Flashcards in Module 2 Quiz Deck (181):
What are the 3 major structural classifications of a joint?
Joints ______ movement
Muscles _________ movement
Ligament/joint capsules _______ movement
How is "muscles create movement" too simplistic?
Muscles create a force on the bones of a joint. It can create movement or stop/modify a movement.
What is the closed-packed position?
Position at which joint is most stable; usually result of max congruency and max ligament tightness
What is a congruent joint?
Articular surfaces of bones best fit each other
What is the open-packed position?
Any position of joint where combo of poor congruency and lax ligaments results in greater mobility and poorer stability
The more mobile a joint is, the less _____ it is (and vice versa)
What 3 factors determine the balance of mobility and stability of a joint?
1. Shape of bones
2. Ligament/joint capsule complex
3. Musculature of the joint (big ms = less mob)
What are the weight-bearing joints?
Almost all lower extremity joints and spinal joints
What is a fibrous joint?
Joint in which bones are held together by dense fibrous connective tissue
What is a cartilaginous joint?
Joint in which bones are held together by either fibrocartilage or hyaline cartilage
What is a synovial joint?
Joint in which bones are connected by a joint capsule, which is composed of 2 distinct layers (an outer fibrous layer and an inner synovial layer)
Which joints do not have a joint cavity?
Fibrous and cartilaginous
The articular ends of bones in a joint cavity are lined with what?
Hyaline cartilage (articular cartilage)
What is a synarthrotic joint?
Allows little to no movement
What is an amphiarthrotic joint?
Allows moderate amount of movement
What is a diarthrotic joint?
Allows a lot of movement
What are the 3 sub-types of synarthroses?
What are the 3 sub-types of fibrous joints?
What is a syndesmosis joint?
United by fibrous ligament or aponeurosis
What is a suture joint?
United by thin layer of fibrous material
What is a gomphosis joint?
Peg-in-hole shaped bones united by fibrous material
What type of joint is the interosseous membrane of the forearm?
What is synostosis?
Joint that has fused over with bone (ex: cranial suture joints)
What is the only gomphosis joint?
Teeth and mandible (movement only allowed early in life)
What kind of cartilage is in a cartilaginous joint?
Fibrocartilage or hyaline cartilage
2 sub-types of cartilaginous joints
What is a symphysis joint?
Fibrocartilage in form of disc unites bodies of 2 bones
What type of joint is intervertebral disc joint or pubic symphysis?
What is a synchondrosis joint?
Hyaline cartilage unites 2 bones
What type of joint is the costal cartilage between a rib and sternum?
What type of joints are wrist, elbow, shoulder, ankle, knee, hip?
What secretes synovial fluid into a joint cavity?
Inner synovial membrane layer
What is a ligament?
Fibrous structure that attaches from bone to bone
What is ligament primarily made of?
Why is it called "ligamentous/joint capsule complex"?
Some ligaments evolved independent of fibrous capsule; other ligaments never fully separated and are considered thickenings of the fibrous capsule
Are ligaments extra- or intra-articular (outside or inside the joint capsule)?
What is a muscle?
Soft tissue specialized to contract
What kind of tendon is the long head of the biceps at the shoulder joint? (intra or extra-articular?)
What is a uniaxial joint?
Allows motion around 1 axis in 1 plane
What is a biaxial joint?
Allows motion around 2 axes in 2 planes
What is a triaxial joint? (polyaxial)
Allows motion around 3 axes in 3 planes
What is a nonaxial joint?
Allows motion within a plane, but only gliding
What are 2 sub-types of uniaxial synovial joint?
What is a hinge joint?
Surface of one bone is spool-like and other bone is concave
Example of hinge joint
What is a pivot joint?
One surface shaped like a ring, other surface shaped to rotate within ring
Example of pivot joint
Atlantoaxial (atlas [C1] and odontoid process [dens, C2]), proximal radio-ulnar (radial notch of ulna and annular ligament)
2 sub-types of biaxial joint?
Condyloid (ovoid, ellipsoid)
What is a condyloid joint?
One bone concave, other convex
Example of condyloid joint?
MCP joint, radiocarpal joint
What is a saddle joint?
Modified condyloid joint; both bones has convexity and concavity to surface; convexity of one fits into concavity of other and vice versa
Example of saddle joint?
CMC (carpometacarpal), sternoclavicular
Which actions can condyloid joints perform?
What plane does flexion/extension occur in the thumb? Adduction/Abduction?
F/E occurs in frontal, Ad/Ab in sagittal (due to orientation of thumb)
If the saddle joint of the thumb moves in all three cardinal planes, why is it a biaxial joint?
Only allows motion around 2 axes
What is the only major type of triaxial synovial joint?
What kind of joints are intercarpal joints (between carpal bones) or facet joints?
Nonaxial synovial joints
What are menisci and articular discs? What are their function?
Additional intra-articular fibrocartilage that maximizes congruency of a joint - this maintains normal joint movements and cushion the joint.
