EXSS 175 Week 6 Notes
EXSS 175 Week 6 Notes EXSS 175
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This 10 page Class Notes was uploaded by Lynde Wangler on Saturday February 20, 2016. The Class Notes belongs to EXSS 175 at University of North Carolina - Chapel Hill taught by Dr. Johna Register-Mihalik in Spring 2016. Since its upload, it has received 11 views. For similar materials see HUMAN ANATOMY in Physical Education at University of North Carolina - Chapel Hill.
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Date Created: 02/20/16
EXSS 175 Week 5 Notes 4A Articular System Articular System: Joints o Hold bones together but permit movement; point of contact occurs between 2 bones, between cartilage and bone, or between teeth and bones; arthrology = study of joints; kinesiology = study of motion Classification of Joints: o Based on the presence or absence of a synovial (joint) cavity and type of connecting tissue… Structural classification (of joints) – fibrous, cartilaginous, and synovial Functional classifications (based upon movement) – immoveable: synarthrosis; slightly moveable: amphiarthrosis; freely moveable: diarthrosis Fibrous Joints: o Lack a synovial cavity; bones held closely together by fibrous connective tissue; little or no movement (synarthroses or amphiarthroses); 3 structural types: Sutures Syndesmoses Gomphoses (hold teeth in place) Fibrous Joints: Sutures – thin layer of dense fibrous connective tissue unites bones of the skull; immovable (synarthrosis); fuse completely in adults and become a synostosis (i.e. frontal bone) Fibrous Joints: Syndesmosis – bones united by ligament; slightly moveable (amphiarthrosis); ex. anterior tibiofibular ligament and interosseous membrane Fibrous Joints: Gomphosis – ligament holds cone-shaped peg in bony socket; immoveable (synarthrosis); ex. teeth in alveolar processes Cartilaginous Joints o Lacks a synovial cavity; allows little or no movement; bones tightly connected by hyaline cartilage or fibrocartilage; 2 types of joints– synchondroses and symphyses (most common one is the pubic symphysis Cartilaginous Joints: Synchondrosis – connecting material is hyaline cartilage; immoveable (synarthrosis); ex. epiphyseal plate (growing bones) or joints between ribs and sternum (costal (hyaline) cartilage) Cartilaginous Joints: Symphysis – fibrocartilage is connecting material; slightly moveable (amphiarthroses); ex. intervertebral discs and pubic symphysis Synovial Joints o General Structure: o 1) Joint Cavity – separates articulating bones o 2) Articular Cartilage – reduces friction, absorbs shock o 3) Articular Capsule – synovial membrane (secretes synovial fluid containing slippery hyaluronic acid allowing joint to move more easily; brings nutrients to articular cartilage; cartilage itself is avascular); fibrous capsule (provides stability and gives it structural strength) o 4) Synovial Fluid – separates articulating bones; joint lubrication; shock absorption; supply oxygen and nutrient to articular cartilage o 5) Accessory ligaments and discs – extracapsular ligament (thickenings of fibrous capsule; MCL for example) and intracapsular ligament (inside the articular capsule) o 6) Articular Discs (menisci) – subdivide the synovial cavity to allow separate movements; allow 2 bones of different shape to fit tightly; increase joint stability; also help with shock absorption to some (debated) extent Synovial Joint: Articular Capsule o Surrounds a diarthrosis, encloses the synovial cavity, and unites the articulating bones; the articular capsule is composed of two layers: Outer fibrous capsule (may contain ligaments) Inner synovial membrane (secretes synovial fluid) o The flexibility of the fibrous capsule permits considerable movement at a joint, whereas its great tensile strength helps prevent bones from dislocating; other capsule features include ligaments (thickening in the fascia) and articular fat pads (fatty deposits that help to protect the joint) Bursae and Tendon Sheaths: o Bursae – fluid-filled saclike extensions of the joint capsule; reduce friction between