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Joints

         Anatomy & Pathology
Joints
 A union or junction between two or
  more bones.
   Articulation
Joint Classification
 Joints can be classified by several
  criteria-
 Simple or Compound- by the number
  of bones articulating with each other.
   Simple- articulations united by two bones.
   Compound- articulations united by more
    than two bones.
Joint Classification
 Structural Classification- classified by
  their uniting medium.
   Fibrous- an articulation united by fibrous
    tissue allowing little or no movement.
   Cartilagenous- an articulation united by
    fibrocartilage, hyline cartilage, or both as
    in a symphysis.
   Synovial- an articulation united by a
    synovial joint capsule, these joints are
    freely movable.
Joint Classification
 Functional Classification- indicates the
  degree of motion possible.
   Synarthrosis- the tight, fixed union allowing
    little or no movement and having great strength.
    Ex. Skull bones
   Amphiarthrosis- connected by CT or
    fibrocartilage allowing slight motion. Ex.
    Vertebrae
   Diarthrosis- united by a joint capsule and are
    freely moveable- synovial joints.
   Gomphosis- the name for fibrous implantation of
    teeth into the jaw.
Synovial Joints
 Characterized by their
  mobility, joint cavity,
  articular cartilage,
  synovial membrane,
  and fibrous capsule.
 This is the most
  common type of joint.
 Functionally, it is
  freely moveable.
Synovial Joints
 Joint capsule- the 2 layered structure
  surrounding the joint.
 Fibrous layer- the white & yellow elastic
  fibrous part of the joint capsule.
   It attaches to the periosteum on or near the
    margin of the articular cartilage.
 Synovial membrane- the inner lining of the
  fibrous layer.
   It is highly vascular, nerve rich, and produces
    synovial fluid.
Synovial Joints
 Synovial fluid- the viscous liquid that
  lubricates the joint and supplies nutrients.
 Articular cartilage- the translucent cartilage
  covering the ends of bones.
   It reduces the effects of friction.
 Ligaments- strong bands of white fibrous CT
  uniting bones.
   They function to keep joint surfaces in apposition
    and still allow movement.
Synovial Joints
 Meniscus or Disc- a plate of
  fibrocartilage partially or completely
  dividing a joint cavity.
   It functions to allow a greater variety of
    motion and alleviate friction.
 Bursa- a sac-like structure between
  different tissue that reduces friction
  between these tissues.
Classification of Synovial Joints
 By movement- the contraction of
  muscles crossing a joint and the shape
  of a joint produce its characteristic
  movements.
   Plane- arthroidal joint having flat
    articular surfaces allowing a gliding or
    sliding motion.
   Ball & Socket- a spheroidal joint
    consisting of a spheroidal head fitting into
    a pit or socket.
Classification of Synovial Joints
 By movement…
   Hinge- a joint allowing movement at right
    angles.
   Pivot- allows rotation around a
    longitudinal axis of a bone.
   Condylar- formed by 2 condyles of one
    bone fitting into the cavities of another
    bone.
Movement of Synovial Joints
 Flexion- decreasing the angle between 2 bones.
 Extension- increasing the angle between 2 bones.
 Abduction- moving a part away from the medial
  plane.
 Adduction- moving a part toward the medial plane.
 Circumdunction- movement circumscribing a cone
  shape accomplished by combining flexion,
  abduction, extension, & adduction.
 Rotation- movement around the long axis of a part.
 Universal- all of the above movements.
Shoulder Joint
Humeroradioulnar
Humeroradioulnar
 Head of the radius-
  articulates with the hureral
  condyle & the ulna.
 Trochlear notch of the Ulna-
  articulates with the trochlea
  of the humeral condyle.
 Anconeal process of the
  Ulna- fits into the olecranon
  fossa of the humerus.
Humeroradioulnar
Carpal Joints
 A hinge joint allowing flexion and
  extension with some lateral
  movement.
 It consists of 3 main joints:
  antebrachiocarpal, middle carpal, &
  carpometacarpal.
Antebrachiocarpal
 Radiocarpal joint
 Between the distal
  radius & ulna and
  the proximal row of
  carpal bones.
