BIOS1168 Functional Musculoskeletal Anatomy A

1.1 Define the anatomical position

 Body upright
 Facing forward
 Feet shoulder width apart
 Arms by side
 Palms facing forward

1.2 Define the following terms of position and direction, which are
related to the standardised anatomical position:

Parasagittal = off centre still divides left/right

Anterior (ventral)
Posterior (dorsal)
Superior (cephalic)
Inferior (caudal)
Superficial – closer to the surface of the body or skin
Deep – further away from the surface of the body or skin

1.3 List the major bones comprising the 2 divisions of the skeleton:
the appendicular and axial divisions

Appendicular skeleton:
 Shoulder girdle
 Upper limbs
 Pelvic girdle
 Lower limbs

Axial Skeleton:
 Vertebral column
 Rib cage
 Skull
 sternum

1.4 List 5 functions of the skeleton

1. support - framework, maintain shape

2. movement - connect to make joints, place of insertion for muscles
3. protection - organs
4. blood cell production – bone marrow
5. storage – minerals e.g. Ca

1.5 Classify bones according to shape and give an example of each type

Long bones – longer than they are wide, e.g. humerus, femur, metacarpals, metatarsals
Short bones – cube shaped, e.g. tarsal and carpal bones
Flat bones – flat may be curved, e.g. scapula, rib, cranium
Irregular bones – complicated shapes, e.g. vertebra sacrum
Sesamoid bones - specialised bones within tendons, e.g. patella
Introductory
Arthrology
1.6 Illustrate the following features of a typical long bone:
diaphysis, epiphysis metaphysis, articular surfaces

Medullary cavity: Cylindrical central cavity of the bone containing

the bone marrow; this canal encloses lipid-rich yellow bone
marrow and state the functions of
1.7 Describe
bone markingsFibrous
Periosteum: (bony membrane
projections rich in blood vessels that
and depressions)
envelopes and except
the bone, find anat the articular surfaces
example of each type of marking Bones respond to force
Spongy bone: Tissue made of trabeculae separated
thus bulgesbyatcavities
sites of
Bonefilled with bone
markings marrow, blood vessels and
indicate: nerves
muscle attachment
BoneSites of attachment
marrow: for
Soft substance contained in bone cavities,
muscles, ligaments, tendonsis red in children, yellow in the
producing blood cells; marrow
longSites
bonesof articulation
of adults. (joint
surfaces)
Metaphysis: Part of the bone between the epiphysis and the
 Conduits for nerves and blood
diaphysis; it contains the connecting cartilage enabling the bone
vessels
to grow, and disappears at adulthood.
Diaphysis: Elongated hollow central shaft of the bone; it is made
of compact tissue and encloses the medullary cavity.
1.8 Interpret bony features, identified
Distal/proximal
in 1.6 and 1.7, onepiphysis: Enlarged flailed ends of the bone,
radiographic
made
images of spongy tissue and articulate with neighbouring bones.
Articular (hyaline) cartilage: on joint surfaces (lubricates)
Endosteum: lines medullary cavity
Physis/Epiphyseal plate: cartilage growth plate which ossifies at
skeletal maturity

2.1 Define a joint (articulation) and its components

Joints: the articulation of 2 or more bones

2.2 Describe 2 main functions of a joint

Joints are responsible for:

 Movement (e.g. the movement of limbs)
 Stability (e.g. the stability found in the bones of the skull)

2.3 Describe the general structure of, and the relative amount of movement available at each of the
following types of joints:

i) fibrous
Bones joined by dense connective tissue
- Suture
 joints between the bones of the skull
 immoveable
 united by an intermediate layer of fibrous tissue

-Syndesmosis
 2 adjacent bones are linked by a ligament
 Uniting fibrous tissue is greater in amount than
in sutures, constituting a ligament or
interosseous membrane
 Movement (from flexibility of membrane and
twisting of ligament) is restricted and controlled

ii) Cartilaginous
Joined by hyaline cartilage
-Primary cartilaginous (synchrondrosis)
 Immoveable
 occur where 2 ossification centres in a
developing bone remain separated by a layer of
cartilage i.e. epiphyseal growth plates of growing bone

