Joints + spine

What is the study of joints or articulations called?

Arthrolgy

Which functional classification describes an immovable joint?

Synarthrosis

Freely movable joints are classified as:

Diarthrosis

Structural classification of joints is based on:

the type of connective tissue between the articulating bones

types of fibrous joints

suture (immovable), syndesmosis (slightly movable), gomphosis (unique type of joint with only limited movement)

Type of cartilaginous joints

synchondrosis, symphysis

Fibrous joints are characterized by:

lack of joint cavity

Fibrous joints are held together by

fibrous connective tissue

Syndesmoses are fibrous types of articulations that are held together by

Interosseous ligaments and slender fibrous cords that allow slight movement at these joints

An example of an syndesmoses joint is

- Inferior tibfib

- SI joints

- carpal and tarsal joints of the wrist and foot

An example of a suture joint is

Between the bones in the skull

A gomphosis joint is found:

between teeth and alveolar sockets

Which type of cartilaginous joint uses fibrocartilage?

symphysis

Synovial joints are best described as:

freely moveable

Cartilaginous joints also lack of joint cavity, and the articulating bones are held together tightly by

Cartilage and allow little to no movement

Name the three functional classifications of joints.

Synarthrodial, Amphiarthrodial, Diarthrodial

symphyses joint (cartilaginous)

Bones united by fibrocartilage which create amphiarthrodial movement

Ex: intervertebral disks, space between pubic symphysis

Synchondroses (cartilaginous)

bones united by hyaline cartilage (epiphyseal plate)

Ex: between epiphyses and metaphysis of long bones, three part union of the pelvis, which forms a cup shaped acetabulum for the hip joint

synovial joints

Freely movable joints with synovial fluid

Generally diarthrodial or or freely movable

Exposed end of these bones contain articular cartilage

Movement types of synovial joints

plane (gliding), ginglymus (hinge), pivot (trochoid), ellipsoid (condylar), saddle (sellar), ball and socket (spheroidal), bicondylar

Intervertebral disk spaces act as

shock absorbers

superior and inferior articular processes make up the

zygapophyseal joints

Epidural space is between bone and

dura mater

pia mater surrounds

individual nerves and spinal cord and follows it out into the intervertebral foramen

What space is where the needle is being placed for a epidural steroid injection?

epidural space

zygapophyseal joints are also known as

facet joint and apophyseal joint

Intervertebral foramen is also known as

neural foramen

Intervertebral foramen are between

superior and inferior vertebral notches

Epidural, Facet joints (zp joints), Nerve root Injections Treatment, imaging and oupatient procedures

Treat pain

-various medications

Uses Imaging

- Fluoro/C-arm

- CT

Outpatient procedures

-pain clinincs

-spine clinics

-Etc

-sesia

feeling

-an

without

Anesthesia medicine is placed into epidural space in a

epidural injections

Anesthesia for a facet joint is placed in the

zygopohyseal joint (facet joint)

Nerve root Injections coming out of

intervertebral foramen

Nerve root injection places needle in area close to

nerve root

Facet joints the location on insertion is

specific joint

-degenerative disease such as arthritis

Two different ways the needle can go into the epidural space

1) between spinous processes

2) through transverse foraminal; across foramen; through intervertebral formamen

A facet block

right into area of zygapophyseal joints or facet joints

encapsulated

nerve root block

coomes right out where the area where nerve is coming through intervertebral foramen or neural foramen

Discogram

- inject directly into disc

- not common

SI injection

- SI joint space

- pt prone

-30 degree oblique

-may need C-arm angle to open joint

Why do we do Vertebroplasty and kyphoplasty?

for vertebral body instability

reasons to do them

- compression fracture

- osteoposorsis

- malignancy

- multiple myeloma

- trauma

- vertebra

vertebra itself

- plasty

reconstructing

Vertebroplasty

- injection of acrylic cement into the vertebral body

kyphoplasty

- a balloon inflated into vertebral body: restores the collapsed portion

- Injection of acrylic cement

(actaully goes into vertebral body itself)

PMMA bone cement injected into vertebral body. What is PMMA?

Polymethyl methacrylate (PMMA)

Vertebroplasty and kyphoplasty

- uses imaging

- fluoro/Carm

- CT

- can be outpatient

- performed in hospital

- surgery center

Which type of joint provides the greatest range of motion?

ball and socket

Which type of joint allows for only uniaxial movement?

hinge

Which of the following is a type of synovial joint?

plane joint

A bursa ________.

prevents friction between skin and bone, or a muscle tendon and bone

At synovial joints, ________.

the joint cavity is filled with a thick, lubricating fluid

At a synovial joint, the synovial membrane ________.

secretes the lubricating synovial fluid

Condyloid joints ________.

include the radiocarpal joint

A meniscus is ________.

a fibrocartilage pad that provides padding between bones

A 63-year-old woman presents with right-sided shoulder pain that started suddenly while playing tennis. Physical examination demonstrates limited mobility at the shoulder joint. Follow-up imaging shows a rotator cuff tendon tear. Which of the following muscles is part of the injured muscle group?

Subscapularis

A 30-year-old man presents with right shoulder and back pain. He is an amateur football player who sustained a big hit on his upper back while playing 2 days ago. On examination, there is marked tenderness to palpation of the upper surface of the right scapula, and increased pain with lateral rotation and abduction of the right arm. Which rotator cuff muscles are most likely to be damaged in this patient?

Infraspinatus, teres minor, supraspinatus

Fibula Part of Knee Joint ?

No

The two collateral ligaments are strong bands at the sides of the knee that prevent

Abduction and abduction movements at the knee

The two cruciate ligaments are strong, rounded cords that cross each other as they attach

To the respective anterior and posterior aspects of the intercondylar eminence of the tibia

Stabilize knee but preventing anterior and posterior movement

The infrapatellar fat pad aids in protecting the _______ aspect of the knee joint

Anterior

LCL

Extends from the femur to the lateral proximal fibula

What is the largest joint space of the human body?

articular cavity of the knee joint

The total knee joint is a synovial type, enclosed in an

Articular capsule or bursa

The articular capsule or bursa is demonstrated in the arthrogram radiograph where a combination of negative and positive contrast media has been injected into the

Articular capsule or bursa

The medial and lateral menisci are crescent shaped

Fibrocartilage discs between the articular facets of the tibia and the femoral condoles

A vertebral compression fracture is best described

as a ______ bone.

An adult vertebra is made up of which of the

following?

The ______ is the oval-shaped structure attached

anteriorly to the vertebral arch that protects the spinal cord.

List 4 muscles associated with the rotator cuff

Supraspinatus

Infraspinatus

Teres minor

Subscapularis

Four major ligaments associated with the knee

Anterior cruciate ligament

Medial collateral ligament

Posterior cruciate ligament

Fibular lateral collateral ligament

What is the purpose of ACL and PCL?

They prevent anterior and posterior move,ment within knee joint

What is the purpose of MCL and LCL?

Prevents abduction and adduction at knee

Which joint can undergo organ arthrogram?

Synovial

What is the technologist responsibility during an arthrogram?

- Set up arthrogram tray

- signed informed consent