AP exam 2 (units 4,5,6)

Joints

Hold bones together but permit movement

Joint points of contact

Between 2 bones, between cartilage & bone, between teeth & bones

Fibrous Joint classification

sutures, syndesmosis, gomphosis

Cartilaginous joint classification 

synchondroses, symphyses 

synovial

Immovable joint

synarthrosis

slightly movable

amphiarthrosis

Freely moveable

diarthosis

Synovial joint structure

1. joint cavity 

2. articular cartilage 

3. articular capsule 

4. synovial fluid 

5. accessory ligaments and discs 

6. articular discs (menisci) 

Bursae

fluid filled saclike extensions of the joint capsule

Bursae qualities

reduce friction between moving structures, skin rubs over bone, tendon rubs over bone, ligament rubs over bone 

Tendon Sheaths

tube-like bursae that wrap around tendons at wrist and ankle where many tendons come together in a confined space

Bursitis

chronic inflammation of a bursa

Sprain

injury to the ligament/joint capsule. Twisiting of joint that stretches or tears ligaments

Strain

injury to the muscle/tendon

dislocation 

bones are forced out of their normal positions at joint 

cartilage damage

tearing of the cartilage

Joint capsule and ligaments contain

pain fibers & sensory receptors

Blood supplies all joint tissues except

articular cartilage which is supplied from the synovial fluid

Osteoarthritis

degenerative joint disease, non-inflammatory & not swelling, deterioration of cartilage produced bone spurs 

Hinge joint

movement in one axis; flexion and extensioin

Examples of Hinge joint

elbow (humeroulnar joint); interphalangeal; knee; TMJ

Pivot Joint

rotation in one axis; cylindrical bone rotates inside notch of other bone; pronation and supination

Examples of Pivot Joint

radioulnar joint (below elbow); both proximal and distal joints

Ball and socket joint 

movement in all axes, flexiona and extension, abduction and adduction, rotation and circumduction 

Ball and socket joint types

Hip and shoulder

Ellipoid/condyloid joint

movement in 2 axes, flexion and extension, abduction and adduction, cicumduction

Examples of ellipsoid/condyloid joint

radial carpal (wrist) MCP

Saddle joint

rotation limited by bone structure; bones are concae and conves, flexion and extension, abduction and adduction, cicumduction and very slight rotation 

Example of saddle joint 

CMC joint of thunb 

Planar/gliding

Glide and rotation; often come in groups

Examples of planar/gliding

intercarpals. CMC joint, intertarsals, acromioclavicular joint; TMJ

Temporomandibular joint TMJ type

hinge/planar 

what defines the TMJ

condylar process of the madnible and mandibular fossa and articular tubercle of temportal bone

Movements that occur at the TMJ 

depression/elevation & protraction/retraction of jaw 

Key features of TMJ

only moveable joint in the skull

Ligaments of the TMJ

lateral, stylomandibular, and sphenomandibular ligaments

Shoulder (glenohumeral) Joint Type

Ball and socket

what defines the shoulder joint

head of the humerus and the glenoid cavity of the scapula

Movements that occur at the shoulder joint

Flexion/extension, abduction/adduction, medial/lateral rotaiton, circumduction

Key features of shoulder joint

CH & AC joints, many stabilizing ligaments

Ligaments of the shoulder joint

coracohumeral, coracoacromial, acromioclavicular, coracoclaicular (conoid & trapezoid portions), sternoclavicular, and glenohumeral (inferior, middle, & superior) ligaments 

Elbow (humeroulnar) joint type

hinge

What defines the elbow joint

trochlea of the humerus, the trochlear notch of the ulna, and the head of the radius

Movements of the Elbow joint

flexion/extension of forearm

Key features of elbow joint

radial annular ligament hold radius in place, collateral ligaments maintain joint

Ligaments of elbow joint 

radial collateral, ulnar collateral, and radial annular ligaments 

Intercarpal joint

gliding, top of the hand

Carometacarpal (CMC) 

gliding, middle of the hand 

Metacarpophalangeal (MCP)

condyloid, “knuckles” flexion/extension, abduction/adduction

Interphalangeal (IP)

Hinge, flexion/extension, tips of fingers and second knuckle

Hand joint ligaments

radial collateral, ulnar collateral, flexor retinaculum (transverse carpal), extensor retinaculum ligaments 

