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- Количество слайдов: 78
Chapter 9 *Lecture Outline *See separate Flex. Art Power. Point slides for all figures and tables pre-inserted into Power. Point without notes. Copyright © The Mc. Graw-Hill Companies, Inc. Permission required for reproduction or display.
Chapter 9 Outline • • Articulations Fibrous Joints Cartilaginous Joints Synovial Joints Selected Articulations in Depth Disease and Aging of the Joints Development of the Joints
Articulations Defined • An articulation, or joint, is: – the place where a bone meets • another bone • cartilage • teeth • Articulations vary in stability and mobility
Joint Mobility vs. Stability • Mobility – varies from immobile to wide range of motions • Stability – articular shape affects mobility and stability • More mobile = less stable – compare shoulder to skull
Relationship Between Joint Mobility and Joint Stability Figure 9. 1
Naming Joints • Joints are usually named for the articulating bones – i. e. , sternoclavicular and radioulnar joints
Classifying Joints Anatomically (by structure) • What exists between the bones? – connective tissue vs. lubricant Physiologically (by function) • How mobile (or stable) are the bones? – stable vs. mobile
Structural Joint Classes • Fibrous – bones held together by collagen fibers • Cartilaginous – bones held together by cartilage • Synovial – bones separated by fluid
Functional Joint Classes • • • Synarthroses – immobile joints (most stable) Amphiarthroses – slightly mobile joints Diarthroses – freely mobile joints
Relationship of Joint Structure and Function Classes
Fibrous Joints • Collagen-filled, no joint cavity • Three specific types: – Gomphoses: teeth to maxilla and mandible – Sutures: between skull bones – Syndesmoses: between parallel bones (radius and ulna, tibia and fibula) • Most immobile or only slightly mobile
Fibrous Joints Figure 9. 2
Cartilaginous Joints • Bones attached by cartilage • No joint cavity • Two specific types: – Synchondroses: bones joined by hyaline cartilage (usually immobile) – Symphyses: bones joined by pad of fibrocartilage (slight mobility)
Cartilaginous Joints Figure 9. 3
Synovial Joints • Anatomy – Articular capsule – Joint cavity – Synovial fluid – Articular cartilages – Ligaments, nerves, and blood vessels • Physiology: freely mobile (diarthroses)
Typical Synovial Joint Figure 9. 4
Articular Capsule • Two layers – outer fibrous layer made of dense regular connective tissue strengthens joint – inner synovial membrane secretes synovial fluid • lubricates and nourishes articular cartilages • absorbs shock during compression of the joint
Articular Cartilages • Articular surfaces in synovial joints are covered by hyaline cartilage –prevents bone-to-bone contact during compression of joint
Ligaments, Nerves, and Blood Vessels • Ligaments: connect bone to bone –strengthen and reinforce capsule • Nerves: signal (pain) when a joint is over stretched • Blood vessels: nourish tissues in the joint
Synovial Joint
Synovial Accessories • Synovial fluid-filled structures to reduce friction – Bursae: sacs outside most synovial joints where ligaments, muscles, tendons, and/or bones rub – Tendon sheaths: elongated bursae around tendons, particularly in confined areas (wrist and ankle) where tendons rub each other
Bursae and Tendon Sheaths Figure 9. 5
Synovial Joint Classes • Classified anatomically by shape of articulating surfaces • Classified physiologically by number of movements allowed – Uniaxial: bone moves in only one plane – Biaxial: bone moves in two planes – Multiaxial: bone moves in more than two planes
Synovial Joint Shapes • In order of increasing movement, the six classes of synovial joint are: – – – Plane joints: Intercarpal Hinge joints: Ulnar/Humerus Pivot joints: Atlas/Axis Condylar joints: Metacarpals Saddle joints: Pollex Ball-and-socket joints: Pectoral/Pelvic Girdle
