ANATOMY OF JOINT/ARTICULATION

I Nyoman Mangku Karmaya

Axial skeleton

Appendicular skeleton

Ventral view

Dorsal view

Human skeleton Axial skeleton consist of 80 bones cranium spine /columna vertebralis ribs sternum Appendicular skeleton consist of 126 bones shoulder arm elbow hand TOTAL: 206 BONES pelvis leg knee ankle foot

Joints/Articulation
A joint, or articulation, is the place where two bones come together. The type depend on the structure in between Fibrous- Immovable:connect bones, no movement. (skull and pelvis). Cartilaginous- slightly movable, bones are attached by cartilage, a little movement (spine or ribs). Synovial- freely movable, much more movement than cartilaginous joints. Cavities between bones are filled with synovial fluid. This fluid helps lubricate and protect the bones.

Fibrous joints
Suture
Bones tightly bound by minimal fiber Only found in skull

Syndemoses
Bones connected by ligaments E.g. tibiofibular ligament, interosseous membrane of radius/ulna

Gomphoses
Peg in socket joint Only found in teeth/alveoli
Fig. 9.1 a, M&M

Describe the name of all sutures at cranium

Fontanela anterior

Fontanela posterior

Fibrous joints
Suture
Bones tightly bound by minimal fiber Only found in skull

Syndemoses
Bones connected by ligaments E.g. tibiofibular ligament, interosseous membrane of radius/ulna Gomphoses
Peg in socket joint Only found in teeth/alveoli
Fig. 8.4, M&M Fig. 9.1 b, M&M

Fibrous joints
Suture
Bones tightly bound by minimal fiber Only found in skull

Syndemoses
Bones connected by ligaments E.g. tibiofibular ligament, interosseous membrane of radius/ulna

Gomphoses
Peg in socket joint Only found in teeth/alveoli
Fig. 9.1 c, M&M

Cartilaginous Joints
Synchondrosis
Hyaline cartilage unites bones Epiphyseal growth plates Costal cartilage-sternum
Fig. 9.2, M&M

Symphyses
Fibrocartilage unites bones Pubic symphysis Intervertebral disc

Intervertebral disc

Medulla spinalis

Medulla spinalis/spinal cord goes through vertebral canal which is formed by vertebral foramen

INTERVERTEBRAL DISC

LOAD

Hernia Nucleus Pulposus (HNP) push the spinal cord

 Most common joints in body Most mobile joints Have Articular surfaces on bone with hyaline cartilage Completely enclosed joint capsule formed from ligamentous connective tissue Synovial fluid within capsule lubricates joint Some have meniscus or articular disc(e.g. knee, jaw joint)

Synovial Joints

Synovial Joint Shape Types

Plane joints--intercarpal joints Hinge joints--elbow,ankle, inter-phalangeal Pivot joints--radio-ulnar joint, atlas-dens joint Condyloid joints (egg into oval)--metacarpophalangeal Saddle joints--carpo-metacarpal joint of thumb Ball-and-socket--hip, shoulder

The type of joint, in part, determines the range and direction of movement

Types of Synovial Joints Based on Shape

Figure 5.29ac
Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Slide

PIVOT JOINT BETWEEN C1 AND C2

Types of Synovial Joints Based on Shape

Figure 5.29df
Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Slide

Types of Joints
Hinge- A hinge joint allows extension and retraction of an appendage. (Elbow, Knee)

Ball and Socket- A ball and socket joint allows for radial movement in almost any direction. They are found in the hips and shoulders. (Hip, Shoulder)

Gliding- In a gliding or plane joint bones slide past each other. Mid-carpal and midtarsal joints are gliding joints. (Hands, Feet)

Saddle- This type of joint occurs when the touching surfaces of two bones have both concave and convex regions with the shapes of the two bones complementing one other and allowing a wide range of movement. (Thumb)

Shoulder Joint
Rotator cuff/ Musculotendineus cuff: m. Supraspinatus m. Infraspinatus m. Teres major m. Subscapularis
Fig. 9.9, M&M

Shoulder Joint

Shoulder Joint

Knee Joint

1. Intra and extra articular ligament; 2. meniscus, 3. sesamoid bone (patella)

Articular disc

Temporo Mandibular Joint

Tendons

are structures that connect bone to muscle and are made up of tendon tissue Can have various shapes Typical is cord-like tendon of biceps

Sheeths are common-aponeuroses e.g. acromiotrapezius origin from thoracic vertebral spines,

aponeurosis
of abdominal wall muscles

TENDON

OUR BODY IS COVERED BY

Skin Fascia superficialis (subcutaneous tissue) Fascia profundus = fascia=fibrous membrane between more specialized tissue such as muscles
More or less continues over the entire body and commonly named according to region eg. Fascia pectoralis, fascia lata etc.

SKIN

Epidermis

Dermis

Function of the fascia

Provide muscles origins and insertions Serving as an elastic sheath for muscles Forming specialized retaining band (retinacula) and fibrous sheaths for tendons Provides pathways for the passage of vessels and nerves (neurovascular sheath) Aided the venous return in lower limb by muscular action May limit or control the spread of pus Strips of fascia are sometimes used for the repair of the tendinous or aponeurotic defects

LIGAMENT
Ligaments connect bone-to-bone or reinforce joints-they are made up of tendinous tissue as well E.g. knee ligaments

SYNOVIAL TENDON SHEATH VS BURSAE

Bursae
Bursae: saclike structures that reduce friction. Located in the shoulder and knee joints. Found between skin and bone, tendons and bones, muscles and bones, ligaments and bones.

Serous Cavities of the Human Body

serous = waterytype fluid. Serous cavities = sacs lined with serous membranes. serve as lubricating devices, reduce the friction during the motion between organs Exp: bursa, pleural, pericardial, peritoneal cavities

Tendon Sheaths: tubelike bursae that wrap

around tendons. Found at the wrist, ankle, fingers and toes.

Types of movement and examples (with muscles) flexion- move lower leg toward upper extension- straightening the leg
abduction- moving leg away from body adduction- movong leg toward the body

rotation- around its axis supination- rotation of arm to palm-up position pronation- palm down
circumduction- swinging arms in circles inversion- turning foot so sole is inward eversion- sole is out

Aging and Joints

Decreased production of synovial fluid Articular cartilage becomes thinner with age, ligaments shortens and lose flexibility. Genetic factors Males commonly develop degenerative changes in the vertebral column-hunched. Osteoarthritis-occurs over age 70.

Arthritis

Gout
Gout is a disease that results from an overload of uric acid in the body. This overload of uric acid leads to the formation of tiny crystals of urate that deposit in tissues of the body, especially the joints. When crystals form in the joints it causes recurring attacks of joint inflammation (arthritis). Chronic gout can also lead to deposits of hard lumps of uric acid in and around the joints and may cause joint destruction, decreased kidney function, and kidney stones.

X-ray of hand affected by arthritis

Bursitis
Inflammation of the Bursa (fluid filled sac surrounding the joint). A bursa can become inflamed from injury, infection (rare in the shoulder), or due to an underlying rheumatic condition. Bursitis is typically identified by localized pain or swelling, tenderness, and pain with motion of the tissues in the affected area.

Tendonitis
Sometimes the tendons become inflamed for a variety of reasons, and the action of pulling the muscle becomes irritating. If the normal smooth gliding motion of your tendon is impaired, the tendon will become inflamed and movement will become painful. This is called tendonitis, and literally means inflammation of the tendon. The most common cause of tendonitis is overuse.

Artificial Hip Joint

TRAUMA !!!

R. I. C. E. :
REST ICE COMPRESS ELEVATE

TERIMAKASIH