moving structures (skin rubs over bone, tendon rubs over bone, and ligament rubs over bone) (ex. greater trochanter bursa sac – trochanter bursitis is common in runners) o Tendon Sheaths – tube-like bursae that wrap around tendons at wrist and ankle where many tendons come together in a confined space; important because they help tendons slide on each other without the constant rubbing o Bursitis – chronic inflammation of a bursa (attempt to protect the joint itself) Nerve and Blood Supply: joint capsule and ligaments contain pain fibers and sensory receptors; blood supply to the structures of a joint are branches from nearby structures (supply nutrients to all joint tissues except the articular cartilage which is supplied from the synovial fluid) Types of Synovial Joints: Planar Joints, Hinge Joints, Pivot Joints, Condyloid Joints, Saddle Joints, Ball-and-socket Joints (all types of synovial joints are functionally classified as diarthrosis) o Planar Joint – bone surfaces are flat or slightly curved; side to side movement only; rotation prevented by ligaments; ex. intercarpal or intertarsal joints, sternoclavicular joint, vertebrocostal joints between vertebral bodies and ribs o Hndge Joint – convex surface of one bone fits into concave surface of 2 bone; uniaxial like a door hinge; ex. knee, elbow, ankle, IP joints; movements produced Flexion: decreasing the joint angle Extension: increasing the joint angle Hyperextension: opening the joint beyond the anatomical position o Pivot Joint – rounded surface of bone articulates with ring formed by 2 nd bone and ligament; monoaxial since it only allows rotation around longitudinal axis; ex. proximal radioulnar joint, supination, pronation, atlanto-axial joint (turning head side to side “no”) o Condyloid or Ellipsoidal Joint – oval-shaped projection fits into oval depression; biaxial = flex/extend or abduct/adduct is possible; ex. wrist and metacapophalangeal joints for digits 2 to 5 o Saddle Joint – one bone is saddle-shaped and the other bone fits as a person would sitting in that saddle; biaxial: (only found in the thumbs) Circumduction – allows tips of thumb to travel in circle Opposition – allows tip of thumb to touch tip of other fingers Ex. trapezium of carpus and metacarpal of the thumb o Ball and Socket Joint – ball fitting into a cuplike depression; multiaxial (flexion/extension, abduction/adduction, and rotation); ex. shoulder joint and hip joint o Common Joint Injuries: Sprain – injury to the ligament/joint capsule; twisting of joint that stretches or tears ligaments; ex. ankle sprain Strain – injury to the muscle/tendon; ex. hamstring strain Grade 1 (mild stretching of the fibers), Grade 2 (increased stretching of the fibers with some structural damage) and Grade 3 (complete rupture) Dislocation – bones are forced out of their normal positions at joint; ex. shoulder dislocation or fingers Cartilage damage – tearing of the cartilage; meniscus tear o Osteoarthritis: Degenerative joint disease (aging, wear and tear); Non- inflammatory no swelling – only cartilage is affected not synovial membrane; deterioration of cartilage produces bone spurs (restricts movement); pain upon awakening (disappears gradually with movement) 4B Selected Joints of the Body o Temporomandibular Joint (TMJ); Shoulder joint (glenohumeral) – Acromioclavicular joint (AC Joint) and Sternoclavicular Joint (SC Joint); Elbow Joint; Hip Joint; Knee Joint \ Temporomandibular Joint (TMJ): o Combined hinge and planar joint; formed by the: Condylar process of the mandible Mandibular fossa and articular tubercle of the temporal bone o Movements include opening and closing and protraction and retraction of the jaw; **only moveable joint of all skull joints o When dislocation occurs, the mouth remains open because the muscles aren’t able to close it as they typically should Temporomandibular Joint: synovial joint, articular disc, gliding above disc, hinge below disc, movements (depression, elevation, protraction, and retraction) Shoulder Joint: ball-and-socket formed by the head of the humerus and the glenoid