Joints

DR S. MUTEMWA
Classification of Joints
 Functional classification
(Focuses on amount of movement)
 Synarthroses (immovable joints)
 Amphiarthroses (slightly movable joints)
 Diarthroses (freely movable joints)
 Structural classification
(Based on the material binding them and
presence or absence of a joint cavity)
 Bony fusion
 Fibrous
 Cartilagenous
 Synovial
Table of Joint Types
Functional across Synarthroses Amphiarthroses Diarthroses
(immovable joints) (some movement) (freely movable)
Structural down

Bony Fusion Synostosis

(frontal=metopic
suture; epiphyseal
lines)
Fibrous Suture (skull only) Syndesmoses Syndesmoses
-fibrous tissue is -ligaments only -ligament longer
continuous with between bones; here, (example: radioulnar
periosteum short so some but not interosseous
a lot of movement membrane)
(example: tib-fib
Gomphoses (teeth) ligament)
-ligament is
periodontal ligament
Cartilagenous Synchondroses Sympheses
(bone united by -hyaline cartilage -fibrocartilage
cartilage only) (examples: (examples: between
manubrium-C1, discs, pubic
epiphyseal plates) symphesis
Synovial Are all diarthrotic
 Fibrous joints
 Bones connected by fibrous tissue: dense regular
connective tissue
 No joint cavity
 Slightly immovable or
not at all
 Types
 Sutures
 Syndesmoses
 Gomphoses
Sutures
 Only between bones of
skull
 Fibrous tissue continuous
with periosteum
 Ossify and fuse in middle
age: now technically
called “synostoses”=
bony junctions
 Syndesmoses
 In Greek:
“ligament”

 Bones connected
by ligaments only

 Amount of
movement
depends on
length of the
fibers: longer
than in sutures
Gomphoses
 Is a “peg-in-
socket”

 Only example is
tooth with its
socket

 Ligament is a
short
periodontal
ligament
Cartilagenous joints

 Articulating bones united by cartilage

 Lack a joint cavity
 Not highly movable
 Two types
 Synchondroses (singular: synchondrosis)
 Sympheses (singular: symphesis)
 Synchondroses

 Literally: “junction of cartilage”

 Hyaline cartilage unites the bones
 Immovable (synarthroses)
 Examples:
 Epiphyseal plates
 Joint between first rib’s costal cartilage and manubrium of the
sternum
Sympheses

 Literally “growing together”

 Fibrocartilage unites the bones
 Slightly movable (amphiarthroses)
 Resilient shock absorber
 Provide strength and flexibility
 Hyaline cartilage on articular
surfaces of bones to reduce friction
 Examples
 Intervertebral discs
 Pubic symphysis of the pelvis
Synchondroses and
sympheses

Also pubic symphsis

Synovial joints

 Include most of the body’s joints

 All are diarthroses (freely

movable)

 All contain fluid-filled joint

cavity
General Structure of Synovial
Joints
1. Articular cartilage
 Hyaline
 Spongy cushions
absorb compression
 Protects ends of bones
from being crushed

2. Joint (synovial) cavity

 Potential space
 Small amount of
synovial fluid
 General structure of synovial joints
(cont.)
3. Articular (or joint)
capsule
 Two layered
 Outer*: fibrous capsule of
dense irregular connective *
tissue continuous with *
periosteum
 Inner*: synovial
membrane of loose *
connective tissue (makes
synovial fluid)
 Lines all internal joint
surfaces not covered by
cartilage*
General structure of synovial joints
(cont.)
4. Synovial fluid
 Filtrate of blood
 Contains special
glycoproteins
 Nourishes cartilage and
functions as slippery
lubricant
 “Weeping” lubricatioin
5. Reinforcing ligaments
(some joints)
 Capsular (most) – thickened
parts of capsule
 Extracapsular
 Intracapsular
General structure of synovial joints
(cont.)
6. Nerves
 Detect pain
 Monitor stretch (one of the
ways of sensing posture
and body movements)

7. Blood vessels
 Rich blood supply
 Extensive capillary beds in
synovial membrane
(produce the blood filtrate)
General structure of
synovial joints
 Some joints…

 Articular disc or
meniscus
(literally “crescent”)
 Only some joints
 Those with bone
ends of different
shapes or fitting poorly
 Some to allow two kinds of movement (e.g. jaw)
 Of fibrocartilage
 Examples: knee
TMJ (temporomandibular joint)
sternoclavicular joint
Bursae and tendon
sheaths
 Contain synovial fluid
 Not joints but often associated with them
 Act like ball bearings
 Bursa means “purse” in Latin
 Flattened sac lined by synovial membrane
 Where ligaments, muscles, tendons, or bones
overlie each other and rub together
 Tendon sheath
 Only on tendons subjected to friction
Bursae and tendon
sheaths
Joint stability
 Articular surfaces
 Shape usually plays only minor role
 Some deep sockets or grooves do provide stability
 Ligaments
 Usually the more, the stronger the joint
 Can stretch only 6% beyond normal length before
tear
 Once stretched, stay stretched
 Muscle tone
 Constant, low level of contractile force
 Keeps tension on the ligaments
 Especially important at shoulders, knees, arches of
foot
Movements allowed by synovial
joints
 Gliding
 Angular movements: or  the angle
between two bones DO TOGETHER
 Flexion
 Extension
 Abduction
 Adduction
 Circumduction
 Rotation
 Special movements
Special movements