-Seconary cartilaginous (symphysis)

 small amount of controlled movement
 hyaline cartilage and fibrocartilage between articular surfaces of bones

iii) Synovial
 Freely mobile
 Articular surfaces of bone covered in hyaline cartilage (hard and smooth thus ↓friction)
 Fibrous joint capsule 9outer lining)
 Synovial membrane (inner lining) secretes synovial fluid into joint cavity (lubricates and
nourishes articular cartilage)
 2.4 Describe the factors which determine
the amount of friction occurring between
articular surfaces during movement at
synovial joints

Coefficient of friction depends on:

 Compressive load
 Articular cartilage (healthy/not
healthy)
 Synovial fluid (lubrication)

2.5 Describe the 3 principal axes of

movement about synovial joints

Transverse Vertical Anteroposterior

axis axis axis
2.6 Classify synovial joints according to

i) Degrees of freedom
- Uniaxial Movement about how
- Biaxial many planes
- Multiaxial
ii) Structure
- Hinge
- Pivot Uniaxial joints

- Ellipsoid
- Condyloid Biaxial joints
- Saddle

- Ball and socket

Multiaxial joints
- Plane (gliding)

2.7 List and identify examples of each type of joint in objectives 2.3 and 2.6
2.8 Define and demonstrate the following types of movement about synovial joints:
i) active - produced by muscles – normal movement
ii) active assisted – produced by muscles and an external fore to assist normal movement
iii)Passive physiological – produced by an external force to mimic normal movement
iv)Passive accessory – produced by an external force, not normal movement

2.9 Define and demonstrate the terms used to describe active

movement about joints:
i) flexion/extension
ii) abduction/adduction
iii) medial (internal) rotation/lateral (external) rotation

2.10 Relate active movements about joints to the anatomical planes and
axes for movement
Shoulder medial and lateral rotation occur:
Shoulder flexion and extension occur: In the transverse plane about a longitudinal axis
In the sagittal plane about a transverse axis

Shoulder abduction and adduction occur:

In the coronal plane about an anteroposterior axis

2.11 Explain the functions of ligaments:

Connect bone to bone
i. mechanical
- prevent unwanted (excessive) movements at joints
-Limit wanted (normal) movements at joints
 ligaments define the range of motion for any joint (determine how much joints can move)
ii. sensory (proprioceptive)
 your ability to know the position of any joint in your body, thus maintaining the correct
posture and movement of an individual

2.12 Define and give examples of each of the following types of ligament:
i. capsular ligaments – form part of the capsule (blend with it),e.g. capsular ligament of shoulder
ii. intracapsular ligaments – are wholly within the capsule
iii. extracapsiular ligaments – cross the joint completely outside the capsule

Intracapsular
ligament

Exracapsular
ligament
2.13 Define and list 5 possible functions of articular discs

Articular Discs - a plate or ring of fibrocartilage attached to the joint capsule

and separating the articular surfaces of the bones

Functions:
1. congruency, allows a better fit between 2 articulating surfaces that are not entirely
congruent
2. allows movement to occur in different direction on either side
3. assists in joint lubrication
4. provides passive restraint to movement - contribute to stability of the joint
5. Acts as a shock absorber

2.14 Define and list the functions of bursae

 Bursae = small fluid-filled sac situated in places where friction would otherwise occur
Functions:
 facilitate the gliding of muscles or tendons over bony or ligamentous surfaces
 lubricate points of friction by secreting synovial fluid
 dissipating force by distributing it through a fluid medium

2.15 Identify examples of different ligament and disc types as listed in 2.12 and 2.13
Introductory Myology

5.1 Describe the following types of external appearance (form) of skeletal muscles
a) Parallel

Fasscicels run parallel to the tendon of the muscle. Muscle fibres extend from origin to insertion.

i) Strap: same thickness all the way along (like a belt) - sartotius
ii) Flat (quadrilateral): same width as length (like rectangles) – pronator quadratus
iii) Triangular (radiate): fibres begin broad and then converge toward the tendon - trapezius
iv) Fusiform: muscle tapers towards tendons – deltoid brachii

b) Oblique

Muscle fibres attach obliquely to a tendon (angled)

i) Unipennate: muscle is angled in one direction on only one side of tendon

ii) Bipennate: muscle inserts into the tendon from both sides (run in 2 angles)
iii) Multipennate: fascicles attach obliquely from many directions to several tendons

c) Circular

Fascicles in concentric circular arrangements form sphincter muscles that enclose an opening
- Orbicularis oris (muscle around eye)
 5.2 Examine the specimens to find an example of each type of skeletal muscle listed in
objectives 5.1
5.3 Discuss the effect of the form of a muscle to:
i) Its final contracted length
ii) The force it can exert
 The

