9 Lecture Articulations Power Point Lecture Presentations prepared

9 Lecture Articulations Power. Point® Lecture Presentations prepared by Jason La. Pres Lone Star College—North Harris 1 © 2012 Pearson Education, Inc.

An Introduction to Articulations • Learning Outcomes • 9 -1 Contrast the major categories of joints, and explain the relationship between structure and function for each category. • 9 -2 Describe the basic structure of a synovial joint, and describe common synovial joint accessory structures and their functions. • 9 -3 Describe how the anatomical and functional properties of synovial joints permit movements of the skeleton. • 9 -4 Describe the articulations between the vertebrae of the vertebral column. 2 © 2012 Pearson Education, Inc.

An Introduction to Articulations • Learning Outcomes • 9 -5 Describe the structure and function of the shoulder joint and the elbow joint. • 9 -6 Describe the structure and function of the hip joint and the knee joint. • 9 -7 Describe the effects of aging on articulations, and discuss the most common age-related clinical problems for articulations. • 9 -8 Explain the functional relationships between the skeletal system and other body systems. 3 © 2012 Pearson Education, Inc.

An Introduction to Articulations • Body movement occurs at joints (articulations) where two bones connect • Joint Structure • Determines direction and distance of movement (range of motion or ROM) • Joint strength decreases as mobility increases 4 © 2012 Pearson Education, Inc.

9 -1 Classification of Joints • Two Methods of Classification 1. Functional classification is based on range of motion of the joint 2. Structural classification relies on the anatomical organization of the joint 5 © 2012 Pearson Education, Inc.

9 -1 Classification of Joints • Functional Classifications • Synarthrosis (immovable joint) • Amphiarthrosis (slightly movable joint) • Diarthrosis (freely movable joint) 6 © 2012 Pearson Education, Inc.

9 -1 Classification of Joints • Structural Classifications • Bony • Fibrous • Cartilaginous • Synovial 7 © 2012 Pearson Education, Inc.

Table 9 -1 Functional and Structural Classifications of Articulations 8 © 2012 Pearson Education, Inc.

Table 9 -1 Functional and Structural Classifications of Articulations 9 © 2012 Pearson Education, Inc.

Table 9 -1 Functional and Structural Classifications of Articulations 10 © 2012 Pearson Education, Inc.

9 -1 Classification of Joints • Synarthroses (Immovable Joints) • Are very strong • Edges of bones may touch or interlock • Four types of synarthrotic joints 1. Suture 2. Gomphosis 3. Synchondrosis 4. Synostosis 11 © 2012 Pearson Education, Inc.

9 -1 Classification of Joints • Suture • Bones interlocked • Are bound by dense fibrous connective tissue • Are found only in skull • Gomphosis • Fibrous connection (periodontal ligament) • Binds teeth to sockets 12 © 2012 Pearson Education, Inc.

9 -1 Classification of Joints • Synchondrosis • Is a rigid cartilaginous bridge between two bones • Epiphyseal cartilage of long bones • Between vertebrosternal ribs and sternum • Synostosis • Fused bones, immovable • Metopic suture of skull • Epiphyseal lines of long bones 13 © 2012 Pearson Education, Inc.

9 -1 Classification of Joints • Amphiarthroses • More movable than synarthrosis • Stronger than freely movable joint • Two types of amphiarthroses 1. Syndesmosis • Bones connected by ligaments 2. Symphysis • Bones separated by fibrocartilage 14 © 2012 Pearson Education, Inc.

9 -1 Classification of Joints • Synovial Joints (Diarthroses) • Also called movable joints • At ends of long bones • Within articular capsules • Lined with synovial membrane 15 © 2012 Pearson Education, Inc.

9 -2 Synovial Joints • Articular Cartilages • Pad articulating surfaces within articular capsules • Prevent bones from touching • Smooth surfaces lubricated by synovial fluid • Reduce friction 16 © 2012 Pearson Education, Inc.

