Joints and Synovial Joints
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Questions and Answers

Under which classification criterion are joints categorized based on the primary type of connective tissue present?

  • Functional range of movement
  • Histological composition (correct)
  • Embryological origin
  • Kinesiological assessment

Which joint type permits movement in only one plane, exemplified by flexion and extension?

  • Ball and Socket (Spheroid) joint
  • Pivot (Trochoidal) joint
  • Hinge (Ginglymus) joint (correct)
  • Plane (Gliding) joint

Which motion is NOT typically associated with a ball and socket joint?

  • Rotation
  • Flexion
  • Abduction
  • Gliding (correct)

Which type of synovial joint allows for movements such as flexion/extension and abduction/adduction?

<p>Oval (condyloid) (A)</p> Signup and view all the answers

What unique movement is primarily facilitated by the saddle joint of the thumb?

<p>Opposition (A)</p> Signup and view all the answers

Which type of joint is characterized by having the LEAST amount of movement?

<p>Plane (gliding) joint (C)</p> Signup and view all the answers

Which functional category of joints primarily allows for little to no movement?

<p>Synarthrotic (A)</p> Signup and view all the answers

Which characteristic is most indicative of the articular surfaces in the Sternoclavicular joint?

<p>Largely fibrocartilaginous and separated by a fibrous disc (B)</p> Signup and view all the answers

Why is a posterior dislocation of the sternoclavicular joint considered more dangerous than an anterior dislocation?

<p>It poses a greater risk to the neurovascular structures in the mediastinum (B)</p> Signup and view all the answers

Which ligaments provide primary support to the Acromioclavicular joint?

<p>Coraco-clavicular, acromio-clavicular, coraco-acromial and trapezoid ligaments (C)</p> Signup and view all the answers

If a patient presents with superior displacement following an A-C joint injury, which ligaments are most likely to have been ruptured?

<p>Acromio-clavicular and coraco-clavicular ligaments (D)</p> Signup and view all the answers

Which statement best describes the mechanical function of abduction in the glenohumeral joint?

<p>0-20 degrees supraspinatus, 20-90 degrees middle deltoid, 90-140 degrees serratus anterior and trapezius (C)</p> Signup and view all the answers

What is the ratio between glenohumeral and scapulothoracic motion during abduction of the arm, and why is this rhythm important?

<p>2:1 ratio, crucial for maximizing range of motion and preventing impingement (B)</p> Signup and view all the answers

Which set of muscles is collectively known as the 'rotator cuff' and what is their primary function?

<p>Supraspinatus, Infraspinatus, Teres minor, Subscapularis; maintains integrity of joint (B)</p> Signup and view all the answers

What type of joint is the elbow joint, and what specific movements does it primarily facilitate?

<p>Hinge joint, primarily facilitating flexion and extension (C)</p> Signup and view all the answers

Which structure is responsible for creating a 'socket' that allows the head of the radius to rotate, facilitating pronation and supination?

<p>Annular ligament (D)</p> Signup and view all the answers

How does the annular ligament contribute to the overall function of the elbow and forearm?

<p>By encircling the radial head allowing pronation and supination (C)</p> Signup and view all the answers

The movement of the radius rotating laterally (outward) around its longitudinal axis so that the dorsum of the hand faces posteriorly, and the palm faces anteriorly is known as:

<p>Supination (A)</p> Signup and view all the answers

What is the primary function of the triangular fibrocartilage complex (TFCC) at the wrist?

<p>To stabilize the distal radio-ulnar joint and provide a smooth articulating surface (B)</p> Signup and view all the answers

Which set of bones articulates to form the radiocarpal joint?

<p>The radius and the proximal row of carpal bones (B)</p> Signup and view all the answers

Why is it important to maintain the integrity of joints?

<p>To maintain structural support and facilitate range of motion (C)</p> Signup and view all the answers

Which of the following is NOT a type of synovial joint?

<p>Fibrous (C)</p> Signup and view all the answers

A patient reports pain and reduced range of motion in their wrist. Radiographic imaging reveals a disruption in the alignment of the carpal bones. Which of the following ligaments, if damaged, could contribute to instability between the scaphoid and lunate carpal bones?

