ANATOMY OF JOINT/ARTICULATIONI Nyoman Mangku Karmaya

Dorsal viewVentral viewAppendicular skeletonAxial skeleton

Human skeleton

Axial skeleton consist of 80 bonescranium spine /columna vertebralisribs sternum Appendicular skeleton consist of 126 bonesshoulderarm elbow hand pelvis leg knee ankle foot TOTAL: 206 BONES

Joints/ArticulationA joint, or articulation, is the place where two bones come together. The type depend on the structure in betweenFibrous- Immovable:connect bones, no movement. (skull and pelvis). Cartilaginous- slightly movable, bones are attached by cartilage, a little movement (spine or ribs).Synovial- freely movable, much more movement than cartilaginous joints. Cavities between bones are filled with synovial fluid. This fluid helps lubricate and protect the bones.

Fibrous jointsSutureBones tightly bound by minimal fiberOnly found in skullSyndemosesBones connected by ligamentsE.g. tibiofibular ligament, interosseous membrane of radius/ulnaGomphosesPeg in socket jointOnly found in teeth/alveoliFig. 9.1 a, M&M

Describe the name of all sutures at cranium

Fontanela anteriorFontanela posterior

Fibrous jointsSutureBones tightly bound by minimal fiberOnly found in skullSyndemosesBones connected by ligamentsE.g. tibiofibular ligament, interosseous membrane of radius/ulnaGomphosesPeg in socket jointOnly found in teeth/alveoliFig. 8.4, M&MFig. 9.1 b, M&M

Fibrous jointsSutureBones tightly bound by minimal fiberOnly found in skullSyndemosesBones connected by ligamentsE.g. tibiofibular ligament, interosseous membrane of radius/ulnaGomphosesPeg in socket jointOnly found in teeth/alveoliFig. 9.1 c, M&M

Cartilaginous JointsSynchondrosisHyaline cartilage unites bonesEpiphyseal growth platesCostal cartilage-sternum

SymphysesFibrocartilage unites bonesPubic symphysisIntervertebral disc

Fig. 9.2, M&M

Intervertebral disc

Medulla spinalis/spinal cord goes through vertebral canal which is formed by vertebral foramenMedulla spinalis

INTERVERTEBRAL DISC

Hernia Nucleus Pulposus (HNP) push the spinal cordLOAD

Synovial JointsMost common joints in bodyMost mobile jointsHaveArticular surfaces on bone with hyaline cartilageCompletely enclosed joint capsule formed from ligamentous connective tissueSynovial fluid within capsule lubricates jointSome have meniscus or articular disc(e.g. knee, jaw joint)

Synovial Joint Shape TypesPlane joints--intercarpal jointsHinge joints--elbow,ankle, inter-phalangealPivot joints--radio-ulnar jointCondyloid joints (egg into oval)--metacarpo-phalangealSaddle joints--carpo-metacarpal joint of thumbBall-and-socket--hip, shoulder

The type of joint, in part, determines the range and direction of movement

Types of Synovial Joints Based on ShapeSlide 5.52aCopyright 2003 Pearson Education, Inc. publishing as Benjamin CummingsFigure 5.29ac

Types of Synovial Joints Based on ShapeSlide 5.52bCopyright 2003 Pearson Education, Inc. publishing as Benjamin CummingsFigure 5.29df

Types of JointsHinge- A hinge joint allows extension and retraction of an appendage. (Elbow, Knee)

Ball and Socket- A ball and socket joint allows for radial movement in almost any direction. They are found in the hips and shoulders. (Hip, Shoulder)

Gliding- In a gliding or plane joint bones slide past each other. Mid-carpal and mid-tarsal joints are gliding joints. (Hands, Feet)

Saddle- This type of joint occurs when the touching surfaces of two bones have both concave and convex regions with the shapes of the two bones complementing one other and allowing a wide range of movement. (Thumb)

Fig. 9.9, M&MRotator cuff/Musculotendineus cuff:m. Supraspinatusm. Infraspinatusm. Teres majorm. Subscapularis Shoulder Joint

Shoulder Joint

Shoulder Joint

1. Intra and extra articular ligament; 2. meniscus, 3. sesamoid bone (patella)Knee Joint

Articular discTemporo Mandibular Joint

Tendons are structures that connect bone to muscle and are made up of tendon tissue

Can have various shapesTypical is cord-like tendon of biceps

Sheeths are common--aponeuroses e.g. acromiotrapezius origin from thoracic vertebral spines, aponeurosis of abdominal wall musclesTENDON

Ligaments connect bone-to-bone or reinforce joints--they are made up of tendinous tissue as well

E.g. knee ligamentsLIGAMENT

SYNOVIAL TENDON SHEATH VS BURSAE

BursaeBursae: saclike structures that reduce friction. Located in the shoulder and knee joints. Found between skin and bone, tendons and bones, muscles and bones, ligaments and bones.

Tendon Sheaths: tubelike bursae that wrap around tendons. Found at the wrist, ankle, fingers and toes.

Types of movement and examples (with muscles)flexion- move lower leg toward upperextension- straightening the leg

abduction- moving leg away from bodyadduction- movong leg toward the body

rotation- around its axissupination- rotation of arm to palm-up positionpronation- palm down

circumduction- swinging arms in circles

inversion- turning foot so sole is inwardeversion- sole is out

Aging and JointsDecreased production of synovial fluidArticular cartilage becomes thinner with age, ligaments shortens and lose flexibility.Genetic factorsMales commonly develop degenerative changes in the vertebral column-hunched.Osteoarthritis-occurs over age 70.

Arthritis

GoutGout is a disease that results from an overload of uric acid in the body. This overload of uric acid leads to the formation of tiny crystals of urate that deposit in tissues of the body, especially the joints. When crystals form in the joints it causes recurring attacks of joint inflammation (arthritis). Chronic gout can also lead to deposits of hard lumps of uric acid in and around the joints and may cause joint destruction, decreased kidney function, and kidney stones.

X-ray of hand affected by arthritis

Bursitis Inflammation of the Bursa (fluid filled sac surrounding the joint).A bursa can become inflamed from injury, infection (rare in the shoulder), or due to an underlying rheumatic condition.Bursitis is typically identified by localized pain or swelling, tenderness, and pain with motion of the tissues in the affected area.

TendonitisSometimes the tendons become inflamed for a variety of reasons, and the action of pulling the muscle becomes irritating. If the normal smooth gliding motion of your tendon is impaired, the tendon will become inflamed and movement will become painful. This is called tendonitis, and literally means inflammation of the tendon.The most common cause of tendonitis is overuse.

Artificial Hip Joint

TRAUMA !!!

R. I. C. E. :REST

ICE

COMPRESS

ELEVATE

TERIMAKASIH

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