Anatomy & Physiology Lecture Outline PDF

Chapter 09 Lecture Outline Anatomy & Physiology AN INTEGRATIVE APPROACH Fourth Edition Michael P. McKinley Valerie Dean O’Loughlin Theresa Stouter Bidle Copyright 2022 © McGraw Hill LLC. All rights res...

Chapter 09 Lecture Outline Anatomy & Physiology AN INTEGRATIVE APPROACH Fourth Edition Michael P. McKinley Valerie Dean O’Loughlin Theresa Stouter Bidle Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Palpable Bony Landmarks Zygomatic bone Medial and lateral epicondyles on the humerus (anteriorly) Olecranon Styloid process of the ulna Iliac crest Anterior-superior crest Sacrum Medial malleolus of the fibula Calcaneus Patella 2 9.1 Classification of Joints 1 Joints (articulations) Places of contact between bones, bones and cartilage, or bones and teeth Bones articulate at a joint Classified by structure and function Function- the movement they allow 3 9.1 Classification of Joints 2 Structural classes: Fibrous joint Bones held together by dense connective tissue Cartilaginous joint Bones joined by cartilage Synovial joint Bones joined by ligaments with fluid-filled joint cavity separating bone surfaces 4 9.1 Classification of Joints 3 Functional classes: Synarthroses Immobile joints Can be fibrous or cartilaginous joints Amphiarthroses Slightly mobile joints Can be fibrous or cartilaginous joints Diarthroses Freely mobile joints All synovial joints 5 9.1 Classification of Joints 4 Range of motion at joints Motion ranges from no movement to extensive movement Structure of each joint determines its mobility and stability Inverse relationship (tradeoff) between mobility and stability For example, skull sutures are immobile but very stable 6 The Relationship Between Mobility and Stability in Joints Figure 9.1 Access the text alternative for slide images. 7 Section 9.1 What did you learn? 1. What is the relationship between mobility and stability in a joint? 2. Are all fibrous joints also synarthroses? Explain why or why not. 8 9.2 Fibrous Joints Characteristics of fibrous joints Connected by dense regular connective tissue Have no joint cavity Immobile or only slightly mobile Three most common types Gomphoses Sutures Syndesmoses 9 9.2a Gomphoses “Peg in a socket” Articulations of teeth with sockets of mandible and maxillae Tooth held in place by fibrous periodontal membranes Function as synarthroses Figure 9.2a Access the text alternative for slide images. 10 9.2b Sutures Found between some skull bones Very short fibers Interlocking, irregular edges Increase stability and decrease risk of fracture Function as synarthroses Allow growth in childhood Become ossified synostoses in older adults Figure 9.2b Access the text alternative for slide images. 11 9.2c Syndesmoses Bound by interosseous membrane, broad ligamentous sheet Found between radius and ulna and between tibia and fibula Function as amphiarthroses Provide pivot for two long bones Figure 9.2c Access the text alternative for slide images. 12 Section 9.2 What did you learn? 3. Where are gomphoses located, and what type of movement do they allow? 4. What is the composition of a suture, and where in the body is it found? 5. What type of movement is allowed at a syndesmosis? 13 9.3 Cartilaginous Joints Properties of cartilaginous joints Either hyaline cartilage or fibrocartilage between bones Lack a joint cavity Immobile or slightly mobile Synchondroses or symphyses 14 9.3a Synchondroses Bones joined by hyaline cartilage Immobile (synarthroses) Figure 9.3a Access the text alternative for slide images. 15 9.3b Symphyses Pads of fibrocartilage between articulating bones Resist compression and act as shock absorbers Allow slight mobility (amphiarthroses) Figure 9.3b Access the text alternative for slide images. 16 Section 9.3 What did you learn? 6. What is the composition of a synchondrosis, and where is it located in the body? 7. Into what functional category is a symphysis placed? Why is it in this category? 17 9.4a Distinguishing Features and Anatomy of Synovial Joints 1 Synovial joints Bones separated by a joint cavity Include most joints in the body Diarthroses (freely mobile) All with several basic features: Articular capsule and joint cavity Synovial fluid Articular cartilage Ligaments, nerves, and blood vessels 18 Synovial Joints Figure 9.4 Access the text alternative for slide images. 19 Synovial Joints B from Gosling J, Harris P, Whitmore I, Willan P: Human anatomy, ed 4, Philadelphia, 2002, Mosby. 