Joint Structure and Function
Dense Connective Tissue Ligaments, joint capsule, tendons Articular Cartilage Hyaline Cartlidge Fibrocartilage Menisci, labra, discs
3 types of Connective Tissue include: Dense Connective Tissue Articular Cartilage Fibrocartilage Name anatomical example of each
one example is ligamentum flavin in the spine which helps the spine return to neutral after forward flexion
A structure that is made of elastin in the human body is:
Joint Capsule PT Implication - Frozen shoulder
A type of dense connective tissue that Protects & binds joints
Ligaments PT Implication - ACL tear
A type of dense connective tissue that Resists tension- is called:
Tendons PT Implication - biceps tendon rupture John Elway tore the long head of his biceps 3 weeks before winning SB 32
A type of dense connective tissue that Transfers forces between muscles and bones
bone spurs Don't forget: Bone is reabsorbed in areas of low stress Risk for stress injury in someone who hasn't been weight bearing
According to wolfs law, Bone is deposited in areas of high stress. What are the negative implications of this?
shock absorb and disperse force
Another fibrous protein that makes up the extracellular matrix of connective tissue is Glycosaminoglycans which form together to make proteoglycans. GAGs are negatively charged which Forces them to remain spaced out 🡪 increasing volume. This allows them serve as __________ like during heel strike of gait, jumping or other forceful movements.
Disperses joint forces Avascular and anural Lacks a perichondrium that contains blood vessels and cells that maintain and repair tissues, allowing for opposing surfaces to form load-bearing surface (does not heal well)
Another type of connective tissue (articular cartilage) is hyaline cartilage. What is its significance?
the convex (rounded surface) part of the joint
As PTs we measure average axis of rotation with goniometry. To do this, we use a predetermined landmark as the axis of rotation. Which bony landmark of joints do we use?
Type I - thick/don't stretch well Ligaments, tendon, fascia, joint capsule Type II - thinner with less tensile strength, maintain shape of tissue Example: hyaline articular cartilage of the knee
Collagen is the most abundant protein in the body and is classified into type 1 and type 2. Name where youd find each of the types of collagen in the body
ligaments. their thickness is based on the demand placed on the joint
Connective tissue (present in diarthrotic joints) that connect bone to bone are called:
Spread to subchondral bone 🡪 cancellous bone 🡪 compact bone of shaft
Ends of long bone receive multidirectional compressive forces through the weight bearing surfaces of articular cartilage. These forces are dispersed in a particular manner. Name the order the force spreads to within bone.
collagen, elastin, and proteoglycans
Fibroblasts - synthesize:
Function: Stabilizes joint Dissipates loads across multiple planes Guides complex arthrokinematics
Fibrocartilage, a type of connective tissue, can be seen in Menisci, Labra, and Discs. What is the significance of fibrocartilage structures?
dense collagen Main component of connective tissue Implications for PT: High Ankle Sprain "Syndesmosis Sprain"
Fibrous synarthotic joints are reinforced by high a concentration of what connective tissue?
through radiographic imaging of the path of serial locations of the instantaneous axis of rotation
How does an Evolute measure axis of rotation?
Involve subchondral bone and articular cartilage Bone may heal, while cartilage may not Cartilage restoration interventions (microfracture, osteochondral grafting)
Intraarticular fractures involve which anatomical structures/tissues of bone?
Synarthrosis - little to no movement Diarthrosis - lots of movement
Joints are Categorized into two types by the amount of movement potential. What are these two types:
more! Tibiofemoral Talocrural Glenohumeral
Joints with longer external moment arms are more or less likely to be injured?
Possess a synovial fluid-filled cavity Allows for movement
Most joints in the body are diarthrosis (one of the two types of joints). These joints allow for Moderate to extensive motion. What structure do these joints posses which allows for that extent of movement?
Ball-and-Socket Plane
Name 2 multiplanar joints:
Saddle Condyloid Ellipsoid
Name 3 biplanar synovial joints:
Sagittal- frontal axis Frontal- sagittal axis Transverse- longitudinal axis
Name the axis that each plane of motion occurs around: Sagittal Frontal Transverse
hinge and pivot
Name two types of uniplanar synovial joints:
Peripheral labrum
Of which of the following fits the following description: Deepen concave side of joint Support and thicken the attachment of the joint capsule Intra-articular disc/meniscus Peripheral labrum Fat pads Bursae Synovial plica
Bursae
Of which of the following fits the following description: Extension of the synovial membrane Exist in areas of stress Absorb force and protect tissue Intra-articular disc/meniscus Peripheral labrum Fat pads Bursae Synovial plica
Intra-articular disc/meniscus
Of which of the following fits the following description: Fibrocartilage between two articular surfaces, Different than hyaline cartilage, Improve congruency, Improve force distribution Intra-articular disc/meniscus Peripheral labrum Fat pads Bursae Synovial plica
articular cartilage
Osteoarthritis is an inflammatory process associated with erosion of __________________ in the joint.
