Transcript Chapter 8 ppt B
© Annie Leibovitz/Contact Press Images PowerPoint ® Lecture Slides prepared by
Human Anatomy & Physiology
Atlantic Cape Community Ninth Edition College
C H A P T E R
8
Joints: Part B
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Types of Synovial Joints
• Six types, based on shape of articular surfaces: –
Plane
–
Hinge
–
Pivot
–
Condylar
–
Saddle
–
Ball-and-socket
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Figure 8.7a The shapes of the joint surfaces define the types of movements that can occur at a synovial joint; they also determine the classification of synovial joints into six structural types.
Metacarpals Carpals Plane joint Nonaxial movement Flat articular surfaces Gliding Examples: Intercarpal joints, intertarsal joints, joints between vertebral articular surfaces
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Figure 8.7b The shapes of the joint surfaces define the types of movements that can occur at a synovial joint; they also determine the classification of synovial joints into six structural types.
Humerus Ulna Hinge joint Uniaxial movement Medial/lateral axis Cylinder Trough Flexion and extension Examples: Elbow joints, interphalangeal joints
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Figure 8.7c The shapes of the joint surfaces define the types of movements that can occur at a synovial joint; they also determine the classification of synovial joints into six structural types.
Ulna Radius Pivot joint Uniaxial movement Vertical axis Sleeve (bone and ligament) Axle (rounded bone) Rotation Examples: Proximal radioulnar joints, atlantoaxial joint
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Figure 8.7d The shapes of the joint surfaces define the types of movements that can occur at a synovial joint; they also determine the classification of synovial joints into six structural types.
Phalanges Metacarpals Condylar joint Biaxial movement Medial/ lateral axis Oval articular surfaces Flexion and extension Examples: Metacarpophalangeal (knuckle) joints, wrist joints Anterior/ posterior axis Adduction and abduction
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Figure 8.7e The shapes of the joint surfaces define the types of movements that can occur at a synovial joint; they also determine the classification of synovial joints into six structural types.
Metacarpal
Trapezium Saddle joint Medial/ lateral axis Biaxial movement Anterior/ posterior axis Articular surfaces are both concave and convex Adduction and abduction Example: Carpometacarpal joints of the thumbs Flexion and extension
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Figure 8.7f The shapes of the joint surfaces define the types of movements that can occur at a synovial joint; they also determine the classification of synovial joints into six structural types.
Scapula Ball-and-socket joint Cup (socket) Medial/lateral axis Multiaxial movement Anterior/posterior axis Vertical axis Humerus Spherical head (ball) Flexion and extension Examples: Shoulder joints and hip joints Adduction and abduction Rotation
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Knee Joint
• Largest, most complex joint of body • Three joints surrounded by a single joint cavity –
Femoropatellar joint
• Plane joint • Allows gliding motion during knee flexion –
Lateral
and
medial tibiofemoral joints
• Femoral condyles with lateral and medial menisci of tibia • Allow flexion, extension, and some rotation when knee partly flexed © 2013 Pearson Education, Inc.
