GENERAL ANATOMY OF JOINTS

DR IRAM IQBAL

AIM To describe the common features of joints

with their main differences ,their stabilizing

factors, classification based on different

criteria along with different type of

movements occurring on these joints.

SEQUENCE Defination

Classification of joints

Classifications of fibrous joints

Classifications of cartilaginous joint

Structure of synovial joint

Classification of synovial joint

Movements around a synovial joint

Factors Stabilizing Synovial Joints

Blood supply of joints, Nerve supply and

Lymphatic's of joints

Point of clinical significance

Conclusion

JOINT / ARTICULATIONS

Joints are the regions of the

skeleton where two or more

bones meet and articulate.

CLASSIFICATION OF JOINTS

SOLID JOINTS

CAVITATED JOINTS

SOLID JOINTS

FIBROUS JOINTS

CARTILAGINOUS JOINTS

MIXED SOLID JOINTS

INTERCHONDRAL FIBROUS JOINTS

OSSEOCHONDRAL FIBROUS JOINTS

A:FIBROUS JOINTS SYNARTHROSES

SUTURES

SYNDESMOSIS

GOMPHOSIS

1. SUTURES there are 33 officially

recognized sutures

1.PLANE:

INTERPALATINE

SUTURE

INTERMAXILLARY

SUTURE

2.SQUAMOUS:

TEMPOROPARIETAL

SUTURE

3.SERRATE:

SAGITTAL SUTURE

4.LIMBOUS:

MODIFIED

TEMPOROPARIETAL

SUTURE

5.DENTICULATE:

LAMBDOID SUTURE

6.SCHINDYLESIS:

(WEDGE AND GROOVE)

VOMEROSPHENOID

7.METOPIC:

FRONTAL SUTURE

2. GOMPHOSIS

“PEG AND SOCKET”

DENTOALVEOLAR

ARTICULATIONS

3. SYNDESMOSIS

12 OFFICIALLY RECOGNIZED MIDDLE RADIOULNAR JOINT MIDDLE TIBIOPFIBULAR JOINT DORSAL PART OF SACROILIAC JOINT

(LIGAMENT) CORACOCLAVICULAR JOINt JOINT BETWEEN VERTEBRAL ARCHES

B:CARTILAGINOUS JOINTS AMPHHIARTHROSIS

1:PRIMARY CARTILAGINOUS JOINTS / SYNCHONDROSIS / TEMPORARY

CRANIAL SYNCHONDROSES POSTCRANIAL SYNCHONDROSES 2:SECONDARY CARTILAGINOUS JOINTS

/ SYMPHOSES / PERMANENT FIBROCARTILAGE WITH CAVITY FIBROCARTILAGE WITHOUT CAVITY

PRIMARY CARTILAGINOUSJOINTS

SYNCHONDROSIS CRANIAL

SQUAMOUS PETROUS MASTOID AND

TYMPANIC PARTS OF TEMPORAL

BONES

PETROBASILAR JOINT

SYNCHINDROSIS POSTCRANIAL

EPIPHSIODIAPHYSEAL/EPIPHYSIOMETAPHYSAL

EPIPHYSIOCORPOREAL

INTRAEPIPHYSEAL IN COMPOUND EPIPHYSIS

MULTIPLEX

STERNALES

MANUBRIOSTERNALIS

XYPHIOSTERNALIS

EPIPHSIODIAPHYSEAL/EPIPHYSIOMETAPHYSIAL

INTRAEPIPHYSEAL IN COMPOUND EPIPHYSIS

MULTIPLEX

STERNALES / MANUBRIOSTERNALIS

MANUBRIOSTERNALIS

SECONDARY CARTILAGINOUSJOINTS

FIBROCARTILAGE WITH CAVITY

PUBIC SYMPHYSIS

INTERVERTEBRAL DISC

MANUBRIOSTERNAL IN LATER YEARS

OF LIFE

FIBROCARTILAGE WITHOUT CAVITY

SYMPHYSIS MENTI

SYMPHYSIS MANUBRIOSTERNALIS IN

EARLY YEARS OF LIFE

C:MIXED SOLID JOINTS

ISLANDS OF FIBROCARTILAGE MAY BE PRESENT IN SUTURAL TISSUE OF MANY SUTURES OF SKULL

D:INTERCHONDRAL FIBROUS

JUNCTION BETWEEN CARTILAGES OF LARYNX

JUNCTION BETWEEN CARTILAGES OF NOSE

D:INTERCHONDRAL FIBROUS

E:OSSEOCHONDRAL FIBROUS

JUNCTION BETWEEN BONY AND CARTILAGINOUS EXTERNAL

AUDITORY MEATUS LARYNX AND HYOID BONE NASAL BONE AND CARTILAGES COSTAL CARTILAGES RIBS AND STERNUM

BONY AND CARTILAGINOUS EXTERNAL AUDITORY MEATUS

NASAL BONE AND CARTILAGESCOSTAL CARTILAGES RIBS AND STERNUM

SYNOVIAL JOINTS

CHARACTERISTICS HYALINE CARTILAGE AT ARTICULAR

SURFACES ARTICULAR CAPSULE SYNOVIAL MEMBRANE CAVITY AND

FLUID FATTY PADS(HAVERSIAN GLANDS)

