Types of Synovial Joints - PowerPoint Presentation

Slide1

Types of Synovial Joints

Slide2

Selected Synovial Joints:The Knee

This is considered the most complex joint in the human body.

It is actually considered three joints working together.

Slide3

The Knee

These are:

An intermediate joint between the patella and distal end of the femur (

femoropatellar

joint). This is a plane joint.

Slide4

The Knee

These are:

An intermediate joint between the patella and distal end of the femur (

femoropatellar

joint). This is a plane joint.

A

lateral

and

medial

tibiofemoral joints between the femoral condyles and the menisci below.

Slide5

(a) Sagittal section through the right knee joint

Femur

Tendon of

quadriceps

femoris

Suprapatellar

bursa

Patella

Subcutaneous

prepatellar bursa

Synovial cavity

Lateral meniscus

Posterior

cruciate

ligament

Infrapatellar

fat pad

Deep infrapatellar

bursa

Patellar ligament

Articular

capsule

Lateral

meniscus

Anterior

cruciate

ligament

Tibia

Figure 8.8a

The knee joint.

Slide6

The Knee

The

menisci

help prevent lateral motion and attach to the outer margins of the joint capsule on the tibia.

They are easily torn.

Slide7

Figure 8.8b The knee joint.

(b) Superior view of the right tibia in the knee joint, showing

the menisci and cruciate ligaments

Medial

meniscus

Articular

cartilage

on medial

tibial

condyle

Anterior

Anterior

cruciate

ligament

Articularcartilage onlateral tibialcondyle

Lateralmeniscus

Posterior

cruciate

ligament

Slide8

The knee is unique in that it is not completely enclosed by a capsule.

Slide9

The knee is unique in that it is not completely enclosed by a capsule.

The articular capsule is found only on the lateral and posterior surfaces.

Slide10

The knee is unique in that it is not completely enclosed by a capsule.

The articular capsule is found only on the lateral and posterior surfaces.

The anterior surface is covered by three ligaments going from the patella to the tibia.

Slide11

These ligaments are:

The

patella ligament

Slide12

These ligaments are:

The

patella ligament &

The

medial

and

lateral patellar retinacula ligaments.

They merge with the articular capsule on each side.

Slide13

The intracapsular ligaments are the

cruciate ligaments.

Slide14

The intracapsular ligaments are the

cruciate ligaments.

The

anterior and posterior cruciate ligaments

cross each other forming an X in the notch between the femoral condyles.

Slide15

The intracapsular ligaments are the

cruciate ligaments.

The

anterior and posterior cruciate ligaments

cross each other forming an X in the notch between the femoral condyles.

They prevent anterior and posterior displacement.

Slide16

Two additional ligaments, the

Fibular

and

Tibial Collateral Ligaments

prevent lateral or medial rotation when the knee is extended.

Slide17

Figure 8.8c The knee joint.

Quadriceps

femoris muscle

Tendon of

quadriceps

femoris muscle

Patella

Lateral patellar

retinaculum

Medial patellar

retinaculum

Tibial collateral

ligament

Tibia

Fibular

collateral

ligament

Fibula

(c) Anterior view of right knee

Patellar ligament

Slide18

Figure 8.8f The knee joint.

Medial femoral condyle

Anterior cruciate

ligament

Medial meniscus on

medial tibial condyle

Patella

(f) Photograph of an opened knee joint; view similar to (e)

Slide19

The synovial cavity of the knee has a complicated shape and over one dozen associated bursae.

Some are easily injured such as the subcutaneous prepatellar bursa which lies just over the patella

(house maid’s knee).

Slide20

House Maid’s Knee

Slide21

Knee Injuries

Common knee injuries involve the 3 C’s:

C

ollateral ligaments

,

Slide22

Knee Injuries

Common knee injuries involve the 3 C’s:

C

ollateral ligaments

,

Cruciate ligaments

and

Slide23

Knee Injuries

Common knee injuries involve the 3 C’s:

C

ollateral ligaments

,

Cruciate ligaments

and

Cartilage (menisci).