Knee Joint
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A&P Flix
™: Movement at the Knee Joint
Right click slide / select “play”
Figure 8.8a The knee joint. Femur Articular capsule Posterior cruciate ligament Lateral meniscus Anterior cruciate ligament Tibia Tendon of quadriceps femoris Suprapatellar bursa Patella Subcutaneous prepatellar bursa Synovial cavity Lateral meniscus Infrapatellar fat pad Deep infrapateller bursa Patellar ligament Sagittal section through the right knee joint
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Figure 8.8b The knee joint. Anterior cruciate ligament Articular cartilage on medial tibial condyle
Anterior
Articular cartilage on lateral tibial condyle Medial meniscus Posterior cruciate ligament Lateral meniscus Superior view of the right tibia in the knee joint, showing the menisci and cruciate ligaments
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Knee Joint
• At least 12 associated bursae • Capsule is reinforced by muscle tendons – E.g., quadriceps and semimembranosus tendons • Joint capsule is thin and absent anteriorly • Anteriorly, quadriceps tendon gives rise to three broad ligaments –
Medial
and
lateral patellar retinacula
–
Patellar ligament
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Figure 8.8c The knee joint. Quadriceps femoris muscle Tendon of quadriceps femoris muscle Patella Lateral patellar retinaculum Fibular collateral ligament Fibula
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Anterior view of right knee Medial patellar retinaculum Tibial collateral ligament Patellar ligament Tibia
Ligaments Stabilizing Knee Joint
• Capsular and extracapsular ligaments – Help prevent hyperextension of knee –
Fibular and tibial collateral ligaments
–
Oblique popliteal ligament
–
Arcuate popliteal ligament
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Figure 8.8d The knee joint. Tendon of adductor magnus Medial head of gastrocnemius muscle Popliteus muscle (cut) Tibial collateral ligament Tendon of semimembranosus muscle Femur Articular capsule Oblique popliteal ligament Lateral head of gastrocnemius muscle Bursa Fibular collateral ligament Arcuate popliteal ligament Tibia
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Posterior view of the joint capsule, including ligaments
Ligaments Stabilizing Knee Joint
• Intracapsular ligaments – Prevent anterior-posterior displacement – Reside outside synovial cavity –
Anterior cruciate ligament
• Attaches to anterior tibia –
Posterior cruciate ligament
• Attaches to posterior tibia © 2013 Pearson Education, Inc.
Figure 8.8e The knee joint. Fibular collateral ligament Lateral condyle of femur Lateral meniscus Tibia Fibula Posterior cruciate ligament Medial condyle Tibial collateral ligament Anterior cruciate ligament Medial meniscus Patellar ligament Patella Quadriceps tendon Anterior view of flexed knee, showing the cruciate ligaments (articular capsule removed, and quadriceps tendon cut and reflected distally)
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Animation: Rotatable Knee
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Figure 8.8f The knee joint. Medial femoral condyle Anterior cruciate ligament Medial meniscus on medial tibial condyle
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Patella Photograph of an opened knee joint; view similar to (e)
Knee Joint Injuries
• Absorbs great vertical force • Vulnerable to horizontal blows, especially laterally blows to extended knee – Three C's • Collateral ligaments • Cruciate ligaments • Cartilages © 2013 Pearson Education, Inc.
Figure 8.9 A common knee injury.
Lateral
Hockey puck Patella (outline)
Medial
Tibial collateral ligament (torn) Medial meniscus (torn) Anterior cruciate ligament (torn)
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Shoulder (Glenohumeral) Joint
• Ball-and-socket joint – Head of humerus with glenoid cavity of scapula • Most freely moving joint in body – Stability sacrificed © 2013 Pearson Education, Inc.
Figure 8.10a The shoulder joint.
Acromion of scapula Coracoacromial ligament Subacromial bursa Fibrous layer of articular capsule Tendon sheath Tendon of long head of biceps brachii muscle Frontal section through right shoulder joint
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Synovial cavity of the glenoid cavity containing synovial fluid Articular cartilage Synovial membrane Fibrous layer of articular capsule Humerus
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Animation: Rotatable Shoulder
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Figure 8.10b The shoulder joint.
Synovial cavity of the glenoid cavity containing synovial fluid Articular cartilage Fibrous layer of articular capsule Humerus Cadaver photo corresponding to (a)
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Shoulder Joint
• Reinforcing ligaments – Primarily on anterior aspect –
Coracohumeral ligament
• Helps support weight of upper limb – Three
glenohumeral ligaments
• Weak and sometimes absent © 2013 Pearson Education, Inc.
Shoulder Joint
• Reinforcing muscle tendons – Tendon of long head of biceps brachii • Travels through the intertubercular sulcus • Secures humerus to glenoid cavity – Four
rotator cuff
tendons encircle the shoulder joint • Subscapularis • Supraspinatus • Infraspinatus • Teres minor © 2013 Pearson Education, Inc.
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 Anterior view of right shoulder joint capsule
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Coracoid process Articular capsule reinforced by glenohumeral ligaments Subscapular bursa Tendon of the subscapularis muscle Scapula
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
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Lateral view of socket of right shoulder joint, humerus removed
Figure 8.10e The shoulder joint.
