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Chapter 9 Articulations Part 1,

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1 Chapter 9 Articulations Part 1, 9.1-9.4

2 What are articulations?
Any place of contact between bones Place of articulation is called a joint arthrology = study of joints (arthro = joint)

3 The tradeoff Mobility Stability stability vs mobility Immobile
Fig. 9.1 Immobile Most mobile Very unstable Most stable Stability Suture Glenohumeral joint (shoulder) Hip joint Elbow joint Intervertebral joints Mobility The tradeoff stability vs mobility

4 Joint classifications — Structural
Fibrous bones held together by dense regular connective tissue Cartilaginous bones joined by cartilage Synovial has fluid-filled cavity fluid separates cartilage-covered bone surfaces bone surfaces enclosed in cavity, joined by ligaments

5 Joint classifications — Functional
Synarthrosis immobile Amphiarthrosis slightly mobile Diarthrosis freely mobile

6 Types of Fibrous Joints
Gomphosis “peg in a socket” In human body, only gomphoses (pl.) are roots of teeth with mandible and maxillae tooth held by periodontal membrane Functional classification: synarthrosis (9.2a) Gomphosis Root of tooth Periodontal membranes Alveolar process of mandible

7 Types of Fibrous Joints
Suture Only in skull Distinct, interlocking, irregular edges increase strength and decrease fractures Permit growth of skull during childhood Become ossified in adulthood When completely fused, called synostoses (pl.) Suture

8 Types of Fibrous Joints
Ulna Syndesmosis (interosseous membrane) Radius Syndesmoses syndesmos = fastening syn = with; desmos = band, ligament Bones joined by long strands of dense regular connective tissue only interosseous membrane Ex. radius and ulna, tibia and fibula Functional classification: amphiarthroses

9 Types of Cartilaginous Joints
Epiphyseal plate Costochondral joints Joint between first rib and sternum (9.3a Synchondroses) NOT these joints Synchondrosis syn = with chondro = cartilage Bones joined by hyaline cartilage Functional classification: synarthroses

10 Types of Cartilaginous Joints
Symphysis Bones joined by pad of fibrocartilage Resists compression and stress Functional classification: amphiarthroses Intervertebral joint Intervertebral disc Pubic symphysis Body of vertebra (9.3b Symphyses)

11 Synovial Joints Basic features articular capsule
Periosteum Yellow bone marrow Basic features articular capsule two layers thick joint cavity with synovial fluid synovial fluid secreted by synovial membrane Fibrous layer Articular capsule Synovial membrane Joint cavity (containing synovial fluid) Articular cartilage Ligament 9.4 Typical synovial joint

12 Synovial Joints Basic features articular cartilage ligaments
Periosteum Yellow bone marrow Basic features articular cartilage ligaments nerves and blood vessels (not shown) Functional classification: diarthrosis Fibrous layer Articular capsule Synovial membrane Joint cavity (containing synovial fluid) Ligament Articular cartilage 9.4 Typical synovial joint

13 Ligaments Dense regular connective tissue Connect bone to bone
Two types: Extrinsic ligaments are outside the articular capsule Intrinsic ligaments are thickening of articular capsule itself include extracapsular ligaments and intracapsular ligaments

14 Accessory structures Bursa
fibrous, saclike structure filled with synovial fluid may be connected to or outside joint cavity alleviate friction tendon sheath is an elongated bursal wrapped around a tendon

15 (b) Tendon sheaths of wrist and hand, anterior view
Fig. 9.5 Tendon sheath (opened) (b) Tendon sheaths of wrist and hand, anterior view Tendon of flexor digitorum superficialis Tendon of flexor digitorum profundus Digital tendon sheaths Tendon sheath around flexor pollicis longus tendon Common flexor tendon sheath Tendon of flexor carpi radialis Tendons of flexor digitorum superficialis and flexor digitorum profundus Tendon of flexor pollicis longus

16 Bursa deep to gastrocnemius muscle Synovial membrane
Fig. 9.5 Femur Suprapatellar bursa Bursa deep to gastrocnemius muscle Synovial membrane Patella Articular capsule Prepatellar bursa Articular cartilage Meniscus Fat pad Joint cavity filled with synovial fluid Infrapatellar bursae Patellar ligament Tibia (a) Bursae of the knee joint, sagittal section

17 Hinge joint (uniaxial)
Fig. 9.6 Synovial Joints Humerus Radius Ulna Hinge Joint Convex surface of one bone fits in concave surface of another Moves along one axis only

