24c

Glenoid labrum

Supraspinatus tendon

Acromion

Capsular ligament

Humerus

Subdeltoid

bursa

Deltoid

muscle

Synovial

membrane

Glenoid cavity

of scapula

Slide51

9-51

Stabilizers of the Shoulder Joint

Figure 9.24b

Acromion

Tendon sheath

Humerus

Clavicle

Acromioclavicular ligament

Subacromial

bursa

Supraspinatus

tendon

Coracohumeral

ligament

Subdeltoid

bursa

Subscapularis

tendon

Transverse

humeral

ligament

Biceps brachii

tendon

(long head)

(b) Anterior view

Glenohumeral

ligaments

Subscapular

bursa

Subcoracoid

bursa

Coracoid

process

Coraco-

acromial

ligament

Coraco-

clavicular

ligament

Slide52

9-52

Tendons of Rotator Cuff Muscles

Figure 9.24d

Coracoid process

Coracohumeral ligament

Subscapular bursa

Subscapularis tendon

Acromion

Supraspinatus

tendon

Subdeltoid

bursa

Infraspinatus

tendon

Glenoid cavity

(articular cartilage)

Synovial membrane

(cut)

Teres minor

tendon

(d) Lateral view , humerus removed

Inferior glenohumeral

ligament

Middle glenohumeral

ligament

Biceps brachii tendon

(long head)

Superior glenohumeral

ligament

Slide53

9-53

Shoulder Dislocation

very painful and sometimes cause permanent damagedownward displacement of the humerus is the most common shoulder dislocationrotator cuff protects the joint in all directions but inferiorlyjoint protected from above by coracoid process, acromion, and clavicledislocations most often occur when the arm is abducted and then receives a blow from abovechildren especially prone to dislocation

Figure 9.24c

Glenoid labrum

Supraspinatus tendon

Acromion

Capsular ligament

Humerus

Subdeltoid

bursa

Deltoid

muscle

Synovial

membrane

Glenoid cavity

of scapula

Slide54

Dissection of Shoulder Joint

Clavicle

Acromion of scapula

Head of humerus

Biceps brachii muscle:

Short head

Long head

Acromioclavicular

joint

Coracobrachialis

muscle

Deltoid muscle

(cut and folded back)

Pectoralis major

muscle

(a) Anterior dissection

Slide55

9-55

The Elbow Joint

Figure 9.25c

elbow is a hinge joint composed of two articulations:humeroulnar joint – where the trochlea of the humerus joins the trochlear notch of the ulnahinge jointhumeroradial joint – where the capitulum of the humerus meets the head of the radiuspivot jointedge of the disc-like head of the radius fits into the radial notch of the ulnaanular ligament holds the head in placeradial head rotates like a wheel against the ulna as the forearm is supinated and pronatedboth enclosed in a single joint capsuleolecranon bursa – on posterior side of the elboweases the movement of the tendons over the jointside-to-side motion of the elbow is restricted by a pair of ligamentsradial (lateral) collateral ligamentulnar (medial) collateral ligament

(b) Sagittal section

Humerus

Trochlea

Joint capsule

Radius

Olecranon

Articular cartilage

Coronoid process

Ulna

Olecranon

bursa

Figure 9.25b

Anular ligament

Joint capsule

Humerus

Coronoid process

Radius

Ulna

Tendon of

triceps brachii

Ulnar collateral

ligament

Olecranon

bursa

Tendon of biceps

brachii (cut)

Slide56

9-56

Elbow Joint

Figure 9.25d

(a) Anterior view

Joint capsule

Humerus

Radius

Ulna

Lateral

epicondyle

Radial collateral

ligament

Anular

ligament

Tendon of

biceps brachii

(cut)

Medial

epicondyle

Ulnar collateral

ligament

Figure 9.25a

(d) Lateral view

Joint capsule

Humerus

Olecranon

Anular ligament

Radius

Ulna

Joint capsule

Tendon of

biceps brachii

(cut)

Lateral

epicondyle

Radial

collateral

ligament

Slide57

9-57

The Coxal (Hip) Joint

coxal (hip) joint – point at which the head of femur inserts into the acetabulum of the hip bonebears much more weight, have deeper sockets, more stable than shoulderacetabular labrum – horseshoe-shaped ring of fibrocartilage that deepens socketdislocations rare: congenital dislocations in infantsligaments supporting hip jointiliofemoral and pubofemoral – on anteriorischiofemoral ligament – on posteriorwhen standing, the ligaments become twisted and pull head of femur tightly into the acetabulumtransverse acetabular ligament – bridges gap on inferior margin of acetabular labrumfovea capitis – pit on the head of femurround ligament, or ligamentum teres – arises from here and attaches to the lower margin of the acetabulumcontains artery that supplies blood to the head of the femur

