Anatomy of Bones and Joints

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Anatomy of Bones and Joints
2015-03-17 01:53:44

Anatomy of Bones and Joints
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  1. How many bones does a typical adult have?
    206. Varies with individual and age because some bones fuse together
  2. Paired vs Unpaired bones
    • Paired= 2 bones, same type on left and right side (86 paired bones)
    • Unpaired= located in midline (34 unpaired)
  3. Body of bone
    Main part
  4. Head of bone
    Enlarged, often rounded end
  5. Neck of Bone
    Constriction between head and body
  6. Margin or border of bone
  7. Ramus
    Branch off body beyond angle
  8. Condyle
    • Smooth rounded articular surface
    • Smooth rounded end covered with articular cartilage
  9. Facet
    Small, flattened articular surface
  10. Line or linea
    Low ridge
  11. Crest or crista
    Prominent ridge
  12. Spine
    Very high ridge
  13. Terms for projections
    • Process
    • Tubercle
    • Tuberosity or tuber
    • Trochanter
    • Epicondyle
  14. Process
    • Prominent projection
    • Usually ligament or tendon attached
  15. Tubercle
    • Small, rounded bump
    • Usually ligament or tendon attached
  16. Tuberosity
    knob; larger than tubercle
  17. Trochanter
    tuberosities on proximal femur
  18. Epicondyle
    Upon a condyle
  19. Openings
    • Foramen
    • Canal or meatus
    • Fissure
    • Sinus or labyrinth
  20. Foramen
    • Hole
    • Usually occupied by something like nerves or blood vessels
  21. Canal or meatus
  22. Fissure
  23. Sinus or labyrinth
  24. Depressions
    • Foss
    • Notch
    • Groove or sulcus
  25. Fossa
    General term for a depression
  26. Notch
    Depression in margin of bone
  27. Groove or sulcus
    Deeper, narrow depression
  28. Axial Skeleton
    • Upright axis of body, includes skull, auditory ossicles, hyoid one, vertebral column, and thoracic cage
    • Protects brain, spinal cord, and vital organs in thorax
  29. How many bones are in the skull?
    • 22 bones
    • 8 bone in brain case
    • 14 facial bones
  30. What 8 bones encase the brain?
    • 2 parietal bone
    • 2 temporal bone
    • 1 Frontal bone
    • 1 Occipital bone
    • 1 Sphenoid bone
    • 1 Ethmoid bone
  31. What 14 bones make up the face?
    • 2 maxilla
    • 2 zygomatic bones
    • 2 palatine bones
    • 2 lacrimal bones
    • 2 nasal bones
    • 2 inferior nasal concha
    • 1 mandible
    • 1 vomer
  32. What are the functions of the facial bones?
    • Support organs of vision, smell, and taste
    • Provide attachment points for muscles involved in mastication, facial expression and eye movement
  33. Bones of the skull are pretty much a single unit. What is the 1 bone that moves freely from the rest?
  34. Calvaria (skull cap)
    Top of skull, usually cut off to reveal interior of skull
  35. What sutures are associated with the parietal bones?
    • 2 parietal bones joined at midline by sagittal suture
    • Joined to frontal bone by coronal suture (anterior)
    • Joined to occipital bone by lamboid suture (posterior)
    • Joined to temporal bones by squamous suture (lateral)
  36. Sutural or wormian bones
    Extra small bones that sometimes form along lamboid suture
  37. External Occipital Protuberance
    • Base of head, palpable through scalp, size varies
    • Site of attachment of ligamentum nuche (nape of neck)
  38. Ligamentum nuchae
    Elastic ligament that extends down neck and helps keep head erect by pulling on occipital region of skull
  39. Nuchal lines
    Set of small ridges that extend laterally from external occipital protuberance. Pts of attachment for many neck muscles.
  40. What bone contains the external auditory meatus or canal?
    • Temporal bones
    • Transmit sound waves to tempanic membranes
  41. What process is posterior and inferior to the EACs?
    • Mastoid process
    • Not solid bone, filled with cavities called mastoid air cells that connect to inner ear. Muscles in neck involved in rotation of head attach to mastoid process
  42. Temporal lines
    • Inferior and superior on lateral surface of parietal bones
    • Attachment points for temporalis muscles involved in mastication
  43. Sphenoid bone
    • One bone that extends across entire head (mostly internal)
    • Greater wing of sphenoid bone is anterior to temporal bone
  44. Zygomatic bone
    • Cheek bone
    • Anterior to sphenoid bone and part of temporal bone
  45. Zygomatic arch
    • Consists of joined processes from temporal and zygomatic bone, forms bridge across side of skull
    • Easily palpable, muscles on each side palpable when jaw opens/closes
  46. Mandible
    • Inferior to maxilla
    • 2 parts: body and ramus, joins angle of mandible
    • Mandibular condyle articulates with temporal bone to allow movement of mandible
  47. Coronoid process
    Attachment pt of temporalis muscle to mandible
  48. Alveolar processes
    Sockets for attachment of teeth on maxillae and mandible.
