Chapter 9
Describe the sequence of injuries that may occur if the extended, weight-bearing knee receives a very strong blow to the lateral side of the knee.
A strong blow to the lateral side of the extended knee will cause the medial side of the knee joint to open, resulting in a sequence of three injuries. First will be damage to the tibial collateral ligament. Since the medial meniscus is attached to the tibial collateral ligament, the meniscus is also injured. The third structure injured would be the anterior cruciate ligament.
Describe the characteristic structures found at all synovial joints.
All synovial joints have a joint cavity filled with synovial fluid that is the site at which the bones of the joint articulate with each other. The articulating surfaces of the bones are covered by articular cartilage, a thin layer of hyaline cartilage. The walls of the joint cavity are formed by the connective tissue of the articular capsule. The synovial membrane lines the interior surface of the joint cavity and secretes the synovial fluid. Synovial joints are directly supported by ligaments, which span between the bones of the joint. These may be located outside of the articular capsule (extrinsic ligaments), incorporated or fused to the wall of the articular capsule (intrinsic ligaments), or found inside of the articular capsule (intracapsular ligaments). Ligaments hold the bones together and also serve to resist or prevent excessive or abnormal movements of the joint.
Briefly define the types of joint movement available at a ball-and-socket joint
Ball-and-socket joints are multiaxial joints that allow for flexion and extension, abduction and adduction, circumduction, and medial and lateral rotation
Describe the two types of cartilaginous joints and give an example each.
Cartilaginous joints are where the adjacent bones are joined by cartilage. At a synchondrosis, the bones are united by hyaline cartilage. The epiphyseal plate of growing long bones and the first sternocostal joint that unites the first rib to the sternum are examples of synchondroses. At a symphysis, the bones are joined by fibrocartilage, which is strong and flexible. Symphysis joints include the intervertebral symphysis between adjacent vertebrae and the pubic symphysis that joins the pubic portions of the right and left hip bones
Describe the structures that provide direct and indirect support for a synovial joint.
Direct support for a synovial joint is provided by ligaments that strongly unite the bones of the joint and serve to resist excessive or abnormal movements. Some joints, such as the sternoclavicular joint, have an articular disc that is attached to both bones, where it provides direct support by holding the bones together. Indirect joint support is provided by the muscles and their tendons that act across a joint. Muscles will increase their contractile force to help support the joint by resisting forces acting on it.
Define how joints are classified based on function. Describe and give an example for each functional type of joint.
Functional classification of joints is based on the degree of mobility exhibited by the joint. A synarthrosis is an immobile or nearly immobile joint. An example is the manubriosternal joint or the joints between the skull bones surrounding the brain. An amphiarthrosis is a slightly moveable joint, such as the pubic symphysis or an intervertebral cartilaginous joint. A diarthrosis is a freely moveable joint. These are subdivided into three categories. A uniaxial diarthrosis allows movement within a single anatomical plane or axis of motion. The elbow joint is an example. A biaxial diarthrosis, such as the metacarpophalangeal joint, allows for movement along two planes or axes. The hip and shoulder joints are examples of a multiaxial diarthrosis. These allow movements along three planes or axes.
Differentiate between endochondral and intramembranous ossification.
Intramembranous ossification is the process by which mesenchymal cells differentiate directly into bone producing cells. This process produces the bones that form the top and sides of the skull. The remaining skull bones and the bones of the limbs are formed by endochondral ossification. In this, mesenchymal cells differentiate into hyaline cartilage cells that produce a cartilage model of the future bone. The cartilage is then gradually replaced by bone tissue over a period of many years, during which the cartilage of the epiphyseal plate can continue to grow to allow for enlargement or lengthening of the bone.
Describe how synovial joints develop within the embryonic limb.
Mesenchyme gives rise to cartilage models of the future limb bones. An area called the joint interzone located between adjacent cartilage models will become a synovial joint. The cells at the center of the interzone die, thus producing the joint cavity. Additional mesenchyme cells at the periphery of the interzone become the articular capsule.
Distinguish between a narrow and a wide fibrous joint and give an example each.
Narrow fibrous joints are found at a suture, gomphosis, or syndesmosis. A suture is the fibrous joint that joins the bones of the skull to each other (except the mandible). A gomphosis is the fibrous joint that anchors each tooth to its bony socket within the upper or lower jaw. The tooth is connected to the bony jaw by periodontal ligaments. A narrow syndesmosis is found at the distal tibiofibular joint where the bones are united by fibrous connective tissue and ligaments. A syndesmosis can also form a wide fibrous joint where the shafts of two parallel bones are connected by a broad interosseous membrane. The radius and ulna bones of the forearm and the tibia and fibula bones of the leg are united by interosseous membranes.
Both functional and structural classifications can be used to describe an individual joint. Define the first sternocostal joint and the pubic symphysis using both functional and structural characteristics.
The first sternocostal joint is a synchondrosis type of cartilaginous joint in which hyaline cartilage unites the first rib to the manubrium of the sternum. This forms an immobile (synarthrosis) type of joint. The pubic symphysis is a slightly mobile (amphiarthrosis) cartilaginous joint, where the pubic portions of the right and left hip bones are united by fibrocartilage, thus forming a symphysis.
Explain the reasons for why joints differ in their degree of mobility.
The functional needs of joints vary and thus joints differ in their degree of mobility. A synarthrosis, which is an immobile joint, serves to strongly connect bones thus protecting internal organs such as the heart or brain. A slightly moveable amphiarthrosis provides for small movements, which in the vertebral column can add together to yield a much larger overall movement. The freedom of movement provided by a diarthrosis can allow for large movements, such as is seen with most joints of the limbs.
Discuss structures that contribute to support of the shoulder joint.
The shoulder joint allows for a large range of motion. The primary support for the shoulder joint is provided by the four rotator cuff muscles. These muscles serve as "dynamic ligaments" and thus can modulate their strengths of contraction as needed to hold the head of the humerus in position at the glenoid fossa. Additional but weaker support comes from the coracohumeral ligament, an intrinsic ligament that supports the superior aspect of the shoulder joint, and the glenohumeral ligaments, which are intrinsic ligaments that support the anterior side of the joint.
The periodontal ligaments are made of collagen fibers and are responsible for connecting the roots of the teeth to the jaws. Describe how scurvy, a disease that inhibits collagen production, can affect teeth.
The teeth are anchored into their sockets within the bony jaws by the periodontal ligaments. This is a gomphosis type of fibrous joint. In scurvy, collagen production is inhibited and the periodontal ligaments become weak. This will cause the teeth to become loose or even to fall out.
Discuss the joints involved and movements required for you to cross your arms together in front of your chest.
To cross your arms, you need to use both your shoulder and elbow joints. At the shoulder, the arm would need to flex and medially rotate. At the elbow, the forearm would need to be flexed.
