Human Anatomy and Physiology Chapter 8 PDF

Human Anatomy and Physiology Eleventh Edition Chapter 08 Joints PowerPoint® Lectures Slides prepared by Karen Dunbar Kareiva, Ivy Tech Community College...

Human Anatomy and Physiology Eleventh Edition Chapter 08 Joints PowerPoint® Lectures Slides prepared by Karen Dunbar Kareiva, Ivy Tech Community College Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Why This Matters Understanding the nature of joints will help you treat patients with injuries such as ankle sprains Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Video: Why This Matters (Career Connection) Click here to view ADA compliant video: Why This Matters (Career Connection) https://mediaplayer.pearsoncmg.com/assets/secs_wtm_ch_08_dea_v2 Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved 8.1 Classification of Joints (1 of 2) Joints, also called articulations: sites where two or more bones meet Functions of joints: give skeleton mobility and hold skeleton together Two classifications: 1. Structural: three types based on what material binds the joints and whether a cavity is present  Fibrous  Cartilaginous  Synovial Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved 8.1 Classification of Joints (2 of 2) 2. Functional classifications: three types based on movement joint allows  Synarthroses: immovable joints  Amphiarthroses: slightly movable joints  Diarthroses: freely movable joints Structural classifications are more clear cut, so these will be used here Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved 8.2 Fibrous Joints (1 of 4) Bones joined by dense fibrous connective tissue No joint cavity Most are immovable – Depends on length of connective tissue fibers Three types of fibrous joints – Sutures – Syndesmoses – Gomphoses Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Sutures Rigid, interlocking joints of skull Allow for growth during youth – Contain short connective tissue fibers that allow for expansion In middle age, sutures ossify and fuse – Immovable joints join skull into one unit that protects brain – Closed, immovable sutures referred to as synostoses Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Fibrous Joints (2 of 4) Figure 8.1a Fibrous joints. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Syndesmoses Bones connected by ligaments, bands of fibrous tissue Fiber length varies, so movement varies – Short fibers offer little to no movement  Example: inferior tibiofibular joint – Longer fibers offer a larger amount of movement  Example: interosseous membrane connecting radius and ulna Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Fibrous Joints (3 of 4) Figure 8.1b Fibrous joints. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Gomphoses Peg-in-socket joints Only examples are the teeth in alveolar sockets Fibrous connection is the periodontal ligament – Holds tooth in socket Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Fibrous Joints (4 of 4) Figure 8.1c Fibrous joints. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved 8.3 Cartilaginous Joints Bones united by cartilage Like fibrous joints, have no joint cavity Not highly movable Two types – Synchondroses – Symphyses Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Synchondroses Bar or plate of hyaline cartilage unites bones Almost all are synarthrotic (immovable) Examples – Temporary epiphyseal plate joints  Become synostoses after plate closure – Cartilage of 1st rib with manubrium of sternum Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Cartilaginous Joints (1 of 2) Figure 8.2a Cartilaginous joints. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Symphyses Fibrocartilage unites bone in symphysis joint – Hyaline cartilage also present as articular cartilage on bony surfaces Symphyses are strong, amphiarthrotic (slightly movable) joints Examples – Intervertebral joints – Pubic symphysis Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Cartilaginous Joints (2 of 2) Figure 8.2b Cartilaginous joints. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved 8.4 Synovial Joints Bones separated by fluid-filled joint cavity All are diarthrotic (freely movable) Include almost all limb joints Characteristics of synovial joints – Have six general features – Have bursae and tendon sheaths associated with them – Stability is influenced by three factors – Allow several types of movements – Classified into six different types Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved General Structure (1 of 4) Synovial joints have six general features: 1. Articular cartilage: consists of hyaline cartilage covering ends of bones  Prevents crushing of bone ends 2. Joint (synovial) cavity: small, fluid-filled potential space that is unique to synovial joints 3. Articular (joint) capsule: two layers thick  External fibrous layer: dense irregular connective tissue  Inner synovial membrane: loose connective tissue that makes synovial fluid Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved General Structure (2 of 4) 4. Synovial fluid: viscous, slippery filtrate of plasma and hyaluronic acid  Lubricates and nourishes articular cartilage  Contains phagocytic cells to remove microbes and debris 5. Different types of reinforcing ligaments  Capsular: thickened part of fibrous layer  Extracapsular: outside the capsule  Intracapsular: deep to capsule; covered by synovial