ARTHRO NEUROLOGY

INNERVATION:
 Joints tend to receive innervation from two sources:
 Articular nerves that are branches of adjacent peripheral nerves
 Branches from nerves that supply muscles controlling the joint
 Each joint is usually supplied by several nerves and their distributions tend to overlap considerably. In general, a particular aspect of a joint capsule is innervated by
branches of the nerve supplying the muscle or muscles that would when contract prevent overstretching of that part of the capsule.
 One notable exception is the anteroinferior aspect of the glenohumeral capsule, which is innervated by a branch from the axillary nerve.
 The nerve fibers of an articular nerve are purely afferent, with the exception of small vasomotor efferent to the blood vessels.
 The fiber sizes range from large myelinated fibers to small myelinated and unmyelinated fibers.

RECEPTORS
 Joint receptors transmit information about the status of the joint to the central nervous system.
 The central nervous system interprets the information sent by the joint receptors and responds by coordinating muscle activity around the joint to meet joint mobility and
stability requirements.
 Joint receptors function to protect the joint from damage incurred by going into the pathologic range of motion.
 They are also partly responsible for determining the appropriate balance between synergistic and antagonistic muscular forces and for generating an image of body
positioning and movement within the central nervous system.
 Four types of joint receptors have been identified, each serving a relatively specific role in the sensorimotor integration of joint function.

TYPE 1 - POSTURAL TYPE 2 – DYNAMIC TYPE 3 - INHIBITIVE TYPE 4 - NOCICEPTIVE

DESCRIPTIO Encapsulated endings similar to Thickly encapsulated, similar to Pacinian thinly encapsulated, similar to
Free nerve ending, and plexus
N Ruffini corpuscle corpuscle Golgi end organ
Primarily located in intrinsic and
extrinsic joint ligaments,
Numerous in the superficial joint Sparse (relative to type I); found in joint
superficial layers of the capsule; Located in most tissues: fibrous
capsule; usually found in clusters capsule and ligaments (deeper layers and fat
LOCATION in the lumbar spine not detected capsule, intrinsic and extrinsic
of six; located primarily in pad); primarily located in the lumbar spine,
in the longitudinal posterior ligaments, fat pads, periosteum
the neck, hip, and shoulder hand, foot, and jaw
ligament, longitudinal anterior
ligament, or iliolumbar ligament
Very slowly adapting (acts for
Slowly adapting (acts up to 1 several minutes following the On adapting, high threshold;
Rapidly adapting, low threshold; dynamic
ACTION minute following the initial initial stimulation), high pain receptors
mechanoreceptor
stimulation), mechanoreceptor threshold; dynamic
mechanoreceptor
Sudden changes in joint motion; may be Stretch at end range; more active Marked mechanical deformation
Changing mechanical stresses in
STIMULUS more active with oscillation techniques than with fast manipulation or tension; direct mechanical or
the joint capsule
with traction techniques chemical irritation
FUNCTION Provides information concerning Fires only on quick change in movement; Monitors direction of Inactive under normal
the static and dynamic position of provides information concerning acceleration movement; has reflex effect on conditions; active when related
the joint; is constantly tiring; and deceleration of joint movement; act at muscle tone to provide a tissue is subject to marked
contributes to regulation of initiation of movement as a "booster" to help “bracing” mechanism against deformation or both are noxious
postural muscle tone; contributes overcome inertia of body parts movement tending to over mechanical or chemical
to kinaesthetic (movement) sense displace the joint stimulation; produces tonic
muscle contraction