The Joints of the Skeleton The Joints of the Skeleton SystemSystem

Primarily Synovial JointsPrimarily Synovial Joints

JOINTSJOINTS Joints or Joints or articulationsarticulations are functional are functional

junction between bones…or the site junction between bones…or the site where two bones meet. where two bones meet.

They bind parts of the skeletal They bind parts of the skeletal system, make possible bone growth, system, make possible bone growth, permit parts of the skeleton to permit parts of the skeleton to change shape during childbirth, and change shape during childbirth, and enable the body to move in response enable the body to move in response to skeletal muscle contractions.to skeletal muscle contractions.

JOINTSJOINTS Joints can also Joints can also

be grouped be grouped according to according to the degree of the degree of movement movement possible at the possible at the bony junction.bony junction.

SynarthroticSynarthrotic – – Immovable jointsImmovable joints

AmphiarthroticAmphiarthrotic- Slightly - Slightly moveablemoveable

DiarthroticDiarthrotic- - Freely movable.Freely movable.

JOINTSJOINTS Joints vary Joints vary

considerably in considerably in structure and structure and functionfunction

However, they can However, they can be classified by the be classified by the type of tissue that type of tissue that binds the bones at binds the bones at each junction.each junction.

Three general Three general groups are:groups are:

Fibrous jointsFibrous joints Cartilaginous Cartilaginous

JointsJoints Synovial JointsSynovial Joints

Fibrous JointsFibrous Joints Fibrous Joints-Fibrous Joints- are so named are so named

because of the fibrous tissue that because of the fibrous tissue that holds them togetherholds them together

In a fibrous joint there is no joint In a fibrous joint there is no joint cavity present.cavity present.

Most fibrous joints are immovable.Most fibrous joints are immovable. They lie between bones that closely They lie between bones that closely

contact one another.contact one another.

Fibrous JointsFibrous Joints Three types of Three types of

fibrous joints: fibrous joints: SyndesmosisSyndesmosis-Distal -Distal

end of the tibia and end of the tibia and fibulafibula

Suture-Suture- only only between flat bones between flat bones in the skullin the skull

Gomphosis-Gomphosis- root of root of a tooth to the a tooth to the jawbonejawbone

Cartilaginous JointsCartilaginous Joints Cartilaginous Joints-Cartilaginous Joints- Hyaline cartilage or Hyaline cartilage or

fibrocartilage connect the bones of this fibrocartilage connect the bones of this joint.joint.

Two Types are:Two Types are: SynchondrosisSynchondrosis (the articulation (the articulation

between the first rib and the between the first rib and the manubrum) manubrum)

SymphysisSymphysis (the smyphiysis pubis in the (the smyphiysis pubis in the pelvis)pelvis)

Cartilaginous JointsCartilaginous Joints

Cartilaginous JointsCartilaginous Joints

SYNOVIAL JOINTSSYNOVIAL JOINTS Most joints of the skeletal system are Most joints of the skeletal system are

synovial joints, and because they allow synovial joints, and because they allow free movement, they are diarthrotic. free movement, they are diarthrotic.

These joints are more complex These joints are more complex structurally than fibrous or cartilaginous structurally than fibrous or cartilaginous joints.joints.

SYNOVIAL JOINTSSYNOVIAL JOINTS Synovial Joint have five distinguishing Synovial Joint have five distinguishing

features.features.1.1. Articular CartilageArticular Cartilage is present at the ends of is present at the ends of

the opposing bonesthe opposing bones2.2. Joint CavityJoint Cavity (synovial) is present. This is (synovial) is present. This is

really just potential space that contains fluid. really just potential space that contains fluid. 3.3. Articular capsuleArticular capsule (aka joint capsule). This (aka joint capsule). This

encloses the joint cavity.encloses the joint cavity.4.4. Synovial Fluid-Synovial Fluid- is present and occupies the is present and occupies the

space within the joint capsule.space within the joint capsule.5.5. Reinforcing LigamentsReinforcing Ligaments – Synovial joints are – Synovial joints are

reinforced and strengthened by a number of reinforced and strengthened by a number of bandlike ligaments. bandlike ligaments.

Bursae and Tendon SheathsBursae and Tendon Sheaths Not strictly Not strictly

associated with associated with synovial joints but synovial joints but are often found are often found associated with associated with them.them.

