Nyki's ch. 08 PPT S19 (1).ppt

Chapter 8 Joints and Movement 8-1 8.1 Classes of Joints • Structural: based on major connective tissue type that binds bones – Fibrous – Cartilaginous – Synovial • Functional: based on degree of motion – Synarthrosis: non-movable – Amphiarthrosis: slightly movable – Diarthrosis: freely movable...

Chapter 8 Joints and Movement 8-1 8.1 Classes of Joints • Structural: based on major connective tissue type that binds bones – Fibrous – Cartilaginous – Synovial • Functional: based on degree of motion – Synarthrosis: non-movable – Amphiarthrosis: slightly movable – Diarthrosis: freely movable 8-2 Fibrous Joints • Characteristics – United by fibrous connective tissue – Have no joint cavity – Move little or none • Types: Sutures, Syndesmoses, Gomphoses 8-3 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. TABLE 8.1 Class and Example of Joint Fibrous and Cartilaginous Joints Bones or Structures Joined Movement Coronal Frontal and parietal None Lambdoid Occipital and parietal None Sagittal The two parietal bones None Squamous Parietal and temporal Slight Radioulnar Ulna and radius Slight Stylohyoid Styloid process and hyoid bone Slight Stylomandibular Styloid process and mandible Slight Tibiofibula Tibia and fibula Slight Tooth and alveolar process Slight Epiphyseal plate Diaphysis and epiphysis of a long bone None Sternocostal Anterior cartilaginous part of first rib; between rib and sternum Slight Sphenooccipital Sphenoid and occipital None Intervertebral Bodies of adjacent vertebrae Slight Manubriosternal Manubrium and body of sternum None Symphysis pubis The two coxal bones None except during childbirth Xiphisternal Xiphoid process and body of sternum None Fibrous Joints Sutures Syndesmoses Gomphoses Dentoalveolar Cartilaginous Joints Synchondroses Symphyses 8-4 Fibrous Joints: Sutures Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Frontal bone Coronal suture Sagittal suture Lambdoid suture Parietal bone Occipital bone • Opposing bones interdigitate. • Periosteum of one bone is continuous with the periosteum of the other. • Sutural ligament: two periostea plus dense, fibrous, connective tissue between. • In adults may ossify completely: synostosis. • Fontanels: membranous areas in the suture between bones. Allow change in shape of head during birth and rapid growth of the brain after birth. Fig. 8.1; Slide # 8-5 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Parietal bone Squamous suture Frontal bone Coronal suture Occipital bone Lambdoid suture Mastoid (posterolateral) fontanel (a) Lateral view Sphenoidal (anterolateral) fontanel Temporal bone Frontal bones (not yet fused into a single bone) Frontal (anterior) fontanel Parietal bone Occipital bone (b) Superior view Sagittal suture Occipital (posterior) fontanel Fig. 8.2; Slide # 8-6 Fibrous Joints: Syndesmoses Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Head of radius Annular ligament Biceps brachii tendon Oblique cord Radioulnar syndesmosis Radius Interosseous membrane Ulna • Bones farther apart than suture and joined by ligaments • Some movement may occur • Examples: radioulnar (interosseus membrane) Anterior view Fig. 8.3; Slide # 8-7 Fibrous Joints: Gomphoses Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Crown of tooth Gingiva (gum) Root of tooth Periodontal ligaments Gomphosis • Specialized joints • Pegs that fit into sockets • Periodontal ligaments: hold teeth in place • Inflammations – Gingivitis leads to… – Periodontal disease Alveolar bone Fig. 8.4; Slide # 8-8 Cartilaginous Joints • Unite two bones by means of cartilage • Types – Synchondroses: hyaline cartilage – Symphyses: fibrocartilage 8-9 Cartilaginous Joints: Synchondroses Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Epiphysis Synchondroses (epiphyseal plates) Ilium Secondary epiphysis Diaphysis Ischium Pubis Synchondroses (a) Lateral view (b) Frontal section First rib Manubriosternal symphysis Sternocostal synchondrosis (costal cartilage of first rib) Manubrium Body Sternal symphyses Xiphoid process Xiphisternal symphysis Costochondral joint Sternum • Joined by hyaline cartilage • Little or no movement • Some are temporary and are replaced by synostoses • Some are permanent • Some like costochondral joints develop into synovial joints • Examples: Epiphyseal plates, sternocostal (c) Anterior view Fig. 8.5; Slide # 8-10 Cartilaginous Joints: Symphyses • Fibrocartilage uniting two bones • Slightly movable • Examples: symphysis pubis, between the manubrium sternum and the body of the sternum, intervertebral disks. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Ilium Sacrum Pubis Symphysis pubis Ischium Fig. 8.6; Slide # 8-11 Anterior view Synovial Joints • Contain synovial fluid • Allow considerable movement • Most joints that unite bones of appendicular skeleton reflecting greater mobility of appendicular skeleton compared to axial • Complex 8-12 Synovial Joints • Articular cartilage: hyaline; provides smooth surface • Joint cavity: synovial; encloses articular surfaces • Capsule – Fibrous capsule: dense irregular connective tissue, continuous with fibrous layer of the periosteum. Portions may thicken to form ligaments. – Synovial membrane and fluid: membrane lines inside of joint capsule except at actual articulation of articular cartilages. Thin, delicate. Sometimes separated from fibrous capsule by areolar C.T. and fat, sometimes merged with fibrous. • Synovial fluid: complex mixture of polysaccharides, proteins, fat and cells. Hyaluronic acid- slippery. • No blood vessels or nerves in articular cartilages; nutrients from nearby blood vessels and synovial fluid • Nerves in capsule help brain know position of joints (proprioception) 8-13 Synovial Joints Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Blood Bursa (extension vessel of joint cavity) Nerve Synovial membrane Fibrous capsule Joint capsule Bone Joint cavity (filled with synovial fluid) Articular cartilage Tendon sheath Tendon Bone Fibrous layer Cellular layer Periosteum Fig. 8.7; Slide # 8-14 Accessory Structures • Bursae – Pockets of synovial membrane and fluid that extend from the joint. Found in areas of friction – Bursitis • Ligaments and tendons: stabilization • Articular discs: temperomandibular, sternoclavicular, acromioclavicular • Menisci: fibrocartilaginous pads in the knee. • Tendon sheaths: synovial sacs that surround tendons as they pass near or over bone 8-15 Types of Synovial joints • Uniaxial: occurring around one axis • Biaxial: occurring around two axes at right angles to each other • Multiaxial: occurring around several axes 8-16 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Class and Example of Joint Plane Acromioclavicular Slight Carpal and metacarpal of thumb Between carpal bones Manubrium of sternum and clavicle Two axes Hinge Cubital (elbow) Knee Interphalangeal Talocrural (ankle) Humerus, ulna, and radius Femur and tibia Between phalanges Talus, tibia, and fibula One axis One axis One axis Multiple axes; one predominates Pivot Atlantoaxial Proximal radioulnar Distal radioulnar Atlas and axis Radius and ulna Radius and ulna Rotation Rotation Rotation Coxal bone and femur Scapula and humerus Multiple axes Multiple axes Atlas and occipital bone Metacarpal bones and phalanges Metatarsal bones and phalanges Radius and carpal bones Mandible and temporal bone Two axes Two axes Sacroiliac Intervertebral Tarsometatarsal Saddle Carpometacarpal pollicis Intercarpal Sternoclavicular Saddle Hinge Pivot Slight Slight Slight Slight Cubital Proximal radioulnar Glenohumeral Ellipsoid Atlantooccipital Metacarpophalangeal (knuckles) Metatarsophalangeal (ball of foot) Radiocarpal (wrist) Temporomandibular Ellipsoid Slight Slight Slight Slight Slight Slight Carpometacarpal Ball-and-Socket Coxal (hip) Glenohumeral (shoulder) Ball-and-socket Movement Acromion process of scapula and clavicle Carpals and metacarpals 2–5 Ribs and vertebrae Between carpal bones Between metatarsal bones Between tarsal bones Between articular processes of adjacent vertebrae Between sacrum and coxal bone (complex joint with several planes and synchondroses) Tarsal bones and metatarsal bones Carpometacarpal Costovertebral Intercarpal Intermetatarsal Intertarsal Intervertebral Plane Structures Joined Atlantooccipital Two axes Multiple axes Multiple axes; one predominates Fig. 8.8; Slide # 8-17 Plane and Saddle Joints • Plane or gliding joints – Uniaxial. some rotation possible but limited by surrounding structures – Example: intervertebral, intercarpal, acromioclavicular, carpometacarpal, costovertebral, intertarsal, sacroiliac, tarsometatarsal • Saddle joints – Biaxial – Example: thumb (carpometacarpal pollicis), intercarpal, sternoclavicular Fig. 8.8; Slide # 8-18 Hinge and Pivot Joints • Hinge joints – Uniaxial – Convex cylinder in one bone; corresponding concavity in the other – Example: elbow, ankle, interphalangeal • Pivot joints – Uniaxial. Rotation around a single axis. – Cylindrical bony process rotating within a circle of bone and ligament – Example: articulation between dens of axis and atlas (atlantoaxial), proximal radioulnar, distal radioulnar Fig. 8.8; Slide # 8-19 Ball-and-Socket and Ellipsoid Joints • Ball-and-socket – Multiaxial – Examples: shoulder and hip joints • Ellipsoid (Condyloid) – Modified ball-and-socket; articular surfaces are ellipsoid – Biaxial – Example: atlantooccipital, Fig. 8.8; Slide # 8-20 8.2 Types of Movement • Gliding: in plane joints; slight movement • Angular – Flexion and Extension • Hyperextension • Plantar and Dorsiflexion – Abduction and Adduction • Circular – Rotation – Pronation and Supination – Circumduction 8-21 Flexion and Extension Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Flexion Flexion Extension © The McGraw-Hill Companies, Inc./Eric Wise, photographer Extension © The McGraw-Hill Companies, Inc./Eric Wise, photographer • Flexion: movement of a body part anterior to the coronal plane • Extension: movement of a body part posterior to the coronal plane Fig. 8.9; Slide # 8-22 Flexion and Extension Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Anterior to coronal plane Anterior to coronal plane Posterior to coronal plane Posterior to coronal plane Posterior to frontal plane Anterior to frontal plane Flexion Extension Flexion Flexion (a) Extension Extension Coronal plane (b) Coronal plane (c) Coronal plane © The McGraw-Hill Companies, Inc./Eric Wise, photographer Fig. 8.10; Slide # 8-23 Dorsiflexion and Plantar Flexion Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. • Exceptions to definition – Plantar flexion: standing on the toes – Dorsiflexion: foot lifted toward the shin Dorsiflexion Plantar flexion © The McGraw-Hill Companies, Inc./Eric Wise, photographer Fig. 8.12; Slide # 8-24 Abduction and Adduction Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Abduction Abduction Abduction Adduction • Abduction: movement away from the median plane • Adduction: movement toward the median plane Adduction (a) (b) a: © The McGraw-Hill Companies, Inc./Jill Braaten, Photographer; b,: © The McGraw-Hill Companies, Inc./Eric Wise, photographer Fig. 8.13; Slide # 8-25 Circular Movements Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Medial rotation Lateral rotation • Rotation: turning of a structure on its long axis – Examples: rotation of the head, humerus, entire body – Medial and lateral rotation; example, the rotation of the arm © The McGraw-Hill Companies, Inc./Eric Wise, photographer Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Pronation • Pronation/Supination: refer to unique rotation of the forearm – Pronation: palm faces posteriorly – Supination: palm faces anteriorly Supination © The McGraw-Hill Companies, Inc./Eric Wise, photographer Fig. 8.14; Slide # 8-26 Circular Movement Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. • Circumduction – Combination of flexion, extension, abduction, adduction – Appendage describes a cone Circumduction Fig. 8.16; Slide # 8-27 © The McGraw-Hill Companies, Inc./Eric Wise, photographer Special Movements • Unique to only one or two joints • Types – – – – – Elevation and Depression Protraction and Retraction Excursion Opposition and Reposition Inversion and Eversion 8-28 Elevation and Depression • Elevation: moves a structure superior • Depression: moves a structure inferior • Examples: shrugging the shoulders, opening and closing the mouth Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Elevation Depression Fig. 8.17; Slide # 8-29 © The McGraw-Hill Companies, Inc./Eric Wise, photographer Protraction and Retraction Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. • Protraction: gliding motion anteriorly • Retraction: moves structure back to anatomic position or even further posteriorly • Examples: scapulae