1. Describe two systems for joint classification.
2. Describe the characteristics of synovial joints.
3. Define osteokinematic and arthrokinematic motions.
4. Describe grading systems for arthrokinematic mobility.
5. Explain the Convex-Concave Rule.
6. Explain the planar classification system.
7. Explain the concept of axis of rotation.
8. Define degrees of freedom of movement.
9. Explain the concept of kinematic chain.

SYNARTHROSIS
• fibrous tissue
• little movement
• sutures
• gomphosis (tooth)
• syndesmosis (interosseous membrane connecting tibia and fibula)
AMPHIARTHROSIS
• fibrocartilage or hyaline cartilage
• usually little movement
• symphysis (symphysis pubis)
• Synchondrosis (first sternocostal joint)
DIARTHROSIS
• joint capsule
• freely moveable
• synovial

• Hyaline cartilage
• Synovial capsule and fluid
• Fibrous outer capsule
• Ligaments
• Menisci are possible

• Ovoid egg shaped
• Sellar saddle shaped

 

OVOID JOINTS

• Concave surface on one bone articulating with convex surface on another
SELLAR JOINTS
• Concave/convex surfaces on EACH articulating surface

See Ovoid and Sellar Picture - 37K

• Osteokinematic bone movements
• Arthrokinematic joint surface movements

OSTEOKINEMATICS
• Flexion, abduction, etc.
• measured via goniometry

 
ARTHROKINEMATICS
• Roll, glide, spin
• measured by palpation - or sometimes radiology

See Arthrokinematics Picture - 15K

GRADING ARTHROKINEMATIC MOVEMENT
 

SPINAL EVALUATION
 
• 0 ankylosis
• 1 significant hypomobility                      HYPOMOBILE
• 2 slight hypomobility
• -------------------------------------------------
• 3 normal mobility                                  NORMAL
• --------------------------------------------------
• 4 slight hypermobility
• 5 significant hypermobility                     HYPERMOBILE
• 6 unstable

 
OTHER EVALUATION AND TREATMENT SYSTEMS
 
AUSTRALIAN SYSTEM (oscillators)
 
• Grade I - small amplitude movement at beginning of range
• Grade II - large amplitude movement at beginning of range
• Grade III - large amplitude movement at end of range
• Grade IV - small amplitude movement at end of range
• Grade V - high velocity thrust beyond the end range (manipulation)

See Australian Grading System Picture - 9K

 

NORWEGIAN SYSTEM (stretchers)
 
• Grade I - small amplitude movement with joint capsule loosened
• Grade II - take up the slack so the joint capsule is tightened
• Grade III - take up the slack then stretch the joint capsule

See Norwegian Grading System Picture - 10K

• Convex moving osteokinematics and arthrokinematics in opposite directions
• Concave moving osteokinematics and arthrokinematics in same direction

PLANAR CLASSIFICATION

• Sagittal - See Sagittal Plane Picture - 47K

• Frontal or coronal - See Frontal Plane Picture - 16K

• Horizontal or transverse - See Transverse Plane Picture - 48K

• Oblique - See Oblique Plane Picture - 46K

AXIS OF ROTATION

• Imaginary "hinge pin" about which rotary motion takes place
• Axis always perpendicular to plane of movement (e.g. gleno-humeral flexion occurs in Sagittal plane while axis of rotation is perpendicular - axis runs from medial to lateral through tip of acromion process)
• Axis not always within the moving structure (e.g. int/ext rotation of hip - because femur is "bowed", axis falls posterior and medial to much of femoral shaft)

• One degree for each plane in which joint movement is permitted
• 1, 2, or 3
• 2 or 3 combine for circumduction

• Open
• Closed

See Open-Closed Chain Picture - 31K