1. Joints of the Skeletal System

2. Joints
Functions
Childbirth
Movement
Bone growth possible

3. Classification of Joints - Function
**How much movement they allow**
Synarthrotic joints
Immovable
Amphiarthrotic joints
Slightly movable
Diarthrotic joints
Freely movable

4. Classification of Joints – Structure
(1) Fibrous joints
Dense connective tissues
Between bones in close contact
(2) Cartilaginous joints
Hyaline or fibrocartilage
(3) Synovial joints
Most complex
Allow free movement

5. (1) Fibrous Joints 1. Suture synarthrotic flat bones thin layer of CT
3 types
1. Suture
Parietal
bone
Margin of
suture
Sutural
bones
(a)
Suture
Occipital
bone
synarthrotic
flat bones
thin layer of CT
Skull
* Synostoses

6. (1) Fibrous Joints 2. Syndesmosis: Amphiarthrotic
Interosseus
membrane
of leg
2. Syndesmosis:
Amphiarthrotic
Fibrous tissue connection
Interosseous membrane
Tibia/Fibula
Radius/Ulna
Fibula
Tibia

7. (1) Fibrous Joints 3. Gomphosis: Synarthroses Tooth in jawbone
Crown of
tooth
Root of
tooth
Alveolar
process of
mandible
Periodontal
ligament

8. (2) Cartilaginous Joints
2 types
1. Synchondrosis
Synarthrotic
Hyaline cartilage
Sternum & first rib
Epiphyseal line
Thoracic
vertebra
First rib
Costal cartilage
Manubrium

9. (2) Cartilaginous Joints
2. Symphysis:
Amphiarthrotic
Fibrocartilage + Hyaline
Pubic Symphysis and Intervertebral Discs
Gelatinous
core
Spinous process
Band of
fibrocartilage
Body of
vertebra
Pubis
Intervertebral
discs
Fibrocartilage disc of symphysis pubis
(a)
(b)

10. (3) Synovial Joints Diarthrotic 5 distinguishing features:
Articular cartilage (hyaline)
Joint (articular) capsule
Joint cavity
Synovial fluid
Ligaments
Spongy
bone
Joint
capsule
Joint cavity
filled with
synovial
fluid
Articular
cartilage
Synovial
membrane

11. (3) Synovial Joint (3) Synovial Joint Tendon attaches muscle to bone
Ligament attaches bone to bone
Odds and Ends:
- Bursae
- Tendon sheaths
Figure 5.28

12. Synovial Joints: Movement
Factors that affect synovial joint stability (3)
1. Articular Surfaces
2. Ligaments
3. Muscle Tone
Types of synovial joint movement
1. Non-axial
2. Uniaxial
3. Biaxial
4. Multiaxial

13. Types of Synovial Joints
Gliding (Plane)
Non-axial
Between carpals
Between tarsals
Hinge
Uniaxial
Elbow joint
Femur and tibia (**modified)
Between phalanges
Humerus
Radius
Ulna
Carpals

14. Types of Synovial Joints
Pivot Joint
Uniaxial
Between atlas (C1)
& axis (C2)
Condylar Joint
Biaxial
Between metacarpals and phalanges
Between radius and carpals
Dens
Transverse
ligament
Atlas
Metacarpal
Axis
(e) Pivot joint
Phalanx

15. Types of Synovial Joints
Saddle Joint
Biaxial
Between carpal and 1st metacarpal (of thumb)
Ball-and-Socket Joint
Multiaxial
Hip joint
Shoulder joint
Hip bone
Head of femur
in acetabulum
First
metacarpal
Femur
Trapezium

16. A closer look at the Synovial Joints of the…

17. Shoulder Joint Head of humerus + glenoid cavity of scapula
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Head of humerus + glenoid cavity
of scapula
Loose joint capsule
Ligaments prevent displacement
Very wide range of movement
circumduction
Acromion process
Clavicle
Coracoid
process
Coracoid
process
Joint
capsule
Clavicle
Coracohumeral
ligament
Acromion
process
Transverse
humeral
ligament
Subscapular
bursa
Tendon of
biceps
brachii
(long head)
Glenohumeral
ligaments
Glenoid
labrum
Glenoid cavity
Humerus
Articular capsule
(glenohumeral
ligaments hidden)
Scapula
Triceps
brachii
(long head)
Scapula
(a)
(b)