9 -2 Synovial Joints • Synovial Fluid • Contains slippery proteoglycans secreted by fibroblasts • Functions of synovial fluid 1. Lubrication 2. Nutrient distribution 3. Shock absorption 17 © 2012 Pearson Education, Inc.

9 -2 Synovial Joints • Accessory Structures • Cartilages • Fat pads • Ligaments • Tendons • Bursae 18 © 2012 Pearson Education, Inc.

9 -2 Synovial Joints • Cartilages • Cushion the joint • Fibrocartilage pad called a meniscus (or articular disc; plural, menisci) • Fat Pads • Superficial to the joint capsule • Protect articular cartilages • Ligaments • Support, strengthen joints • Sprain – ligaments with torn collagen fibers © 2012 Pearson Education, Inc. 19

9 -2 Synovial Joints • Tendons • Attach to muscles around joint • Help support joint • Bursae • Singular, bursa, a pouch • Pockets of synovial fluid • Cushion areas where tendons or ligaments rub 20 © 2012 Pearson Education, Inc.

9 -2 Synovial Joints • Factors That Stabilize Synovial Joints • Prevent injury by limiting range of motion • Collagen fibers (joint capsule, ligaments) • Articulating surfaces and menisci • Other bones, muscles, or fat pads • Tendons of articulating bones 21 © 2012 Pearson Education, Inc.

Figure 9 -1 a The Structure of a Synovial Joint Medullary cavity Spongy bone Periosteum Fibrous joint capsule Synovial membrane Articular cartilages Joint cavity (containing synovial fluid) Compact bone Synovial joint, sagittal section © 2012 Pearson Education, Inc. 22

Figure 9 -1 b The Structure of a Synovial Joint Bursa Joint capsule Quadriceps tendon Femur Synovial membrane Meniscus Intracapsular ligament © 2012 Pearson Education, Inc. Patella Articular cartilage Fat pad Patellar ligament Tibia Joint cavity Meniscus Knee joint, sagittal section 23

9 -2 Synovial Joints • Injuries • Dislocation (luxation) • Articulating surfaces forced out of position • Subluxation • A partial dislocation • Sprain • Tear in a ligament due to joint being carried through ROM greater than normal but without dislocation or fracture • Strain • Tear in a muscle 24 © 2012 Pearson Education, Inc.

9 -3 Movements • Three Types of Dynamic Motion 1. Linear movement (gliding) 2. Angular movement 3. Rotation • Planes (Axes) of Dynamic Motion • Monaxial (1 axis) • Biaxial (2 axes) • Triaxial (3 axes) © 2012 Pearson Education, Inc. 25

Figure 9 -2 A Simple Model of Articular Movement Initial position Gliding movement Angular movement Circumduction Rotation 26 © 2012 Pearson Education, Inc.

9 -3 Movements • Types of Movement at Synovial Joints • Terms describe: • Plane or direction of motion • Relationship between structures 27 © 2012 Pearson Education, Inc.

9 -3 Movements • Types of Movement at Synovial Joints • Gliding Movement • Two surfaces slide past each other • Between carpal or tarsal bones 28 © 2012 Pearson Education, Inc.

9 -3 Movements • Angular Movement • Flexion • Angular motion • Anterior–posterior plane • Reduces angle between elements • Extension • Angular motion • Anterior–posterior plane • Increases angle between elements 29 © 2012 Pearson Education, Inc.

9 -3 Movements • Angular Movement • Hyperextension • Angular motion • Extension past anatomical position 30 © 2012 Pearson Education, Inc.

Figure 9 -3 a Angular Movements Extension Flexion Hyperextension Flexion Extension Flexion Hyperextension Extension © 2012 Pearson Education, Inc. Hyperextension Flexion/extension 31

9 -3 Movements • Angular Movement • Abduction • Angular motion • Frontal plane • Moves away from longitudinal axis • Adduction • Angular motion • Frontal plane • Moves toward longitudinal axis 32 © 2012 Pearson Education, Inc.