<p>Scapholunate interosseous ligament (B)</p> Signup and view all the answers

Which specific anatomical feature contributes to the stability of the shoulder joint, given its inherent shallow articulation?

<p>The presence of the rotator cuff muscles (A)</p> Signup and view all the answers

Which of the following ligaments is LEAST involved in stabilizing the sterno-clavicular joint (SCJ)?

<p>The coracoclavicular ligament (C)</p> Signup and view all the answers

When assessing a patient with a suspected acromioclavicular (AC) joint injury, which clinical finding is MOST indicative of a complete AC separation with significant disruption of both the AC and coracoclavicular ligaments?

<p>Palpable step-off deformity at the AC joint accompanied by significant pain. (A)</p> Signup and view all the answers

A patient presents with pain and weakness during shoulder abduction, particularly between 60 and 120 degrees. Strength testing reveals weakness specifically in external rotation. Which muscle is MOST likely involved?

<p>Infraspinatus (C)</p> Signup and view all the answers

Following a direct blow to the lateral aspect of the elbow, a patient is diagnosed with a radial head fracture. Which of the following associated injuries should the physician most urgently assess for, considering the biomechanical relationships at the elbow?

<p>Dislocation of the distal radioulnar joint (DRUJ). (A)</p> Signup and view all the answers

A gymnast falls off the balance beam and lands on their outstretched hand, resulting in a wrist injury. Radiographs reveal a fracture of the scaphoid bone. What is the PRIMARY concern regarding a scaphoid fracture, considering its blood supply and potential long-term complications?

<p>High likelihood of nonunion and avascular necrosis due to retrograde blood supply. (C)</p> Signup and view all the answers

A carpenter repetitively uses a hammer throughout his day, leading to chronic wrist pain. Clinical examination reveals tenderness over the anatomical snuffbox, and a positive Finkelstein's test. Which of the following anatomical structures is MOST likely involved in this individual’s condition:

<p>Abductor pollicis longus and extensor pollicis brevis tendons. (D)</p> Signup and view all the answers

A patient presents with acute wrist pain after falling onto their outstretched hand. Radiographs are negative for fracture, but the patient has significant pain and instability with forearm rotation. Which of the following injuries should be suspected, considering the mechanism and reported instability?

<p>Triangular fibrocartilage complex (TFCC) tear (C)</p> Signup and view all the answers

A rock climber with complaints of dorsal wrist region pain, particularly during wrist extension and gripping activities. On examination, the physician notes mild swelling on the dorsum of the wrist and tenderness upon palpation between the extensor carpi radialis longus and brevis tendons. Which of the following conditions is MOST likely contributing to this presentation?

<p>Dorsal wrist ganglion cyst (C)</p> Signup and view all the answers

A patient presents with chronic elbow pain, particularly with resisted wrist flexion and pronation. Palpation reveals tenderness over the medial epicondyle of the humerus. Considering the common anatomical involvement, which of the following structures is MOST likely contributing directly to the patient’s symptoms?

<p>Pronator teres and flexor carpi ulnaris tendons (C)</p> Signup and view all the answers

Which statement is true regarding joints?

<p>Synovial fluid secreted by vascular membrane into a synovial cavity, which nourishes articular cartilage with no blood supply and lubricates the joint (A)</p> Signup and view all the answers

Which of the following are NOT a supporting ligament of the Acromio-Clavicular joint?

<p>Glenohumeral Ligaments (A)</p> Signup and view all the answers

What is the most frequent injury of the Sterno-Clavicular Joint?

<p>Anterior Dislocation (D)</p> Signup and view all the answers

Which of the following is a key distinction between the structural and functional classification systems for joints?

<p>Structural classification emphasizes the type of connective tissue present, while functional classification is based on the degree of movement allowed. (C)</p> Signup and view all the answers

Which distinguishing feature characterizes a synovial joint compared to fibrous and cartilaginous joints?

<p>Presence of a joint cavity filled with lubricating fluid. (B)</p> Signup and view all the answers

During a biomechanical analysis of human movement, what is the significance of understanding how a joint is classified?

