1. Joints (Articulations)
Definition: Site at which two or more bones come together
Some joints have no movement
some only slight movement
some are freely moveable

2. Fibrous (Fixed) Joints
In these joints, the bones
are in very close contact
and are separated only
by a thin layer of fibrous
connective tissue
An example of this type of joint is the sutures in the skull between skull bones

3. Cartilaginous (slightly moveable) joints
These joints are
characterized by
bones that are
connected by
hyaline cartilage
(fibro cartilage)
Example: The joints between the vertebral bodies

4. Synovial (freely moveable) joints
(Diarthrosis joint)
Most joints are freely
movable
Considerable
movement
is permitted at all
synovial joints

5. Types of movement
Movements which can occur are:
Flexion - Extension
Abduction - Adduction
Rotation - Circumduction
Pronation - Supination
Inversion - Eversion

6. Flexion and Extension Extension at the elbow joint
Flexion at the elbow joint

7. Abduction and Adduction
Abduction at the hip joint
Adduction at the hip joint

8. Rotation and Cicumduction
Rotation at the atlas – axis joint
Circumduction at the shoulder joint

9. Types of Synovial joint
Synovial joints are subdivided according to the movements possible
They are subdivided into:
Ball and Socket
Condyloid
Saddle
Pivot
Hinge
Gliding

10. Ball and Socket joints
The ball-shaped end of one bone fits into a cup-shaped socket on the other bone allowing the widest range of motion including rotation.
Examples include the shoulder and hip

11. Condyloid joints Oval shaped condyle fits into elliptical cavity of
another allowing angular
motion but not rotation.
This occurs between the metacarpals (bones in the palm of the hand) and phalanges (fingers) and between the metatarsals (foot bones excluding heel) and phalanges (toes).

12. Saddle joints This type of joint occurs when the touching
surfaces of two bones
have both concave and
convex regions,
the shapes of the two
bones complement one
another and allow a
wide range of movement
The only saddle joint in the body is in the thumb

13. Pivot joints Rounded or conical surfaces of bone fit
into a ring of bone or
tendon allowing
rotation
An example is the
joint between the
axis and atlas in the neck

14. Hinge joints A convex projection on one bone fits into
a concave depression
in another permitting
only flexion and
extension
Examples of hinge joints
= elbow and knee joints

15. Gliding joints Flat or slightly flat surfaces move against
each other allowing
sliding or twisting
without any circular
movement
This happens in the carpals in the wrist and the tarsals in the ankle.

16. Characteristics of a synovial joint
Articular or Hyaline Cartilage
Strong enough to support the weight of the body
Provides smooth surface for articulation
Capsular Ligament
Sleeve of fibrous tissue which joins the bones together,
therefore provides joint stability
Sufficiently loose to allow movement

17. Synovial membrane
This is composed of secretory epithelial cells that secrete a thick, sticky fluid which:
a) acts as a lubricant
b) provides nutrients
c) helps maintain joint stability
(prevents the ends of bone separating)
(Little sacs of synovial fluid – bursae -
are found in some joints, act as cushions)

18. Extra capsular structures
Ligaments
help stabilise the joint
Muscles
enable movement
Nerves

19. Case Study 1
Callum is four years old. He has just fallen from the slide in the park and has banged his head. He is developing a bit of a lump on his forehead (there is no skin injury) and he has started crying. His mother is also really upset and wants to take him to A & E.
What advice would you give his mother?
What sort of bone is the skull?
What is the function of the skull bone?

20. Case Study 2
Stephen is 21 years old and has been trying to get fit and improve his health. He has started playing rugby and has injured his ankle in a match. He finished the game but now is limping and his ankle is looking very bruised and swollen.
What advice would you give Stephen?
What is the collective name for the bones in the ankle?
What sort of bones are these?
What injuries are common in the ankle?

21. Case Study 3
Melanie has been diagnosed with schizophrenia and has been taking antipsychotic medication for a few years. Unfortunately, she has put on five stone in weight during this time. The CPN calculates her BMI as 31.6 (5ft 6ins and 14stone).
How might this excess weight affect Melanie’s joints?
Which joints are more likely to be affected?
What advice would you give her?

22. Case Study 5
Mrs Evans (who is 65 years of age) has Non Insulin Dependent Diabetes Mellitus (NIDDM). She is quite concerned about her risk of osteoporosis (her mother had the condition and fractured her hip, twice).
Is she at risk?
What nutrients and hormones are required for bone health?
What advice would you give to Mrs Evans?