Figure 9 -3 b Angular Movements Abduction Adduction © 2012 Pearson Education, Inc. Abduction/adduction 33

Figure 9 -3 c Angular Movements Adduction Abduction Adduction/abduction 34 © 2012 Pearson Education, Inc.

9 -3 Movements • Angular Movement • Circumduction • Circular motion without rotation • Angular motion 35 © 2012 Pearson Education, Inc.

9 -3 Movements • Types of Movement at Synovial Joints • Rotation • Direction of rotation from anatomical position • Relative to longitudinal axis of body • Left or right rotation • Medial rotation (inward rotation) • Rotates toward axis • Lateral rotation (outward rotation) • Rotates away from axis 36 © 2012 Pearson Education, Inc.

Figure 9 -4 a Rotational Movements Head rotation Right rotation Lateral (external) rotation Left rotation Medial (internal) rotation 37 © 2012 Pearson Education, Inc.

9 -3 Movements • Rotation • Pronation • Rotates forearm, radius over ulna • Supination • Forearm in anatomical position 38 © 2012 Pearson Education, Inc.

9 -3 Movements • Special Movements • Inversion • Twists sole of foot medially • Eversion • Twists sole of foot laterally Dorsiflexion (ankle flexion) • Dorsiflexion • Flexion at ankle (lifting toes) • Plantar flexion • Extension at ankle (pointing toes) © 2012 Pearson Education, Inc. Plantar flexion (ankle extension) 39

9 -3 Movements Opposition • Opposition • Thumb movement toward fingers or palm (grasping) • Reposition • Opposite of opposition • Protraction • Moves anteriorly • In the horizontal plane (pushing forward) • Retraction • Opposite of protraction • Moving anteriorly (pulling back) © 2012 Pearson Education, Inc. Retraction Protraction 40

9 -3 Movements • Special Movements • Elevation • Moves in superior direction (up) • Depression • Moves in inferior direction (down) • Lateral flexion • Bends vertebral column from side to side 41 © 2012 Pearson Education, Inc.

Figure 9 -5 Synovial Joints Depression Elevation 42 © 2012 Pearson Education, Inc.

Figure 9 -5 Synovial Joints Lateral flexion 43 © 2012 Pearson Education, Inc.

9 -3 Movements • Classification of Synovial Joints by Shape • Gliding • Hinge • Pivot • Condylar • Saddle • Ball-and-socket 44 © 2012 Pearson Education, Inc.

9 -3 Movements • Gliding Joints • Flattened or slightly curved faces • Limited motion (nonaxial) • Hinge Joints • Angular motion in a single plane (monaxial) • Pivot Joints • Rotation only (monaxial) 45 © 2012 Pearson Education, Inc.

Figure 9 -6 Synovial Joints Gliding joint le lavic C Manubrium Movement: slight nonaxial or multiaxial Examples: • Acromioclavicular and claviculosternal joints • Intercarpal and intertarsal joints • Vertebrocostal joints • Sacro-iliac joints 46 © 2012 Pearson Education, Inc.

Figure 9 -6 Synovial Joints Hinge joint Humerus Ulna Movement: monaxial Examples: • Elbow joint • Knee joint • Ankle joint • Interphalangeal joint 47 © 2012 Pearson Education, Inc.

Figure 9 -6 Synovial Joints Pivot joint Movement: monaxial (rotation) Examples: Atlas • Atlanto-axial joint • Proximal radio-ulnar joint Axis 48 © 2012 Pearson Education, Inc.

9 -3 Movements • Condylar Joints • Oval articular face within a depression • Motion in two planes (biaxial) • Saddle Joints • Two concave, straddled (biaxial) • Ball-and-socket Joints • Round articular face in a depression (triaxial) 49 © 2012 Pearson Education, Inc.

Figure 9 -6 Synovial Joints Condylar joint Movement: biaxial Examples: Scaphoid bone Ulna • Radiocarpal joint • Metacarpophalangeal joints 2– 5 • Metatarsophalangeal joints 50 © 2012 Pearson Education, Inc.

