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Joints & Joint Movements Human Anatomy Sonya Schuh-Huerta, Ph.D.

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1 Joints & Joint Movements Human Anatomy Sonya Schuh-Huerta, Ph.D.

2 Joints Rigid elements of the skeleton meet at joints or articulations Greek root “arthro” means joint Structure of joints –Enables resistance to crushing, tearing, & other forces

3 Classifications of Joints Joints can be classified by function or structure Functional classification  based on amount of movement –Synarthroses  immovable; common in axial skeleton –Amphiarthroses  slightly movable; common in axial skeleton –Diarthroses  freely movable; common in appendicular skeleton (all synovial joints)

4 Classifications of Joints Structural classification based on –Material that binds bones together –Presence or absence of a joint cavity –Structural classifications include: Fibrous Cartilaginous Synovial

5 Classifications of Joints

6 Sutures – A Type of Fibrous Joint Bones are tightly bound by a minimal amount of fibrous tissue Only occur between the bones of the skull Allow bone growth so the skull can expand with brain during childhood Fibrous tissue ossifies in middle age –Synostoses = closed sutures

7 Syndesmoses – A Type of Fibrous Joint Bones are connected exclusively by ligaments Amount of movement depends on length of fibers –Tibiofibular joint = immovable synarthrosis –Interosseous membrane between radius & ulna = freely movable diarthrosis

8 Gomphoses – A Type of Fibrous Joint Tooth in a socket Connecting ligament  the periodontal ligament

9 Fibrous Joints Dense fibrous connective tissue Suture line Root of tooth Socket of alveolar process Periodontal ligament Fibula Tibia Ligament (a) Suture Joint held together with very short, interconnecting fibers, and bone edges interlock. Found only in the skull. (b) Syndesmosis Joint held together by a ligament. Fibrous tissue can vary in length but is longer than in sutures. (c) Gomphosis Peg-in-socket fibrous joint. Periodontal ligament holds tooth in socket.

10 Cartilaginous Joints Bones are united by cartilage Lack a joint cavity 2 types –Synchondroses –Symphyses

11 Synchondroses Hyaline cartilage unites bones –Epiphyseal plates –Joint between first rib & manubrium Epiphyseal plate (temporary hyaline cartilage joint) Sternum (manubrium) Joint between first rib and sternum (immovable) (a) Synchondroses Bones united by hyaline cartilage

12 Symphyses Fibrocartilage unites bones; resists tension & compression Slightly movable joints that provide strength with flexibility –Intervertebral discs –Pubic symphysis Hyaline cartilage  present as articular cartilage

13 Symphyses Fibrocartilaginous intervertebral disc Pubic symphysis Body of vertebra Hyaline cartilage (b) Symphyses Bones united by fibrocartilage

14 Synovial Joints Most movable type of joint!!! All are diarthroses  what does that mean? Each contains a fluid-filled joint cavity

15 General Structure of Synovial Joints Articular cartilage –Ends of opposing bones are covered with hyaline cartilage –Absorbs compression Joint cavity (= synovial cavity) –Unique to synovial joints –Cavity is a potential space that holds a small amount of synovial fluid

16 General Structure of Synovial Joints Articular capsule  joint cavity is enclosed in a 2-layered capsule –Fibrous capsule  dense irregular connective tissue, which strengthens joint –Synovial membrane  loose connective tissue Lines joint capsule & covers internal joint surfaces Makes synovial fluid

17 General Structure of Synovial Joints Synovial fluid –A viscous fluid similar to raw egg white A filtrate of blood –Arises from capillaries in synovial membrane Contains glycoprotein molecules secreted by fibroblasts

18 General Structure of Synovial Joints Reinforcing ligaments –Often are thickened parts of the fibrous capsule –Sometimes are extracapsular ligaments  located outside the capsule –Sometimes are intracapsular ligaments  located internal to the capsule

