Arthrology SHANDONG UNIVERSITY Liu Zhiyu Classification two major types Continuous joints Discontinuous joints synovial joints Continuous joints Fibrous joints Syndesmosis Suture Cartilaginous joints Synchondrosis Symphysis Synosteosis Synovial Joints Basic structures Articular surface covered by articular cartilage Articular capsule Fibrous membrane Synovial membrane Articular cavity Containing a trace of synovial fluid Subatmospheric pressure in it Synovial Joints Accessory structures Ligaments (lig.) Extracapsular ligaments intracapsular ligaments Articular disc and articular labrum Synovial fold and synovial bursa Joint Movement Terminology Translation Flexion and extension Adduction and abduction Rotation Medial and lateral rotation Pronation ans supination Inversion and eversion Circumduction flexion\ extension adduction\ abduction Rotation Bone revolves around its own longitudinal axis medial rotation is turning of anterior surface in towards the midline lateral rotation is turning of anterior surface away from the midline Pronation Supination Inversion Eversion Circumduction Movement of a distal end of a body part in a circle Combination of flexion, extension, adduction and abduction Occurs at ball and socket, saddle and condyloid joints Classification of synovial joints 1. Uniaxial joints hinge joints cylindrical end of 1 bone fits into trough shape of other angular movement-1 plane (eg) elbow, ankle, interphalangal trochoid (pivot) joints round end fits into ring of bone + ligament rotation on long axis (eg) prox. radius/ulna, atlas/dens Classification of synovial joints 2. Biaxial joints ellipsoid joints egg-shape articular surface + oval concavity side-to-side, back+forth movement (eg) metacarpophalangeal (knuckle) saddle joints articular surface both concave + convex side-to-side, back-forth movement (eg) carpometacarpal jt of thumb Classification of synovial joints 3. Multiaxial joints : ball-and-socket joint spherical head + round socket multiaxial movement(eg) shoulder, femur plane joints articular surface in flat plane Short gliding movement (eg) intertarsal, articular processes of vertebrae Sprains • • • Torn or stretched ligaments. Spine, ankle & knee are common sites. Completely torn ligaments must be repaired. Edema associated with injury can further degrade the ligament. Dislocations Arthritis Joints of Bones of Trunk Vertebral column consists of 24 vertebrae, the sacrum, and the coccyx. Joints of the vertebral bodies Intervertebral discs Lie between bodies of adjacent vertebrae, composed of: Nucleus pulposus an inner soft, pulpy, highly elastic structure (gelatinous core ) Annulus fibrosus an outer fibrous ring consisting of fibrocartilage Joints of the vertebral bodies Anterior longitudinal ligament Strong band covering the anterior part of the vertebral bodies and intervertebral discs running from the anterior margin of foramen magnum to the S1~S2 Maintains stability of the intervertebral disc and prevents hyperextension of the vertebral column Joints of the vertebral bodies Posterior longitudinal ligament Attached to the posterior aspect of the intervertebral discs and posterior edges of the vertebral bodies from C2 vertebra to sacrum Prevents hyperflexion of the vertebral column and posterior protrusion of the discs Hemination of nucleus pulposus Joints of the vertebral arches Ligamenta flava ― elastic ligament, unite laminae of adjacent vertebrae, and complete the posterior wall of vertebral canal; tend to prevent hyperflexion of the vertebral column Interspinal ligament Supraspinal ligament Ligamentum nuchae Intertansverse ligament Zygapophysial joint Atlantooccipital joint Between superior articulating surfaces of atlas and occipital condyles Supported by membrances and ligaments that join occipital bone and atlas Action ― nodding of head, lateral tilting of head Atlantoaxial joint Three synovial joints between atlas and axis Laterally, paired joints between articulating facets Median joint between dens of axis and anterior arch of atlas Supported by ligaments apical ligament of dens alar ligament transverse ligament of atlas tectorial membrane Action ― allow atlas (and head) to pivot on the axis and vertebral column The vertebral column as a whole Anterior aspect: the breadth of vertebral bodies increases from C2 to S2, then diminishes rapidly Dorsal aspect: the spinous processes of cervical vertebrae are short and bifid; the spinous processes of thoracic vertebrae are long, point obliquely downward and overlapped each other; the spinous processes of lumber vertebrae are nearly horizontally. Lateral aspect: shows four physiological curves The vertebral column as a whole Four physiological curves Cervical curvature convex forward Thoracic curvature Lumbar curvature Sacral curvature convex backward The vertebral column as a whole Movement of the vertebral column flexion extension lateral flexion rotation Lateral radiograph of the neck. The cervical curve of the vertebral column is well shown. Sagittal MRI of cervicothoracic spine. Sagittal MRI of thoracolumbosacral spine. Spina bifida cystica Thoracic cage Composition twelve thoracic vertebrae twelve pairs of ribs and costal cartilages sternum Thoracic cage Costovertebral joints Joints of costal head Costotransverse joints Sternocostal joints Sternocostal synchondrosis of first rib Sternocostal joints Interchondral joints between costal cartilages 8, 9, and 10 to form the costal arch General features of thoracic cage Roughly cone-shape, narrow above and broad below, flattened from beforebackwards, longer behind than in front Inlet of thorax : Outlet of thorax : Infrasternal angle : bounded by upper border of manubrium, first rib, and vertebra T1 bounded by vertebra T12, 12th and 11th ribs, costal arch and xiphoid process formed by the costal arch of both side Intercostal spaces : between the ribs lie Thoracic cage Function: protects the organs in the thoracic cavity and upper abdominal cavity plays a vital role in the process of breathing Inspiration Expiration Joints of skull Continuous joints: Sutures Synchondrosis or synosteosis Temporomandibular joint Temporomandibular joint Aticulating surfaces Capsule: thin and lax in front and behind; strengthened by the lateral ligament Articular disc: Mandibular fossa and articular tubercle, above Head of mandibule, below separates surfaces forming upper and lower compartments within joint Movement: mandible may be elevated or depressed protruded or retracted rotation may also occurs as in chewing( a slight amount of side to side movement is also permitted)