 Lots of movement.
Middle Carpal Joint
 Between the 2 rows
  of carpal bones.
 It communicates
  with the
  carpometacarpal
  joint.
 Lots of movement.
Carpometacarpal Joint
 Between the distal
  row of carpal bones
  and the metacarpal
  bones.
 Very little
  movement.
Intercarpal Joints
 Plane joints between the individual carpal
  bones.
 Articulations between the proximal ends
  of the metacarpal bones.
Metacarpaophalangeal Joints
 The articulation
  between the
  metacarpals & the
  proximal phalanges
  including the palmar
  sesamoid bones.
 A modified hinge joint
  allowing flexion &
  extension.
Phalangeal Joints
 Proximal
  Interphalangeal
  joints- synovial
  joints between the
  proximal and middle
  phalanges.
 Distal
  Interphalangeal
  Joints- between the
  middle and distal
  phalanges.
Pelvic Joints
 relatively
  immovable
  articulation
  between the wings
  of the sacrum & the
  ilium.
   This is a combined
    cartilagenous and
    synovial joint.
Pelvic Joints
 Pelvic Symphysis- a
  slightly moveable
  joint between the 2
  hip bones.
 Coxofemoral- the
  ball & socket type
  synovial joint
  between the head
  of the femur and
  the acetabulum of
  the pelvis.
Stifle
 A condylar joint
  which acts like a
  hinge joint with a
  little rotation.
Stifle
 **Patellar Ligament-
  the part of the tendon
  insertion of the
  quadriceps muscle
  between the patella
  and tibial tuberosity.
Stifle
 Medial & Lateral
  Menisci- the crescent,
  fibrocartilagenous discs
  between the tibial &
  femoral articulating
  condyles.
Stifle
 Cranial & Caudal
  Cruciate Ligaments-
  intra-articular
  ligaments named for
  their tibial
  attachments.
    **Cranial CL- inserts
     cranially on the tibia.
    **Caudal CL- inserts
     caudally on the tibia.
Tibiofibular Joint
Tarsus
 “Hock”
 A compound hinge
  joint allowing for
  flexion & extension.
Skull Joints

 Mandibular Symphysis-
  cartilagenous joint
  joining the left & right
  mandibular bodies.
Vertebral Column
 Intervertebral articulations consist of
  2 types of joints:
   Cartilagenous- are formed by
    interveterbral disks joining adjacent
    vertebral bodies.
   Synovial- are formed by caudal and
    cranial articular processes of adjacent
    vertebrae.
Vertebral Column
 Costovertebral Joints- the 2 distinct
  articulations between most ribs and
  the vertebral column.
   The head of each rib forms a ball & socket
    joint with the vertebrae.
   The tubercle of each rib forms a joint with
    the transverse process of the vertebrae.
   Each has a joint capsule.
Vertebral Column
 Atlanto-occipital Joint- the “yes”
  joint.
 Atlanto-axial Joint- the “no” joint.
   A pivot joint between the axis & atlas.
 Intervertebral Disks-
   The layers of fibrocartilage between
    bodies of adjacent vertebrae each
    consisting of an outer fibrous ring and an
    inner pulpy nucleus.
Vertebral Column

Costochondral Junction or Joints- the
 fibrous joints between the ribs and
 costal cartilages.
Joint Pathology
Osteochondrosis Dessicans
 A failure of
  cartilage
  maturation.
 Pressure on such
  defective cartilage
  may cause a piece
  (joint mouse) to be
  separated and float
  free in the synovial
  space.
Pathology…
 Arthritis-
   Inflammation of a joint
 Bursa-
   Small, fluid-filled sac in places where
    friction might occur
 Bursitis-
   Inflammation of the bursa
Pathology…
 False Joints- a joint formed in an
  unreduced (unhealed) fracture, having
  all the structures of a synovial joint.
 Luxation or Dislocation- an articular
  separation usually due to injury or
  degenerative changes.
Hip Dysplasia
 A malformed hip
  joint resulting in a
  progressive
  degenerative
  disease having a
  high incidence in
  some breeds.