arrangement of fibres within a muscle determine how much it can shorten when it contracts
 The longer the fibres in a muscle, the more the muscle can contract and so the greater the range
of motion it can produce
o Parallel muscles extend the length of the muscle and thus have a greater range of
motion
o Pennate muscles not very long therefore smaller range of motion
 The power of a muscle depends on the total number of fibres it contains (because a short fibre
can contract as forcefully as a long one)
o Parallel muscles have fewer fascicles and thus exert less force
o Pennate muscles have more fibres packed into the same area and therefore are more
powerful
5.4 Describe and identify examples of each type of muscle attachment:
i) Tendinous: a cord of dense connective tissue that attaches a muscle to the periosteum
of a bone e.g. Biceps brachii
ii) Aponeurotic: indirect, connective tissue extends beyond end of muscle to form a flat
sheet called an aponeurosis which then attaches to bone
e.g. rectus sheath of abdomen
iii) “Fleshy” or “Muscular”: epimysium of muscle is fused to the periosteum of the bone
(appears to attach directly to bone)
e.g. face muscles
iv) Raphe: a seam of fibrous tissue called raphe
e.g. under the tongue

5.5. Define the following terms related to muscles:

i) Origin: the attachment of a muscle tendon to the immoveable bone
ii) Insertion: the attachment of muscle tendon to the moveable bone
iii) Action: movements produced when a muscle contracts concentrically in isolation
iv) Tendon sheath (bursa): filled sacs situated between where muscles or tendons would
pass over bone i.e. serve to reduce friction during movement
v) Torque: a force that causes rotation
vi) Contraction: the activation of tension-generating sites within muscle fibres – does not
necessarily mean muscle shortening because muscle tension can be produced without
changes in muscle length
vii) Function: ???

5.6 Define the following terms relating to different types of muscle contraction
i) static/isometric
 muscle develops tension but does not shorten
 due, for example, to an external force
ii) Dynamic/isotonic
 Muscle shortens – produces movement
 Concentric: muscle shortens
 Eccentric: muscle lengthens (essential for controlled movements and resistance to gravity)

Muscles Of The Shoulder Region And Functional Anatomy Of

The Shoulder
6.2 Define the following terms related to the functions of muscles:

i) agonist: the muscle producing the desired movement by contracting either

concentrically or eccentrically. The agonist can be either a:

- prime mover
-assistant mover

ii) antagonist: muscle which must relax to allow the desired movement to occur

iii) synergist (neutraliser): muscle that eliminated an undesired movement that would
otherwise be produced by the mover(s)

iv) stabiliser: muscle which supports a body part so that another muscle will have a firm
base from which to act

6.3 Specifically describe the functional roles of the rotator cuff muscle group in providing dynamic
stability at the shoulder joint

The function of the rotator cuff muscles is to provide dynamic stability at the shoulder joint by:
 Tighten capsule = ↑ligament function, ↑structural support, ↑proprioception
 Stabiliser function: providing a medial force to the humeral head to accurately position it in
the centre of the glenoid fossa
 It is misleading to say that “supraspinatus initiates abduction”

 Synergist Function: to cancel out unwanted rotation during abduction

o Subscapularis: internal rotation
Cancel each other out
o Infraspinatus: external rotation

 Synergist function: to prevent superior glide of humeral head during abduction

o Deltoid contraction during abduction will cause humeral head to glide superiorly
(this will result in squashing and inflammation of tendons/bursae under acromion 
impingement)

 Inferior part of subscapularis Synergist function to prevent superior glide.

 Inferior part of infraspinatus Since their line of pull is downwards they pull
 Teres minor head down counteracting superior gliding

 Synergist Function: prevent anterior glide

of humeral head during flexion
 o Anterior deltoid is the mover during flexion; contraction of anterior deltoid causes
humeral head to glide anteriorly

 Supraspinatus
Stabilise by synergist function to prevent
 Infraspinatus
 Teres minor anterior glide of humeral head – pull down

 Synergist Function: during extension

o During extension posterior deltoid and latissimus dorsi (movers) contract and pull
humeral head posteriorly

 subscapularis Stabilise by synergist function to prevent

posterior glide of humeral head – pull up

OVERALL: rotator cuff responds to torque producer to keep humeral head in centre of fossa

6.4 Specifically describe the functional roles of the trapezius (upper and lower fibres) and serratus
anterior during lateral rotation of the scapula