BursaeBursae are flattened are flattened fibrous sacs lined with fibrous sacs lined with synovial membrane synovial membrane and containing a thin and containing a thin film of synovial fluid.film of synovial fluid.

Tendon SheathTendon Sheath is is essentially an essentially an elongated bursa that elongated bursa that wraps completely wraps completely around a tendon around a tendon subjected to friction.subjected to friction.

Bursae and Tendon SheathsBursae and Tendon Sheaths

SYNOVIAL JOINTSSYNOVIAL JOINTS6 Types6 Types

Ball and SocketBall and Socket The Ball and The Ball and

Socket joint Socket joint consists of a bone consists of a bone with a globular or with a globular or slightly egg- slightly egg- shaped head the shaped head the articulates with the articulates with the cup-shaped cavity cup-shaped cavity of another.of another.

Such joint allows a Such joint allows a wider range of wider range of motion than does motion than does any other kind.any other kind.

Permitting Permitting movements in all movements in all planes, as well as planes, as well as rotation movement rotation movement around a central around a central axisaxis..

Examples: Examples: Hip and Hip and Shoulder Shoulder contain joints contain joints of this type. of this type.

Ball and SocketBall and Socket

Condyloid JointCondyloid Joint Condyloid Condyloid

joint, the oval joint, the oval condyle of one condyle of one bone fits into bone fits into the elliptical the elliptical cavity of cavity of another bones.another bones.

This type of This type of joints permits a joints permits a variety of variety of movements in movements in different planes; different planes; rotational rotational movement, movement, however,is however,is NOTNOT possiblepossible..

Condyloid Joint Condyloid Joint exists between exists between the metacarpals the metacarpals and the and the phalangesphalanges..

And the And the radiocarpal radiocarpal (wrist) joints.(wrist) joints.

Condyloid JointCondyloid Joint

GLIDING JOINTSGLIDING JOINTS(aka Plane Joints)(aka Plane Joints)

The The articulating articulating surfaces of surfaces of gliding joints gliding joints are nearly are nearly flat or slightly flat or slightly curved. curved.

These joints These joints allow sliding allow sliding or back-and-or back-and-forth motion forth motion and twisting and twisting movementsmovements..

Most of the joints Most of the joints within the wrist and within the wrist and ankle.ankle.

The articular The articular processes of processes of adjacent vertebrae.adjacent vertebrae.

Joints formed by ribs Joints formed by ribs 2-7 connecting the 2-7 connecting the sternum are also sternum are also gliding joints.gliding joints.

GLIDING JOINTSGLIDING JOINTS(aka Plane Joints)(aka Plane Joints)

HINGE JOINTHINGE JOINT In a hinge In a hinge

joint, the joint, the convex surface convex surface of one bone of one bone fits into the fits into the concave concave surface of surface of another.another.

Such a joint Such a joint resembles the resembles the hinge of a door hinge of a door in that it in that it permits permits movement in movement in one plane one plane only.only.

The elbow The elbow and the and the joints of the joints of the phalanges.phalanges.

HINGE JOINTHINGE JOINT

PIVOT JOINTPIVOT JOINT In a pivot joint, In a pivot joint,

the cylindrical the cylindrical surface on one surface on one bone rotates bone rotates within a ring within a ring formed on bone formed on bone and fibrous and fibrous tissue of a tissue of a ligament.ligament.

Movement at Movement at such a joint is such a joint is limited to limited to rotation rotation around a around a central axis.central axis.

The joint The joint between the between the proximal ends of proximal ends of the radius and the radius and the ulna.the ulna.

A pivot joint A pivot joint functions in the functions in the neck as the head neck as the head turns from side turns from side to side.to side.

PIVOT JOINTPIVOT JOINT

SADDLE JOINTSADDLE JOINT A saddle joint A saddle joint

forms between forms between bones whose bones whose articulating articulating surfaces have both surfaces have both concave and concave and convex regions. convex regions. The surface on one The surface on one bone fits the bone fits the complementary complementary surface of another.surface of another.

This physical This physical relationship relationship permits a permits a variety of variety of movements, movements, mainly in two mainly in two planes.planes.

The joint The joint between the between the carpal and the carpal and the metacarpal of metacarpal of the thumb.the thumb.