membrane Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved General Structure (3 of 4) 6. Nerves and blood vessels  Nerves detect pain; monitor joint position and stretch  Capillary beds supply filtrate for synovial fluid Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved General Structure of a Synovial Joint Figure 8.3 General structure of a synovial joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved General Structure (4 of 4) Other features of some synovial joints: – Fatty pads  For cushioning between fibrous layer of capsule and synovial membrane or bone – Articular discs (menisci)  Fibrocartilage separates articular surfaces to improve “fit” of bone ends, stabilize joint, and reduce wear and tear Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Bursae and Tendon Sheaths (1 of 3) Bags of synovial fluid that act as lubricating “ball bearing” – Not strictly part of synovial joints, but closely associated Bursae: reduce friction where ligaments, muscles, skin, tendons, or bones rub together Tendon sheaths: elongated bursae wrapped completely around tendons subjected to friction Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Bursae and Tendon Sheaths (2 of 3) Figure 8.4a Bursae and tendon sheaths. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Bursae and Tendon Sheaths (3 of 3) Figure 8.4b Bursae and tendon sheaths. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Factors Influencing Stability of Synovial Joints Three factors determine stability of joints to prevent dislocations: 1. Shape of articular surface (minor role)  Shallow surfaces less stable than ball-and-socket 2. Ligament number and location (limited role)  The more ligaments, the stronger the joint 3. Muscle tone keeps tendons taut as they cross joints (most important)  Extremely important in reinforcing shoulder and knee joints and arches of the foot Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Table 8.2-1 Structural and Functional Characteristics of Body Joints Table 8.2 Structural and Functional Characteristics of Body Joints Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Table 8.2-2 Structural and Functional Characteristics of Body Joints Table 8.2 Structural and Functional Characteristics of Body Joints Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (1 of 15) All muscles attach to bone or connective tissue at no fewer than two points – Origin: attachment to immovable bone – Insertion: attachment to movable bone Muscle contraction causes insertion to move toward origin Movements occur along transverse, frontal, or sagittal planes Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (2 of 15) Range of motion allowed by synovial joints – Nonaxial: slipping movements only – Uniaxial: movement in one plane – Biaxial: movement in two planes – Multiaxial: movement in or around all three planes Three general types of movements – Gliding – Angular movements – Rotation Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (3 of 15) Gliding movements – One flat bone surface glides or slips over another similar surface – Examples  Intercarpal joints  Intertarsal joints  Between articular processes of vertebrae Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (4 of 15) Figure 8.5a Movements allowed by synovial joints. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (5 of 15) Angular movements – Increase or decrease angle between two bones – Movement along sagittal plane – Angular movements include:  Flexion: decreases the angle of the joint  Extension: increases the angle of the joint – Hyperextension: movement beyond the anatomical position Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (6 of 15) Figure 8.5b Movements allowed by synovial joints. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (7 of 15) Figure 8.5c Movements allowed by synovial joints. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (8 of 15) Figure 8.5d Movements allowed by synovial joints. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (9 of 15) Angular movements (cont.) – Abduction: movement along frontal plane, away from the midline – Adduction: movement along frontal plane, toward the midline – Circumduction  Involves flexion, abduction, extension, and adduction of limb  Limb describes cone in space Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (10 of 15) Figure 8.5e Movements allowed by synovial joints. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (11 of 15) Rotation: turning of bone around its own long axis, toward midline or away from it – Medial: rotation toward midline – Lateral: rotation away from midline – Examples  Rotation between C1 and C2 vertebrae  Rotation of humerus and femur Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (12 of 15) Figure 8.5f Movements allowed by synovial joints. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (13 of 15) Special movements – Supination and pronation: rotation of radius and ulna  Supination: palms face anteriorly – Radius and ulna are parallel  Pronation: palms face posteriorly – Radius rotates over ulna – Dorsiflexion and plantar flexion of foot  Dorsiflexion: bending foot toward shin  Plantar flexion: pointing toes Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Special Body Movements (1 of 6) Figure 8.6a Special body movements. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Special Body Movements (2 of 6) Figure 8.6b Special body movements. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (14 of 15) Special movements (cont.) – Inversion and eversion of foot  Inversion: sole of foot faces medially  Eversion: sole of foot faces laterally – Protraction and retraction: movement in lateral plane  Protraction: mandible juts out  Retraction: mandible is pulled toward neck Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Special Body Movements (3 of 6) Figure 8.6c Special body movements. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Special Body Movements (4 of 6) Figure 8.6d Special body movements. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Movements Allowed by Synovial Joints (15 of 15) Special movements (cont.) – Elevation and depression of mandible  Elevation: lifting body part superiorly – Example: shrugging shoulders  Depression: lowering body part – Example: opening jaw – Opposition: movement of thumb  Example: touching thumb to tips of other fingers on same hand or any grasping movement Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Special Body Movements (5 of 6) Figure 8.6e Special body movements. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Special Body Movements (6 of 6) Figure 8.6f Special body movements. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Table 8.3 Movements at Synovial Joints Table 8.3 Movements at Synovial Joints Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Types of Synovial Joints There are six different types of synovial joints – Categories are based on shape of articular surface, as well as movement joint is capable of  Plane  Hinge  Pivot  Condylar  Saddle  Ball-and-socket Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Six Types of Synovial Joint Shapes Determine the Movements that can Occur at a Joint (1 of 6) FOCUS FIGURE 8.1a Synovial Joints Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Six Types of Synovial Joint Shapes Determine the Movements that can Occur at a Joint (2 of 6) FOCUS FIGURE 8.1b Synovial Joints Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Six Types of Synovial Joint Shapes Determine the Movements that can Occur at a Joint (3 of 6) FOCUS FIGURE 8.1c Synovial Joints Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Six Types of Synovial Joint Shapes Determine the Movements that can Occur at a Joint (4 of 6) FOCUS FIGURE 8.1d Synovial Joints Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Six Types of Synovial Joint Shapes Determine the Movements that can Occur at a Joint (5 of 6) FOCUS FIGURE 8.1e Synovial Joints Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Six Types of Synovial Joint Shapes Determine the Movements that can Occur at a Joint (6 of 6) FOCUS FIGURE 8.1f Synovial Joints Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved 8.5 Selected Synovial Joints Synovial joints are diverse All have general features, but some also have unique structural features, abilities, and weaknesses Five main synovial joints – Jaw (Tempormandibular Joint) – Shoulder – Elbow – Hip – Knee Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Temporomandibular Joint (TMJ) (1 of 2) Jaw joint is a modified hinge joint Mandibular condyle articulates with temporal bone – Posterior temporal bone forms mandibular fossa, while anterior portion forms articular tubercle Articular capsule thickens into strong lateral ligament Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Temporomandibular Joint (TMJ) (2 of 2) Two types of movement – Hinge: depression and elevation of mandible – Gliding: side-to-side (lateral excursion) grinding of teeth Most easily dislocated joint in the body Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Temporomandibular (Jaw) Joint (1 of 3) Figure 8.7a The temporomandibular (jaw) joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Temporomandibular (Jaw) Joint (2 of 3) Figure 8.7b The temporomandibular (jaw) joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Temporomandibular (Jaw) Joint (3 of 3) Figure 8.7c The temporomandibular (jaw) joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Clinical – Homeostatic Imbalance 8.1 (1 of 2) Dislocation of TMJ is most common because of shallow socket of joint Almost always dislocates anteriorly, causing mouth to remain open – To realign, physician must push mandible back into place Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Clinical – Homeostatic Imbalance 8.1 (2 of 2) Symptoms: ear and face pain, tender muscles, popping sounds when opening mouth, joint stiffness Usually caused by grinding teeth, but can also be due to jaw trauma or poor occlusion of teeth – Treatment for grinding teeth includes bite plate – Relaxing jaw muscles helps Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Shoulder (Glenohumeral) Joint (1 of 3) Most freely moving joint in body Stability is sacrificed for freedom of movement Ball-and-socket joint – Large, hemispherical head of humerus fits in small, shallow glenoid cavity of scapula  Like a golf ball on a tee Articular capsule enclosing cavity is also thin and loose – Contributes to freedom of movement Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Shoulder Joint (1 of 5) Figure 8.8a The shoulder joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Animation: Rotating Bone Model: Shoulder Click here to view ADA compliant Animation: Rotating Bone Model: Shoulder