General Anatomy of Joints

GENERAL ANATOMY OF
JOINTS
DR IFRA SAEED

JOINTS / ARTICULATIONS
Joints are the regions of th skeleton where two
or more bones meet and articulate. It is simply
the connective tissue present at the meeting
place between bones or cartilages

 SOLID JOINTS (SYNARTHROSIS)
 CAVITATEDJOINTS (DIARTHROSIS)
CLASSIFICATION OF JOINTS

SOLID JOINTS
 FIBROUS JOINTS (Synarthrosis)
 CARTILAGINOUS JOINTS (Amphiarthrosis)
 MIXED SOLID JOINTS (Mixed Synarthrosis)
 INTERCHONDRAL FIBROUS JOINTS (joints of
larynx and between cartilages of nose)
 OSSEOCHONDRAL FIBROUS JOINTS( ribs and
sternum)

CAVITATED JOINTS/ SYNOVIAL
JOINTS/DIARTHROSIS
 A cavity is formed with in the
connective tissue of the joint
 Two bones forming the joint are united
with each other by a sleeve of
connective tissue (fibrous capsule)
 Bone ends are capped by free and
smooth articular surfaces

A:FIBROUS JOINTS
SYNARTHROSES
The bones are united by means of fibrous
connective tissue. Immovable in adults
1. SUTURES
2. SYNDESMOSIS
3. GOMPHOSIS

SUTURES
 Amount of connective tissue is minimal
 Found only in skull
 Movements only occurs in fetuses and
young children
 In adults fibrous tissue is gradually
replaced by bone = synostosis

Sutural tissue is known as sutural ligament or middle layer
Sutural surfaces are covered by continuation of periosteum

1. SUTURES Immovable/ Fixed
There are 33 officially
recognized sutures
1.PLANE SUTURES:
opposition of two
perpendicular and
contaguous surfaces
INTERPALATINE SUTURE
INTERMAXILLARY
SUTURE

2.SQUAMOUS:
TEMPOROPARIETAL
SUTURE
3.SERRATE:
SAGITTAL SUTURE
4.LIMBOUS:
MODIFIED
TEMPOROPARIETAL
SUTURE

TEMPOROPARIETAL
SUTURE
SAGGITAL
SUTURE
TEMPOROPA
RIETAL
SUTURE
LAMBOID
SUTURE

5.DENTICULATE:
LAMBDOID SUTURE
6.SCHINDYLESIS:
(WEDGE AND GROOVE)
VOMEROSPHENOID
7.METOPIC:
FRONTAL SUTURE

2. GOMPHOSIS
“PEG AND SOCKET”
DENTOALVEOLAR
ARTICULATIONS
EACH TOOTH AND SOCKET
FORMS A JOINT WHICH IS
FILLED BY CONNECTIVE
TISSUE (LIGAMENT)
PERIODONTIUM

3. SYNDESMOSIS BAND LIKE
12 OFFICIALLY RECOGNIZED
THE CLOSELY OPPOSED LONG SURFACES ARE CONNECTED
BY FIBROUS TISSUE
 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
JOINT IS FORMED BY A HYALINE CARTILAGE WHICH IS
TEMPORARILY PRESENT TILL THE GROWTH OF THE
BONE
They are seen between the various centers of ossification
 CRANIAL SYNCHONDROSES
 POSTCRANIAL SYNCHONDROSES

CRANIAL SYNCHONDROSIS
 Skull consists of many bones and each
bone has many parts which is ossified
by a separate center of ossification
 SQUAMOUS PETROUS MASTOID AND
TYMPANIC PARTS OF TEMPORAL
BONES

POSTCRANIAL
SYNCHONDROSIS
 EPIPHSIODIAPHYSEAL/EPIPHYSIOMETAPHYSAL
 INTRAEPIPHYSEAL IN COMPOUND EPIPHYSIS
 MULTIPLEX ( between two or more primary centres
of a compound bone)
 STERNALES
 MANUBRIOSTERNALIS
 XYPHIOSTERNALIS

INTRAEPIPHYSEAL IN COMPOUND
EPIPHYSIS

SECONDARY
CARTILAGINOUS
JOINTS/
Symphosis/SYMPHYSIS

SYMPHYSIS
 Presence of disc of fibrocartilage
ENCASED IN HYALINE CARTILAGE
 No sliding surfaces
 They persist through out the life
 An incomplete fibrous capsule may
surround the joint
 Observed to be present in median
plane

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

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 CARTILAGES
COSTAL CARTILAGES RIBS AND STERNUM

CLASSIFICATION OF JOINTS
 SOLID JOINTS (SYNARTHROSIS)
 CAVITATEDJOINTS (DIARTHROSIS)

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

Articular Cartilage
 Thin layer of specialized hyaline cartilage
 Wear resistant, low friction, compressible,
and elastic structure
 Avascular, non nervous

Synovial cavity, membrane
and Fluid
 Synovial membrane
 Synovial villi ( pink, smooth, shiny finger like
projections)
 Haversion glands
 Function
1. Act like flexible cushions to fill the potential
spaces and irregularities in the joint cavity
2. Act as swabs