SADDLE JOINTSADDLE JOINT

Movements Allowed by Movements Allowed by Synovial JointsSynovial Joints

Every skeletal muscle of the body is Every skeletal muscle of the body is attached to bone or other connective attached to bone or other connective tissue structures at no fewer than tissue structures at no fewer than two pointstwo points

The muscles The muscles originorigin is attached to is attached to the immovable ( or less moveable ) the immovable ( or less moveable ) bone. bone.

Its other end, the Its other end, the insertioninsertion, is , is attached to the moveable bone.attached to the moveable bone.

Gliding MovementsGliding Movements AKA as translation, are the simplest AKA as translation, are the simplest

joint movements. joint movements. Back and forth or side to side!Back and forth or side to side!

Angular MovementsAngular Movements Angular Movements increase or Angular Movements increase or

decrease an angle between two decrease an angle between two bones.bones.

FlexionFlexion FlexionFlexion- Bending - Bending

movement, that movement, that decreases the angel of decreases the angel of the joint and bring the the joint and bring the articulating bones articulating bones closer togethercloser together

Ex: bending the head Ex: bending the head forward on the chest; forward on the chest; bending the knee from bending the knee from a straight to an angled a straight to an angled position.position.

ExtensionExtension ExtensionExtension- -

opposite of flexion, opposite of flexion, that increases the that increases the angel of the joint angel of the joint and brings the and brings the articulating bones articulating bones farther apart.farther apart.

Ex: Straightening Ex: Straightening a flexeda flexed

HyperextensionHyperextension

HyperextensionHyperextension- - Bending part of the Bending part of the body past its body past its straight upright straight upright position. position.

Abduction/AdductionAbduction/Adduction AdductionAdduction- -

Moving a part Moving a part toward the midline. toward the midline. (returning into the (returning into the side of the body)side of the body)

AbductionAbduction- - Moving a part away Moving a part away from the body.from the body.

CircumductionCircumduction Circumduction- Circumduction- - -

Moving a limb so Moving a limb so that it describes a that it describes a cone in space. cone in space.

The quickest way The quickest way to exercise the to exercise the many muscles that many muscles that move the hip and move the hip and shoulder ball and shoulder ball and socket joints.socket joints.

..

Dorsiflexion and Plantar Flexion Dorsiflexion and Plantar Flexion of the Footof the Foot

DorsiflexionDorsiflexion- Lifting the foot so that - Lifting the foot so that its superior surface approaches the its superior surface approaches the shin. shin.

Dorsiflexion and Plantar Flexion Dorsiflexion and Plantar Flexion of the Footof the Foot

Plantar FlexionPlantar Flexion- depressing the - depressing the foot or pointing the toes.foot or pointing the toes.

Special MovementsSpecial Movements Some movements do Some movements do NOTNOT fit into a fit into a

specific category and occur only at a specific category and occur only at a few joints. few joints.

They are illustrated in the next few They are illustrated in the next few slides.slides.

RotationRotation

Rotation- The Rotation- The turning of a bone turning of a bone around its own around its own long axis. long axis.

It is the only It is the only movement allowed movement allowed between the C1 between the C1 and C2 vertebraand C2 vertebra

Common at the hip Common at the hip and shoulder joint.and shoulder joint.

Supination and PronationSupination and Pronation

Both of these refer to movement of Both of these refer to movement of the radius around the ulna. the radius around the ulna.

SupinationSupination meaning “turning meaning “turning backwards”..rotate the arm so the backwards”..rotate the arm so the palm is facing anteriorlypalm is facing anteriorly

PronationPronation-- meaning turning meaning turning forward…rotate the arm so the palm forward…rotate the arm so the palm is facing posteriorly. is facing posteriorly.

Supination and PronationSupination and Pronation

Inversion and EversionInversion and Eversion Both of these refer Both of these refer

to special to special movement of the movement of the foot.foot.

InversionInversion- the - the sole of the foot sole of the foot turns mediallyturns medially

EversionEversion- the sole - the sole faces laterally.. faces laterally..

Protraction and RetractionProtraction and Retraction Nonangular Nonangular anterior anterior

and posterior and posterior movements in a movements in a transverse plane.transverse plane.

The mandible is The mandible is protractedprotracted when you when you jut out your jaw.jut out your jaw.