cavity of the scapula (allows a lot of motion at the expense of stability) o Movements – flexion/extension; abduction/adduction; medial/lateral rotation; circumduction o Rotator cuff injury and dislocation (GH) or separated (AC) shoulder are the most common injuries to this joint Glenohumeral (Shoulder) Joint – articular capsule from glenoid cavity to anatomical neck; glenoid labrum deepens socket; many nearby bursa (subacromial) if bursa becomes inflamed, it puts pressure on long head of biceps tendon and can cause a lot of pain Supporting Structures at Shoulder: AC Joint – associated ligaments strengthen joint capsule; transverse humeral ligament holds biceps tendon in place (unique in that it doesn’t connect two bones but two bony prominences together – greater and lesser tubercles) Rotator Cuff Muscles – attach the humerus to the scapula; encircle the joint supporting the capsule; hold head of humerus in socket Elbow Joint: Humeroulnar Joint o Hinge joint formed by the trochlea of the humerus, the trochlear notch of the ulna, and the head of the radius o Movements at this joint are flexion and extension of the forearm o Common Pathologies: tennis elbow (lateral epicondylitis), Golfer’s elbow (medial epicondylitis), dislocation of the radial head (common in youth) medial lateral epicondyles are a major attachment site for many of the muscles of the forearm o Articular Capsule of the Elbow Joint – radial annular ligament hold head of radius in place; collateral ligaments maintain integrity of joint (damaged in baseball players) Wrist Joints: o Distal radioulnar joint – pivot, supination/pronation o Radiocarpal joint – condyloid/ellipsoidal; flexion/extension; abduction/adduction; circumduction Hand Joint: o Intercarpal Joints – gliding o Carpometacarpal (CMC) – gliding o Metacarpophalangeal (MCP) – condyloid; “knuckles;” flexion/extension; abduction/adduction o Interphalangeal (IP) – hinge; flexion/extension Wrist & Hand Joints o Stability provided by ligaments; extrinsic ligaments: attach between carpal bones & radius or metacarpals Ulnar collateral ligament Radial collateral ligament o Intrinsic ligaments – originate and insert on the carpal/metacarpal bones; ulnar and radial collateral ligaments of the MCP, PIP, and DIP joints Radial Collateral Ligament: o Attaches from the radial styloid process to the scaphoid bone and a portion of the trapezium bone; limits excessive ulnar deviation Ulnar Collateral Ligament: o Attaches from the ulnar styloid process to the triquetral bone and the pisiform form; limits excessive radial deviation Flexor Retinaculum: o Also referred to as the transverse carpal ligament; attaches from the hook of hamate and pisiform (medially) to the tubercle of the trapezium and tuberosity of the scaphoid (laterally); forms the roof of the carpal tunnel Carpal Tunnel: located on anterior surface of wrist; contents of the tunnel are contained y the flexor retinaculum; anatomical structures of the carpal tunnel: median nerve, finger flexors, flexor pollicis longus 4C Hip Joint: o 3 major areas Hip joint proper – head of femur in acetabulum Sacroiliac joint Symphysis pubis – junction between pubic bones Hip Joint Proper: ball-and-socket joint is formed by the head of the femur and the acetabulum of the hip bone; sacrifices mobility for stability; movements at this joint include… Flexion/extension Abduction/adduction Circumduction Medial and lateral rotation of the thigh o This is an extremely stable joint due to the bones making up the joint and the ligaments and muscles o Hip Joint: head of femur and acetabulum of hip bone; ball and socket type of joint; all types of movement possible because it is a ball-and- socket joint o Hip Joint Structures: acetabular labrum (deepens socket and causes negative pressure to help hold it in place), ligament of the head of the femur, articular capsule Hip Joint Capsule: o Dense, strong capsule reinforced by ligaments – iliofemoral ligament (two parts; wide ligament), ischiofemural ligament, pubofemural ligament Hip Joint Ligaments: o Iliofemoral ligament – one of the strongest