Slide24

Knee Injuries

Lateral blows are the most dangerous, tearing the tibial collateral ligament and the medial meniscus and the anterior cruciate ligament.

Slide25

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Figure 8.9 A common knee injury.

Lateral

Medial

Patella

(outline)

Tibial collateral

ligament

(torn)

Medial

meniscus (torn)

Anterior

cruciate

ligament (torn)

Hockey puck

Slide28

Arthroscopic Knee Surgery

Arthroscopy is a common surgical procedure in which a joint (

arthro

-) is viewed (-

scopy

) using a small camera.

Slide29

Arthroscopic Knee Surgery

Arthroscopy gives doctors a clear view of the inside of the knee. This helps them diagnose and treat knee problems.

Slide30

Arthroscopic Knee Surgery

The orthopaedic surgeon will make a few small incisions in your knee. A sterile solution will be used to fill the knee joint and rinse away any cloudy fluid. This helps your orthopaedic surgeon see your knee clearly and in great detail.

Slide31

Arthroscopic Knee Surgery

Slide32

Knee Replacement

People with degenerative arthritis, chronic injuries often lose that smooth articular cartilage.The result is bone on bone. The knee joints must be replaced.

Slide33

Knee Replacement

Slide34

Shoulder (Glenohumeral) Joint

The large head of the humerus fits into the glenoid cavity of the scapula.

The cavity is extended by a fibrocartilage ring called the

glenoid labrum

.

Connective tissue support comes from three groups of ligaments.

Slide35

Shoulder (Glenohumeral) Joint

A)

Coracohumeral ligament

provides the only strong support of the upper limb. It runs from the coracoid process to the greater tubercle of the humerus.

Slide36

Figure 8.10c The shoulder joint.

Acromion

Coracoacromial

ligament

Subacromial

bursa

Coracohumeral

ligament

Greater

tubercle

of humerus

Transverse

humeral

ligament

Tendon sheath

Tendon of long

head of biceps

brachii muscle

Articular

capsule

reinforced by

glenohumeral

ligaments

Subscapular

bursa

Tendon of the

subscapularis

muscle

Scapula

Coracoidprocess

(c) Anterior view of right shoulder joint capsule

Slide37

Shoulder (Glenohumeral) Joint

B) Three

Glenohumeral ligaments

strengthen the front of the capsule. These ligaments are weak.

Slide38

Figure 8.10d The shoulder joint.

Acromion

Coracoid process

Articular capsule

Glenoid cavity

Glenoid labrum

Tendon of long head

of biceps brachii muscle

Glenohumeral ligaments

Tendon of the

subscapularis muscle

Scapula

Posterior

Anterior

(d) Lateral view of socket of right shoulder joint,

humerus removed

Slide39

Shoulder (Glenohumeral) Joint

C) The

Rotator Cuff

is formed from four tendons and muscles that encircle the joint. The muscles include the

Subscapularis, Supraspinatus

I

nfraspinatus and

T

eres minor

.

Slide40

Shoulder (Glenohumeral) Joint

Slide41

Shoulder InjuriesRotator Cuff

Because of its mobility, the stability of the shoulder joint has been sacrificed.

Anterior dislocations are the most common along with damage to the rotator cuff muscles due to severe circumduction.

Slide42

Slide43

Shoulder Dislocationand Reduction

Slide44

Shoulder InjuriesRotator Cuff

Supraspinatus

and

Infraspinatus

are the most commonly injured rotator cuff muscles.

Due to the function of these muscles, sports which involve a lot of shoulder rotation – for example, pitching in baseball, swimming, – often put the rotator cuff muscles under a lot of stress.

Slide45

Shoulder InjuriesRotator Cuff

Problems with the rotator cuff muscles can be classed into two categories – Tears of the tendons/muscles, and inflammation of the tendons (often called tendinopathy or tendonitis).

Slide46

Shoulder InjuriesRotator Cuff

Surgery to repair a torn rotator cuff tendon usually involves:

Removing loose fragments of tendon, bursa, and other debris from the space in the shoulder where the

rotator cuff moves

(

debridment

).

