JOINTS: ARTICULATION, ARTHROSIS 2.

SYNDESMOSIS
 A joint is a point of contact between two bones, between  Greater distance between bones and greater amount of
bone and cartilage, or between bone and teeth. dense irregular connective tissue
 The scientific study of joints is termed ARTHROLOGY.  Examples
CLASSIFICATIONS  Distal tibia to distal fibula, “tibiofibular joint”
 Structurally: by their anatomy (amphiarthrosis)
 Fibrous, cartilaginous, or synovial  Gomphosis (amphiarthrosis) “dentoalveolar joint”:
 Functionally: by the degree of movement they permit tooth root in socket (alveolar process) of mandible
 Immovable, slightly movable, and freely movable or maxilla
STRUCTURAL CLASSIFICATION
Based on what is between bones:
 Space present? (synovial cavity)
 Type of connective tissue present
TYPES OF BONE BY STRUCTURAL CLASSIFICATION
1. FIBROUS JOINTS: no cavity, just dense irregular
connective tissue
2. CARTILAGINOUS JOINTS: no cavity, bones held together
by CARTILAGE
3. SYNOVIAL JOINTS: have synovial cavity, dense irregular 3. INTEROSSEOUS MEMBRANE (AMPHIARTHROSIS)
tissue of articular capsule, and often by accessory  Has greater amount of dense irregular connective tissue,
ligaments binds neighboring long bones
FUNCTIONAL CLASSIFICATION  Examples: extensive membranes between shafts of some
Based on degree of movement they permit long bones
TYPES OF BONE BY FUNCTIONAL CLASSIFICATION  RADIUS-ULNA
1. SYNARTHROSIS: immovable  TIBIA-FIBULA
 Coronal suture, epiphyseal cartilage Interosseous membrane are sites for attachments in muscles
2. AMPHIARTHROSIS: slightly movable especially muscles responsible for movement of digits of the
 Tibia-fibula, Teeth, intervertebral joints, pelvic hands and feet.
symphysis
3. DIARTHROSIS: freely movable
 Most joints of the body
 All diarthrotic joints are synovial
 Synovial cavity with its fluid present characteristics
making joints extend its range of motion
FIBROUS JOINTS
-Permit little or no movement
1. SUTURE (ADULTS–SYNARTHROSIS; INFANTS-
AMPHIARTHROSIS)
 Joined by thin layer of dense fibrous connective tissue
 Example: between bones of skull FIGURE 6: RADIUS ULNA
 Synostosis (Synarthrosis) – suture replaced by bone Attached at last page
The irregular, interlocking edges of sutures give them added
strength (stability) and decrease their chance of fracturing. CARTILAGINOUS JOINTS
Fontanels function for allowing the brain of young child to grow  Lacks a synovial cavity and allows little or no movement.
and develop in size it also allows the head to be delivered in the vaginal  the articulating bones are tightly connected by either hyaline
area (normal vaginal delivery). Anterior fontanel will fuse first before cartilage or fibrocartilage
posterior fontanel because of size 1. SYNCHONDROSIS (AMPHIARTHROSIS-SYNARTHROSIS)
 Hyaline cartilage connects two areas of bone
 Example: MANUBRIUM AND 1ST RIB
In an x-ray of a young person’s skeleton, the synchondroses are
easily seen as thin dark areas between the white-appearing bone tissues.
Doctors use epiphyseal plates and cartilaginous joints
signifying/characteristic a young person. When epiphyseal plates are
present there is still development of the bone for growth. Once
epiphyseal plates close there will be a limitation for the growth
lengthwise. Fractures extending to the epiphyseal plate can develop
problems in lengthening.
  Examples: EPIPHYSEAL (GROWTH) PLATE that connects the
epiphysis and diaphysis of a growing bone
 Functionally, epiphyseal cartilage is an immovable joint
(SYNARTHROSIS).
 When bone elongation ceases, bone replaces the hyaline
cartilage, and becomes a SYNOSTOSIS, a bony joint.