Synovial Joint Shapes Figure 9. 6
Synovial Joint Movements • Four types of motions: – Gliding: Plane Joints – Angular: Flexion/Extension/Abd uction/Adduction/Circundaction – Rotational: Rotation/pronation/ Supination – Special: Depression/Elevation/ retraction
Gliding Motion • • Articular surfaces sliding back-and-forth or side-to-side Occurs mainly in plane joints – i. e. , between carpals
Angular Motions • An angle between bones changes – Flexion vs. extension, hyperextension – Lateral flexion – Abduction vs. adduction – Circumduction
Flexion vs. Extension Enlarge art as much as possible Figure 9. 7
Flexion vs. Extension Enlarge art as much as possible Figure 9. 7
Lateral Flexion Figure 9. 7
Abduction vs. Adduction Figure 9. 8
Abduction vs. Adduction Figure 9. 8
Circumduction Figure 9. 9
Rotational Motions • A bone turns along its longitudinal axis – alantoaxial joint turning back-andforth in the “no” gesture – limbs turning to and from median plane • medial and lateral rotation • pronation vs. supination
Rotation Figure 9. 10
Medial and Lateral Rotation Enlarge art as much as possible Figure 9. 10
Pronation vs. Supination Figure 9. 10
Special Movements • Occur only at specific joints – depression vs. elevation – dorsiflexion vs. plantar flexion – inversion vs. eversion – protraction vs. retraction – opposition
Depression vs. Elevation Figure 9. 11
Dorsiflexion vs. Plantar Flexion Copyright © The Mc. Graw-Hill Companies, Inc. Permission required for reproduction or display. Dorsiflexion Plantar flexion Figure 9. 11 (b) b: © The Mc. Graw-Hill Companies, Inc. / Photo by Jw Ramsey
Inversion vs. Eversion Figure 9. 11
Protraction vs. Retraction Figure 9. 11
Opposition Figure 9. 11
Selected Articulations • Joints of the axial skeleton – temporomandibular joint – intervertebral articulations – sternoclavicular joint
Axial Skeleton Joints
Axial Skeleton Joints
Temporomandibular Joint (TMJ) • Diarthrotic hinge between mandibular condyle and temporal bone with: – articular disc – ligaments • sphenomandibular • stylomandibular • temporomandibular (lateral)
Temporomandibular Joint (TMJ) Figure 9. 12
Intervertebral Articulations • Amphiarthroses between vertebral bodies: intervertebral discs with – – • outer anulus fibrosus inner nucleus pulposus Diarthroses between superior and inferior articular processes with – ligaments: anterior and posterior longitudinal, interspinous, supraspinous, ligamentum nuchae, ligamentum flavum
Intervertebral Articulations Figure 9. 13
Joints of the Pectoral Girdle and Upper Limbs
Joints of the Pectoral Girdle and Upper Limbs
Sternoclavicular Joint • Diarthrotic saddle between manubrium of sternum and sternal end of the clavicle – ligaments • anterior and posterior sternoclavicular • costoclavicular • interclavicular
Sternoclavicular Joint Figure 9. 14
Acromioclavicular Joint • Diarthrosis between acromial end of clavicle and acromion of scapula – ligaments: • acromioclavicular • coracoclavicular
Acromioclavicular Joint Figure 9. 15
Glenohumeral Joint • Diarthrotic ball-and-socket between head of humerus and glenoid cavity of scapula – – with: glenoid labrum ligaments: coracoacromial, coracohumeral, glenohumeral, transverse humeral muscles: rotator cuff (4) bursae: subacromial, subcoracoid, subdeltoid, and subscapular
Glenohumeral Joint Figure 9. 15
Glenohumeral Joint Figure 9. 15
Elbow Joint • Diarthrotic hinge between humerus, and ulna and radius – ligaments: • radial (lateral) collateral • ulnar (medial) collateral • anular
Elbow Joint Figure 9. 16
Radiocarpal (Wrist) Joint • Diarthrotic condylar joint between: – distal articular surface of radius and – three proximal carpal bones • scaphoid • lunate • triquetrum
Radiocarpal (Wrist) Joint Figure 9. 17