  49. Orbits
    • Protect eye and attachment pts for eye muscles
    • Contains blood vessels, nerves, fat, eyeballs, and muscles
    • Several openings between orbit and other cavities
  50. Superior and inferior orbital fissures
    Nerves and blood vessels pass
  51. Optic canal
    Optic nerve passes into cranial cavity
  52. Nasolacrimal canal
    • Passes from orbit into nasal cavity
    • Duct that takes tears from eye to nasal cavity
  53. Nasal Cavity
    Divided into right and left halves by nasal septum
  54. Nasal Septum
    • Bony part of nasal septum: primarily the vomer inferiorly and perpindicular plate of ethmoid bone superiorly
    • Anterior part of nasal septum is hyaline cartilage called septal cartilage
  55. Deviated nasal septum
    • Usually in median plane until about 7 yrs old and then deviates slightly to 1 side
    • Can deviate significantly at birth or due to injury
    • Surgically repaired
  56. What does a "broken nose" typically involve?
    Fracture of nasals, ethmoid, vomer, or maxillae
  57. Nasal conchae
    • Lateral of wall of nasal cavity
    • Middle and superior nasal conchae are projections from ethmoid bone
    • Inferior nasal conchae is a separate bone
  58. What are the functions of the nasal conchae and septum?
    Promotes moistening and warming of inhaled air and removal of particles from air by mucous membranes
  59. Paranasal sinuses
    • Decrease weight of skull and act as resonating chambers during voice production
    • Frontal, maxillary, and sphenoidal sinuses
    • Ethmoidal sinuses=ethmoidal labyrinth
  60. Foramen Magnum
    • Most prominent foramen.
    • Connects spinal cord and brain.
    • Located in occipital bone.
  61. Occipital Condyles
    Next to foramen magnum, connect skull and vertebral column
  62. Carotid canals
    Blood carried to brain through internal carotid arteries and vertebral arteries (foramen magnum)
  63. How does blood leave the brain?
    • Through internal jugular veins
    • Exit through jugular foramina, lateral to occipital condyles
  64. Styloid processes (2)
    • Long, pointed projections from inferior surface of temporal bone
    • Muscles involved in movement of tongue, hyoid bone, and pharynx attached to each process
  65. Mandibular Fossa
    Where mandibular condyle articulates with skull, anterior to styloid process
  66. Medial and lateral pterygoid plates
    • Vertical bony plates of sphenoid bone
    • Binds each side of posterior nasal cavity
  67. Vomer
    Most of posterior portion of nasal septum
  68. Hard or Bony Palate
    • Forms floor of nasal cavity
    • Formed by 4 bones
  69. What 4 bones form the hard palate?
    • 2 palatine processes of maxillae (2/3)
    • Horizontal plates of 2 palatine bones (1/3)
  70. Hard and soft palate function
    Separates nasal cavity from mouth allowing humans to chew and breathe at the same time
  71. Cleft lip and cleft palate
    • Cleft lip: maxillae don't form normally or fuse
    • Cleft palate: Palatine processes of maxillae don't fuse. Difficult to eat, drink, or speak distinctly because opening between oral and nasal cavities
  72. Superior view of skull with calvaria removed
    • 1) Anterior cranial fossa
    • 2) Middle cranial fossa
    • 3) Posterior cranial fossa
  73. Crista galli of ethmoid bone (rooster's comb)
    • Prominent ridge in anterior cranial fossa
    • Attachment point for one of the meninges
  74. Cribiform Plates
    • on each side of crista galli
    • Olfactory nerves extend from cranial cavity into roof of nasal cavity through sievelike perforations in cribiform plate called olfactory foramina
  75. Sella turcica (Turkish saddle)
    Center of spehnoid bone, resembles saddle, houses pituitary gland
  76. Petrous (rocky) part of temporal bone
    • Thick, bony ridge lateral to foramen magnum
    • Hollow, contains middle and inner ear (auditory ossicles in middle ear)
    • Carotid canal runs anteromedially within petrous aprt of temporal bone
  77. What allows people to hear their own heartbeat?
    Thin plate of bone between carotid canal and middle ear
  78. Hyoid bone
    • Not part of adult skull, no direct bony attachment to skull
    • "floats" in superior aspect of neck just inferior to mandible
    • Attachment for some tongue and neck muscles that elevate larynx during speech/swallowing.
