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PowerPoint® Lecture Slides
prepared by
Leslie Hendon
University of Alabama,
Birmingham
CHAPTER
9
Part 1
Joints
Copyright © 2011 Pearson Education, Inc.
Classifications of Joints
Joints
•  Rigid elements of the skeleton meet at joints
or articulations
•  Greek root “arthro” means joint
•  Structure of joints
•  Enables resistance to crushing, tearing, and
other forces
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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 (all
synovial joints)
•  Structural classification ---based on
•  Material that binds bones together
•  Presence or absence of a joint cavity
•  Structural classifications include
•  Fibrous
•  Cartilaginous
•  Synovial
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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
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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
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Ligament
Periodontal
ligament
Figure 9.1
1
Cartilaginous Joints
Synchondroses
•  Bones are united by cartilage
•  Lack a joint cavity
•  Two types
•  Hyaline cartilage unites bones
•  Epiphyseal plates
•  Joint between first rib and manubrium
•  Synchondroses
•  Symphyses
(a) Synchondroses
Bones united by hyaline cartilage
Sternum
(manubrium)
Epiphyseal
plate (temporary
hyaline cartilage
joint)
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Symphyses
Figure 9.2a
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Symphyses
•  Fibrocartilage unites bones; resists tension
and compression
•  Slightly movable joints that provide strength
with flexibility
(b) Symphyses
Bones united by fibrocartilage
Body of vertebra
Fibrocartilaginous
intervertebral
disc
•  Intervertebral discs
•  Pubic symphysis
•  Hyaline cartilage—present as articular
cartilage
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Joint between
first rib and
sternum
(immovable)
Hyaline cartilage
Pubic symphysis
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Synovial Joints
General Structure of Synovial Joints
•  Most movable type of joint
•  All are diarthroses
•  Each contains a fluid-filled joint cavity
•  Articular cartilage
Figure 9.2b
•  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
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2
General Structure of Synovial Joints
General Structure of Synovial Joints
•  Articular capsule—joint cavity is enclosed in
a two-layered capsule
•  Synovial fluid
•  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
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General Structure of Synovial Joints
•  A viscous fluid similar to raw egg white
•  A filtrate of blood
•  Arises from capillaries in synovial
membrane
•  Contains glycoprotein molecules secreted
by fibroblasts
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General Structure of Synovial Joints
•  Reinforcing ligaments
•  Often are thickened parts of the fibrous capsule
•  Sometimes are extracapsular ligaments—located outside the
capsule
•  Sometimes are intracapsular ligaments—located internal to the
capsule
•  Richly supplied with sensory nerves
•  Detect pain
•  Most monitor how much the capsule is being stretched
•  Have a rich blood supply
•  Most supply the synovial membrane
•  Extensive capillary beds produce basis of synovial fluid
•  Branches of several major nerves and blood vessels
Ligament
Joint cavity
(contains
synovial fluid)
Articular (hyaline)
cartilage
Fibrous
Articular
capsule
capsule
Synovial
membrane
Periosteum
(a) A typical synovial joint
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Synovial Joints with Articular Discs
How Synovial Joints Function
•  Some synovial joints contain an articular
disc
•  Synovial joints—lubricating devices
•  Friction could overheat and destroy joint
tissue
•  Are subjected to compressive forces
•  Occur in the temporomandibular joint and at
the knee joint
•  Occur in joints whose articulating bones have
somewhat different shapes
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Figure 9.3a
•  Fluid is squeezed out as opposing
cartilages touch
•  Cartilages ride on the slippery film
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3
Bursae and Tendon Sheaths
•  Bursae and tendon sheaths are not
synovial joints
•  Closed bags of lubricant
•  Reduce friction between body elements
•  Bursa—a flattened fibrous sac lined by a
synovial membrane
•  Tendon sheath—an elongated bursa that
wraps around a tendon
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Bursae and Tendon Sheaths
Coracoacromial
ligament
Subacromial
bursa
Acromion
of scapula
Coracoacromial
ligament
Subacromial
bursa
Joint cavity
containing
synovial fluid
Fibrous
articular
capsule
Hyaline
cartilage
Tendon
sheath
Tendon of
long head
of biceps
brachii
muscle
Synovial
membrane
Fibrous
capsule
Humerus
(a) Frontal section through the right
shoulder joint
Cavity in
bursa containing
synovial fluid
Humerus resting
Bursa rolls
and lessens
friction.
Humerus head
rolls medially as
arm abducts.