Its own retraction

cancels out protraction
produced by serratus
anterior
Its own elevation cancels
out depression produced by
lower trapezius

Its own protraction

Its own depression cancels out cancels out retraction
elevation produced by upper produced by middle
trapezius trapezius

6.5 Describe and state the functional significance of scapulohumeral rhythm

Scapulohumeral rhythm = co-ordination between humeral and scapular movements

 Required to achieve full upper limb elevation:

Lateral rotation of scapula  glenoid fossa tilts upwards accentuates movement of humerus
upwards (able to be lifted above head)

Scapular remains Lateral rotation of scapula

theevery 1 of
stationary onFor O
movement
tilts glenoid fossa
rib cage, at scapula there is 1.5
upwards 0
ofaccentuates
movement only movementmovement
at humerus at glenoid fossa
occurring at GHJ  full upper limb elevation

6.6 Describe shoulder muscle coordination during full range abduction, flexion and extension of the
upper limb

ABDUCTION

 Rotator cuff function during abduction

 Upper Trapezius , Lower Trapezius and Serratus Anterior

o Rotate scapula and stabilise scapula against pull of rotator cuff and deltoid muscles,
therefore only movement produced is abduction

FLEXION
  Rotator Cuff = Synergist Function: prevent anterior glide of humeral head during flexion
o Anterior deltoid is the mover during flexion; contraction of anterior deltoid causes
humeral head to glide anteriorly
o
 Supraspinatus
 Infraspinatus Stabilise by synergist function to prevent
 Teres minor anterior glide of humeral head – pull down

 Upper Trapezius, Lower Trapezius and Serratus Anterior

o Rotate scapula and stabilise scapula against pull of rotator cuff and deltoid muscles,
therefore only movement produced is abduction

EXTENSION

 Rotator Cuff = Synergist Function: during extension

o During extension posterior deltoid and latissimus dorsi (movers) contract and pull

 Subscapularis Stabilise by synergist function to prevent

posterior glide of humeral head – pull up

 Upper Trapezius, Lower

Trapezius and Serratus Anterior
o Not needed to rotate scapula
o Rhomboid major may be working to medially rotate scapula
o Latissimus dorsi may provide some stability

Muscle Tissue
7.1 Describe the functions of muscle tissue

 Produce movement
 Open/close body passageways – sphincter muscles encircling body openings, function as
valves
 Maintain posture and body position – skeletal muscle contracts continuously to maintain
posture
 Generate heat – muscle contraction produces heat
 Moving substances within the body – cardiac muscle pumps blood; smooth muscle in blood
vessels contract/relax to regulate blood flow; smooth muscle contractions move food
through gastrointestinal tract

7.2 Describe the distribution and organisation of skeletal, smooth and cardiac muscle tissue

Skeletal Muscle:
 Attach to bones
 Pull on bones to cause body movements
 Striated – highly organised arrangement of myofilaments
 Voluntary – subject to conscious control
Cardiac Muscle:
 Wall of the heart
 Striated
 Involuntary contraction – autonomic nervous system but also intrinsic system regulation
 Cardiac cells branch and join at junctions called intercalated discs
Smooth Muscle:
 Walls of hollow internal organs (e.g. stomach, blood vessels)
 Squeezes substances through these organs by alternately contracting/relaxing
 Non-striated
 Involuntary – autonomic nerves, hormones, local chemicals
7.3 Describe the following features of skeletal muscle tissue: myofibrils, A bands, I bands, Z line,
sarcomere

 The connective sheaths (epimysium, perimysium, endomysium) are continuous with one another as
well as with the tendons. When muscle fibres contract they pull on these sheaths which transmit
the pulling force to the bone to be moved
 Each muscle fibre (the muscle cell) has multiple nuclei for efficient production of the massive no. of
proteins needed for these huge cells (some 30cm long)
 Sarcolemma = plasma membrane of muscle fibre
 Sarcoplasm = cytoplasm of muscle cell
 Myofibrils = the contractile organelles of the muscle fiber  they actively shorten
 Sarcomere = repeating functional units of myofibrils
o Composed of myofilaments – the contractile proteins
 Thick: contain MYOSIN; extend entire length of A-band; dark band
 Thin: contrain ACTIN; extend across I band and partway into A band (zone of overlap);
light band