Slide47

Shoulder InjuriesRotator Cuff

Surgery to repair a torn rotator cuff tendon usually involves:

Removing loose fragments of tendon, bursa, and other debris from the space in the shoulder where the rotator cuff moves (

debridement

).

Making more room for the rotator cuff tendon so it is not pinched or irritated.

Slide48

Shoulder InjuriesRotator Cuff

Surgery to repair a torn rotator cuff tendon usually involves:

Removing loose fragments of tendon, bursa, and other debris from the space in the shoulder where the rotator cuff moves (

debridement

).

Making more room for the rotator cuff tendon so it is not pinched or irritated.

Sewing the torn edges of the supraspinatus tendon together and to the top of the upper arm bone (humerus).

Slide49

Shoulder InjuriesRotator Cuff

Slide50

Shoulder InjuriesRotator Cuff

Slide51

Elbow Joint

This is a hinge joint where the radius and ulna articulate with the condyles of the humerus.

The ulna’s trochlear notch forms a tight hinge with the trochlear of the humerus.

This articulation allows for flexion and extension only.

Slide52

Elbow Joint

Side to side movement is prevented by the ulnar collateral ligament (triangular) and radial collateral ligament.

Slide53

Figure 8.11d The elbow joint.

Articular

capsule

Anular

ligament

Coronoid

process

(d) Medial view of right elbow

Radius

Humerus

Medial

epicondyle

Ulnar

collateral

ligament

Ulna

Slide54

Figure 8.11c The elbow joint.

Anular

ligament

Humerus

Medial

epicondyle

Ulnar

collateral

ligament

Ulna

Articular

capsule

Radius

Coronoid

process

(c) Cadaver photo of medial view of right elbow

Slide55

Figure 8.11b The elbow joint.

Humerus

Lateral

epicondyle

Articular

capsule

Radial

collateral

ligament

Olecranon

process

Anular

ligament

Radius

Ulna

(b) Lateral view of right elbow joint

Slide56

Elbow Joint Injuries

Slide57

Tommy John Surgery

This procedure, more formally known as UCL (Ulnar Collateral Ligament) reconstruction, is designed to repair a torn elbow ligament—an injury typically caused by strong, repetitive overhead throwing motions of the arm.

Slide58

Tommy John Surgery

It was first performed in 1974 on baseball

pitcher

Tommy John.

The procedure typically lasts about an hour and a half, and patients usually leave the hospital the same day.

Slide59

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Elbow Dislocations

Slide62

Elbow Dislocations

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Hip (Coxal Joint)

This is a ball and socket joint whose movement is limited by strong ligaments.

It is formed from the spherical

head of the femur

and the deeply cupped

acetabulum

in the pelvis.

Slide64

Figure 8.12b The hip joint.

Acetabular

labrum

Synovial

membrane

Ligament

of the head

of the femur

(ligamentum

teres)

Head

of femur

Articular

capsule (cut)

(b) Photo of the interior of the hip joint, lateral view

Slide65

Hip (Coxal Joint)

There is a thick articular capsule with several strong ligaments reinforcing the capsule. These include the:

Iliofemoral ligament

Pubofemoral ligament &

Ischiofemoral ligament

Slide66

Figure 8.12c The hip joint.

Ischium

Iliofemoral

ligament

Ischiofemoral

ligament

Greater

trochanter

of femur

(c) Posterior view of right hip joint, capsule in place

Slide67

Hip (Coxal Joint)

The ligamentum teres attaches the femur to the acetabulum.

Slide68

Figure 8.12a The hip joint.

Articular cartilage

Coxal (hip) bone

Ligament of

the head of

the femur

(ligamentum

teres)

Synovial cavity

Articular capsule

Acetabular

labrum

Femur

(a) Frontal section through the right hip joint

Slide69

Hip Injuries

Common injuries to the hip joint include fractures and dislocations.

Hip fractures typically involve the neck of the femur and are the result of underlying disease such as osteoporosis.