Flexor retinaculum

attaches from the hook of hamate and pisiform (medially) to the tubercle of the trapezium and tuberosity of the scaphoid (laterally), forms the roof the carpal tunnel

Carpal Tunnel

located on anterior surface of wrist, contents of tunnel are contained by the flexor retinaculum

anatomical structures of carpal tunnel

median nerve, finger flexors, flexor pollicis longus

Portions of the Hip bone (Coxal bone)

Illium, sacrum, coccyx, ischium, pubis

Bony landmarks of the illium

acetabulum, anterior superior iliac spine (ASIS), anterior inferior iliac spine (AIIS), posterior inferior illiac spine (PIIS), body, illiac crest, greater sciatic notch, illiac fossa

Bony landmarks of the ischium 

ischial tuberosity, acetabulum, ischial spine, lesser sciatic notch, ischial tuberosity, obuturator foramen 

Bony landmarks of the pubis

acetabulum, bod, pubic crest

Bony landmarks of the femur

head, neck, shaft, greater trochanter, lesser trochanter, intertrochanteric line, intertrochanteric cres, linear aspera, medial condyle, lateral condyle, medial epicondyle (adductor tubercle), lateral epicondyle, popliteal surface, patellar surface 

Bony landmarks of the tibia

medial condyle, lateral condyle, tibial tuberosity, shaft, anterior border (anterior crest), soleal line, medial malleolus, fibular notch, medial border

Boney landmarks of the fibula

head, shaft, lateral malleolus

Bones of the tarsal

calcaneus, talus, navicular, cuboid, third cuneiform, second cuneiform, first cuneiform, metatarsals, phalanges

Medial longitudinal arch

1st metatarsal, 1st cuneifrom, navicular, calcaneus

lateral longitudinal arch

calcaneus, cuboid, 5th metatarsal

Big toe

Hallucis

Metatarsal bony landmarks

base, shaft, head, condyles

Muscles of illiac region

psoas major, illiacus

origin or psoas major

transverse processes of lumbar vertebrae (bodies, intervertebral disk)

insertion of psoas major

lesser trochanter of femur

Action of psoas major

flexes thigh & flexes trunk

innervation of psoas major

L2 and L3 branches of lumbar plexus

Origin of iliacus

upper 2/3 of illiac fossa

insertion of iliacus

lesser trochanter with tendon of psoas major

action of iliacus

flexes thigh

innervation of iliacus

femoral nerve

Gluteal region

gluteus maximus, glueteus medius, gluteus minimus, tensor fascia latae, pirformis, obturator internus, femellus superior, gemellus inferior, quadratus femoris, obturator externus 

orgin of gluteus maximus 

outer surface of ilium, adjacent posterior surface of scrum and coccyx 

insetion of gluteus maximus

illiotibial tract, gluteal tuberosity

action of gluteus maximus

abducts, extends, and laterally roates thigh

innervation of gluteus maximus

inferior gluteal nerve

origin of gluteus medius

outer surface of ilium inferior to iliac crest

insertion of gluteus medius 

lateral surface of greater trochanter 

action of gluteus medius

abducts and medially roates thigh

innervation of gluteus medius

superior gluteal nerve

Origin of gluteus minimus

outer surface of ilium between anterior and inferior gluteal line

insertion of gluteus minimus

anterior surface of greater trochanter

action of gluteus minimus 

abducts and medially rotaes thigh 

innervation of gluteus minimus

superior gluteal nerve

Origin of tensor fascia latae

outer lip of iliac crest between ASIS and iliac tubercle

insertion of tensor fascia latae

upper part of iliotibial tract

action of tensor fascia latae

abducts and flexes thigh

innervation of tensor fascia latae 

superior gluteal nerve 

origin of piriformis

internal surface of scrum

insertion of piriformis

upper border of greater trochanter

action of piriformis

laterally roates and abducts thigh

innervation of piriformis

1st and 2nd sacral nerve

origin of obturator internus

pelvis surface of obturator membrane and surrounding bones

insertion of obturator internus

common tendon with superior and inferior. gemelli to medial surface of greater trochanter

action of obturator internus

laterally rotates thigh