肌肉骨骼系统

1. 肌肉骨骼系统 关节&软骨

2. Content • 关节种类 • 软骨种类 • 主要四肢关节 • 椎间盘 • 关节置换&再生

3. Joints Joints and their classification bony joints fibrous joints cartilaginous joints Synovial joints Anatomy of selected diarthroses humeroscapular joint 肱肩胛关节 elbow joint coxal joint 髋关节 knee joint 9-3

4. Joints and Their Classification • Arthrology = study of the joints • Kinesiology = study of musculoskeletal movement • Classified by freedom of movement • diarthrosis (freely movable) • amphiarthrosis (slightly movable)微动关节 • synarthrosis (little or no movement)不动关节 • Classified how adjacent bones are joined • Fibrous • Cartilaginous • bony or synovial 9-4

5. Bony Joint (Synostosis)骨性结合 Gap between two bones ossifies frontal and mandibular bones in infants 额骨和下颌骨 cranial sutures in elderly 颅缝 attachment of first rib and sternum 胸骨 Can occur in either fibrous or cartilaginous joint

6. Fibrous Joints (Synarthrosis) Collagen fibers span the space between bones Sutures gomphoses 钉状关节 Syndesmoses韧带联合 9-6

7. Immovable fibrous joints bind skull bones together Serrate - interlocking lines(齿状联合) Coronal(冠状缝), sagittal(矢状缝) and lambdoid sutures(人字缝) Lap - overlapping beveled edges temporal and parietal bones(颞和颅顶骨) Plane - straight, nonoverlapping edges palatine processes(腭突) of the maxillae Fibrous Joint -- Sutures 9-7

8. Types of Sutures 9-8

9. Fibrous Joint – Gomphoses钉状关节 Attachment of a tooth to its socket Held in place by fibrous periodontal ligament(牙周韧带) collagen fibers attach tooth to jawbone(颚骨) Some movement while chewing

10. Two bones bound by ligament only interosseus membrane Most movable of fibrous joints Interosseus membranes unite radius to ulna and tibia to fibula Fibrous Joint – Syndesmosis韧带联合

11. Cartilaginous Joint – Synchondrosis软骨结合 Bones are joined by hyaline cartilage(透明软骨) rib attachment to sternum(胸骨) epiphyseal plate(骺板)in children binds epiphysis(骨骺) and diaphysis(骨干) 9-11

12. Cartilaginous Joint – Symphysis骨联合 2 bones joined by fibrocartilage(纤维软骨) pubic symphysis(耻骨联合) and intervertebral discs Only slight amount of movement is possible

13. Synovial Joint(滑膜关节) Joint in which two bones are separated by a space called a joint cavity Most are freely movable 9-13

14. General Anatomy Articular capsule encloses joint cavity continuous with periosteum(骨膜) lined by synovial membrane Synovial fluid = slippery fluid; feeds cartilages Articular cartilage = hyaline cartilage covering the joint surfaces Articular discs and menisci(半月板) jaw, wrist, sternoclavicularand knee joints absorbs shock, guides bone movements and distributes forces Tendon attaches muscle to bone Ligament attaches bone to bone 9-14

15. Tendon Sheaths and Bursae Bursa = saclike extension of joint capsule 滑囊 between nearby structures so slide more easily past each other Tendon sheaths = cylinders of connective tissue lined with synovial membrane and wrapped around a tendon 9-15

16. Components of a Lever A lever is a rigid object that rotates around a fixed point called a fulcrum(支点) Rotation occurs when effort overcomes resistance resistance arm and effort arm are described relative to fulcrum 9-16

17. Mechanical Advantage of a Lever Two kinds of levers lever that helps increase output of force human moving a heavy object with help of crowbar(撬棍) lever move object further and faster movement of row boat with paddle(桨) Types of levers produce either increase in speed or force 9-17

18. Mechanical Advantage Mechanical advantage is calculated from the length of the effort arm divided by the length of the resistance arm Contraction of the biceps muscle (肱二头肌)causes the hand to move fast and further (MA <1.0) 9-18

19. First-Class Lever Has fulcrum in the middle between effort and resistance Atlantooccipital joint(寰枕关节) lies between the muscles on the back of the neck and the weight of the face loss of muscle tone(肌张力) occurs when you nod off in class 9-19

20. Second-Class Lever Resistance between fulcrum and effort Resistance from the muscle tone of the temporalis(颞肌 ) muscle lies between the jaw joint(下颌关节) and the pull of the diagastric muscle(二腹肌前腹) on the chin(下巴) as it opens the mouth quickly 9-20

21. Third-Class Lever Effort between the resistance and the fulcrum most joints of the body The effort applied by the biceps muscle is applied to the forearm between the elbow joint and the weight of the hand and the forearm 9-21

22. Range of Motion Degrees through which a joint can move Determined by structure of the articular surfaces strength and tautness of ligaments, tendons and capsule stretching of ligaments increases range of motion double-jointed people have long or slack ligaments action of the muscles and tendons nervous system monitors joint position and muscle tone 9-22

23. Axes of Rotation Shoulder joint has 3 degrees of freedom = multiaxial joint多轴关节 Other joints – monoaxial or biaxial 9-23

24. Types of Synovial Joints 9-24

25. Ball-and-Socket Joints Smooth hemispherical(半球) head fits within a cuplike depression head of humerus(肱骨) into glenoid cavity of scapula head of femur into acetabulum(髋臼) of hip bone Multiaxial joint 9-25