Figure 9.26b

Acetabulum

Labrum

Femur

Round

ligament (cut)

Fovea

capitis

Head of

femur

Greater

trochanter

Transverse

acetabular

ligament

Ischial

tuberosity

Obturator

membrane

(b) Lateral view, femur retracted

Slide58

9-58

Hip (Coxal) Joint

Figure 9.26c,d

Ilium

Femur

Pubis

Pubofemoral

ligament

Iliofemoral

ligament

Greater

trochanter

Lesser

trochanter

Femur

(d) Posterior view

Iliofemoral

ligament

Ischiofemoral

ligament

Greater

trochanter

Ischial

tuberosity

Slide59

9-59

Dissection of Hip Joint

Figure 9.26a

Acetabular labrum

Acetabulum

Round ligament

Head of femur

Greater trochanter

Shaft of femur

(a) Anterior dissection

Slide60

9-60

Treatment of Congenital Hip Dislocation

Slide61

9-61

The Knee Joint

tibiofemoral (knee) joint – largest and most complex diarthrosis of the bodyprimarily a hinge jointcapable of slight rotation and lateral gliding when knee flexedpatellofemoral joint – gliding jointjoint capsule encloses only the lateral and posterior aspects of the knee, not the anterioranterior covered by patellar ligament and lateral and medial retinaculaall are extensions of the tendon of quadriceps femoris muscleknee stabilized:quadriceps tendon in fronttendon of semimembranosus muscle on rear side of thighjoint cavity contains two C-shaped cartilageslateral meniscus and medial meniscusjoined by transverse ligamentabsorbs shock on the kneeprevents femur from rocking side-to-side on the tibia

Figure 9.29c

Femur

Meniscus

Tibia

Joint cavity

Infrapatellar fat pad

Synovial membrane

Patellar ligament

Patella

Prepatellar bursa

Articular cartilage

Joint capsule

Bursa under lateral

head of gastrocnemius

Quadriceps

femoris

Quadriceps

femoris tendon

Suprapatellar

bursa

Superficial

infrapatellar bursa

Deep

infrapatellar bursa

Slide62

9-62

The Knee Joint

popliteal region of kneesupported by a complex array of: extracapsular ligaments – external to joint capsuleprevent knee from rotating when joint is extendedfibular (lateral) collateral ligamenttibial (medial) collateral ligamenttwo intracapsular ligaments deep within joint capsulesynovial membrane folds around them, so they are excluded from the fluid filled synovial cavityligaments cross each other to form an Xanterior cruciate ligament (ACL)prevents hyperextension of knee when ACL is pulled tightone of the most common sites of knee injuryposterior cruciate ligament (PCL)prevents femur from sliding off tibiaprevents the tibia from being displaced backwardability to “lock” the kneesimportant aspect of human bipedalismwhen knee is extended to the fullest degree allowed by ACLfemur rotates medially on the tibialocks the knee, and all major knee ligaments are twisted and taut“unlock” knee – popliteus muscle rotates the femur laterally and untwists the ligaments

Figure 9.29c

Femur

Meniscus

Tibia

Joint cavity

Infrapatellar fat pad

Synovial membrane

Patellar ligament

Patella

Prepatellar bursa

Articular cartilage

Joint capsule

Bursa under lateral

head of gastrocnemius

Quadriceps

femoris

Quadriceps

femoris tendon

Suprapatellar

bursa

Superficial

infrapatellar bursa

Deep

infrapatellar bursa

Slide63

Knee Joint – Sagittal Section

knee joint has at least 13 bursaefour anterior: superficial infrapatellar, suprapatellar, prepatellar, and deep infrapatellarpopliteal region: popliteal bursa and semimembranosus bursaseven more bursae on lateral and medial sides of knee joint

9-63

Figure 9.29c

Femur

Meniscus

Tibia

Joint cavity

Infrapatellar fat pad

Synovial membrane

Patellar ligament

Patella

Prepatellar bursa

Articular cartilage

Joint capsule

Bursa under lateral

head of gastrocnemius

Quadriceps

femoris

Quadriceps

femoris tendon

Suprapatellar

bursa

Superficial

infrapatellar bursa

Deep

infrapatellar bursa

Slide64

9-64

Knee Joint – Anterior and Posterior Views

Figure 9.29a,b

Femur

Patellar surface

Medial condyle

Fibula

Tibia

Medial meniscus

(a) Anterior view

Lateral

condyle

Fibular

collateral

ligament

Lateral

meniscus

Transverse

ligament

Posterior cruciate

ligament

Anterior cruciate

ligament

Tibial collateral

ligament

Patellar ligament

(cut)

