Bone, joint, cartilage & ligament lecture

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Describe the five classifications of bones

Long bone tubular (humerus)
Short bones cuboidal, found only in the ankle (tarsus) and wrist (carpus)
Flat bones serve protective functions (skull)
Irregular bones various shapes (facial bones)
Sesmoid bones develop in certain tendons and are found where tendons cross the ends of
long bones in the limbs (patella)

Define various bone markings and formations

Capitulum small, round, articular head
Condyle rounded, knuckle like articular area
Crest ridge of bone (iliac crest)
Epicondyle eminence superior to a condyle (lateral epicondyle)
Facet smooth flat area, usually covered with cartilage (vertebrae/rib)
Foramen passage through a bone (vertebral foramen)
Fossa hollow or depressed area (infraspinous fossa of scapula)
Groove elongated depression or furrow (bicupital groove of humerus)
Head large, round articular end (head of humerus)
Line linear elevation
Malleolus rounded process
Notch indentation at the edge of a bone
Protuberance projection of bone (occipital protuberance)
Spine thorn-like process
Spinous process projecting spine-like part
Trochanter large blunt elevation
Trochlea spool-like articular process or process that acts as a pulley
Tubercle small raised eminence (greater tubercle of humerus)
Tuberosity large rounded elevation (ischial tuberosity)
Describe bone development and compare the two types
Intramembranous ossification
Direct ossification of the mesenchyme begins in the fetal period. Forms woven bone,
which then becomes lamellar.
Formed from connective tissue. i.e. the skull
Endochondral ossification
Cartilage models of the bones from mesenchyme during the fetal period and bone
subsequently replaces most of the cartilage. Occurs in primary and secondary
ossification centers
Formed from cartilage. Most bones

4.

Describe the elementary principles of joint design

joint: articulation, or the place of union or junction, between two or more rigid components
(bones, cartilages, or even parts of the same bone.)

A joints design is determined by its function (multiple functions, more complex)

Stability - ends of bones fit together and are braced with capsules, ligaments, tendons
Mobility - ends of bones fit together and capsule are filled with synovial fluid, occasionally
cartilage wedges are present
Need some stability in order to have mobility

Synovial membrane lines the inner surface of the capsule

Synovial fluid forms a film over the joint surfaces
Hyaline cartilage covers the joint surfaces

5.

Define arthrokinematics and osteokinematics and discriminate between the two

Arthrokinematics describes the movement of one joint surface in relation to another. Impacts
osteokinematics. Movement depends on joint surface and can slide, roll, or spin.
Osteokinematics describes the movement of bone segments in space. Determined by joint
surface, capsule, ligaments, tendons and other bones. Can be defined by type of motion
(rotary motion at a joint), location of motion (plane of movement), and magnitude of motion (arc
moved through).

6.
Describe the three major joint classifications and their characteristics
Functional Classifications:
o Synarthrosis nonmovable bones are directly joined by connective tissue
Amphiarthosis slightly movable
Diarthrosis freely movable
Structural Classifications
o Fibrous - fibrous tissue unites the bones
o Cartilaginous - fibrocartilage connects the bones
o Synovial- (diarthroses) - bones are indirectly joined by a capsule with - moderate to
maximal movement
7.
Describe the structure and function of the six major types of synovial joints
Pivot joint 1 one surface shaped like a ring, the other is shaped to rotate within the ring.
Movement in horizontal plane around vertical axis. Ligaments around the socket. Permit
rotation around a central axis. (ie. Atlas and axis).
Hinge joint 1 permit flexion and extension only in sagittal plane, joint capsule is thin and lax ,
joined by strong ligament (ie. IP joints of finger and elbow joints).
Saddle joint 2 each surface is convex in one plane and concave in another. permit abduction
and adduction as well as flexion and extension, opposing articular surfaces are shaped like a
saddle. Example: CMC of thumb
Condyloid joint 2 concave surface and convex surface. Sagittal (flex) and frontal (abd).
Example: MP joint of fingers, wrist
Plane joint 3 permit gliding or sliding or rotating movements, opposing surfaces are flat or
almost flat. Small joints with minimal movement. Carpals
Ball and socket joint 3 allow movement in multiple axes and planes. Large joints with
maximal movement. Shoulder, hip.
8.

Describe the degrees of freedom and planes/axis of movement of joints in the body
i.e. the shoulder has 3 DoF
o Shoulder external/internal rotation

o Adduction/abduction
o Flexion/extension
9.

Describe the structures that contribute to joint stability and mobility.