  79. Function of Vertebral Column
    • 1) Supports weight of head and trunk
    • 2) Protects spinal cord
    • 3) Allows spinal nerves to exit spinal cord
    • 4) Site of attachment for muscles
    • 5) Permits movement of head and trunk
  80. How many bones and regionsare in the vertebral column?
    • 26 bones
    • 5 regions
    • 7 cervical
    • 12 thoracic
    • 5 lumbar
    • 1 sacral
    • 1 coccygeal
  81. Why does the developing embryo have 33-34 vertebrae?
    5 sacral vertebrae fuse to form sacral bone and 4-5 coccygeal bones fuse
  82. 4 major curves in adult spine
    • Concave anteriorly: Thoracic and sacral curve
    • Convex anteriorly: Cervical and Lumbar
  83. Which spinal curves form in the fetus?
    Thoracic and sacral curves. C-shape curve of fetus
  84. Which spinal curve forms when infant lifts head a few months after birth?
  85. Which spinal curve forms when the infant learns how to sit and walk?
  86. What are 3 types of abnormal spine curvature?
    • Lordosis: Exaggeration of lumbar curve (swayback condition)
    • Kyphosis: Exaggeration of thoracic curve (hunchback)
    • Scoliosis: abnormal lateral and rotational curvature of spine
  87. What is the weight bearing portion of the vertebrae?
    Body of vertebrae
  88. Vertebal arch
    Projects posteriorly from vertebral foramen
  89. Vertebral foramen
    Contains spinal cord and cauda equina
  90. What 2 structures are attached to the vertebral body?
  91. What two structures extend from transverse processes to spinous processes?
  92. What structures serve as attachment points for the back muscles?
    • Spinous processes
    • Transverse processes
  93. Transverse process
    Extends laterally from each side of arch between lamina and pedicle
  94. Spinous process
    • At junction between 2 laminae
    • Can be palpated down midline of back
  95. Articular processes
    • Support and movement of vertebral column between individual vertebrae.
    • Each has a smooth articular facet allowing movement between processes.
  96. How many articular processes does each vertebrae have?
    • 4 articular processes: 2 superior and 2 inferior
    • Superior articular process of one vertebrae articulates with inferior process of next superior vertebrae.
  97. Intervertebral foramina
    • Exit of spinal nerves between vertebrae.
    • Formed by superior and inferior intervertebral notches.
  98. Spina bifida
    • Vertebral laminae partially or completely fail to fuse during fetal development.
    • Most common in lumbar region
    • If severe, may interfere with normal nerve function below point of defect.
  99. Intervertebral Disks
    • Pads of fibrocartilage between bodies of adjacent vertebrae
    • Shock absorbers and allow vertebral column to bend
  100. What two components make up the intervertebral disks?
    • Annulus fibrosus: external, fibrous
    • Nucleus pulposus: internal, gelatinous
  101. What happens to intervertebral disks with age?
    Disks more compressed, decreased height, weakend annulus fibrosus, increase suceptibility for herniation.
  102. Herniated or Ruptured Intervertebral Disks
    • Brakage or ballooning of annulus fibrosus with partial or complete release of nucleus pulposus.
    • Herniated portion can push on and compress spinal cord, cauda equina, or nerves, decreasing function and increasing pain.
    • Most common in lumbar and cervical spines
  103. Cervical vertebrae differences
    • All have transverse foramen for vertebral arteries to go towards head
    • Also small bodies, bifid spinous processes except C&
  104. C1
    • Atlas
    • No body, no spinous process
    • Holds up head, large superior articular facets that articulate with occipital condyles on base of skull
    • Nodding and tilting of head (side to side, front to back)
  105. C2
    • Axis
    • Articulates with Atlas (C1) for "no" motion of head
    • Dens or odontoid process (protrudes superiorly from body)
  106. C7
    Only cervical vertebrae with non-bifid spinous process
  107. Verteba prominens
    Easily palpable between shoulders, usually spinous process of C7 sometimes C6 or T1
  108. Thoracic Vertebrae Differences
    • Have attachment sites for ribs
    • T1-T10 have articular facets on their transverse processes to articulate with tubercles of ribs.
