PM 701: Chapter 3 (Arthrology)

What types of injury is prone in bone, ligament, and muscle *mechanism of stabilization*?

*-Mechanism of stabilization* (important to know!!!!) -give clue to most common types of injury for a particular joint *clinical correlation* 1)Bony fit stabilizing factor: prone to *fracture, dislocation, and subluxation (partial dislocation)* 2)ligament stabilizing factor: prone to *sprain* (stretching and tearing of ligament) 3)muscle stabilizing factor: prone to *strain* (a stretch, tear, or rip in the muscle or connecting tissue such as the fascia or muscle tendons) or dislocation.

What is *Hilton's law*? What does nerve supply compose of? What are 5 functions of *sensory fibers*?

-*Hilton's Law*: nerves supplies the muscles and skin over the joint 1)there are a lot of articular nerves in joint capsule. 2)Contain vasomotor and sensory fibers. 3)Sensory fibers (GSA): -Pain -Stretch -Vibration -Rapid movement -Position sense (Proprioception) 4)Sensory input essential for coordination of movement. 5)Denervation -> joint degeneration.

Describe the types of body position in *loose-packed position*. What are 3 properties of *loose-packed position*?

-All other positions. minimal joint contact 1)Stability decreased. 2)Capsule more relaxed. 3)More movement permitted. Ex. knee flexion

Describe the bone structure in *closed-packed position*. What are 3 characteristics of being in this position?

-Two adjacent bones fit together in the position of best fit (maximum contact between the two surfaces) 1)Greatest stability. 2)Tension and twist on capsule and ligaments increased. 3)Movement, therefore, beyond this position is resisted. Ex. full knee extension

What is another name for *Not in cardinal plane *? What are 4 characteristics of this?

-triplanar movement. 1) motion occurs across all three planes (pronation - abduction, dorsifleion, and eversion) 2)Axis of movement -*STILL* 90 degree to the plane in which the movement occurs. -*NOT* at the intersection of the cardinal planes. -at an *angle *from all three cardinal planes.

What are the 3 uses of *Synovial Fluid*? What is the most distinguishing characteristic?

1) lubricates to reduce friction 2) Nutrient Ex. articular surfaces, synovial membrane, articular disks 3) filtrate of plasma to decrease intima cells's bind to protein *-Hyaluronic acid present (most distinguishing characteristic)* ->Make synovial fluid viscous, elastic, and slippery

What are 3 uses of *sensory nerve endings* in capsule? (GSA)

1) pain 2) pressure 3) *proprioception (position sense)* mnemonic: 3 P sticking out of joint capsule

(2) What are 2 types of *cartilaginous joints*?

1) primary (synchondrosis) 2) secondary (symphysis)

What are 4 properties of *synchondrosis*? Examples? (classification of joint: cartilaginous joint)

1) primary cartilaginous joint 2) synarthrosis: immoveable 3) *synostosis*: sometimes 4) Hyaline cartilage 5) Growth: primarily Ex. Epiphyseal plates., first sternocostal joint (permanent synchondrosis) mnemonic: chondrosis = cartilage.

What 2 uses of *Synovial Membrane*?

1) produces *synovial fluid * to fill joint capsule/cavity - lubricate and nourish articular cartilage 2) ^Line all capsules except articular cartilage

What are 2 characteristics of *Extrinsic (Accessory) Ligaments*? Examples of extra and intra-capsular

1) reinforce capsule 2) from different embryonic tissue Ex. -extra-capsular (Ex. coracoacromial ligament) -intra-capsular (Ex. ligament of head of femur) mnemonic: extrinsic = not part of nature

What are 2 characteristics of *Intrinsic (Capsular) Ligaments*? Example?

1) reinforce capsule 2) from same embryonic tissue Ex. coracohumeral ligament mnemonic: intrinsic = naturally

What are the 3 uses of *articular cartilage*?

1) shock absorb 2) withstand compression and shear force 3) low friction

What are 3 types of *fibrous joints*?