<p>It provides insight into the potential range of motion and stability at that location. (C)</p> Signup and view all the answers

Damage to the articular cartilage within a synovial joint can lead to which of the following pathological outcomes?

<p>Inflammation, pain, and reduced joint lubrication. (C)</p> Signup and view all the answers

In a patient with rheumatoid arthritis affecting the metacarpophalangeal joints, what type of synovial joint is primarily involved?

<p>Oval (condyloid) joint (D)</p> Signup and view all the answers

Which of the following scenarios would MOST directly result from damage to the interclavicular ligament?

<p>Compromised stability and coordination between both sternoclavicular joints. (C)</p> Signup and view all the answers

When evaluating a patient with suspected sternoclavicular joint injury, what clinical finding would raise highest suspicion for a posterior dislocation?

<p>Complaints of difficulty swallowing or breathing due to retrosternal compression. (B)</p> Signup and view all the answers

A direct blow to the superior aspect of the shoulder results in a visible step-off deformity at the acromioclavicular joint. What is the MOST appropriate initial imaging modality to assess the extent of the injury?

<p>AP radiograph of the shoulder to evaluate for AC joint separation. (A)</p> Signup and view all the answers

After sustaining a shoulder injury, a patient exhibits pain and instability during overhead activities. What functional test would MOST specifically assess the integrity of the coracoclavicular ligaments?

<p>Piano key sign to evaluate AC joint laxity. (B)</p> Signup and view all the answers

A baseball pitcher reports anterior shoulder pain and decreased throwing velocity. Clinical examination reveals pain with resisted internal rotation and weakness in external rotation. Which rotator cuff muscle is MOST likely implicated?

<p>Infraspinatus (A)</p> Signup and view all the answers

What is the primary biomechanical implication of the oblique orientation of the medial collateral ligament (MCL) at the elbow?

<p>Its posterior fibers become taut in flexion, resisting valgus stress. (C)</p> Signup and view all the answers

During elbow dislocation, what structural relationship predisposes the ulnar nerve to injury?

<p>The ulnar nerve courses posterior to the medial epicondyle in the cubital tunnel. (D)</p> Signup and view all the answers

What is the functional significance of the convergence of wrist ligaments on the capitate bone?

<p>It serves as a stable central column for load transfer and balanced motion. (A)</p> Signup and view all the answers

Following a fall on an outstretched hand, a patient complains of persistent wrist pain. Imaging reveals no fracture, but there is significant pain with resisted wrist extension and grip. If this also involved the anatomical snuffbox, what injury should be suspected?

<p>Scaphoid fracture with potential avascular necrosis (C)</p> Signup and view all the answers

In a patient presenting with chronic wrist pain and clicking, what is the MOST likely long-term consequence of untreated scapholunate ligament injury?

<p>Progressive radiocarpal arthritis and carpal instability (SLAC wrist). (C)</p> Signup and view all the answers

Considering the movements at the Proximal Radio-Ulnar Joint, what specific anatomical feature MOST directly facilitates pronation and supination of the forearm?

<p>The annular ligament encasing the radial head within the radial notch of the ulna. (A)</p> Signup and view all the answers

Why is the triangular fibrocartilage complex (TFCC) prone to injury?

<p>It has a relatively poor blood supply, limiting its capacity for healing. (D)</p> Signup and view all the answers

How might injury to the triangular fibrocartilage complex (TFCC) specifically affect wrist function?

<p>Instability with axial loading and forearm rotation. (A)</p> Signup and view all the answers

What is the significance of the palmar radiocarpal ligaments?

<p>Are the primary stabilizers of the wrist. (B)</p> Signup and view all the answers

What is the clinical implication of the scaphoid crossing both rows of carpals?

<p>Provides stability between proximal and distal carpal rows (B)</p> Signup and view all the answers

Flashcards

What is a Joint?

The connection between bones, linking the skeletal system into a functional unit.

Fibrous Joints

Connect bones with dense connective tissue; allows very little movement.

Cartilaginous Joints

Connect bones with cartilage ; allows slight movement.