and mandibles Protraction Retraction © The McGraw-Hill Companies, Inc./Eric Wise, photographer Fig. 8.18; Slide # 8-30 Excursion • Lateral: moving mandible to the right or left of midline • Medial: return the mandible to the midline Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Lateral excursion to the right Lateral excursion to the left © The McGraw-Hill Companies, Inc./Eric Wise, photographer Fig. 8.19; Slide # 8-31 Opposition and Reposition Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Opposition Reposition • Opposition: movement of thumb and little finger toward each other • Reposition: return to anatomical position © The McGraw-Hill Companies, Inc./Eric Wise, photographer Fig. 8.20; Slide # 8-32 Inversion and Eversion Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. • Inversion: turning the ankle so the plantar surface of foot faces medially • Eversion: turning the ankle so the plantar surface of foot faces laterally Eversion Inversion © The McGraw-Hill Companies, Inc./Eric Wise, photographer Fig. 8.21; Slide # 8-33 8.3 Range of Motion • • Amount of mobility demonstrated at a given joint Types – – • Active: amount of movement accomplished by muscle contraction Passive: amount of movement accomplished by some outside force Both active and passive can be influenced by 1. 2. 3. 4. 5. 6. 7. Shape of articular surfaces forming joint Amount and shape of cartilage covering surfaces Strength and location of ligaments and tendons Location of muscles associated with joint Amount of fluid in and around joint Amount of pain in and around joint Amount of use/disuse of joint 8-34 8.4 Temporomandibular Joint Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Lateral view Temporal bone Zygomatic arch External auditory canal Lateral ligament Joint capsule Styloid process • TMJ • Combination plane and ellipsoid joint • Fibrocartilage disk divides joint into superior and inferior cavities • Allows depression/elevation, excursion, protraction/retraction • TMJ Disorders Stylomandibular ligament Mandible Superior joint cavity Temporal bone Articular disk Inferior joint cavity Lateral pterygoid muscle Mandibular condyle Mandible Sagittal section of temporomandibular joint – Cause of most chronic orofacial pain Fig. 8.22; Slide # 8-35 Shoulder (Glenohumeral) Joint • Ball-and-socket: stability is reduced, mobility is increased compared to hip • Flexion/extension, abduction/adduction, rotation, circumduction • Glenoid labrum: rim of fibrocartilage built up around glenoid cavity; joint capsule attachment • Bursae: subacromial and subscapular • Rotator cuff: four muscles that along with ligaments give stability to the joint • Tendon of biceps brachii passes through the joint capsule 8-36 Shoulder (Glenohumeral) Joint Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Clavicle (cut and elevated) Acromioclavicular ligament Acromion process Trapezoid ligament Conoid ligament Coracoacromial ligament Subacromial bursa Coracoclavicular ligament Transverse scapular ligament Coracohumeral ligament Coracoid process Humerus Superior glenohumeral ligament Transverse humeral ligament Middle glenohumeral ligament Inferior glenohumeral ligament Joint capsule Tendon sheath on tendon of long head of biceps brachii Biceps brachii (long head) tendon Hook retracting subscapularis muscle Triceps brachii tendon (long head) Anterior view Acromion process (articular surface) Subacromial bursa Joint cavity Articular cartilage over head of humerus Articular cartilage over glenoid cavity Tendon sheath on tendon of long head of biceps brachii Scapula (cut surface) Glenoid labrum Biceps brachii (long head) tendon Joint capsule Humerus Biceps brachii (long head) muscle Frontal section Fig. 8.23; Slide # 8-37 8-38 Elbow Joint Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Humerus Joint capsule Synovial membrane Joint cavity Articular cartilage Fat pad Coronoid process Trochlea Articular cartilage of the trochlear notch Ulna (a) Sagittal section Humerus Lateral epicondyle Joint capsule Radial collateral ligament (cut) Olecranon process Olecranon bursa Radial annular ligament (cut) Biceps brachii tendon (cut) Radius Interosseus membrane Ulna (b) Lateral view Radial annular ligament Humerus Medial epicondyle Biceps