Hyaline cartilagemobility
Syonovial fluidmobility
Joint capsulestability
Ligamentstability
Muscle/tendonstability (deep muscle), mobility (superficial muscle)

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Describe the role of ligaments and brainstorm positions that stretch ligaments in the
body (for example flexing the spine stretches the posterior longitudinal ligament)
Extending the spine would flex the anterior longitudinal ligament
Describe the role of cartilage and the types of cartilage in the body
Cartilage is softer than bone(more water, no mineral) but more resilient. Cartilage doesnt
regenerate because its avascular.
Hyaline articular cartilage-articular cartilage (ribs)
o Hyaline cartilage is the thin covering on the end of most bones at joints which
provides a smooth articular surface
Elastic cartilage-ears, epiglottis
Fibrocartilage-intervertebral discs, labrum, menisci

Compare a closed kinematic chain with an open kinematic chain

Closed chain distal end of the joint is fixed, motion occurs in a predictable fashion, joints are
interdependent (standing, push up)
Open chain distal end of the joint is free, motion occurs in various fashions, joints may
function independently or in unison (waving hand, kicking ball)
Define closed and loose-packed position and compare the close and loose-packed
positions of a joint
Close packed joint surfaces are maximally congruent and ligaments and joint capsule are
maximally taut, so joint is most stable (knee extended)
Loose packed joint surfaces are relatively free to move in relation to the other, so structures
are more lax. Loose ligaments and joint incongruence.
Describe the effect of the close and open pack position on motion and stability
Closed pack position - joint surfaces are maximally congruent and ligaments and joint capsule
are maximally taut, so joint is most stable (elbow, knee, and IP extension). More stable, less
movement.
Loose pack position - joint surfaces are relatively free to move in relation to the other, so
structures are more lax (MP extension). Less stable, more movement. Joint play is performed
at loose pack position.
Describe how joints are innervated; Hiltons Law
Hiltons Law states that the nerves supplying a joint also supply the muscles moving the joint or
the skin covering their attachments

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Describe Wolffs law and how bones can change based upon these principles
States the remodeling of bone is influenced by mechanical stresses (walking, etc.)

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Describe the pathology and cause of osteoarthritis (degenerative joint disease)

Destruction of cartilage and bone. Rheumatic disease (age, gender, heredity, obesity, joint
abnormalities, injury and joint overuse) where cartilage in joints breaks down, causing pain and
stiffness. Can be limited to specific joints. Cartilage wears away and bone ends thicken and
bony growths (osteophytes) appear where cartilage used to be.
Describe the osteokinematics/arthrokinematics that occur at the joint with motion
Osteokinematics
o Determined by shape of the joint surfaces, joint capsule, ligaments, muscle bulk,
tendons, and bones
o ROM is normal, hypermobile, or hypomobile dependent on bony and soft tissue
Arthrokinematics
o Movement of one joint surface in relation to another with one surface as more stable
base
o Roll - rolling of 1 joint surface on another, as in a tire rolling on the road (femoral
condyles rolling on tibia)
o Sliding - gliding of 1 component over another, as when a braked wheel skids (prox
phalanx on metacarpal)
o Spin - rotation of the movable component, as when a top spins, a pure rotatory
motion (radius on humerus in pron/sup)

Humerus
o
o
o
o
o
o
o
o
o
o

Scapula

Humeral head
Greater tubercle
Lesser tubercle
Intertubercular sulcus
aka bicipital groove
Deltoid tuberostiy
Radial groove or spiral groove
Medial epicondyle
Lateral epicondyle
Olecranon fossa

o
o

glenoid cavity aka glenoid fossa

supraglenoid tubercle

Biceps brachii
o Origin:
Short head: tip of coracoid process of scapula
Long head: supraglenoid tubercle of scapula
o Attachment:
Tuberosity of radius and fascia of forearm
o Innervation:
Musculocutaneous nerve
o Action:
Supinates forearm and flexes it (when supinated)
Flexes arm
o Bicipital tendon: the tendon that joins the short and long heads to their attachments
o Bicipital Aponeurosis: the layers of flat tendons, located at the cubital fossa, and seperates
superficial from deep structures
o The aponeurosis reinforces the cubital fossa, and helps to protect the brachial artery and the
median nerve running underneath.

o
Brachialis
o Origin:
distal half of anterior surface of humerus
o Attachment:
coronoid process and tuberosity of ulna
o Innervation:
Musculocutaneous nerve
o Action:
Flexes forearm in all positions

o
Coracobrachialis
o
o
o
o

Origin:
Tip of coracoid process of scapula
Attachment:
Middle third of medial surface of humerus
Innervation:
Musculocutaneous nerve
Action:
Helps flex and adduct arm

Veins
Cephalic vein*
Basilic vein
Median cubital vein

Arteries
Subclavian artery*
Axillary artery*
Brachial artery
o Deep Brachial
o Radial artery
o Ulnar artery