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59 Cards in this Set

  • Front
  • Back

Define Joints

Joints connect body segments together, and allow movement between the segments

What does joint design show

Reflects the demand of the joint




Form Follows Function - appearance of object assists in determining its function

What role do functional demands play in joint design

May help determine the structure.

Example of Function --> Structure (Hip Joint)

Components develop before birth but structure is dependent on interaction between the femur and acetabulum.

3 components of Joint function

Structure (Design)


Composition (materials)
Function




S+c Determine function


Demand leads to change in S+C

What are the types of joints?

Synarthroses


-Fibrosis


-Cartilaginous




Diarthrosis


-Synovial

Define Fibrous Joints

Skull Sutures


Tooth in mandible/maxilla

Define Cartilaginous joints

Symphysis Pubis


Sternum and 1st rib

Define Synovial Joints

Ends of bones are free to move at the articulation




Ends of bones connected by joint capsule that encloses the joint

What are the Essential Elements of Synovial Joints

Articular capsule


joint capsule


synovial membrane


ligaments


blood vessels


sensory nerves

What are the additional elements of synovial joints

Bursa


menisci


fat bad


labra


discs

Define Menisci

Intra-articular Discs


Assist by spreading forces over larger area




Found at:


-Tibfib


-Distal radio-ulnar


-SC Joint


-AC Joint


-TMJ

How are Synovial joints Classified?

Uniaxial


-hinge/pivot


Biaxial


-Ellipsodial Joint


-Saddle joint


-Condyloid joint


Triaxial


-Ball and Socket


-Plane Joint

What are Ovoid Joints

Paired surfaces that are imperfectly spherical, or egg shaped. One concave the other convex.

What are Saddle Joints

2 surfaces: one concave, other convex. Oriented at right angles to each other.



Spin is limited.

Instantaneous VS Average Axis of Rotation

I: Applies to specified arc of motion




A: Entire arc of motion - used clinically

Major types of connective tissue?

Capsule ligament tendon cartilage = periarticular tissue




Bone

Types of Cells - Fixed

Fibroblasts Form ligaments, tendons and other supportive tissue (Type I collagen)


Chondrocytes Form hyaline articular and fibrocartilage (Type II collagen)


Osteoblasts Fibroblast found in bone. (Type I collagen and hydoxyapatite)


Osteoclasts Responsible for bone resorption


Mast Cell inflammatory mediators


Adipose Cell produce and store fat


Mesenchyme Cell can differentiate into any connective tissue cell type

Types of Cells - Transient

Lymphocytes - WBC


Neutrophils - WBC involved in fighting infection


Macrophages - Involved in immune response


Plasma Cells - B lymphocytes producing antibodies

What is Extracellular Matrix

-Part of tissue outside of cell


-Contains Fibrous proteins (collagen and elastin) and Ground substance - water and proteins



Type 1 vs Type 2 Collagen

Type 1: Thick, litle elongation - ideal for binding and support




Type 2: Thinner. Framework for maintaining shape and consistency

Describe Elastin

Resists tensile forces but have more "give"


-Aorta


-Lig Flavum




Easily returns to original shape when deformed

What are Glycosaminoglycans

Negatively charge


Hydrophillic


Composition of tissue will vary based on demands

Where are the different types of GAG found?

Hyaluronan - syn fluid, loose CT, cartilage




Condroitin Sulfate - Cart, bone heart valuves, tendons, lig




Heparin - intracellular granules in mast cells




Keratan sulfate - cornea bone cartialge

What are the two dense connective tissue types

Irregular - Haphazard orientation of collagen fibers


Resists tensile forces from multiple directions




Regular - Orderly, near parallel orientation of fibers (lig/tendons)


Resist forces along long axis of tissue

What are Ligaments

Connect bone to bone


Some are just a thickening of a capsule


Small amt of cells large extracell matrix


Mainly Type I Collagen

What is a ligament

Denselypacked collagen bundles arranged in line with tensile forces. May be aligned in more than one direction dueto need to provide stability.

Names descriptively based on

Location


Structure


Bony Attachement

What is a tendon?

Connects muscle to bone and transmits forces


Increased % of Type I collagen

Describe Collagen fibers in tendons?

Fiberstend to align straight and parallel to allow for force transfer from muscle tothe bony lever

What is an epitendon?

Sheath which encloses the entire tendon

What is Paratendon?

Double layered sheath of tissue loosely attached to the outer surface of the epitendon

What is tenosynovium?

Synovium filled sheath in tendons subjected to increased friction

What is Peritendon?