SYNOVIAL JOINTS: STRUCTURE

1. SYNOVIAL CAVITY (JOINT CAVITY)
 space containing fluid; allows considerable joint movement
2. ARTICULAR CARTILAGE
 A layer of hyaline cartilage that covers ends of bones, absorbs
shock and reduces friction
3. ARTICULAR CAPSULE (JOINT CAPSULE)
 Unites articulating bones
 2 Layers:
2. SYMPHYSIS (AMPHIARTHROSIS)
 INNER LAYER: synovial membrane (areolar connective
 End of articulating bones are covered w/ HYALINE
tissue with elastic fibers) that secretes synovial fluid
CARTILAGE, but a broad, flat disc of FIBROCARTILAGE
(reduces friction, supplies nutrients)
connects the bones
 OUTER LAYER: fibrous membrane, dense irregular
 All occur in the midline of the body
connective tissue (continuation of periosteum in between
 Examples: PUBIC SYMPHYSIS, STERNAL ANGLE AND
the bones)
INTERVERTEBRAL DISCS
Because the synovial cavity allows considerable movement at a joint, all
synovial joints are classified functionally as freely movable (diarthroses).

ADDITIONAL SYNOVIAL JOINT STRUCTURES

In some cases synovial joints include:
Ligaments help stabilize the normal anatomical position of the bones.
They hold bones in position and allow a certain degree of movement.
They are sturdy but because of its flexibility it allows movement.
Sternal angle corresponds to the articulation of the costal cartilage of  ACCESSORY LIGAMENTS
second rib.  EXTRACAPSULAR LIGAMENTS – outside the articular
capsule; Example: FIBULAR AND TIBIAL COLLATERAL
3. EPIPHYSEAL CARTILAGES LIGAMENTS of the knee joint
 HYALINE CARTILAGE growth centers during endochondral
bone formation, not joints associated with movements
  INTRACAPSULAR LIGAMENTS – within the articular capsule
but excluded from synovial cavity; Example: ANTERIOR AND
POSTERIOR CRUCIATE LIGAMENTS of the knee joint
 MENISCI (ARTICULAR DISCS) a piece of cartilage found where
two bones meet (joint space)
 ARTICULAR FAT PADS: depositions of adipose fatty tissues
 LABRUM
 Prominent in ball-and-socket joints of the shoulder and hips
 BURSAE
 Sacs made of synovial membranes containing fluid
 Located where friction can occur
 Examples: between skin-bone, tendons-bones, muscles-
bones, ligaments-bones

TYPES OF MOVEMENTS AT SYNOVIAL JOINTS

 GLIDING
 Flat bone surfaces moving across each other
 INTERCARPAL AND INTERTARSAL JOINTS
 ANGULAR MOVEMENTS
 There is an increase or a decrease in the angle between
articulating bones
 The major angular movements are flexion, extension,
lateral flexion, hyperextension, abduction, adduction,
and circumduction(circular movements in distal area)
ANGULAR MOVEMENTS
 FLEXION
 Decrease in angle between articulating bones.
 EXTENSION
 Increase in angle between articulating bones
 In ANATOMICAL POSITION the body is in full extension.
 HYPEREXTENSION
 Bending beyond 180 degrees, such as moving humerus
backwards behind anatomical position.

GLIDING MOVEMENTS AT SYNOVIAL JOINTS

ANGULAR MOVEMENT
 ABDUCTION
 Movement of bone away
from midline
 ADDUCTION
 Movement of bone toward
midline
 CIRCUMDUCTION
 Movement of distal end in a
circle
 ROTATION
 Bone revolves around its
own LONGITUDINAL AXIS

ANGULAR MOVEMENTS AT SYNOVIAL JOINTS

In angular movements, there is an increase or decrease in the angle
between articulating bones.
  Protract clavicles at the ACROMIOCLAVICULAR AND
STERNOCLAVICULAR JOINTS by crossing arms
 RETRACTION
 Movement backward into anatomical position

SPECIAL MOVEMENTS
 INVERSION
 Move soles medially
 EVERSION
SPECIAL MOVEMENTS
 Move soles laterally
 ELEVATION
 DORSIFLEXION
 Movement upward
 Bend foot toward dorsum (“stand on heels”)
 Closing mouth at the TMJ
 PLANTAR FLEXION
 DEPRESSION
 Bend foot toward plantar surface (“stand on toes”)
 Movement downward
 Open mouth to depress the MANDIBLE
 Return shrugged shoulders (depress SCAPULA AND
CLAVICLE)
 PROTRACTION
 Movement forward
 Protract MANDIBLE at TMJ