18 Plane joint (uniaxial)
Fig. 9.6 Synovial Joints Triquetrum Hamate bone Plane Joint AKA planar or gliding joing least mobile diarthrosis only side-to-side movement between carpals and between tarsals

19 Saddle Joint Fig. 9.6 Synovial Joints Trapezium First metacarpal bone
Saddle joint (biaxial) Saddle Joint surfaces of both bones have convex and concave surfaces (like a saddle) Enables movement in more than one direction

20 Condylar joint (biaxial)
Fig. 9.6 Synovial Joints Metacarpal bone Proximal phalanx Condylar Joint AKA condyloid or ellipsoid joints oval, convex surface on one bone, concave surface on other move back and forth and side-to-side Condylar joint (biaxial)

21 Pivot Joint Turn around an axis
Protrusion of one bone articulates with concave surface and ligament of another neck joint; proximal radioulnar joint Dens of axis Atlas Axis Pivot joint (uniaxial)

22 Ball-and-socket joint (multiaxial)
Fig. 9.6 Synovial Joints Ball-and-socket joint (multiaxial) Ball-and-socket Joint multiaxial; most freely mobile spherical head of one bone fits into cuplike socket of another bone shoulder and hip joints Ilium Head of femur

23 Angular motion Flexion: decreases angle between bones
Extension Hyperextension Hyperextension Flexion Extension Flexion Flexion Extension Angular motion Flexion: decreases angle between bones Extension: straightening action, increases angle Hyperextension: extension beyond 180º

24 Angular motion Lateral Flexion: trunk of body moves on coronal plane

25 Adduction: movement of body part toward central plane
Abduction Adduction Angular motion Adduction: movement of body part toward central plane Abduction: movement of body part away from central plane

26 Circumduction Angular motion Circumduction: circular movement of distal end of appendage

27 Rotational motion Rotation: Pivoting around a longitudinal axis
Lateral rotation Rotation Medial rotation Rotational motion Rotation: Pivoting around a longitudinal axis Lateral rotation: turning away from the midsaggital plane Medial rotation: turning toward the midsaggital plane

28 Lateral rotation Medial rotation

29 Depression: Inferior movement Elevation: superior movement

30 Plantar flexion Dorsiflexion Dorsiflexion: bending foot up; talocrural joint bends, raising superior surface of foot Plantar flexion: pointing toes; extension of foot so toes point inferiorly

31 Inversion: sole of foot turns medially
Eversion Inversion Inversion: sole of foot turns medially Eversion: sole of foot turns laterally

32 Protraction: anteriorly directed movement of body part
Retraction Protraction: anteriorly directed movement of body part Retraction: posteriorly directed movement of body part

33 Opposition: thumb moves across palm of hand
Reposition: movement back to anatomical position

34 pronation: rotation of forearm or foot so that anatomical position of palm or sole of foot is facing posteriorly supination: rotation of forearm or foot so that anatomical position of palm or sole of foot is facing anteriorly

35 pronation: rotation of forearm or foot so that anatomical position of palm or sole of foot is facing posteriorly supination: rotation of forearm or foot so that anatomical position of palm or sole of foot is facing anteriorly

36 Temporomandibular joint (TMJ)
Fig. 9.12 Temporomandibular joint (TMJ) head of mandible with articular tubercle of temporal bone and mandibular fossa only mobile joint in skull surrounded by loose articular capsule Hinge joint Gliding joint Copyright © McGraw-Hill Education. Permission required for reproduction or display. 36

37 Temporomandibular ligament
Fig. 9.12 Temporomandibular ligament Articular capsule External acoustic meatus Styloid process Stylomandibular ligament Sphenomandibular ligament Coronoid process of mandible 37

38 Fig. 9.12 Temporomandibular joint
Articular surface of mandibular fossa Articular disc Articular capsule Head of mandible Articular tubercle Styloid process 38

39 Intervertebral articulations
Fig. 9.13 Facet of superior articular process Anulus fibrosus Intervertebral articulations only C1-C2 lacks disc disc is anulus fibrosus around nucleus pulposus articulations between bodies of vertebrae superior and inferior articular processes articulations between superior and inferior articular processes are plane joints prevent gliding movements surrounded by articular capsule Intervertebral disc Nucleus pulposus Inferior articular process Superior articular process

