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93 Cards in this Set

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Arthrology
The study of joints.
Freedom of Motion
The number of axes or planes that the joint can move in.
Range of Motion
The amount of motion available within the anatomic limits of the joint structure itself (degrees of motion).
What deteremines Range of Motion?
The shape and congruency of the articulating joint surfaces.
Joint
A junction between bones-also called an "articulation". Note that this does not necessarily imply motion.
In what cases does Joint not refer to a bone on bone articulation?
Scapulothoracic or Coracohumeral joints.
What are the two main classifications of Joints?
Functional (physiological) or structural (anatomical).
What are the subclassifications of Functional Joints?
Synarthrosis, Amphiarthrosis, Diarthrosis.
Synarthrosis
An immovable joint.
Amphiarthrosis
A joint that allows minimal movement.
Diarthrosis
A joint that is freely moveable. The type and amount of movement generally depends on the joint shape and stabilizing structures.
What are the subclassificaions of Structural Joints?
Fibrous, Cartilaginous, Synovial.
Fibrous Joint
There is no joint (synovial) cavity and bones are held together by fibrous connective tissue. They allow little (amphiarthosis) to no (synarthrosis) movement.
Cartilaginous Joint
There is no joint cavity and the bones are held together by cartilage, either fibrocartilage or hyaline cartilage. These joints also allow little (amphiarthosis) to no (synarthosis) movement.
Synovial Joint
There is a joint or synovial cavity between the articulating bones that is surrounded by an articular capsule. They are all freely moveable and are therefore classified as Diarthroses.
How are Fibrous Joints joined?
Suture or Syndesmosis
Suture
Bones are held tightly together by a thin layer of dense fibrous connective tissue. Relatively immovable (cranial sutures).
Syndesmosis
Means connected by a band or ligament. These joints consist of a short, intimately associated membrane or ligament that attaches the two bones together. There is a visible spce between the two bones and permits slight movement (between bones of forearm and tibia/fibula).
Synchondrosis
Cartilaginous joint held together by hyaline cartilage. Dense rigid structure that allows for growth rather than motion
What are the types of Cartilaginous Joints?
Synchondrosis and Symphysis.
Symphysis
Means grown together. The articulating surfaces of the bones are covered with hyaline cartilage but are held together using fibrocartilage. Allows for very limited movement between two bones (intervertebral discs and pubis symphysis).
What are the parts of a Synovial Joint?
Synovial Cavity, Articular Cartilage, Articular Capsule, Accessory Ligaments or Articular Discs, Synovial Fluid.
Synovial Joint Cavity
Consists of the space between the articulating bones of the joint.
What is the purpose of the Synovial Joint Cavity.
It purpose is to provide a potential space for a small volume of fluid and to permit motion within the joint.`
Articular Cartilage
Articulating surfaces of the bones within the joint are covered with this. Usually consists of hyaline cartilage, occasionally fibrocartilage.
What is the purpose of Articular Cartilage?
To reduce friction during movement and absorb shock.
What is Cartilage composed of?
Consists of collagen, protein-polysaccharides, and water. Thickness of articular cartilage ranges from 1-7mm and is typically inversely related to the congruence of joint surfaces (ie. less congruent joint surfaces require thicker cartilage).
Articular Capsule
A sleeve-like structure that surrounds the joint, encloses the synovial cavity, and unites the articulating bones.
What are the parts of the Articular Capsule?
Fibrous outer layer and the Synovial Membrane inner layer.
Fibrous outer layer (articular capsule)
Consists of dense, irregular fibrous connective tissue. Its firmly attached to the periosteum and is strengthened by surrounding ligaments to provide joint stability.
Synovial Membrane
Consists of areolar connective tissue with elastic fibers. Its a loose and highly vascular structure that lines the outer fibrous layer.
What is the purpose of the Synovial Membrane?
Secretes synovial fluid into joint for lubrication and nutrition. Lines the inside of the fibrous layer of the capsule
Accessory Ligaments or Articular Discs
Consist of dense, regular connective tissue that attch bone to bone and provide structural support and stability to the joint.
What are the types of Accessory Ligaments?
Extracapsular, intracapsular
Extracapsular Ligaments
Lie outside the articular capsule. Examples are the medial and lateral collateral ligaments of the knee.