(b) Posterior view

Femur

Fibula

Tibia

Lateral meniscus

Anterior cruciate

ligament

Fibular collateral

ligament

Articular cartilage

of tibia

Medial

condyle

Tibial

collateral

ligament

Medial

meniscus

Posterior

cruciate

ligament

Slide65

9-65

Knee Joint – Superior View

medial and lateral meniscus absorb shock and shape joint

Figure 9.29d

Medial meniscus

Lateral meniscus

(d) Superior view of tibia and menisci

Posterior cruciate

ligament

Synovial

membrane

Medial condyle

of tibia

Anterior cruciate

ligament

Lateral condyle

of tibia

Slide66

9-66

Dissection of Knee Joint

Figure 9.28

Femur:

Shaft

Patellar surface

Medial condyle

Lateral condyle

Joint cavity:

Joint capsule

Medial meniscus

Lateral meniscus

Lateral condyle

Tuberosity

Medial condyle

Patellar ligament

Articular facets

Lateral

Medial

Anterior cruciate

ligament

Patella

(posterior surface)

Quadriceps

tendon (reflected)

Tibia:

Slide67

Knee Injuries

highly vulnerable to rotational and horizontal stressmost common injuries are to the meniscus and anterior cruciate ligament (ACL)heal slowly due to scanty blood flowarthroscopy – procedure in which the interior of the joint is viewed with a pencil-thin arthroscope inserted through a small incisionless tissue damage than conventional surgeryrecovery more quicklyarthroscopic ACL repair – about nine months for healing to be complete

Foot fixed

Patellar ligament

Twisting motion

Anterior cruciate

ligament (torn)

Tibial collateral

ligament (torn)

Medial

meniscus (torn)

Figure 9.30

Slide68

The Ankle Joint

talocrural (ankle) joint – includes two articulations:medial joint – between tibia and taluslateral joint – between fibula and talusboth enclosed by one joint capsulemalleoli of tibia and fibula overhang the talus on either side and prevent side-to-side motionmore restricted range of motion than the wristankle ligamentsanterior and posterior tibiofibular ligaments – bind the tibia to fibulamultipart medial (deltoid) ligament – binds the tibia to the foot on the medial sidemultipart lateral (collateral) ligament – binds fibula to the foot on the lateral sidecalcaneal (Achilles) tendon – extends from the calf muscle to the calcaneusplantarflexes the foot and limits dorsiflexionsprains (torn ligaments and tendons) are common at the anklepain and immediate swelling

Slide69

9-69

Ankle Joint and Foot Ligaments

Figure 9.31a,c,d

Posterior tibiofibular

ligament

Lateral malleolus

Posterior talofibular

ligament

Calcaneofibular

ligament

Calcaneus

(d) Posterior view

Medial

malleolus

Interosseous

membrane

Fibula

Tibia

Calcaneal

tendon

Calcaneus

Tibia

Tendons of

tibialis anterior and posterior

Metatarsal I

Navicular

Medial ligament

Calcaneofibular ligament

Anterior talofibular ligament

Posterior talofibular ligament

Tendons of

fibularis longus

and brevis

Metatarsal v

Calcaneus

Calcaneal

tendon

Anterior and

posterior tibiofibular

ligaments

Tibia

Fibula

(a) Lateral view

Lateral ligament:

Slide70

9-70

Dissection of the Foot

Figure 9.31b

Anterior talofibular ligament

(b) Lateral dissection

Calcaneofibular ligament

Slide71

9-71

Arthritis

arthritis

- a broad term for pain and inflammation of a joint

most common crippling disease in the United States

rheumatologists

– physicians who treat arthritis and other joint disorders

osteoarthritis

(OA) – most common form of arthritis

‘wear-and-tear arthritis’

results from years of joint wear

articular cartilage softens and degenerates

accompanied by crackling sounds called

crepitus

bone spurs develop on exposed bone tissue causing pain

Slide72

9-72

Arthritis and Artificial Joints

rheumatoid arthritis (RA)

- autoimmune attack against the joint tissues

misguided antibodies (

rheumatoid factor

) attack synovial membrane, enzymes in synovial fluid degrade the articular cartilage, joint begins to ossify

ankylosis

– solidly fused, immobilized joint

remissions occur, steroids and aspirin control inflammation

arthroplasty

- the replacement of diseased joint with artificial device called

prosthesis

Slide73

9-73

Rheumatoid Arthritis

(b)

CNRI/Science Photo Library/Photo Researchers, Inc.

Figure 9.32b

Slide74

Joint Prostheses

Joints Joints and Their Classification - PowerPoint Presentation

Joints Joints and Their Classification - PPT Presentation

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