Humerus moving
(b) Enlargement of (a), showing how a bursa
eliminates friction where a ligament (or other
structure) would rub against a bone
Figure 9.5a, b
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Movements Allowed by Synovial Joints
Gliding Joints
•  Three basic types of movement
•  Flat surfaces of two bones slip across
each other
•  Gliding occurs
between
•  Gliding—one bone across the surface of
another
•  Angular movement—movements change the
angle between bones
•  Rotation—movement around a bone's long
axis
•  Carpals
•  Articular
processes
of vertebrae
•  Tarsals
Gliding
(a) Gliding movements at the wrist
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Angular Movements
Figure 9.6a
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Angular Movements
•  Increase or decrease angle between bones
•  Movements involve
Extension
•  Flexion and extension
•  Abduction and adduction
•  Circumduction
Flexion
(b) Angular movements: flexion and extension of the neck
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Figure 9.6b
4
Angular Movements
Angular Movements
Extension
Flexion
Extension
Flexion
Flexion
Extension
(c) Angular movements: flexion and extension of the trunk
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(d) Angular movements: flexion and extension at the shoulder and knee
Figure 9.6c
Angular Movements
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
Abduction
PLAY
Adduction
Figure 9.6d
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Movement of the
pectoral girdle (a)
Circumduction
(e) Angular movements: abduction, adduction, and
circumduction of the upper limb at the shoulder
Figure 9.6e
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Rotation
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Special Movements
•  Elevation—lifting a body part superiorly
•  Depression—moving the elevated part
inferiorly
Rotation
Lateral
rotation
Medial
rotation
Elevation
of mandible
Depression
of mandible
(f) Rotation of the head, neck, and lower limb
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Figure 9.6f
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(a) Elevation
Lifting a body part
superiorly
Depression
Moving a body part
inferiorly
Figure 9.7a
5
Special Movements
Special Movements
•  Protraction—nonangular movement
anteriorly
•  Retraction—nonangular movement
posteriorly
•  Supination—forearm rotates laterally, palm
faces anteriorly
•  Pronation—forearm rotates medially, palm
faces posteriorly
•  Brings radius across the ulna
Protraction
of mandible
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(b) Protraction
Moving a body part in the
anterior direction
Retraction
of mandible
Retraction
Moving a body part in the
posterior direction
Figure 9.7b
Special Movements
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Special Movements
Pronation
(radius rotates
over ulna)
Supination
(radius and ulna
are parallel)
•  Opposition—thumb moves across the palm
to touch the tips of other fingers
Opposition
(c) Pronation (P)
Rotating the forearm so the
palm faces posteriorly
Supination (S)
Rotating the forearm so the
palm faces anteriorly
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Special Movements
Figure 9.7c
(d) Opposition
Moving the thumb to touch the tips
of the other fingers
Figure 9.7d
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Special Movements
•  Inversion and eversion
•  Special movements at the foot
•  Inversion—turns sole medially
•  Eversion—turns sole laterally
Inversion
(e) Inversion
Turning the sole of the foot
medially
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Eversion
Eversion
Turning the sole of the foot
laterally
Figure 9.7e
6
Special Movements
Special Movements
Dorsiflexion
•  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
Plantar flexion
(f) Dorsiflexion
Lifting the foot so its superior
surface approaches the shin
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Synovial Joints Classified by Shape
Plantar flexion
Depressing the foot
elevating the heel
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Figure 9.7f
Plane Joint
•  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
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Synovial Joints Classified by Shape
Nonaxial movement
Metacarpals
Carpals
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Figure 9.8a
Hinge Joint
•  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
Gliding
(a) Plane joint
Uniaxial movement
Humerus
Medial/
lateral
axis
Ulna
Flexion and extension
(b) Hinge joint
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Figure 9.8b
7
Synovial Joints Classified by Shape
Pivot Joint
•  Pivot joints
•  Classified as uniaxial – rotating bone only
turns around its long axis
•  Examples
•  Proximal radioulnar joint
•  Joint between atlas and axis
Vertical
axis
Ulna
Radius
Rotation
(c) Pivot joint
