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Bone, Joint, Cartilage &

Ligament
OT 5762
January 2016

1. Describe the five classifications of bones and examples for each classification
2. Define general purpose and types of bone markings/formations
3. Describe the two methods of bone development and compare/contrast
4. Describe the elementary principles of joint design and 2 categories of joints
5. Define arthrokinematics and osteokinematics and discriminate between the two
6. Describe the structure and function of the six major types of synovial joints
7. Describe the degrees of freedom for different synovial joints and usual planes/axes of
movement for these joint types
8. Describe the structures that contribute to joint stability and mobility.
9. Describe the role of ligaments and brainstorm positions that stretch ligaments in the body
(for example flexing the spine stretches the posterior longitudinal ligament)
10. Describe the role of cartilage and the types of cartilage in the body
11. Compare a closed kinematic chain with an open kinematic chain and give examples of each
12. Define and compare closed and loose-packed positions of a joint
13. Describe how joints are innervated; Hiltons Law
14. Describe Wolffs law and how bones can change based upon these principles
15. Describe the pathology and cause of osteoarthritis (degenerative joint disease)

Readings
Moore text: pgs. 2-16
Levangie text: pgs. 64-83, 88-104

Planes and Axes


Planes/axes: http://www.physicalsolutions.co.uk/articles/Understanding
%20Planes%20and%20Axes%20of
%20Movement.pdf

Planes and Axes

Picture source: http://www.physical-solutions.co.uk/articles/Understanding%20Planes%20and


%20Axes%20of%20Movement.pdf

Planes and Axes


Watch this video about planes and axes
https://www.youtube.com/watch?
v=WzM256oL3y8

Tissues of the Human Body


Epithelial tissue - very little extracellular
material between the cells (line the outer and
inner surfaces of the body such as skin, blood
vessel lining, pericardium)
Muscular tissue contractile cells
Nervous tissue conductible cells
Connective tissue - extra-cellular material
between the cells (bone, tendons, ligaments,
fat, blood)

Types of Connective Tissues


(including but not limited to):

Bone
Ligament
Cartilage
Tendon

Skin
Fat
Blood
Fascia

Connective Tissue
All connective tissue is made of
Cellular components
Chondroblast, fibroblast, osteoblasts, tenocytes, etc.

Extracellular components
Collagen
Elastin
Water

Different types of connective tissue vary in:


-Types of cellular components
-Proportion of extracellular components

Forces applied to connective tissue


Tension: distractive force (pull on
connective tissue)
carry a bucket, stretch a muscle

Compression: compressing force (push


together connective tissue)
weight bearing, gravity, fall on hand, jumping

Shear: forces in opposite directions at right


angles to the connective tissue
bend over, hit from the side

Different types of forces

Bone
Hardest connective tissue in the body
More collagen than elastin
60% water

Withstands greater compression (being pushed on) than tension


(being pulled on)
Living organ that

Hurts when injured nerve supply


Bleeds when fractured blood supply
Remodels in response to stress
Changes with age

Bone Layers
Periosteum - outside cover (except articulating surfaces)
Compact bone - (cortex) hard outer layer within
periosteum
Spongy/cancellous bone - inner bone
Medullary cavity - filled with
bone marrow
Yellow marrow stores fat
Red marrow creates blood cells

Blood supply - (Haversian system)

Bone Development
Intramembranous
ossification
(membranous bone
formation)
embryonic connective
tissue (mesenchyme)
begins ossification
during the fetal period
i.e., skull

Endochondral
ossification
(cartilaginous bone
formation)
embryonic connective
tissue (mesenchyme)
form cartilage models
bone replaces the
cartilage
i.e., most bones

Bone Development
Watch this video about the two types of
bone development
https://www.youtube.com/watch?v=p3PuLXp9Wg

Endochondral ossification in
long bones

Classification of Bones
Long bones
Tubular (humerus and
phalanges)

Short bones
Cuboidal (carpals and
tarsals)

Flat bones
Protective (sternum and
skull)

Irregular bones
Other types of bones
(vertebra)

Sesamoid bones
Develops within a tendon
(patella)

Classification of bones

Bone Markings & Formations


Serve as attachments for muscles, grooves to protect
tendons/nerves/vessels, facilitate articulations between bones

condyle
crest
epicondyle
facet
foramen
fossa
groove
line

malleolus
notch
protuberance
spine
spinous process
trochanter
tubercle
tuberosity

Bone Markings & Formation


Watch this video describing different bone
markings and formations
https://www.youtube.com/watch?
v=WZ_JF2yKWWg

Bone Markings & Formation


Bone markings flashcards
http://quizlet.com/3792064/bone-markingtypes-flash-cards/
These flashcards are for your reference. It is
not necessary that you know these
definitions for this class, but they may be
used to help you review the material.