26. Condyloid (ellipsoid) Joints Oval convex surface(椭圆凸面) on one bone fits into a similarly shaped depression on the next Radiocarpal joint(腕桡关节) of the wrist metacarpophalangeal joints(掌指关节) at the bases of the fingers Biaxial joints 9-26

27. Saddle Joints 鞍状关节 Each articular surface is shaped like a saddle鞍, concave(凹面) in one direction and convex(凸面) in the other trapeziometacarpal joint(拇指腕关节) at the base of the thumb Biaxial joint more movable than a condyloid or hinge joint(铰链关节) forming the primate(灵长目) opposable thumb 9-27

28. Gliding Joints(arthrodia) 滑动关节 Flat articular surfaces in which bones slide over each other Limited monoaxial joint Considered amphiarthroses 9-28

29. Hinge Joints枢纽关节 One bone with convex surface that fits into a concave depression on other bone ulna and humerus at elbow joint femur and tibia at knee joint finger and toe joints Monoaxial joint 9-29

30. Pivot Joints车轴关节 One bone has a projection that fits into a ringlike ligament of another First bone rotates on its longitudinal axis relative to the other atlantoaxial joint寰枢关节 (dens and atlas) proximal radioulnar joint allows the radius during pronation and supination 9-30

31. Flexion, Extension and Hyperextension Flexion decreases the angle of a joint Extension straightens and returns to the anatomical position Hyperextension = extension beyond 180 degrees过伸 9-31

32. Flexion, Extension and Hyperextension 9-32

33. Abduction and Adduction Abduction is movement of a part away from the midline 外展 hyperabduction – raise arm over back or front of head Adduction is movement towards the midline内收 hyperadduction – crossing fingers 9-33

34. Elevation and Depression Elevation is a movement that raises a bone vertically垂直 Mandibles(下颌) are elevated during biting and clavicles(锁骨) during a shrug Depression is lowering the mandible or the shoulders 9-34

35. Protraction and Retraction Protraction = movement anteriorly on horizontal plane伸长 thrusting the jaw forward, shoulders or pelvis forward Retraction is movement posteriorly收回 9-35

36. Circumduction Movement in which one end of an appendage remains stationary while the other end makes a circular motion Sequence of flexion, abduction, extension and adduction movements baseball player winding up for a pitch 9-36

37. Rotation Movement on longitudinal axis rotation of trunk, thigh, head or arm Medial rotation turns the bone inwards Lateral rotation turns the bone outwards 9-37

38. Supination and Pronation In the forearm and foot Supination 旋后 rotation of forearm so that the palm faces forward inversion and abduction of foot (raising the medial edge of the foot) Pronation旋前 rotation of forearm so the palm faces to the rear Eversion外翻 and abduction外展 of foot (raising the lateral edge of the foot) 9-38

39. Movements of Head and Trunk Flexion, hyperextension and lateral flexion of vertebral column 屈曲 过伸 侧屈 9-39

40. Rotation of Trunk and Head Right rotation of trunk Rotation of head 9-40

41. Movements of Mandible下颌骨 Lateral excursion偏移 = sideways movement Medial excursion = movement back to the midline side-to-side grinding during chewing Protraction – retraction缩进 of mandible 9-41

42. Movement of Hand and Digits Radial and ulnar flexion 桡偏尺偏 Abduction of fingers and thumb 拇外展 Opposition is movement of the thumb to approach or touch the fingertips对指运动 Reposition is movement back to the anatomical position 9-42

43. Movements of the Foot Dorsiflexion is raising of the toes as when you swing the foot forward to take a step (heel strike) 背屈 Plantarflexion is extension of the foot so that the toes point downward as in standing on tiptoe 跖屈 Inversion is a movement in which the soles are turned medially Eversion is a turning of the soles to face laterally 外翻 9-43

44. Content • 关节种类 • 软骨种类 • 主要四肢关节 • 椎间盘 • 关节置换&再生

45. PERICHONDRIUM 软骨膜 Dense irregularly arranged connective tissue (type I collagen) Ensheaths the cartilage Houses the blood vessels that nourish滋养 chondrocytes

46. CHONDROBLAST成软骨细胞 Progenitor of chondrocytes Lines border between perichondrium and matrix Secretes type II collagen and other ECM components Chondroblasts build

47. CHONDROCYTE软骨细胞 Mature cartilage cell Reside in a space called the lacuna Clear areas = Golgi and lipid droplets

48. Chondrocytes completely fill their lacunae RER(粗面内质网)and euchromatic nuclei Synthetically active, secrete matrix CHONDROCYTE软骨细胞 N RER Cartilage matrix

49. MATRIX Provides the rigidity, elasticity, & resilience回复力 FIBERS Collagenous and elastic GROUND SUBSTANCE Glycosaminoglycans粘多糖 (chondroitin sulfates, keratin sulfate, hyaluronic acid) Proteoglycans蛋白聚糖: GAGs + core protein Water Basophilic嗜碱性 Territorial matrix - high [sulfated proteoglycans ]

50. CARTILAGE GROWTH Appositional Increasing in WIDTH; chondroblasts deposit matrix on surface of pre-existing cartilage Interstitial Increasing in LENGTH; chondrocytesdivide and secrete new matrix , expanding the cartilage from within (inside out)