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Synovial Joints Classified by Shape
Figure 9.8c
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Condyloid Joint
•  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
Biaxial movement
Phalanges
Metacarpals
Flexion and
extension
(d) Condyloid joint
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Synovial Joints Classified by Shape
Anterior/
posterior
axis
Medial/
lateral
axis
Adduction and
abduction
Figure 9.8d
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Synovial Joints Classified by Shape
•  Saddle joints
Metacarpal 1
•  Each articular surface has concave and
convex surfaces
•  Classified as biaxial joints
•  1st carpometacarpal joint is a good example
•  Allows opposition of the thumb
Medial/
lateral
axis
Trapezium
Anterior/
posterior
axis
Adduction and
abduction
Flexion and
extension
(e) Saddle joint
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Figure 9.8e
8
Synovial Joints Classified by Shape
Ball-and-Socket Joint
Multiaxial movement
•  Ball-and-socket joints
Medial/lateral
axis
Scapula
•  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
Anterior/posterior
axis
Vertical
axis
Humerus
Flexion and
extension
(f) Ball-and-socket joint
PLAY
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Factors Influencing Stability of Synovial
Joints
•  Articular surfaces
•  Shapes of articulating surfaces determine
movements possible
•  Seldom play a major role in joint stability
•  Exceptions that do provide stability
•  Hip joint, elbow joint, and ankle
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Selected Synovial Joints
Adduction
and abduction
Rotation
Movement of the
glenohumeral joint (a)
Figure 9.8f
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Factors Influencing Stability of Synovial
Joints
• 
• 
• 
Ligaments
•  Capsules and ligaments prevent excessive motions
•  On the medial or inferior side of a joint – prevent excessive abduction
•  Lateral or superiorly located—resist adduction
•  Anterior ligaments—resist extension and lateral rotation
•  Posterior ligaments—resist flexion and medial rotation
The more ligaments, usually stronger and more stable
Muscle tone
•  Helps stabilize joints by keeping tension on tendons
•  Is important in reinforcing:
•  Shoulder and knee joints
•  Supporting joints in arches of the foot
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Selected Synovial Joints
•  Sternoclavicular joint
•  Is a saddle joint
•  Four ligaments surround the joint
•  Anterior and posterior sternoclavicular ligaments
•  Interclavicular ligament
•  Costoclavicular ligament
•  Performs multiple complex movements
Anterior
sternoclavicular
ligament and
joint capsule
Clavicle
Interclavicular
ligament
Articular
disc
Retraction
Posterior
rotation
Protraction
Depression
Costoclavicular
ligament
Costal cartilage
of 1st rib
Manubrium
of sternum
(a) Sternoclavicular joint, anterior view
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Elevation
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(b) Sternoclavicular movements
Figure 9.9
9
Selected Synovial Joints
The Temporomandibular Joint
Mandibular fossa
Articular tubercle
Zygomatic process
Infratemporal fossa
•  Temporomandibular Joint
•  Is a modified hinge joint
•  The head of the mandible articulates with the
temporal bone
•  Lateral excursion is a side-to-side movement
•  Two surfaces of the articular disc allow
•  Hinge-like movement
•  Gliding of superior surface anteriorly
Mandibular
fossa
Articular disc
Articular
tubercle
Articular
capsule
External
acoustic
meatus
Lateral
ligament
Articular
capsule
Superior
joint
cavity
Synovial
membranes
Mandibular
condyle
Ramus of
mandible
Inferior joint
cavity
Ramus of mandible
(a) Location of the joint in the skull
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(b) Enlargement of a sagittal section through the joint
(arrows indicate movement in each part of the joint cavity)
Figure 9.10
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The Temporomandibular Joint
Selected Synovial Joints
•  Shoulder (glenohumeral) joint
•  The most freely movable joint lacks stability
•  Articular capsule is thin and loose
•  Muscle tendons contribute to joint stability
•  The rotator cuff is made up of four muscles and their
associated tendons (“SITS”)
•  Subscapularis
•  Infraspinatus
•  Teres minor
•  Supraspinatus
•  Rotator cuff injuries are common shoulder injuries
Figure 9.10c
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Glenohumeral Joint
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The Shoulder Joint
Acromion
Acromion
of scapula
Coracoacromial
ligament
Subacromial
bursa
Fibrous
articular capsule
Coracoacromial
ligament
Subacromial
bursa
Coracohumeral
ligament
Glenoid labrum
Glenoid labrum
Synovial cavity
of the glenoid
cavity containing
synovial fluid
Hyaline
cartilage
Synovial cavity
of the glenoid
cavity containing
synovial fluid