40 Sternoclavicular Joint
Fig. 9.14 Interclavicular ligament Sternoclavicular Joint saddle joint between manubrium and sternal end of clavicle contains articular disc enables elevation, depression, and circumduction Sternoclavicular ligament Clavicle Articular disc First rib Articular capsule Costoclavicular ligament (a) Anterior view with upper limbs in anatomic position

41 Acromioclavicular Joint
Fig. 9.15 Acromioclavicular ligament Clavicle Acromion Coracoclavicular ligament Acromioclavicular Joint between acromion and acromial end of clavicle has articular disc helps provide range of movement in shoulder Coracoid process (a) Right shoulder region, anterior view

42 Glenohumeral Joint Acromion Coracoacromial ligament Subacromial bursa
Fig. 9.15 Glenohumeral Joint Acromion Coracoacromial ligament Subacromial bursa Coracohumeral ligament Coracoid process Subdeltoid bursa Glenohumeral ligaments Tendon sheath Tendon of long head of biceps brachii (a) Right shoulder region, anterior view Humerus

43 Elbow Joint humeroulnar joint and humeroradial joint
Fig. 9.16 Humerus Elbow Joint humeroulnar joint and humeroradial joint thick articular capsule many strong ligaments Lateral epicondyle Articular capsule Medial epicondyle Radial collateral ligament Ulnar collateral ligament Anular ligament Tendon of biceps brachii (cut) Radius Ulna Flexion (a) Right elbow, anterior view Extension

44 Fig. 9.16 Humerus Elbow Joint radial collateral ligament (aka lateral collateral ligament) stabilizes lateral surface extends around head of radius between anular ligament and lateral epicondyle of humerus Lateral epicondyle Articular capsule Medial epicondyle Radial collateral ligament Ulnar collateral ligament Anular ligament Tendon of biceps brachii (cut) Radius Ulna (a) Right elbow, anterior view

45 Fig. 9.16 Humerus Elbow Joint ulnar collateral ligament (aka medial collateral ligament) stabilizes medial surface extends from medial epicondyle of humerus to coronoid process of ulna, posteriorly to olecranon Lateral epicondyle Articular capsule Medial epicondyle Radial collateral ligament Ulnar collateral ligament Anular ligament Tendon of biceps brachii (cut) Radius Ulna (a) Right elbow, anterior view

46 Fig. 9.16 Humerus Elbow Joint anular ligament surrounds neck of radius, holds radius in place Lateral epicondyle Articular capsule Medial epicondyle Radial collateral ligament Ulnar collateral ligament Anular ligament Tendon of biceps brachii (cut) Radius Ulna (a) Right elbow, anterior view

47 Elbow Joint Fig. 9.16 Anular ligament Humerus Tendon of biceps
brachii (cut) Articular capsule Lateral epicondyle Radius Radial collateral ligament Ulna (b) Right elbow, lateral view

48 Elbow Joint Fig. 9.16 Articular capsule Tendon of Anular Humerus
biceps brachii (cut) Anular ligament Humerus Radius Medial epicondyle Ulnar collateral ligament Ulna (c) Right elbow, medial view

49 Elbow Joint Fig. 9.16 Trochlea Articular capsule Humerus
Coronoid process Radius Articular cartilage Ulna Olecranon Trochlear notch (d) Right elbow, medial sagittal section

50 Dislocated shoulder Clavicle Acromioclavicular separation
Dislocated head of humerus “Squared-off” shoulder Glenoid cavity Displaced head of humerus Dislocated glenohumeral joint. Radiograph of acromioclavicular and glenohumeral dislocations.

51 Fig. 9.17 Radiocarpal Joint scaphoid, lunate, and triquetrum (carpals) and distal radius, and articular disc disc separates ulna from radiocarpal joint Distal radioulnar joint Radiocarpal joint Articular disc Radial collateral ligament Ulnar collateral ligament Scaphoid Intercarpal joints Triquetrum Carpometacarpal joint of thumb Right radiocarpal joint, coronal section

52 Fig. 9.17 Radiocarpal Joint articular capsule covers entire wrist joint ligaments support and stabilize carpal bone positions flexion, extension, adduction, abduction, and circumduction (not rotation) plane joints between carpals are intercarpal articulations Distal radioulnar joint Radiocarpal joint Articular disc Radial collateral ligament Ulnar collateral ligament Scaphoid Intercarpal joints Triquetrum Carpometacarpal joint of thumb Right radiocarpal joint, coronal section

