Chapter 9 Articulations

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Chapter 9 Articulations
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Joint Functional Classification

• Synarthroses immovable
• Amphiarthroses slightly movable
• Diarthroses freely movable

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Fibrous Joints (Synarthroses)
Sutures Teethlike projection interlock Found in
the skull

• Syndesmoses
• Fibrous bands connect 2 bones
• Joints between distal and radial end of ulna

Gomphoses Occurs between the root of tooth and
alveolar process
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Cartilaginous Joints (Amphiarthroses)
Symphysis Pad of disk of fibrocartilage connects
2 bones Vertebral disc

• Synchondroses
• Has hyaline cartilage between articulating bones
• Articulation between first rib and sternum
• Also during growth years between epiphysis and
  diaphysis

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Synovial Joints (Diarthroses)

• Majority of joints between bones in the
  appendicular skeleton are synovial joints

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Structure of Synovial Joints
Pillow-like structure filled with synovial fluid.
Function to cushion joint at bony prominances
Moist membrane that lines inner surface of joint
capsule
Sleeve-like extension of periosteum of
articulating bones. Forms casing around bone end
Cords of dense fibrous tissue. Lash bones firmly
together
Ligament
Thin layer of hyaline cartilage cushioning
articulating surface of bone
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Types of Synovial Joints

• Uniaxial permit movement around only one axis and
  in only one plane
• Hinge joint
• Pivot joints
• Biaxial permit around 2 perpendicular axes and
  planes
• Saddle joints
• Condyloid joints
• Multiaxial permit movement around 3 or more axes
  and planes
• Ball and socket joints
• Gliding joints

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Types of Synovial Joints
Hinge Joint distal bone can move only in one
plane, flexion and extension (forward and
backward).
pivot joints movement is limited to rotation.
Condyloid Distal bone has an ovoid articular
surface and is received into an elliptical cavit,
which makes it impossible for the bones to
perform axial rotation.
Ball and Socket Distal bone can move around a
center in an indefinite number of axes.
saddle joint consists of two opposing surfaces
that are reciprocally concave-convex, wich allows
flexion, extension, adduction, abduction, and
circumduction, but no axial rotation.
Gliding The main movements are flexion-extension
and rotation.
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Types of Synovial Joints
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Humeroscapular Joint / Shoulder Joint
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Humeroscapular Joint / Shoulder Joint
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Elbow Joint
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Elbow Joint
Helps cushion joint
Ulnar nerve
Medially cubital vein
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Forearm and Wrist Joints

• Proximal radioulnar pivot joint between the
  circumference of the head of the radius and the
  ring formed by the radial notch of the ulna and
  the annular ligament.
• Distal radioulnarpivot-joint formed between the
  head of the ulna and the ulnar notch on the
  distal radius.

• Proximal radioulnar pivot joint between the
  circumference of the head of the radius and the
  ring formed by the radial notch of the ulna and
  the annular ligament.
• Distal radioulnarpivot-joint formed between the
  head of the ulna and the ulnar notch on the
  distal radius.

• Proximal radioulnar pivot joint between the
  circumference of the head of the radius and the
  ring formed by the radial notch of the ulna and
  the annular ligament.
• Distal radioulnarpivot-joint formed between the
  head of the ulna and the ulnar notch on the
  distal radius.

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Forearm and Wrist Joints

• Radiocarpal (wrist) Condyloid joint formed by
  the radius and the articular disk proximally and
  the proximal row of carpal bones distally.

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Hand and Finger Joints
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Hand Joints

• Intercarpal Articulations between the individual
  carpal bones. They are plane synovial joints. The
  small amount of movement between the carpal bones
  at these joints contributes to total wrist
  mobility.

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Hand and Finger Joints
Interphalageal
Synovial Joints
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Hip Joint

• synovial joint formed by the articulation of the
  rounded head of the femur and the cup-like
  acetabulum of the pelvis. It forms the primary
  connection between the bones of the lower limb
  and the axial skeleton of the trunk and pelvis.
• surfaces are covered with a strong but lubricated
  layer called articular hyaline cartilage.

