9 PART 1 Joints Pages 208 222 224226

9 PART 1 Joints Pages 208 -222, 224226, 228 -231 Power. Point® Lecture Presentations prepared by Leslie Hendon University of Alabama, Birmingham © 2014 Pearson Education, Inc.

Joints • Rigid elements of the skeleton meet at joints or articulations • Structure of joints • Enables resistance to crushing, tearing, and other forces • Hold bones together • Allow rigid skeleton some flexibility © 2014 Pearson Education, Inc.

Classifications of Joints • Joints can be classified by function or structure • Functional classification—based on amount of movement • Synarthroses—immovable; common in axial skeleton • Amphiarthroses—slightly movable; common in axial skeleton • Diarthroses—freely movable; common in appendicular skeleton/limbs (all synovial joints) © 2014 Pearson Education, Inc.

Classifications of Joints • Structural classification based on • What separates the articulating bones (fibers, cartilage or joint cavity) • Structural classifications include • Fibrous • Cartilaginous • Synovial © 2014 Pearson Education, Inc.

Classifications of Joints © 2014 Pearson Education, Inc.

Fibrous Joints • Bones are connected by fibrous connective tissue • Do not have a joint cavity • Most are immovable or slightly movable • Types • Sutures • Syndesmoses • Gomphoses © 2014 Pearson Education, Inc.

Fibrous Joints (a) Suture (b) Syndesmosis (c) Gomphosis Joint held together with very short, interconnecting fibers, and bone edges interlock. Found only in the skull. Joint held together by a ligament. Fibrous tissue can vary in length but is longer than in sutures. Peg-in-socket fibrous joint. Periodontal ligament holds tooth in socket. Suture line Fibula Tibia Socket of alveolar process Root of tooth Dense fibrous connective tissue © 2014 Pearson Education, Inc. Ligament Periodontal ligament Figure 9. 1

Proximal Part of the Ulna Radial notch of the ulna Head Neck Radial tuberosity Olecranon process Neck of radius Coronoid process Proximal radioulnar joint Ulna Radius © 2014 Pearson Education, Inc. Head of radius Trochlear notch Interosseous membrane Styloid process of radius (a) Anterior view Olecranon process Ulnar notch of the radius Head of ulna Distal radioulnar joint Styloid process of ulna Interosseous membrane Ulnar notch of the radius Head of ulna Radius Styloid process of ulna (b) Posterior view Styloid process of radius Figure 8. 4 a, b

Cartilaginous Joints • Bones are united by cartilage • Lack a joint cavity • Two types • Synchondroses • Symphyses © 2014 Pearson Education, Inc.

Synchondroses • Hyaline cartilage unites bones • Epiphyseal plates • Joint between first rib and manubrium (a) Synchondroses Bones united by hyaline cartilage Sternum (manubrium) Epiphyseal plate (temporary hyaline cartilage joint) © 2014 Pearson Education, Inc. Joint between first rib and sternum (immovable) Figure 9. 2 a

Symphyses (b) Symphyses Bones united by fibrocartilage Body of vertebra Fibrocartilaginous intervertebral disc Hyaline cartilage Pubic symphysis © 2014 Pearson Education, Inc. Figure 9. 2 b

Synovial Joints • Most movable type of joint • All are diarthroses • Each contains a fluid-filled joint cavity © 2014 Pearson Education, Inc.

General Structure of Synovial Joints • Articular cartilage • Ends of opposing bones are covered with hyaline cartilage • Absorbs compression • Joint cavity (synovial cavity) • Unique to synovial joints • Cavity is a potential space that holds a small amount of synovial fluid © 2014 Pearson Education, Inc.

General Structure of Synovial Joints Ligament Joint cavity (contains synovial fluid) Articular (hyaline) cartilage Fibrous Articular capsule Synovial membrane Periosteum © 2014 Pearson Education, Inc. (a) A typical synovial joint Figure 9. 3 a

General Structure of Synovial Joints • Articular capsule—joint cavity is enclosed in a two-layered capsule • Fibrous capsule—dense irregular connective tissue, which strengthens joint • Synovial membrane—loose connective tissue • Lines joint capsule and covers internal joint surfaces • Functions to make synovial fluid © 2014 Pearson Education, Inc.