53 Hip Joint AKA coxal joint
Fig. 9.18 Right hip, anterior view, internal aspect of joint (c) Right hip, coronal section Hip Joint Acetabular labrum Acetabular labrum Acetabulum Greater trochanter AKA coxal joint Acetabular labrum is fibrocartilage ring around acetabulum strengthens and stabilizes joint Ischium

54 Hip Joint ligament of head of femur AKA ligamentum teres
Fig. 9.18 Right hip, anterior view, internal aspect of joint (c) Right hip, coronal section Hip Joint ligament of head of femur AKA ligamentum teres originates along acetabulum attaches to center of head of femur contains artery that supplies blood to head of femur Ligament of head of femur

55 Hip Joint Articular capsule surrounds joint very strong capsule
Fig. 9.18 Right hip, anterior view, internal aspect of joint (c) Right hip, coronal section Hip Joint Articular capsule surrounds joint very strong capsule extends from acetabulum to trochanters of femur Articular capsule

56 Hip Joint 3 spiraling ligaments reinforce capsule iliofemoral ligament
Fig. 9.18 3 spiraling ligaments reinforce capsule iliofemoral ligament Y-shaped supports anterior capsule pubofemoral ligament triangular shape from capsule’s inferior region Hip Joint Iliofemoral ligament Greater trochanter Pubofemoral ligament Lesser trochanter (a) Right hip, anterior view

57 Hip Joint 3 spiraling ligaments reinforce capsule
Fig. 9.18 Hip Joint Iliofemoral ligament Ischiofemoral ligament 3 spiraling ligaments reinforce capsule ischiofemoral ligament located posteriorly supports posterior capsule Together, ligaments strengthen joint, especially when extended Greater trochanter Lesser trochanter Ischial tuberosity (b) Right hip, posterior view

58 Hip Joint Fig. 9.18 Iliofemoral ligament Ischiofemoral ligament
Greater trochanter Pubofemoral ligament Lesser trochanter Ischiofemoral ligament Ischial tuberosity (b) Right hip, posterior view (a) Right hip, anterior view Hip Joint

59 Knee Joint Largest diarthrosis Most complex diarthrosis
Primarily hinge joint When flexed, capable of slight rotation and lateral gliding Very strong, often injured 2 articulations Tibiofemoral joint between condyles of femur and condyles of tibia Patellofemoral joint between petella nd patellar surface of femur Articular capsule encloses the medial, lateral, and posterior regions of joint

60 (d) Right knee, anterior deep view (e) Right knee, posterior deep view
Fig. 9.19b Femur Femur Articular cartilage Lateral condyle Lateral condyle Medial condyle Medial condyle Tibia Fibula Fibula Tibia (d) Right knee, anterior deep view (e) Right knee, posterior deep view 60

61 AKA medial collateral ligament
Fig. 9.19b Femur Articular cartilage Lateral condyle Lateral condyle Medial condyle Fibular collateral ligament AKA lateral collateral ligament Fibular collateral ligament Tibial collateral ligament AKA medial collateral ligament Fibula Tibia Tibia Fibula (d) Right knee, anterior deep view (e) Right knee, posterior deep view 61

62 Tibial collateral ligament
Fig. 9.19b Anterior cruciate ligament Posterior cruciate ligament Anterior cruciate ligament Fibular collateral ligament Medial meniscus Lateral meniscus Fibular collateral ligament Tibial collateral ligament Posterior cruciate ligament Anterior cruciate ligament (ACL) connects posterior femur to anterior tibia prevents hyperextension of knee Posterior cruciate ligament (PCL) connects anterior femur to posterior tibia prevents hyperflexion of knee, posterior displacement of tibia on femur Cross in middle of joint, making X shape (hence, “cruciate”) 62

63 Tibial collateral ligament
Fig. 9.19b Femur Medial condyle Lateral meniscus Medial meniscus Lateral meniscus Tibial collateral ligament Tibia Fibula Tibia Fibula (d) Right knee, anterior deep view (e) Right knee, posterior deep view Meniscus is C-shaped pad of fibrocartilage on tibial condyle cushion and stabilize joint change shape to conform to surface of femur as it moves 63

64 (a) Right knee, anterior superficial view
Fig. 9.19a Quadriceps femoris muscle Flexion Quadriceps femoris tendon Fibular collateral ligament Tibial collateral ligament Extension Patella within quadriceps tendon (a) Right knee, anterior superficial view Patellar ligament Fibula Tibia

65 (b) Right knee, posterior superficial view
Fig. 9.19a Femur Gastrocnemius muscle heads (cut) (b) Right knee, posterior superficial view Articular capsule Oblique popliteal ligament Fibular collateral ligament Tibial collateral ligament Arcuate popliteal ligament Popliteus muscle (cut) Fibula Tibia