    • Long, thin spinous processes directed inferiorly
  109. Lumbar Vertebrae Differences
    • Large, thick bodies and heavy, rectangular transverse and spinous processes
    • Superior articular facets face mdially, inferior articular facets face laterally
    • When superior articular surface of one vertebrae join inferior articular process of another, tends to "lock" adjacent vertebrae together increasing stability and decreasing rotation
  110. Sacral Vertebrae Differences
    • Margins of sacral body unite after 20 years.
    • Transverse processes fuse to form lateral parts of sacrum, interior ossifies around midlife.
  111. Alae
    Wing shaped superior and lateral parts of sacrum (top corners)
  112. Auricular Surfaces
    Most of lateral surface of sacrum; joins sacrum to pelvic bone. Ear shaped
  113. Median Sacral Crest
    Partially fused spinous processes of S1-S4
  114. Sacral Hiatus
    • S5 spinous process doesn't form, exposes sacral canal
    • Used to access sacral canal and administer anesthetics during child birth.
  115. What landmark separates abdomen and pelvis?
    • Sacral promontory
    • Can be felt during pelvic exam
  116. Coccyx (Tailbone)
    • 4 or more fused vertebrae into 1 bone
    • No foramen or processes
    • Easily broken in fall or during childbirth
  117. Thoracic Cage
    T1-T12, ribs, associated costal cartilage and sternum
  118. How many pairs of ribs do humans have?
    • 12 pairs
    • Articulate posteriorly with thoracic vertebrae
  119. What is the role of costal cartilage?
    Attach many ribs anteriorly with sternum
  120. What is the difference between "true ribs" and "false ribs"?
    • True ribs: attach to sternum (1-7)
    • False ribs: don't attach to sternum directly, attach through common cartilage of rib 7 (8-10)
  121. What are "floating ribs"?
    Don't attach to sternum at all (11 and 12)
  122. What are the 2 points of articulation of ribs with vertebrae?
    • 1) Head: articulates with bodies of 2 adjacent vertebrae and intervetebral disk
    • 2) Tubercle: articulates with transverse process of inferior vertabrae
  123. What are the 3 main parts of the sternum?
    • Like a sword
    • 1) Manubrium (handle)
    • 2) Body (blade)
    • 3) Xiphoid process (tip)
  124. Jugular Notch
    B/w ends of clavicles whre the articulate with manubrium, base of the human neck. Depression easily visible.
  125. Sternal angle
    • Slight ridge at junction of manubrium and body
    • 2nd rib is lateral to it
    • Angle of Louis
  126. What are the components of the pectoral girdle?
    • 2 scapulae and 2 clavicles
    • Each humerus --> scapula --> Clavicle --> Sternum
  127. Glenoid Cavity
    Depression in scapula where humerus attaches
  128. What are the 3 fossa of the scapula?
    • Posterior surface: 1) Supraspinous 2)Infraspinous (separated by scapular spine)
    • Anterior surface: 3) Subscapular fossa
  129. Acromion
    • Extension of spine forming point of shoulder
    • Protective cover for shoulder
    • Attachment site for clavicle and some shoulder muscles
  130. Coracoid process
    Curves below clavicle and is attachment point for arm and chest muscles
  131. Clavicle
    • Acromial (lateral end)
    • Sternal (medial end), articulates with manubrium
  132. Where does the humeral head articulate with the scapula?
    Glenoid cavity
  133. What is the anatomical neck of the humerus?
    Around the humeral head, attachment point for connective tissue for shoulder
  134. What is the surgical neck of the humerus?
    Common site of fracture requiring surgery
  135. What are the functions of the greater and less tubercles of the humerus?
    Sites for muscle attachment
  136. What structure is between the greater and lesser tubercles? What is in this structure?
    • Biceptal (Intertubercular) Groove
    • Tendon of biceps brachii muscle
  137. Deltoid tuberosity
    • Lateral surface of humerus
    • 1/3 way down humerus
    • Attachement point for deltoid muscle
  138. What are the two condyles on the distal end of the humerus?
    • Capitulum
    • Trochlea
  139. What bone does the trochlea articulate with?
  140. What bone does the capitulum articulate with?
  141. What are the two epicondyles on the humerus? What are their functions?
    • Medial and lateral epicondyles
    • Attachment points for forearm muscles
  142. What are the two bone in the forearm?
    • Radius (lateral side, thumb side)
    • Ulna (Medial side, pinky side)
