Phase II, Year I Academic Year: 1444 (2022-2023)

Man and His Environment and Health Block

JOINTS
DR. MAHA AMER
DR. MUHAMMAD RAMADAN
 Objectives
- Define the joints. Mention their types.

- Describe the anatomical features of the different

types of joints with an example for each.

- Describe the structure, classifications and

arterial and nerve supply of the synovial joints.

- Define the bursae. Mention their sites and

clinical importance.
 JOINTS
Defination: Joint is the meeting of two or more bones or bone and
cartilage (articulation).

Classification of joints: structural classification according to tissues

that connect the bones:

1- Fibrous joints
2- Cartilaginous joints.
3- Synovial joints.

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1. Fibrous joints:
– the bones are united together by fibrous tissue, they are
immovable joints.
- EXAMPLES:
1. Sutures of skull. (ossifies with age).
2. Inferior tibiofibular joint (syndesmosis).
3. Teeth = gomphosis.

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2. Cartilaginous joints:
– Types: Primary cartilaginous and secondary cartilaginous.
-Primary cartilaginous joints:
- Two bones unite by hyaline cartilage. - No movement.
• Examples:
1- Epiphyseal plate (between epiphysis and diaphysis of a growing bone).
2- Between 1st rib and sternum.
-Secondary cartilaginous joints:
- Articular surfaces are covered by hyaline cartilage and a disc of fibrocartilage
present between the bones. - Slightly movable. - Found in midline joints.
• Examples:
1- Intervertebral disc (joints betweeen bodies of vertebrea).
2- Symphysis pubis.
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3- Synovial joints:
• The most common and most movable type.
• The bones join by fibrous capsule but separated by a space called
a joint cavity containing lubricating liquid called synovial fluid.

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* Characteristic features of the synovial joints:
1- Articular cartilage on articular surfaces of bones (to reduce friction).
2- Joint Cavity filled with Synovial Fluid (viscous fluid for lubrication ).
3- Synovial membrane lines the inner ascepect of capsule and secretes synovial fluid.
4- Fibrous capsule encloses (surrounds) joint cavity.
5- Capsular ligaments = thickened bands of the capsule to support the joint. also,
extracapsular and intracapsular ligaments may present.
* Structures inside synovial joint cavity (Intra-articular structures):
1. Cartilages: e.g. the two menisci inside the knee joint.
2. Ligaments: e.g. the cruciate ligaments inside the knee joint.
3. Tendons: e.g. the tendon of long head of biceps muscle inside the shoulder joint.
 * Types of synovial joints:
- According to the number of axes along which the movements occur, the
synovial joints can be classified into:
I – UNIAXIAL SYNOVIAL JOINTS:
1- Hinge synovial
2- Pivot synovial

II – BIAXIAL SYNOVIAL JOINTS:

1- Ellipsoid (Condyloid) synovial
2- Saddle synovial

III – MULTIAXIAL SYNOVIAL JOINTS:

1- Ball & socket synovial
2- Plane synovial

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 I: UNIAXIAL SYNOVIAL JOINTS

1 ) Hinge uniaxial synovial

joints:
The movements occurs along a
horizontal axis

• Examples:
Elbow joint
Ankle joint

• Movements:
Flexion
Extension
 I: UNIAXIAL SYNOVIAL JOINTS
2 ) Pivot uniaxial synovial joints:
Movements occurs along vertical axis

• Examples:

Superior & inferior radio-ulnar joints

Atlantoaxial joint

• Movements:
Rotation
atlantoaxial joint
 II: BIAXIAL SYNOVIAL JOINTS
1) Ellipsoid biaxial synovial joints:
Convex surface articulate with
Elliptical (oval) concave surface
• Examples:
Wrist joint
Metacarpo-phalangeal joint
• Movements:
Flexion
Extension
Adduction
Abduction
 Wrist joint
ELLIPSOID
BIAXIAL SYNOVIAL
JOINT
II: BIAXIAL SYNOVIAL JOINTS

2) Saddle biaxial synovial joints:

Concavo-convex surfaces articulating

together

• Example:
1st Carpo-metacarpal joint = of the thumb

• Movements:

Flexion
Extension
Adduction
Abduction
 III: POLYAXIAL SYNOVIAL JOINTS
1) Ball and Socket polyaxial synovial
joints:
Ball like head in socket like
concavity - They permits all types
of movement in all directions
• Examples:
Shoulder joint
Hip joint
• Movements:
Flexion
Extension
Adduction
Abduction
Medial Rotation
Lateral Rotation
Circumduction
 III: POLYAXIAL SYNOVIAL JOINTS
2-Plane polyaxial synovial joints:

Flat articular surfaces

It permits slight movements in all
directions

• Examples:
Acromioclavicular joint
Acromioclavicular joint

• Movements:
Sliding / Gliding movements in all
directions.
MAIN JOINTS OF THE LOWER LIMB

Hip joint
Synovial polyaxial ball and socket

Superior tibiofibular joint

Synovial polyaxial plane

Ankle joint
Synovial uniaxial hinge
JOINTS OF THE UPPER LIMB
Acromioclavicular joint
Synovial polyaxial plane

Shoulder joint
Synovial polyaxial ball and socket

Elbow joint
Synovial uniaxial hinge.

Wrist joint
Synovial Biaxial ellipsoid.

Superior & inferior radioulnar joints

Synovial uniaxial Pivot

1st carpometacarpal joint of the thumb

synovial biaxial saddle
• Factors affecting Joint Stability:
Stability depends on:
1- Shape of articular surfaces.
2- Tone (tension) of Muscle acting on the joint.
3- Supporting Ligaments.
Nerve supply of joints
Sensory nerves suppling the joints are called
articular nerves, which end in fibrous capsule
and ligaments.
Hilton’s law: Nerve supply to muscles acting
on the joint tend to give a branch to capsule
and skin covering the joint.

Blood supply of joints

Articular branches from nearby arteries,
tends to form anastomosis around the joints.
*Applied anatomy:
 Separation of the articular surfaces of the bones forming a joint is called
dislocation.
 Bursae
• Is closed flattened serous sac containing fluid.
• Function: It minimizes friction between moving structures.
• Sites: Most of the bursae lie near joints and may communicate with
the cavity of these joints.
Bursae are named according to their sites as follows:
1. Subcutaneous bursa: between the skin and bone at sites of pressure (where
skin is subjected to repeated pressure against bone) e.g. back of elbow.
2. Subtendinous bursa: between tendon and underlying structure.
3. Interligamentous bursa: between 2 ligaments.
4. Submuscular bursa: between a muscle and a bone.
Inflammation of the bursa is called bursitis
Cause: Continuous friction
Clinical manifestation: pain and swelling
Housemaid's Knee (Prepatellar Bursitis)
Bursitis in prepatellar bursa (subcutanous
bursa i.e between skin and patellar bone).
THANK YOU