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ЂЂ&Joints 2 Plane Joint Plane joints Articular surfaces are essentially flat Allow only slipping or gliding movements Only examples of nonaxial joints Types of Synovial Joints Hinge joints Cylindrical projections of one bone fits into a trough-shaped surface on another Motion is along a single plane Uniaxial joints permit flexion and extension only Examples: elbow and interphalangeal joints Pivot Joints Rounded end of one bone protrudes into a “sleeve,” or ring, composed of bone (and possibly ligaments) of another Only uniaxial movement allowed Examples: joint between the axis and the dens, and the proximal radioulnar joint Condyloid or Ellipsoidal Joints Oval articular surface of one bone fits into a complementary depression in another Both articular surfaces are oval Biaxial joints permit all angular motions Examples: radiocarpal (wrist) joints, and metacarpophalangeal (knuckle) joints Saddle Joints Similar to condyloid joints but allow greater movement Each articular surface has both a concave and a convex surface Example: carpometacarpal joint of the thumb Ball-and-Socket Joints A spherical or hemispherical head of one bone articulates with a cuplike socket of another Multiaxial joints permit the most freely moving synovial joints Examples: shoulder and hip joints Synovial Joints: Knee Largest and most complex joint of the body Allows flexion, extension, and some rotation Three joints in one surrounded by a single joint cavity Femoropatellar joint Lateral and medial tibiofemoral joints Synovial Joints: Knee Ligaments and Tendons – Anterior View Tendon of the quadriceps femoris muscle Lateral and medial patellar retinacula Fibular and tibial collateral ligaments Patellar ligament Other Supporting Structures Anterior cruciate ligament Posterior cruciate ligament Medial meniscus (semilunar cartilage) Lateral meniscus Posterior Superficial View Adductor magnus tendon Articular capsule Oblique popliteal ligament Arcuate popliteal ligament Semimembranosus tendon Synovial Joints: Shoulder (Glenohumeral) Ball-and-socket joint in which stability is sacrificed to obtain greater freedom of movement Head of humerus articulates with the glenoid fossa of the scapula Synovial Joints: Elbow Hinge joint that allows flexion and extension only Radius and ulna articulate with the humerus Annular ligament Ulnar collateral ligament Radial collateral ligament Synovial Joints: Shoulder Stability Weak stability is maintained by: Thin, loose joint capsule Four ligaments – coracohumeral, and three glenohumeral Tendon of the long head of biceps, which travels through the intertubercular groove and secures the humerus to the glenoid cavity Rotator cuff (four tendons) that encircles the shoulder joint and blends with the articular capsule Synovial Joints: Hip (Coxal) Joint Ball-and-socket joint Head of the femur articulates with the acetabulum Good range of motion, but limited by the deep socket and strong ligaments Synovial Joints: Hip Stability Acetabular labrum Iliofemoral ligament Pubofemoral ligament Ischiofemoral ligament Ligamentum teres Temporomandibular Joint (TMJ) Mandibular condyle articulate with the temporal bone Two types of movement Hinge – depression and elevation of mandible Side to side – (lateral excursion) grinding of teeth Sprains The ligaments reinforcing a joint are stretched or torn Partially torn ligaments slowly repair themselves Completely torn ligaments require prompt surgical repair Cartilage Injuries The snap and pop of overstressed cartilage Common aerobics injury Repaired with arthroscopic surgery Dislocations Occur when bones are forced out of alignment Usually accompanied by sprains, inflammation, and joint immobilization Caused by serious falls and are common sports injuries Subluxation – partial dislocation of a joint Inflammatory and Degenerative Conditions Bursitis An inflammation of a bursa, usually caused by a blow or friction Symptoms are pain and swelling Treated with anti-inflammatory drugs; excessive fluid may be aspirated Tendonitis Inflammation of tendon sheaths typically caused by overuse Symptoms and treatment are similar to bursitis Arthritis More than 100 different types of inflammatory or degenerative diseases that damage the joints Most widespread crippling disease in the U.S. Symptoms – pain, stiffness, and swelling of a joint Acute forms are caused by bacteria and are treated with antibiotics Chronic forms include osteoarthritis, rheumatoid arthritis, and gouty arthritis Osteoarthritis (OA) Most common chronic arthritis; often called “wear-and-tear” arthritis Affects women more than men 85% of all Americans develop OA More prevalent in the aged, and is probably related to the normal aging process Osteoarthritis: Course OA reflects the years of abrasion and compression causing increased production of metalloproteinase enzymes that break down cartilage As one ages, cartilage is destroyed more quickly than it is replaced The exposed bone ends thicken, enlarge, form bone spurs, and restrict movement Joints most affected are the cervical and lumbar spine, fingers, knuckles, knees, and hips Osteoarthritis: Treatments OA is slow and irreversible Treatments include: Mild pain relievers, along with moderate activity Magnetic therapy Glucosamine sulfate decreases pain and inflammation Rheumatoid Arthritis (RA) Chronic, inflammatory, autoimmune disease of unknown cause, with an insidious onset Usually arises between the ages of 40 to 50, but may occur at any age Signs and symptoms include joint tenderness, anemia, osteoporosis, muscle atrophy, and cardiovascular problems The course of RA is marked with exacerbations and remissions Rheumatoid Arthritis: Course RA begins with synovitis of the affected joint Inflammatory chemicals are inappropriately released Inflammatory blood cells migrate to the joint, causing swelling Inflamed synovial membrane thickens into a pannus Pannus erodes cartilage, scar tissue forms, articulating bone ends connect The end result, ankylosis, produces bent, deformed fingers Rheumatoid Arthritis: Treatment Conservative therapy – aspirin, long-term use of antibiotics, and physical therapy Progressive treatment – anti-inflammatory drugs or immunosuppressants The drug Enbrel, a biological response modifier, neutralizes the harmful properties of inflammatory chemicals Gouty Arthritis Deposition of uric acid crystals in joints and soft tissues, followed by an inflammation response Typically, gouty arthritis affects the joint at the base of the great toe In untreated gouty arthritis, the bone ends fuse and immobilize the joint Treatment – colchicine, nonsteroidal anti-inflammatory drugs, and glucocorticoids Developmental Aspects of Joints By embryonic week 8, synovial joints resemble adult joints Few problems occur until late middle age Advancing years take their toll on joints: Ligaments and tendons shorten and weaken Intervertebral discs become more likely to herniate Most people in their 70s have some degree of OA 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