Capsule Ligament Tendon Articular (Hyaline) Cartilage Fibrocartilage
Periarticular tissue is a type of connective tissue found in synovial joints. Other tissues and structures associated with periarticular tissue include: (5)
it's long axis
The Greatest strength of bone is when its compressed along which axis?
diarthrosis
The following elements are part of which main type of joint, (diarthrosis/synarthrosis): Intra-articular disc/meniscus Peripheral labrum Fat pads Bursae Synovial plica
Promote stability
The function of a synarthrotic joint is to Strongly bind and transfer forces between bones. As a PT, if a patient presents with an injury to a synarthrotic joint, what is your primary goal?
Compact (Cortical) Bone
The part of a bone that is Dense and is the Outer shaft and around joint surfaces is called:
Cancellous (Trabecular) Bone
The part of bone that is Porous and on the End of long bones, inner vertebral body, and flat bones is called:
Fibrous Proteins: Collagen Type (I & II) Elastin
The types of fibrous proteins that make up a connective tissue's extracellular matrix include: (2)
True, they provide Delivery of nutrients and oxygen as well as Sensation of pain and pressure
True or false, Vascular and neural tissue is present in bones.
Synovial Fluid Articular Cartilage Joint Capsule (External Fibrous Layer) Synovial Membrane (Internal Layer) Ligaments Blood Vessels Sensory Nerve
What are the 7 common elements of diarthrotic (or synovial) joints?
Uniplanar (single axis, single plane of motion) Hinge Pivot Biplanar Saddle Condyloid Ellipsoid Multiplanar Ball-and-Socket Plane
What are the three diarthrotic (synovial joint) classifications?
Changes in tissue can be identified within days of immobilization Loss in bone, muscle, tendon, cartilage
What are the time implications of immobilization on tissue
Intracapsular/Capsular Ligaments Example: Anterior Cruciate Ligament (ACL) Extracapsular Ligaments Example: Medial Collateral Ligament
What are the two types of ligaments that are present in diarthrotic joints?
Fibrous - no to minimal motion Cartilaginous (Amphiarthrosis) - slight motion
What are the two types of synarthrosis joints (little to no movement)
Covers the articular surfaces of the joint Reduces friction as well as provides cartilage with nutrients
What is the function of synovial fluid?
Covers the articular (joint) surface of bone Consists of hyaline cartilage which is resistant to compression and tension
What is the significance of articular cartilage in a diarthrotic (synovial) joint?
Lamellae -
What term is being described? layers of compact bone matrix
Osteon -
What term is being described? subunit of compact bone
hinge joint (uniplanar) mechanical correlate- door hinge
Which specific type of synovial joint is being described? Primary Angular Motion: Flexion/extension Anatomic Examples: Humero-ulnar joint
Saddle Joint (Biplanar) Mechanical Analogy: Horse rider on a saddle
Which specific type of synovial joint is being described? Primary Angular Motion: Flexion/extension & abduction and adduction Rotation is absent due to interlocking of the bones Anatomic Examples: Carpometacarpal joint of the thumb
Ellipsoid Joint (Biplanar) Mechanical Analogy: Flattened convex ellipsoid (sphere) paired with concave trough
Which specific type of synovial joint is being described? Primary Angular Motion: Flexion/extension and abduction/adduction Anatomic Examples: Radiocarpal joint
Condyloid Joint (Biplanar) Mechanical Analogy: Spherical convex surface (like a knuckle) paired with a shallow concave cup golf ball in golf t
Which specific type of synovial joint is being described? Primary Angular Motion: Flexion/extension and abduction/adduction Flexion/extension and internal/external rotation Anatomic Examples: Tibiofemoral (knee) joint Rotation; screw home mechanism
Ball-and-Socket Joint (Triplanar) Mechanical Analogy: Ball in a socket
Which specific type of synovial joint is being described? Primary Angular Motion: Flexion/extension, abduction/adduction, internal/external rotation Anatomic Examples: Glenohumeral joint
Pivot Joint (uniplanar) Mechanical Analogy: Doorknob
Which specific type of synovial joint is being described? Primary Angular Motion: Spinning around a single axis of rotation Anatomic Examples: Humeroradial joint
Plane Joint (Triplanar) Mechanical Analogy: Book on a table
Which specific type of synovial joint is being described? Primary Angular Motion: Translation or translation with rotation Anatomic Examples: Intercarpal/intertarsal joints
Ovid
Which term is being described - paired mating surfaces that are imperfectly spherical, or egg-shaped, with adjacent parts possessing a changing surface curvature. One side convex, one side concave (most joints)
Saddle
Which term is being described - Paired curved surfaces that are opposite in direction approximately 90 degrees to each other
Hyaline Cartilage (Synchondrosis) Fibrocartilage (Symphysis) These joints areTypically located at the midline of the body Pubic Symphysis Intervertebral Disc First Rib
cartilaginous synarthrotic joints can be joined by which two types of connective tissue?