General Structure of Synovial Joints • Synovial fluid • A viscous fluid similar to raw egg white • A filtrate of blood • Arises from capillaries in synovial membrane • Contains glycoprotein molecules secreted by fibroblasts © 2014 Pearson Education, Inc.

General Structure of Synovial Joints Ligament Joint cavity (contains synovial fluid) Articular (hyaline) cartilage Fibrous Articular capsule Synovial membrane Periosteum © 2014 Pearson Education, Inc. (a) A typical synovial joint Figure 9. 3 a

General Structure of Synovial Joints • Reinforcing ligaments • Often are thickened parts of the fibrous capsule • Richly supplied with sensory nerves © 2014 Pearson Education, Inc.

General Structure of Synovial Joints Ligament Joint cavity (contains synovial fluid) Articular (hyaline) cartilage Fibrous Articular capsule Synovial membrane Periosteum © 2014 Pearson Education, Inc. (a) A typical synovial joint Figure 9. 3 a

Movements Allowed by Synovial Joints • Three basic types of movement • Gliding—one bone across the surface of another • Angular movement—movements change the angle between bones • Rotation—movement around a bone's long axis © 2014 Pearson Education, Inc.

Gliding Joints • Flat surfaces of two bones slip across each other • Gliding occurs between • Carpals • Articular processes of vertebrae • Tarsals Gliding (a) Gliding movements at the wrist © 2014 Pearson Education, Inc. Figure 9. 6 a

Angular Movements • Increase or decrease angle between bones • Movements involve • Flexion and extension • Abduction and adduction • Circumduction © 2014 Pearson Education, Inc.

Angular Movements Extension Flexion (b) Angular movements: flexion and extension of the neck © 2014 Pearson Education, Inc. Figure 9. 6 b

Angular Movements Extension Flexion (c) Angular movements: flexion and extension of the trunk © 2014 Pearson Education, Inc. Figure 9. 6 c

Angular Movements Abduction Adduction Circumduction (e) Angular movements: abduction, adduction, and circumduction of the upper limb at the shoulder © 2014 Pearson Education, Inc. Figure 9. 6 e

Rotation • Involves turning movement of a bone around its long axis • The only movement allowed between atlas and axis vertebrae • Occurs at the hip and shoulder joints © 2014 Pearson Education, Inc.

Rotation Lateral rotation Medial rotation © 2014 Pearson Education, Inc. (f) Rotation of the head, neck, and lower limb Figure 9. 6 f

Special Movements • Elevation—lifting a body part superiorly • Depression—moving the elevated part inferiorly Elevation of mandible Depression of mandible (a) Elevation Lifting a body part © 2014 Pearson Education, Inc. superiorly Depression Moving a body part inferiorly Figure 9. 7 a

Special Movements • Protraction—nonangular movement anteriorly • Retraction—nonangular movement posteriorly Protraction of mandible © 2014 Pearson Education, Inc. (b) Protraction Moving a body part in the anterior direction Retraction of mandible Retraction Moving a body part in the posterior direction Figure 9. 7 b

Special Movements • Supination—forearm rotates laterally, palm faces anteriorly • Pronation—forearm rotates medially, palm faces posteriorly • Brings radius across the ulna © 2014 Pearson Education, Inc.

Special Movements Pronation (radius rotates over ulna) (c) Pronation (P) Rotating the forearm so the palm faces posteriorly © 2014 Pearson Education, Inc. Supination (radius and ulna are parallel) Supination (S) Rotating the forearm so the palm faces anteriorly Figure 9. 7 c

Special Movements • Opposition—thumb moves across the palm to touch the tips of other fingers Opposition (d) Opposition Moving the thumb to touch the tips of the other fingers © 2014 Pearson Education, Inc. Figure 9. 7 d

Special Movements • Inversion and eversion • Special movements at the foot • Inversion—turns sole medially • Eversion—turns sole laterally © 2014 Pearson Education, Inc.

Special Movements Inversion (e) Inversion Turning the sole of the foot medially © 2014 Pearson Education, Inc. Eversion Turning the sole of the foot laterally Figure 9. 7 e

Special Movements • Dorsiflexion and plantar flexion • Up-and-down movements of the foot • Dorsiflexion—lifting the foot so its superior surface approaches the shin • Plantar flexion—depressing the foot, elevating the heel © 2014 Pearson Education, Inc.