And And retractedretracted when when you move it back to its you move it back to its original position.original position.

Elevation and DepressionElevation and Depression ElevateElevate-- lifting a body lifting a body

part superiorly. part superiorly. (shrugging your (shrugging your shoulders)shoulders)

DepressionDepression is moving is moving the elevated part the elevated part inferiorly.inferiorly.

Chewing your food is Chewing your food is alternately both alternately both elevation and elevation and depression.depression.

OppositionOpposition OppositionOpposition – found in – found in

the saddle joint the saddle joint between the between the metacarpal and the metacarpal and the carpals. carpals.

This is the action taken This is the action taken when you touch your when you touch your thumb to the tips of the thumb to the tips of the other fingers on the other fingers on the same hand.same hand.

..

What type of movements do What type of movements do we have here?we have here?

1. Abduction at the right hip, adduction at both shoulders.

What type of movements do What type of movements do we have here?we have here?

• Flexion at the left knee

• Flexion at the left hip,

• Extension at the

right hip, • Extension at

the right knee.

What type of movements do What type of movements do we have here?we have here?

• Flexion at both hips• Abduction at the

shoulders• Extension at the elbows • Extension at both knees.

What type of movements do What type of movements do we have here?we have here?

•  Flexion at both hips,

• Flexion at both knees,

• Extension at both elbows.

What type of movements do What type of movements do we have here?we have here?

1. Rotation / extension at the hips.

What type of movements do What type of movements do we have here?we have here?

• Flexion at both knees,

• Adduction at the shoulders

What type of movements do What type of movements do we have here?we have here?

Abduction at both hips.

What type of movements do What type of movements do we have here?we have here?

1. Flexion / rotation at the shoulder.

The KneeThe Knee The knee joint is the largest and The knee joint is the largest and

most complex joint in the body.most complex joint in the body. It allows flexion, extension, and some It allows flexion, extension, and some

rotation.rotation. It is actually composed of 3 separate It is actually composed of 3 separate

joints.joints.

The KneeThe Knee Be able to identify the ACL, PCL, Be able to identify the ACL, PCL,

meniscus, all three bursa sacs, and meniscus, all three bursa sacs, and the femur, tibia, and patella.the femur, tibia, and patella.

YOU NEED TO DRAW COLOR AND YOU NEED TO DRAW COLOR AND LABEL THE KNEE…you will have to LABEL THE KNEE…you will have to label this on a test. Please add this label this on a test. Please add this to the back side of your first drawing. to the back side of your first drawing. Due at the end of class today!!! Due at the end of class today!!!

Pg 266 (a)Pg 266 (a)

The KneeThe Knee

You need to know the following You need to know the following joints.joints.

What type of joints will you find here? Both What type of joints will you find here? Both structural and functional (or movements)structural and functional (or movements)

SkullSkull IntervertebralIntervertebral Sternocostal (ribs 1-7)Sternocostal (ribs 1-7) ShoulderShoulder ElbowElbow Radioulnar (proximal and distal)Radioulnar (proximal and distal) WristWrist IntercarpalIntercarpal CarpometacarpalCarpometacarpal

You need to know the following You need to know the following joints.joints.

What type of joints will you find here? Both What type of joints will you find here? Both structural and functional (or movements)structural and functional (or movements)

Knuckle Knuckle FingerFinger Pubic SymphysisPubic Symphysis HipHip KneeKnee TibiofibularTibiofibular AnkleAnkle IntertarsalIntertarsal TarsometatarsalTarsometatarsal MetatarsolphalangealMetatarsolphalangeal

When your Joints hurt!!When your Joints hurt!!

Usually we don’t think about joints Usually we don’t think about joints until we have a problem and they until we have a problem and they begin to hurt us.begin to hurt us.

This can be caused by trauma, This can be caused by trauma, inflammation, and/or arthritis.inflammation, and/or arthritis.

Sprains!!Sprains!! SprainSprain- the ligaments - the ligaments

reinforcing a joint are reinforcing a joint are stretched or torn.stretched or torn.

Lumbar region of the Lumbar region of the spine, ankle and knee are spine, ankle and knee are common. common.

Ligaments heal very slowly Ligaments heal very slowly because they are poorly because they are poorly vascularized.vascularized.