20 9.4a Distinguishing Features and Anatomy of Synovial Joints 2 Double-layered articular capsule (joint capsule) Outer fibrous layer Formed from dense connective tissue Strengthens joints to prevent bones being pulled apart Inner synovial membrane Composed primarily of areolar connective tissue Covers internal joint surfaces not covered by cartilage Helps produce synovial fluid 21 9.4a Distinguishing Features and Anatomy of Synovial Joints 3 Articular cartilage Hyaline cartilage on bone surface at joint Functions Reduces friction during movement Acts as a cushion to absorb joint compression Prevents damage to articulating ends of bones Lacks a perichondrium Avascular 22 9.4a Distinguishing Features and Anatomy of Synovial Joints 4 Joint cavity Space between articulating bones Lined by synovial membrane secreting synovial fluid Viscous, oily substance Functions: Lubricates articular cartilage on articulating surfaces Nourishes the chondrocytes of articular cartilage Acts as a shock absorber 23 9.4a Distinguishing Features and Anatomy of Synovial Joints 5 Ligaments Dense regular connective tissue Connect one bone to another Stabilize, strengthen, and reinforce synovial joints 24 9.4a Distinguishing Features and Anatomy of Synovial Joints 6 Sensory receptors and blood vessels Numerous in synovial joints Receptors detect painful stimuli, report on movement and stretch Tendons Composed of dense regular connective tissue Not part of the synovial joint itself Attach muscle to bone Help stabilize joints 25 9.4a Distinguishing Features and Anatomy of Synovial Joints 7 Bursae Fibrous, saclike structures containing synovial fluid Lined internally by synovial membrane Found in synovial joints where bones, ligaments, muscles, skin, or tendons rub together Connected to or separate from joint cavity Alleviate friction 26 Bursae of the Knee Joint Figure Access the text alternative for slide images. 9.5a 27 9.4a Distinguishing Features and Anatomy of Synovial Joints 8 Other accessory structures Tendon sheaths, elongated bursae Wrap around tendons where friction is excessive Common in wrist and ankle Fat pads Act as protective packing material in joint periphery Can fill spaces when joint shape changes 28 Tendon Sheaths of the Wrist and Hand Figure Access the text alternative for slide images. 9.5b 29 9.4b Classification of Synovial Joints 1 Classified by movements allowed and shapes of joint surfaces Classes by movement Uniaxial joint Bone moves in just one plane or axis Biaxial joint Bone moves in two planes or axes Multiaxial joint Bone moves in multiple planes or axes 30 Uniaxial, Biaxial, and Multiaxial Joints 31 9.4b Classification of Synovial Joints 2 Classes by shape of joint surfaces, listed from least mobile to most freely mobile: Plane joints Hinge joints Pivot joints Condylar joints Saddle joints Ball-and-socket joints 32 9.4b Classification of Synovial Joints 3 Plane joint Articular surfaces flat Simplest, least mobile synovial articulation Uniaxial: limited side-to-side gliding movement in a single plane Hinge joint Convex surface within concave depression Uniaxial: like the hinge of a door Pivot joint Bone with rounded surface fits into ligament ring Uniaxial joint: rotation on longitudinal axis 33 34 35 9.4b Classification of Synovial Joints 4 Condylar joint Oval, convex surface articulating with concave surface Biaxial Saddle joint Convex and concave surfaces resembling saddle shape Biaxial Ball-and-socket joint Spherical head of one bone fitting into cuplike socket Multiaxial, permitting movement in three planes The most freely mobile type of joint 36 37 38 Section 9.4 What did you learn? 8. What are the basic characteristics of all types of synovial joints? 9. What are the three primary functions of synovial fluid in the joint? 10. What types of movements do each of the six kinds of joints allow? 39 9.5 The Movements of Synovial Joints Four types of motion occur at synovial joints: Gliding Angular Rotational Special movements Motions that occur only at specific joints 40 9.5a Gliding Motion Gliding Two opposing surfaces sliding back-and-forth or side-to-side Only limited movement possible in any direction Typically occurs along plane joints for example, between carpals or tarsals 41 9.5b Angular Motion 1 Angular motion Increases or decreases angle between two bones Includes specific types: Flexion and extension Hyperextension Lateral flexion Abduction and adduction Circumduction 42 9.5b Angular Motion 2 Flexion Movement in an anterior-posterior plane Decreases the angle between bones: brings bones closer together for example, bending finger Extension Also in anterior-posterior plane, but opposite of flexion Increases angle between articulating bones for example, straightening your fingers after making a fist 43 9.5b Angular Motion 3 Hyperextension Extension beyond normal range of motion Possible with extensively mobile joints or an injury Lateral flexion Trunk of body moving in coronal plane laterally Occurs between vertebrae in the cervical and lumbar region 44 Flexion, Extension, and Lateral Flexion (a) ©McGraw-Hill Education/Tamara Klein; (b, c) ©McGraw-Hill Education/Jw Ramsey; (d) ©McGraw-Hill Education/Tamara Klein; (e) ©McGraw-Hill Education/Jw Ramsey Figure 9.7 Access the text alternative for slide images. 