Synovial Joints

Highly mobile joints with a fluid-filled cavity.

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Hinge Joint (Ginglymus)

Joint with movement in one plane (flexion and extension).

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Pivot Joint (Trochoidal)

Rotation around a longitudinal axis.

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Ball and Socket Joint (Spheroid)

Articulation with greatest freedom of movement.

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Oval Joint (Condyloid)

Movements of flexion, extension, abduction and adduction occur.

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Saddle Joint (Sellar)

Allows unique opposition movement of the thumb.

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Plane Joint (Gliding)

Joint where least amount of movement (gliding or sliding) occurs.

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Synarthrotic Joint

Joint with no movement.

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Amphiarthrotic Joint

Joint with slight movement.

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Diarthrotic Joint

Joint with free movement.

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Sterno-Clavicular Joint

Joint where the sternum and 1st costal cartilage articulate with the clavicle

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Costo-clavicular Ligaments

Ligaments that strengthen costo-clavicular.

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Fibrous Disc

Structure made largely of fibrocartilage, separates articular surfaces.

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Clavicle Fracture

Where the clavicle dislocates before damaging the S-C joint.

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Anterior Sterno-Clavicular Ligaments

Connects the clavicle to the sternum

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Inter-Clavicular Ligament

Connects the clavicles to each other

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Costo-Clavicular Ligaments

Connects ribs to clavicle

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Acromio-Clavicular Joint

Joint where the acromion of the scapula meets the clavicle.

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Supporting Ligaments of AC Joint

Ligaments that support the joint including coraco-acromial, and conoid.

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Coraco-Acromial Arch

Ligament between the coracoid process and acromion of the scapula

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Acromion and Clavicle

Bones which make up the acromio-clavicular joint

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Gleno-Humeral Joint

Where the head of the humerus articulates with the glenoid fossa of the scapula.

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Gleno-Humeral Ligaments

Ligaments surrounding the glenohumeral joint capsule for stability.

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Glenoid Labrum

Socket that Deepens the glenoid cavity

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Shoulder Abduction

Joints with movement of supraspinatus, middle deltoid...

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Humeral Head Position

Indication of anterior shoulder dislocation

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Elbow Joint

Joint consisting of the humerus, radius, and ulna.

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Normal Elbow Joint

Joint consisting of the humerus, radius, and ulna.

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Radial Collateral Ligament

Structure provides elbow stability.

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Anular Ligament

Surrounds the head of the radius

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Function of Anular Joint

Attach ulnar notch, forming a collar around joint

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Fat Pads and Bursae

Joint containing olecranon bursa to reduce friction

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Supination

Movement rotates radius laterally, palm faces anterior

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pronation

Movement produced pronator teres; radius rotated palm faces posterior

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Proximal Radio-Ulnar Joint

Joint showing radial head, coronoid process, facets, and notch

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Normal Forearm

Forearm

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Proximal Joint Action

Radius rotates the ulna.

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Triangular Fibrocartilage Complex

Ligament stabilizing this joint

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Radio-carpal joint

Radius, scaphoid, lunate, triquetrum

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Capitate-Hamate Ligament

Ligament between the carpel bones.

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Name of the distal carpal row?

Bones; trapezium, trapezoid, capitate, hamate

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Adduction

Movement by a digit towards midline of the body

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Abduction

Movement by finger away from the midline of body

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Study Notes

What is a Joint?

  • Joints are the connections between bones in the body
  • They link the skeletal system into a functional unit
  • Depending on the joint type, separated elements may or may not move on one another
  • Joints can be classified histologically, based on connective tissue type, or functionally, based on the amount of movement allowed
  • The 3 types of joints in the body, histologically, include: Fibrous, cartilaginous, and Synovial