ligaments in the body; from the AIIS to intertrochanteric line; prevents hyperextension o Pubofemoral ligament – pubic portion of acetabular rim to neck of femur; prevents excessive abduction o Ischiofemoral ligament – ischial portion of acetabular rim to neck of femur; prevents hyperextension; weakest of the three hip proper ligaments All three limit medial rotation of the hip Sacroiliac (SI) Joint o Synovial (gliding) o Stability – Ligaments: anterior sacroiliac, posterior sacroiliac, sacrotuberous, sascrospinous (ischial spine), iliolumbar o Movements – very limited but does occur; mostly gliding Symphysis Pubis: o Cartilaginous – symphysis fibrocartilaginous disc o Stability – ligaments: superior pubic (between pubic crests), arcuate pubic (between inferior pubic rami Knee Joints: o This is the largest and most complex joint of the body and consists of three joints – tibiofemoral (“true knee joint”), patellofemoral, proximal tibiofibular o Movements at this joint include flexion, extension, slight medial rotation, and lateral rotation of the leg in a flexed position o Some common injuries are rupture of the medial collateral ligament and a dislocation of the knee Tibiofemoral Joint: o Between femur, tibia, and patella; hinge joint between tibia and femur; gliding joint between patella and femur; flexion, extension, and slight rotation of tibia on femur when knee is flexed o Articular capsule (mostly ligs and tendons); lateral and medial menisci = articular discs; many bursae; vulnerable joint; knee injuries damage ligaments and tendons since bones do not fit together well External Views of Knee Joint: patella is part of joint capsule anteriorly; rest of articular capsule is extracapsular ligaments – fibular (lateral) and tibial (medial) collateral ligaments Intracapsular Structures of Knee: medial meniscus (C-shaped fibrocartilage); lateral meniscus (nearly circular); posterior cruciate ligament; anterior cruciate ligament Menisci: o Fibrocartilaginous discs: shock absorbers, provide stability, compensate for lack of geometric congruity, move with tibia in flex/ext; with femur in rotation o Two at “knee joint” Medial meniscus – “C-shaped,” slip from MCL Lateral meniscus – nearly circular Patellofemoral: o Synovial – saddle joint; runs in groove between femoral condyles o Main movement: gliding o Provides increased pull for quadriceps musculature Patellofemoral Dysfunction (“Runner’s/Jumper’s Knee) o Patellar tracking/ patellar stress syndrome Weakness of medial musculature; excessive pull of lateral musculature; excessive tension in lateral stabilizing elements (lateral retinaculum, iliotibial band) Proximal Tibiofibular Joint – synovial vs. fibrous: plane or gliding vs. syndesmosis Trauma to the Knee: o Anterior cruciate ligament (ACL) ruptures are common (females > males) o Medial collateral ligament (MCL) occur more frequently o Medial meniscal tears occur more often than later o The Unhappy Triad: Injury to all three of these structures (ACL, MCL, Med. Meniscus) Ankle Region Joints: o 2 Main Areas: Talocrural jint – “ankle:” talus, fibula, tibia & distal tibiofibular joint Talocrural Joint – “true ankle joint” (the ankle mortise); synovial – hinge (talus sits in mortise – distal tib-fib) Talus: o Wide anterior – sits in mortise when in neutral/dorsi flexion o Narrow posterior – sits in mortise when in plantar flexion Talocrural Joint: o Stability: medial ligaments – deltoid, ant/post tibiotalar, tibiocalcaneal, tibionavicular, thicker & stronger than lateral ligaments; muscular support o Stability: lateral ligaments – Anterior Talofibular (ATF), Calcaneofibular (CF), Posterior Talofibular (PTF); muscular support Distal Tibiofibular Joint: Fibrous – syndesmosis; stability: ligaments – Anterior Tibiofibular Ligament, Posterior Tibiofibular Ligament, Strong interosseous membrane Other Foot Joints: subtalar – inversion/eversion; tarsometatarsal – gliding; intertarsal – gliding; metatarsophalangeal – ellipsoid (sup-pro); interphalangeal – flexion/extension (toes 2-5 – proximal & distal) Ankle Injuries: o Sprains – most