45 9.5b Angular Motion 4 Abduction Lateral movement of body part away from midline for example, arm or thigh moved laterally from body midline Adduction Medial movement of body part toward midline for example, arm or thigh brought back toward midline 46 Abduction and Adduction a, b, c) ©McGraw-Hill Education/Jw Ramsey; (d, left, right ) ©McGraw-Hill Education/Tamara Klein Figure 9.8 Access the text alternative for slide images. 47 Circumduction Proximal end of appendage relatively stationary Distal end makes a circular motion Movement makes an imaginary cone shape for example, drawing a circle on the blackboard (a, b) ©McGraw-Hill Education/Jw Ramsey Figure 9.9 48 9.5c Rotational Motion Rotation Bone pivots on its own longitudinal axis Lateral rotation Turns anterior surface of bone laterally Medial rotation Turns anterior surface of bone medially Pronation Medial rotation of forearm so palm of hand posterior Supination Lateral rotation of forearm so palm of hand anterior 49 Rotational Movements ©McGraw-Hill Education/Jw Ramsey Figure Access the text alternative for slide images. 9.10 50 9.5d Special Movements Special movements do not readily fit other functional categories Depression Inferior movement of a body part For example, movement of mandible while opening mouth Elevation Superior movement of a body part For example, movement of mandible when closing mouth 51 Depression and Elevation (a) ©McGraw-Hill Education/Tamara Klein Figure 9.11a 52 Dorsiflexion and Plantar Flexion Dorsiflexion Limited to ankle joint Talocrural (ankle) joint bent so the dorsum (superior surface) of foot moves toward the leg For example, when digging in your heels Plantar flexion Talocrural joint bent so dorsum pointed inferiorly For example, ballerina on tiptoes in full plantar flexion Figure 9.11b ©McGraw-Hill Education/Jw Ramsey 53 Eversion and Inversion Eversion Occurs only at intertarsal joints of foot Sole turns laterally Inversion Occurs only at intertarsal joints of the foot Sole turns medially Figure 9.11c ©McGraw-Hill Education/Jw Ramsey 54 Protraction and Retraction Protraction Anterior movement from anatomic position for example, jutting jaw anteriorly at temporomandibular joint Retraction Posterior movement from anatomic position for example, pulling in jaw posteriorly at temporomandibular joint ©McGraw-Hill Education/ Tamara Klein Figure 9.11d 55 Opposition and Reposition Opposition Movement of thumb toward tips of fingers at carpometacarpal joint Enables the thumb to grasp objects Reposition Opposite movement ©McGraw-Hill Education/ Tamara Klein Figure 9.11e 56 Section 9.5 What did you learn? 11. What joints typically use gliding motion? 12. How do flexion and extension differ? What movements are involved in circumduction? 13. What is pronation, and where in the body may this type of movement be performed? 14. What is the difference between inversion and eversion, and which joints allow these movements? 57 9.6 Synovial Joints and Levers Synovial joint movements can be compared to the mechanics of a lever system Biomechanics – applying mechanical principles to biology 58 9.6a Terminology of Levers Lever Elongated, rigid object Rotates around fixed point, fulcrum Effort applied to one point Resistance located at some other point Movement occurs if effort exceeds resistance Effort arm Part of lever from fulcrum to point of effort Resistance arm Part of lever from fulcrum to point of resistance 59 First-Class Levers Fulcrum is between effort and resistance For example, pair of scissors Effort applied to handle of scissors Fulcrum along the middle of scissors For example, atlanto-occipital joint of the neck (a) ©McGraw-Hill/Electronic Publishing Services, Inc., NY Figure 9.12a Access the text alternative for slide images. 60 Second-Class Levers Resistance is between fulcrum and effort Small force able to balance larger weight For example, wheelbarrow Fulcrum far from effort Rare in the body For example, standing on tiptoe Figure 9.12b Access the text alternative for slide images. 61 Third-Class Levers Effort applied between resistance and fulcrum for example, forceps Most common in body For example, at elbow joint Joint is fulcrum; biceps tendon applies effort; weight in hand provides resistance Figure 9.12c Access the text alternative for slide images. 62 Section 9.6 What did you learn? 15. What is the difference between the effort arm and the resistance arm in a lever? 