7-INTORDUCTION TO ARTHROLOGY (1).pptx

INTORDUCTION TO ARTHROLOGY ISTANBUL UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF ANATOMY WARNINGS ! ! These lecture slides are prepared using the available anatomy lecture resources. ! These lecture slides are for lecture purposes only. ! You can use other resources and visuals to follow these lect...

INTORDUCTION TO ARTHROLOGY ISTANBUL UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF ANATOMY WARNINGS ! ! These lecture slides are prepared using the available anatomy lecture resources. ! These lecture slides are for lecture purposes only. ! You can use other resources and visuals to follow these lecture slides. ! These lecture slides are 34 in total. ! The references of these lecture slides are indicated on slide 34. ! No part or content of these lecture slides may be reproduced. ! These lecture slides cannot be used as references. ARTHROLOGY SYNDESMOLOGY Arthrology is the study of joints. The prefix "arthro-" refers to joints, from the Greek (ἄρθρον) arthron Syndesmology is the study of ligaments. Structural Classification (binding tissue) Today, joints are divided into three groups according to their structures: 1- Fibrous joints: joined with dense fibrous connective tissue (cranial sutures, distal tibiofibular and cuboideonavicular joints) (non-synovial joints) 2- Cartilaginous joints: joined by cartilage (costochondral joints); two types: primary - synchondrosis (composed of hyaline cartilage), secondary - symphysis (hyalin cartilage covers the bones, but the fibrocartilage connects them) (non-synovial joints) 3- Synovial joints: not directly joined; the bones share synovial cavity that is closed with articular capsule which connects the bones (sternoclavicular, shoulder, elbow, hip, knee, radiocarpal, proximal tibiofibular joints) Functional Classification (movement) Joints used to be divided into three according to their movement or function: 1- Synarthrosis: little/no mobility, mostly fibrous joints 2- Amphiarthrosis: slight mobility, mostly cartilaginous joints 3- Diarthrosis: freely movable, synovial joints I- Non-Synovial Joints: A- Synarthrosis (little/no mobility) 1- Sutura 2- Schindylesis 3- Gomphosis B- Amphiarthrosis (slight mobility) 1-Syndesmosis 2-Symphysis 3-Synchondrosis II- Synovial Joints: A- Diarthrosis (freely movable) CLASSIFICATION OF JOINTS 1. Fibrous joints 2. Cartilaginous joints 3. Synovial joints CLASSIFICATION OF JOINTS Fibrous joints Sutures Syndesmosis Gomphosis CLASSIFICATION OF JOINTS Fibrous joints Types of Sutures  Plane suture  Serrate suture  Squamous suture  Denticulate suture  Schindylesis CLASSIFICATION OF JOINTS Fibrous joints Gomphosis: a peg fits into a socket CLASSIFICATION OF JOINTS Fibrous joints Syndesmosis; uniting fibrous tissue *Inferior tibiofibular joint CLASSIFICATION OF JOINTS Cartilaginous joints Cartilaginous joints are connected entirely by cartilage (fibrocartilage or hyaline). Cartilaginous joints allow more movement between bones than a fibrous joint but less than the highly mobile synovial joint. Syncondrosis (primary cartilaginous) Symphysis (secondory cartilaginous) CLASSIFICATION OF JOINTS Cartilaginous joints Synchondrosis (primary cartilaginous) Between the diaphysis and epiphysis of long bone CLASSIFICATION OF JOINTS Cartilaginous joints Symphysis (secondary cartilaginous) Fibrocartilage Symphysis pubis CLASSIFICATION OF JOINTS Synovial joints • Most of the joints in the body are from this group. In these joints, the joint faces are individually covered with hyaline cartilage • The joint capsule surrounds the knowledge of the joint Synovial joints re are structures required for these joints to be fully mo 1. Joint cavity 2. Articular cartilage 3. Articular capsule 4. Articular ligaments Joint cavity: The spacecavity between the cartilage-covered surfaces and the inner face of the joint capsule. It is filled with synovial fluid secreted from the synovial membrane. Articular capsule: Made of collagen fibers. It completely covers the joint faces and joint space. It is in two layers in terms of structure and function. Fibrosa to membrane outside, synovialis to membrane inside. • Articular cartilage: It is the hyaline cartilage that covers the joint faces of the bones (facies articularis) that make up the joint. Their surfaces are polished and slippery. It acts as a buffer. It reduces the reflection of impacts to the bone. Articular cartilages lack nerves and blood vessels. They are fed by blood vessels in the bone marrow and synovial diffusion. • Articular ligaments: The bones that make up the joint