19 Periosteum Ligament Fibrous capsule Synovial membrane Joint cavity (contains synovial fluid ) Articular (hyaline) cartilage Articular capsule (a) A typical synovial joint General Structure of Synovial Joints

20 Richly supplied with sensory nerves –Detect pain –Most monitor how much the capsule is being stretched

21 General Structure of Synovial Joints Have a rich blood supply –Most supply the synovial membrane –Extensive capillary beds produce basis of synovial fluid –Branches of several major nerves & blood vessels

22 Synovial Joints with Articular Discs Some synovial joints contain an articular disc –Temporomandibular joint & Knee joint –Occur in joints whose articulating bones have somewhat different shapes

23 How Synovial Joints Function Synovial joints  lubricating devices Friction could overheat & destroy joint tissue & bone ends Are subjected to compressive forces Fluid is squeezed out as opposing cartilages touch Cartilages ride on the slippery film

24 Bursae & Tendon Sheaths Bursae & tendon sheaths are not synovial joints –Closed bags of lubricant –Reduce friction between body elements Bursa = a flattened fibrous sac lined by a synovial membrane Tendon sheath = an elongated bursa that wraps around a tendon

25 Bursae & Tendon Sheaths Acromion of scapula Joint cavity containing synovial fluid Synovial membrane Fibrous capsule Humerus Hyaline cartilage Coracoacromial ligament Subacromial bursa Fibrous articular capsule Tendon sheath Tendon of long head of biceps brachii muscle (a) Frontal section through the right shoulder joint Coracoacromial ligament Subacromial bursa Cavity in bursa containing synovial fluid (b) Enlargement of (a), showing how a bursa eliminates friction where a ligament (or other structure) would rub against a bone Humerus resting Humerus moving Bursa rolls and lessens friction. Humerus head rolls medially as arm abducts.

26 Movements Allowed by Synovial Joints 3 basic types of movement –Gliding  one bone across the surface of another –Angular movement  movements change the angle between bones –Rotation  movement around a bone's long axis

27 Gliding Joints Flat surfaces of two bones slip across each other Gliding occurs between: –Carpals –Articular processes of vertebrae –Tarsals Gliding (a) Gliding movements at the wrist

28 Angular Movements Increase or decrease angle between bones Movements involve: –Flexion & extension –Abduction & adduction –Circumduction

29 Angular Movements (b) Angular movements: flexion & extension of the neck Extension Flexion

30 Angular Movements Flexion Extension (c) Angular movements: flexion & extension of the trunk

31 Angular Movements Extension Flexion (d) Angular movements: flexion & extension at the shoulder and knee

32 Angular Movements Abduction Adduction (e) Angular movements: abduction, adduction, & circumduction of the upper limb at the shoulder Circumduction

33 PLAY Movement of the glenohumoral joint

34 Rotation Involves turning movement of a bone around its long axis The only movement allowed between atlas & axis vertebrae Occurs at the neck, shoulder, elbow, hip

35 Rotation Lateral rotation Medial rotation (f) Rotation of the head, neck, & lower limb Rotation

36 Special Movements Elevation  lifting a body part superiorly Depression  moving the elevated part inferiorly Elevation of mandible Depression of mandible Elevation Depression

37 Special Movements Protraction  nonangular movement anteriorly Retraction  nonangular movement posteriorly Protraction of mandible Retraction of mandible Protraction Moving a body part in the anterior direction Retraction Moving a body part in the posterior direction

38 Special Movements Supination  forearm rotates laterally, palm faces anteriorly Pronation  forearm rotates medially, palm faces posteriorly –Brings radius across the ulna

39 Special Movements Supination (radius and ulna are parallel) Pronation (P) Rotating the forearm so the palm faces posteriorly Supination (S) Rotating the forearm so the palm faces anteriorly Pronation (radius rotates over ulna)

40 Special Movements Opposition  thumb moves across the palm to touch the tips of other fingers Opposition

41 Special Movements Inversion & eversion –Special movements at the foot Inversion  turns sole medially Eversion  turns sole laterally