16. How does the position of the fulcrum, resistance, and effort vary in first-class, second-class, and third-class levers? 63 Temporomandibular Joint Figure Access the text alternative for slide images. 9.13 64 9.7b Shoulder Joint 2 Acromioclavicular Joint Plane joint Formed from acromion and lateral end of clavicle Fibrocartilaginous articular disc within joint cavity Joint capsule strengthened superiorly by acromioclavicular ligament Clavicle bound to coracoid process by coracoclavicular ligament If torn, acromion and clavicle no longer align (shoulder separation) 65 9.7b Shoulder Joint 3 Glenohumeral (Shoulder) Joint Ball-and socket joint Formed by head of humerus and glenoid cavity of scapula Permits greatest range of motion of any joint in the body Most unstable and most frequently dislocated Fibrocartilaginous glenoid labrum encircles socket Abundant bursae Decrease friction where tendons and muscles extend across capsule 66 9.7b Shoulder Joint 4 Glenohumeral (Shoulder) Joint (continued) Supporting ligaments and tendons Coracoacromial ligament, coracohumeral ligament, glenohumeral ligament Tendon of long head of biceps brachii Most joint stability due to rotator cuff muscles Subscapularis, supraspinatus, infraspinatus, teres minor Work as a group to hold head of humerus in glenoid cavity Tendons encircle joint and fuse with articular capsule 67 Acromioclavicular and Glenohumeral Joints: Anterior View (a) ©McGraw-Hill Education/Christine Eckel Figure Access the text alternative for slide images. 9.15a 68 Acromioclavicular and Glenohumeral Joints: Lateral View and Coronal Section Figure 9.15b-c Access the text alternative for slide images. 69 Clinical View: Shoulder Joint Dislocations Common due to joint instability Shoulder separation refers to acromioclavicular joint dislocation Pain when arm abducted more than 90 degrees Acromion appearing prominent Glenohumeral joint dislocations usually occur when fully abducted humerus struck hard Shoulder appears flattened and “squared-off ” Humeral head anterior and inferior to glenohumeral joint capsule 70 9.7c Elbow Joint 1 Elbow is a hinge joint composed of two articulations Humeroulnar joint Trochlear notch of ulna articulating with trochlea of humerus Humeroradial joint Capitulum of humerus articulating with head of radius Both enclosed within a single articular capsule 71 Elbow Joint: Anterior and Lateral Views Figure 9.16a- Access the text alternative for slide images. b 72 Elbow Joint: Medial View and Medial Sagittal Section Figure 9.16c-d Access the text alternative for slide images. 73 9.7c Elbow Joint 2 Elbow is very stable because Articular capsule is thick Bony surfaces of humerus and ulna interlock closely Multiple, strong ligaments reinforce articular capsule Radial collateral ligament Stabilizes joint at lateral surface Extends around head of radius Ulnar collateral ligament Stabilizes medial side of the joint Extends from medial epicondyle of humerus to coronoid and olecranon of ulna Annular ligament Surrounds the neck of the radius Binds head of the radius to the ulna 74 Clinical View: Subluxation of the Head of the Radius Subluxation refers to incomplete dislocation Subluxation of the head of the radius Head pulled out of annular ligament Occurs almost exclusively in children (usually < 5 yrs.) Child’s annular ligament thin and radial head not fully formed Pediatrician may maneuver radial head back into annular ligament 75 9.7d Hip Joint 1 Articulation between head of the femur and acetabulum of os coxa Acetabular labrum—fibrocartilaginous ring that deepens socket More stable, less mobile than glenohumeral joint 76 Hip Joint: Anterior and Posterior Views Figure 9.17a- Access the text alternative for slide images. b 77 Hip Joint: Coronal Section and Internal Aspect (d) ©McGraw-Hill Education/Christine Eckel Figure 9.17c-d Access the text alternative for slide images. 78 9.7d Hip Joint 2 Support of the hip joint Secured by articular capsule, ligaments, and muscles Articular capsule Extends from acetabulum to trochanters Encloses femoral head and neck Retinacular fibers Ligamentous fibers of articular capsule Reflect around femur neck Retinacular arteries here Supply most blood to femur head and neck 79 9.7d Hip Joint 3 Intracapsular ligaments Iliofemoral ligament Ligament providing support for anterior articular capsule Ischiofemoral ligament Intracapsular ligament posteriorly located Pubofemoral ligament Triangular thickening of capsule’s inferior region Become taut when hip extended Ligament of the head of femur (ligamentum teres) Small ligament from acetabulum to fovea of head of femur Does not provide stability Contains artery supplying head of femur 80 Clinical View: Fracture of the Femoral Neck Fracture of femur is often incorrectly