Figure 9 -6 Synovial Joints Saddle joint Movement: biaxial Examples: III II Metacarpal bone of thumb • First carpometacarpal joint Trapezium 51 © 2012 Pearson Education, Inc.

Figure 9 -6 Synovial Joints Ball-and-socket joint Scapula Movement: triaxial Examples: • Shoulder joint • Hip joint Humerus 52 © 2012 Pearson Education, Inc.

9 -3 Movements • Joints • A joint cannot be both mobile and strong • The greater the mobility, the weaker the joint • Mobile joints are supported by muscles and ligaments, not bone-to-bone connections 53 © 2012 Pearson Education, Inc.

9 -4 Intervertebral Articulations • C 2 to L 5 spinal vertebrae articulate: • At inferior and superior articular processes (gliding joints) • Between adjacent vertebral bodies (symphyseal joints) 54 © 2012 Pearson Education, Inc.

9 -4 Intervertebral Articulations • Intervertebral Discs • Pads of fibrocartilage • Separate vertebral bodies • Anulus fibrosus • Tough outer layer • Attaches disc to vertebrae • Nucleus pulposus • Elastic, gelatinous core • Absorbs shocks 55 © 2012 Pearson Education, Inc.

Figure 9 -7 Intervertebral Articulations Superior articular facet Intervertebral foramen Ligamentum flavum Posterior longitudinal ligament Intervertebral Disc Vertebral end plate Anulus fibrosus Nucleus pulposus Spinal cord Spinal nerve Interspinous ligament Supraspinous ligament Anterior longitudinal ligament 56 © 2012 Pearson Education, Inc.

9 -4 Intervertebral Articulations • Vertebral Joints • Also called symphyseal joints • As vertebral column moves: • Nucleus pulposus shifts • Disc shape conforms to motion • Intervertebral Ligaments • Bind vertebrae together • Stabilize the vertebral column 57 © 2012 Pearson Education, Inc.

9 -4 Intervertebral Articulations • Six Intervertebral Ligaments 1. Anterior longitudinal ligament • Connects anterior bodies 2. Posterior longitudinal ligament • Connects posterior bodies 3. Ligamentum flavum • Connects laminae 58 © 2012 Pearson Education, Inc.

9 -4 Intervertebral Articulations • Six Intervertebral Ligaments 4. Interspinous ligament • Connects spinous processes 5. Supraspinous ligament • Connects tips of spinous processes (C 7 to sacrum) 6. Ligamentum nuchae • Continues supraspinous ligament (C 7 to skull) 59 © 2012 Pearson Education, Inc.

9 -4 Intervertebral Articulations • Damage to Intervertebral Discs • Slipped disc • Bulge in anulus fibrosus • Invades vertebral canal • Herniated disc • Nucleus pulposus breaks through anulus fibrosus • Presses on spinal cord or nerves 60 © 2012 Pearson Education, Inc.

Figure 9 -8 a Damage to the Intervertebral Discs T 12 Normal intervertebral disc L 1 Slipped disc L 2 © 2012 Pearson Education, Inc. A lateral view of the lumbar region of the spinal column, showing a distorted intervertebral disc (a “slipped” disc) 61

Figure 9 -8 b Damage to the Intervertebral Discs Compressed area of spinal nerve Nucleus pulposus of herniated disc Spinal nerve Spinal cord Anulus fibrosus A sectional view through a herniated disc, showing the release of the nucleus pulposus and its effect on the spinal cord and adjacent spinal nerves © 2012 Pearson Education, Inc. 62

9 -4 Intervertebral Articulations • Movements of the Vertebral Column 1. Flexion 2. Extension 3. Lateral flexion 4. Rotation 63 © 2012 Pearson Education, Inc.

9 -5 The Shoulder Joint • Also called the glenohumeral joint • Allows more motion than any other joint • Is the least stable • Supported by skeletal muscles, tendons, ligaments • Ball-and-socket diarthrosis • Between head of humerus and glenoid cavity of scapula 64 © 2012 Pearson Education, Inc.