 SUPINATION
Movement of forearm so palms face forward or upward
 
 PRONATION
 Movement of forearm so palms face backward or downward
 OPPOSITION
 Movement of the thumb at the carpometacarpal joint in which
the thumb moves across the palm to touch the tips of the
fingers on the same hand
FIGURE 1: SUMMARY OF MOVEMENTS AT SYNOVIAL JOINTS
Attachment at last page
SIX TYPES OF SYNOVIAL JOINTS
 Although all synovial joints have many characteristics in common,
the shapes of the articulating surfaces vary = many types of
movements are possible.
 Synovial joints are divided into six categories based on type of
movement:
 PLANE, HINGE, PIVOT, CONDYLOID, SADDLE, AND BALL-
AND-SOCKET.
PLANAR JOINTS
 Articulating surfaces flat or slightly curved
 permit back-and-forth and side-to-side movements between the
flat surfaces of bones, but they may also rotate against one
another
Examples: between CARPALS (INTERCARPALS), TARSALS
(INTERTARSAL JOINTS), STERNUM-CLAVICLE
(STERNOCLAVICULAR JOINT & ACOMIOCLAVICULAR
JOINTS), SCAPULA-CLAVICLE, STERNOCOSTAL JOINTS,
VERTERBROCOSTAL JOINTS (thoracic bodies and traverse processes
which have articulations with the head and the tubercles of the rib; joints
formed by the rib and thoracic vertebrae are planar joints)
 Movements: GLIDING
HINGE JOINTS
 Ginglymus joint
 CONVEX-TO-CONCAVE surfaces
 As the name implies, hinge joints produce an angular, opening-
andclosing motion like that of a hinged door
 In most joint movements, one bone remains in a fixed position
while the other moves around an axis.
 Examples: ELBOW, KNEE, ANKLE, INTERPHALANGEAL
 Movements: FLEXION (F) AND EXTENSION (E) ONLY
(MONOAXIAL)
  Movements: F-E, ABD-ADD + LIMITED CIRCUMDUCTION
(BIAXIAL)

SADDLE JOINTS
 Sellar joint
 One side is saddle-shaped, other like a rider sitting on the
“saddle”
 Example: CARPOMETACARPAL JOINT: trapezium (carpal) to
PIVOT JOINTS metacarpal-1 (thumb)
 Trochoid joint  Movements: BIAXIAL (F-E, ABD-ADD + LIMITED
 Rounded surface with ring formed by bone and ligament CIRCUMDUCTION)
 Examples: ATLANTOAXIAL JOINT (to turn head to say “no”) and
RADIUS-ULNA for pronation-supination
 Movement: ROTATION (ROT)

BALL-AND-SOCKET JOINTS
 Spheroid joint
 Ball-like surface into cuplike socket surface
 Example: shoulder, hip
 Movements: TRIAXIAL (F-E, ABD-ADD, ROT)

CONDYLOID JOINTS FIGURE 2: SUMMARY OF TYPES OF SYNOVIAL JOINT

 Ellipsoidal joint
 CONVEX OVAL SURFACE TO CONCAVE OVAL SURFACE FIGURE 3: SUMMARY OF STRUCTURAL AND FUNCTIONAL
 Examples: RADIOCARPAL (WRIST) and metacarpophalangeal CLASSFICATIONS OF JOINTS
(2nd to 5th digits)
FIGURE 4: 3RD SUMMARY OF SIX TYPES OF SYNOVIAL JOINTS

TEMPOROMANDIBULAR JOINT (TMJ)

 The temporomandibular joint (TMJ)
 A combined hinge and plane joint formed by the condylar process
of the mandible and the mandibular fossa and articular tubercle of
the temporal bone.
 The temporomandibular joint is the only freely movable joint
between skull bones (with the exception of the ear ossicles-for
transmission of sound and vibration)
 All other skull joints are sutures and therefore immovable or
slightly movable.
 CREPITUS is the abnormal popping or crackling sound in a joint.
It is often accompanied by a popping or crunching sensation that
may sometimes be uncomfortable or painful. Signifies a stiffened
joint.

SHOULDER JOINT FIGURE 6: ELBOW JOINT

 Ball-and-socket joint formed by the head of the humerus and the
glenoid cavity of the scapula. HIP JOINT
 It is also referred to as the humeroscapular or glenohumeral joint The hip joint (coxal joint) is a ball-and-socket joint formed by the head
of the femur and the acetabulum of the hip bone.
KNEE JOINT
The KNEE JOINT (TIBIOFEMORAL JOINT) is the largest and most
complex joint of the body.
It is a modified hinge joint (because its primary movement is a
UNIAXIAL hinge movement) that consists of three joints within a
single synovial cavity:
1. Laterally is a TIBIOFEMORAL JOINT, between the lateral
condyle of the femur, lateral meniscus, and lateral condyle of
the tibia, which is the weight-bearing bone of the leg.
2. Medially is ANOTHER TIBIOFEMORAL JOINT, between the
medial condyle of the femur, medial meniscus, and medial
condyle of the tibia.
3. An INTERMEDIATE PATELLOFEMORAL JOINT is between the
patella and the patellar surface of the femur.
  In a total hip replacement, damaged portions of the acetabulum
and the head of the femur are replaced by PROSTHESES.

