PHYT 622
CLINICAL GROSS ANATOMY
ARTHROLOGY
(Joints, Articulations, Anatomical Study Of)
1. Be able to describe the movements permitted at each of the joints listed on this sheet.
2. Be able to describe the component parts, both of bone and connective tissue (capsule,
ligaments, tendons) which comprise the joints listed on this sheet.
3. Identify the degrees of freedom for each joint, planes of motion, and planes of each
joint axis.
Joints and Component Parts of Joints - Upper Extremity
1. Scapulothoracic Joint: Not a bony (synovial) joint. Between scapula and posteriolateral chest wall.
Parts: costal (anterior) surface of the scapula, covered by subscapularis, posterior
and lateral surfaces of thoracic cage, ribs 2-7, intercostal muscles, fascia, and
intervening muscle tissue of serratus anterior.
Movements: elevation, depression, abduction, adduction, upward rotation,
downward rotation, protraction (abduction with upward rotation), and retraction
(adduction with downward rotation).
2. Sterno-clavicular Joint: Between the manubrium of the sternum and the proximal end
of the clavicle.
Parts: socket formed by the manubrium of the sternum and 1st rib cartilage,
enlarged medial or proximal end of the clavicle, anterior and posterior sternoclavicular ligaments, interclavicular ligament, costoclavicular ligament, articular
disc, joint capsule.
Type: Saddle-multiaxial (acts more like a plane joint)
Movements: circumduction (flexion, extension, abduction, adduction, and
rotation).
3. Acromio-clavicular (A-C) Joint: Between the acromion process of the scapula and
clavicle distal (or lateral) end.
Parts: acromial end of the clavicle, medial margin of acromion, acromioclavicular ligament with support from the coraco-clavicular ligament; (a)
trapezoid, (b) conoid
14and the coraco-acromial ligament
Type: Gliding (plane)-multiaxial
Movements: All in limited degrees.
4. Coraco-clavicular Joint: A fibrous (non-moveable union) joint connecting coracoid
process of scapula and acromion. Connect by the coraco-clavicular ligament consisting of
two parts (a) trapezoid and (b) conoid.
5. Coraco-Acromial Joint: A fibrous joint connecting the coracoid process of the scapula
with the acromion of the scapula. Connected by the coraco-acromial ligament.
6. Gleno-humeral Joint: Between the glenoid fossa of the scapula and the head of the
humerus.
Parts: Glenoid fossa, glenoid labrum, weak gleno-humeral ligaments, strong
coraco-humeral ligament, joint capsule, tendons of subscapularis, supraspinatus,
and the tendon of the long head of the biceps brachii.
Type: Ball in socket-multiaxial
Movements: All
7. Elbow Joint: (Humero-ulnar and Humero-radial) Articulation of humerus with ulna
and radius. AKA "true" elbow.
Parts: Trochlea, capitulum, and olecranon fossa of humerus, olecranon process
and trochlea of ulna, fovea of the head of the radius, ulnar collateral ligament,
radial collateral ligament, and annular ligament.
Type: Hinge-uniaxial
Movements: Flexion and extension
8. Radio-ulnar Joints: (Proximal, middle, and distal)
Proximal - Joint between the head of the radius and the radial notch of the ulna.
Parts: Head of the radius, radial notch of the ulna, annular ligament, joint capsule.
Type: Pivot - uniaxial
Movements: Rotation of the head of radius to provide supination and pronation of
the forearm/hand.
15
Middle - Union between the middle aspects of body of radius and ulna.
Parts: Body of the radius, body of ulna, interosseous membrane.
Type: Fibrous
Movements: None
Distal - Joint between the head of the ulna and ulnar notch of radius.
Parts: As above, joint capsule, small articular disc.
Type: Pivot - Uniaxial
Movements: Rotation of the distal end of the radius.
9. Radio-Carpal Joint: Articulation of the distal end of the radius with the scaphoid,
lunate, and triquetrum carpal bones.
Parts: Concave elliptical articular surface of the distal end of the radius and
articular disc, convex surface created by scaphoid, lunate, and triquetrum carpal
bones, palmar and dorsal radiocarpal ligaments, radio-collateral ligament, and
joint capsule.
Type: Ellipsoid (condyloid) - biaxial
Movements: Cicumduction - flexion, extension, abduction, and adduction. Note:
No true rotation at this joint.
10. Mid-carpal Joint: Between the proximal and distal row of carpal bones.
Parts: Proximal carpal bones (scaphoid, lunate, and triquetrum), distal row of
carpal bones (hamate, capitate, trapezoid, and trapezium), intercarpal ligaments,
joint capsules.
Type: Gliding - multiaxial
Movements: All in small degrees. Play a major role in what is perceived as wrist
flexion, extension, abduction, and adduction. Works closely with many small
intercarpal joints.
16
11. Carpo - metacarpal Joints (2 - 5): Between the metacarpal bones and respective
carpal bones.
Parts: Digit 2 with trapezoid, 3 with capitate, 4 with capitate and hamate, 5 with
hamate, joint capsule, transverse palmar ligaments.