42 Eversion Inversion Turning the sole of the foot medially Eversion Turning the sole of the foot laterally Special Movements

43 Dorsiflexion & plantar flexion –Up-and-down movements of the foot –Dorsiflexion  lifting the foot so its superior surface approaches the shin –Plantar flexion  depressing the foot, elevating the heel (ballet toe point)

44 Special Movements Dorsiflexion Plantar flexion Dorsiflexion Lifting the foot so its superior surface approaches the shin Plantar flexion Depressing the foot elevating the heel

45 PLAY Eversion of Ankle joint (5a)

46 Synovial Joints Classified by Shape Plane joint –Articular surfaces are flat planes –Short gliding movements are allowed Intertarsal & intercarpal joints Movements are nonaxial Gliding does not involve rotation around any axis

47 Plane Joint (a) Plane joint Gliding Metacarpals Carpals Nonaxial movement

48 Synovial Joints Classified by Shape Hinge joints –Cylindrical end of one bone fits into a trough on another bone –Angular movement is allowed in one plane –Elbow, ankle, & joints between phalanges –Movement is uniaxial  allows movement around one axis only

49 Hinge Joint (b) Hinge joint Medial/ lateral axis Flexion & extension Humerus Ulna Uniaxial movement

50 Synovial Joints Classified by Shape Pivot joints –Classified as uniaxial – rotating bone only turns around its long axis –Examples Proximal radioulnar joint Joint between atlas & axis

51 Pivot Joint (c) Pivot joint Ulna Vertical axis Rotation Radius

52 Synovial Joints Classified by Shape Condyloid joints –Allow moving bone to travel: Side to side  abduction-adduction Back & forth  flexion-extension –Classified as biaxial = movement occurs around 2 axes –Phalanges

53 Condyloid Joint (d) Condyloid joint Medial/ lateral axis Adduction & abduction Flexion & extension Metacarpals Phalanges Anterior/ posterior axis Biaxial movement

54 Synovial Joints Classified by Shape Saddle joints –Each articular surface has concave & convex surfaces –Classified as biaxial joints –1st carpometacarpal joint is a good example Allows opposition of the thumb

55 Saddle Joint (e) Saddle joint Anterior/ posterior axis Medial/ lateral axis Adduction and abduction Metacarpal 1 Trapezium Flexion and extension

56 Synovial Joints Classified by Shape Ball-and-socket joints –Spherical head of one bone fits into round socket of another –Classified as multiaxial  allow movement in all axes Shoulder & hip joints are examples

57 Ball-and-Socket Joint (f) Ball-and-socket joint Medial/lateral axis Anterior/posterior axis Vertical axis Rotation Adduction and abduction Flexion and extension Scapula Humerus Multiaxial movement

58 PLAY Movement of the glenohumeral joint (a)

59 Factors Influencing Stability of Synovial Joints Articular surfaces –Shapes of articulating surfaces determine movements possible

60 Factors Influencing Stability of Synovial Joints Ligaments –Capsules & ligaments prevent excessive motions –On the medial or inferior side of a joint  prevent excessive abduction –Lateral or superiorly located  resist adduction

61 Factors Influencing Stability of Synovial Joints Ligaments (cont…) –Anterior ligaments  resist extension & lateral rotation –Posterior ligaments  resist flexion & medial rotation The more ligaments  usually the stronger & more stable

62 Factors Influencing Stability of Synovial Joints Muscle tone –Helps stabilize joints by keeping tension on tendons –Is important in reinforcing: Shoulder & knee joints Supporting joints in arches of the foot

63 Selected Joints

64 Selected Synovial Joints Temporomandibular Joint –Is a modified hinge joint –The head of the mandible articulates with the temporal bone –Lateral excursion is a side-to-side movement –2 surfaces of the articular disc allow: Hinge-like movement Gliding of superior surface anteriorly

