This section reviews the structure and function of the major joints and their connecting bony structures, muscles, and soft tissues. To lay the foundation for skilled assessment of the musculoskeletal system, it is essential for you to learn both the surface landmarks and underlying anatomy of each of the major joints. Anatomy and Physiology follows a "head to toe" sequence, beginning with the jaw and joints of the upper extremities, then proceeding to the spine and hip and the joints of the lower extremities. For each joint there are subsections on Overview, Bony Structures and Joints, and Muscle Groups and Additional Structures. The Overview should help orient you to the distinguishing anatomic and functional features of each joint. As you study Anatomy and Physiology, practice identifying the important surface landmarks on yourself or a fellow student. Then turn to Techniques of Examination, also "head to toe," to learn the fundamental steps for examining the joints—inspection; palpation of bony landmarks and soft-tissue structures; assessment of range of motion, or the directions of joint movement; and maneuvers to test joint function.
It is helpful to begin by reviewing some anatomic terminology. Articular structures include the joint capsule and articular cartilage, the synovium and synovial fluid, intra-articular ligaments, and juxta-articular bone. Nonartic-ular structures include periarticular ligaments, tendons, bursae, muscle, fascia, bone, nerve, and overlying skin. You will need to visualize and assess all these structures to care for your patients with joint complaints. Note that ligaments are ropelike bundles of collagen fibrils that connect bone to bone. Tendons are collagen fibers connecting muscle to bone. Another type of collagen matrix forms the cartilage that overlies bony surfaces. Bursae are pouches of synovial fluid that cushion the movement of tendons and muscles over bone or other joint structures.
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