Head of humerus Muscle of rotator cuff (cut) Posterior view of an opened shoulder joint
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Acromion (cut) Glenoid cavity of scapula Capsule of shoulder joint (opened)
Elbow Joint
• Articulation of radius and ulna with humerus • Hinge joint – Primarily trochlear notch of ulna with trochlea of humerus – Flexion and extension only © 2013 Pearson Education, Inc.
Figure 8.11a The elbow joint.
Humerus Fat pad Tendon of triceps muscle Bursa Articular capsule Synovial membrane Synovial cavity Articular cartilage Coronoid process Tendon of brachialis muscle Ulna Trochlea Articular cartilage of the trochlear notch Median sagittal section through right elbow (lateral view)
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Elbow Joint
•
Anular ligament
– Surrounds head of radius • Two capsular ligaments restrict side-to side movement –
Ulnar collateral ligament
–
Radial collateral ligament
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Figure 8.11b The elbow joint.
Humerus Lateral epicondyle Articular capsule Radial collateral ligament Olecranon Lateral view of right elbow joint
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Anular ligament Radius Ulna
Figure 8.11d The elbow joint.
Articular capsule Anular ligament Coronoid process Radius Medial view of right elbow
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Humerus Medial epicondyle Ulnar collateral ligament Ulna
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Animation: Rotatable Elbow
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Figure 8.11c The elbow joint.
Anular ligament Radius Articular capsule Coronoid process Cadaver photo of medial view of right elbow
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Humerus Medial epicondyle Ulnar collateral ligament Ulna
Hip (Coxal) Joint
• Ball-and-socket joint • Head of the femur articulates with acetabulum • Good range of motion, but limited by the deep socket – Rim of fibrocartilage -
Acetabular labrum
• Enhances depth of socket so hip dislocations rare © 2013 Pearson Education, Inc.
Figure 8.12a The hip joint. Articular cartilage Acetabular labrum Femur Coxal (hip) bone Ligament of the head of the femur (ligamentum teres) Synovial cavity Articular capsule Frontal section through the right hip joint
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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) Photo of the interior of the hip joint, lateral view
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Hip Joint
• Reinforcing ligaments – Iliofemoral ligament – Pubofemoral ligament – Ischiofemoral ligament – Ligamentum teres © 2013 Pearson Education, Inc.
Figure 8.12c The hip joint. Ischium Iliofemoral ligament Ischiofemoral ligament Greater trochanter of femur Posterior view of right hip joint, capsule in place
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Animation: Rotatable Hip
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Figure 8.12d The hip joint. Anterior inferior iliac spine Greater trochanter Iliofemoral ligament Pubofemoral ligament Anterior view of right hip joint, capsule in place
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Temporomandibular Joint (TMJ)
• Mandibular condyle articulates with temporal bone • Two types of movement – Hinge—depression and elevation of mandible – Gliding—e.g., side-to-side (lateral excursion) grinding of teeth • Most easily dislocated joint in the body © 2013 Pearson Education, Inc.
Figure 8.13a The temporomandibular (jaw) joint. Mandibular fossa Articular tubercle Zygomatic process Infratemporal fossa External acoustic meatus
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Articular capsule Ramus of mandible Lateral ligament Location of the joint in the skull
Figure 8.13b The temporomandibular (jaw) joint. Mandibular fossa Articular capsule Articular disc Articular tubercle Superior joint cavity Synovial membranes Condylar process of mandible
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Ramus of mandible Inferior joint cavity Enlargement of a sagittal section through the joint
Figure 8.13c The temporomandibular (jaw) joint. Outline of the mandibular fossa Superior view Lateral excursion: lateral (side-to-side) movements of the mandible
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Common Joint Injuries
• Cartilage tears – Due to compression and shear stress – Fragments may cause joint to lock or bind – Cartilage rarely repairs itself – Repaired with
arthroscopic surgery
• Ligaments repaired, cartilage fragments removed with minimal tissue damage or scarring – Partial menisci removal renders joint less stable but still mobile; complete removal leads to osteoarthritis – Meniscal transplant in younger patients – Perhaps meniscus grown from own stem cells in future © 2013 Pearson Education, Inc.