Intracapsular Ligaments
Lie within the articular capsule and outside the synovial cavity and membrane. Examples are the anterior and posterior cruciate ligaments of the knee.
Articular Discs
Known as Menisci, are pads of fibrocartilage that lie between the articular surfaces of adjacent bones. Attached to the fibrous capsule.
What is the function of Articular Discs?
To improve congruency or fit between the joint surfaces, absorb shcok, and assist in the distribution of flow of synovial fluid.
Synovial Fluid
Specialized fluid produced by the synovial membrane that forms a thin film over all joint surfaces.
What is the purpse of Synovial Fluid?
Provides a liquid enviroment, supply nutrients to and remove metabolic wastes from the articular cartilage, menisci, etc., lubricant to increase efficiency and reduce friction and erosion of joint surfaces.
What are the subtypes of Synovial Joints?
Hinge Joint, Pivot Joint, Condyloid Joint, Saddle Joint, Plane Joint, Ball and Socket Joint.
Hinge Joint
Spool-shaped surface fits into concave surface. FOM is uniaxial (Ulnotrochlear (elbow), ankle.
Modified Hinge Joint
The knee is a special case. At the least biaxial, most identify it as multiaxial.
Pivot Joint
One bone serves as a pin while the other and its ligaments form a circle, enlcosing the pin. One bone rotates around another bony, peg-like pivot. FOM is uniaxial (atlantoaxial joint/proximal radioulnar joint).
Condyloid Joint
A concave surface glides over a convex surface. FOM biaxial - no rotation (metacarpophalangeal joint "knuckle" can move up and down, side to side, radiocarpal joint (wrist proper)).
Saddle Joint
A joint in which each surface is both convex and concave.
What is the FOM of a Saddle Joint?
Biaxial, note that rotation is especially limited (Carpometacarpal Joint of the thumb)
Plane Joint
May also be termed Gliding Joint. Two relatively flat surfaces gliding over one another.
What is the FOM of a Plane Joint?
Biaxial or multiaxial sliding motion. (Intercarpal and Intertarsal Joints, acromioclavicular and Sternoclavicular joints)
Ball and Socket Joint
Ball-like structure fits into a concave socket.
What is the FOM of a Ball and Socket Joint?
Multi-axial. Allows increase function, increase joint complexity, made more for motion than stability. (Shoulder (glenohumeral) or hip joints).
What are the classifications of movement for Synovial Joints?
Close pack position, Open pack position, Osteokinematics, Arthrokinematics.
Closed Pack Position
The position of the joint in which joint surfaces are maximally congruent, and ligaments and capsule are taut. Position of maximal joint stability.
Open Pack Position
The position of the joint in which surfaces are free to move in relation to each other, and ligaments and capsule are slack. Position of increased joint laxity.
Osteokinematics
The movement of the bones, the direction they move as you voluntarily move them.
Arthrokinematics
The movements taking place between joint surfaces as a result of motion of the bones. This is involuntary motion. Usually one of the joint surfaces is stationary and the other more mobile.
What three movements are associated with Arthokinematics?
Roll, Slide, and Spin.
What is Roll in association with Arthokinematics?
Many points of one joint surface contact many points along second joint surface.
What is Slide in association with Arthokinematics?
One point of a joint surface contact many points along the second joint surface.
What is Spin in association with Arthokinematics?
Many points of one joint surface contact a single point on a second joint surface.
What is similar between most movements of Synovial joints?
Sliding and rolling occur simultaneously during most movements within synovial joints. If only Roll, then dislocation would occur. If only Slide, impingement of full movement would occur.
What are the factors that affect the Type and Amount of Movement in Synovial Joints?
Structure of Shape of the articulating bone surfaces, Strength and Tension of ligaments, Arrangement and Tension of muscles, Apposition of soft tissue, Hormones, Disuse.
How does Structure and Shape of the articulating bones surfaces affect movement?
It determines the amount of joint congruency or how closely the bones fit together. Interlocking joints, such as the ball and socket joint structure of the hip, will allow movement in multiple planes to include rotation, but will limit motion at end ranges.
How does Strength and Tension of ligaments of the articulating bones affect movement?
Serves to limit and direct the motion that occurs withing a joint.
How does the Arrangement and Tension of muscles of articulating bones affect movement?
Muscle contraction forces can generate joint movement. Tensional (stretch) forces within a muscle will renforce ligaments in restraining movement.
