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Articulations

Articulations. A rticulation = joint = point of contact between bones. Joint Classification. Synarthroses Fibrous Joints. Amphiarthoses Cartilaginous. Diarthroses Synovial. Most numerous Most complex Structures joint capsule

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Articulations

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  1. Articulations Articulation = joint = point of contact between bones

  2. Joint Classification

  3. SynarthrosesFibrous Joints

  4. AmphiarthosesCartilaginous

  5. DiarthrosesSynovial • Most numerous • Most complex • Structures • joint capsule • sleevelike encasing around bone ends to bind them together • synovial membrane • membrane lining capsule to secrete synovial fluid • bursae • cushions joints and helps tendons move • joint cavity • small space between bones • articular cartilage • hyaline cartilage covering bone ends • menisci • pads of fibrocartilage between bones • Ligaments • strong, dense, white fibrous tissue that hold bones firmly together bursae

  6. Knee Joint (Hyaline cartilage) (fibrocartilage)

  7. Ankle Joint Anterior interior tibiofibular ligament Achilles tendon (cut)

  8. Types of Joints ellipsoidal

  9. allows only flexion and extension examples – elbow, knee knee joint largest joint, most complex, most frequently injured Uniaxial Joints permits movement around one axis and one plane • projection of one bone articulating with a ring/notch of another bone • examples - between vertebrate

  10. Biaxial Jointspermits movement around two perpendicular axes and planes • Example • thumb • only saddle joint in the body • condyle fits into an elliptical socket • Example • between radius and carpals ellipsoidal

  11. Multiaxial Joints permits movement around three or more axes and planes • most moveable joints • ball shaped head fits into concave depression • example - shoulder, hip • humeroscapular joint • most mobile joint • sacroiliac joint • hip joint • relatively flat articulating surface that allows gliding movement • example • between carpals • between tarsals • between vertebrate

  12. Multiaxial Ball and socket

  13. Multiaxial Ball and socket

  14. Multiaxial Gliding

  15. Uniaxial Hinge

  16. ROM(Range of Motion) • Goniometer • Used to determine extent of injury and progress of rehabilitation • measures range of motion (degree of angle)

  17. Angular ROM • flexion – decreases angle, movement towards body • extension – increase angle, movement away from body • hyperextension – stretching or extending beyond anatomical position • plantar flexion – increase angle between top of foot and front of leg (point down) • dorsiflexion – decrease angle between top of foot and front of leg (point up) • ABduction – move AWAY from medial plane • ADduction – move TOWARDS medial plane

  18. Circular ROM • rotation – pivoting a bone on its axis • circumduction – distal end of a body part moves in a circle • supination – hand palm side up • pronation – hand palm side down

  19. Special Movements • inversion – turn sole outward • eversion – turn sole inward • protraction – move part forward • retraction – move part backward • elevation – move part up • depression – move part down

  20. Joint Disorders • Inflammatory (IJD) • Rheumatoid arthritis • Gout • Noninflammatory (NIJD) • Osteoarthritis • Tramatic Injuries • Dislocation • Meniscus tear • Sprain • Ligament tear • Herniated disc

  21. Joint Disorders • Rheumatoid arthritis • Chronic and systemic • Inflammation of synovial membrane • Cartilage destroyed, bone erosion • Progressive crippling and deformity • Pain, inflammation, decreased mobility, aching, stiffness • Treat with corticosteroid drugs and NSAIDS

  22. Joint Disorders • Gouty arthritis • Also referred to as just Gout • Excessive uric acid in blood • Crystals get deposited in synovial fluid • Chronic inflammation and tissue damage • Swelling, tenderness • Pin in wrists, fingers, ankles, knees, elbows • Treat with Allopurinol (inhibits uric acid synthesis) and Uloric (new med)

  23. Joint Disorders NIJDC Osteoarthritis IJD IJD Gout Rheumatoid arthritis

  24. Joint Disorders • Osteoarthritis • Most common NIJD • Wear and tear deterioration • Atrophy of articular cartilage • Formation of new bone at joint surface • Most common in weight-bearing joints • Stiffness, pain, limited movement • Treat symptoms with NSAIDS

  25. Joint Disorders • Dislocation • Articular surfaces not in proper contact • Tear vessels, nerves, ligaments, muscles • Pain and swelling • Treat with realignment (reduction); sometimes surgery

  26. Joint Disorders • Sprain • Stretching of ligaments surrounding joint • Due to twisting motion • Hematoma, limited motion • Treatment: R.I.C.E. • Rest • Ice • compression • elevation

  27. Degree of Sprains • 1st degree ankle sprain • Some stretching or perhaps tearing may have occurred • No loss of function • Mild pain, little bruising • Little or no swelling • Some joint stiffness or difficulty walking • 2nd degree ankle sprain • Difficulty walking • Moderate to severe pain • Swelling and tenderness in the ankle joint • Bruising may start after 3 to 4 days • 3rd degree ankle sprain • most serious • Total rupture of a ligament • Walking may not be possible • Severe pain initially and substantial swelling • May require surgery

  28. Joint Disorders • Ligament Tears (3rd degree Sprain) • Bruising, pain, swelling, instability • Physical therapy • Partial tear vs. complete tear • Partial Tear – boot/brace, crutches • Complete Tear - Surgery after most swelling subsides

  29. Joint Disorders - Knee • Meniscus Tear • One of most common athletic injuries • Swelling, pain, instability, limited motion • Treat with arthroscopic surgery

  30. Meniscus Normal Tear of medial meniscus

  31. Joint Disorders - Knee • ACL tear • Women more likely than men • Will hear a popping sound • Usually due to twisting motion • Get hit very hard on the side of your knee, such as during a football tackle • Overextend the knee joint • Quickly stop moving and change direction while running, landing from a jump, or turning • Repair by grafting (not sew back together) • Patellar tendon autograft (autograft comes from the patient) • Hamstring tendon autograft • Quadriceps tendon autograft • Allograft (taken from a cadaver) patellar tendon, Achilles tendon, semitendinosus, gracilis, or posterior tibialis tendon

  32. ACL, MCL, PCL tears

  33. Arthroscopic surgery • 3-4 very small incisions ¼ in. • fiber-optic light source • video camera • terile saline solution is continuously pumped through the knee via a cannula

  34. Vertebral Disc Disorders

  35. Herniated disc Treatment • Steroid epidural • Use long needle to inject steroid into epidural space in order to shrink the herniation (cartilage) • Surgery • (microdisectomy) • Cut off protruding cartilage

  36. Steroid Epidural

  37. Knee Arthroscopic Surgery • http://www.cartilagerepaircenter.org/treatment-options/meniscal-procedures.html • http://www.youtube.com/watch?v=nAj2_pgTkEA • http://www.youtube.com/watch?v=kpW2MOOI5yw Knee Replacement • http://www.youtube.com/watch?v=H3xkj_1dZQ0

  38. Hip Replacement • http://www.youtube.com/watch?v=DosqbEy8ecY • http://www.webmd.com/pain-management/video/hip-restoration • http://www.youtube.com/watch?v=lh2UX8gQnBM • http://www.youtube.com/watch?v=vJL8n_82ITM

  39. Ankle Arthroscopy • http://www.youtube.com/watch?v=A22lTyPnguY Herniated disc epidural • http://www.youtube.com/watch?v=97m4VICMJoU Herniated disc microdisectomy • http://www.youtube.com/watch?v=rU8YYESYXzc&feature=related

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