JOINTS

The technical name for a joint is an

articulation. Names of actual joints
are often based on the names of the
bones or structures involved in the
joint. Examples are the atlanto-
occipital joint and atlanto-axial
joint-
The sternoclavicular joint-

The acromioclavicular joint-

The glenohumeral joint-

The tibiotalar joint-

The humeroradial, humeroulnar
and radioulnar joints-

and many others.

Joints are also classified based on

how the bones in the joint are
connected. The four major
classifications are: 1) bony
(synostosis)-formed by ossification
of either fibrous or cartilaginous
joints- i.e. infant frontal and
mandibular bones-
growth plates-
2) fibrous (synarthrosis)-adjacent
bones are bound together by
collagen fibers-i.e. sutures,
gomphoses (associated with
periodontal ligaments) and
syndesmoses (more mobile than a
suture or gomphosis)-
Three types of sutures:
3) cartilaginous (amphiarthrosis)-
two bones connected by cartilage-
i.e. synchondroses (bones bound by
hyaline cartilage) and symphyses
(fibrocartilage disc sandwiched
between two bones).
4) synovial (diarthroses)- the most
numerous joints in the body. Freely
moveable. Most complex. Most
prone to crippling dysfunctions.
Where the bones come together,
they are coated with articular
(hyaline) cartilage. The joint space
(cavity) contains synovial fluid
(contains albumin and hyaluronic
acid) used to nourish the hyaline
cartilage, remove wastes and make
movement almost frictionless. A
joint (articular) capsule made of
connective tissue encloses the cavity
to keep the fluid in. The outer
fibrous capsule is connected to the
periosteum of the bones and the
cellular synovial membrane. This
secretes the fluid. Lamellar
(Pacinian) corpuscles and other
nerve endings send signals to the
brain to monitor limb positions and
joint movement.

A SIMPLE SYNOVIAL JOINT

Accessory structures associated
with synovial joints include
tendons, ligaments, bursae (sacs of
synovial fluid between adjacent
muscles) and tendon (synovial)
sheaths.
When synovial fluid is warmed by
exercise, it becomes thinner and is
more easily absorbed by the
articular cartilage. The cartilage
swells and is a thicker cushion to
protect against compression. Since
there is no circulation to the
cartilage, this is important for
nutrition and waste removal.

Joints and Levers-

A lever is an elongated, rigid object

that rotates around a fixed point
(fulcrum). In the skeleton, the
fulcrum is a joint. The muscle
applies the effort and the resistance
can be a weight being lifted, the
weight of the limb itself or the
tension in an opposing muscle.
First-class lever-the fulcrum is in
the middle like a seesaw. The
atlanto-occipital joint is an
example. Muscles of the back of the
neck pull down on the occipital
bone to counter the forward pull of
the skull.

Second-class lever-resistance is in
the middle. Sitting in a chair and
bouncing a child on the knee causes
the femur to pivot at the hip joint
(the fulcrum).

Third-class lever-the effort is

applied between the fulcrum and
the resistance. In rowing, the
forearm acts as the lever as the
elbow is flexed.

Range of motion at a joint-

determined by 1) structure of the
articular surfaces, 2) strength and
tautness of ligaments and the joint
capsule and 3) action of muscles
and tendons.

Classes of synovial joints-

1) Spheroidal (ball and

socket)-globular head fits
into a socket. EX: femur
into acetabulum, humeral
head into glenoid fossa.
2) Condylar (ellipsoidal)-ovoid
surface fits into an elliptical
cavity. EX: TMJ
(temporomandibular joint),
knee joint
3) Saddle joint (sellaris)-
opposing surfaces are
concavo-convex. EX:
carpo-metacarpal joint of
thumb. (trapezium-1st
metacarpal) and
sternoclavicular joint.
4) Gliding joint (planar)-two
planar (flat) surfaces
articulate. EX: vertebrae
articulating with each other
(joint of Luschka, facet
joint) and the carpal and
tarsal bones.
5) Ginglymus (hinge)-articular
surfaces molded together to
permit motion in one plane
only. EX: elbow and
interphalangeal (finger and
toe) joints.
6) Trochoid (pivot)-rotation
only. A ring moves around
a process. EX: atlas
rotating on dens
(atlantoaxial joint), radial
head articulating with the
humerus (capitulum)
(radioulnar joint).
Some joints have several different
types combined into one. The
temporomandibular joint, for
example, can be a combination of
condylar, hinge and planar joints.

The humeroradial joint is both a

hinge joint and a pivot joint.

Movement at synovial joints-

Flexion-closing the angle of the

joint.

Extension-opening the angle at the

joint.
Abduction-movement of the part
away from the midline.

Adduction-movement of the part

towards the midline.

Elevation-raising a body part.

Depression-lowering a body part.

Protraction-anterior movement of a
body part.

Retraction-posterior movement of a
body part.

The jaw is also capable of lateral

and medial excursion.
Circumduction-one end of the
appendage is stable while the other
end makes a circular motion.

Rotation-a bone spins onits

longitudinal axis. May be internal
or external.
Supination-palm or body is face up.

Pronation-palm or body is face

down.
Special movements of the head and
trunk-flexion, hyperextension,
lateral flexion, rotation. Extension
is simply standing upright.
Special movements of the hands
and digits-

Radial Flexion Ulnar Flexion

Finger Abduction Thumb Opposition

Special movements of the foot-

Dorsiflexion and Plantar Flexion

Inversion and Eversion of the Ankle
Joints that are not diarthrotic-

1) Synarthroses (immovable)-
surfaces of the bones are in
direct contact connected by
connective tissue or hyaline
cartilage. Sutures (already
discussed) and
Synchondroses-temporary
joints where cartilage is
converted to bone. EX:
growth plate.
2) Amphiarthroses (slightly
movable)-the bony surfaces are
united by cartilage.

a) Syndesmosis-two bones
united by an interosseous
ligament. EX: distal tibio-
fibular joint.
b) Symphysis-bony surfaces
are connected by a piece of
fibrocartilage disc. EX: pubic
symphysis, intervertebral discs.