JOINTS

• PREPARED BY E.Y MUSHOSHO

• BSC RADIOGRAPHY PART 1 SEMESTER 2
 JOINTS
• OBJECTVES
• Explain the classification of joints
• Describe the different movements if synovial
joints
• Describe some special selected body joints
which are the mandible, shoulder, elbow, hip
and knee joints.
• Discuss the effect of aging on joints
 DEFINITION
• Joints also known as articultion.
• Point of contact between 2 bones, between
bone and cartilage or between bones and
teeth.
 CLASSIFICATION
• Joints are classified structurally and
functionally.
• STRUCTURAL TYPES
1. FIBROUS JOINTS
• No synovila cavity
• Bones held together by dense fibrous
irregular tissue rich in collagen fibres.
• Examples are coronary sutures.
 CARTILAGENOUS JOINTS
• No synovial cavity.
• Bones held together by cartilage
• Examples is pubic symphysis
 SYNOVIAL JOINTS
• Have synovial cavity
• Joined by either articular capsule or by
accessory ligament
• Example is the knee joint
 FUNCTIONAL TYPE OF JOINTS
SYNARTHROSIS
– Immovable joint
– Example sutures.
AMPHIARTHROSIS
– Slightly movable
– Examples is distal tibiofemoral joint
DIARTHROSIS
– Movable joint
– Example knee joint
 CLASSIFICATION OF FIBROUS JOINTS
• Can be divided into three types which are
sutures, syndesmoses and interosseous
membranes
• SUTURES: found in bones of the skull
• Irregular interlocking edges gives them strength.
• In adults they are non movable in nature and in
infants they are partially movable.
• In adults these are called synostosis
 SUTURES
• Examples in infants are frontal bones which join
together later on in life.
SYNDESMOSES
Fibrous joint where there are greater spaces
between the articulating surfaces than the suture.
Ligaments are found in the syndesmoses and allow
limited movement which makes them
amphiarthrosis joints.
Example is the tibiofibular joint.
 SYNDESMOSES

