arthrosis, articulation)
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1 Joint (arthrosis( arthrosis, articulation) Region in which bones are capped and surrounded by connective tissues that hold the bones together and determine the type and degree of movement between them Syndesmology the scientific study of ligaments Arthrology the scientific study of joints
2 Types of joints diarthrosis (synovial joint) free bone movement synarthrosis (solid olid, non-synovial joint) very limited or no movement syndesmosis bones are linked by an interosseous ligament of dense connective tissue permits a certain amount of movement synchondrosis (syn + chondros) bones are linked by hyaline cartilage permits a certain amount of movement synostosis (syn, together + osteon + Gr. osis, condition) bones linked by bone tissue no movement takes place
3 Systems of Classifying the Joints
4 Syndesmosis (fibrous joint) A collagenous (or fibroelastic) junction between bones Classification Interosseus ligament Interosseus membrane Suture Gomphosis
5 Interosseus ligament the dorsal part of the sacroiliac junction & interosseous ligaments, e.g. the carpus and tarsus
6 Interosseus membrane the interosseous membranes of the forearm and calf
7 Suture periosteum Cambial Middle Capsular Sutures are limited to the skull Margins of bones are separated only by connective tissue (= sutural ligament or membrane) Layers Cambial osteogenic cells Capsular fibrous tissue Middle loose connective tissue (contains blood vessels) Types of sutures continuous with the periosteum plane suture simple apposition (e.g. between maxillae) serrate suture saw-like (e.g. saggital) squamous bones overlap (e.g.temporoparietal)
8 Gomphosis Restricted to the fixation of teeth in their alveolar sockets in the mandible and maxillae. The collagen of the periodontium connects dental cement with alveolar bone.
9 Special type of fibrous joint - schindylesis A ridged bone fits into a groove on a neighbouring element, e.g. the cleft between the alae of the vomer, which receives the rostrum of the sphenoid.
10 Cartilaginous joints A cartilaginous junction between bones Classification primary cartilaginous joint synchondrosis secondary cartilaginous joint symphysis The terms primary and secondary are only useful in the instances of certain symphyses which, developmentally, are preceded by synchondroses within which further differentiation occurs
11 Synchondrosis hyaline cartilage Two ossifying fronts closely bonded by a specialized hyaline growth cartilage the rate of ossification of both surfaces is unequal the growth cartilage structure is asymmetrical (e.g. long bones) the rate of ossification of both surfaces is approx. equal the growth cartilage has a central quiescent zone equidistant from the surfaces (e.g. crania bones)
12 Synchondrosis - occurrence During development synchondroses are primarily growth mechanisms the cartilage is a template of the developing bone and eventually disappears Synchondroses remaining in adulthood Sternocostal joint - between the sternum and first rib Petrobasilar joint - between the petrous portion of the temporal bone and the basilar part of the occipital bone
13 Sternocostal joints Rib I Rib I
14 Symphysis - fibrocartilage A piece of fibrocartilage between the flat surfaces of two bones (tremendous pressure) all symphyses are median topographically Collagenous ligaments extend from the periosteum across the symphysis and blend with the perichondrium The capsule is incomplete but like synovial joints it contains plexuses of afferent nerve terminals
15 Intervertebral disks Pubic symphysis Symphysis - occurrence Manubriosternal - between manubrium and sternal body
16 Symphysis - intervertebral disks Intervertebral symphyses (presacral), displaying age-related changes. Partial or complete synostosis is the normal fate of sacral and coccygeal symphyses.