65 The Temporomandibular Joint Zygomatic process Mandibular fossa Articular tubercle Infratemporal fossa External acoustic meatus Articular capsule Ramus of mandible (a) Location of the joint in the skull Lateral ligament Articular capsule Mandibular fossa Articular disc Articular tubercle Superior joint cavity Inferior joint cavity Mandibular condyle Ramus of mandible Synovial membranes (b) Enlargement of a sagittal section through the joint (arrows indicate movement in each part of the joint cavity)

66 The Temporomandibular Joint

67 Selected Synovial Joints Shoulder (= Glenohumeral) joint –The most freely movable joint (lacks stability!) –Articular capsule is thin & loose –Muscle tendons contribute to joint stability

68 The Shoulder Joint Acromion of scapula Synovial membrane Fibrous capsule Hyaline cartilage Coracoacromial ligament Subacromial bursa Fibrous articular capsule Tendon sheath Tendon of long head of biceps brachii muscle (a) Frontal section through right shoulder joint Synovial cavity of the glenoid cavity containing synovial fluid Glenoid labrum Humerus

69 Fibrous capsule Hyaline cartilage Synovial cavity of the glenoid cavity containing synovial fluid Glenoid labrum Humerus (b) Cadaver photo corresponding to (a) The Shoulder Joint

70 Glenohumeral Joint The rotator cuff is made up of 4 muscles & their associated tendons –Supraspinatus –Infraspinatus –Teres minor –Subscapularis  (= SITS muscles) Rotator cuff injuries are common shoulder injuries

71 The Shoulder Joint Acromion Coracoacromial ligament Subacromial bursa Coracohumeral ligament Greater tubercle of humerus Transverse humeral ligament Tendon sheath Tendon of long head of biceps brachii muscle Articular capsule reinforced by glenohumeral ligaments Subscapular bursa Tendon of the subscapularis muscle Scapula Coracoid process (c) Anterior view of right shoulder joint capsule

72 The Shoulder Joint Acromion Coracoid process Articular capsule Glenoid cavity Glenoid labrum Tendon of long head of biceps brachii muscle Glenohumeral ligaments Tendon of the subscapularis muscle Scapula PosteriorAnterior (d) Lateral view of socket of right shoulder joint, humerus removed (e) Posterior view of an opened left shoulder joint Head of humerus Muscle of rotator cuff (cut) Acromion (cut) Glenoid cavity of scapula Capsule of shoulder joint (opened)

73 Selected Synovial Joints Elbow joint –Allows flexion & extension –The humerus’ articulation with the trochlear notch of the ulna forms the hinge –Tendons of biceps & triceps brachii provide stability

74 The Elbow Joint Articular capsule Synovial membrane Synovial cavity Articular cartilage Coronoid process Tendon of brachialis muscle Ulna Humerus Fat pad Tendon of triceps muscle Bursa Trochlea Articular cartilage of the trochlear notch (a) Mid-sagittal section through right elbow (lateral view)

75 The Elbow Joint Humerus Lateral epicondyle Articular capsule Radial collateral ligament Olecranon process (b) Lateral view of right elbow joint Annular ligament Radius Ulna

76 The Elbow Joint Articular capsule Annular ligament Coronoid process (d) Medial view of right elbow Radius Humerus Medial epicondyle Ulnar collateral ligament Ulna

77 Wrist Joint Stabilized by numerous ligaments Composed of radiocarpal & intercarpal joint –Radiocarpal joint  joint between the radius & proximal carpals (the scaphoid & lunate) Allows for flexion, extension, adduction, abduction, & circumduction –Intercarpal joint  joint between the proximal & distal rows of carpals Allows for gliding movement

78 Wrist Joint Radius Ulna Lunate Triquetrum Pisiform Hamate Capitate Scaphoid Trapezoid Trapezium Thumb Radiocarpal joint (a) Right wrist, anterior (palmar) view