brachii tendon Radius Interosseus membrane Ulna Joint capsule (c) Medial view Radial annular ligament Biceps brachii tendon (cut) Radius Interosseus membrane Humerus Lateral epicondyle Joint capsule Radial collateral ligament Olecranon process Olecranon bursa Ulnar collateral ligament Olecranon process Olecranon bursa Ulna (d) Lateral view • Compound hinge joint – Humeroulnar joint – Humeroradial joint – Proximal radioulnar joint • Shape of trochlear notch and trochlea limit movement to extension and flexion • Rounded head of radius allows pronation and supination • Ligaments – Ulnar collateral ligament – Radial collateral ligament – Radial annular ligament • Subacromial bursa Fig. 8.24; Slide # 8-39 Hip (Coxal) Joint • Ball-and-socket with acetabulum deepened by fibrocartilage acetabular labrum and transverse acetabular ligament • More stable but less mobile than shoulder joint • Flexion/extension, abduction/adduction, rotation, circumduction • Extremely strong joint capsule reinforced by ligaments including the iliofemoral ligament that bears much of the body weight while standing • Ligament of head of femur (round ligament of femur); often bears nutrient artery 8-40 Hip (Coxal) Joint Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Coxal bone Tendon of rectus femoris muscle (cut) Iliofemoral ligaments Articular cartilage Acetabulum Joint cavity Ligament of head of femur Acetabular labrum Joint Pubofemoral capsule ligament Greater trochanter Greater trochanter Head of femur Transverse acetabular ligament Lesser trochanter Femur Lesser trochanter Femur (a) Anterior view (b) Frontal section Acetabular labrum Ligament of head of femur Head of femur Articular capsule (cut) (c) Right hip joint, anterior view, internal aspect of joint c: © The McGraw-Hill Companies, Inc./Photo and Dissection by Christine Eckel Fig. 8.25; Slide # 8-41 8-42 Knee Joint • Condyloid: allowing flexion/extension, small amount of rotation • Menisci: fibrocartilage articular disks that build up the margins of the tibia and deepen articular surface • Cruciate ligaments: extend between intercondylar eminence of tibia and fossa of the femur – Anterior cruciate ligament (ACL). Prevents anterior displacement of tibia – Posterior cruciate ligament (PCL). Prevents posterior displacement of tibia • Collateral and popliteal ligaments: along with tendons of thigh muscles strengthen the joint • Bursae: may result in slow accumulation of fluid in the joint (water on the knee) 8-43 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Knee Femur Quadriceps femoris muscle (cut) Suprapatellar bursa Quadriceps femoris tendon Lateral (fibular) collateral ligament Patella in quadriceps tendon Patellar retinaculum Medial (tibial) collateral ligament Tendon of biceps femoris muscle (cut) Patellar ligament Fibula Tibia Patellar surface of femur Posterior cruciate ligament Lateral condyle Anterior cruciate ligament Medial meniscus Transverse ligament Tendon of Biceps femoris muscle (cut) Medial (tibial) collateral ligament Fibula (a) Anterior view Tendon of adductor magnus muscle (cut) Medial condyle Lateral (fibular) collateral ligament Lateral meniscus Tibia (b) Anterior view Femur Quadriceps femoris muscle (cut) Femur Medial head of gastrocnemius muscle (cut) Lateral head of gastrocnemius muscle (cut) Medial (tibial) collateral ligament Arcuate popliteal ligament Tendon of biceps femoris muscle (cut) Oblique popliteal ligament Lateral (fibular) collateral ligament Tendon of semimembranosus muscle (cut) Popliteus muscle Tibia Fibula (c) Posterior view Anterior cruciate ligament Lateral condyle Lateral (fibular) collateral ligament Medial condyle Posterior meniscofemoral ligament Medial meniscus Lateral meniscus Medial (tibial) collateral ligament Posterior cruciate ligament Fibula Tibia (d) Posterior view Fig. 8.26; Slide # 8-44 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Quadriceps femoris tendon Posterior cruciate ligament Suprapatellar bursa Femur Subcutaneous prepatellar bursa Medial (tibial) collateral ligament Lateral (fibular) collateral ligament Anterior cruciate ligament Lateral meniscus Medial meniscus Patella Articular cartilage Fat pad Patellar ligament Meniscus Deep infrapatellar bursa Tibia (e) Anterior view (f) Sagittal section e: © R. T. Hutchings Fig. 8.26; Slide # 8-45 8-46 Knee Injuries and Disorders Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Lateral Medial Direction of force Medial (tibial) collateral ligament Anterior cruciate ligament Medial meniscus Anterior view • Football injuries: often tear the medial collateral ligament (MCL), the anterior cruciate ligament (ACL), and damage the medial meniscus • Bursitis • Chondromalacia: softening of cartilage due to abnormal movement of the patella or to accumulation of fluid in fat pad posterior to patella • Hemarthrosis: acute accumulation of blood in joint Fig. 8A; Slide # 8-47 Ankle (Talocrural) Joint Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Tibia (medial malleolus) Medial ligament Plantar calcaneonavicular ligament Calcaneal tendon (cut) Plantar calcaneocuboid ligament Talus Long plantar ligament Calcaneus (a) Medial view Tibia Posterior tibiofibular ligament Fibula (lateral malleolus) Calcaneofibular ligament Anterior tibiofibular ligament Anterior talofibular ligament Calcaneal tendon (cut) Long plantar ligament Tendon of fibularis longus muscle Calcaneus (b) Lateral view Tendon of fibularis brevis muscle • Highly modified hinge joint • Lateral and medial thickening of articular capsule to prevent side-toside movement • Dorsiflexion/plantar flexion, limited inversion and eversion • Ligaments of arch – Hold bones in proper relationship – Transfer weight Fig. 8.27; Slide # 8-48 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Direction of force Torn fibers of anterior talofibular ligament Torn fibers of calcaneofibular ligament Lateral view Fig. 8B; Slide # 8-49 8-50 8.5 Effects of Aging on Joints • Tissue repair slows; rate of new blood vessel development decreases • Articular cartilages wear down and matrix becomes more rigid • Production of synovial fluid declines • Ligaments and tendons become shorter and less flexible: decrease in range of motion (ROM) • Muscles around joints weaken • A decrease in activity causes less flexibility and decreased ROM 8-51 • Arthritis Joint Disorders – Osteoarthritis: wear and tear – Rheumatoid: caused by transient infection or autoimmune disease • Joint infections. Lyme disease (with ticks as vector), suppurative arthritis, tuberculous arthritis • Gout. Metabolic disorders of unknown cause (idiopathic). Increase in uric acid in blood results in deposition of monosodium urate crystals in joints and kidneys • Hallux valgus and bunion. Caused by ill-fitting shoes • Joint replacement. Prosthetic joint used to eliminate excruciating pain, usually due to arthritis 8-52 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (a) (b) a: © James Stevenson/Science Photo Library/ Photo Researchers, Inc.; b: © CNRI/Science Photo Library/Photo Researchers, Inc. Fig. 8C; Slide # 8-53 Ch. 8 Learning Objectives After reading this chapter, students should be able to: • Explain the structure of a fibrous joint, list the three types, and give an example of each type. • Contrast the two types of cartilaginous joints and give examples of each type. • Illustrate the structure of a synovial joint and explain the roles of the components of a synovial joint. • Classify synovial joints based on the shape of the bones in the joint and give an example of each type. • Demonstrate the difference between the following pairs of movements: flexion and extension; plantar flexion and dorsiflexion; abduction and adduction; supination and pronation; elevation and depression; protraction and retraction; opposition and reposition; inversion and eversion. 8-54 Ch. 8 Learning Objectives • Explain the difference between active and passive range of motion. • List the factors that affect normal range of motion. • Compare and contrast the ball and socket joints of the shoulder and hip. • Compare and contrast the hinge joints of the elbow, knee, and ankle. • Describe the ligaments that support the complex ellipsoid joint of the knee. • Explain the structure and functions of the arches of the foot. • Discuss the common disorders that affect these major joints. 8-55 Ch. 8 Learning Objectives • Describe the effects of aging on the joints. • Explain the most effective preventive measures against the effects of aging on the joints. 8-56