common injuries in sports setting; Lateral (plantar flexion/inversion) more common than medial (eversion) longer lateral malleolus, stronger medial ligaments, and shape of talus Arthroscopy = examination of joint; instrument is the size of a pencil; remove torn knee cartilages and repair ligaments; small incision only Arthroplasty = preplacement of joints; total hip replaces acetabulum and head of femur; plastic socket and metal head; knee replacements are common as well 5A Nervous System Objectives: discuss the anatomical structures and corresponding functions of: central nervous system (brain and spinal cord); cranial nerves; spinal nerves; peripheral nerves; sensory organs (our 5 senses) make clinical application to commonly seen injuries and ailments Functions of the Nervous System: o Sensory – senses changes in the internal and external environment o Integrative – analyzes data, stores data, decides which stimuli are important o Motor – responds to stimuli through muscular contractions or glandular secretions 2 Principle Divisions: o Central Nervous System (CNS) – brain: lies above foramen magnum; spinal cord: lies below foramen magnum o Peripheral Nervous System (PNS) – cranial nerves, spinal nerves, peripheral nerves The Neuron: Functional Classification of Neurons o Afferent (sensory) neurons o Efferent (motor) neurons o Interneurons (association neurons) Typical Neuron: Nerve Cell – 3 main components dendrites, cell body (soma), axon; many axons make up a nerve Structural Classification of Neurons: multipolar neurons, bipolar neurons, unipolar neurons Dendrite: input to neuron; branched processes emerging from cell body, function: Conduct nerve impulses “toward” cell body Relay information from external environment Several dendrites per neuron Axon: long, thin, cylindrical process; joins the cell body at axon-hillock; function – transmit nerve impulses to other neurons, muscle fibers, organs, or glands; communicates with other cells via axon terminals Axon Terminals: synaptic end bulb; synaptic vesicle; neurotransmitter Synapses: junction between 2 neurons or between neuron and effector (muscle, organ, or gland) Myelination: o Myelin Sheath – multilayered lipid, insulates axons, increases nerve conduction velocity, Schwann cells o Nodes of Ranvier Varying Degrees of Myelination: Types o A-alpha – large, myelination, fast transmission (motor) o A-beta – large, myelinated, fast, respond to touch o A-delta – small, slow, lightly myelinated, respond to pain and temperature o C – very small, very slow, unlyelinated, respond to pain Multiple Sclerosis (MS) o Deterioration of myelin sheath Sensory or motor neurons Neurons become ineffective Muscle atrophy Decreased coordination o Currently no cure Protection of the CNS: o Skeletal Protection – skull, vertebral column o Meninges – layers of connective tissue o Fat layer (epidural fat layer) o Cerebrospinal fluid Meninges: o Dura Mater – outer layer o Arachnoid Mater – middle layer o Pia Mater – inner layer Dura Mater: o “Tough Mater” o Outermost layer containing many blood vessels and nerves o Epidural Space – between dura mater and vertebral column (contains fat layer) Arachnoid Mater: “Spider Mother;” thin, spider-like middle layer of connective tissue ; avascular; subdural space – between arachnoid and dura mater Pia Mater: “little mother;” highly vascular inner layer; provides nutrients and oxygen; subarachnoid space (contains cerebrospinal fluid) Epidural vs. Subdural Hematomas Denticulate Ligaments: extension of the pia mater; suspend spinal cord in the dural sheath; protects cord from shock and displacement Cerebrospinal Fluid: circulates throughout subarachnoid space; clear, colorless liquid o Functions: mechanical protection, chemical protection, circulates nutrients and waste o “Spinal Tap” Meningitis: bacteria or virus invades CSF; causes inflammation of meninges (arachnoid and pia mater); occurs most often in infants and children; complications – loss of vision, loss of hearing, mental function disruption, death
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