9 -5 The Shoulder Joint • Socket of the Shoulder Joint • Glenoid labrum • Deepens socket of glenoid cavity • Fibrocartilage lining • Extends past the bone 65 © 2012 Pearson Education, Inc.

9 -5 The Shoulder Joint • Processes of the Shoulder Joint • Acromion (clavicle) and coracoid process (scapula) • Project laterally, superior to the humerus • Help stabilize the joint • Shoulder Separation • Dislocation of the shoulder joint 66 © 2012 Pearson Education, Inc.

9 -5 The Shoulder Joint • Shoulder Muscles (Rotator Cuff) • Shoulder Bursae • Subacromial • Supraspinatus • Subcoracoid • Infraspinatus • Subdeltoid • Subscapularis • Subscapular • Teres minor 67 © 2012 Pearson Education, Inc.

Figure 9 -9 a The Shoulder Joint Acromioclavicular Coracoclavicular ligaments ligament Tendon of supraspinatus muscle Clavicle Acromion Articular capsule Subdeltoid bursa Synovial membrane Scapula Humerus Articular cartilages Joint cavity Glenoid labrum Articular capsule Anterior view, frontal section © 2012 Pearson Education, Inc. Coraco-acromial ligament Coracoid process 68

Figure 9 -9 b The Shoulder Joint Acromioclavicular ligament Coraco-acromial ligament Tendon of supraspinatus muscle Clavicle Coracoclavicular ligaments Tendon of biceps brachii muscle Coracohumeral ligament (cut) Coracoid process Subcoracoid bursa Subscapularis muscle Acromion Subacromial bursa Tendon of infraspinatus muscle Teres minor muscle Glenohumeral ligaments Articular capsule Glenoid cavity Scapula Glenoid labrum © 2012 Pearson Education, Inc. Lateral view of pectoral girdle 69

9 -5 The Elbow Joint • A stable hinge joint • Humero-ulnar joint • Humeroradial joint 70 © 2012 Pearson Education, Inc.

Figure 9 -10 a The Right Elbow Joint Showing Stabilizing Ligaments Humerus Radial collateral ligament Radial tuberosity Antebrachial interosseous membrane Radius Ulna Capitulum Annular ligament (covering head and neck of radius) Lateral view © 2012 Pearson Education, Inc. 71

Figure 9 -10 b The Right Elbow Joint Showing Stabilizing Ligaments Tendon of biceps brachii muscle Annular ligament Humerus Articular capsule Antebrachial interosseous membrane Medial epicondyle Ulnar collateral ligament Radius Ulna Olecranon of ulna Medial view 72 © 2012 Pearson Education, Inc.

9 -6 The Hip Joint • Also called coxal joint • Strong ball-and-socket diarthrosis • Wide range of motion • Head of femur fits into socket of acetabulum 73 © 2012 Pearson Education, Inc.

Figure 9 -11 a The Right Hip Joint Iliofemoral ligament Fibrocartilage pad Acetabular labrum Ligament of the femoral head Acetabulum Transverse acetabular ligament (spanning acetabular notch) Fat pad in acetabular fossa A lateral view with the femur removed 74 © 2012 Pearson Education, Inc.

Figure 9 -11 b The Right Hip Joint Pubofemoral ligament Greater trochanter Iliofemoral ligament Lesser trochanter An anterior view 75 © 2012 Pearson Education, Inc.

Figure 9 -11 c The Right Hip Joint Iliofemoral ligament Ischiofemoral ligament Greater trochanter Lesser trochanter Ischial tuberosity A posterior view, showing additional ligaments that add strength to the capsule © 2012 Pearson Education, Inc. 76

9 -6 The Knee Joint • A complicated hinge joint • Transfers weight from femur to tibia • Articulations of the knee joint • Two femur–tibia articulations • At medial and lateral condyles • One between patella and patellar surface of femur 77 © 2012 Pearson Education, Inc.