Bone Markings & Formation

Bone Remodeling
Bone has the ability to remodel, alter its
size, shape and structure to meet the
mechanical demands placed on it
Gains or loses cancellous and/or cortical
bone in response to the level of stress
Wolffs law states the remodeling of bone
is influenced by mechanical stresses

Wolffs Law

Wolffs Law
Watch this video explanation of bone
remodeling and Wolffs Law
https://www.youtube.com/watch?
v=yENNqRJ2mu0

Cartilage
Flexible connective tissue that forms a model for bony
growth, makes up certain body parts, covers the end of
bones & buffers between joints
3 types
white fibrocartilage-intervertebral discs, labrum
yellow elastic cartilage-ears, epiglottis
hyaline articular cartilage-articular cartilage

Cellular component: chondroblasts/cytes


Extracellular components: vary by type
Up to 85% water
No blood supply or nerves, limited healing

Types of cartilage
Fibrocartilage
Bonding cement in joints with little motion
IV discs, labrum, menisci
Only type I collagen

Elastic cartilage
In ears and epiglottis
Contains mostly elastin
Has elastic recoil

Hyaline cartilage
Smooth covering on bone ends in synovial joints
Contains more glycoproteins than other cartilages

Ligaments
Bind bones together at joints
20% cellular component: fibroblasts
80% extracellular component: more collagen
than elastin; yet varies in ligament

70% water
Resists forces in more than 1 direction
Withstand compression, tension, and shear
forces

Tendons
Connect muscle to bone
Small cellular component: fibroblasts
Large extracellular component:
collagen and elastin proportions vary
Resists high unidirectional tensile
forces
75% water
Withstands greater tension than shear
Most vulnerable at the ends

Muscles
Provides mobility and stability at the joints
Consist of muscle tissue (contractile tissue)
wrapped in connective tissue and connected
to the bones by connective tissue
tendons, tracts, aponeurosis

Vary by type, size, fiber content, etc


More about muscles in future classes

Connective tissue changes


Connective tissue changes structure and
function in response to internal and external
forces applied to the tissue
Viscoelasticity
elastic: ability of material to return to original
state following deformation of shape/length
viscosity: ability of material to dampen
shearing forces

Viscoelasticity
Connective tissue will return to previous
shape after deforming force unless force is:
applied for a long duration
a high magnitude force gradually increased in
intensity
applied to a higher-temperature tissue

Response to Force
Elastic region
deformation only temporary, returns to normal
shape after force removed

Plastic region
deformation permanent after load removed

Ultimate failure
load continues in plastic range and the tissue
ruptures, avulses or fractures

Joints
Union of 2 or more bones
Can be simple or complex depending on function
Stability - ends of bones fit together and are braced
with capsules, ligaments, tendons (i.e., knee)
Mobility- ends of bones fit together and capsules
are filled with synovial fluid, occasionally cartilage
wedges are present (i.e., shoulder)
Need some stability in order to have mobility

Two Joint Categories


Synarthroses
bones are directly
joined by connective
tissue - no to minimal
movement
1. Fibrous joints fibrous
tissue unites the bones
2.Cartilaginous joints
fibrocartilage connects
the bones

Diarthroses
bones are indirectly
joined by a capsule
with - moderate to
maximal movement
Also called
synovial

Joints
Watch this video about types of synarthrotic
joints/ joint structure:
https://www.youtube.com/watch?
v=FknWsN9EVJA

Fibrous Joints (synarthrosis)


Suture

Gomphosis

Ends of bones
interlock and are
united by a thin
layer of dense
fibrous tissue
Sutures between
skull bones

Syndemosis

Bones adapted to
each other and
united by fibrous
tissue

Bones joined directly


by a ligament, cord
or aponeurotic
membrane

Tooth into
mandible or
maxilla

Interosseous
membrane between
fibula and tibia

Suture joint

Gomphosis joint

Syndemosis joint

Cartilaginous Joints (synarthrosis)


Symphysis

Synchondrosis

Bones joined by
fibrocartilaginous
discs or plates

Parts of the bone are


joined by hyaline
growth cartilage

Pubic symphysis,
IV discs

Epiphyseal plate in
long bones, 1st
sternocostal joint

Symphysis joint

Synchondrosis joint

Synovial Joint Construction


(diarthrosis)
Joint capsule formed of fibrous tissue
Joint cavity contains synovial fluid
Synovial membrane lining inner surface of
the capsule
Synovial fluid forms a film over the joint
surfaces
Hyaline cartilage covers the joint surfaces