ACCESSORY LIGAMENTS ARTICULAR DISC AND MENISCI BURSAE LABRUM TENDONS WITH SYNOVIAL

MRMBRANES

CLASSIFICATION OF SYNOVIAL JOINTS

A:GENERAL MORPHOLOGY

1.SIMPLEHOMOMORPHIC

INTERMETATARSALINTERMETACARPAL

HETEROMORPHIC ACROMIOCLAVICULAR JOINT SHOULDER JOINT

2.COMPOUND ELBOW JOINT KNEE JOINT3.COMPLEX KNEE JOINT TEMPOROMANDIBULAR JOINT

1.SIMPLE JOINT

2.COMPOUND JOINT

3.COMPLEX JOINT

B:DEGREE OF FREEDOMa. Joints with translation/sliding

movement

b. Joint with angular movement1.UNI-AXIAL ELBOW JOINT INTERPHALANGEAL JOINT

2.BI-AXIAL WRIST JOINT

3.TRI/MULTI-AXIAL SHOULDER JOINT HIP JOINT

C. Joint with circumductory movement

1.UNI-AXIAL

UNI-AXIAL

2.BI-AXIAL

3.TRI/MULTI-AXIAL

C:GROSS MORPHOL0GICAL CLASSIFICATION

PLANE

INTERMETATARSAL

SOME INTERCARPAL HINGE JOINT

ELBOW JOINT

INTERPHALANGEAL JOINT PIVOT JOINT

MEDIAN ATLANTOAXIAL JOINT

PROXIMAL RADIOULNAR JOINT

CONDYLOID KNEE JOINT TEMPOROMANDIBULAR JOINT ELLIPSOID RADIOCARPAL JOINT METACARPOPHALANGEAL JOINT SADDLE CARPOMETACARPAL JOINTS OF THUMB ANKLE JOINT CALCANEOCUBOID JOINT BALL AND SOCKET

HIP JOINT SHOULDER

ELLIPSOID JOINT

In Biaxial joints the articular surface of one bone is oval (ellipsoid) and it fits into an identically shaped socket on the other bone. All movements except rotation can occur in this shape of joint. Examples include the Radio carpal joint.

D:TYPES OF MOVEMENT: 1. GLIDING/SLIDING/TRANSLATION:

Plane joint 2. ANGULAR:

Flexion Extension Abduction Adduction

Condyloid joint/Hinge/ellipsoid/…… 3. ROTATORY:

Medial Rotation Lateral Rotation Pivot joints

Classification of rotation according to axis of a bone

Classification of the rotation according to the causative factor Shape of the joint (conjunct,) Muscle action ( adjunct) Gravity “ External forces ”

4. CIRCUMDUCTORY:

Ball and socket joints

OPPOSITION Caropetacarpal joint of thumb

Inversion & eversion Talocalcaneonavicular joint

Movement of mendible Elevation Depression Protrusion Retraction Rotation

Movement of scapula

Movement of scapulaElevationDepressionProtractionRetractionForward rotationBackward rotation

Movement of shoulder girdle Pronation & supination

BLOOD SUPPLY OF JOINTS1.ARTERIAL SUPPLY:

Epiphyseal arteries

Periarticular plexus

Circulus articularis vasculosus

2.VENOUS DRAINAGE:

Veins follow arteries

LYMPHATIC DRAINAGEThe lymphatics drain into the adjacent regional veins

NERVE SUPPLY Free nerve endings capsule and ligament are highly sensitive Synovial membrane less sensitive Articular discs and cartilages are anervous

HILTON’S LAW

THE MOTOR NERVE TO A MUSCLE TENDS TO GIVE A BRANCH OF SUPPLY TO THE JOINT WHICH THE MUSCLES MOVES AND ALSO INNERVATES THE SKIN OVER THE JOINT

Gardner(1948)

Each nerve innervates a specific region of capsule, which may overlap with each other. this part of fibrous capsule made taut on the contraction of a given muscle or a group of muscles is usually innervated by the nerve or nerves supplying their antagonists.

FACTORS STABILIZING SYNOVIAL JOINTS

Nature of articulating surfaces (Shape,size and arrangfments) Tension of Ligaments Tendons Articular Discs Tension of muscles crossing joint Apposition of soft parts Force of cohesion Atmospheric pressure

SYNOSTOSIS“Fusion of any type of joint with aging”

Can take place in all types of joints .eg;

>FIBROUS JOINTS:

Sutures

>CARTILAGINOUS JOINTS:

Manubriosternal joints

>SYNOVIAL JOINTTS:

Sacroiliac joints

CLINICAL CORELATION Arthritis Osteoarthritis Joint injuries Dislocations Subluxation Synovitis Arthroscopy Joint replacement

REFERENCE

Gray's Anatomy(40thedition)(36thedition).Grant’s method of Anatomy.(10thedition).Clinical Anatomy by Richard S. Snell,(7thedition).www.google.com

CONCLUSION