Joints of the Pelvic Girdle and Lower Limbs Copyright © The Mc. Graw-Hill Companies, Inc. Permission required for reproduction or display. Pelvic Girdle and Lower Limb Joints Table 9. 5 Joint Articulation Components Structural Classification Sacroiliac Auricular surfaces of sacrum and ilia Synovial (plane) Hip (coxal) Head of femur and acetabulum of os coxae Synovial (ball-and-socket) Pubic symphysis Two pubic bones Cartilaginous (symphysis) Description of Movement Diarthrosis Slight gliding; more movement during pregnancy and childbirth Diarthrosis Abduction, adduction, circumduction, extension, flexion, medial and lateral rotation of thigh Amphiarthrosis Sacroiliac Functional Classifi cation Very slight movements; more movement during childbirth Diarthrosis Extension, flexion, lateral rotation of leg in flexed position, slight medial rotation Amphiarthrosis Slight rotation of fi bula during dorsiflexion of foot Diarthrosis Dorsiflexion and plantar flexion Diarthrosis Eversion and inversion of foot Diarthrosis Slight gliding Hip Pubic symphysis Knee Tibiofi bular Patellofemoral (knee) Patellofemoral joint: Patella and patellar surface of femur Tibiofemoral joint: Condyles of femur and condyles of tibia Both synovial (acts as hinge) and synovial (plane) at patellofemoral joint; synovial (acts as hinge) at tibiofemoral joint 1 Superior joint: Head of fi bula and lateral condyle of tibia Inferior joint: Distal end of fi bula and fi bular notch of tibia Superior joint: Synovial (plane) Inferior joint: Fibrous (syndesmosis) Distal end of tibia and medial malleolus with talus Lateral malleolus of fi bula and talus Synovial (hinge) Tibiofemoral (knee) Tibiofibular (superior) Talocrural Intertarsal Between the tarsal bones Tarsometatarsal Synovial (plane) Three cuneiforms (tarsal bones), cuboid, and bases of five metatarsal bones Tibiofibular (inferior) Talocrural Synovial (plane) Metatarsophalangeal (MP joints) Intertarsal Synovial (condylar) Heads of metatarsals and bases of proximal phalanges Diarthrosis Tarsometatarsal Metatarsophalangeal (MP) Interphalangeal (IP joints) Heads of proximal and middle phalanges with bases of middle and distal phalanges, respectively Abduction, adduction, circumduction, extension, and flexion of proximal phalanges Synovial (hinge) Diarthrosis Extension and flexion of phalanges
Joints of the Pelvic Girdle and Lower Limbs
Hip (Coxal) Joint • Diarthrotic ball-and-socket between head of femur and acetabulum of os coxae with: – articular capsule with retinacular fibers – ligaments: • • iliofemoral ischiofemoral pubofemoral ligament of head of femur
Hip (Coxal) Joint Insert Figure 9. 18 a, b, c and d Figure 9. 18
Knee Joint • • Diarthrotic hinge between femur, tibia, and patella Largest and most complex joint in body with: – medial and lateral menisci – ligaments: • • patellar fibular (lateral) collateral tibial (medial) collateral anterior and posterior cruciate (ACL and PCL)
Knee Joint Figure 9. 19
Talocrural (Ankle) Joint • Diarthrotic hinge between distal ends of tibia and fibula and talus of tarsals – ligaments: • deltoid • lateral • anterior and posterior tibiofibular
Talocrural (Ankle) Joint Figure 9. 20
Talocrural (Ankle) Joint Figure 9. 20
Joints of the Foot • Diarthroses: – – intertarsal: plane between tarsals tarsometatarsal: plane between distal tarsal bones and metatarsals metatarsophalangeal (MP): condyle between metatarsal and proximal phalanges interphalangeal (IP): hinge between phalanges
Joints of the Foot Copyright © The Mc. Graw-Hill Companies, Inc. Permission required for reproduction or display. Interphalangeal (IP) joints Metatarsophalangeal (MP) joints I II IV V Tarsometatarsal joints Cuneiform bones Intertarsal joints Cuboid bone Navicular bone Talus Figure 9. 21 Calcaneus Right foot, superior view