Cartilage is avascular and Cartilage is avascular and it rarely can obtain it rarely can obtain sufficient nourishment to sufficient nourishment to repair itself. It usually repair itself. It usually stays torn.stays torn.

Cartilage fragments can interfere Cartilage fragments can interfere with joint function by causing joints with joint function by causing joints to lock or bind. So most sports to lock or bind. So most sports physicians recommend that the physicians recommend that the central par of a damaged cartilage central par of a damaged cartilage be removed. be removed.

This can be done by arthroscopic This can be done by arthroscopic surgery.surgery.

Sprains!!Sprains!!

Arthroscopic surgery.Arthroscopic surgery.

DislocationDislocation A dislocation occurs A dislocation occurs

when bones are forced when bones are forced out of alignment.out of alignment.

Usually accompanies Usually accompanies sprains, inflammation, sprains, inflammation, and joint and joint immobilizationimmobilization

Repeat dislocation of Repeat dislocation of the same joint are the same joint are common because the common because the initial dislocation initial dislocation stretches the joint stretches the joint capsule and capsule and ligaments.ligaments.

Bursitis/TendonitisBursitis/Tendonitis Bursitis is Bursitis is

inflammation of a inflammation of a bursa and is usually bursa and is usually caused by a blow or caused by a blow or frictionfriction

Tendonitis is Tendonitis is inflammation of inflammation of tendon sheaths, tendon sheaths, typically caused by typically caused by overuse.overuse.

Treatments for both Treatments for both include…rest, ice, and include…rest, ice, and anti-inflammatory anti-inflammatory drugs. drugs.

OsteoarthritisOsteoarthritis It is the most common It is the most common

chronic arthritischronic arthritis It is chronic It is chronic

degenerative, often degenerative, often called “wear and tear” called “wear and tear” arthritis.arthritis.

Normal in the aging Normal in the aging processprocess

The normal joint use The normal joint use prompts the release of prompts the release of enzymes that break down enzymes that break down articular cartilage.articular cartilage.

The result is softened, The result is softened, roughened, pitted, and roughened, pitted, and eroded articular eroded articular cartilages.cartilages.

Rheumatoid ArthritisRheumatoid Arthritis

It is not as common but still effects millions.It is not as common but still effects millions. Effect women more than men, usually between the ages Effect women more than men, usually between the ages

of 40-50of 40-50 In early stages joint tenderness and stiffness are commonIn early stages joint tenderness and stiffness are common Usually effects small joints like wrist, ankles, fingers, and Usually effects small joints like wrist, ankles, fingers, and

feet.feet. Has both flare ups and remissionsHas both flare ups and remissions

RA- is an autoimmune RA- is an autoimmune disease- a disorder in disease- a disorder in which the body’s which the body’s immune system immune system attacks its own tissue. attacks its own tissue.

Unknown cause but Unknown cause but suspects include suspects include bacterium and viruses.bacterium and viruses.

Synovial fluid can Synovial fluid can increaseincrease

Rheumatoid ArthritisRheumatoid Arthritis

Gouty Gouty ArthritisArthritis

The symptoms of gout are almost always acute and sudden, happening often at night with no warning. Symptoms in the affected joints may include:

Intense pain Swelling Tenderness Redness

One of the oldest known diseases, gout was once One of the oldest known diseases, gout was once considered "the disease of kings" because it was associated considered "the disease of kings" because it was associated with those wealthy enough to overindulge in rich food and with those wealthy enough to overindulge in rich food and drink. drink.

In fact gout is a complex disorder that can affect anyone In fact gout is a complex disorder that can affect anyone and does affect more than 2 million Americans. and does affect more than 2 million Americans.

Gouty ArthritisGouty Arthritis

Seen more often in men Seen more often in men than womenthan women

Genetic factors are Genetic factors are definitely implicated.definitely implicated.

Excess alcohol can Excess alcohol can promote excess uric acid..promote excess uric acid..

Gout is caused by high blood levels of uric acid, a waste formed from the breakdown of purines.

If the body produces too much or eliminates too little uric acid, it builds up and forms needle-like crystals in a joint or the surrounding tissue,

At the right is a photograph of crystals of monosodiumurate, which cause gout. They are identified by their shape and physical properties when seen under a microscope