referred to as “fractured hip” Intertrochanteric fractures Extracapsular fractures Usually in younger and middle-aged individuals Sub capital fractures Occur within hip articular capsule Usually in elderly people with osteoporosis May result in tearing of retinacular arteries May have avascular necrosis in the region 81 9.7e Knee Joint 1 Knee joint Largest and most complex diarthrosis Primarily a hinge joint Capable of slight rotation and lateral gliding when flexed Composed of two separate articulations Tibiofemoral joint Between condyles of femur and condyles of tibia Patellofemoral joint Between patella and patellar surface of femur 82 Knee Joint: Anterior and Posterior Superficial Views Figure 9.18a- Access the text alternative for slide images. b 83 Knee Joint: Anterior and Posterior Deep Views Figure 9.18c-d Access the text alternative for slide images. 84 9.7e Knee Joint 2 Structures of the knee joint Articular capsule Encloses only medial, lateral, and posterior knee regions Quadriceps femoris muscle tendon Passes over knee’s anterior surface, surrounds patella Patellar ligament Extends from patella to tibial tuberosity Fibular collateral ligament Reinforces lateral surface of joint Extends from femur to fibula Prevents hyperadduction 85 9.7e Knee Joint 3 Structures of the knee joint (continued ) Tibial collateral ligament Reinforces medial surface of joint Extends from femur to tibia Prevents hyperabduction Medial meniscus and lateral meniscus Deep to articular capsule within knee joint C-shaped fibrocartilage pads on top of tibial condyles Cushioning between articular surfaces Change shape to conform to articulating surfaces Partially stabilize joint medially and laterally 86 9.7e Knee Joint 4 Structures of the knee joint (continued ) Cruciate ligaments—cross each other Deep to articular capsule Anterior cruciate ligament (ACL) Extends from posterior femur to anterior tibia Prevents hyperextension and anterior displacement of tibia Posterior cruciate ligament (PCL) Extends from anteroinferior femur to posterior tibia Prevents hyperflexion and posterior displacement of tibia 87 Clinical View: Knee Ligament and Cartilage Injuries Tibial collateral ligament injury when leg forcibly abducted Fibular collateral ligament injury when medial side of knee is struck ACL injury when leg hyperextended PCL injury when leg hyperflexed Meniscus injury due to trauma and/or overuse Unhappy triad: injury of tibial collateral ligament, medial meniscus, and ACL Occurs due to a lateral blow to the knee that abducts and laterally rotates leg 88 9.7f Talocrural (Ankle) Joint 1 Talocrural joint Highly modified hinge joint Permits dorsiflexion and plantar flexion Includes two articulations within one articular capsule Between distal end of tibia and talus Between distal end of fibula and lateral aspect of talus 89 Talocrural Joint: Lateral View Figure Access the text alternative for slide images. 9.19a 90 Talocrural Joint: Medial View Figure Access the text alternative for slide images. 9.19b 91 9.7f Talocrural (Ankle) Joint 2 Anatomical features of talocrural joint Medial and lateral malleoli of tibia and fibula Prevent talus from sliding medially or laterally Articular capsule covers distal tibia, medial malleolus, lateral malleolus, and talus Deltoid ligament binds tibia to foot on medial side Prevents over eversion Lateral ligament binds fibula to foot on lateral side Prevents over inversion Prone to sprains and tears Anterior and posterior tibiofibular ligaments 92 Clinical View: Ankle Sprains and Pott Fractures Sprain Stretching or tearing of ligaments without fracture or dislocation Results from twisting foot, usually over inversion Fibers of lateral ligament stretched or torn Localized swelling and tenderness anteroinferior to lateral malleolus Pott fracture Occurs with over eversion Medial malleolus avulsed off of tibia (fracture) Talus moves laterally and fractures fibula 93 Section 9.7 What did you learn? 1 17. What movements are allowed at the temporomandibular joint? 18. Why is the shoulder joint considered the most mobile and at the same time the most unstable joint in the human body? 19. What is the function of the annular ligament in the elbow joint, and what injury may occur to this ligament and joint in young children? 94 Section 9.7 What did you learn? 2 20. How do the glenohumeral and hip joints compare with respect to their mobility and stability? 21. What are the functions of each of the intracapsular ligaments of the knee joint? 22. What bones articulate at the talocrural joint, and what movements are permitted at this joint? 95  End of Main Content Because learning changes everything. ® www.mheducation.com Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.