1) suture 2) gomphosis 3) syndesmosis

(1) What are 3 properties of *suture*? What is the importance of *suture* in fetus? (classification of joint: fibrous joints)

1) synostosis 2) synarthrosis: immovable 3)Using short connective tissue fibers and periosteum to close irregular bone edges 1)*fontanelles*: Long connective tissue fiber that allows fetal skull to change shape for childbirth.

Where are 2 locations of *synovial membrane*? What are their purpose?

1) synovial tendon sheath *[4]*: low friction for tendon (Ex. wrist, ankle) 2) bursae *[5]*: -low friction for tissue -consistency of an egg (Ex. Between skin and bony prominence. Between tendon and ligament. Between tendons.)

What are 4 properties of *open chain movement *? Examples?

1) weightless movement 2)the proximal joint member is fixed or stable while the distal member moves. 3)also for upper Ex. Reaching to grasp an object in space, or kicking a ball 4)Basis for classical muscle actions and anatomical descriptions mnemonic: activity to do in an "opened" environment --> kicking ball

What are the 2 properties of *multiaxial*? Examples?

1)3 or infinite degrees of freedom => all movement possible 2)3 independent axes 90 degrees to one another. Ex. -Ball and socket like hip joint [1,2] (flexion/ extension, abduction/ adduction, rotation, circumduction [2 degress of movement]) -plane joints like intertarsal joints of the foot [3,4] (gliding movement)

What are 3 properties of *blood supply*?

1)Anastomotic plexuses of blood vessels surround and penetrate the capsule and bone. 2) arteries feeds periarticular anastomosis, which supplies synovial membrane and epiphyses. 3)*Articular cartilage avascular.*

What are 2 characteristics of movement in *cardinal plane*?

1)Axis of movement *always *90 to the plane in which the movement occurs (true to upper) Ex. flexion - extension of knee 2)Axis of movement *always *at the intersection of the *other two *cardinal planes. (true to upper) Ex. Flexion: extension of knee occurs in the sagittal plane; axis is at the intersection of the coronal and horizontal planes.

What are 4 characteristics of *bicondylar joint*?

1)Biaxial 2)2 angular movement or 1 angular + 1 rotational movement. 3)At least 2 condyles. 4)has *conjunct rotation * Ex. knee joint: tibiofemoral portion mnemonic: bicycle has two wheels that spins together

What are 5 properties of *Ellipsoid joint*? Example?

1)Biaxial 2)One surface convexed and the other concaved. 3)Permits angular movements of flexion - extension and abduction - adduction. 4)Circumduction as a secondary movement permitted. 5)Axes of unequal lengths, therefore, primary movements have unequal ranges of motion. Ex. wrist (radiocarpal), metatarsophalangeal joints

What are 3 characteristics of *Conjunct rotation*? Examples?

1)Dependent of rotation: Automatic and inevitable because of ligaments around the joint and the shape of the joints surfaces. 2) Small joint rotation simultaneously as primary actions of the joint. 3) in active and passive movements. 4) in bicondylar and saddle joints Ex. tibia lateral rotation with knee extension (tibiofemoral portion) Ex. femur medial roatation when standing. mnemonic: conjunct = joined together

What are 5 *intraarticular structures*?

1)Fat Pads 2)Labra 3)Articular Disks & Menisci 4)Tendons 5)Ligaments mnemonic: FLAT L

What are 7 *shapes of articular surfaces*?

1)Hinge (Ginglymus) Joint 2)Pivot (Trochoid) Joint 3)Bicondylar Joint 4)Ellipsoid Joint 5)Saddle (Sellar) Joint 6)Ball and socket (spheroidal) 7)Plane (Planar; Gliding) Joint

What are 6 properties of *Fat pads*?

1)In synovial membrane (subintima) 2)Vascularized 3)distribute blood to joint 4)Reduce friction 5)Fill spaces between articulating bones 6)Shock absorption

What are 3 properties of *Accessory Movement*? Examples?