Hip Dysplasia
Cranial Cruciate Ligament Rupture
and Repair
 When the cruciate ligament is
  torn or stretched, instead of
  moving like a hinge, the knee
  joint will actually make a
  sliding motion.
 This abnormal motion and
  instability creates trauma
  within the joint that leads to
  wearing of cartilage, increased
  synovial fluid production and
  inflammation.
CCLR
 A torn cruciate ligament can occur in any
  dog if just the right (or wrong!) forces
  impact the knee joint.
 Most commonly seen in larger breeds of dogs
  and in dogs that are overweight
 The ACL surgical procedure does not actually
  repair the torn ligament but rather replaces
  the ligament with artificial material that
  takes over the function of the Cruciate
  Ligament.
Cranial Drawer Test
Patellar Luxation
 Patellar luxation is usually a congenital condition in
  which the kneecap, or patella, dislocates outside of
  its normal trochlear groove.
 Dislocation, clinically referred to as luxation, can
  occur on either the medial, or inside surface, or the
  lateral, or outside surface, of the knee.
 There are varying degrees of patellar luxation that
  are graded depending on whether the patella is
  intermittently or constantly luxated.
 This abnormal displacement of the kneecap results
  in pain, cartilage damage, and arthritis.
 There are varying degrees of severity of this
  disease, and surgery may be needed.
Joint Fluid Analysis
Indications
 Helps determine the cause of pain or
  swelling in a joint
 Synovial fluid is collected for
  cytological, bacterial or biochemical
  analysis
 Normal synovial fluid has a low cellularity,
  with virtually no red blood cells & only small
  numbers of leukocytes.
 The main functions of synovial fluid are
  nutritive support, lubrication, and
  “cushioning” of the articular cartilage.
 In addition to cytologic evaluation, the
  fluid should be assessed for:
     Volume obtained
     Turbidity
     Mucin quality/concentration
     Protein concentration
     Color
     Viscosity
Sample Handling & Test Priorities

 Normal synovial fluid does not clot.
   However, with hemorrhage or blood
    contamination, samples may clot unless
    processed immediately or placed in an
    anticoagulant tube.
   EDTA is preferred for cytologic
    examination, while heparin is
    recommended for the mucin clot test.
Color & Turbidity
 Normal synovial fluid is clear to straw
  yellow and non-turbid.
   Turbidity, when present, is caused by
    cells, protein (or fibrin), or cartilage.
Viscosity
 Viscosity is frequently decreased in
  joints with bacterial inflammation.
Synovial Fluid
Synovial Fluid
The End!!
Lp 4 joints 2008

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Lp 4 joints 2008

  • 1. Joints Anatomy & Pathology
  • 2. Joints  A union or junction between two or more bones.  Articulation
  • 3. Joint Classification  Joints can be classified by several criteria-  Simple or Compound- by the number of bones articulating with each other.  Simple- articulations united by two bones.  Compound- articulations united by more than two bones.
  • 4. Joint Classification  Structural Classification- classified by their uniting medium.  Fibrous- an articulation united by fibrous tissue allowing little or no movement.  Cartilagenous- an articulation united by fibrocartilage, hyline cartilage, or both as in a symphysis.  Synovial- an articulation united by a synovial joint capsule, these joints are freely movable.
  • 5. Joint Classification  Functional Classification- indicates the degree of motion possible.  Synarthrosis- the tight, fixed union allowing little or no movement and having great strength. Ex. Skull bones  Amphiarthrosis- connected by CT or fibrocartilage allowing slight motion. Ex. Vertebrae  Diarthrosis- united by a joint capsule and are freely moveable- synovial joints.  Gomphosis- the name for fibrous implantation of teeth into the jaw.
  • 6. Synovial Joints  Characterized by their mobility, joint cavity, articular cartilage, synovial membrane, and fibrous capsule.  This is the most common type of joint.  Functionally, it is freely moveable.
  • 7. Synovial Joints  Joint capsule- the 2 layered structure surrounding the joint.  Fibrous layer- the white & yellow elastic fibrous part of the joint capsule.  It attaches to the periosteum on or near the margin of the articular cartilage.  Synovial membrane- the inner lining of the fibrous layer.  It is highly vascular, nerve rich, and produces synovial fluid.
