JOINTS

DR AISHA MOHD
DIN
Department of Basic Sciences
 Objectives
• Joints and their classification
– bony joints
– fibrous joints
– cartilaginous joints
• Synovial joints
• Anatomy of joints
– humeroscapular joint
– elbow joint
– hip joint
– knee joint
Joints and Their Classification
• Arthrology = study of the joints
• Kinesiology = study of musculoskeletal
movement
• Classified by freedom of movement
– diarthrosis (freely movable)
– amphiarthrosis (slightly movable)
– synarthrosis (little or no movement)
• Classified how adjacent bones are joined
– fibrous, cartilaginous, bony or synovial
 Bony Joint (Synostosis)

• Gap between two bones ossifies

– frontal and mandibular bones in infants
– cranial sutures in elderly
– attachment of first rib and sternum
• Can occur in either fibrous or
cartilaginous joint
Fibrous Joints (Synarthrosis)

• Collagen fibers span the space

between bones
– sutures, gomphoses and syndesmoses
 Fibrous Joint -- Sutures
• Immovable fibrous joints
– bind skull bones together
• Serrate - interlocking lines
– coronal, sagittal and lambdoid
sutures
• Lap - overlapping beveled
edges
– temporal and parietal bones
• Plane - straight,
nonoverlapping edges
– palatine processes of the
maxillae
Types of Sutures

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 Fibrous Joint -- Gomphoses
• Attachment of a tooth to
its socket
• Held in place by fibrous
periodontal ligament
– collagen fibers attach
tooth to jawbone
• Some movement while
chewing
 Fibrous Joint -- Syndesmosis
• Two bones bound
by ligament only
– interosseus
membrane
• Most movable of fibrous joints
• Long collagenous fibers
• Interosseus membranes unite radius to
ulna and tibia to fibula
 Cartilaginous Joint

• Synchondrosis
• Symphysis
Cartilaginous Joint -- Synchondrosis

• Bones are joined by

hyaline cartilage
– rib attachment to
sternum
– other costal
cartilages are joined
to the sternum by
synovial joints
Cartilaginous Joint -- Synchondrosis
– epiphyseal plate in
children binds
epiphysis and
diaphysis
Cartilaginous Joint -- Symphysis

• 2 bones joined by
fibrocartilage
– pubic symphysis
and intervertebral
discs
– provides flexibility
to spine
• Only slight amount
of movement is
possible
 Synovial Joint

• Joint in which two bones are separated by a space called a

joint cavity
• Most are freely movable
 General Anatomy
• Articular capsule encloses joint
cavity
– continuous with periosteum
– lined by synovial membrane
• Articular cartilage = hyaline
cartilage covering the joint surfaces
• Synovial fluid is rich in albumin and
hyaluronic acid
• Nourishes the articular cartilages
• Removes their wastes and prevents
friction during movements
 General Anatomy
• Menisci
– knee joints
– cartilages extend inward
– do not entirely cross the joint
– improve the fit between the
bones
– stabilize the joint
– reduces the chance of
dislocation
• Tendon attaches muscle to bone
• Ligament attaches bone to bone
 General Anatomy
Accessory structures
1.Tendon
•Sheet of tough collagenous connective
tissue that attaches a muscle to a bone
2. Ligament
•Attaches one bone to another
3. Bursa
•Fibrous sac filled with synovial fluid
•Between adjacent muscles, bone and skin
•Cushion muscles
•Bursitis- inflammation of bursa
 Axes of Rotation

• Shoulder joint has 3 degrees of freedom =

multiaxial joint
• Other joints – uniaxial or biaxial
Types of Synovial Joints
 Ball-and-Socket Joints
• Smooth hemispherical
head fits within a
cuplike depression
– head of humerus into
glenoid cavity of
scapula
– head of femur into
acetabulum of hip bone
• Multiaxial joint
 Condyloid (ellipsoid) Joints
• Oval convex surface on one bone fits into a
similarly shaped depression on the next
– radiocarpal joint of the wrist
– metacarpophalangeal joints at the bases of the
fingers
• Biaxial joints
 Saddle Joints
• Each articular surface is shaped like a saddle, concave
in one direction and convex in the other
– trapeziometacarpal joint at the base of the thumb
• Biaxial joint
– more movable than a condyloid or hinge joint forming the
primate opposable thumb
 Gliding Joints
• Flat articular surfaces in which bones
slide over each other
• Limited uniaxial joint
• Considered amphiarthroses (slightly
movable)
 Hinge Joints
• One bone with convex
surface that fits into a
concave depression on
other bone
– ulna and humerus at
elbow joint
– femur and tibia at knee
joint
– finger and toe joints
• Uniaxial joint
 Pivot Joints
• One bone has a projection that fits into a ringlike
ligament of another
• First bone rotates on its longitudinal axis relative to
the other
– atlantoaxial joint (dens and atlas)
– proximal radioulnar joint allows the radius during pronation
and supination
 Flexion, Extension and
Hyperextension