  143. What is the trochlear or semilunar notch?
    Fits over trochlea of humerus and forms most of elbow joint
  144. What are the 2 processes in the elbow?
    • Olecranon: posterior process (tip of elbow), site of attachment for posterior arm muscles
    • Coronoid process: Anterior process, smaller
  145. Head of radius
    • Proximal end, concave, articulates with capitulum of humerus
    • Lateral surface forms a smooth cylinder where radius rotates against radial notch of ulna
  146. Radial and ulnar tuberosities
    • Just distal of elbow
    • Attachment point for arm muscles
  147. Distal head of ulna
    Small head, articulates with radius and carpal bones
  148. What is the purpose of the ulnar and radial styloid processes?
    Attachment points for wrist ligaments
  149. What population is most at risk for radius fractures?
    People 50+
  150. Which hand position is associated with a radius fracture?
    Fall on outstretched hand, posterior displacement of hand.
  151. What is a Colles fracture?
    Complete, transverse fracture of radius 2.5 cm proximal to wrist. Often comminuted or impacted.
  152. What are the 8 carpal bones in the wrist?
    • Proximal row (thumb to pinky): Scaphoid, lunate, triquetrum, pisiform
    • Distal row (thumb to pinky): Trapezium, Trapezoid, Capitate, Hamate
  153. What is carpal tunnel syndrome?
    • Bones and ligaments form "carpal tunnel" on anterior (ventral) side of wrist without much give
    • Overuse or trauma can cause fluid and/or enlarged tendons to associated with inflammation to apply pressure to major nerve in carpal tunnel.
    • Symptoms: numbness, tingling and burning in hand
  154. How are the metacarpals numbered? What do their distal ends form?
    • 1-5 (thumb to pinky)
    • Knuckles
  155. What are the 2 phalanges in the thumb? 3 in fingers?
    • Thumb: Proximal and distal phalanges
    • Fingers: Proximal, middle, and distal phalanges
  156. What are the distal interphalangeal (DIP), proximal interphalangeal (PIP), and metacarpophalangeal (MCP) joints?
    • DIP: between distal and middle phalanges
    • PIP: between middle and proximal phalanges
    • MCP: between proximal phalanges and metacarpals
  157. Where do the coxal bones join anteriorly and posteriorly?
    • Anteriorly: Pubic symphysis
    • Posteriorly: Sacrum
  158. What are the components of the pelvis?
    • 1)Right and left coxal bones
    • 2) Sacrum
    • 3) Coccyx bone
  159. What are the 3 parts of each coxal bone?
    • 1) Ilium (superior)
    • 2) Ischium (inferior and posterior)
    • 3) Pubis (Inferior and anterior)
  160. What is the acetabulum?
    • Fossa on lateral surface of each coxal bone
    • Point of articulation with lower extremities
    • Lunate surface: crescent shape, superior and leteral aspects of fossa (articular surface)
  161. Obturator foramen
    • Large, opening in ischium where nerves and blood vessels pass
    • Mostly closed off by connective tissue that separates pelvic cavity and superficial structures.
    • Only a few, small blood vessels and nerves pass.
  162. Iliac crest
    • Superior part of ilium, easily palpable
    • Ends anteriorly at anterior superior iliac spine and posteriorly at posterior superior iliac spine
  163. Anterior superior iliac spine
    Attachment point for anterior thigh muscles
  164. Posterior inferior iliac spine
    Attachment point for ligaments anchoring coxal bone to sacrum
  165. Ischial tuberosity
    • Attachment point for posterior thigh muscles
    • Part of coxal bone where person sits
  166. Auricular surface of Ilium
    Joins auricular surface of sacrum to form sacroiliac joint
  167. What passes through the greater and lesser sciatic notch?
    Nerves and blood vessels
  168. Pelvic Brim
    Bony boundary from sacral promontory to pubic crest
  169. False or greater pelvis
    Superior to pelvic brim and partially surrounded by bone on posterior and lateral sides.
  170. True pelvis
    Inferior to pelvic brim, completely surrounded by bone
  171. Pelvic Inlet
    Superior opening of true pelvis at pelvic brim
  172. Pelvic Outlet
    Inferior opening of true pelvis, bordered by inferior margin of pubis, ischial spines, tuberosities and coccyx.
