anat

anat
omy lecture on
JOINTSFri 5 Dec
 Joints
• A site where 2 or more bones come together,
whether or not movement occurs between
them, is called a joint.
• Joints are classified according to the tissues
that lie between the bones:
1. fibrous joints,
2. cartilaginous joints, and
3. Synovial joints.
 3 types of Joints
Joints are classified into 3 types:
1. Fibrous (synarthroses): bones joined by fibrous
connective tissue
2. Cartilaginous (amphiarthroses): bones joined by
cartilage, or cartilage and fibrous tissue
3. Synovial (diarthroses): bones joined by a joint
cavity filled with a small amount of synovial fluid
and surrounded by a capsule; the bony articular
surfaces are covered with hyaline cartilage
 Fibrous Joints
• The articulating surfaces of the bones are
joined by fibrous tissue
• and thus very little movement is possible.
• examples of fibrous joints:
– The sutures of the vault of the skull and
– the inferior tibiofibular joints
Fibrous jt
 Cartilaginous Joints
Cartilaginous joints can be divided into 2
types:
1. primary and
2. secondary
 primary cartilaginous joint
• A primary cartilaginous joint is one in which
the bones are united by a plate or a bar of
hyaline cartilage. No movement is possible.
Examples:
– the union between epiphysis & diaphysis of a
growing bone
– between the 1st rib & the manubrium sterni
 secondary cartilaginous joint
• A secondary cartilaginous joint is one in
which the bones are united by a plate of
fibrocartilage and the articular surfaces of the
bones are covered by a thin layer of hyaline
cartilage. A small amount of movement is
possible. Examples:
– the joints between the vertebral bodies
– the symphysis pubis
Cartilaginous jt
 Synovial Joints
• The articular surfaces of the bones are covered by a
thin layer of hyaline cartilage separated by a joint
cavity.
• This arrangement permits a great degree of
freedom of movement
• The cavity of the joint is lined by synovial
membrane, which extends from the margins of one
articular surface to those of the other.
• The synovial membrane is protected on the outside
by a tough fibrous membrane referred to as the
capsule of the joint.
Synovial jt
 Synovial Joints …ctd
• The articular surfaces are lubricated by a
viscous fluid called synovial fluid, which is
produced by the synovial membrane.
• In certain synovial joints, (ex: knee joint), discs
or wedges of fibrocartilage are interposed
between the articular surfaces of the bones.
These are referred to as articular discs.
• Fatty pads are found in some synovial joints
lying between the synovial membrane and the
fibrous capsule or bone.
– Ex: hip & knee joints
 Applied anatomy
• The presence of cartilaginous discs within
joints, especially weight-bearing joints, as in
the case of the knee, makes them particularly
susceptible to injury in sports.
– During a rapid movement, the disc loses its
normal relationship to the bones and becomes
crushed between the weight-bearing surfaces
 degree of movement in a synovial joint
• is limited by the shape of the bones participating in
the joint, the coming together of adjacent anatomic
structures (e.g., the thigh against the anterior
abdominal wall on flexing the hip joint), and the
presence of fibrous ligaments uniting the bones.
• Most ligaments lie outside the joint capsule, but in
the knee some important ligaments, the cruciate
ligaments, lie within the capsule.
• Synovial joints can be classified according to the
arrangement of the articular surfaces and the types
of movement that are possible.
Type of joint description Movements possible examples
Plane joint the apposed articular surfaces permits the bones to slide sternoclavicular &
are flat or almost flat on one another acromioclavicular joints
Hinge joint resemble the hinge on a door flexion & extension elbow, knee & ankle
joints

Pivot joint a central bony pivot is rotation atlantoaxial & superior

surrounded by a bony– radioulnar joints
ligamentous ring
Condyloid 2 distinct convex surfaces flexion, extension, abduction metacarpophalangeal
joint articulate with 2 concave surfaces & adduction + a small joints or knuckle joints
amount of rotation
Ellipsoid joint elliptical convex articular surface flexion, extension, abduction Wrist joint
fits into an elliptical concave & adduction, but rotation is
articular surface impossible
Saddle joint articular surfaces are reciprocally flexion, extension, carpometacarpal joint
concavo-convex & resemble a abduction, adduction & of the thumb
saddle on a horse’s back rotation