Synovial Joint

Types of Synovial Joints


Uniaxial
Hinge
Pivot

Biaxial
Condyloid
Saddle

Triaxial
Plane
Ball and socket

Synovial Joints - uniaxial


Hinge
Joint surfaces designed to allow motion in a
sagittal plane only
Flexion and extension

Joint capsule is thin and lax


Bones are joined by strong collateral ligaments
Interphalangeal joints of fingers, elbow joint

Hinge joint

Synovial Joints - Uniaxial


Pivot
1 surface shaped like a ring and other shaped to
rotate within the ring
Movement occurs in the horizontal plane only
around vertical axis
Ligaments surround the socket
Dens of C1- atlas around C2 - axis vertebrae

Pivot joint

Synovial Joints - biaxial


Condyloid
Concave surface of 1 bone slides over convex
surface of other
Sagittal (flex/ext) & Frontal planes (abd/add)
Metacarpal-phalangeal joint of the fingers

Condyloid joint

Synovial Joints - biaxial


Saddle
Each joint surface is convex in 1 plane and
concave in other - like a rider in a saddle
Motions in 2 planes (flex/ext) & (abd/add)
Carpometacarpal joint of the thumb

Saddle joint

Synovial Joints - triaxial


Plane
Adjacent joint surfaces glide or rotate on each
other
Small joints with minimal movement in all
planes
Carpal joints in the wrist

Plane joint

Synovial Joints - triaxial


Ball-and-socket
Ball-like convex surface fits into a concave
socket
Large joints with maximal movement permitted
in all planes
Gleno-humeral joint of the shoulder; hip joint

Ball-and-socket joint

Summary of Synovial Joints in


the Body

Synovial Joints
Watch this video describing the six different
kinds of synovial joints
http://study.com/academy/lesson/the-sixtypes-of-synovial-joints-examplesdefinition.html

Hiltons Law
States that the nerves supplying a joint
also supply the muscles moving the
joint or the skin covering their
attachments

Hiltons Law
For example:
Musculocutaneous
nerve supplies
innervation to muscles
that move the elbow,
as well as, pain and
proprioception

Kinematic chain
Linkage of a series of joint in such a way
that motion at one of the joints in the series
is accompanied by motion at an adjacent
joint
2 types
Open
Closed

Kinematic chains
Closed chain
distal end of the joint
linkage (limb) is fixed
motion occurs in a
predictable fashion
joints are interdependent

Open chain
distal end of the
joint linkage (limb)
is free
motion occurs in
various fashions
joints may function
independently or in
unison

Free
Fixed

Osteokinematics
(osteo = bone; kinematics = movement)
Movement of the bones
Flexion/extenstion
Abduction/adduction

Movement that is measured in ROM


Determined by shape of the joint surfaces, joint
capsule, ligaments, muscle bulk, tendons, and
bones
ROM is normal, hypermobile, or hypomobile
dependent on bony and soft tissue

Arthrokinematics
(arthro = joint; kinematics = movement)

Movement of 1 joint surface in relation to


another with 1 surface a more stable base
Type of movement which occurs at a joint
depends on the shape of the articular surface
Motion can be roll, slide, or spin

A combination of these motions keep opposing


joint surfaces in contact and increases ROM

Convex surface is moving on fixed concave


surface
Convex articulating surface moves in a
direction opposite the direction traveled by
the shaft of the bone

Fixed bony lever

Concave surface is moving on a fixed convex


surface
Concave articulating surface moves in the same
direction as the remaining portion of the bony
lever

If humerus did not both roll and slide, it


would roll out of glenoid fossa

Arthrokinematics
Closed pack position - joint surfaces are
maximally congruent and ligaments and joint
capsule are maximally taut, so joint is most
stable
Usually at extreme end of ROM
Little to no joint play
Elbow, knee, and IP extension

Arthrokinematics
Loose pack position - joint surfaces are
relatively free to move in relation to the
other, so structures are more lax
Any position other than closed-pack
MP extension

Joint Play
Joint play is the non-voluntary movement of
one articular surface on another
Assessed by therapists movement of joint
Too lax = instability
Too tight = restricted movement

Osteoarthritis
Degenerative joint disease
Leads to degradation of joint

Cartilage becomes less effective as shock


absorber and lubricating surface
Articulation between bones becomes vulnerable
to friction
May cause pain, stiffness, discomfort, inactivity

Osteoarthritis

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