Lecture: The articulating skeleton

rounded articular area

ridge of bone

• passage through a bone
• (look for a hole)

• hollow or depressed area
• (not mu-fossa from the lion king)

rounded process

indentation at the edge of a bone

projection of bone

thornlike process

projection from the surface

• large blunt elevation
• (you're beautiful, you're beautiful it's true ... james blunt)

• small raised eminence
• (she put a square around this for some unknown reasons)

large rounded elevation

• closest to midline
• (this was a medterm so i doubt that you'll get this wrong)

furthest from midline

closest

furthest

• 1. cranium, face (of the skull)
• 2. hyoid (associated bones), sternum, ribs (thoracic cage)
• 3. vertebrae, sacrum, coccyx (vertebral column)
• (for some reason i have a hard time spelling coccyx - it's weird)
• 4. clavicle, scapula (pectoral girdle)
• 5. tarsal bones, metatarsal bones, phalanges (lower limbs)

• 1. frontal bone (1)
• 2. occipital bone (1)
• 3. parietal bones (2)
• 4. temporal bones (2)
• 5. sphenoid bone (1)
• 6. ethmoid bone (1)

FOCUS: on parietal bone, temporal bone, ethmoid

FOCUS: frontal bone, sphenoid, occipital bone, occipital condyle, foramen magnum

• 1. mandible (1)
• 2. maxillae (maxillary bone) (2)
• 3. zygomatic bones (2)
• 4. lacrimal bones (2)
• 5. nasal bones (2)
• 6. inferior nasal conchae (2)
• 7. palatine bones (2)
• 8. vomer bone (1)

FOCUS: vomer, zygomatic bone, nasal bone

FOCUS: palatine bone

FOCUS: lacrimal bone, maxillary bone, inferior nasal concha, mandible

• 1. Hyoid bone - level of C3, suspended by muscles that attach it to the larynx, tongue, pharynx
• 2. sternum - manubrium, body, xyphoid process
• 3. costae (Ribs) - 1-7 (true), 8-10 (false), 11-12 (floating of the false)

• 1. vertebrae (7 cervical - atypical vertebrae: different, C1 (atlas), C2 (axis); 12 thoracic; 5 lumbar) --> REMEMBER: breakfast at 7, lunch at 12, and dinner at 5; t before x for atlas vs axis; you say yes before no (atlas - nod head, axis - shake head)
• 2. sacrum (5-6 fused vertebrae)
• 3. coccyx (3-4 fused vertebrae)

• connects arms to trunk via scapular and clavicle
• FOCUS: acromion, coracoid process
• 

• FOCUS: acromion, coracoid process in relation to manubrium (sternum)
• and the acromial end and sternal end

• 1. tarsus: 7 tarsal bones
• 2. calcaneus: largest of the tarsals, attachment site of Achilles tendon
• 3. talus: articulates proximally with tibia
• 4. metatarsals: foot bone (I-V)
• 5. hallux (big toe): 2 phalanges
• 6. 4 toes: 3 phalanges each toe

FOCUS: calcaneus, talus, proximal phalanx (2), middle phalanx, distal phalanx (2), metatarsal bones

• FOCUS: vertebrae (24), sacrum, coccyx : of the vertebral column
• humerus (2), radius (2), ulna (2), carpal bones (16), metacarpal bones (10), phalanges (28) (proximal, middle, distal) : upper limbs
• pelvic girdle (2)
• femur (2), patella (2), tibia (2), fibula (2) : lower limbs

Joint

• syn = together (2 bones together)
• NO movement, STRONGEST joint

• aka Synovial
• Dia = through, across, apart
• supported, BUT not connected
• free movement, weakest joint

• amphi = on BOTH sides, of both kinds, BOTH
• held together by fibrous or cartilaginous connection
• Slight movement, INTERMEDIATE strength joint

di < amphi < syn

• 1. fibrous
• 2. cartilaginous
• 3. body fusion

• 1. suture (sewing) - interlocking bones with fibrous connections
• 2. gomphosis (bolting) - insertion plus fibrous wrap

synchondrosis - rigid, cartilage bridge

synostosis - bone to bone

FOCUS: i dunno just memorize this

• 1. syndesmosis
• 2. symphysis

• desmos = band/ligaments
• bones connected by a ligament

• physis = growth
• fibrous cartilage pad between two bones

FOCUS: top and bottom ... for Amphiarthosis: syndesmosis vs symphysis

TO be FILLED IN cause i didn't pay attention here

• 1. Disk protusion/distortion - weakened posterior longitudinal ligaments, intervertebral disc distorted but intact
• 2. herniated disk - weakened posterior longitudinal ligament, intervertebral disc ruptures (nucleus pulposus escapes)
• BOTH: spinal nerve or spinal cord can be compressed.

problems with the vertebral articulations

• 1. monoaxial
• 2. biaxial
• 3. triaxial

• joint moves 1 dimension
• MOST stable

• joint moves 2 dimension
• less stable

• joint moves 3 dimension
• LEAST stable

triaxial < biaxial < monoaxial

• 1. shapes of articulating surfaces
• 2. fat pads
• 3. bones
• 4. ligaments
• 5. muscles
• 6. tendons
• 7. joint capsule