• In the tibiofibular joint the anterior tibiofibular

ligament connects the tibia and fibula.
• Gomphosis is another example which is a
dentoalveolar joint in which a cone shaped
peg fits into a socket. There is a thin dontal
ligament
 INTEROSSEOUS MEMBRANE
• Substantial sheet of dense irregular
connective tissue that binds neighbouring long
bones and permits slight movement.
• Two types of interosseous membranes in the
human body are between the radius and ulnar
and between the tibia and fibula.
CLASSIFICATION OF CARTILAGINOUS JOINTS
• SYNDESMOSES
• Classfied into three which are:synchondroses,
symphyses and epiphyseal cartilage
• SYNCHONDROSES
• Connecting material is the hyaline cartilage.
• Slightly movable to immovable type of joints.
• Example first rib and manubrium of the sternum.
Illustration: In an xray of a young person skeleton
the synchondrosis ar seen as dark areas between
white appearing bone tissue.
 SYMPHYSES
• Ends of articulating bones are covered with
hyaline cartilage.
• A broad flat disc of cartilage connects the bones.
• Occurs in the midline of the body.
• Pubic symphysis which is between the anterior
surfaces of the hip bones.
• Manubrium ad body of sternum
• Intervertebral joints and these are slightly
movable.
 EPIPHYSEL CARTILAGE
• Hyaline cartilage which are the growth centres
during endochondoral bone formation and are
not associated with movement.
• Example epiphyseal plate which connects the
epiphysis and diaphysis f the growing bone.
• An immovable joint.
• After bone elongation ceases and the bone
replaces hyaline cartilage, it becomes
synostosis.
 SYNOVIAL JOINTS
• All are diarthrosis
• Bones are covered by a layer of hyaline
cartilage called articular cartilage, cartilage
reduces friction between bones in the joint
and absorbs shock
 COMPONENTS OF SYNOVIAL JOINTS
• Articular capsule: Sleeve like articular casule
surround the synovial joint.
• Encloses the synovial cavity and unites the
articulating bones.
• Capsule is composed of 2 layers which are outer
fibrous layer and inner synovial membrane.
• Fibrous layer: consists of dense irregular
connective tissue that attaches to the periosteum
of the articulating bones
 ARTICULAR CAPSULE
• Fibrous layer: Is a thickened continuation of
the periosteum between the articulating bone
tissue.
• Flexibility of the membrane allows joint
movement while it prevents dislocation.
• Some fibres are arranged as parallel bundles of
dense regular connective tissue to resist strains.
• Strength of ligaments hold the bones together
 SYNOVIAL MEMBRANE
• Consist of areolar connective tissue with elastic
fibres.
• The synovial membrane includes accumulation of
adipose tissue known as articular fat pads.
• Example is the infrapatellar fat pad in the knee.
• In cases of being double jointed it means greater
flexibility with joint that allows a range of motion
where one can put their ankles behind the neck
 SYNOVIAL FLUID
• Secreted by synovial membrane.
• It’s a viscous clear or pale yellow fluid which appear like uncooked
egg white.
• Consists of hyaluronic acid and interstitial fluid from the blood
plasma.
Function: reduce friction
• Absorbs shock.
• Supply oxygen and nutrients and remove carbon dioxide and
metabolic wastes from the chondrocytes within the articular
cartilage.
• Contain phagocytic cells that remove microbes and debris that
results from normal wear and tear in the joint.
 ACCESSORY LIGAMENTS, ARTICULA DISCS
AND LABRUM
• Synovial joints contain accessory ligaments
called
• : extracapsular ligaments which are; tibial and
fibular collateral ligaments.
• Intracapsular ligaments which are anterior and
posterior cruciate ligaments.
• These occur inside the capsule but not in the
synovial cavity.
 ARTICULAR DISCS
These are crescent shaped pads of of
fibrocartilage which lie in between the
articular surfaces.
These are called discs or menisci. Lateral and
medial menisci.
They divide the synovial cavity into 2 spaces.
 FUNCTION OF ARTICULAR DISCS
• Shock absorbers
• Provide better fit between the articulating bone
surfaces.
• Provide adaptable surfaces for combined
movements
• Weight distribution over a greater contact
surface.
• Distribution of synovial lubrication across the
articular surfaces.
 LABRUM
• Seen in the ball and socket joint of the
shoulder and hip.
• Deepens the joint socket and increases the
area of contact between the socket and the
ball like surface of the head of the humerous
or femur
 BURSAE AND TENDON SHEATH
• Sac like structures called bursae are
strategically situated to alleviate friction in
some joints such as shoulder and knee joint.
• Tendon sheath reduce friction at the joith or
synovial sheath
MOVEMENTS OF THE SYNOVIAL JOINTS

• Grouped into 4 categories:

