Cardio > MSK L3 Joint structure and function > Flashcards

MSK L3 Joint structure and function Flashcards

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1
Q

Classification of Joints:

A

According to structure

According to function

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2
Q

Classification of Joints: According to structure

A
  1. Fibrous
  2. Cartilaginous
  3. Synovial
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3
Q

Classification of Joints:

According to function

A

Synarthroses
Amphiarthroses
Diarthroses

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4
Q
  1. Synarthroses
A

no/little movement (fibrous and some cartilaginous joints

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5
Q
  1. Amphiarthroses
A

– some movement (cartilaginous joints)

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6
Q
  1. Diarthroses
A

free movement (always synovial joints)

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7
Q

Fibrous

A

no joint cavity and dense fibrous connective tissue joining articulating surface.

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8
Q

Cartilaginous joints

A

no cavity and two bones are joined y pad of cartilage – fibrous or hyaline.

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9
Q

Synovial –

A

cavity between ends of articulating bones – ends covered with fibrous or hyauline for protection.

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10
Q

Fibrous Joints: 3 sub classifications:

A
  1. Sutures
  2. Syndesmoses
  3. Gomphoses
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11
Q

Sutures

A

Found only in the skull,
Form at 18mths of age when they replace fontanels
Fibrous tissue covered by periosteum

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12
Q

Several types of sutures

A
  1. Serrate (between frontal and parietal bones)
  2. Lap or squamous - overlap (between parietal and temporal bones
  3. Plane or butt (between paired maxillary bones forming hard palate).
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13
Q

Synostosis sutures

A

Sutures may become totally ossified in adults forming a synostosis (e.g. between frontal bones)

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14
Q

Syndesmoses:Definition

A

Bones joined by interosseous ligament or dense aponeurotic membrane

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15
Q

Syndesmoses: Example

A

Interosseous membrane between radius and ulna

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16
Q

Syndesmoses: Movement

A

Flexibility of collagen fibres in ligament may allow limited movement

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17
Q

Gomphoses: Definition

A

Pegs and sockets, held in place by bundles of regular collagenous connective tissue

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18
Q

Gomphoses: Example

A

Found between teeth and bones of jaw – periodontal ligaments

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19
Q

Gomphoses:Movement

A

Allow sight movement of teeth during mastication as collagen fibres are orientated in different planes.

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20
Q

Cartilaginous joints: types

A
  1. Synchondroses (primary)

2. Symphyses (secondary)

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21
Q

Syncondroses (primary) Definition

A

Advancing centres of ossification separated by hyaline cartilage

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22
Q

Syncondroses (primary) Temporary types

A

Most are temporary (e.g. epiphyseal growth plates (and fuse in adults

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23
Q

Syncondroses (primary) Permanent types

A

Some persist throughout life e.g. costal cartilages, which allow some flexibility of rib cage during inspiration.