https://mediaplayer.pearsoncmg.com/assets/rotating-bone-model-shoulder Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Shoulder Joint (2 of 5) Figure 8.8b The shoulder joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Shoulder (Glenohumeral) Joint (2 of 3) Glenoid labrum: fibrocartilaginous rim around glenoid cavity – Helps to add depth to shallow cavity – Cavity still only holds one-third of head of humerus Reinforcing ligaments – Primarily on anterior aspect – Coracohumeral ligament  Helps support weight of upper limb – Three glenohumeral ligaments  Strengthen anterior capsule, but are weak support Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Shoulder Joint (3 of 5) Figure 8.8c The shoulder joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Shoulder Joint (4 of 5) Figure 8.8d The shoulder joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Shoulder (Glenohumeral) Joint (3 of 3) Reinforcing muscle tendons contribute most to joint stability – Tendon of long head of biceps brachii muscle is “superstabilizer”  Travels through intertubercular sulcus  Secures humerus to glenoid cavity – Four rotator cuff tendons encircle the shoulder joint  Subscapularis  Supraspinatus  Infraspinatus  Teres minor Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Shoulder Joint (5 of 5) Figure 8.8e The shoulder joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Clinical – Homeostatic Imbalance 8.2 Shoulder dislocations are common injuries due to mobility in the shoulder Structures reinforcing this joint are weakest anteriorly and inferiorly, so head of humerus can easily dislocate forward and downward Glenoid cavity provides poor support when humerus is rotated laterally and abducted – ex: when football player uses arm to tackle opponent Blows to top and back of shoulder can also cause dislocations. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved A&P Flix: Rotator Cuff Muscles: Overview (a) Click here to view ADA compliant Animation: A&P Flix: Rotator Cuff Muscles: Overview (a) https://mediaplayer.pearsoncmg.com/assets/apf-rotator-cuff-muscles-overview-a Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved A&P Flix: Rotator Cuff Muscles: Overview (b) Click here to view ADA compliant Animation: A&P Flix: Rotator Cuff Muscles: Overview (b) https://mediaplayer.pearsoncmg.com/assets/apf-rotator-cuff-muscles-overview-b Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved A&P Flix: Movement at the Glenohumeral Joint: An Overview Click here to view ADA compliant Animation: A&P Flix: Movement at the Glenohumeral Joint: An Overview https://mediaplayer.pearsoncmg.com/assets/apf-movement-at-the-glenohumeral-joint-overview Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved A&P Flix: Movement at the Glenohumeral Joint (a) Click here to view ADA compliant Animation: A&P Flix: Movement at the Glenohumeral Joint (a) https://mediaplayer.pearsoncmg.com/assets/apf-movement-at-the-glenohumeral-joint-a Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved A&P Flix: Movement at the Glenohumeral Joint (b) Click here to view ADA compliant Animation: A&P Flix: Movement at the Glenohumeral Joint (b) https://mediaplayer.pearsoncmg.com/assets/apf-movement-at-the-glenohumeral-joint-b Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Elbow Joint Humerus articulates with radius and ulna Hinge joint formed primarily from trochlear notch of ulna articulating with trochlea of humerus – Allows for flexion and extension only Anular ligament surrounds head of radius Two capsular ligaments restrict side-to-side movement – Ulnar collateral ligament – Radial collateral ligament Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved A&P Flix: Movement of Elbow Joint (b) Click here to view ADA compliant Animation: A&P Flix: Movement of Elbow Joint (b) https://mediaplayer.pearsoncmg.com/assets/apf-muscles-of-the-elbow-joint-b Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Elbow Joint (1 of 4) Figure 8.9a The elbow joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Elbow Joint (2 of 4) Figure 8.9b The elbow joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Elbow Joint (3 of 4) Figure 8.9c The elbow joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Animation: Rotating Bone Model: Elbow Click here to view ADA compliant Animation: Rotating Bone Model: Elbow https://mediaplayer.pearsoncmg.com/assets/rotating-bone-model-elbow Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Elbow Joint (4 of 4) Figure 8.9d The elbow joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved A&P Flix: The Elbow Joint and Forearm: An Overview Click here to view ADA compliant Animation: A&P Flix: The Elbow Joint and Forearm: An Overview https://mediaplayer.pearsoncmg.com/assets/apf-the-elbow-joint-and-forearm-overview Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Hip (Coxal) Joint (1 of 2) Ball-and-socket joint Large, spherical head of the femur articulates with deep cup-shaped acetabulum Good range of motion, but limited by the deep socket – Acetabular labrum: rim of fibrocartilage that enhances depth of socket (hip dislocations are rare) Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Hip Joint (1 of 4) Figure 8.10a The hip joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved A&P Flix: Movement at Hip Joint: Overview Click here to view ADA compliant Animation: A&P Flix: Movement at Hip Joint: Overview