  173. Where does the femur articulate with the coxal bone?
    Acetabulum of coxalbone
  174. What are the greater and lesser trochanter of the femur?
    • Attach muscles that fasten hip to leg
    • Greater trochanter and ssociated muscles are wides part of hips
  175. What are 3 other muscle attachment points on the femur?
    • 1) Pectineal line
    • 2) Gluteal tuberosity
    • 3) Linea aspera
  176. What are the major structures of the distal end of the femur?
    • Medial and Lateral condyles
    • Medial and lateral epicondyles
    • Adductor tubercle
  177. What is the role of the medial and lateral condyles?
    Articulation with the tibia
  178. What is the role of the meidal and lateral epicondyles?
    Ligament attachment
  179. What is the role of the patella?
    • Articulation with femur in patellar groove
    • Holds tendon away from distal end of femur and changes angle of tendon between quadriceps femoris muscle and tibia where tendon attaches
    • Change in angle increases force with less muscle contraction because of more leverage
  180. Where is the patella located?
    Large, sesamoid bone within tendon of quadriceps femoris muscle group
  181. What are the two bones of the lower leg?
    Tibia (larger) and Fibula (smaller)
  182. Tibia
    • Larger, weight bearing bone of leg
    • Rounded condyles of femur rest on flat medial and lateral condyles on proximal end of tibia.
  183. What is the function of the tibial tuberosity?
    • Attachment point for quadriceps femoris, easily palpable just inferior to patella
    • Convex anteriorly
  184. What is the sharp edge of the shin called?
    Anterior crest of tibia
  185. What is the medial malleolus?
    • Distal, enlarged end of Tibia
    • Medial aspect of ankle
  186. Does the fibula articulate with the femur?
    NO! Articulates with tibia
  187. What is the lateral malleolus?
    Distal, slightly enlarged end of fibula
  188. What is the thinnest, weakest point of the fibula?
    Just proximal to lateral malleolus
  189. How many bones are in the foot?
    • 7 tarsal bones
    • Proximal rows: Navicular, Talus, and Calcaneus
    • Distal row: Medial, intermediate, and distal cuniforms and cuboid
  190. What is the talus?
    • Articulates with tibia and fibula to form ankle joint
    • Unusual, no muscle attachments
  191. Calcaneus
    • Heel
    • Attachment point for large calf muscles
  192. Foot Eversion Injury
    • Medial malleolus moves to ground, plantar surface outward
    • Talus slides laterally forcing malleoli to separate.
    • Ligament is stronger than bone in the ankle so medial malleolus breaks as talus slides laterally
    • Can cause lateral malleolus to shear off or fracture the fibula (Pott's fracture)
  193. Foot Inversion Injury
    • Plantar surface inward
    • Can fracture fibula just proximal to lateral malleolus
    • Often ligament between medial malleolus and tarsal bones is weaker than bones and ligaments are damaged with no fracture=sprain
  194. What forms the ball of the foot?
    Distal ends of metatarsals
  195. What are the 3 arches of the foot?
    • Medial longitudinal arch
    • Lateral longitudinal arch
    • Transverrse arch
  196. Medial longitudinal arch
    • Calcaneus, talus, navicular, cuniforms, and 3 medial metatarsals
    • Highest arch
  197. Lateral longitudinal arch
    Calcaneus, cuboid, 2 lateral metatarsals
  198. Transverse arch
    Cuboid and cuniforms
  199. Shifting of weight to different bones while walking
    Tibula-fibula --> Talus --> Calcaneus --> Lateral arch system --> Ball of foot
  200. Which types of joints allow more movement?
    • Cartilagnous joints with smooth articulating surfaces
    • Fibrous joints have much less movement
  201. What are the 3 classes of joints?
    • 1) Fibrous
    • 2) Cartilaginous
    • 3) Synovial
  202. Fibrous Joints
    • 2 bones, united with fibrous connective tissue
    • No joint cavity
    • Little or no movement
  203. What are the 3 types of fibrous joints?
    1) Sutures 2) Syndesmoses 3) Gomphoses
  204. Sutures
    • Fibrous joints between skull bones
    • Dense, regular collagenous connective tissue
    • Interlocking finger like process increases stability
    • Margins of bone in suture: continuous intramembrane bone growth and many become ossified
  205. Synostosis
    Two bones fuse together across a joint to form a single bone (ie. Frontal bone)
  206. Syndesmoses
    • Joint where bones are farther apart than suture
    • Joined by ligaments, some movement (ie. Radioulnar syndesmoses)
  207. Gomphoses
    Pegs held in place within sockets by fibrous tissue (ie.  Joints between teeth and alveoli of mandible and maxillae)