66 Fig. 9.19a Femur (c) Right knee, sagittal section Quadriceps femoris tendon Suprapatellar bursa Articular capsule Patella Prepatellar bursa Menisci Infrapatellar fat pad Anterior cruciate ligament Patellar ligament Infrapatellar bursae Tibial tuberosity Tibia

67 Arthroscopic view of knee joint, showing torn meniscus
Page 277 Arthroscopic view of knee joint, showing torn meniscus “Unhappy triad” of injuries to the right knee. Lateral blow to knee Torn tibial collateral ligament Torn anterior cruciate ligament Torn medial meniscus 67

68 Ankle Joint AKA talocrural joint Two articulations in one capsule
Fig. 9.20 Plantar flexion Ankle Joint Dorsiflexion Fibula Tibia Fibula AKA talocrural joint Two articulations in one capsule distal end of tibia with talus distal end of fibula and lateral aspect of talus capsule covers distal tibia, malleoli, and talus Tibia Anterior tibiofibular ligament Talus Talus Lateral ligament Lateral ligament Posterior tibiofibular ligament Calcaneus Calcaneus Metatarsal V Metatarsal V (a) Right foot, lateral view (b) Right foot, anterolateral view Deltoid ligament Tibia Tibia Deltoid ligament Navicular bone Talus Talus Calcaneus Calcaneus Metatarsal I Metatarsal I Navicular bone (c) Right foot, medial view

69 Ankle Joint Medial and lateral malleoli prevent side-to-side movement
Fig. 9.20 Medial and lateral malleoli prevent side-to-side movement deltoid ligament binds tibia to medial foot prevents overeversion Ankle Joint Deltoid ligament Tibia Tibia Deltoid ligament Navicular bone Talus Talus Calcaneus Calcaneus Metatarsal I Metatarsal I Navicular bone (c) Right foot, medial view

70 Ankle Joint Lateral ligament binds fibula to lateral foot Fig. 9.20
prevents overinversion prone to sprains and tears Fibula Tibia Fibula Tibia Talus Talus Lateral ligament Lateral ligament Calcaneus Calcaneus Metatarsal V (a) Right foot, lateral view Metatarsal V (b) Right foot, anterolateral view

71 Fig. 9.20 Plantar flexion Ankle Joint Dorsiflexion Anterior and posterior tibiofibular ligaments attach tibia to fibula at distal end Fibula Tibia Anterior tibiofibular ligament Talus Lateral ligament Posterior tibiofibular ligament Calcaneus Metatarsal V (a) Right foot, lateral view

72 Foot Joints Four synovial joints Intertarsal joints
Fig. 9.21 Right foot, superior view Foot Joints Four synovial joints Intertarsal joints enable inversion and eversion of foot Tarsometatarsal joints plane articulations permit twisting and some side-to-side movement III I V II IV Tarsometatarsal joints Cuneiform bones Intertarsal joints Cuboid bone Navicular bone Talus Calcaneus

73 Foot Joints Metatarsophalangeal (MP) joints
Interphalangeal (IP) joints Fig. 9.21 Foot Joints Metatarsophalangeal (MP) joints between metatarsals and phalanges condylar joints permit adduction and abduction of toes, flexion and extension Interphalangeal (IP) joints between phalanges permits flexion and extension only (curling toes) Metatarsophalangeal (MP) joints I II III IV V Cuneiform bones Navicular bone Cuboid bone Talus Calcaneus Right foot, superior view

74 Aging of the Joints Size, flexibility and shape of joints affected and modified by use active joints have larger and thicker capsules active joints have larger ligaments and bones Age or injury can cause calcification or synostosis of joint Arthritis involves damage to articular cartilage osteoarthritis (degenerative arthritis) usually results from wear and tear exercise compresses articular cartilages, synovial fluid squeezed out and pulled back in, providing nutrients to joints exercise strengthens muscles supporting joints extreme exercise may aggravate joint problems, leading to osteoarthritis

75 Other forms of arthritis
Gouty arthritis (gout) results from uric acid buildup in blood often seen in middle age and older, especially in males urate crystals accumulate in blood, synovial fluid, and synovial membranes causes joint pain Rheumatoid arthritis (RA) is autoimmune disease usually develops in young or middle-aged people causes pain and swelling of joints, muscle weakness, osteoporosis may lead to blindness

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