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24
Q

Symphyses (secondary) Definition

A

Fibro-cartilage pads between a.c. of adjacenet bones

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25
Symphyses (secondary) Movement
Allow for slight movement: Symphysis pubis allows expansion of pelvis in childbirth.
26
Symphyses (secondary)Examples
Symphysis pubis – childbirth | Intervertebral discs allow limied motion between vertebrae
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Symphyses (secondary)Examples that fuse
Some symphses fuse during growth (e.g. sacral and coccygeal discs)
28
Synovial Joints: Definition
Articulating bones separated by synovial cavity filled with synovial fluid
29
Synovial Joints: Movement
Cavity gives synovial joints wide range of movement compared to other joints
30
Synovial Joints: Examples of movement in different planes
``` Plane (or gliding) Hinge Pivot Ellipsode(or condyloid) Saddle Ball and socket ```
31
Plane (gliding) joints: Definition
Opposing surfaces almost flat or slightly convex and concave
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Plane (gliding) joints: Allow
Small side0to-side or back-and-forth movements and small amount of rotation
33
Plane (gliding) joints: Examples
1. Sacroiliac joints 2. Apopphyseal joints of spine • Allow thoracic sine ribs to movement upwards and outwards during inspiration
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Hinge joints → Definition
Convex and of one bone articulates with concave end of another.
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Hinge joints → Allow
Hinge-type movement about a single axis such as flexion and extension.
36
Hinge joints →Examples
Interphalangeal joints of fingers, and tibio-femoral joint of knee.
37
Pivot joints:Definition
Conical or rounded surface of one bone fits into depression on another.
38
Pivot joints: Allows
Rotation about a single axis
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Pivot joints: v
1. Joint between head of radius and ulnar allows rotation of forearm. 2. Atlanto-axial joint between atlas and axis allows rotation of head.
40
Ellipsoid:Definition
Oval convex surface articulates with ellipsoid concavity.
41
Ellipsoid:Allows
Bi-axial movement in 2 planes but no rotation.
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Ellipsoid:Examples
1. Atlanto-occipital joint in neck 2. Meta-carpophalangeal (MCP) joints in hands Radiocarpal joint of wrist
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Saddle joints: Definition
Two saddle-shaped surfaces articulate at right angles to one another
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Saddle joints: Allows
Modified condyloid joint, allows wide range of movement about 2 axes
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Saddle joints:Examples
Found in carpometacarpal (CMC) joint of thumb, and in ankle.
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Ball and Socket Joints: Definition
Almost spherical head (ball) articulates with almost spherical cup (socket)
47
Ball and Socket Joints:Movement
Allow for greatest range of movement of al joints, allow multi-axial movement in all planes
48
Ball and Socket Joints: Examples
Hip and shoulder joints
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1. All synovial joints are surround by
joint capsule which fully encloses articulating surfaces.
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2. Joint capsule is lined by
synovium/synovial membrame – lines inner surface of joint capsule except where there is articular cartilage
51
3. Joint cavity – filled with
synovial fluid.
52
Capsule
Outer fibrous capsule | Inner synovial membrane (synovium
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Outer fibrous capsule
Blends with periosteum
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Outer fibrous capsule composed of
Dense irregular connective
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Function of outer
Type 1 collagen – resists tensile loads as it is an irregular orientation – allows resistance of a range of mvoements
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Innervation of capsule
Highly innervated – site of joint pain rather than articular cartilage which has non blood supply or innervation.
57
Inner capsule (syovium) Definition
Lines joint cavity except for articular surfaces
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Inner capsule (syovium) Functions
Produces constiuents of synovial fluid
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Ligaments: (within capsule) Formed from
Localised thickening of fibrous capsule
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Ligaments: (within capsule) Composed of
Denses REGULAR CT comprising parallel collagen fibres (mainly type 1)
61
Function of collagen arrangement
Gives ligaments great tensile strength along their length
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Where synovium meets articular cartilage
Lots of infolding and villi Villi → have many capillaries to ensure constituents e.g. oxygen and nutrients can transfer into the synovial fluid. Articualar (avascular) relies on this.
63
2 main layers of synovium
1. Supporting layer or stroma (sub0intima) | 2. Lining of synovial cells in contact with synovial fluid
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2 types of synovial cell in inner lining
3. Type A
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Type A cells → Derived from → Function
Derived form bone marrow (macrophages) Secretory and phagocytic functions → high density of mito and golgi. → Remove cell debris from synovial fluid
66
Type B cells →Cell type → Function
Type of fibroblasts | Role in synthesis of hyaluronic acid (HA) and proteins → important for maintenance of viscosity (lubrication).
67
Synovitis
Inflammation of synovium – symptom of RA
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Articular Cartilage: Contains
Cells, fibres and matrix arranged in zones