How does Apposition of Soft Tissue of articulating bones affect movent?
Soft tissue approximation or apposition occurs when muscle or adipose tissue prevents further mobility within a joint. For example, the biceps brachii and anterior forearm musculature will limit the amount of flexion at the elbow.
How does Hormones affect movement of articulating bones?
Hormone levels may affect the amount of joint flexibility throughout the body. For example, relaxin is released during pregnancy to increase the flexibility of the pubic symphysis fibrocartilage and surrounding ligaments to allow for child birth.
How does Disuse affect movement of articulating bones?
Immobilization and/or disuse will adversely affect the amount of joint motion. Restricted mobility results from decreased or thickened synovial fluid, diminished ligament and tendon flexibility, and muscle atrophy.
What are the forces that act upon joints?
Muscle Contraction, Gravity, Friction, and External Resistance.
What are examples of Muscle Contraction?
Hamstring, quads and biceps, triceps.
What are examples of Gravity?
Vertebral column especially when running. Other examples include hip and knee (weight bearing joints).
What are examples of Friction?
Over use, wearing of cartilage, ligament or tendon, meniscus at knee and impingement at shoulder.
What are examples of External Resistance?
Carrying heavy shoulder bags or weight training.
What are the effects of Aging on Synovial Joints?
Causes decreased ability to produce synovial fluid. Less synovial fluid equals less nutrition and lubrication to the joint. Articular carilage wears thin. Ligaments become tighter forcing joint surfaces together.
What is the effect of Less Lubrication on Synovial Joints?
Increased thickness of fluid resulting in decreased motion which again results in thicker fluid. Becomes a vicious cycle.
What are the Joint Disorders?
Osteoarthritis, Rheumatoid Arthritis, Gout, Capsular Restrictions.
Osteoarthritis
Deterioration of articular cartilage until subchondral bone surfaces are exposed. Usually not symmetrical in the joints it affects (unilateral)
What are the effects of Osteoarthritis?
New bone forms in irregular manner in subchondral regions and joint margins resulting in Osteophytes or bone spurs.
Rheumatoid Arthritis
Chronic, systemic, autoimmune disease of the joints where the immune system of the body attacks its own cartilage and joint linings. Usually symmetrical and attacks both sides of body (bilateral). Small joints most affected.
What are the effects of Rheumatoid Arthritis?
Chronic inflammation of the synovial membrane, articular cartilage erosion, joint deformity, and ultimately joint fusion or immobility.
Gout
Excessive formation or insufficient excretion of uric acid.
What are the effects of Gout?
Uric acid builds up in the blood and reacts with sodium to form salt crystals. These crystals can accumulate in the soft tissue of joints and erode the articular cartilage.
What are th two types of Capsular Restrictions?
Capsular Pattern and Non-Capsular Pattern.
Capsular Pattern
A predictable pattern of restriction for each joint. Restriction is due to a problem in the capsule but also may have some muscle spasm involved. A capsular pattern is usually a reaction by the join to an injury and/or inflammation, and results in the loss of motion.
Non-Capsular Pattern
Restriction in the joint that is not predictable. May lose motion in one or two directions, but the limitation is due to a mechanical block (ie. scar tissue, meniscal tear, etc).
What are the capsular restrictions from greatest to least in the C-Spine?
Sidebending > Rotation > Extension
What are the capsular restrictions from greatest to least in the Shoulder
External Rotation > Abduction > Internal Rotation > Flexion
What are the capsular restrictions from greatest to least in the Elbow
Flexion > Extension
What are the capsular restrictions from greatest to least in the Wrist
Flexion = Extension
What are the capsular restrictions from greatest to least in the Hip
Flexion > Abduction > Internal Rotation
What are the capsular restrictions from greatest to least in the Knee
Flexion > Extension
What are the capsular restrictions from greatest to least in the Ankle
Plantar Flexion > Dorsi Flexion
What are the five reasons human joints are superior to artificial joints.
Low coefficient of friction from natural joint padding (articulate cartilage and synovail fluid), Increased sensation and proprioceptive feedback from joint sensory receptors, growth or "repair" responses to wear and tear through the body's natural healing process, Mechanically more complex than manufactured joints (natural design with surrounding structures) and handles stress more efficiently (metal fatigue factor)