79 Wrist Joint Distal radioulnar joint Ulnar collateral ligament Articular disc Radial collateral ligament Radiocarpal joint Intercarpal joint (b) Wrist joints, coronal section

80 Wrist Joint Hamate Carpo- metacarpal ligaments Pisiform Lunate RadiusUlna Ulnar collateral ligament Radial collateral ligament Palmar radiocarpal ligament Intercarpal ligaments Trapezium Capitate Scaphoid (c) Ligaments of the wrist, anterior (palmar) view

81 Selected Synovial Joints Hip joint –A ball-and-socket joint –Movements occur in all axes Limited by ligaments & acetabulum –Head of femur articulates with acetabulum –Stability comes chiefly from acetabulum & capsular ligaments –Muscle tendons contribute somewhat to stability

82 PLAY Movement of the hip joint

83 The Hip Joint Articular cartilage Coxal (hip) bone Ligament of the head of the femur (ligamentum teres) Synovial cavity Articular capsule Acetabular labrum Femur (a) Frontal section through the right hip joint

84 Anterior inferior iliac spine Iliofemoral ligament Pubofemoral ligament Greater trochanter (d) Anterior view of right hip joint, capsule in place The Hip Joint Ischium Iliofemoral ligament Ischiofemoral ligament Greater trochanter of femur (c) Posterior view of right hip joint, capsule in place

85 Selected Synovial Joints Knee joint –The largest & most complex joint –Primarily acts as a hinge joint –Has some capacity for rotation when leg is flexed –Structurally considered compound & bicondyloid –2 fibrocartilage menisci occur within the joint cavity –Femoropatellar joint  shares the joint cavity Allows patella to glide across the distal femur

86 Sagittal Section of Knee Joint (a) Sagittal section through the right knee joint Femur Tendon of quadriceps femoris Suprapatellar bursa Patella Subcutaneous prepatellar bursa Synovial cavity Lateral meniscus Posterior cruciate ligament Infrapatellar fat pad Deep infrapatellar bursa Patellar ligament Articular capsule Lateral meniscus Anterior cruciate ligament Tibia

87 Superior View of Knee Joint (b) Superior view of the right tibia in the knee joint, showing the menisci and cruciate ligaments Medial meniscus Articular cartilage on medial tibial condyle Anterior cruciate ligament Articular cartilage on lateral tibial condyle Lateral meniscus Posterior cruciate ligament

88 Anterior View of Knee Quadriceps femoris muscle Tendon of quadriceps femoris muscle Patella Lateral patellar retinaculum Medial patellar retinaculum Tibial collateral ligament Tibia Fibular collateral ligament Fibula (c) Anterior view of right knee Patellar ligament

89 Knee Joint Ligaments of the knee joint: –Become taut when knee is extended –These extracapsular & capsular ligaments are: Fibular & tibial collateral ligaments Oblique popliteal ligament Arcuate popliteal ligament

90 Knee Joint Intracapsular ligaments –Cruciate ligaments Cross each other like an “X” –Each cruciate ligament runs from the proximal tibia to the distal femur Anterior cruciate ligament (ACL) Posterior cruciate ligament (PCL)

91 Anterior View of Flexed Knee Fibular collateral ligament Posterior cruciate ligament Medial condyle Tibial collateral ligament Anterior cruciate ligament Medial meniscus Patellar ligament Patella Quadriceps tendon Lateral condyle of femur Lateral meniscus Fibula (e) Anterior view of flexed knee, showing the cruciate ligaments (articular capsule removed, and quadriceps tendon cut and reflected distally) Tibia Medial femoral condyle Anterior cruciate ligament Medial meniscus on medial tibial condyle Patella (f) Photograph of an opened knee joint; view similar to (e)

92 Knee Joint Intracapsular ligaments –Cruciate ligaments  prevent undesirable movements at the knee Anterior cruciate ligament  prevents anterior sliding of the tibia Posterior cruciate ligament  prevents forward sliding of the femur or backward displacement of the tibia

