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Joints & Joint Movements

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

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 (a) Synchondroses Bones united by hyaline cartilage Sternum (manubrium) Epiphyseal plate (temporary hyaline cartilage joint) Joint between first rib and sternum (immovable)

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

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

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

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

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

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

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

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

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 Pronation (radius rotates over ulna) 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

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

43 Special Movements 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 Nonaxial movement (a) Plane joint Metacarpals Carpals
Gliding (a) Plane joint

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

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 Vertical axis Ulna Radius Rotation (c) Pivot joint

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

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

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

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
Mandibular fossa Articular tubercle Zygomatic process Infratemporal fossa Mandibular fossa Articular disc Articular tubercle Articular capsule External acoustic meatus Superior joint cavity Lateral ligament Synovial membranes Articular capsule Ramus of mandible Mandibular condyle Inferior joint cavity Ramus of mandible (a) Location of the joint in the skull (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 Glenoid labrum Coracoacromial
ligament Synovial cavity of the glenoid cavity containing synovial fluid Subacromial bursa Fibrous articular capsule Hyaline cartilage Tendon sheath Synovial membrane Fibrous capsule Tendon of long head of biceps brachii muscle Humerus (a) Frontal section through right shoulder joint

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

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

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

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

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

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

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

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

80 Wrist Joint Palmar radiocarpal ligament Radius Ulna Lunate Radial
collateral ligament Ulnar collateral ligament Scaphoid Intercarpal ligaments Pisiform Hamate Trapezium Carpo- metacarpal ligaments Capitate (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 Acetabular labrum Coxal (hip) bone Articular cartilage
Ligament of the head of the femur (ligamentum teres) Acetabular labrum Femur Synovial cavity Articular capsule (a) Frontal section through the right hip joint

84 The Hip Joint Iliofemoral Iliofemoral ligament Anterior inferior
iliac spine Ischium Ischiofemoral ligament Pubofemoral ligament Greater trochanter Greater trochanter of femur (c) Posterior view of right hip joint, capsule in place (d) Anterior 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
Tendon of quadriceps femoris Femur Suprapatellar bursa Articular capsule Patella Posterior cruciate ligament Subcutaneous prepatellar bursa Synovial cavity Lateral meniscus Lateral meniscus Anterior cruciate ligament Infrapatellar fat pad Deep infrapatellar bursa Tibia Patellar ligament (a) Sagittal section through the right knee joint

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

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

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

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

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

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

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

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

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