17 Intervertebral disk annulus fibrosus: dense connective tissue + overlapping laminae of fibrocartilage (collagen type I) nucleus pulposus: a few rounded cells embedded in a viscous matrix rich in hyaluronic acid and type II collagen fibrils Nucleus pulposus
18 Synostosis - Synostosis is the normal fate of almost all synchondroses when endochondral growth has ceased Skull & pelvic bones in adulthood newborn adolescent synchondrosis Blue = unossified (cartilaginous) regions
19 Synovial joints Accommodate the movement of bones and minimize the friction between them The osseous surfaces involved are not in continuity bony surfaces are covered by articular cartilage contact is strictly limited between cartilage sliding contact is facilitated by viscous fluid lubricant
20 Components of synovial joints Articular cartilage: covers the bony parts forming the joint Synovial capsule Fibrous layer - dense connective tissue, continuous with the periosteum Synovial layer (=( synovial membrane) - covers all nonarticular surfaces Articular cavity - contains a high concentration of hyaluronic acid and the glycoprotein lubricin combined with filtrate of plasma Articular ligaments
21 Section through knee joint
22 Articular cartilage The collagen fibers of the cartilage are arranged as gothic arches Hyaline cartilage with no perichondrium The collagen fibers of the articular surface cartilage are arranged to distribute the forces generated by pressure in this tissue No o nerves or blood vessels nutrition depends on a vascular plexus in the synovial membrane and synovial fluid
23 Synovial capsule Fibrous layer - dense connective tissue, continuous with the periosteum Synovial layer (=( synovial membrane) - covers all nonarticular surfaces There is no basal lamina between the lining cells and the underlying connective tissue This tissue is rich in blood capillaries and contains a variable number of adipose cells (AD)
24 Cells of the synovial layer Type A cells are macrophages responsible for removing debris from the joint space Type B cells resemble fibroblasts secrete the synovial fluid There is no basal lamina between the lining cells and the underlying connective tissue Synovial cells do not divide actively in normal synovial membranes. Their division rate increases dramatically in response to acute trauma and haemarthrosis (Type A cells) (Type B cells)
25 Articular (synovial) cavity Hermetically closed Filled with synovia (fluid) glucose protein hyaluronic acid Clear, yellowish, viscous fluid, containing cells (fibroblast-like like cells, monocytes, lymphocytes) In some joints lined on the outside with small, s pillow-like, like, flaccid sacs bursa reduce friction of tendons tendon sheath bursa wrapped around a tendon Synovia: syn - together ovi egg (-white)
26 Exercise and Articular Cartilage When synovial fluid is warmed by exercise, it becomes thinner (less viscous) and more easily absorbed by the articular cartilage. The cartilage then swells and provides a more effective cushion against compression. For this reason, a warm-up period before vigorous exercise helps protect the articular cartilage from undue wear and tear. Because cartilage is nonvascular, its repetitive compression during exercise is important to its nutrition and waste removal. Each time a cartilage is compressed, fluid and metabolic wastes are squeezed out of it. When weight is taken off the joint, the cartilage absorbs synovial fluid like a sponge, and the fluid carries oxygen and nutrients to the chondrocytes. Lack of exercise causes the articular cartilages to deteriorate more rapidly from lack of nutrition, oxygenation, and waste removal.
27 Articular ligaments Meniscus: men - moon iscus - little All synovial joints are reinforced by connective tissue ligaments placed to resist motion in undesirable directions extrinsic (= extracapsular) ligaments intrinsic (= intracapsular) ligaments Have a minimal blood supply and are slow to heal Articular meniscus - an ingrowth of the fibrous capsule between the articular cartilages of the bone provide additional cushioning of the cartilage Other articular labrum (fibrocartilaginous( annular a nular lip), articular disc
28 Synovial joints can be classified based on number of surfaces shape of surfaces number of planes in space (x, y, z), in which they move
29 Types of synovial joints based on number of surfaces 2 articular surfaces contains an intra-articular disc or meniscus more than 2 articular surfaces Humerus Ulna R
30 Types of synovial joints based on shape of surfaces hemispherical head fits into a cuplike depression projection of a bone fits into a ringlike ligament of another bone convex surface fits into a concave depression (nearly) flat bones slide over each other 2 surfaces shaped like a saddle convex surface fits in elliptical depression
31 Types of synovial joints based on number of planes Monaxial the bone can move in only one plane Biaxial the bone can move can move in two planes Multiaxial the bone can move can move in three planes
32 Features of various types of synovial joints Ball-and-socket multiaxial; shoulder and hip joints Hinge monaxial; elbow, knee, and interphalangeal joints Saddle biaxial; trapeziometacarpal joint, allows thumb opposition Pivot monaxial; atlantoaxial and proximal radioulnar joints Gliding monaxial; intercarpal, intertarsal, and sternoclavicular joints; joints between the articular processes of the vertebrae Condyloid (ellipsoid) biaxial; radiocarpal and metacarpophalangeal joints
33 Principal movements of diarthroses Angulation flexion-extension abduction-adduction axial rotation gliding
34 Temporomandibular Principal Diarthroses Humeroscapular Elbow Coxal Knee Ankle
35 Arthroscopy
36 Joint disease - rheumatoid arthritis Proliferating synovium extends into the joint space, burrows into the bone beneath the articular cartilage, and covers the cartilage The articular cartilage is destroyed ankylosis Joint is destroyed and becomes fused (=ankylosis) ankylosis Essentials of Rubin's Pathology, 5th Edition
37 Joint disease - osteoarthrosis Chandrasoma & Taylor, Concise Pathology 3rd Ed
38 Joint prostheses
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