  208. Periodontal ligaments
    Fibrous connective tissue between teeth and sockets
  209. What are cartilaginous joints?
    Unite 2 bones with either hyaline or fibrocartilage
  210. What are synchondroses?
    • Hyaline cartilage with little to no movement
    • Most are temporary with bone replacing cartilage to form synostosis
    • Ie. Ilium, ischium, and pubis before fusion, ephyseal plates, and sternocostal synchondroses
  211. Symphysis
    • Fibrocartilage uniting 2 bones
    • I.e. manubrium, sternum, invertertebral disks and symphysis pubis
  212. What are synovial joints?
    • Freely moveable, contain synovial fluid in a cavity surrounding ends of articulating bones
    • Articular cartilage=hyaline cartilage
    • Joint capsule surrounds ends of bones forming synovial joints forming a joint cavity
  213. What are articular disks?
    • Disks located between articular cartilage of bones
    • Absorb and distribute forces between articular cartilage as bones move (TMJ, sternoclavicular, and AC joints)
  214. What is the meniscus?
    • Incomplete, crescent shaped fibrocartilage pad found in joints like knee and wrist.
    • "articular disk with hole in the center"
  215. Outer fibrous capsule
    • Dense, irregular connective tissue, continuous with periosteum
    • May thicken and collagen fibers may arrange to become ligaments
  216. Synovial Membrane
    • Lines joint cavity except over articular cartilage and disks
    • Thin, delicate membrane of modified connective tissue
    • Produces synovial fluid
  217. What is synovial fluid made of?
    • Serum filtrate, polysaccharides, proteins, fats, and cells
    • Major polysaccharide is hyaluronic acid (lubricant)
  218. Bursa
    • Pocket or sac of synovial membrane that extends away from the rest of the joint cavity
    • Provide cushioning between structures that would normally rub against each other like tendons and bones
  219. Are bursa always associated with bones?
    • No; some provide cushion between skin and underlying bone prominences like the subcutaneous olecranon bursae
    • Others extend along tendons forming a tendon sheath
  220. What are the 6 types of synovial joints?
    • 1) Plane
    • 2) Pivot
    • 3) Hinge
    • 4) Ball and socket
    • 5) Elipsoid
    • 6) Saddle
  221. Plane (Gliding) Joints
    2 opposed flat surfaces that can glide against each other (uniaxial)
  222. Pivot Joints
    • Cylindrical process rotates within a ring
    • Uniaxial rotation
  223. Hinge Joints
    • Concave end of 1 bone and convex end of another bone
    • Uniaxial bending
  224. Ball and socket joints
    • Head of one bone (ball) and a socket of another bone where the ball fits in
    • Multiaxial
  225. Ellipsoid Joints
    • Modified ball and socket joints, ellipsoid articular surfaces
    • Biaxial
  226. Saddle Joints
    • 2 saddle shaped articulating surfaces oriented perpendicular to each other
    • Biaxial
  227. Flexion
    to bend or move in anterior direction
  228. Extension
    To straighten or move in posterior direction
  229. Plantarflexion
    Standing on tiptoes
  230. Dorsiflexion
    Towards shin
  231. Abduction
    Away from midline
  232. Adduction
    Towards midline
  233. Lateral flexion
    axial skeleton to one side
  234. Lateral excursion
    Mandible away from midline (chewing)
  235. Medial excursion
    Mandible back to neutral position
  236. Temporomandibular Joint (TMJ)
    • Mandibular condyle fits into mandibular fossa of temporal bone
    • Fibrocartilage articular disk located between mandible and temporal bone separates joint into superior and inferior joint cavities
    • Ellipsoid and plane joint (mainly ellipsoid)
  237. Temporomandibular disorder (TMD)
    • 2nd most common cause of orofacial pain after toothache
    • 1) Muscle related TMD
    • 2) Joint related TMD
  238. Muscle related TMD
    • More common, muscle hyperactivity like grinding of teeth during sleep and jaw clenching when stressed
    • Radiographs may appear normal
  239. Joint related TMD
    • Caused by disk displacement, degeneration of joint, arthritis, infection etc
    • Abnormal movement of disk causes popping or clicking sound, may make impossible to open mouth fully
  240. Glenohumeral Joint (shoulder)
    • Ball and socket joint, decreases stability for more mobility
    • Flexion, extension, abduction, adduction, rotation, and circumduction
    • Round head of humerus articulates with shallow glenoid cavity of scapula
  241. Glenoid Labrum
    • Rim of glenoid cavity built up by fibrocartilage ring where joint capsule attaches
    • Subacromial bursa is outside joint cavity
  242. Rotator Cuff
    • Maintains stability of glenohumeral joint
    • Consists of 4 muscles and ligaments
  243. Biceps brachii muscle tendon
    • Also stabilizes glenohumeral joint with rotator cuff
    • Attaches at supraglenoid tubercle, crosses over head of humerus within joint cavity and passes through the intertubercular groove and joins biceps brachii