Ball-and- Ball-shaped head of one bone fits Free movements: flexion, shoulder & hip joints
socket joint into a socket-like concavity of extension, abduction,
another adduction, medial rotation,
lateral rotation &
circumduction
 A. Plane joints
(sternoclavicular & acromioclavicular joints)
Type of joint description Movements possible examples
Plane joint the apposed articular surfaces permits the bones to slide sternoclavicular &
are flat or almost flat on one another acromioclavicular joints
Hinge joint resemble the hinge on a door flexion & extension elbow, knee & ankle
joints

Pivot joint a central bony pivot is rotation atlantoaxial & superior

surrounded by a bony– radioulnar joints
ligamentous ring
Condyloid 2 distinct convex surfaces flexion, extension, abduction metacarpophalangeal
joint articulate with 2 concave surfaces & adduction + a small joints or knuckle joints
amount of rotation
Ellipsoid joint elliptical convex articular surface flexion, extension, abduction Wrist joint
fits into an elliptical concave & adduction, but rotation is
articular surface impossible
Saddle joint articular surfaces are reciprocally flexion, extension, carpometacarpal joint
concavo-convex & resemble a abduction, adduction & of the thumb
saddle on a horse’s back rotation

Ball-and- Ball-shaped head of one bone fits Free movements: flexion, shoulder & hip joints
socket joint into a socket-like concavity of extension, abduction,
another adduction, medial rotation,
lateral rotation &
circumduction
B. Hinge joint
(elbow joint)
Type of joint description Movements possible examples
Plane joint the apposed articular surfaces permits the bones to slide sternoclavicular &
are flat or almost flat on one another acromioclavicular joints
Hinge joint resemble the hinge on a door flexion & extension elbow, knee & ankle
joints

Pivot joint a central bony pivot is rotation atlantoaxial & superior

surrounded by a bony– radioulnar joints
ligamentous ring
Condyloid 2 distinct convex surfaces flexion, extension, abduction metacarpophalangeal
joint articulate with 2 concave surfaces & adduction + a small joints or knuckle joints
amount of rotation
Ellipsoid joint elliptical convex articular surface flexion, extension, abduction Wrist joint
fits into an elliptical concave & adduction, but rotation is
articular surface impossible
Saddle joint articular surfaces are reciprocally flexion, extension, carpometacarpal joint
concavo-convex & resemble a abduction, adduction & of the thumb
saddle on a horse’s back rotation

Ball-and- Ball-shaped head of one bone fits Free movements: flexion, shoulder & hip joints
socket joint into a socket-like concavity of extension, abduction,
another adduction, medial rotation,
lateral rotation &
circumduction
 C. Pivot joint
(atlantoaxial joint)
Type of joint description Movements possible examples
Plane joint the apposed articular surfaces permits the bones to slide sternoclavicular &
are flat or almost flat on one another acromioclavicular joints
Hinge joint resemble the hinge on a door flexion & extension elbow, knee & ankle
joints

Pivot joint a central bony pivot is rotation atlantoaxial & superior

surrounded by a bony– radioulnar joints
ligamentous ring
Condyloid 2 distinct convex surfaces flexion, extension, abduction metacarpophalangeal
joint articulate with 2 concave surfaces & adduction + a small joints or knuckle joints
amount of rotation
Ellipsoid joint elliptical convex articular surface flexion, extension, abduction Wrist joint
fits into an elliptical concave & adduction, but rotation is
articular surface impossible
Saddle joint articular surfaces are reciprocally flexion, extension, carpometacarpal joint
concavo-convex & resemble a abduction, adduction & of the thumb
saddle on a horse’s back rotation

Ball-and- Ball-shaped head of one bone fits Free movements: flexion, shoulder & hip joints
socket joint into a socket-like concavity of extension, abduction,
another adduction, medial rotation,
lateral rotation &
circumduction
D. Condyloid
joint
(metacarpo-
phalangeal
joint)
Type of joint description Movements possible examples
Plane joint the apposed articular surfaces permits the bones to slide sternoclavicular &
are flat or almost flat on one another acromioclavicular joints
Hinge joint resemble the hinge on a door flexion & extension elbow, knee & ankle
joints