 M line
 Connects thick filaments to neighbouring thick filamnets
 Stabilises the position of thick filaments
 H band
 Thick filaments only
 Zone of Overlap
 Thin filaments in between thick filaments
 I band
 Thin filaments only
 Z lines
 Contains the protein actinin that interconnect thin filaments of adjacent sarcomeres
 Elastic protein titin extend from thick filaments into I band and attach to Z line
o Keep thick filaments in place thereby maintaining organisation
o Aid in restoring sarcomere length after contraction
 o Helps resist extreme stretching THE SLIDING FILAMENT MODEL OF CONTRACTION
7.4 Describe the role played in muscles contraction by each of the following components:
sarcoplasm, sarcolemma, myofilament, myofibril, A band,
1. IAband,
muscleZ line,
fibersarcomere
at rest: thick and thin filaments are
separated due to presence of troponin-tropomyosin
complex covering the active sites on actin, preventing
actin-myosin interaction
2. A neuron activates a muscle fibre by stimulating its
sarcolemma
3. The action potential is carried throughout to all
myofibrils via the T-tubules
4. At triads, the action potential triggers the release of Ca 2+
from the cisternae of the sarcoplasmic reticulum
5. Ca2+ then interact with troponin-tropomyosin complex
acting to change its position, exposing the myosin-
binding active sites on actin
6. Thin filaments then slide past the thick ones so that
actin and myosin filaments overlap to a greater degree
7. Interaction between thick-thin filaments results in
muscle fibre contraction
8. These filament interactions produce active tension
During contraction sliding occurs across every
sarcomere along the myofibril. As a result, the
myofibril gets shorter. Because myofibrils are
attached to the sarcolemma at each Z line and
at either end of the muscle fiber, when
myofibrils get shorter, so does the muscle fiber.
 7.5 Briefly describe the difference between fast fibres, slow fibres and intermediate fibres in skeletal
muscle tissue

Fast Intermediate Slow

- Pale (cos little myoglobin – an - Contract fairly quickly - Depend on aerobic metabolism,
O2 binding pigment) - Depend largely on aerobic so:
- Lots of myofilaments therefore metabolism, so:  Large no. of
generate heaps of power  High myoglobin content mitochondria
- Depend on anaerobic pathways  Large no. mitochondria  Rich supply of capillaries
to make ATP so:  Rich supply of capillaries  Abundant content of
 Few mitochondria - Fatigue intermediately myoglobin
 Few capillaries - Intermediate power - Extremely resistant to fatigue
- Many glycosomes (contain - Intermediate diameter - deliver prolonged contractions
glycogen as a fuel) - small diameter so do not
- Contract rapidly generate much power
- Fatigue quickly
- Comparatively large diameter

7.6 Describe the gross and histological structure of the myotendinous junction and specific functions
they serve

 myotendinous junction is the site of connection between muscle and tendon

o Perimysium of muscles become continuous with collagen fibres of tendon
 Primary site of force transmission
o transduces muscle contraction force to the skeletal system
 weak point – susceptible to injury

7.7 Describe the normal blood and nerve supply of the myotendinous junction
 blood supply to the region comes from 2 points: blood from bone and blood from muscle
o However, no direct blood supply to the region
o Therefore, area of hypovascularity (less than usual blood supply)
o This means if myotendinous junction is damaged, harder to repair
 Region contains sensory receptors
o Information on muscle length, tension and pain
Generalised Connective Tissue and Synovium

9.1 Describe the structure, properties and functions of the 3 components of generalised connective
tissue: cells, fibres and ground substance

Ground Substance:
 Unstructured material that fills the space between the cells and contains the fibers
 Composed of:
o Interstitial fluid (extra-cellular fluid)
o Hydrated molecules = glycosaminoglycans (GAG’s)
 These GAGs, such as hyaluronic acid, ↑viscosity of ground substance
 Acts as a medium through which nutrients/dissolved substances can diffuse between
capillaries and cells

Fibers
 Provide support and strength
 Include:
o Collagen (very high tensile strength  tough, strong)
o Elastic (stretch and recoil easily)

Cells
 Each major class of connective tissue has a resident cell type:
o Fat and the fibrous tissue of ligaments = fibroblast
o Cartilage: chondroblast
o Bone: osteoblast
 Accessory cells:
o Macrophages
 Phagocytosis  eliminate microorganisms and debris
contribute to immune reactions
o Mast cells
 Produce:
 Heparin (anticoagulant – prevent blood clotting)
 Histamine (makes capillaries leaky)