 Joints that have been severely damaged by diseases such as

arthritis, or by injury, may be replaced surgically with artificial
joints in a procedure referred to as ARTHROPLASTY
(arthro=joint; plasty=repair)
HIP REPLACEMENT

DETAILS OF A SYNOVIAL JOINT: KNEE JOINT

 LIGAMENTS
 Tibial and fibular collateral ligaments
 ANTERIOR CRUCIATE LIGAMENT (ACL): 70% of knee
injuries (Because of increase in friction & there is this factor
wherein we put tension/pressure to our knees like heavy
sports.)
 POSTERIOR CRUCIATE LIGAMENT (PCL)
 Patellar ligament
 Oblique and arcuate popliteal ligaments
 MENISCI (MEDIAL AND LATERAL)
 Fibrocartilage discs that increase stability of knee joint
 BURSAE

AGING AND JOINTS

 Decrease in production of synovial fluid; smooth transition of
joints will not be the same that is why there will be limitation of
movement for older adults
 Thinning of articular cartilage
 Ligaments shorten and lose flexibility
 Influenced by genetic factors
 Degenerative joint changes may appear as early as 20 years old
 80 years old – almost everyone develops degeneration
 stretching and aerobic exercises – minimize effects of aging

TOTAL HIP AND KNEE REPLACEMENT

 Rheumatoid arthritis is because of an autoimmune reason the body’s
immune system attacks the joint causing inflammation (swollen
inflamed synovial membrane).
Gouty arthritis-deposition of uric acid crystals because of increased
uric acid within our body. Because also of increased intake of foods rich
in uric acid and maybe the decrease of excretion of uric acid

If there is an imbalance in the body always think about increase of

production or intake or decrease in excretion or removal of a particular
substance

KNEE REPLACEMENT

COMMON DISORDERS OF JOINTS

 COMMON JOINT INJURIES  LYME DISEASE
 Rotator cuff injury: SITS muscle (Supraspinatus, Infraspinatus,  A spiral-shaped bacterium called Borrelia burgdorferi causes
Teres minor, Subscapularis) Lyme disease
 Separated shoulder  The bacteria are transmitted to humans mainly by deer
 Tennis elbow: condition that causes pain around the outside of the  These ticks are so small that their bites often go unnoticed.
elbow. It's clinically known as lateral epicondylitis. It often happens after
overuse or repeated action of the muscles of the forearm, near the elbow
joint.
 Dislocation of the radial head
 Knee injuries: swollen knee, rupture of tibial collateral ligaments,
dislocated knee
 RHEUMATISM: rheumatoid arthritis, osteoarthritis, gouty arthritis
Arthritis is a degenerative disease meaning it undergoes wear and tear
of joints. When we become older joints also wear and tear also losing the
flexibility that’s why we have osteoarthritis.
SPRAIN AND STRAIN
SPRAIN
 A sprain is the forcible wrenching or twisting of a JOINT that
stretches or tears its LIGAMENTS but does not dislocate the
bones. It occurs when the ligaments are stressed beyond their
normal capacity.
 Added trauma because change of position. In this case it is a
tearing of the tibiofibular ligament and calcaneofibular ligament
because of inversion of the foot

STRAIN
 A strain is a stretched or partially torn muscle or MUSCLE AND
TENDON. It often occurs when a muscle contracts suddenly and
powerfully—such as the leg muscles of sprinters when they spring
from the blocks.
 FIGURE 1: SUMMARY OF MOVEMENTS AT SYNOVIAL JOINTS

FIGURE 2: SUMMARY OF TYPES OF SYNOVIAL JOINT

FIGURE 3: SUMMARY OF STRUCTURAL AND FUNCTIONAL CLASSIFICATIONS OF JOINTS
FIGURE 4: SIX TYPES OF SYNOVIAL JOINTS
ELBOW JOINT
FIGURE 6: RADIUS ULNA
HIP JOINT
SHOULDER JOINT