1)Movements only in the presence of resistance 2) Joint movements are involuntary Ex. Object held in hand (between carpal bones). When one stands on uneven terrain (between tarsal bones), or passive movements

What are the 2 properties of *Uniaxial joints:*? Examples?

1)One degree of freedom. 2)Movement around only one axis. Ex. -Hinge joints like elbow joint (flexion and extension) [1] -pivot joints like proximal radioulnar joint (rotation) [2]

What are 2 properties of *tendons*? Examples?

1)Pass through or originate within joint cavity 2)Covered with synovial membrane ->Increase stability of the joint Ex. Shoulder Joint

What is the difference between *peripheral and central development of joint?*

1)Peripherally: form capsular and other ligaments 2)Centrally - Disappears to form Joint Cavity

What are the 3 components of *Cardinal Plane*?

1)Sagittal 2)Coronal (Frontal) 3)Transverse (Horizontal)

What can be said about strength and fit, mobility and stabilityof bones of joints?

1)Strength of joint is proportional to the fit (distance) between bones and joints 2)mobility is inversely prop to stability

What are 3 categories of joint in *degree of mobility*?

1)Synarthrosis - Immovable 2)Amphiarthrosis - Slightly Movable Ex. cartilagnious joints (symphses) 3)Diarthrosis - Fully Movable Ex. synovial joints

What are the 2 properties of *biaxial joints:*? 3 Examples?

1)Two degrees of freedom. 2)2 independent axes 90 degree to one another. Ex. 1)Bicondylar like knee joint [1] (flexion/ extension and leg rotation) 2)saddle joints [3] like first carpometacarpal joint [4] + 3)ellipsoid joint like wrist joint [2] (flexion/ extension, adbuction and adduction, circumduction) mnemonic: riding a bicycle on a saddle in an ellipse path over and over again

What are 3 axes of movement for joints?

1)Uniaxial joints 2)Biaxial joints 3)Multiaxial (Polyaxial) joints

What are 4 properties of *closed-chain*? Examples?

1)also for upper 2)movement at a joint with weight-bearing 3)Distal joint member is fixed or stable, and the proximal member moves. 4) Basis for biomechanics Ex. The stance phase of walking, rising from a chair, or pull-up. mnemonic: Activity to do in closed environment --> pull up with weights

What is another name for *hinge joint*? What are 2 characteristics of *hinge joint*? Examples?

1)ginglymus 1)Uniaxial 2)Flexion/ Extension Ex. Elbow joint, Interphalangeal joints, *ankle or talo-crural joint* mnemonic: the hinge of a door is made out of ginger

What are the 3 characteristics of *axes of movement*?

1)imaginary line about which movement occurs 2)Axes placed through the center of the curved articular surfaces. Ex. like the axle of a wheel. 3)*Degrees of freedom of joint: *The number of such possible axes around which movement may be produced, independently and actively

What 2 chains are included in *Gait cycle*?

1)include both open-chain and closed-chain

What 4 things does *joint stability* depend on?

1)muscles and tendons. 2)articular surfaces shape and fit 3)capsule and ligaments orientation and strength 4)Opposition of other tissues: bone to bone, soft tissue to soft tissue

What is another name for *plane joint*? What are 3 properties of *Plane joint*? Examples?

1)planar, gliding joint 1)Multiaxial 2)Nearly flat articular surfaces. 3)Permits gliding (translational) movement in many planes. Ex. *intermetatarsal joints*, Intercarpal joints, Intertarsal joints

What is another name for *saddle joint*? What are 5 properties of *saddle joint*? Examples?

1)sellar 1)Biaxial 2)Articular surfaces has concave and convex portion like a "saddle". 3)Primary movements: flexion/ extension and abduction/ adduction. 4)Secondary movement: circumduction. 5)May permit *conjunct rotation.* Ex. carpometacarpal joint of the thumb, *calcaneocuboid joint*

What is another name for *ball and socket joint*? What are 3 properties of *ball and socket joint*? Examples?