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Articular Cartilage: Zones
1. Tangential zone 2. Transitional zone 3. Radial zone – column arrangement 4. Calcified cartilage (by ossified bone)
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Articular Cartilage: Cartilage cells
Chondrocytes; density varies with age, morphology changes in different zones.
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Articular Cartilage: Fibres of Articular collagen
Fibres are collagen, mostly type II – resist stress | Small amount so type VI,IX,XI
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Articular Cartilage: Matrix composed of
Large aggregated proteoglycans (aggrecan) some smaller PGs (decorin and biglycan).
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Articular Cartilage: GAG side changed important for
Hydrophillic and therefore attract water into the cartilage – allows it to resist pressure and forces.
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Articular Cartilage: Surface of articular cartilage
Lamina splendens – covers articular surface | Provides a low friction surface
75
Articular cartilage sits on
Subchondral bone
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Subchondral bone Definition
Cortical bone plate supported by trabecular bone
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Subchondral bone:In children
Perforated by blood vessels where it provides route for nutrient exchange, in adults it gathers nutrients from synovial fluid.
78
Subchondral bone: In disease
Shows biochemical and structure changes in some joint diseases.
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Menisci: Definition
Articular discs or pads composed of fibro-cartilage
80
Menisci: Located
Within capsule, provide extra strength and support
81
Menisci: Greater contact area action
Increases stability and decreases stress on joint.
82
Bursae: Definition
Flattened sacs filled with synovial fluid
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Bursae: Location
Often found where tendon passes over bone
84
Bursae:Modified bursae
Form tendon sheaths that surround tendons
85
Bursae: Inflammation
Bursitis can occur with overuse
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Synovial Fluid: Definition
Fills joint cavity and any bursae
87
Synovial Fluid: Components
Similar to interstial fluid but contained high concentratinos of Hyalornic acid.
88
Synovial Fluid: Hyalornic acid
``` Forms structure (longitudinal molelcus) GAG attach to to form aggregates. Provides viscosity properties – helps with lubrication ```
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Synovial Fluid:Role
1. Lubrication | 2. Cartilage nutrition
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Mechanical Function of synovial joints:
1. Synovial joints allow movement whilst providing stability 2. Shape of articulating surfaces influences type and range of movement 3. Increased mobility associated with reduced stability
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Improving stability:
1. Bones enlarge at ends to provide large contact are (increased stability and reduced stress). 2. Deformed cartilage and menisci also increase contact area
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3. Stability further increased by:
a. Capsule and ligaments surrounding joint b. Internal ligaments e.g. cruciates in knee – prevent forward and backward sliding c. Attachment of muscles and tendons across joint.
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Mechanical function of cartilage:
1. To protect bone from high stresses by distributing load evenly on to subchondral bone 2. To provide low-friction low-wear surfaces (helped by presence of joint lubricants
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Role of mechanical factors in joint disorder: Shear causes friction leading to
1. Loss of energy 2. Increase in temperature 3. Wear and tear at bearing surface
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Role of mechanical factors in joint disorder: Lubrication reduces
Damaging effects of friction
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Role of mechanical factors in joint disorder:In synovial joints, two main types of lubrication
Fluid-film | Boundary
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Fluid Film lubrication: Static compressive loading
1. Load acting in centre 2. Film of synovial fluid between two joint surfaces which acts to separate the surfaces 3. Fluid will try to move laterally but because cartilage is deformable and permeable it spreads the load over a larger area leaving the film 4. Fluid is also added
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Fluid Film lubrication: Dynamic loading e.g. walking
Hydrodynamic lubrication 1. Fluid filled is dragged between the surfaces. 2. At leading edge where cartilage is being loaded 3. The fluid gets dragged between the two joint surfaces
99
Fluid Film lubrication: Boundary lubrication
Lubricin – bound tightly to articular surface. | Charged molecules – like charged particles will repel eachother maintain a distance between the two surface
100
Lubrication Failure:
1. Failure of lubrication mechanisms can lead to increased friction and fibrillation of cartilage surface 2. Roughened fibrillated surface results in increased friction and wear and may lead to further cartilage damage.
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Effects of sustained or repetitive loading:
1. Mechanical loading causes fluid changes in cartilage, which are usually reversible 2. Sustained compression squeezes fluid out, reducing cartilage thickness and ability to equalise stress on underlying bone. 3. Repetitive cyclic loading can cause proteoglycan loss at cartilage surface and distortion of collagen network
102
Effects of mechanical overload:
2. High levels of mechanical loading can: a. Damage cartilage surface b. Kill chondrocytes
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