Type: Plane or gliding joints (multi-axial)
Movements: All in small degrees
12. Carpo-metacarpal Joint (Thumb):
Parts: Trapezium, first metacarpal, oblique ligament, joint capsule.
Type: Saddle - multiaxial
Movements: All
13. Metacarpo-phalngeal (MP) joints
Parts: Proximal phalange with respective metacarpal
Type: Ellipsoid - biaxial
Movements: Flexion, extension, abduction, adduction, (circumduction), passive
rotation
14. Interphalangeal Joints:
Parts: Adjoining phalanges, collateral ligaments, joint capsule.
Type: Hinge
Movements: Flexion and extension.
Articulations of the vertebral column
Two Main Types of Articulations in the Vertebral Column are the Intervertebral Joints
(between vertebral bodies) and the Facet Joints (between inferior and superior articular
processes. Associated with both types of joints are the Anterior Longitudinal Ligament,
the Posterior Longitudinal Ligament, the Supraspinous ligament (Ligamentum Nuchae in
the Neck), the Interspinous Ligament, Ligamentum Flavum, and the Intertransversus
Ligament (highly developed in
17lumbar region).
1. Intervertebral Joints:
Parts: Adjoining vertebral bodies, the non-synovial fibrocartilaginous connection
(annulus fibrosus), anterior and posterior longitudinal ligaments.
Type: Fibrocartilaginous
Movements: All but limited degrees
2. Typical Facet Joints:
Parts: Superior articular facet of one vertebrae with inferior articular facet of
vertebrae above, joint capsules, supraspinous, interspinous, and intertransversus
ligaments.
Type: Gliding - Multiaxial
Movements: All
3. Atlanto-axial Joint:
Parts: concave superior facets of axis, dens of axis, convex inferior facets of atlas,
transverse ligament, anterior and posterior atlantoaxial ligaments, ligamentum
nuchae, tectorial membrane.
Type: Pivot
Movements: Rotation
4. Atlanto-occipital Joint:
Parts: Two concave superior facets of the atlas, two convex condyles of the
occipital bone, same ligaments as in #3 above.
Type: Saddle
Movements: Mainly limited nodding (flexion/extension)
Joints and Component Parts
18
of Joints - Lower Extremity
1. Hip Joint: Between the head of the femur and acetabulum of the pelvis
Parts: Head of the femur and acetabulum, articular capsule, acetabular labrum,
iliofemoral (Y), pubofemoral, and ischiofemoral ligaments, head ligament,
transverse ligament
Type: Ball - in - socket - multiaxial
Movements: All
2. Knee Joint: Articulation of the femoral condyles with the condyles of tibia, also
includes articulation of patella with the femur
Parts: Femoral condyles, tibial condyles, with their menisci, posterior surface of
patella, articular capsule, popliteal fascia, tibial and fibular collateral ligaments,
anterior and posterior cruciate ligaments, transverse ligament, coronary ligaments,
medial and lateral retinacula
Type: Modified hinge-essentially uniaxial with passive rotary components
Movements: Flexion and extension, limited external and internal rotation, gliding
of the patella
3. Tibio-Fibular Joint: Proximal, middle, and distal
Proximal
Parts: Lateral condyle of the tibia, head of the fibula, articular capsule, anterior
and posterior ligaments
Type: Gliding - multiaxial
Movements: All, very small range, mainly passive
Middle
Parts: Shafts of the tibia and fibula with interosseous membrane
Type: Fibrous
Movements: None
19
Distal
Parts: Medial side of the distal end of the fibula, lateral side of the distal end of
the tibia, anterior and posterior
Type: Syndemosis
Movement: None
4. Talo-Crural: Ankle articulation of tibial and fibular malleoli and the distal end of the
tibia with the talus
Parts: Medial articular surface of the distal end of the fibula (lateral malleolus),
distal end of the tibia, medial malleolus of the tibia, articular capsule, deltoid
ligament, anterior and posterior talofibular ligament, and calcaneofibular ligament
Type: Hinge – uniaxial
Movements: Plantar and dorsiflexion
5. Subtalar Joint: Articulation between the talus and the calcaneus and navicular. Two
parts, anterior and posterior, combine to produce inversion and eversion
Posterior portion
Parts: Posterior facets of talus and the calcaneus
Type: Gliding - multiaxial
Movements: All, limited range
Anterior portion
Parts: Head of talus, concave articular facets in calcaneous and navicular bones
Type: Gliding -
20multiaxial
Movements: All, limited range
6. Transverse Tarsal Joint: (calcaneocuboid and talonavicular). Articulation between the
calcaneous and cuboid and the talus with navicular. Combine with intertarsal and
tarsometatarsal to produce forefoot abduction and adduction.
Ligaments related to subtalar and transverse tarsal; calcaneonavicular, talonavicular,
anterior talocalcaneal, posterior talocalcaneal, interosseous talocalcaneal, cervical,
bifurcate, long plantar, short plantar, and plantar calcaneonavicular.
21