TYPS AND CLASS
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| • Fibrous joint – 3 TYPS | thin layer of fibrous periosteum between 2 bones. Provides shape and strength. Little or no joint movement. 3 types
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| synarthrosis:TYPE 1 | suture like such as those that make up the skull. The bones interlock and there is no movement because they are meant to provide shape and stability (moves slightly in kids but not at all with adults-the fontanels fuse).
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| Syndesmosis TYPE 2 | Ligamentous): ligament joint such as the distal radioulnar joint or distal tibiofibular joint. A small amount of twisting or stretching can occur.
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| Gomphosis: TYPE 3 | peg in socket or “bolting together” such as your teeth (either in the mandible or maxilla).
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| •Cartilaginous Joint ( | Amphiarthroidal) – hyaline (also called articulating cartilage) or fibrocartilage ( between 2 bones. Allows a small amount of movement (bending/twisting/compression). Provides lots of stability.
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| Hyaline | appears transparent or glassy and is not vascular (receives nourishment from synovial fluid).
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| Synovial Joint (Diarthrodial) | – no direct union between bone ends. Components: Joint capsule (“sleeve”) filled with synovial fluid. Allows for a lot of free motion. Outer layer of joint capsule is fibrous; the inner has a synovial membrane which secretes synovial fluid
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| Nonaxial | (gliding) – movement mostly linear (1 axis/1 plane). Usually nonaxial motion occurs secondary to some other joint motion CARPLES
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| Uni-axial | (hinge/pivot) movement occurs in one plane around one axis. Angular motion much like a hinge. Examples are elbow/knee flexion/extension, atlas/axis, radius/ulna.
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| Bi-axial | (condyloid/saddle) motion occurs in 2 different directions (2 axes, 2 planes). Ex. Wrist, MP’s. o The thumb carpalmetacarpal joint (CMC) is a saddle joint with a convex surface on one plane and a concave surface o
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| Tri-axial | multiaxial, ball and socket) movement occurs in all the axes/planes (3 axes, 3 planes). Hip and shoulder (has 10 different motions)
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| ligaments - | - bands of fibrous connective tissue that holds and supports the 2 bones of a joint together. Flexible but, not elastic
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| joint capsule - | every synovial joint has a joint capsule.
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| Hyaline | articular)– covers ends of opposing bones, smooth surface. No blood supply or nerve supply. Gets nutrition from synovial fluid. Unable to repair self.
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| Fibrocartilage | – shock absorber. Esp. important in weight bearing joints such as knee and vertebrae.
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| Labrum of shoulder: | It completely encases the joint forming a partial vacuum that helps hold the head of the humerus against the glenoid fossa of the scapula.
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| tendon - | can be cord like (long head of biceps) or flattened band. Some are encased in tendon sheaths when it is subject to pressure or friction,
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| aponeurosis - | broad, flat tendinous sheet. Found where muscles attach to bones (latissimus dorsi/Linea alba).
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| Bursae | – found around most joints. Are small pad like sacs called bursae. They are located in areas of excessive friction such as under tendons and over bony prominences (natural
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| Fracture | broken bone (disruption in the continuity of a bone) In kids tends to be incomplete – greenstick or epiphyseal. In elderly tend to be of the hip or wrist from fall
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| Dislocation | complete separation of the 2 articular surfaces of a joint. Portion of joint capsule is torn.
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| Subluxation | partial dislocation of a joint and usually occurs over a period of time. I.e. CVA
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| Sprain | partial or complete tearing of fibers of a ligament
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| Strain | overstretching of a muscle
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| Tendonitis | inflammation of a tendon
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| Tenosynovitis | inflammation of a tendon sheath. Caused by repetitive use.
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| Synovitis | inflammation of the synovial membrane.
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| Capsulitis | inflammation of the joint capsule.
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| End feel | - subjective assessment of the quality of the feel when slight pressure is applied at the end of the joints passive range of motion. There are 3 major types
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| Bony end feel | - characterized by a hard or abrupt limit to joint motion. Occurs when bone contacts bone at end of the ROM. AKA – hard end feel. Ex. Normal terminal elbow extension
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| Soft tissue stretch: | Firm sensation that has slight give when the joint is taken to end ROM. This is the most common end feel resulting from tension in surrounding muscles, ligaments and capsule.
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| Soft tissue approximation – | Asymptomatic limited ROM. Normal when soft tissue prevents further motion such as in elbow flexion
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| Abnormal End Feel: | Characterized by sudden hard stop usually fell well before end of normal ROM , when abnormal bony structures such as osteophytes block the joint’s motion
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| Springy block – | rebound movement felt at the end of ROM. Occurs with internal derangement such as torn cartilage.
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| Empty end feel | – characterized by lack of mechanical limitation of joint ROM. Occurs when motion is limited by pain and there is complete disruption of soft-tissue constraints.
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| Muscle spasm | – reflex or spasm during motion. Protective response seen with acute injury. Palpation of muscle will reveal spasm.
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| Boggy end feel | - found in acute conditions in which soft tissue edema is present. It has soft, wet spongy feel ex. Sprained ankle, synovitis
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| accessory movement | - motion that accompany the classical movement and are essential to normal full range and pain less function.
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| Joint play | - occurs in response to external force and not under voluntary control. Normally exists at the end of all active ROMs.
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| Component movements- | take place within a joint to facilitate a particular active motion. Ex. Anterior glide of the tibia as knee goes into extension.
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| Joint mobilization | - passive oscillatory motion or sustained stretch applied at a slow speed by an external force.
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| Traction,distraction or tension occurs | when external force is exerted on a joint causing the joint surfaces to be pulled apart. Assists in mobility of a joint.
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| Approximation or compression occurs | when external force is exerted on a joint causing the joint surfaces to be pushed closer together. Assists in stability of a joint.
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| Shear forces occur | parallel to the surface. Results in a glide motion at the joint.
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