93 Stabilizing function of cruciate ligaments During movement of the knee the anterior cruciate prevents anterior sliding of the tibia; the posterior cruciate prevents posterior sliding of the tibia. Anterior cruciate ligament (a) Posterior cruciate ligament Quadriceps muscle Femur Patella Lateral meniscus Tibia Medial condyle (b) Anterior cruciate ligament Posterior cruciate ligament When the knee is fully extended, both cruciate ligaments are taut and the knee is locked. 1 2

94 The “Unhappy Triad” Lateral blows to the knee can tear: –Tibial collateral ligament & medial meniscus –Anterior cruciate ligament –Are common sports injuries!

95 Selected Synovial Joint Ankle joint –A hinge joint between: United distal ends of tibia & fibula The talus of the foot –Allows the movements of: Dorsiflexion & plantar flexion only

96 The Ankle Joint –Medially & laterally stabilized by ligaments Medial (deltoid) ligament Lateral ligament –Inferior ends of tibia & fibula are joined by ligaments Anterior & posterior tibiofibular ligaments

97 The Ankle Joint Tibia Calcaneal tendon Calcaneus Navicular bone Subtalar joint (a) Cadaver photo of ankle and foot, sagittal section Intermediate cuneiform bone Tendon of flexor digitorum longus Metatarsal bone (II) Interphalangeal joint Metatarsophalangeal joint Cuneonavicular joint Talonavicular joint Talocalcaneal ligament Tibialis posterior muscle Ankle (talocrural) joint Tarsometatarsal joint Talus

98 Ligaments of the Ankle Joint Medial malleolus Calcaneus Sustentaculum tali Medial (deltoid) ligament Talus Navicular Tibia 1st metatarsal (b) Right ankle, medial view

99 Ligaments of the Ankle Joint Anterior tibiofibular ligament Anterior talofibular ligament Calcaneus Metatarsals Lateral malleolus Posterior tibiofibular ligament Posterior talofibular ligament Calcaneofibular ligament Tibia Talus Cuboid Fibula (c) Right ankle, lateral view Lateral ligament

100 Disorders of Joints Structure of joints makes them prone to traumatic stress Function of joints makes them subject to friction and wear & tear Affected by inflammatory & degenerative processes

101 Joint Injuries Torn cartilage  common injury to meniscus of knee joint Sprains  ligaments of a reinforcing joint are stretched or torn Dislocation  occurs when the bones of a joint are forced out of alignment

102 Inflammatory & Degenerative Conditions Bursitis  inflammation of a bursa due to injury or friction Tendonitis  inflammation of a tendon sheath Swollen bursa surrounding the knee

103 Inflammatory & Degenerative Conditions Arthritis  describes over 100 kinds of joint- damaging diseases –Osteoarthritis  most common type of “wear & tear” arthritis –Rheumatoid arthritis  a chronic inflammatory disorder –Gouty arthritis (gout)  uric acid build-up causes pain in joints Lyme disease  inflammatory disease often resulting in joint pain

104 The Joints Throughout Life Synovial joints develop from mesenchyme By week 8 of fetal development, joints resemble adult joints –Outer region of mesenchyme becomes fibrous joint capsule –Inner region becomes the joint cavity

105 The Joints Throughout Life During youth  injury may tear an epiphysis off a bone shaft; breaks near joints; dislocations Advancing age  osteoarthritis becomes more common Exercise  helps maintain joint health!

106 Keeping Your Joints Healthy Exercise is key – strengthens the muscles around the joints & stabilizes them; decreases injuries, joint disorders, wear-&-tear, etc. Also good: proper nutrition, hydration, & vitamins/ supplements (glucosamine a good one) The journey of a mother & daughter

107 Keeping Your Joints Healthy

108 Questions…? What’s Next? Lab: Finish Bones & Joints Wed Lecture: Skeletal muscle Wed Lab: Skeletal muscle tissue & muscles

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