Special Movements Dorsiflexion Plantar flexion (f) Dorsiflexion Lifting the foot so its superior surface approaches the shin © 2014 Pearson Education, Inc. Plantar flexion Depressing the foot elevating the heel Figure 9. 7 f

Synovial Joints Classified by Shape • Plane joint • Articular surfaces are flat planes • Short gliding movements are allowed • Intertarsal and intercarpal joints • Movements are nonaxial • Gliding does not involve rotation around any axis © 2014 Pearson Education, Inc.

Plane Joint Nonaxial movement Metacarpals Carpals Gliding (a) Plane joint © 2014 Pearson Education, Inc. Figure 9. 8 a

Synovial Joints Classified by Shape • Hinge joints • Cylindrical end of one bone fits into a trough on another bone • Angular movement is allowed in one plane • Elbow, ankle, and joints between phalanges • Movement is uniaxial—allows movement around one axis only © 2014 Pearson Education, Inc.

Hinge Joint Uniaxial movement Humerus Medial/ lateral axis Ulna Flexion and extension (b) Hinge joint © 2014 Pearson Education, Inc. Figure 9. 8 b

Synovial Joints Classified by Shape • Pivot joints • Classified as uniaxial – rotating bone only turns around its long axis • Examples • Proximal radioulnar joint • Joint between atlas and axis © 2014 Pearson Education, Inc.

Pivot Joint Vertical axis Ulna Radius Rotation (c) Pivot joint © 2014 Pearson Education, Inc. Figure 9. 8 c

Synovial Joints Classified by Shape • Condyloid joints • Allow moving bone to travel • Side to side—abduction-adduction • Back and forth—flexion-extension • Classified as biaxial—movement occurs around two axes © 2014 Pearson Education, Inc.

Condyloid Joint Biaxial movement Phalanges Anterior/ posterior axis Medial/ lateral axis Metacarpals (d) Condyloid joint © 2014 Pearson Education, Inc. Flexion and extension Adduction and abduction Figure 9. 8 d

Synovial Joints Classified by Shape • Saddle joints • Each articular surface has concave and convex surfaces • Classified as biaxial joints • 1 st carpometacarpal joint is a good example • Allows opposition of the thumb © 2014 Pearson Education, Inc.

Synovial Joints Classified by Shape Metacarpal 1 Medial/ lateral axis Trapezium Anterior/ posterior axis Adduction and abduction Flexion and extension (e) Saddle joint © 2014 Pearson Education, Inc. Figure 9. 8 e

Synovial Joints Classified by Shape • Ball-and-socket joints • Spherical head of one bone fits into round socket of another • Classified as multiaxial—allow movement in all axes • Shoulder and hip joints are examples © 2014 Pearson Education, Inc.

Ball-and-Socket Joint Multiaxial movement Scapula Medial/lateral axis Anterior/posterior axis Vertical axis Humerus (f) Ball-and-socket joint Flexion and extension PLAY © 2014 Pearson Education, Inc. Adduction and abduction Rotation Movement of the glenohumeral joint (a) Figure 9. 8 f

Glenohumeral Joint- ball & socket Acromion of scapula Coracoacromial ligament Subacromial bursa Fibrous articular capsule Glenoid labrum Synovial cavity of the glenoid cavity containing synovial fluid Hyaline cartilage Tendon sheath Synovial membrane Fibrous capsule Tendon of long head of biceps brachii muscle Humerus (a) Frontal section through right shoulder joint © 2014 Pearson Education, Inc. Figure 9. 11 a, b

Glenohumeral Joint • The rotator cuff is made up of four muscles and their associated tendons • Subscapularis • Supraspinatus • Infraspinatus • Teres minor • Rotator cuff injuries are common shoulder injuries © 2014 Pearson Education, Inc.