• Flexion decreases the

angle of a joint
• Extension straightens
and returns to the
anatomical position
• Hyperextension =
extension beyond 180
degrees
Flexion, Extension and
Hyperextension
 Abduction and Adduction

• Abduction is movement of a part away from the

midline
– hyperabduction – raise arm over back or front of head
• Adduction is movement towards the midline
– hyperadduction – crossing fingers
 Elevation and Depression

• Elevation is a movement that raises a bone

vertically
– mandibles are elevated during biting and clavicles
during a shrug
• Depression is lowering the mandible or the
shoulders
 Protraction and Retraction

• Protraction =
movement anteriorly
on horizontal plane
– thrusting the jaw
forward, shoulders or
pelvis forward
• Retraction is
movement posteriorly
 Circumduction
• Movement in which one
end of an appendage
remains stationary while
the other end makes a
circular motion
• Sequence of flexion,
abduction, extension and
adduction movements
– baseball player winding up
for a pitch
 Rotation
• Movement on
longitudinal axis
– rotation of trunk,
thigh, head or arm
• Medial rotation
turns the bone
inwards
• Lateral rotation
turns the bone
outwards
Supination and Pronation
• In the forearm and foot
• Supination
– rotation of forearm so that the
palm faces forward
– inversion and abduction of foot
(raising the medial edge of the
foot)
• Pronation
– rotation of forearm so the palm
faces to the rear
– eversion and abduction of foot
(raising the lateral edge of the
foot)
 Movements of Head and
Trunk

• Flexion, hyperextension and lateral flexion of

vertebral column
 Rotation of Trunk and Head

• Right rotation of trunk; rotation of head

 Movements of Mandible

• Lateral excursion = sideways movement

• Medial excursion = movement back to the midline
– side-to-side grinding during chewing
• Protraction – retraction of mandible
Movement of Hand and Digits
• Radial and ulnar
flexion
• Abduction of
fingers and thumb
• Opposition is
movement of the
thumb to approach
or touch the
fingertips
• Reposition is
movement back to
the anatomical
position
 Movements of the Foot

• Dorsiflexion is raising of the toes as when you swing the foot

forward to take a step (heel strike)
• Plantarflexion is extension of the foot so that the toes point
downward as in standing on tiptoe
• Inversion is a movement in which the soles are turned
medially
• Eversion is a turning of the soles to face laterally
 The Glenohumeral Joint
• Most freely movable joint in the body
– shallowness and looseness
– deepened by glenoid labrum
• Supported by ligaments and tendons
– 3 glenohumeral, coracohumeral,
transverse humeral and biceps
tendon are
important joint stabilizer
• Supported by rotator cuff musculature
– tendons fuse to joint capsule and
strengthens it
– supraspinatus, infraspinatus, teres
minor and subscapularis,
• 4 Bursae associated with shoulder joint
Stabilizers of the Shoulder
Joint
Tendons of Rotator Cuff
Muscles
Dissection of Shoulder Joint
 The Elbow Joint
• Single joint capsule
enclosing the
humeroulnar and
humeroradial joints
• Humeroulnar joint is
supported by collateral
ligaments.
• Radioulnar joint is head
of radius held in place by
the anular ligament
encircling the head
Elbow Joint
 The Hip Joint

• Head of femur articulates with acetabulum

• Socket deepened by acetabular labrum
• Blood supply to head of femur found in
ligament of the head of the femur Joint capsule
strengthened by ligaments
Hip Joint
• Joint capsule
strengthened by
ligaments
– pubofemoral
– ischiofemoral
– iliofemoral
Dissection of Hip Joint
 The Knee Joint
• Most complex diarthrosis
– patellofemoral = gliding joint
– tibiofemoral = gliding with slight
rotation and gliding possible in
flexed position
• Joint capsule anteriorly
consists
of patella and extensions of
quadriceps
femoris tendon
• Capsule strengthened by
extracapsular and intracapsular
ligaments
Knee Joint – Sagittal Section
 Knee Joint – Anterior and
Posterior Views

• Anterior and lateral cruciate ligaments limit

anterior and posterior sliding movements
• Medial and lateral collateral ligaments prevent
rotation of extended knee
 Knee Joint – Superior View

• Medial and lateral meniscus absorb shock and shape joint

Dissection of Knee Joint
 Arthritis

• Arthritis is a broad term for pain and

inflammation
• Osteoarthritis results from years of joint
wear
– articular cartilage softens and degenerates
– accompanied by crackling sounds called
crepitus
– bone spurs develop on exposed bone tissue
causing pain
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 Arthritis and Artificial Joints
• Rheumatoid arthritis is autoimmune
attack on joint
– antibodies attack synovial membrane,
enzymes in synovial fluid degrade the
cartilage, bones ossify
– remissions occur, steroids and aspirin
control inflammation
• Arthroplasty is replacement of
diseased joint with artificial device
called prosthesis
Rheumatoid Arthritis
Joint Prostheses
THANK YOU