• Gliding
• Angular movements
• Rotation
• Special movements
 MOVEMENTS
• Gliding: side to side and back and forth
• Angular movements: flexion: reduction of
joint angle.
• Extension: Increase of angle.
• Lateral flexion and hyperextension.
• Abduction:towards mid line
• Adduction: away from the mid line
• Circumduction:circular movement
 MOVEMENTS
• Rotation: bone revolves around it own longitudinal
axis
• Special Movements: Elevation : superior movement
of a part of a body
• Depression: An inferior movement of a part the
body.
• Protraction : movement of the part of the body
interiorly in the transverse plane
• Retraction: movement of a protracted part of the
body back to the anatomical position
 MORE SPECIAL MOVEMENTS
• Inversion: to turn inward
• Aversion: to turn outward
TYPES OF SYNOVIAL JOINTS
 PIVOT JOINT
• At a pivot joint, a rounded portion of a bone is enclosed within a
ring formed partially by the articulation with another bone and
partially by a ligament). The bone rotates within this ring. Since the
rotation is around a single axis, pivot joints are functionally classified
as a uniaxial diarthrosis type of joint. An example of a pivot joint is
the atlantoaxial joint, found between the C1 (atlas) and C2 (axis)
vertebrae. Here, the upward projecting dens of the axis articulates
with the inner aspect of the atlas, where it is held in place by a
ligament. Rotation at this joint allows you to turn your head from
side to side. A second pivot joint is found at the proximal radioulnar
joint. Here, the head of the radius is largely encircled by a ligament
that holds it in place as it articulates with the radial notch of the
ulna. Rotation of the radius allows for forearm movements.
 HINGE JOINT
• In a hinge joint, the convex end of one bone articulates
with the concave end of the adjoining This type of joint
allows only for bending and straightening motions
along a single axis, and thus hinge joints are
functionally classified as uniaxial joints. A good example
is the elbow joint, with the articulation between the
trochlea of the humerus and the trochlear notch of the
ulna. Other hinge joints of the body include the knee,
ankle, and interphalangeal joints between the phalanx
bones of the fingers and toes.
 CONDYLOID JOINT
• At a condyloid joint (ellipsoid joint), the shallow depression at the end
of one bone articulates with a rounded structure from an adjacent
bone or bones The knuckle (metacarpophalangeal) joints of the hand
between the distal end of a metacarpal bone and the proximal
phalanx bone are condyloid joints. Another example is the radiocarpal
joint of the wrist, between the shallow depression at the distal end of
the radius bone and the rounded scaphoid, lunate, and triquetrum
carpal bones. In this case, the articulation area has a more oval
(elliptical) shape. Functionally, condyloid joints are biaxial joints that
allow for two planes of movement. One movement involves the
bending and straightening of the fingers or the anterior-posterior
movements of the hand. The second movement is a side-to-side
movement, which allows you to spread your fingers apart and bring
them together, or to move your hand in a medial-going or lateral-going
direction
 SADDLE JOINT

• At a saddle joint, both of the articulating surfaces for the bones

have a saddle shape, which is concave in one direction and
convex in the other This allows the two bones to fit together like
a rider sitting on a saddle. Saddle joints are functionally classified
as biaxial joints. The primary example is the first carpometacarpal
joint, between the trapezium (a carpal bone) and the first
metacarpal bone at the base of the thumb. This joint provides the
thumb the ability to move away from the palm of the hand along
two planes. Thus, the thumb can move within the same plane as
the palm of the hand, or it can jut out anteriorly, perpendicular to
the palm. This movement of the first carpometacarpal joint is
what gives humans their distinctive “opposable” thumbs. The
sternoclavicular joint is also classified as a saddle joint.
 PLANE JOINT

• At a plane joint (gliding joint), the articulating surfaces of the

bones are flat or slightly curved and of approximately the same
size, which allows the bones to slide against each other The
motion at this type of joint is usually small and tightly constrained
by surrounding ligaments. Based only on their shape, plane joints
can allow multiple movements, including rotation. Thus plane
joints can be functionally classified as a multiaxial joint. However,
not all of these movements are available to every plane joint due
to limitations placed on it by ligaments or neighboring bones.
Thus, depending upon the specific joint of the body, a plane joint
may exhibit only a single type of movement or several
movements. Plane joints are found between the carpal bones
(intercarpal joints) of the wrist or tarsal bones (intertarsal joints)
of the foot, between the clavicle and acromion of the scapula
(acromioclavicular joint), and between the superior and inferior
articular processes of adjacent vertebrae (zygapophysial joints).
 FACTORS AFFECTING CONTACT AND
RANGE OF MATION AT SYNOVIAL JOINTS