1)spheroidal joint 1)Multiaxial 2)Reciprocal segments of a hypothetical sphere. 3)Permits all types of movements. Ex. Shoulder joint, *Hip joint*

What are 3 uses of *intracapsular ligament*?

1)stability of joint 2)Serve to restrain motion in an undesirable direction 3)Covered with synovial membrane

What is the *horizontal* movement of thigh and foot? What does the plane intersect?

1)thigh/ knee: medial/ lateral rotation 2)foot: abduction/ adduction

What is the *coronal* movement of thigh and foot? What does the plane intersect?

1)thigh: abduction/ adduction 2)foot: eversion/ inversion intersect sagittal and horizontal

What is another name for *pivot joint*? What are 2 characteristics of *pivot joint*? Examples?

1)trochoid 1)Uniaxial 2)Rotational around a longitudinal axis Ex. Proximal radioulnar joint, Atlantoaxial joint mnemonic: a truck pivots in the space

Describe the *development of joints*. What 3 joints will arise?

1)undifferentiated mesenchyme --> *interzonal mesenchyme *[B] --> into: -> fibrous joints [D] -> cartilaginous joints [C] ->Synovial joint: synovial membrane lines the capsule and articular surfaces

Which of the following is NOT always present as part of a synovial joint? a) Intraarticular disc b) Articular cartilage c) Capsule d) Synovial fluid e) Joint cavity

a

Pronation of the foot is a triplanar action that is a composite of which three movements? Answer: ____________, ____________, and ____________.

abduction, dorsiflexion, and eversion.

Movement at a joint that is dependent upon the simultaneous occurrence of another movement is called: a) Accessory b) Conjunct c) Close-packed d) Adjunct e) Open-chain

b

In which of the following pairs is there an INCORRECT association? a) Suture - fibrous joint b) Interosseous membrane - syndesmosis c) Symphysis - amphiarthrosis d) Synostosis - synarthrosis e) Synchondrosis - secondary cartilaginous joint

e

What is passive movement

movement produce by another person

The axis of inversion and eversion of the foot is at the intersection of the ____________ and ____________ planes.

sagittal and horizontal (transverse)

What is a *clinical *complication for developing bone in *joint capsules*? Describe what happens when adult bone get injured.

!!!Location of capsular attachment important!!! -Developing Bone 1) If epiphyseal plate is intracapsular (within the capsule), a joint infection may be detrimental to growth. -reduce blood supply to other structure Ex. femoral neck fractures can prevent blood from reaching the head of the femur.

What are 5 properties of *synovial joints*?

1) *articular (hyaline) cartilage* covers articular surface and is held together 2) *articular (fibrous) capsule* join ^ together and surround *joint cavity* 3) *synovial membrane *under ^, and its intima produces *synovial fluid* 4) *joint cavity *is filled with *synovial fluid*, which lubricate and nourish *articular cartilage* 5) For movement. 6) Most common type in the human body 7) Additional intra-articular structures may be present.

What is a *joint*?

1) A point of contact between bones, cartilage and bones, or teeth and bones

What are the *5 essential components* of synovial joints?

1) Articular cartilage 2) Articular (fibrous) capsule 3) synovial membrane 4) joint (synovial) cavity 5) synovial fluid

What are the 5 uses of *articular disk and menisci*? Examples?

1) Fit enhancement between bones ->Stabilizes joint ->Assists in controlling complex movements 2) Shock absorbers 3) Spread of synovial fluid 4) Fibrocartilage intervene between articular surface 5) Attach peripherally to capsule Ex. articular disks: TMJ Ex. menisci: knee joint

What are the 2 properties of *Labrum*?

1) Improves fit 2)Increases depth and surface area of sockets 3) Fibrocartilaginous lips attached marginally to articular surface Ex. hip joint, shoulder joint

What are 2 types of *Ligaments*.