Synovial fluid
 Clear or pale yellow
 Viscous
 Lubricant and nutrient for articular
cartilage

Fibrous Capsule
 Slightly elastic cuff like fibrous structure
 Internally lined by SM
 Dense irregular connective tissue but in
some regions dense regular connective
tissue is also present Capsular ligament
 Extra and intracapsular epiphyseal line
 Prevent dislocations and accessory
movements

ACCESSORY LIGAMENTS
1. EXTRA CAPSULAR and
INTRACAPSULAR cruciate ligament
2. FUNCTIONS Prevent dislocations and
accessary movements
ARTICULAR DISCS
Circular rim of fibrocartilage
MENISCUS
Incomplete rim of fibrocartilage having
triangular appearance on cross section

FUNCTIONS
 Shock absorber
 Enhances the congruence
 Facilitate the combined movement
 Distribution of weight over large
surface area
 Protection

CLASSIFICATION OF SYNOVIAL
JOINTS

Based upon complexity of organization
1.SIMPLE ( one pair of articulating surfaces are involved )
HOMOMORPHIC (AS similar, mostly plain)
INTERMETATARSAL
INTERMETACARPAL
HETEROMORPHIC (one surface is larger and convex,
other is concave and smaller)
SHOULDER JOINT
2.COMPOUND ( more than one pair of articulating surface)
ELBOW JOINT
KNEE JOINT
3.COMPLEX ( presence of disc or menisci)
KNEE JOINT
TEMPOROMANDIBULAR JOINT

B:DEGREE OF FREEDOM of MOVEMENT
a. Joints with translation/sliding
movement (INTERTARSAL, INTERCARPAL)
b. Joint with angular movement
1.UNI-AXIAL
 ELBOW JOINT
 INTERPHALANGEAL JOINT
2.BI-AXIAL
 WRIST JOINT
3.TRI/MULTI-AXIAL
 SHOULDER JOINT
 HIP JOINT
C. Joint with circumductory movement

C:GROSS MORPHOL0GICAL
CLASSIFICATION
 PLANE (Flat articular surfaces)
INTERMETATARSAL
SOME INTERCARPAL (sliding movement)
 HINGE JOINT (reciprocal convexity and concavity)
ELBOW JOINT
INTERPHALANGEAL JOINT (uniaxial)
 PIVOT JOINT (uniaxial, in the form of rotation)
MEDIAN ATLANTOAXIAL JOINT
PROXIMAL RADIOULNAR JOINT

BICONDYLOID uniaxial
KNEE JOINT
TEMPOROMANDIBULAR JOINT
ELLIPSOID
RADIOCARPAL JOINT
METACARPOPHALANGEAL JOINT
Articular surfaces are longer in one plane
SADDLE
CARPOMETACARPAL JOINTS OF
THUMB
ANKLE JOINT
CALCANEOCUBOID JOINT
BALL AND SOCKET
HIP JOINT
SHOULDER

ELLIPSOID JOINTS ( SINGLE MALE
AND SINGLE FEMALE SURFACE )

D:TYPES OF MOVEMENT:
 1. GLIDING/SLIDING/TRANSLATION:
 Plane joint
 2. ANGULAR:
 Flexion
 Extension
 Abduction
 Adduction
 3. ROTATORY:
 the bone moves along its own long axis
 CLASSIFICATION ACCORDING TO REFERENCE POINT ON
TANGENT
 Medial Rotation
 Lateral Rotatio
 Pivot joints

Classification of rotation according to
axis of a bone
1.Axis may lie in separate bone (axis and
atlas)
2.Parallel or along shaft of long bone
(humerus)
3.May pass through two points of same
bone (femur)
4.Axis passes through two separate
bones (head of radius and base of ulna)

Classification of the rotation
according to the causative factor
a. Shape of the joint (conjunct)uniaxial
b. Muscle action,Gravity and External
forces (adjunct) biaxial
c. Simultaneous conjunct and adjunct
rotations
1.Cospin
2.Antispin
3.Nullifying swing ”

 OPPOSITION
Caropetacarpal joint of thumb
 Inversion & eversion
Talocalcaneonavicular joint
 Movement of mendible
 Elevation
 Depression
 Protrusion
 Retraction
 Rotation
 Movement of scapula

 Movement of scapula
Elevation
Depression
Protraction
Retraction
Forward rotation
Backward rotation
 Movement of shoulder girdle
 Pronation & supination

BLOOD SUPPLY OF JOINTS
1.ARTERIAL SUPPLY:
Epiphyseal arteries
Periarticular plexus
Circulus articularis vasculosus
2.VENOUS DRAINAGE:
Veins follow arteries

LYMPHATIC DRAINAGE
The 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

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(40th
edition)(36th
edition).
Grant’s method of Anatomy.
(10th
edition).
Clinical Anatomy by Richard S. Snell,
(7th
edition).
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