Anatomy/physiology

• Axial skeleton:

  • Skull
  • Vertebral column
  • Thoracic cage
• Appendicular skeleton:

  • Upper limb bones
  • Lower limb bones
  • Shoulder girdle - scapula, clavicle
  • Pelvis
• Tendons = connect muscle to bone

  Pathology = strains or tendinitis
• Ligaments = connect bone to bone

  Pathology = sprain
• Enthesis = point where connective tissue (ligament, tendon, joint capsule, bursa) attaches to bone e.g. Achilles tendon, plantar fascia

  Common site for enthesitis in ankylosing spondylitis is the lower limb e.g. Achilles tendinitis and plantar fasciitis

  Sometimes in chest as intercostal enthesitis causing chest wall pain
• Types of joint - function:

  • Synarthroses - do not move e.g. joints in skull
  • Amphiarthroses - limited movement, mix of stability and some motion e.g. intervertebral disc
  • Diarthroses - can move freely in most directions, mostly found in limbs e.g. shoulders, knee, hips
• Types of joint - composition:

  • Fibrous - connect bones with dense fibrous connective tissue and mostly don't move e.g. skull sutures
  • Cartilaginous joints - connect joints using cartilage, don't move much e.g. intervertebral discs, pubic symphysis
  • Synovial - ends of bones that make up the joint are covered in cartilage, the bones forming the joint are enclosed by a capsule full of synovial fluid - minimises friction and absorbs shock e.g. shoulder, knee
• 6 types of synovial joints:

  • Hinge - movement in one plane e.g. elbow
  • Ball and socket e.g. shoulders and hips
  • Condyloid - 2 oval shaped bones that fit together - similar to ball and socket but can't rotate in full circle e.g. wrist
  • Pivot e.g. neck
  • Planar - 2 mostly flat bones come together - one bone slides over the other e.g. acromioclavicular joint
  • Saddle - 2 curved bones meet - can move in any direction but not rotate e.g. carpometacarpal joint