18. Shoulder Joint Clavicle Acromion process Subdeltoid bursa
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Clavicle
Acromion process
Subdeltoid bursa
Joint capsule
Synovial membrane
Joint cavity
Joint capsule
Joint cavity
Head of humerus
Articular cartilage
Scapula
Humerus
Humerus
Articular cartilage
Scapula
(a)

19. Hip Joint Ball-and-socket joint Heavy joint capsule
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Ball-and-socket joint
Heavy joint capsule
Many reinforcing ligaments
Less freedom of movement than shoulder joint
Circumduction
Hip bone
Joint cavity
Articular cartilage
Synovial membrane
Ligamentum capitis
Joint capsule
Femur
(a)

20. Hip Joint (b) Hip bone Ilium Ilium Articular cartilage Joint cavity
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Hip bone
Ilium
Ilium
Articular
cartilage
Joint cavity
Pubofemoral
ligament
Head of femur
Iliofemoral
ligament
Pubis
Joint capsule
Greater
trochanter
Iliofemoral
ligament
Ischiofemoral
ligament
Femur
Ischium
Lesser
trochanter
Femur
Femur
(a)
(b)
(b)
© Paul Reimann

21. Ulnar collateral ligament Radial collateral ligament
Elbow Joint
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Humerus
Humerus
Medial
epicondyle
Tendon of biceps
brachii muscle
Lateral epicondyle
Anular ligament
Radius
Anular ligament
Radius
Ulna
Coronoid process
Ulnar collateral ligament
Olecranon process
Radial collateral ligament
Ulna
(a)
(b)

22. Elbow Joint Many reinforcing ligaments Stable joint Hinge joint (a)
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Humerus
Hinge joint
Many reinforcing
ligaments
Stable joint
Joint capsule
Synovial
membrane
Joint cavity
Articular cartilage
Coronoid process
Anular
ligament
Radius
Ulna
Olecranon
process
Trochlea
(a)

23. Knee Joint Largest joint Most complex Strengthened by many ligaments
Femur
Synovial membrane
Suprapatellar bursa
Largest joint
Most complex
Strengthened by many ligaments
& tendons
Menisci separate femur and tibia
Bursae
Quadriceps femoris tendon
(patellar tendon)
Patella
Prepatellar bursa
Joint cavity
Articular cartilage
Patellar ligament
Menisci
Infrapatellar bursa
Joint capsule
Tibia

24. Knee Joint (b) Femur Tendon of adductor magnus (cut) Femur
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Femur
Tendon of
adductor
magnus (cut)
Femur
Anterior cruciate
ligament
Joint
capsule
Posterior
cruciate
ligament
Femur
Gastroc-
nemius
muscle
(cut)
Lateral condyle
Plantaris
muscle
(cut)
Medial
condyle
Lateral
condyle
Lateral meniscus
Anterior
cruciate
ligament
Tendon of
semimembranosus
(cut)
Oblique
popliteal
ligament
Lateral
meniscus
Articular
cartilage
Medial
meniscus
Tibial
collateral
ligament
Fibular
collateral
ligament
Lateral
condyle
Medial
condyle
Lateral
condyle
Popliteus
muscle
cut)
Fibular
collateral
ligament
Arcuate
popliteal
ligament
Tibial
collateral
ligament
Head of fibula
Tibia
Fibula
Patellar
ligament
(cut)
Tibia
Fibula
Fibula
Tibia
(b)
(a)
(b)
© Paul Reimann