are connected to each other by joint ligaments. The articular capsule can also be considered a joint ligament. Bursae • Bursae are small fluidfilled sacs that reduce friction between moving parts in your body's joints. Shoulder bursitis is inflammation or irritation of a bursa (shown in blue) in your shoulder Classification of Synovial Joints Hinge Joint or Ginglymus Plane Joint Pivot Joint or Articulatio Trochoidea Ellipsoid Joint or Condyloid Joint Saddle Joint or Articulatio Sellaris Ball-Socket Joint or Articulatio Spheroidea • Bicondylar Joint • • • • • • Ginglymus or Hinge Joint • The hinge, or ginglymus, joint is a modified sellar joint with each mating surface ovoid on its right and left sides. This modification reduces movement to a backward-forward swing like that allowed by the hinge of a box or a door. • They move on the transverse axis • Ex: Humero-ulnar joint Ginglymus or Hinge Joint EXAMPLES • The Elbow – Humero-ulnar joint • The Hand – Metacarpophalangeal joints – Proximal interphalangeal joints – Distal interphalangeal joints • The Foot • The Knee • The Ankle Plane Joint • One of the joint faces is straight, slightly concave or convex, and the other face is shaped to match it • Due to the straight joint faces, there is no specific axis • These joints have only limited sliding movements • Ex: Intercarpal joint Pivot Joint or Articulatio trochoidea • It has an axis extending in the vertical direction • This type of joint makes a rotational movement • The convex face is like a cylinder, and the concave face is like a groove that partially encloses this cylinder • Proximal-distal radioulnar joint, atlantoaxial median joint Ellipsoidal Joint • Joint faces are oval. There is a condyle on one side and a face that fits on the other. It moves in transverse and sagittal axes. • Metacarpophalangeal joint, Atlantooccipital joint, radiocarpal joint, is an example of this type of attachment. Saddle Joint or Articulatio sellaris • Both joint faces are concave in one direction, and convex in the other direction. It has sagittal and transverse axes. Ex: Calcaneocuboid joint Carpometacarpal joint of the thumb Ball-and-Socket Joint or Spheroidal Joint (enarthrosis) • It moves in 3 main axes as vertical, sagittal and transverse. The term diarthrosis is used for all swing joints. The term enarthrosis is also used for the spheroid type of movable joints. There is a convex joint face in the form of a sphere and a concave joint face in the form of a pit to contain this face. Ex: shoulder joint, hip joint Bicondylar Joint • The convex joint face is in the form of 2 condyles, and the concave joint face is in the form of a slightly hollow. The joint space is divided partially or completely by 2 meniscus or discus located between the faces. Movement occurs in the transverse axis • On the other hand, the restricted rotational motion occurs around the vertical axis. Ex: Knee joint, temporomandibular joint Functional classification (axes) Movable joints are divided into 4 groups according to their axes. 1- Uniaxial (monoaxialuniaxial) joints: The axis is either transverse or vertical. If there is a transverse axis, there are flexion and extension movements. If there is a vertical axis, there will be rotation. For example: Ginglymus, trochoid group joints. The Elbow Humero-ulnar joint 2- Biaxial joints: One axis is transverse and the other is sagittal. Flexion-extension movements in the transverse axis and abductionadduction movements in the sagittal axis can be performed. Ex: Ellipsoid, sellar group joints. Metacarpophalangeal joint 3- Multiaxial or Polyaxial Joints: There are three main axes in the joint: transverse, sagittal and vertical. Flexion-extension, abductionadduction, rotation and circumduction movements can be performed in this joint. Ex: Spheroidal joint • 4- Joints that do not have a definite axis: Here the joint faces are straight. Only sliding movements can be made. Ex: Plane joint REFERENCES 1.Arıncı K, Elhan A. Anatomi. 2. Baskı. Güneş Kitabevi, Ankara, 1997. 2.Çimen A. Anatomi. 5. Bası. Uludağ Üniversitesi Basımevi, Bursa, 1987. 3.Dere F. Anatomi Atlası ve Ders Kitabı. 5. Baskı. Adana Nobel Tıp Kitabevi, Adana, 1999. 4.Ferner H, Jochen Staubesand J. Çeviren: Arıncı K. Sobotta İnsan Anatomisi Atlası, Cilt 12, Atlas Tıp Kitapçılık, Ankara, Urban&Schwarzenberg, München-Wien-Baltimo, 1985. 5.Gökmen FG. Sistematik Anatomi. Nobel Tıp Kitabevleri, İzmir, 2003. 6.Grant JCB. Method of Anatomy. 6th Edition. Willialms-Wilkins, Baltimore, 1958. 7.Kuran O. Sistematik Anatomi. 3. 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