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Hip Joint
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Knee Joint (tibiofemoral) Hinge
Has several ligaments
Has several ligaments
Has several ligaments
Has several ligaments
Has several ligaments
Concavity of tibia forms a shallow socket for
condyle of femur
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Knee Joint
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Ankle Joint

• synovial hinge joint that connects the distal
  ends of the tibia and fibula in the lower limb
  with the proximal end of the talus bone in the
  foot
• Most common injury sprained ankle is caused by
  internal rotation to anterior talofibular ligament

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Vertebral Joints
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Vertebral Joints

• Caliginous joints between bodies of adjacent
  vertebra classified symphyses
• Permit only slight movement
• Synovial joints between articulating surfaces of
  vertebral processes are classified as gliding

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ROM
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Measuring ROM

• ROM is measured with a goniometer

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Measuring ROM
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Types of Movement

• Synovial joints permit one or more of the
  following movements
• Angular change the size of angle between
  articulating bones
• Circular results in arclike rotation around axis
• Gliding moves over articulating surfaces without
  angular or circular movement
• Special Dont fit in any movement category

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Angular Movements

• Flexion Decrease angle, bends or folds one part
  to another
• Extension Increase angle between bones
• Hyperextension Stretching part beyond anatomical
  position

• Flexion Decrease angle, bends or

• Flexion Decrease angle, bends or

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Angular Movements

• Plantar Flexion foot is stretched down and back.
  Increases angle between top of foot and front of
  leg
• Dorsiflexion foot is tilted upward decreasing
  angle

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Angular Movements

• Abduction moves part away from median body plane
• Adduction Moves toward median body plane

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Circular Movement

• Rotation pivoting bone on own axis. Moving head
  side to side (NO)
• Circumduction distal ends move in circle. Such
  as pitching
• Supination turns palms side up
• Pronation turns palms side down

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Special Movement

• Inversion turn sole of foot inward
• Eversion Turn sole of foot outward

• Protraction moves part forward
• Retraction Moves part back

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Special Movement

• Elevation moves part up
• Depression Moves part down

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Bursitis
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Joint Disorders

• Noninflammatory
• Does not involve inflammation of synovial
  membrane.
• Doesnt produce systemic signs or symptoms such
  as fever or damage other organs
• Inflammatory

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Noninflammatory

• Osteoarthritis/degenerative joint disease.
• Most common noninflammatory disorder
• Wear and tear degeneration
• Fracturing of articulating cartilage
• Abnormal formation of new bone such as bone spurs
• Cause unknown but attributed to obesity, aging
  and wear and tear
• Symptoms are treated with NSAIDS, glucosamine,
  chondriton or injections of gelatinous type
  lubricating fluid, and surgery

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Osteoarthritis
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Swelling deformities of the distal
interphalangeal joints
Swelling deformities of the distal
interphalangeal joints
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Noninflammatory

• Dislocation (subluxation)
• Usually resulting from trauma
• Can be an emergency due to association with blood
  vessels and nerves
• Articulating surfaces no longer in proper contact

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Arthroscopy

• Surgical procedure orthopaedic surgeons use to
  visualize, diagnose, and treat problems inside a
  joint.

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Inflammatory Joint Diseases
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Arthritis

• General term for many different inflammatory
  joint diseases
• Can be caused by variety of factors such as
  infection, injury, genetics and autoimmunity

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Rheumatoid Arthritis (RA)
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Rheumatoid Arthritis (RA)

• Systemic autoimmune disease
• Involves chronic inflammation of many tissues and
  organs, generally starting with the joints
• Pannus is granulation tissue that is formed
  within the synovium by proliferating fibroblasts
  and inflammatory cells
• Pannus adheres to cartilage, destroying it and
  eventually fusing bones

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Rheumatoid Arthritis

• Deformity of the fingers known as ulnar deviation
  is common
• Treated with NSAIDs, corticosteroids, and other
  antirheumatic meds
• New drugs that alter immune response such as TNF
  blockers are showing promise

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Juvenile Rheumatoid Arthritis

• appears between the ages of 6 months and 16
  years.
• first signs often are joint pain or swelling and
  reddened or warm joints

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Gouty arthritis

• Metabolic disorder
• Excess blood levels of uric acid are deposited as
  sodium urate crystals within synovial fluid of
  joints (tophi)
• Can lead to very swollen and painful joints
• Treated with Allopurinol (inhibits synthesis of
  uric acid)

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