What is an articular disc?
Ring-shaped fibrocartilaginous structure that increases joint congruency
What is a meniscus?
Crescent shaped fibrocartilaginous structure that increases joint congruency
Where would you find an articular disc?
Where would you find articular menisci?
Between tibia and femur
How many moveable elements of the spine?
How many bones in the coccyx?
What is a scoliosis?
Any spinal curve that exists from a posterior view of the spine
What is a left lumbar scoliosis?
Curve in lumbar spine convex to the left
What are the primary spinal curves?
Formed before birth (thoracic and sacrococcygeal)
What are the secondary spinal curves?
Formed after birth (lumbar and cervical)
What does kyphotic mean?
Concave anteriorly, convex posteriorly
What does lordotic mean?
Convex anteriorly, concave posteriorly
What creates cervical lordosis?
Baby lifting head to look around
What creates lumbar lordosis?
Baby extending the back to sit up
An adult curved spine is attained at approximately what age?
What are the 4 functions of the spine?
1. Structural support for body
2. Allow for movement
3. Protect the spinal cord
4. Shock absorption
At what joint does the head move relative to the neck?
At what joint does the pelvis move relative to the trunk?
What are the 2 ways the spine provides shock absorption from compression forces?
1. Nucleus pulposus absorbs force in disc
2. Curves of spine bend and increase slightly
A spinal joint such as C5-C6 is also referred to as a ___?
segmental level of the spine
What is the medial joint in a spinal segment?
Intervertebral disc joint
What are the 2 lateral joints in a spinal segment?
R/L facet joints
What is different about the medial spinal joint at the AOJ and AAJ?
They are not disc joints
What type of joint is the spinal disc joint?
Cartilaginous symphysis (amphiarthrotic)
What is a disc joint composed of?
1. Outer annulus fibrosus
2. Inner nucleus pulposus
3. 2 vertebral endplates
Discs account for how much of the spine's height?
The thicker a spinal disc is...
the greater the shock absorption and movement
How much body weight (%) is distributed between disc joint and facet joints?
80% of weight above = disc
20% of weight above = facet
What is the implication of a compressed disc joint?
Decreased opening of intervertebral foramina where the spinal nerves travel
What are symptoms of a pinched nerve?
Pain, numbness, weakness
What is the annulus fibrosus made of?
Nucleus pulposus is what % water?
Vertebral endplate is made of?
Fibro and hyaline cartilage
Importance of basket weave configuration of concentric layers of annulus fibrosus?
Resists and stabilizes disc joint during distraction, shear, and torsion forces
How do you keep the nucleus pulposus hydrated?
Thixotropy (movement of the spine)
What is a slipped disc?
Injury to the annulus fibrosus which allows nucleus pulposus to bulge or rupture through the fibers; can compress a nerve through bulging or thinning the disc
Where are vertebral facet joints located?
Between articular processes of 2 contiguous vertebrae (superior to inferior process)
What type of joint are facet joints?
Synovial plane joints (diarthrotic)
Orientation of facets in upper cervical spine?
Transverse plane (rotation)
Orientation of facets in mid-cervical spine
45 deg transverse/frontal plane (rotation and lateral flexion)
Orientation of facets in thoracic spine
Frontal (lateral flexion)
Orientation of facets in lumbar spine
Function of facet joints?
Guides motion in orientation best suited for that specific segment (but can glide in other directions)
Ligaments of the spine (9)?
Fibrous capsules of facet joints
Annulus fibrosus of disc joints
Anterior longitudinal ligament
Posterior longitudinal ligament
In what direction does a ligament limit motion?
Direction that is opposite itself (anterior ligament limits posterior motion)
What motions are allowed by spinal joints?
Translation (R/L, A/P, Sup/Inf)
What is the anterior longitudinal ligament?
Runs along anterior margins of vertebral bodies; limits extension
What is the posterior longitudinal ligament?
Runs along posterior margins of vertebrae in spinal canal; limits flexion
What are the ligamenta flava?
2 ligaments that run along L/R anterior margins of laminae in the spinal canal; limit flexion
What are the interspinous ligaments?
Separate short ligaments between adjacent spinous processes; limit flexion
What is the supraspinous ligament?
Runs along posterior margins of spinous processes; limits flexion
What are the intertransverse ligaments
Separate short ligaments between adjacent transverse processes; limit contralateral lateral flexion and rotation
What ligaments are absent in the neck compared to the spine?
What is the nuchal ligament?
Runs along and between spinous processes from C7 to external occipital protuberance; thickening of supraspinous ligament; limits flexion and is attachment for muscles
Which muscles attach to the nuchal ligament?
Serratus posterior superior
Muscles that produce spinal extension are where? Fiber direction?
Posterior trunk - vertical direction
Muscles that produce spinal flexion are where? Fiber direction?
Anterior trunk - vertical direction
Muscles that produce spinal lateral flexion are where? Fiber direction?
