MSK/Movement Flashcards
Joints
Head & Neck
- Craniovertebral joints
- Temporomandibular joints
Pectoral Girdle
- Acromioclavicular joints
- Sternoclavicular joints
Thorax
- Sternal Angle
- Costochondral joints
- Sternocostal joints
Pelvic Girdle
- Sacroiliac joints
- Pubic symphysis
Upper Limb
- Shoulder Joints
- Elbow Joints
- Distal & Proximal Radioulnar Joints
- Wrist Joints
- Metacarpophalangeal joints
- Interphalangeal joints (Proximal & Distal)
Lower Limb
- Hip Joints
- Knee Joints
- Proximal & Distal Tibiofibular Joints
- Ankle Joint
- Subtalar Joints
- Midtarsal joints
- Interphalangeal joints (Middle, Proximal, Distal)
Nerve Supply and Arterial Supply of Joints
Sensory nerve supply - sensory receptors detect pain, touch, temperature, proprioception
Arteries supplying joints arise from large name arteries near joint - articular branches
Periarticular arterial anastomoses are common
Fibrous Joint
Limited mobility
Quite stable
Syndesmoses - unite bones with fibrous membrane sheet
Sutures - between bones of skull
Fontanelles - wide sutures in neonatal skull (anterior, posterior, lateral), allow growth skull bones to slide over each other, makes baby’s head smaller for birth canal
Cartilaginous Joint
Limited mobility
Relatively stable
Primary
- Synchondroses
- Bones joined by Hyaline cartilage
- Permit growth in bone length
- Ossification and fusion
- Slipped femoral epiphysis (in relation to growth plate)
Secondary
- Symphyses
- Strong
- Slightly moveable
- Fibrocartilage
- Slipped disc - compress spinal cord
- I.e. intervertebral discs (outer fibrous annulus fibrosus, inner soft nucleus pulposus)
Synovial Joint
Features
- 2 or more bones articulating
- Articular surfaces (hyaline articular cartilage)
- Capsule around joint
- Joint cavity (with synovial fluid)
- Supported by ligaments
- Associated with skeletal muscle and their tendons
- Associated with bursae (prevent friction, extension of cavity)
- Special features
5 types
- Pivot
- Ball & Socket
- Plane
- Hinge
- Biaxial
Mobility & Stability
Type of joints dictates this
Synovial is the most mobile and then cartilaginous and fibrous
Shape & Fit
- Shoulder joint has greater mobility than hip joint but this means the shoulder joint can dislocate more easily
- Shoulder joint has a shallow pocket
- Hip joint has a deep pocket
Direction of Movement
Shapes of articular surfaces determines possible movements
Subluxation & Dislocation
Subluxation –> Reduced area of contact between articular surfaces
Dislocation –> Complete loss of contact between articular surfaces
Common Dislocations
Craniovertebral Joint
Temporomandibular joint
Shoulder joint
Elbow joint
Interphalangeal joint
Acromioclavicular joints
Hip joints
Pubic symphysis
Knee Joints
Ankle joints
The Temporomandibular Joints
Synovial articulation between mandibular fossa and the articular tubercle of the temporal bone superiorly and the head of the condylar process of the mandible inferior
Skeletal Muscle
Structure
Skeletal muscle produce movement
Skeletal muscles usually found deep to deep fascia
Tough fibrous CT covering
Types
- Circular
- Fusiform
- Flat with aponeurosis
- Pennate
- Quadrate
Longer muscle fibres have a greater potential of shortening and greater potential range of movement at joint
Naming
- Shape
- Location
- Size (minor/major)
- Main bony attachment
- Main action/movement
Attachment
- At least 2 points of attachment to bone (origin and insertion)
- Function (move origin and insertion closer together during contraction, muscle fibres shorten along long axis)
- Tendons attach muscle to bone
- Aponeurosis is a flattened tendon (attach muscle to soft tissue)
Direction of Movement
Depends on which side of the joint the muscle spans
E.g. Biceps brachii
- Spans shoulder joint anteriorly = flexes arm
- Spans elbow joint anteriorly = flexes forearm
- Spans proximal radioulnar joint anteriorly = supination of forearm
E.g. Deltoid
- Posterior fibres = shoulder extension
- Middle fibres = abduction of shoulder
- Anterior fibres = flexion of shoulder
Clinical Examination of Joints
Testing ability to move and power of movement
Testing muscles and nerves supplying it
Testing relfexes
Reflexes
Protective
Automatic
Stretch Reflex
- Deep tendon reflex
- Tendon hammer (sudden stretch to muscle via tendon
- Normal reflex to being stretched = contract
- Reflex contract = brief twitch of muscle belly or movement in normal direction
- Reflexes are protective against overstretching
- Sensory nerve (detect stretch) –> Spinal Cord (synapse between sensory and motor nerves) –> Motor nerve –> Muscle (contract)
- Neuromuscular junction (where synapse between motor nerve and skeletal muscle is)
- Action potential route –> reflex arc
- Descending controls from brain
Flexion withdrawal reflex
- Sudden flexion to withdraw from danger
- Nerve connections at spinal cord level (brain not involved)
Paralysis
Muscle without a functioning motor nerve
No contraction
Muscle would have reduced tone