  244. What are the most common shoulder disorders?
    • Dislocations and muscle or tendon tears
    • Most commonly dislocated joint because major ligaments cross superior part but no ligaments across inferior side
  245. In which direction is the glenohumeral joint most likely to dislocate?
    • Dislocation of humerus most likely to occur inferiorly into axilla
    • Can damage axillary nerve and blood vessels
  246. Elbow Joint
    • Humeroulnar and humeroradial joints
    • Shape of trochlear notch and trochlea limit movement to flexion and extension
    • Joint capsule reinforced by ligaments
    • Olecranon bursa covers proximal and posterior surface of olecranon processes
  247. What happens during pronation and supination?
    Rounded radial head rotates in radial notch of ulna against capitulum of humerus to allow pronation and supination
  248. What are two common elbow problems?
    • 1) Olecranon bursitis (student's elbow)
    • 2) Nursemaid's elbow
  249. Olecranon bursitis (student's elbow)
    Excessive rubbing of elbow against a hard surface
  250. Nursemaid's elbow
    • Radial head subluxated from annular ligament of radius
    • Can happen if child is lifted by one hand
  251. Coxal Joint (Hip)
    • Femoral head articulates with concave acetabulum of coxal bone
    • Flexion, extension, abduction, adduction, rotation, and circumduction
    • Acetabulum is deepened and strengthened by a lip of fibrocartilage called acetabular labrum
    • Extremely strong joint capsule, reinforced by several ligaments, extends from rim of acetabulum to neck of femur
  252. Which side of the knee is more likely to be injured?
    • Medial side because MCL is weaker than LCL.
    • Medial meniscus is tightly attached to MCL and is damaged 20x more than lateral meniscus (thinner and not attached to LCL)
  253. Torn meniscus in knee
    • Causes "clicking" sound during extension
    • If severe damage, torn cartilage may move between articular surfaces causing knee to "lock" in partially flexed position
  254. Torn ACL and PCL
    • If knee is driven anteriorly, ACL maybe torn
    • If flexed and driven posteriorly, PCL may be torn
  255. Housemaid's knee
    Bursitis of subcutaneous prepatellar bursa "housemaid's knee" from prolonged work performed while on hands and knees
  256. Clergyman's Knee
    • Affects subcutaneous infrapatellar bursa
    • From excessive kneeling
  257. Chondromalacia
    Softening of cartilage resulting in abnormal movement of patella within patellar groove
  258. Fat Pad Syndrome
    Accumulation of fluid in fat pad posterior to patella
  259. Hip dislocation
    • When hip is flexed and femur is driven posteriorly such as when a person is sitting in MVC
    • Head of femur usually dislocates from posterior to acetabulum tearing accetabular labrum, fibrous capsule, and ligaments.
    • Fracture of femur and coxal bones are usually associated
  260. Knee Joint
    • Femur joins tibia and patella
    • Fibula joins tibia
    • Distal end of femur has 2 large, round condyles with a deep intercondylar fossa between them
    • Femur articulates with tibia's proximal condyles that are flattened with a crest called the intercondylar eminence
  261. Where is the patella located?
    within tendons of quadriceps femoris
  262. ACL and PCL
    • ACL attaches anteriorly to intercondylar eminence on tibia
    • PCL attaches posteriorly to intercondylar eminenc on tibia
    • Prevent tibia sliding anteriorly or posteriorly on femur
  263. MCL and LCL
    • Strengthen medial and lateral sides of knee
    • Prevent femur from tipping side to side on tibia
  264. Knee bursae
    • Suprapatellar bursa
    • Subcutaneous prepatellar bursa
    • Deep infrapatellar bursa
  265. Suprapatellar bursa
    • Largest, superior extension of joint capsule
    • Allows movement of anterior thigh muscles over distal end of femur
  266. Talocrural Joint (Ankle)
    • Medial and lateral malleoli of tibia and fibula form sides
    • Almost non-existent anterior and posterior margins
    • Most of weight beared by tibia and talus
    • Ligaments from lateral and medial malloli attach to trasal bones and stabilize joint
    • Arches of foot supported by ligaments that distribute weight and return to normal position