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Slide73

Hip Replacement

Hip replacement surgery, also called total hip

arthroplasty

, involves removing a diseased hip joint and replacing it with an artificial joint, called a prosthesis.

Slide74

Hip Replacement

Hip replacement is typically used for people with hip joint damage from arthritis or an injury. Followed by rehabilitation, hip replacement can relieve pain and restore range of motion and function of your hip joint

Lets do a hip replacement!

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Slide76

Temporomandibular Joint

T

wo distinct movements can occur with the jaw, a hinge like movement and the second is a lateral movement.

Slide77

Temporomandibular Joint

Slide78

Figure 8.13c The temporomandibular (jaw) joint.

Lateral excursion: lateral (side-to-side) movements of the

mandible

Outline of

the mandibular

fossa

Superior view

Slide79

Temporomandibular Joint

A lateral ligament attaches the ramus of the mandible to the zygomatic arch of the temporal bone.

Slide80

Figure 8.13a The temporomandibular (jaw) joint.

Zygomatic process

Mandibular fossa

Articular tubercle

Infratemporal fossa

External

acoustic

meatus

Articular

capsule

Ramus of

mandible

Lateral

ligament

(a) Location of the joint in the skull

Slide81

Injuries to the Jaw

Injuries to the jaw include fractures and dislocations.

Slide82

Injuries to the Jaw

Injuries to the jaw include fractures and dislocations.

A broken jaw is a break in the jaw bone.

A dislocated jaw means the lower part of the jaw has moved out of its normal position at one or both joints .

Slide83

Dislocation of the Jaw

Symptoms of a dislocated jaw include pain in or around the jaw, the misalignment of teeth, and forward movement of the jaw beyond its regular position.

Other symptoms include difficulty opening and closing the mouth.

Slide84

Dislocation of the Jaw

A dislocated jaw can be caused by forceful yawning or by some sort of trauma or impact with the face.

Common causes of jaw dislocation include a punch to the face, sports injuries, and car accidents.

Slide85

Dislocation of the Jaw

Slide86

Fractures of the Jaw

A broken jaw) is a common facial injury.

Fractures (these are breaks in the bone) are generally the result of a direct force to the jaw.

Slide87

Slide88

Diseases of the joints

Besides trauma, inflammation from over use or repetitive motions are the most common diseases seen in the joints.

Slide89

Bursitis

Inflammation of a bursal sac usually as the result of chronic irritation

Slide90

Slide91

Arthritis

Arthritis is a common term for over 100 conditions which describe degenerative processes found in the joints.

Major examples include osteoarthritis, rheumatoid arthritis and gout.

Slide92

Slide93

Figure 8.15 X ray of a hand deformed by rheumatoid arthritis.

Slide94

Osgood–Schlatter disease

Is also known as

tibial tubercle apophyseal traction injury

is a rupture of the growth plate at the tibial tuberosity.

Slide95

Osgood–Schlatter disease

The condition occurs in active boys and girls aged 9–16 coinciding with periods of growth spurts. It occurs more frequently in boys than in girls.

Slide96

Osgood–Schlatter disease

The condition is usually self-limiting and is caused by stress on the patellar tendon that attaches the quadriceps muscle at the

the

tibial tuberosity.

Treatment is conservative with rest,

RICE

(

R

est,

I

ce,

C

ompression, and

E

levation),

Slide97

Slide98

Shin Splints

Shin splints

is a general medical term denoting

medial tibial stress syndrome

(MTSS), a slow healing and painful condition in the shins, usually caused by exercise such as running, jumping, swimming, cycling, dancing or other sports.

Slide99

The onset of shin splints is most common after exercise, caused by high impact training, excessive training, poor technique

Slide100

Knuckle Cracking

When one cracks a knuckle, the stretching of the capsule lowers the pressure inside the joint and creates a vacuum which is filled by the gas previously dissolved in the synovial fluid. This creates a “bubble” which then bursts producing the characteristic “popping” or “cracking” sound.

Slide101

Knuckle Cracking

There is no evidence that cracking knuckles causes any damage such as arthritis in the joints.

Slide102

Questions?