 Pronation  Protraction
 Supination  Retraction
 Dorsiflexion  Elevation
 Plantar flexion  Depression
 Inversion  Opposition
 Eversion
Joint movements pics
(from Marieb, 4th ed.)
Synovial joints
classified by shape
(of their articular
surfaces)
 Plane (see right)
 Hinge (see right)
 Pivot
 Condyloid
 Saddle
 Ball-and-socket
Selected synovial joints

Shoulder
(glenohumeral)
joint
 Stability sacrificed for
mobility
 Ball and socket: head of
humerus with glenoid
cavity of scapula
 Glenoid labrum: rim of Rotator cuff muscles add to stability
fibrocartilage
 Thin, loose capsule
 Strongest ligament:
coracohumeral
 Muscle tendons help
stability
 Disorders
Biceps tendon is intra-articular
Elbow joint

 Hinge: allows only

flexion and extension
 Annular ligament of
radius attaches to
capsule
 Capsule thickens into:
 Radial collateral
ligament
 Ulnar collateral
ligament
 Muscles cross joint
 Trauma
 1. Radiocarpal joint
Wrist joint  Between radius and
proximal carpals
Two major joint surfaces (scaphoid and
Several ligaments stabilize lunate)
 Condyloid joint
 Flexion extension
adduction,
abduction,
circumduction

2. Intercarpal or
midcarpal joint
 Between the
proximal and distal
rows of carpals
Hip (coxal) joint

 Ball and socket

 Moves in all axes but
limited by ligaments
and deep socket
 Three ext. ligaments
“screw in” head of
femur when
standing
 Iliofemoral
 Pubofemoral
 Ischiofemoral
 Acetabular labrum
diameter smaller
than head of femur
 Dislocations rare
 Ligament of head of
femur supplies artery
 Muscle tendons cross
joint
 Hip fractures
common in elderly
because of
osteoporosis
Right hip, AP view
Knee joint

 Largest and most complex joint

 Primarily a hinge
 Compound and bicondyloid: femur and tibia
both have 2 condyles
 Femoropatellar joint shares joint cavity
 At least a dozen bursae
 Prepatellar
 Suprapatellar
 Lateral and medial
menisci
 “torn cartilage”
 Capsule absent
anteriorly
 Capsular and
extracapsular
ligaments
 Taut when knee
extended to prevent
hyperextension
 Patellar ligament
 Continuation of
quad tendon
 Medial and
lateral retinacula
 Fibular and tibial
collateral
ligaments
 Called medial
and lateral
 Extracapsular
 Oblique popliteal
 Arcuate popliteal
Cruciate
ligaments
 Cross each other
(cruciate means cross)
 Anterior cruciate (ACL)
 Anterior intercondylar
area of tibia to medial
side of lateral condyl of
femur
 Posterior cruciate
 Posterior intercondylar
area of tibia to lateral
side of medial condyl
 Restraining straps
 Lock the knee
Cruciate ligaments
Knee injuries

 Flat tibial surface

predisposes to
horizontal injuries
 Lateral blow:
multiple tears
 ACL injuries
 Stop and twist
 Commoner in
women athletes
 Heal poorly
 Require surgery
nkle joint

 Hinge joint
 Distal tibia and fibula to
talus
 Dorsiflexion and plantar
flexion only
 Medial deltoid ligament
 Lateral ligaments: 3 bands
 Anterior talofibular
 Posterior talofibular
 Calcaneofibular
 Anterior and posterior
tibiofibular (syndesmosis)
Right ankle, lateral view
Temporomandibular
joint (TMJ)
 Head of mandible
articulates with
temporal bone
 Disc protects thin
mandibular fossa of
temporal bone
 Many movements
Demonstrate movements
together

 Disorders common
 Sternoclavicular joint

 Saddle joint
 Only other example is
trapezium and metacarpal 1
(thumb), allowing opposion
 Sternum and 1st costal (rib)
cartilage articulate with clavicle
 Very stable: clavicle usually
breaks before dislocation of
joint
 Only bony attachment of axial
skeleton to pectoral girdle
Demonstrate movements
together
Disorders of joints

 Injuries
 Sprains
 Dislocatios
 Torn cartilage
 Inflammatory and degenerative
conditions
 Bursitis
 Tendinitis
 Arthritis
 Osteoarthritis (“DJD” – degenerative joint
disease)
 Rheumatoid arthritis (one of many
“autoimmune” arthritites)
 Gout (crystal arthropathy)