Pivot joint a central bony pivot is rotation atlantoaxial & superior

surrounded by a bony– radioulnar joints
ligamentous ring
Condyloid 2 distinct convex surfaces flexion, extension, abduction metacarpophalangeal
joint articulate with 2 concave surfaces & adduction + a small joints or knuckle joints
amount of rotation
Ellipsoid joint elliptical convex articular surface flexion, extension, abduction Wrist joint
fits into an elliptical concave & adduction, but rotation is
articular surface impossible
Saddle joint articular surfaces are reciprocally flexion, extension, carpometacarpal joint
concavo-convex & resemble a abduction, adduction & of the thumb
saddle on a horse’s back rotation

Ball-and- Ball-shaped head of one bone fits Free movements: flexion, shoulder & hip joints
socket joint into a socket-like concavity of extension, abduction,
another adduction, medial rotation,
lateral rotation &
circumduction
E. Ellipsoid joint
(wrist joint)
Type of joint description Movements possible examples
Plane joint the apposed articular surfaces permits the bones to slide sternoclavicular &
are flat or almost flat on one another acromioclavicular joints
Hinge joint resemble the hinge on a door flexion & extension elbow, knee & ankle
joints

Pivot joint a central bony pivot is rotation atlantoaxial & superior

surrounded by a bony– radioulnar joints
ligamentous ring
Condyloid 2 distinct convex surfaces flexion, extension, abduction metacarpophalangeal
joint articulate with 2 concave surfaces & adduction + a small joints or knuckle joints
amount of rotation
Ellipsoid joint elliptical convex articular surface flexion, extension, abduction Wrist joint
fits into an elliptical concave & adduction, but rotation is
articular surface impossible
Saddle joint articular surfaces are reciprocally flexion, extension, carpometacarpal joint
concavo-convex & resemble a abduction, adduction & of the thumb
saddle on a horse’s back rotation

Ball-and- Ball-shaped head of one bone fits Free movements: flexion, shoulder & hip joints
socket joint into a socket-like concavity of extension, abduction,
another adduction, medial rotation,
lateral rotation &
circumduction
 F. Saddle joint
(carpometacarpal joint of the thumb)
Type of joint description Movements possible examples
Plane joint the apposed articular surfaces permits the bones to slide sternoclavicular &
are flat or almost flat on one another acromioclavicular joints
Hinge joint resemble the hinge on a door flexion & extension elbow, knee & ankle
joints

Pivot joint a central bony pivot is rotation atlantoaxial & superior

surrounded by a bony– radioulnar joints
ligamentous ring
Condyloid 2 distinct convex surfaces flexion, extension, abduction metacarpophalangeal
joint articulate with 2 concave surfaces & adduction + a small joints or knuckle joints
amount of rotation
Ellipsoid joint elliptical convex articular surface flexion, extension, abduction Wrist joint
fits into an elliptical concave & adduction, but rotation is
articular surface impossible
Saddle joint articular surfaces are reciprocally flexion, extension, carpometacarpal joint
concavo-convex & resemble a abduction, adduction & of the thumb
saddle on a horse’s back rotation

Ball-and- Ball-shaped head of one bone fits Free movements: flexion, shoulder & hip joints
socket joint into a socket-like concavity of extension, abduction,
another adduction, medial rotation,
lateral rotation &
circumduction
G. Ball-and-socket joint (hip joint)
 Applied anatomy
• The knowledge of the classification of joints is
of great value because,
• for example, certain diseases affect only
certain types of joints.
• Gonococcal arthritis affects large synovial
joints such as the ankle, elbow, or wrist,
• whereas tuberculous arthritis also affects
synovial joints and may start in the synovial
membrane or in the bone.
Breaktime!
 Stability of Joints
• depends on 3 main factors:

1. the shape, size, and arrangement of the

articular surfaces;
2. the ligaments; and
3. the tone of the muscles around the joint.
 1. Articular Surfaces
• The ball-and-socket arrangement of the hip
joint and the mortise arrangement of the
ankle joint are good examples of how bone
shape plays an important role in joint stability.
• Other examples of joints, however, in which
the shape of the bones contributes little or
nothing to the stability include the
acromioclavicular joint, the calcaneocuboid
joint, and the knee joint.
The 3 main factors responsible for stabilizing a joint:
1. Shape of articular surfaces
 2. Ligaments
• Fibrous ligaments prevent excessive movement in a joint,
– but if the stress is continued for an excessively long period, then
fibrous ligaments stretch.
– For example, the ligaments of the joints between the bones
forming the arches of the feet will not by themselves support the
weight of the body.
– Should the tone of the muscles that normally support the arches
become impaired by fatigue, then the ligaments will stretch and
the arches will collapse, producing flat feet.
• Elastic ligaments, conversely, return to their original length
after stretching.
– The elastic ligaments of the auditory ossicles play an active part in
supporting the joints and assisting in the return of the bones to
their original position after movement.
2. Ligaments
 3. Muscle Tone
• In most joints, muscle tone is the major factor
controlling stability.
– For example, the muscle tone of the short muscles around
the shoulder joint keeps the hemispherical head of the
humerus in the shallow glenoid cavity of the scapula.
Without the action of these muscles, very little force would
be required to dislocate this joint.
– The knee joint is very unstable without the tonic activity of
the quadriceps femoris muscle.
– The joints between the small bones forming the arches of
the feet are largely supported by the tone of the muscles of
the leg, whose tendons are inserted into the bones of the
feet
3. Muscle tone
 Applied anatomy:
Examination of Joint
• When examining a patient, the clinician should assess the
normal range of movement of all joints.
• When the bones of a joint are no longer in their normal
anatomic relationship with one another, then the joint is said
to be dislocated.
• Some joints are particularly susceptible to dislocation because
of lack of support by ligaments, the poor shape of the
articular surfaces, or the absence of adequate muscular
support.
– Ex: shoulder joint, temporomandibular joint & acromioclavicular
joints
• Dislocation of the hip is usually congenital, being caused by
inadequate development of the socket that normally holds
the head of the femur firmly in position
 Ligaments
• A ligament is a cord or band of connective tissue
uniting 2 structures
• Commonly found in association with joints
• 2 types:
1. Most are composed of dense bundles of collagen
fibers and are unstretchable under normal conditions
– e.g., the iliofemoral ligament of the hip joint and
– the collateral ligaments of the elbow joint
2. The second type is composed largely of elastic tissues
and can therefore regain its original length after
stretching
– e.g., the ligamentum flavum of the vertebral column and
– the calcaneonavicular ligament of the foot
 Nerve Supply of Joints
• The capsule and ligaments receive an
abundant sensory nerve supply.
• A sensory nerve supplying a joint also
supplies the muscles moving the joint and
the skin overlying the insertions of these
muscles.
• this law is known as the Hilton’s law.
 Applied anatomy
• remember that more than one joint may
receive the same nerve supply.
• For example, both the hip and knee joints are
supplied by the obturator nerve.
• Thus, a patient with disease limited to one of
these joints may experience pain in both.
• This is known as referred pain
 Applied anatomy
• In certain diseases of the nervous system (e.g.,
syringomyelia), the sensation of pain in a joint
is lost.
• This means that the warning sensations of
pain felt when a joint moves beyond the
normal range of movement are not
experienced.
• This phenomenon results in the destruction of
the joint.
 Bursae
• A bursa is a lubricating device consisting of a closed fibrous
sac lined with a delicate smooth membrane.
• Contents: a film of viscous fluid.
• Bursae are found wherever tendons rub against bones,
ligaments, or other tendons.
• They are commonly found close to joints where the skin rubs
against underlying bony structures, for example, the
prepatellar bursa.
• Occasionally, the cavity of a bursa communicates with the
cavity of a synovial joint.
– Ex: the suprapatellar bursa communicates with the knee joint and
– the subscapularis bursa communicates with the shoulder joint.
4 bursae related to
the front of the knee
joint.

Note that the

suprapatellar bursa
communicates with
the cavity of the joint.
 Synovial Sheath
• A synovial sheath is a tubular bursa that surrounds a tendon.
• The tendon invaginates the bursa from one side so that the
tendon becomes suspended within the bursa by a
mesotendon
• The mesotendon enables blood vessels to enter the tendon
along its course.
• In certain situations, when the range of movement is
extensive, the mesotendon disappears or remains in the form
of narrow threads, the vincula (e.g., the long flexor tendons
of the fingers and toes).
• Synovial sheaths occur where tendons pass under ligaments
and retinacula and through osseofibrous tunnels.
• Their function is to reduce friction between the tendon and
its surrounding structures.
 Synovial
sheaths
around the
long tendons
of the fingers
How tendon indents synovial sheath during development &
how blood vessels reach the tendon through the mesotendon
Degenerative joint disease
That’s all for today..
 Thank you

Next class on mon 8 Dec

Topic: muscular system