9 -6 The Knee Joint • The Articular Capsule and Joint Cavity • Medial and lateral menisci • Fibrocartilage pads • At femur–tibia articulations • Cushion and stabilize joint • Give lateral support 78 © 2012 Pearson Education, Inc.

9 -6 The Knee Joint • Seven Major Supporting Ligaments 1. Patellar ligament (anterior) 2. & 3. Two popliteal ligaments (posterior) 4. & 5. Anterior and posterior cruciate ligaments (inside joint capsule) 6. Tibial collateral ligament (medial) 7. Fibular collateral ligament (lateral) 79 © 2012 Pearson Education, Inc.

Figure 9 -12 a The Right Knee Joint Quadriceps tendon Patellar retinaculae Fibular collateral ligament Joint capsule Tibial collateral ligament Patellar ligament Tibia © 2012 Pearson Education, Inc. Anterior view, superficial layer 80

Figure 9 -12 b The Right Knee Joint Femur Joint capsule Plantaris muscle Gastrocnemius muscle, lateral head Gastrocnemius muscle, medial head Bursa Fibular collateral ligament Tibial collateral ligament Cut tendon of biceps femoris muscle Popliteal ligaments Popliteus muscle Tibia Fibula © 2012 Pearson Education, Inc. Posterior view, superficial layer 81

Figure 9 -12 c The Right Knee Joint Patellar surface Fibular collateral ligament Posterior cruciate ligament Lateral condyle Medial condyle Tibial collateral ligament Lateral meniscus Cut tendon Medial meniscus Tibia Anterior cruciate ligament Fibula © 2012 Pearson Education, Inc. Deep anterior view, flexed 82

Figure 9 -12 d The Right Knee Joint Femur Posterior cruciate ligament Fibular collateral ligament Medial condyle Lateral condyle Tibial collateral ligament Lateral meniscus Cut tendon Medial meniscus Anterior cruciate ligament Fibula Tibia Deep posterior view, extended © 2012 Pearson Education, Inc. 83

9 -7 Effects of Aging on Articulations • Degenerative Changes • Rheumatism • A pain and stiffness of skeletal and muscular systems • Arthritis • All forms of rheumatism that damage articular cartilages of synovial joints • Osteoarthritis • Caused by wear and tear of joint surfaces, or genetic factors affecting collagen formation • Generally in people over age 60 84 © 2012 Pearson Education, Inc.

9 -7 Effects of Aging on Articulations • Rheumatoid Arthritis • An inflammatory condition • Caused by infection, allergy, or autoimmune disease • Involves the immune system • Gouty Arthritis • Occurs when crystals (uric acid or calcium salts) • Form within synovial fluid • Due to metabolic disorders 85 © 2012 Pearson Education, Inc.

9 -7 Effects of Aging on Articulations • Joint Immobilization • Reduces flow of synovial fluid • Can cause arthritis symptoms • Treated by continuous passive motion or CPM (therapy) • Bones and Aging • Bone mass decreases • Bones weaken • Increases risk of hip fracture, hip dislocation, or pelvic fracture 86 © 2012 Pearson Education, Inc.

9 -8 Integration with Other Systems • Bone Recycling • Living bones maintain equilibrium between: • Bone building (osteoblasts) • And breakdown (osteoclasts) 87 © 2012 Pearson Education, Inc.

9 -8 Integration with Other Systems • Factors Affecting Bone Strength 1. Age 2. Physical stress 3. Hormone levels 4. Calcium and phosphorus uptake and excretion 5. Genetic and environmental factors 88 © 2012 Pearson Education, Inc.

9 -8 Integration with Other Systems • Bones Support Body Systems • Support and protect other systems • Store fat, calcium, and phosphorus • Manufacture cells for immune system 89 © 2012 Pearson Education, Inc.

9 -8 Integration with Other Systems • Bones Support Body Systems • Disorders in other body systems can cause: • Bone tumors • Osteoporosis • Arthritis • Rickets (vitamin D deficiency) 90 © 2012 Pearson Education, Inc.