• 1. articular capsule
• 2. additional cartilage pads
• 3. fat pads
• 4. ligaments
• 5. tendons
• 6. bursae

• lined by:
• -synovial membrane - areolar tissue, epithelium
• -articular cartilage : ends of bone (epiphysis), slick, smooth
• joint cavity - synovial fluid: lubricant (proteoglycan rich, clear, viscous solution), nutrient distribution, shock distribution

• often outside the capsule
• support, shock absorption

• bone to bone
• support, strengthen, reinforce

• muscles to bones
• support, limit range of motion

• pouch
• synovial fluid filled pockets
• response to friction between tissues
• reduce friction
• shock absorption

• 1. linear/planar- gliding
• 2. angular - flexion/extension, abduction/adduction, circumduction
• 3. rotation

• 1. gliding joints
• 2. hinge joints
• 3. pivot joints
• 4. ellipsoidal joints
• 5. saddle joints
• 6. ball and socket joints

• limited motion
• nonaxial or multiaxial
• ex: intercarpal joints, sacroiliac joints, acromion (scapula)-clavicle and clavicle-manubrium (sternum)

• monoaxial: 1D: flexion/extension
• ex: elbow and knee
• 2 types

• monoaxial: 1D : rotation
• ex: atlas (1C)/ axis (C2), radius and ulna (proximal)

• biaxial: 1D: flexion/extension - perpendicular to the plane of the body
• 2D: abduction/adduction - in the plane of the body, circumduction (2D)
• ex: radius to carpal bones, metacarpal to phalange

• biaxial: 1D: flexion/extension
• 2D: abduction/adduction -circumduction (2D), opposition (2D)
• ex: metacarpal-carpal joints (thumb)

• triaxial: 1D: flexion/extension
• 2D: adduction/abduction - circumduction (2D)
• 3D: rotation
• ex: hip and shoulders
• 2 types

membrane phospholipids --phospholipase A2 (PLA2) --> Arachidonic acid -- (1.lipoxygenases/2. Cyclooxygenase [Cox-1,Cox-2]) --> 1. leukotrienes/2. PGH₂ --(1. PG synthesis/2. TBX synthases) --> 1. other prostaglandins/2. thromboxanes

• 1. steroidal anti-inflammatory drugs (SAIDs)
• 2. Non- steroidal anti-inflammatory drugs (NSAIDs)
• 3. Acetaminophen (Tylenol) ?? possible

• PLA 2 inhibitors
• -glucocorticoids (cortisone, betamethasone)

• mixed COX-1 and COX-2 inhibitors (aspirin, ibuprofen, naproxen)
• COX-2 inhibitors (Celecoxib [Celebrex], Valdecoxib [Bextra], Rofecoxib [Vioxx])

• possible COX-3 inhibitor
• not considered an NSAID
• reduces pain (analgesic) and fever, but not anti-inflammatory

• inflammation of bursae
• increased irritation and very painful
• causes: repetitive movements, prolonged or excessive pressure, trauma (car accident, falls), infection
• treatment: rest and protect, ice packs, NSAIDs, SAIDs

• 1. osteoarthritis
• 2. rheumatoid arthritis
• 3. gouty arthritis

• 1. degenerative arthritis - in hands (distal fingers), weight bearing joints
• 2. MOST COMMON arthritis (60 years +) - articular cartilage wears away with time, creates friction
• 3. risk factors (collagen) - age, genetics, injury, obesity, hypermobility
• 4. symptoms - joints aching and sore, pain after overuse or prolonged inactivity, bony enlargements
• 5. treatment - acetaminophen; NSAIDs, SAIDs, physical therapy; weigh control; surgery, Glucosamine and Chondroitin? (why is there a question mark here, just tell me upfront with me!)

• 1. inflammatory arthritis - hands (proximal fingers), feet, wrists, ankles
• 2. immune mediated disorder - synovial membrane --> inflamed --> thicken, with time affects articular cartilage, WBC, caused by: unknown, genetics, autoimmune disease?, rheumatoid factors
• 3. risk factors- gender (women 2-3x); smoking
• 4. symptoms - joints aching and sore; joints change appearance, bony enlargements; low grade fever
• 5. treatment - acetaminophen; anti-inflammatory agents, SAIDs, TNFa Ab: Infliximab (Remicade)

• 1. deposition of uric acid crystals in synovial joints - Xanthine oxidase: converts purines to uric acids, usually excreted by kidney (most cases decreased uric acid clearance)
• 2. risk factors - high purine diet (meat/seafood main culprit); men more likely, excessive alcohol consumption.
• 3. symptoms - excruciating and sudden pain, swelling, redness, stiff joint, usually affects big toe, but other possible
• 4. treatment - acetaminophen; NSAIDs, Xanthine oxidase inhibitors (Allopurinol), Uricosurics (Probenecid) , dietary changes --> low purine diet, reduce alcohol, keep well hydrated