1. Structure or shape of the articulating bones.

2. Strength and tension of the joint ligaments;
strength of the ligaments determine the range
of motion and movement of the articulating
bones.
3. Arrangement and tension of the muscles;
muscles reinforce effect of the ligaments and
thus restrict movement.
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4. Contact of soft parts ; point at which body
surface contact another may limit mobility.
5. Hormones; joint flexibility may be affected by
hormones, in the case relaxin produced by
the placenta and ovaries increases the
flexibility of the fibrocartilage of of the pubic
symphysis and loosens the ligaments between
the sacrum, hip bone and coccyx towards end
of pregnancy.
 Continue
• 6. Disuse; movement of a joint may be
restricted if a joint has not been used for an
extended period
SELECTED JOINTS OF THE BODY
 TEMPOMANDIBULAR JOINT (TJM)
• Combination of hinge and plane joint.
• Formed by the condylar process of the
mandible and the mandibular fossa and
articular tubercleof the temporal bone.
• It’s the only joint of the skull that moves.
 COMPONENTS OF TMJ
• Articular disc( meniscus), fibrocartilage disc that
separates the synovial cavity into 2 that is superior and
inferior compartments.
• Articular capsule; thin loose envelope around the
circumference of the joint.
• Lateral ligament; two short bands on the lateral surface
of the articular capsule that extends inferiorly and
posteriorly from the inferior boarder and tubercle of the
zygomatic process of the temporal bone to the lateral
and posterior aspect of the neck of the mandible.
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• Covered by carotid gland.
• Helps strengthen the joint laterally and
prevents displacement.
• Sphenomandibular ligament ; extends
inferiorly from the spine of the sphenoid bone
to the ramus of the mandible.
• No contribution towards the strength of the
joint.
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• Stylomandibular Ligament; deep cervical
fascia that extends from the styloid process of
the temporal bone to the inferior and
posterior boarder of the ramus of the
mandible.
• Separates the parotid gland from the
submandibular gland.
 MOVEMENTS OF THE TMJ
• Depression ; opening
• Elevation ; closing
• Protraction
• Retraction
• Lateral displacement
• Slight rotation
 SHOULDER JOINT
• Ball and socket joint formed by the head of
the humerous and the glenoid cavityof the
scapular.
• Referred to as humeroscapular or
glenohumeral joint.
 COMPONENTS OF THE SHOULDER JOINT

• Capsule: thin loose sac that envelope the joint.