25. Anterolateral Ligament (ALL)
1) Two knee surgeons at University Hospitals Leuven have provided the first full anatomical description of a previously enigmatic ligament in the human knee. The ligament appears to play an important role in patients with anterior cruciate ligament (ACL) tears.
Despite successful ACL repair surgery and rehabilitation, some patients with ACL-repaired knees continue to experience so-called 'pivot shift', or episodes where the knee 'gives way' during activity. For the last four years, orthopaedic surgeons Dr Steven Claes and Professor Dr Johan Bellemans have been conducting research into serious ACL injuries in an effort to find out why. Their starting point: an 1879 article by a French surgeon that postulated the existence of an additional ligament located on the anterior of the human knee.
That postulation turned out to be correct: the Belgian doctors are the first to provide a full anatomical description of the ligament after a broad cadaver study using macroscopic dissection techniques. Their research shows that the ligament, called the anterolateral ligament (ALL), was noted to be present in all but one of the 41 cadaveric knees studied. Subsequent research shows that pivot shift, the giving way of the knee in patients with an ACL tear, is caused by an injury in the ALL ligament.
KU Leuven. (2013, November 5). Surgeons describe new ligament in the human knee. ScienceDaily. Retrieved February 27, 2014 from
2) They propose, given its structure and location in the knee, that the ALL controls the rotation of the tibia, one of the two bones in the lower leg, and that pivot shift may be caused by an injury to the ALL.
They have since carried out some research that appears to confirm this.

26. Types of Joint Movements
4 general movements
1. Gliding

27. Types of Joint Movements
2. Angular - Increase or decrease angle between 2 bones - Flexion (˅) - Extension (˄) - Hyperextension

28. Flexion, Extension and Hyperextension

29. Abduction and Adduction
Abduction (away from the midline)
Adduction (towards the midline)

30. Circumduction
Movement in which one end of an appendage remains stationary while the other end makes a circular motion

31. 3. Rotation Turning around long axis Medial (inwards)
rotation of trunk, thigh, head or arm
Medial (inwards)
Lateral (outwards)

32. 4. Special Supination and Pronation
Forearm
Supination
palm faces anterior
Pronation
palm faces posterior

33. Movements of the Foot Dorsiflexion - raising of the toes
Plantarflexion -toes point downward
Inversion - soles are turned medially
Eversion - soles face laterally

34. Protraction and Retraction
Protraction - movement anteriorly on transverse plane
thrusting the jaw forward
shoulders or pelvis forward
Retraction - movement posteriorly

35. Elevation and Depression
Elevation – upward vertical movement
mandibles are elevated during biting
clavicles during a shrug
Depression – downward vertical movement

36. Opposition When you touch your finger to your thumb Grasping
Manipulation of objects

37. Movements of Head and Trunk
Flexion, hyperextension and lateral flexion of vertebral column

38. Rotation of Trunk and Head
Right rotation of trunk; rotation of head

39. Movements of Mandible Lateral excursion = sideways movement
Medial excursion = movement back to the midline
side-to-side grinding during chewing
Protraction – retraction of mandible

40. Movement of Hand and Digits
Radial and ulnar flexion
Abduction of fingers and thumb
Opposition is movement of the thumb to approach or touch the fingertips
Reposition is movement back to the anatomical position

41. Cracking your knuckles
Bones pulling apart
Stretching synovial joint capsule = increasing volume
Increase volume = decrease pressure
Decrease in volume means gasses lose solubility and form bubbles
Cavitation
When pressure gets low enough, bubbles pop and that is the cracking sound
Takes about minutes for gas to redissolve into joint. During this time you cannot crack that joint (it won’t make the sound)
Only 1 study done
Results – does not cause arthritis, may cause soft tissue damage and decreased grip strength
Due to repeated stretching of ligaments around joint
Does show increased mobility

42. Benign joint hypermobility syndrome
Girls
Genetic
Disease
Issues
SIGNS OF HYPERMOBILITY
Can you touch the floor with the palms
of your hands flat while the knees are
straight?
Can your elbows go beyond straight?
Can your knees move beyond
Can you move your thumb to touch
your forearm as shown?
Can your little fingers be moved
so they are perpendicular to the
upper arm as shown?

43. Injuries
Sprains
Cartilage
Dislocation

44. Arthritis Musculoskeletal disorders 3 main types Osteoarthritis
Rheumatoid
Juvenile