https://mediaplayer.pearsoncmg.com/assets/Jirf4rMy79khLIAJX1SjXh_rVifmv9lZ Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Hip Joint (2 of 4) Figure 8.10b The hip joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Hip (Coxal) Joint (2 of 2) Reinforcing ligaments include: – Iliofemoral ligament – Pubofemoral ligament – Ischiofemoral ligament – Ligament of head of femur (ligamentum teres)  Slack during most hip movements, so not important in stabilizing  Does contain artery that supplies head of femur Greatest stability comes from deep ball-and-socket joint Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Hip Joint (3 of 4) Figure 8.10c The hip joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Hip Joint (4 of 4) Figure 8.10d The hip joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Animation: Rotating Bone Model: Hip Click here to view ADA compliant Animation: Rotating Bone Model: Hip https://mediaplayer.pearsoncmg.com/assets/rotating-bone-model-hip Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Knee Joint (1 of 4) Largest, most complex joint of body Consists of three joints surrounded by single cavity 1. Femoropatellar joint  Plane joint  Allows gliding motion during knee flexion 2. Lateral joint and 3. Medial joint  Lateral and medial joints together are called tibiofemoral joint  Joint between femoral condyles and lateral and medial menisci of tibia  Hinge joint that allows flexion, extension, and some rotation when knee partly flexed Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Knee Joint (1 of 6) Figure 8.11a The knee joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Knee Joint (2 of 6) Figure 8.11b The knee joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved A&P Flix: Muscles that Cross the Knee Joint: Overview Click here to view ADA compliant Animation: A&P Flix: Muscles that Cross the Knee Joint: Overview https://mediaplayer.pearsoncmg.com/assets/apf-muscles-that-cross-the-knee-joint-overview Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Knee Joint (2 of 4) Joint capsule is thin and absent anteriorly Anteriorly, quadriceps tendon gives rise to three broad ligaments that run from patella to tibia – Medial and lateral patellar retinacula that flank the patellar ligament  Doctors tap patellar ligament to test knee-jerk reflex At least 12 bursae associated with knee joint Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Knee Joint (3 of 6) Figure 8.11c The knee joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Knee Joint (3 of 4) Capsular, extracapsular, or intracapsular ligaments act to stabilize knee joint Capsular and extracapsular ligaments help prevent hyperextension of knee – Fibular and tibial collateral ligaments: prevent rotation when knee is extended – Oblique popliteal ligament: stabilizes posterior knee joint – Arcuate popliteal ligament: reinforces joint capsule posteriorly Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Knee Joint (4 of 6) Figure 8.11d The knee joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Knee Joint (4 of 4) Intracapsular ligaments reside within capsule, but outside synovial cavity Help to prevent anterior-posterior displacement – Anterior cruciate ligament (ACL)  Attaches to anterior tibia  Prevents forward sliding of tibia and stops hyperextension of knee – Posterior cruciate ligament  Attaches to posterior tibia  Prevents backward sliding of tibia and forward sliding of femur Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Knee Joint (5 of 6) Figure 8.11e The knee joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Animation: Rotating Bone Model: Knee Click here to view ADA compliant Animation: A&P Flix: Rotating Bone Model: Knee https://mediaplayer.pearsoncmg.com/assets/rotating-bone-model-knee Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The Knee Joint (6 of 6) Figure 8.11f The knee joint. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Clinical – Homeostatic Imbalance 8.3 Knee absorbs great amount of vertical force; however, it is vulnerable to horizontal blows – Common knee injuries involved the 3 C’s:  Collateral ligaments  Cruciate ligaments  Cartilages (menisci) – Lateral blows to extended knee can result in tears in tibial collateral ligament, medial meniscus, and anterior cruciate ligament – Injuries affecting just ACL are common in runners who change direction, twisting ACL – Surgery usually needed for repairs Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved The “Unhappy Triad:” Ruptured ACL, Ruptured Tibial Collateral Ligament, and Torn Meniscus Figure 8.12 The “unhappy triad:” ruptured ACL, ruptured tibial collateral ligament, and torn meniscus. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved 8.6 Disorders of Joints Common Joint Injuries Cartilage tears – Due to compression and shear stress – Fragments may cause joint to lock or bind – Cartilage rarely repairs itself – Repaired with arthroscopic surgery – Partial menisci removal renders joint less stable but mobile; complete removal leads to osteoarthritis – Meniscal transplant possible in younger patients – Perhaps meniscus grown from own stem cells in future Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Arthroscopic Photograph of A Torn Medial Meniscus Figure 8.13 Arthroscopic photograph of a torn medial meniscus. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Common Joint Injuries (1 of 2) Sprains – Reinforcing ligaments are stretched or torn – Common sites are ankle, knee, and lumbar region of back – Partial tears repair very slowly because of poor vascularization – Three options if torn completely  Ends of ligaments can be sewn together  Replaced with grafts  Just allow time and immobilization for healing Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Common Joint Injuries (2 of 2) Dislocations (luxations) – Bones forced out of alignment – Accompanied by sprains, inflammation, and difficulty moving joint – Caused by serious falls or contact sports – Must be reduced to treat Subluxation: partial dislocation of a joint Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Inflammatory and Degenerative Conditions (1 of 9) Bursitis – Inflammation of bursa, usually caused by blow or friction – Treated with rest and ice and, if severe, anti-inflammatory drugs Tendonitis – Inflammation of tendon sheaths, typically caused by overuse – Symptoms and treatment similar to those of bursitis Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Inflammatory and Degenerative Conditions (2 of 9) Arthritis – >100 different types of inflammatory or degenerative diseases that damage joints – Most widespread crippling disease in the U.S. – Symptoms: pain, stiffness, and swelling of joint – Acute forms: caused by bacteria, treated with antibiotics – Chronic forms: osteoarthritis, rheumatoid arthritis, and gouty arthritis Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Inflammatory and Degenerative Conditions (3 of 9) Osteoarthritis (OA) – Most common type of arthritis – Irreversible, degenerative (“wear-and-tear”) arthritis – May reflect excessive release of enzymes that break down articular cartilage  Cartilage is broken down faster than it is replaced  Bone spurs (osteophytes) may form from thickened ends of bones – By age 85, half of Americans develop OA, more women than men Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Inflammatory and Degenerative Conditions (4 of 9) Osteoarthritis (OA) (cont.) – OA is usually part of normal aging process – Joints may be stiff and make crunching noise referred to as crepitus, especially upon rising – Treatment: moderate activity, mild pain relievers, capsaicin creams  Glucosamine, chondroitin sulfate, and nutritional supplements not effective Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Inflammatory and Degenerative Conditions (5 of 9) Rheumatoid arthritis (RA) – Chronic, inflammatory, autoimmune disease of unknown cause  Immune system attacks own cells – Usually arises between ages 40 and 50, but may occur at any age; affects three times as many women as men – Signs and symptoms include joint pain and swelling (usually bilateral), anemia, osteoporosis, muscle weakness, and cardiovascular problems Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Inflammatory and Degenerative Conditions (6 of 9) Rheumatoid arthritis (RA) (cont.) – RA begins with inflammation of synovial membrane (synovitis) of affected joint – Inflammatory blood cells migrate to joint, release inflammatory chemicals that destroy tissues – Synovial fluid accumulates, causing joint swelling – Inflamed synovial membrane thickens into abnormal pannus tissue that clings to articular cartilage – Pannus erodes cartilage, scar tissue forms and connects articulating bone ends (ankylosis) Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Inflammatory and Degenerative Conditions (7 of 9) Rheumatoid arthritis (RA) (cont.) – Treatment includes steroidal and nonsteroidal anti-inflammatory drugs to decrease pain and inflammation – Disruption of destruction of joints by immune system  Immune suppressants slow autoimmune reaction  Some agents target tumor necrosis factor to block action of inflammatory chemicals – Can replace joint with prosthesis Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved A Hand Deformed by Rheumatoid Arthritis Figure 8.14 A hand deformed by rheumatoid arthritis. Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Inflammatory and Degenerative Conditions (8 of 9) Gouty arthritis – Deposition of uric acid crystals in joints and soft tissues, followed by inflammation – More common in men – Typically affects joint at base of great toe – In untreated gouty arthritis, bone ends fuse and immobilize joint – Treatment: drugs, plenty of water, avoidance of alcohol and foods high in purines, such as liver, kidneys, and sardines Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Inflammatory and Degenerative Conditions (9 of 9) Lyme disease – Caused by bacteria transmitted by tick bites – Symptoms: skin rash, flu-like symptoms, and foggy thinking – May lead to joint pain and arthritis – Treatment  Long course of antibiotics Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Developmental Aspects of Joints (1 of 2) By embryonic week 8, synovial joints resemble adult joints Joint’s size, shape, and flexibility modified by use – Active joints have thicker capsules and ligaments Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Developmental Aspects of Joints (2 of 2) Advancing years take toll on joints – Ligaments and tendons shorten and weaken – Intervertebral discs more likely to herniate – Most people in 70s have some degree of OA Full-range-of-motion exercise key to postponing joint problems Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved Copyright Copyright © 2019, 2016, 2013 Pearson Education, Inc. All Rights Reserved