Side of body - vertical direction
(almost all flexors and extensors are also ipsilateral lateral flexors)
What is the joint between the occiput and C1
What is the joint between C1 and C2?
What type of joint is the AOJ?
Synovial condyloid (triaxial diarthrotic)
What is the median joint of the AAJ? The two lateral joints?
Median: atlanto-odontoid (posterior surface of anterior arch of atlas and anterior surface of odontoid process [dens] of axis)
Lateral: facet joints
What type of joint is the atlanto-odontoid joint?
What type of joint are the lateral facets of the AAJ?
Is AAJ uniaxial, biaxial, or triaxial?
When you turn your head from side to side (as in "no), majority of movement occurs at what joint?
Ligaments of the upper cervical (occipito-atlantoaxial) region (11)
Facet joint fibrous capsules of AOJ
Facet joint fibrous capsules of AAJ
Posterior AO membrane
Accessory atlantoaxial ligament
Cruciate ligament of the dens
Alar ligaments of the dens
Apical odontoid ligament
Anterior longitudinal ligament
Anterior atlanto-occipital membrane
What is a continuation of the ligamentum flavum in the cervical spine?
Posterior atlanto-occipital membrane (posterior arch of atlas and occiput)
What is a continuation of the posterior longitudinal ligament in the cervical spine?
What attaches the dens of the axis to the atlas and occiput?
Cruciate ligament of the dens (transverse, superior, and inferior bands)
What is the name of C7
What kind of spinous/transverse processes does the cervical spine have?
What is the uncinate process?
Superior surfaces of cervical vertebral bodies curve upward laterally
What is an uncovertebral joint?
Where lateral sides of 2 contiguous cervical vertebrae meet each other - add some stability
If the neck performs a lateral flexion, what other movement also occurs?
Ipsilateral rotation (due to facet joints in oblique plane)
Explain thorax vs abdomen
Thorax = thoracic spine region
Abdomen = lumbar spine region
On each rib, what are the 2 costospinal articulations with the spine?
What is the costovertebral joint?
Where the rib meets the bodies/discs of the spine
What is the costotransverse joint?
Where the rib meets the transverse process of the spine
What kind of joints are costovertebral and costotransverse?
Which ribs articulate with the sternum and therefore have sternocostal joints?
Why is the thoracic spine injured less often?
It is more stable (moves less) than cervical/lumbar spines
Why is proper movement of the rib joints extremely important?
The head of the rib forms the costovertebral joint how?
Attaches to the inferior costal hemifacet of the superior vertebra, and superior costal hemifacet of the inferior vertebra
Which ligament stabilizes the costovertebral joint?
What is different between rib 1 and ribs 2-10?
Rib 1 meets a full costal facet at superior end of body of T1 vertebra
Where does costovertebral joints form for ribs 11 and 12?
11 and 12 meet a full facet at the superior body of T11 and T12, respectively
Why don't ribs 11 and 12 have costotransverse joints?
They do not articulate with transverse processes of thoracic spine
What are the muscles of respiration?
Any muscles that have the ability to change the volume of the thoracic cavity - includes abdominal muscles
Primary muscle of inspiration?
Diaphragm (elevates lower 6 ribs)
What muscles are working during relaxed breathing?
Just the diaphragm
Which ribs are true? false? floating?
What kind of joints are sternocostal?
Cartilaginous synchondrosis (amphiarthrotic, gliding)
What are the 3 joints of the sternocostal joint?
Costochondral joint (rib and cartilage)
Chondrosternal joint (cartilage and sternum)
Interchondral joint (between cartilage of ribs 5-10)
What are the 2 intrasternal joints?
What is the common term for hyperlordosis?
The lumbar spine moves freely in all directions except...
Why does the lumbosacral joint region not allow sagittal plane motions (flexion/extension)?
Because the facets have changed from sagittal to frontal orientation
Why is the low back injured so often?
It needs a lot of stability for weight bearing, but it also allows for a lot of mobility
When the lumbar spine performs lateral flexion, what motion is also produced?
What are the large sheets of fibrous tissue located in the trunk? Where are they located? Function?
Thoracolumbar fascia (posterior trunk) and abdominal aponeurosis (anterior trunk)
Functions: attachment sites for muscles; add stability
How many layers of thoracolumbar fascia?
Spine Range of Motion
Flexion/Extension occurs in what plane? around what axis?
Lateral flexion occurs in what plane? around what axis?
Rotation occurs in what plane? around what axis?
Major muscles of spinal joints (general)?
Muscles of atlanto-axial region?
Rectus capitis anterior
Recuts capitis lateralis
ROM of C2-3 to C7-T1
ROM of C1-2 to C7-T1
Thoracic spine ROM
3 sub-types of rib joints
3 sub-types of sternocostal joints
Interchondral (manubriosternal, sternoxyphoid)
Abdominal breathing is primarily what body part?
Thoracic breathing is primarily what body part?
What does the sacral base angle determine?
Curve of the spine
Lumbar spine ROM?