  • 8. Synovial Joints  Synovial fluid- the viscous liquid that lubricates the joint and supplies nutrients.  Articular cartilage- the translucent cartilage covering the ends of bones.  It reduces the effects of friction.  Ligaments- strong bands of white fibrous CT uniting bones.  They function to keep joint surfaces in apposition and still allow movement.
  • 9. Synovial Joints  Meniscus or Disc- a plate of fibrocartilage partially or completely dividing a joint cavity.  It functions to allow a greater variety of motion and alleviate friction.  Bursa- a sac-like structure between different tissue that reduces friction between these tissues.
  • 10. Classification of Synovial Joints  By movement- the contraction of muscles crossing a joint and the shape of a joint produce its characteristic movements.  Plane- arthroidal joint having flat articular surfaces allowing a gliding or sliding motion.  Ball & Socket- a spheroidal joint consisting of a spheroidal head fitting into a pit or socket.
  • 11. Classification of Synovial Joints  By movement…  Hinge- a joint allowing movement at right angles.  Pivot- allows rotation around a longitudinal axis of a bone.  Condylar- formed by 2 condyles of one bone fitting into the cavities of another bone.
  • 12. Movement of Synovial Joints  Flexion- decreasing the angle between 2 bones.  Extension- increasing the angle between 2 bones.  Abduction- moving a part away from the medial plane.  Adduction- moving a part toward the medial plane.  Circumdunction- movement circumscribing a cone shape accomplished by combining flexion, abduction, extension, & adduction.  Rotation- movement around the long axis of a part.  Universal- all of the above movements.
  • 15. Humeroradioulnar  Head of the radius- articulates with the hureral condyle & the ulna.  Trochlear notch of the Ulna- articulates with the trochlea of the humeral condyle.  Anconeal process of the Ulna- fits into the olecranon fossa of the humerus.
  • 17. Carpal Joints  A hinge joint allowing flexion and extension with some lateral movement.  It consists of 3 main joints: antebrachiocarpal, middle carpal, & carpometacarpal.
  • 18. Antebrachiocarpal  Radiocarpal joint  Between the distal radius & ulna and the proximal row of carpal bones.  Lots of movement.
  • 19. Middle Carpal Joint  Between the 2 rows of carpal bones.  It communicates with the carpometacarpal joint.  Lots of movement.
  • 20. Carpometacarpal Joint  Between the distal row of carpal bones and the metacarpal bones.  Very little movement.
  • 21. Intercarpal Joints  Plane joints between the individual carpal bones.  Articulations between the proximal ends of the metacarpal bones.
  • 22. Metacarpaophalangeal Joints  The articulation between the metacarpals & the proximal phalanges including the palmar sesamoid bones.  A modified hinge joint allowing flexion & extension.
  • 23. Phalangeal Joints  Proximal Interphalangeal joints- synovial joints between the proximal and middle phalanges.  Distal Interphalangeal Joints- between the middle and distal phalanges.
  • 24. Pelvic Joints  relatively immovable articulation between the wings of the sacrum & the ilium.  This is a combined cartilagenous and synovial joint.
  • 25. Pelvic Joints  Pelvic Symphysis- a slightly moveable joint between the 2 hip bones.  Coxofemoral- the ball & socket type synovial joint between the head of the femur and the acetabulum of the pelvis.
  • 26. Stifle  A condylar joint which acts like a hinge joint with a little rotation.
  • 27. Stifle  **Patellar Ligament- the part of the tendon insertion of the quadriceps muscle between the patella and tibial tuberosity.
  • 28. Stifle  Medial & Lateral Menisci- the crescent, fibrocartilagenous discs between the tibial & femoral articulating condyles.
  • 29. Stifle  Cranial & Caudal Cruciate Ligaments- intra-articular ligaments named for their tibial attachments.  **Cranial CL- inserts cranially on the tibia.  **Caudal CL- inserts caudally on the tibia.
  • 31. Tarsus  “Hock”  A compound hinge joint allowing for flexion & extension.