• It extends from the glenoid cavity to the
anatomical neck of the humerus.
• Coracohumeral Ligament; strong broad
ligament that strengthens the superior part of
the articular capsule.
• Extends from the coracoid process of the
scapular to the greater tubercule.
 CONTINUE
• Glenohumeral ligament; three thickening of the
articular capsule over the anterior surface of the
joint.
• Extends from the glenoid cavity to the lessor
tubercule and anatomical neck of the humerous.
• Often indistinct or abscent and provide
minimum strength.
• Has the stabilization effect.
 CONTINUE
• Transverse humeral ligament; narrow sheet.
• Extends from the greater tubercule to the
lesser tubercule of the humeorus.
• Acts as a retaining band of connective tissue
holding the long head of the biceps brachii
muscle.
 CONTINUE
• Glenoid labrum: narrow ring of cartilage
around the edge of the glenoid cavity.
• It deepens and enlarges the glenoid cavity.
• Bursae: four bursae are associated with the
shoulder joint which are:
• Subscapular
• Subdeltoid
• Subcromial and
• Subcoracoid bursae
 MOVEMENTS
• Flexion
• Extension.
• Hyperextemsion.
• Abduction
• Adduction
• Medial rotation
• Lateral rotation
• Circumduction
• Most freedom of movement among all other body joints.
 ELBOW JOINT
• Hinge joint formed by the trochlea and
capitulum of the humerous, trochlea of the
ulna and head of the radius.
 COMPONENTS
• ARTICULAR CAPSULE: anterior part covers the
anterior part of the elbow joint from the radial and
coronoid fossa of the humerous to the coronoid
process of the ulna and the annular ligament of the
radius.
• Posterior part extend from the capitulum olecranon
fossa and the lateral epicondyle of the humerous to
the annular ligament of the radius, the olecranon of
the ulna and the ulna posterior to the radial notch.
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• Ulna collateral ligament: thick triangular ligament
that extends from the medial epicondyle of the
humerous to the coranoid process and olecranon
process and olecranon of the ulna.
• Part of the ligament deepens the socket of the
trochlea of the humerous.
• Radial Collateral ligament:strong trangular ligament.
• Extends from the lateral epicondyle of the humerous
to the annular ligament of the radius and the radial
notch of the ulna.
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• Annular Ligament; ligament of the radius .
• Band that encircles the head of the radius.
• Hold the head of the radius in the radial notch
of the ulna.
 MOVEMENT
• Allows flexion and extension of the forearm.
 HIP JOINT
• Ball and socket joint formed by the head of
the femur and the acetabulum of the hip bone
 COMPONENTS
• Articular capsule; one of the strongest capsules
of the human body when combined with the
accessory ligaments.
• Consists of circular and longitudinal fibres .
• Attached to the rim of the acetabulum and
extends to the neck of the femur.
• Accessory ligaments, which are iliofemoral,
pubefemoral, and ischeofemoral reinforce the
longitudinal fibres of the articular capsule.
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• Iliofemoral ligament; strongest ligament which
prevents hyperextension of the femur .
• Extends from the anterior inferior iliac spine of
the hip to the intertrochanteric line of the femur.
• Pubofemoral Ligament; Prevents overabduction
of the femur at the hip joint and strengthen the
capsule.
• Extends from the pubic part of the rim of the
acetabulum to the neck of the femur.
 CONTINUE
• Ischiofemoral ligament; sleckens during adduction and
tenses during abduction.
• Strengthens the articular capsule.
• Extends from the ischial wall boardering the acetabulum
to the neck of the femur.
• Ligament of the Head of femur; synovial fold.
• Flat triangular band which extends from the acetabulum
foss to the fovea capitis of the head of the femur.
• Contains artery that supplies head of femur.
 CONTINUE
• Acetebular labrum;fibrocartilage rim attached to
the margin of the acetabulumand enhences the
depth of the acetabulum.
• Makes dislocation of the femur rare.
• Transverse Ligament of the acetabulum; strong
ligament that crossesover tha acetabulum notch .
• Supports part of the acetabulum and connected
with the ligament of the head of the femur and
the articular surface.
 MOVEMENTS
• Flexion
• Extension
• Abduction
• Adduction
• Lateral and medial rotation
• Circumduction of the thigh
• Hip joint has limited flexion when compared
to the shoulder
 KNEE JOINT
• Largest and most complex joint of the body.
• Modified hinge joint that comprise of three
joints within a single synovial cavity.
• The three joints are as follows:
• Lateral tibiofemoral joint; formed by the
lateral condyle of the femur, lateral meniscus
and lateral condyle of the tibia which is the
weight bearing bone of the leg.
 CONTINUE
• Medially tibiofemoral joint; formed by the
medial condyle of the femur, medial meniscus
and medial condyle of tibia.
• Patellofemoral joint; formed by the patella
and the patella surface of the femur.
 COMPONENTS
• Articular capsule; no complete independent capsule
unites the bones of the knee joint.
• Ligament sheath surrounding the joint consist of
muscle tendons.