1) Intracapsular 2) capsular

What 2 components reinforces *capsule*?

1) Intrinsic (Capsular) Ligaments: 2) Extrinsic (Accessory) Ligaments:

What is the use of *subtalar joint*? What are its 2 modes of movement. What movements do they compose?

1) Movements in combination of three "pure" cardinal plane movements 1) Pronation: abduction, dorsiflexion, and eversion. 2) Supination: adduction, plantar flexion, and inversion

What are the 6 composition of *articular cartilage*?

1) No periochondrium 2) avascular 3) no lymphatics 5) no nerve endings 4) lack regenerative capability 6) thickness varies with location, load, and age

What are 2 uses of *Articular (Fibrous) Capsule*? What is attached to its outer and inner layer?

1) Surrounds joint cavity 2) unites the articulating bones. 1) Outer attaches to *periosteum*. 2) Inner layer is the *synovial membrane.*

What are 3 characteristics of *joint (synovial) cavity*?

1) a small space between the articulating bones which is filled with synovial fluid. 2) enclosed by joint capsule 3) appears larger than it really is in radiographs because articular cartilage is radiolucent (transparent)

What are 4 properties of *symphysis*? (classification of joint: cartilaginous joint)

1) amphiarthrosis: slightly moveable 2) *Fibrocartilage *fusion between two bones 3) Hyaline cartilage covers the articular surfaces of bones. 4) Strength, Shock Absorption, movement. Ex. Intervertebral discs, Pubic symphysis. mnemonic: symphysis means growing together.

What is *capsule* bound to? What is its purpose?

1) bound to collagen fiber for strength and some elasticity

What is the *sagittal *movement of foot at the ankle? What does the plane intersect?

1) dorsiflexion/ plantar flexion 1) intersect coronal and horizontal

What 3 types of structural classification for *junctional materials *? What do they arise from?

1) fibrous joints 2) cartilaginous joints 3) synovial joints They arise from undifferentiated mesenchyme into *interzonal mesenchyme*

What are 3 types of *capsules*.

1) fibrous, joint, or articular capsule

What does *synostosis* mean?

1) fusion between two bones to form a joint 2) synarthrosis: immovable 3) synchondroses undergoes this for a while mnemonic: syn = together, ostosis: bone

What does *synarthrosis* mean? What 3 structures have this type of characteristic?

1) immovable 1) fibrous joints (usually) 2) synchondroses (sometimes) [primary cartilaginous joint] 3) synostosis (always all) mnemonic: syn + arthrosis (joint).

What is the function of *capsular ligament*?

1) increase strength of the capsule thereby increase stability of joint Ex. Hip joint

What 1 characteristics of *Adjunct Rotation*? Examples?

1) independent rotation: The voluntary, active rotation movements that you perform to rotate a bone about its longitudinal axis. Ex. knee bent to a right angle you can medially and laterally rotate your tibia about its longitudinal axis by the action of the medial and lateral hamstring muscle groups respectively. mnemonic: things added to something else, not part of the essential

What 2 layers line the *synovial membrane*? What are their functions? Where do they not cover?

1) intima *[2]* -adjacent to joint cavity -secrete and absorb synovial fluid 2) subintima *[3]* -between intima and joint capsule -Vascular support mnemonic: an intimate make out session need to be right next to your partner and secret bodily fluid. A not so intimate make out session is to be between diseased couples who are hooked up to blood support

What is *syndesmosis*? Example?

1) join bone using ligament. Ex. distal tibiofibular joint, middle radioulnar joint mnemonic: syn + desmosis = ligament.

What is *gomphosis*? Example?

1) joint between tooth and its socket Ex. periodontal ligament mnemonic: chewing gum with teeth

Which of the following joint types may be capable of circumduction? I. Pivot II. Ellipsoid III. Planar IV. Saddle V. Ball and socket

II, IV, V c (secondary degree of freedom)