Paratendon + Epitendon

Decreased loads on Musculotendinous junctions

Becomes flatter and weaker. Important to note after a period of immobilization

What are the cartilage types?

Fibrocartilage:IV Discs, glenoid and acetabular labra, and intra-articular discs/menisci




Elasticcartilage: Found in ears




Hyaline(articular) cartilage: Ends of bones in synovial joints

Describe Fibrocartilage

Mixture of dense connective tissue and articular cartilage.




Providesresilience and shock absorption of articular cartilage and tensile strength ofligaments and tendons.




Anueral: Does not produce pain




Limited blood supply - relies on diffusion from adjacent cells

Nutrients and weight bearing

Diffusion of nutrients and removal of waste assisted by "milking" action of intermittent weight bearing

Describe Articular cartilage

Specialized type of hyaline cartilage - forms the load bearing surface of joints.




Avascular and aneural - lacks perichondrium = poor maintenance and repair

Role of Articular cartilage

Distributes compreessive forces


reduces friction between joint surfaces

Breakdown of Articular cartilage

Damage to superficial layer, increase inflammation, decreased nutrition, proteoglycan loss --> eroding and thinning of cartilage

Compostion of bone

Minerals: Ca and Phosphate

Collagen


Gelatinous Ground Substance


Water

What are the purposes of the organic and inorganic components of bone

O: Flexibility and resilience

I: Rigidity

What is an Osteon

Structual subunit


Concentric layers


Contains Haversian canal which contains blood and nerve vessels

What are the two types of bone

Cortical - compact bone


-Always surrounds cancellous - 3-30% porous


Cancellous - Trabecular bone


-30-90%porous

What is the periosteum

Dense fibrous membrane covering the bone


Outside blood vessel and nerves


Inner contains osteoblasts




Long bones - Endosteum

Properties of bone

Dynamic Tissues

Consistant remodeling


responds to hormonal changes


Greatest strength when compressed along long axis

Properties of Tendons

-Creep with tensile loading


-Resistance and elongation determined by many factors


-Responds to tension


-Vulnerable at the ends - mid tears uncommon


-Tensile loading increases size, collagen concentration and cross-links

Ligament tissue properties

Similar to tendons mechanically


decreased tensile loading intolerance


Immobilization causes rapid weakening

How does Cartilage resist load?

1.Stressin collagen in extracellular matrix (type II collagen)


2.Pressuredeveloped in fluid phase (proteoglycans and water)


3.Frictionaldrag as fluid flows through extracellular matrix

Ways to cause changes due to immoblization

Casting


Bed Rest


Paralysis


Weakness




Periarticular connective tissue relies on PA to maintain structure

Changes to tissues due to immobilization

Capsule - Adaptiveshortening, “contractures”


Ligamentand Tendon -Decreasedcollagen content, decreased cross-linking


ArticularSurface -Thinningand softening of articular cartilage and Increaseddeformation under loading


Bone - Wolff’sLaw :Boneis laid down in areas of high stress, and reabsorbed in areas of low stress

Tissues responses to exercise

Bone


- Increasedwith weight-bearing exercise (see Wolff’s Law)


-Lowmagnitude produces response


Cartilage


-Tissuehealth dependent on application and removal of loads


-Tissueformed is fibrocartilage, not articular cartilage


Tendon


-Increasedtensile loads lead to increased size, collagen concentrationand cross-links


-Structuraland materialchangesoccur Ligament


-Preventionof negative changes in healing ligaments. Effect on normal ligaments unknown.

What is Acute Trauma

Single overwhelming event


Instability - long EMA and High ET


-leads to increased loading on other structures



What is Chronic Trauma?

"Overuse Syndromes"


Sudden application of large load


Accumulation of unreparied, relatively minor damage

What can recurring instabillity lead to?

Abnormal loading and mechanical failure




Length change


Dec Resistance to comp and shear forces


Reduced shock absorption

What is Osteoarthritis

Gradual erosion of articular cartilage, lack of inflammatory component


Sunchondral bone becomes weight bearing surface

What is Rheumatoid Arthritis

Systemic autoimmune disorder with inflammatory component


Articular Cartilage eroded by enzymatic procecss


Inflam in capsule and synovium

What effect does age have on the tissues?

Histologica changes in periarticular CT and Bone


Accumulation of mirotrauma leads to subclinal damage


AC - Decrease on GAGs leads to Dec H2O conc


Tendon - less stiff, dec mechanical efficiency dec transfer of muscle force


Bone - Dec ossteo activity.