Synovial joints

  • There are six types of synovial joints
  • Hinge (Ginglymus) joints allow movement in one plane and are responsible for flexion and extension
  • Elbow and IP joints of digits are hinge joints
  • Pivot (Trochoidal) joints are constructed for rotation around a longitudinal axis
  • C1-C2 articulation and forearm rotation are pivot joints
  • Ball and Socket (Spheroid) joints have articulation with the greatest freedom of movement
  • Flexion, extension, abduction/adduction, and rotation occur at ball and socket joints
  • Shoulder & hip joints are ball and socket joints
  • Oval (Condyloid) joints are biaxial joints where movements of flexion/extension and abduction/adduction occur
  • Wrist joint, MP joints of fingers are oval joints
  • Saddle (Sellar) joints have unique opposition movement of the thumb
  • Plane (Gliding) joints have the least amount of movement
  • They allow for gliding or sliding movements between bones
  • Intercarpal and carpometacarpal joints of fingers are plane joints

Functional categories of joints

  • Synarthrotic joints have no movement
  • Amphiarthrotic joints allow for little movement
  • Diarthrotic joints allow for free movement

Sterno-Clavicular Joint

  • The sternum and 1st costal cartilage articulate with the medial end of the clavicle
  • The S-C joint is formed through this articulation
  • The capsule of the sterno-clavicular joint is strengthened by ligaments
  • Costo-clavicular ligaments strengthen this capsule
  • Articular surfaces of the sterno-clavicular joint are largely fibrocartilaginous and separated by a fibrous disc
  • Anterior dislocation of the sterno-clavicular joint is more common than posterior dislocation
  • Posterior dislocation of the joint is more dangerous
  • The sternoclavicular ligaments are very strong
  • The clavicle would likely break before the S-C joint dislocates
  • The sterno-clavicular joint is supported by anterior sterno-clavicular ligaments, costo-clavicular ligaments, and inter-clavicular ligaments

Acromio-Clavicular Joint

  • Four supporting ligaments of the Acromio-Clavicular Joint include: Coraco-acromial ligament, Acromio-clavicular ligaments, Coraco-clavicular Ligaments, Conoid ligament (medial), and Trapezoid ligament (lateral)
  • If a 52-year-old man fell onto his left shoulder, the Acromion process of the scapula and the Acromion end of the clavicle make up the acromio-clavicular joint
  • Rupture of the Acromio-clavicular ligaments and Coraco-clavicular ligaments is necessary to have superior displacement of the A-C joint

Gleno-Humeral Joint

  • Gleno-humeral ligaments include the superior, middle, and inferior glenohumeral ligaments
  • The shoulder moves in a 2:1 ratio, scapulohumeral rhythm

Shoulder Motion

  • 0-20 degrees of abduction of the shoulder come from the supraspinatus
  • 20-90 degrees of abduction come from the middle deltoid
  • 90-140 degrees of abduction come from the serratus anterior and trapezius

Shoulder Dislocation

  • In an anterior shoulder dislocation, the humeral head is displaced

Elbow Joint

  • The Radial head articulates with the capitellum of the humerus
  • The trochlear notch of the ulna articulates with the trochlear of the humerus

Radio-Ulnar Joints

  • Supination is the movement of the forearm that rotates the radius laterally about it's longitudinal axis
  • This causes the dorsum of the hand faces posteriorly and the palm to face anteriorly
  • Pronation is the movement of the forearm produced by the pronator teres and pronator quadratus
  • Pronation rotates the radius medially around its longitudinal axis so that the palm of the hand faces posteriorly and the dorsum faces anteriorly
  • The annular ligament attaches to the radial notch of the ulna, forming a collar around the head of the radius
  • This creates a pivot type of synovial joint, and the articular cavity of the joint is continuous with that of the elbow joint
  • The head of the radius rotates in the socket formed by the annular ligament and radial notch of the ulna

Distal Radio-Ulnar Joint

  • The articular disc is referred to clinically as the triangular ligament of the distal radio-ulnar joint to firmly unite joints

Wrist and Hand

  • Bones of the radio-carpal joint include the radius and proximal carpal row (scaphoid, lunate, triquetrum)
  • Bones of the distal carpal row are trapezium, trapezoid, capitate, and hamate

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Description

Explore the connections between bones known as joints, which unite the skeletal system. Learn about the classification of joints based on tissue type and function, including the types of synovial joints. Understand the movements allowed by hinge, pivot, and ball and socket joints.

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