• Some capsular fibres connect the articulating bones.
• Medial and Lateral Patellar Retinacula; fused
tendons of insertion of the quadriceps femoris
muscle and the the fascial lata that strengthens the
anterior surface of the knee joint.
 CONTINUE
• Patella Ligament; continuation of the
common tendon of insertion of the
quadriceps femoris muscle that extends from
the patella to the tibia tuberosity.
• Strengthens the anterior surface of the joint.
• Posterior surface of the ligament is separated
from the synovial membrane by an
infrapatellar fat pad.
 CONTINUE
• Oblique popliteal ligament; broad flat ligament.
• Extends from the intercondylar fossa and lateral
condyle of the femur to the head and medial condyle
of the tibia.
• Strengthens the posterior surface of the knee.
• Arcuate Popliteal ligament; extends from the lateral
condyle of the femur to the styloid process of the head
of the fibular.
• Strengthens lower lateral part of the posterior surface
of the joint.
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• Tibial collateral ligament; broad flat ligament.
• Extends from the medial condyle of the femur to the
medial condyle of the tibia.
• Tendons of the surtorius gracilis and semitendonosus
muscle cross the ligament and strengthens the medial
joint.
• Firmly attached to the medial meniscus.
• Fibular lateral ligament; strong rounded ligament of
the lateral surface of the joint.
• Extends from the lateral condyle of the femur to the
lateral side of the fibular.
• Strengthens the lateral joint.
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• Intracapsular Ligaments; Ligaments within the
capsule connecting tibia and femur.
• The anterior and posterior cruciate ligaments
are named based on their origins relative to
the intercondyle area of the tibia.
• From their origin they cross on their way to
their destinations on the femur.
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• The anterior cruciate ligament ACL; extends
posteriorly and laterally form the point anterior to
the intercondyle area of the tibia to the posterior
part of the medial surfce of the lateral condyle of
the femur.
• Limits hyperextension of the kneeand prevents
anterior sliding of the tibia on the knee.
• ACL injuries are common in females than males.
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• Posterior cruciate ligament PCL; extends
anteriorly and medially from the depression on
the posterior intercondyle area of the tibia and
lateral meniscus to the lateral surface of the
medial condyle of the femur.
• PCL prevents posterior sliding of the tibia when
the knee is flexed.
• Example is when walking down the stairs or a
steep incline.
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• Articular discs; two fibrocartilagenous discs between
the tibial and frmoral condyles.
• Help compensate for the irregular shapes of the
bones and circulate the synovial fluid.
• Medial meniscus;semi-circular peace of
fibrocartilage.
• Anterior surface attached to the anterior
intercondyle fossaof the tibiaanterior to the ACL.
• Posterior end attached to the posterior intercondyle
fossa of the tibia between the attachments of the
PCL and lateral meniscus.
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• Lateral meniscus; nearly circular piece of fibrocartilage.
• Anterior aspect attached anteriorly to the epicondyle
eminence of the tibia and laterally and posteriorly to the
ACL.
• Posterior end is attached posteriorly to the intercondylar
emminence of the tibia and anteriorly to the posterior end
of the medial meniscus.
• The anterior surfaces of the medial and lateral menisciare
connected to each other by the transverse ligamentof the
knee and the margins of the head of the tibia by the
coronary ligament.
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• Bursae of the knee; they are three:
• Prepatella bursa;between patella and the
skin.
• Infrapatella bursa; between the superior part
of the tibia and the patellar.
• Suprapatellar bursa; between the inferior part
of the femur and deep surface of the
quadriceps femoris muscles.
 MOVEMENTS
• Flexion
• Extension
• Slight medial rotation and lateral rotation of
the leg in a flexed position.
 EFFECTS OF AGING ON JOINTS
• Reduction of synovial fluids in joints
• Articular cartilage becomes thinner with age
• Ligaments shorten and loose flexibility
• Effects are influenced by genetic factors and some wear
and tear.
• Degeration changes occur as early as 20 years.
• Most changes occur much later.
• By age of 80 years almost everyone develops some
degenaration in the knees, elbow, hip and shoulders. Its
also common to have degeration changes in the vertebrae
column which result in hunched over posture and pressure
on nerve roots
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• Osteoarthritis is partially related to age.
• Nearly everyone over the age of 70 years has
evidence of some osteoarthritic changes.
• Stretching and aerobis exercisesthat attempt to
maintain full range of motionhelp in minimizing
the effects of aging.
• These help to maintain the effective functioning
of the ligaments, tendons, muscles, synovial fluid
and articular cartilage
 END
• THANK Y0U
• WISH YOU THE BEST AND STAY SAFE