Figure 8.14 Arthroscopic photograph of a torn medial meniscus. Femur Meniscus Tear in meniscus Tibia
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Common Joint Injuries
• Sprains – Reinforcing ligaments stretched or torn – Partial tears slowly repair heal • Poor vascularization – Three options if torn completely • Ends sewn together • Replaced with grafts • Time and immobilization © 2013 Pearson Education, Inc.
Common Joint Injuries
• •
Dislocations (luxations)
– Bones forced out of alignment – Accompanied by sprains, inflammation, and difficulty moving joint – Caused by serious falls or contact sports – Must be reduced to treat
Subluxation
—partial dislocation of a joint © 2013 Pearson Education, Inc.
Inflammatory and Degenerative Conditions
• Bursitis – Inflammation of bursa, usually caused by blow or friction – Treated with rest and ice and, if severe, anti inflammatory drugs • Tendonitis – Inflammation of tendon sheaths typically caused by overuse – Symptoms and treatment similar to bursitis © 2013 Pearson Education, Inc.
Arthritis
• >100 different types of inflammatory or degenerative diseases that damage joints • Most widespread crippling disease in the U.S.
• Symptoms: pain, stiffness, and swelling of joint • Acute forms: caused by bacteria, treated with antibiotics • Chronic forms: osteoarthritis, rheumatoid arthritis, and gouty arthritis © 2013 Pearson Education, Inc.
Osteoarthritis (OA)
• Common, irreversible, degenerative (''wear-and-tear'') arthritis • May reflect excessive release of enzymes that break down articular cartilage • By age 85 half of Americans develop OA, more women than men • Probably related to normal aging process © 2013 Pearson Education, Inc.
Osteoarthritis (OA)
• More cartilage is destroyed than replaced in badly aligned or overworked joints • Exposed bone ends thicken, enlarge, form bone spurs, and restrict movement • Treatment: moderate activity, mild pain relievers, capsaicin creams – Glucosamine, chondroitin sulfate, and nutritional supplements not effective © 2013 Pearson Education, Inc.
Rheumatoid Arthritis (RA)
• Chronic, inflammatory,
autoimmune disease
of unknown cause – Immune system attacks own cells • Usually arises between ages 40 and 50, but may occur at any age; affects 3 times as many women as men • Signs and symptoms include joint pain and swelling (usually bilateral), anemia, osteoporosis, muscle weakness, and cardiovascular problems © 2013 Pearson Education, Inc.
Rheumatoid Arthritis
• RA begins with
synovitis
joint of the affected – Inflammatory blood cells migrate to joint, release inflammatory chemicals that destroy tissues – Synovial fluid accumulates joint swelling and inflamed synovial membrane which thickens
pannus
that clings to articular cartilage – Pannus erodes cartilage, scar tissue forms and connects articulating bone ends (ankylosis) © 2013 Pearson Education, Inc.
Rheumatoid Arthritis: Treatment
• Disrupt destruction of joints by immune system • Steroidal and nonsteroidal anti-inflammatory drugs decrease pain and inflammation • Immune suppressants slow autoimmune reaction • Some agents target
tumor necrosis factor
to block action of inflammatory chemicals • Can replace joint with prosthesis © 2013 Pearson Education, Inc.
Figure 8.15 A hand deformed by rheumatoid arthritis.
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Gouty Arthritis
• Deposition of uric acid crystals in joints and soft tissues, followed by inflammation • More common in men • Typically affects joint at base of great toe • In untreated gouty arthritis, bone ends fuse and immobilize joint • Treatment: drugs, plenty of water, avoidance of alcohol © 2013 Pearson Education, Inc.
Lyme Disease
• Caused by bacteria transmitted by tick bites • Symptoms: skin rash, flu-like symptoms, and foggy thinking • May lead to joint pain and arthritis • Treatment – Long course of antibiotics © 2013 Pearson Education, Inc.
Developmental Aspects of Joints
• By embryonic week 8, synovial joints resemble adult joints • Joint's size, shape, and flexibility modified by use • Advancing years take toll on joints – Ligaments and tendons shorten and weaken – Intervertebral discs more likely to herniate – Most people in 70s have some degree of OA • Full-range-of-motion exercise key to postponing joint problems © 2013 Pearson Education, Inc.