9.2 Classify generalised connective tissue

4 main classes of connective

9.3 Describe tissue:
how the
arrangement of the
1. Generalised connective
components of different
connective tissue typestissue
2. Cartilage
facilitate their function
3. Bone
4. Blood
 Contains many adipocytes (fat cells)

Complex 3D network of reticular fibers

Provide a loose scaffold around cells

9.4 Describe the sequence of events occurring in loose connective tissue during an acute
inflammatory response

Primarily parallel collagen fibers

A few elastic fibres
Parallel arrangement  withstands great tensile
stress when pulling force is applied in 1 direction

Primarily irregularly arranged collagen fibers

Withstands tension exerted in many directions
Provides structural strength
9.5 Describe the structure, properties and functions of synovial membrane and synovial fluid

Synovial Membrane
 Function
o Secretes and absorbs synovial fluid
 Structure
o Vascular connective tissue with folds and villi
 This ↑ membrane SA and promotes distribution of synovial fluid
o Inner cellular layer with 2 types of cells
 Cells that phagocytose debris
 Cells that produce hyaluronic acid (a type of GAG)
o Outer vascular/fibrous layer
 Contains varying amounts of adipose tissues
 Properties
o Lines capsule

Synovial Fluid
 Function
o Lubricant to reduce joint friction
o ↑ joint efficiency
o ↓ erosion of articular surfaces
o Nutritive source for articular cartilage and articular discs
o Removes wastes products of metabolism of articular cartilage and discs
 Structure
o Plasma-like fluid BUT containing
 Only 1/3 protein content of plasma
 Hyaluronic acid
 Affects viscosity by controlling free fluid content
  Controls protein content
 Property
o Thixotropic = viscosity varies with environmental factors
 Viscosity decreases with
 ↑ temperature
 ↑ joint velocity (i.e. fast motions at joint)
9.6 Describe the effects of inflammation on the synovial membrane and synovial fluid

Changes to synovial membrane during inflammation:

 Membrane becomes more permeable (↑blood, ↑swelling)
 Fibroblasts proliferate and produce more collagen (thickens membrane)
o Prevents normal movement of H2O, small proteins, nutrients and removal of
metabolic wastes  build-up of wastes
 Membrane becomes excessively vascular: large proteins move from vascular compartments
into synovial membrane clogging it up
 Macrophage like cells lining the membrane die (due to lack of nutrients and O2 from
thickened membrane)
o Decreased phagocytic activity  more debris (dead cells) coat synovial membrane
 With more debris  further friction against articulating surfaces  further damage
 Decreased hyaluronic acid production  decreased viscosity of synovial fluid
o Lose ability to modulate viscosity
Overall: membrane becomes thickened (collagen), excessively vascular and densely cellular (coated
in dead cells)

9.7 Explain how the synovial fluid changes when structural change occurs in the synovial membrane
due to inflammation
 Increased amounts of synovial fluid
o Due to ↑no. and permeability of vessels in synovial membrane
o ↑synovial fluid  joint swelling  stretch of ligaments  rupture of ligaments  joint
instability and deformation
 ↓hyaluronic acid content  ↓ in viscosity  ↓ joint protection
 Not thixotropic  unable to regulate viscosity  no change in viscosity  ↓joint protection
 ↑protein content
o Due to ↑permeability of vessels in synovial membrane and ↓amount of hyaluronic acid
clotting  ↑joint damage from abrasion of articular surface
 ↓nutrition and metabolic waste transfer to articular cartilage discs  cartilage death (starved of
nutrients)  abrasion of articular surfaces by cartilage fragments

9.8 Describe the effects of inflammation of the synovium on synovial joint function

 Abnormalities in synovial fluid: lead to joint damage in inflammatory joint disease

1. Increase in volume of synovial fluid
 joint swelling  stretching of ligaments  rupture of ligaments  joint instability and
deformation
2. Composition
 Decreased hyaluronan content of synovial fluid
- reduced viscosity and elasticity
 Increased protein content
- clotting of synovial fluid
- decreased protection of articular surfaces  abrasions
- cartilage erosion
  Decreased nutrition and metabolic waste transfer
- chondrocytes starved of nutrients and die
- fragments of cartilage float in fluid  abrasions of articular surfaces
3. Cellular composition:
 Increased inflammatory cells – inflammatory response continues
 Cartilage fragments – damage to articular surface  abrasions
 Dead and dying cells  dislodged from membrane type A and B cells