Chapter 9
Articulations
Joint Functional Classification
Synarthroses: immovable
Amphiarthroses: slightly movable
Diarthroses: freely movable
Fibrous Joints (Synarthroses)
Sutures
Teethlike
projection
interlock
Syndesmoses
•Fibrous bands
connect 2 bones
•Joints between
distal and radial end
of ulna
Found in the
skull
Gomphoses
Occurs
between the
root of tooth
and alveolar
process
Cartilaginous Joints (Amphiarthroses)
Synchondroses
Symphysis
•Has hyaline cartilage between
articulating bones
Pad of disk of
fibrocartilage
connects 2 bones
•Articulation between first rib
and sternum
Vertebral disc
•Also during growth years
between epiphysis and
diaphysis
Synovial Joints (Diarthroses)
Majority of joints between bones in
the appendicular skeleton are
synovial joints
Structure of Synovial Joints
Pillow-like
structure
filled with
synovial
fluid.
Function to
cushion joint
at bony
prominances
Cords of
dense
fibrous
tissue. Lash
bones firmly
together
Moist membrane that
lines inner surface of
joint capsule
Ligament
Sleeve-like extension of
periosteum of
articulating bones.
Forms casing around
bone end
Thin layer of hyaline
cartilage cushioning
articulating surface of bone
Types of Synovial Joints
Uniaxial permit movement around only
one axis and in only one plane
– Hinge joint
– Pivot joints
Biaxial permit around 2 perpendicular
axes and planes
– Saddle joints
– Condyloid joints
Multiaxial permit movement around 3 or
more axes and planes
– Ball and socket joints
– Gliding joints
Types of Synovial Joints
Hinge Joint:
distal bone can
move only in
one plane,
flexion and
extension
(forward and
backward).
Ball and Socket
Distal bone can
move around a
center in an
indefinite
number of axes.
Gliding
The main
movements are
flexion-extension
and rotation.
pivot joint´s
movement is
limited to
rotation.
Condyloid
Distal bone has an
ovoid articular surface
and is received into an
elliptical cavit, which
makes it impossible
for the bones to
perform axial rotation.
saddle joint consists of two
opposing surfaces that are
reciprocally concave-convex,
wich allows flexion, extension,
adduction, abduction, and
circumduction, but no axial
rotation.
Types of Synovial Joints
Humeroscapular Joint / Shoulder
Joint
Humeroscapular Joint / Shoulder
Joint
Elbow Joint
Elbow Joint
Helps cushion joint
Ulnar nerve
Medially cubital vein
Forearm and Wrist Joints
Proximal radioulnar: pivot joint between
the circumference of the head of the
radius and the ring formed by the radial
notch of the ulna and the annular
ligament.
Distal radioulnar:pivot-joint formed
between the head of the ulna and the
ulnar notch on the distal radius.
Forearm and Wrist Joints
Radiocarpal (wrist): Condyloid joint
formed by the radius and the
articular disk proximally and the
proximal row of carpal bones distally.
Hand and Finger Joints
Hand Joints
Intercarpal: Articulations between
the individual carpal bones. They are
plane synovial joints. The small
amount of movement between the
carpal bones at these joints
contributes to total wrist mobility.
Hand and Finger Joints
Interphalageal
Synovial
Joints
Hip Joint
synovial joint formed by the articulation of
the rounded head of the femur and the
cup-like acetabulum of the pelvis. It forms
the primary connection between the bones
of the lower limb and the axial skeleton of
the trunk and pelvis.
surfaces are covered with a strong but
lubricated layer called articular hyaline
cartilage.
Hip Joint
Knee Joint (tibiofemoral) Hinge
Has several ligaments
Concavity of tibia
forms a shallow
socket for condyle
of femur
Knee Joint
Ankle Joint
synovial hinge joint that connects the
distal ends of the tibia and fibula in the
lower limb with the proximal end of the
talus bone in the foot
Most common injury sprained ankle is
caused by internal rotation to anterior
talofibular ligament
Vertebral Joints
Vertebral Joints
Caliginous joints between bodies of
adjacent vertebra classified
symphyses
Permit only slight movement
Synovial joints between articulating
surfaces of vertebral processes are
classified as gliding
ROM
Measuring ROM
ROM is measured with a goniometer
Measuring ROM
Types of Movement
Synovial joints permit one or more of
the following movements:
– Angular: change the size of angle
between articulating bones
– Circular: results in arclike rotation
around axis
– Gliding: moves over articulating
surfaces without angular or circular
movement
– Special: Don’t fit in any movement
category
Angular Movements
Flexion: Decrease angle, bends or
folds one part to another
Extension: Increase angle between
bones
Hyperextension: Stretching part
beyond anatomical position
Angular Movements
Plantar Flexion: foot is stretched
down and back. Increases angle
between top of foot and front of leg
Dorsiflexion: foot is tilted upward
decreasing angle
Angular Movements
Abduction: moves part away from
median body plane
Adduction: Moves toward median
body plane
Circular Movement
Rotation: pivoting bone on own axis.
Moving head side to side (NO)
Circumduction: distal ends move in
circle. Such as pitching
Supination: turns palms side up
Pronation: turns palms side down
Special Movement
Inversion: turn sole of foot inward
Eversion: Turn sole of foot outward
•Protraction: moves part
forward
•Retraction: Moves part
back
Special Movement
Elevation: moves part up
Depression: Moves part down
Bursitis
Joint Disorders
Noninflammatory:
– Does not involve inflammation of
synovial membrane.
– Doesn’t produce systemic signs or
symptoms such as fever or damage
other organs
Inflammatory
Noninflammatory
Osteoarthritis/degenerative joint disease.
–
–
–
–
Most common noninflammatory disorder
Wear and tear degeneration
Fracturing of articulating cartilage
Abnormal formation of new bone such as bone
spurs
– Cause unknown but attributed to obesity,
aging and wear and tear
– Symptoms are treated with NSAIDS,
glucosamine, chondriton or injections of
gelatinous type lubricating fluid, and surgery
Osteoarthritis
Swelling deformities of the distal
interphalangeal joints
Swelling deformities of the distal
interphalangeal joints
Noninflammatory
Dislocation (subluxation)
– Usually resulting from trauma
– Can be an emergency due to association
with blood vessels and nerves
– Articulating surfaces no longer in proper
contact
Arthroscopy
Surgical procedure orthopaedic
surgeons use to visualize, diagnose,
and treat problems inside a joint.
Inflammatory Joint
Diseases
Arthritis
General term for many different
inflammatory joint diseases
Can be caused by variety of factors
such as infection, injury, genetics
and autoimmunity
Rheumatoid Arthritis (RA)
Rheumatoid Arthritis (RA)
Systemic autoimmune disease
Involves chronic inflammation of
many tissues and organs, generally
starting with the joints
Pannus is granulation tissue that is
formed within the synovium by
proliferating fibroblasts and
inflammatory cells
Pannus adheres to cartilage,
destroying it and eventually fusing
bones
Rheumatoid Arthritis
Deformity of the fingers known as ulnar
deviation is common
Treated with NSAIDs, corticosteroids, and
other antirheumatic meds
New drugs that alter immune response
such as TNF blockers are showing promise
Juvenile Rheumatoid Arthritis
appears between the ages of 6
months and 16 years.
first signs often are joint pain or
swelling and reddened or warm
joints
Gouty arthritis
Metabolic disorder
Excess blood levels of uric acid are
deposited as sodium urate crystals within
synovial fluid of joints (tophi)
Can lead to very swollen and painful joints
Treated with Allopurinol (inhibits synthesis
of uric acid)