  • 32. Skull Joints  Mandibular Symphysis- cartilagenous joint joining the left & right mandibular bodies.
  • 33. Vertebral Column  Intervertebral articulations consist of 2 types of joints:  Cartilagenous- are formed by interveterbral disks joining adjacent vertebral bodies.  Synovial- are formed by caudal and cranial articular processes of adjacent vertebrae.
  • 34. Vertebral Column  Costovertebral Joints- the 2 distinct articulations between most ribs and the vertebral column.  The head of each rib forms a ball & socket joint with the vertebrae.  The tubercle of each rib forms a joint with the transverse process of the vertebrae.  Each has a joint capsule.
  • 35. Vertebral Column  Atlanto-occipital Joint- the “yes” joint.  Atlanto-axial Joint- the “no” joint.  A pivot joint between the axis & atlas.  Intervertebral Disks-  The layers of fibrocartilage between bodies of adjacent vertebrae each consisting of an outer fibrous ring and an inner pulpy nucleus.
  • 36. Vertebral Column Costochondral Junction or Joints- the fibrous joints between the ribs and costal cartilages.
  • 38. Osteochondrosis Dessicans  A failure of cartilage maturation.  Pressure on such defective cartilage may cause a piece (joint mouse) to be separated and float free in the synovial space.
  • 39. Pathology…  Arthritis-  Inflammation of a joint  Bursa-  Small, fluid-filled sac in places where friction might occur  Bursitis-  Inflammation of the bursa
  • 40. Pathology…  False Joints- a joint formed in an unreduced (unhealed) fracture, having all the structures of a synovial joint.  Luxation or Dislocation- an articular separation usually due to injury or degenerative changes.
  • 41. Hip Dysplasia  A malformed hip joint resulting in a progressive degenerative disease having a high incidence in some breeds.
  • 43. Cranial Cruciate Ligament Rupture and Repair  When the cruciate ligament is torn or stretched, instead of moving like a hinge, the knee joint will actually make a sliding motion.  This abnormal motion and instability creates trauma within the joint that leads to wearing of cartilage, increased synovial fluid production and inflammation.
  • 44. CCLR  A torn cruciate ligament can occur in any dog if just the right (or wrong!) forces impact the knee joint.  Most commonly seen in larger breeds of dogs and in dogs that are overweight  The ACL surgical procedure does not actually repair the torn ligament but rather replaces the ligament with artificial material that takes over the function of the Cruciate Ligament.
  • 46. Patellar Luxation  Patellar luxation is usually a congenital condition in which the kneecap, or patella, dislocates outside of its normal trochlear groove.  Dislocation, clinically referred to as luxation, can occur on either the medial, or inside surface, or the lateral, or outside surface, of the knee.  There are varying degrees of patellar luxation that are graded depending on whether the patella is intermittently or constantly luxated.  This abnormal displacement of the kneecap results in pain, cartilage damage, and arthritis.  There are varying degrees of severity of this disease, and surgery may be needed.
  • 48. Indications  Helps determine the cause of pain or swelling in a joint  Synovial fluid is collected for cytological, bacterial or biochemical analysis
  • 49.  Normal synovial fluid has a low cellularity, with virtually no red blood cells & only small numbers of leukocytes.  The main functions of synovial fluid are nutritive support, lubrication, and “cushioning” of the articular cartilage.
  • 50.  In addition to cytologic evaluation, the fluid should be assessed for:  Volume obtained  Turbidity  Mucin quality/concentration  Protein concentration  Color  Viscosity
  • 51. Sample Handling & Test Priorities  Normal synovial fluid does not clot.  However, with hemorrhage or blood contamination, samples may clot unless processed immediately or placed in an anticoagulant tube.  EDTA is preferred for cytologic examination, while heparin is recommended for the mucin clot test.
  • 52. Color & Turbidity  Normal synovial fluid is clear to straw yellow and non-turbid.  Turbidity, when present, is caused by cells, protein (or fibrin), or cartilage.
  • 53. Viscosity  Viscosity is frequently decreased in joints with bacterial inflammation.

Editor's Notes

  1. Know ab and adduction
  2. ** Know for practical