Structures of the Scapula Acromion Suprascapular notch Coracoid process Glenoid cavity Lateral border Superior angle Subscapular fossa Medial border (a) Right scapula, anterior aspect © 2014 Pearson Education, Inc. Inferior angle Figure 8. 2 a

Structures of the Scapula Suprascapular notch Coracoid process Acromion Superior angle Supraspinous fossa Spine Glenoid cavity at lateral angle Infraspinous fossa Medial border Lateral border (b) Right scapula, posterior aspect © 2014 Pearson Education, Inc. Figure 8. 2 b

Glenohumeral Joint 1 Coracohumeral ligament 2 Glenohumeral Ligament Posterior view, right © 2014 Pearson Education, Inc.

Glenohumeral Joint Acromion Coracoacromial ligament Subacromial bursa Coracohumeral ligament Greater tubercle of humerus Transverse humeral ligament Tendon sheath Tendon of long head of biceps brachii muscle (c) Anterior view of right shoulder joint capsule © 2014 Pearson Education, Inc. Coracoid process Articular capsule reinforced by glenohumeral ligaments Subscapular bursa Tendon of the subscapularis muscle Scapula Figure 9. 11 c

Elbow Joint- hinge Articular capsule Synovial membrane Humerus Fat pad Tendon of triceps muscle Bursa Synovial cavity Articular cartilage Coronoid process Tendon of brachialis muscle Ulna Trochlea Humerus Articular cartilage of the trochlear notch (a) Mid-sagittal section through right elbow (lateral view) Anular ligament Radius Lateral epicondyle Articular capsule Radial collateral ligament Olecranon process Ulna (b) Lateral view of right elbow joint © 2014 Pearson Education, Inc. Figure 9. 12 a, b

Elbow Joint Humerus Anular ligament Medial epicondyle Radius Articular capsule Anular ligament Coronoid process Ulnar collateral ligament Radius Coronoid process of ulna (c) Cadaver photo of medial view of right elbow © 2014 Pearson Education, Inc. Humerus Medial epicondyle Ulnar collateral ligament Ulna (d) Medial view of right elbow Figure 9. 12 c, d

Elbow Joint 1 Lateral (radial) collateral ligament 2 Medial (ulnar) collateral Ligament Medial view, left © 2014 Pearson Education, Inc.

Hip Joint- ball & socket 1 Iliofemoral ligament 2 Ischiofemoral ligament 3 Pubofemoral ligament Anterior view, right © 2014 Pearson Education, Inc.

Frontal Section and Anterior View of the Hip Joint Coxal (hip) bone Articular cartilage Acetabular labrum Ligament of the head of the femur (ligamentum teres) Femur Synovial cavity Articular capsule (a) Frontal section through the right hip joint © 2014 Pearson Education, Inc. Figure 9. 14 a,

Posterior View of the Hip Joint Iliofemoral ligament Ischium Ischiofemoral ligament Greater trochanter of femur (c) Posterior view of right hip joint, capsule in place © 2014 Pearson Education, Inc. Anterior inferior iliac spine Iliofemoral ligament Pubofemoral ligament Greater trochanter (d) Anterior view of right hip joint, capsule in place Figure 9. 14 c, d

Knee Joint- Hinge 1. Patellar Ligament 2. Lateral (Fibular) Collateral Ligament 3. Medial (Tibial) Collateral Ligament 4. Anterior Cruciate Ligament 5. Posterior Ligament 6. Medial Meniscus 7. Lateral Meniscus © 2014 Pearson Education, Inc.

Anterior View of Flexed Knee Fibular collateral ligament Lateral condyle of femur Lateral meniscus Posterior cruciate ligament Medial condyle Tibial collateral ligament Anterior cruciate ligament Medial meniscus Tibia Patellar ligament Fibula Anterior cruciate ligament Medial meniscus on medial tibial condyle Patella Quadriceps tendon (e) Anterior view of flexed knee, showing the cruciate ligaments (articular capsule removed, and quadriceps tendon cut and reflected distally) © 2014 Pearson Education, Inc. Medial femoral condyle Patella (f) Photograph of an opened knee joint; view similar to (e) Figure 9. 15 e, f

© 2014 Pearson Education, Inc.

© 2014 Pearson Education, Inc.

© 2014 Pearson Education, Inc.

© 2014 Pearson Education, Inc.

© 2014 Pearson Education, Inc.

© 2014 Pearson Education, Inc.