Greater
tubercle
of humerus
Transverse
humeral
ligament
Hyaline
cartilage
Tendon
sheath
Synovial membrane
Fibrous capsule
Tendon of
long head
of biceps
brachii muscle
(a) Frontal section through right shoulder joint
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Humerus
Fibrous capsule
Tendon sheath
Humerus
Tendon of
long head
of biceps
brachii
muscle
(b) Cadaver photo corresponding to (a)
Figure 9.11a, b
(c) Anterior view of right shoulder joint capsule
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Coracoid
process
Articular
capsule
reinforced by
glenohumeral
ligaments
Subscapular
bursa
Tendon of the
subscapularis
muscle
Scapula
Figure 9.11c
10
The Shoulder Joint
Selected Synovial Joints
•  Elbow joint
Acromion
Coracoid
process
Articular
capsule
Glenoid cavity
Glenoid labrum
Tendon of long
head of biceps
brachii muscle
Glenohumeral
ligaments
Tendon of the
subscapularis
muscle
Scapula
Glenoid
cavity of
scapula
Head of
humerus
Capsule of
shoulder
joint
(opened)
Muscle
of rotator
cuff (cut)
Posterior
Anterior
(d) Lateral view of socket of right shoulder joint,
humerus removed
•  Allows flexion and extension
•  The humerus’ articulation with the trochlear
notch of the ulna forms the hinge
•  Tendons of biceps and triceps brachii provide
stability
Acromion
(cut)
(e) Posterior view of an opened left shoulder joint
Figure 9.11d, e
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Elbow Joint
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Elbow Joint
Articular
capsule
Synovial
membrane
Humerus
Fat pad
Tendon of
triceps
muscle
Bursa
Synovial cavity
Articular cartilage
Humerus
Coronoid process
Radius
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
Anular
ligament
Medial
epicondyle
Ulna
Trochlea
Articular
capsule
Anular
ligament
Tendon of
brachialis muscle
Articular
capsule
Coronoid
process
Ulnar
collateral
ligament
Radius
Coronoid
process of
ulna
(c) Cadaver photo of medial view of right elbow
Humerus
Medial
epicondyle
Ulnar
collateral
ligament
Ulna
Ulna
(d) Medial view of right elbow
Ulna
(b) Lateral view of right elbow joint
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Figure 9.12a, b
Wrist Joint
•  Stabilized by numerous ligaments
• 
•  Composed of radiocarpal and intercarpal joint
•  Radiocarpal joint —joint between the radius and
proximal carpals (the scaphoid and lunate)
•  Allows for flexion, extension, adduction,
abduction, and circumduction
•  Intercarpal joint —joint between the proximal and
distal rows or carpals
•  Allows for gliding movement
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Wrist Joint
Radiocarpal
joint
Radial
collateral
ligament
Distal
radioulnar
joint
Articular
disc
Ulnar
collateral
ligament
Intercarpal
joint
(b) Wrist joints, coronal section
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Figure 9.12c, d
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Figure 9.13b
11
Wrist Joint
Palmar
radiocarpal
ligament
Radius
Selected Synovial Joints
Ulna
Lunate
Radial
collateral
ligament
•  Hip joint
•  A ball-and-socket structure
•  Movements occur in all axes
•  Limited by ligaments and acetabulum
•  Head of femur articulates with acetabulum
•  Stability comes chiefly from acetabulum and
capsular ligaments
•  Muscle tendons contribute somewhat to
stability
Ulnar
collateral
ligament
Scaphoid
Intercarpal
ligaments
Pisiform
Hamate
Trapezium
Carpometacarpal
ligaments
Capitate
(c) Ligaments of the wrist, anterior (palmar) view
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Figure 9.13c
Frontal Section and Anterior View of the Hip
Joint
Articular cartilage
Acetabular labrum
Coxal (hip) bone
Acetabular
labrum
Ligament of the
head of the femur
(ligamentum teres)
Synovial
membrane
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Posterior View of the Hip Joint
Iliofemoral
ligament
Ischium
Ischiofemoral
ligament
Ligament
of the head
of the femur
(ligamentum
teres)
Femur
Greater
trochanter
of femur
Head
of femur
Iliofemoral
ligament
Anterior inferior
iliac spine
Pubofemoral
ligament
Greater
trochanter
Articular
capsule (cut)
Synovial cavity
Articular capsule
(a) Frontal section through the right hip joint
(b) Photo of the interior of the hip joint, lateral view
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Selected Synovial Joints
(c) Posterior view of right hip joint, capsule in
place
Figure 9.14a, b
The largest and most complex joint
Primarily acts as a hinge joint
Has some capacity for rotation when leg is flexed
Structurally considered compound and bicondyloid
Two fibrocartilage menisci occur within the joint cavity
Femoropatellar joint—shares the joint cavity
•  Allows patella to glide across the distal femur
Figure 9.14c, d
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Sagittal Section of Knee Joint
Tendon of
quadriceps
femoris
•  Knee joint
• 
• 
• 
• 
• 
• 
(d) Anterior view of right hip joint, capsule in place
Femur
Articular
capsule
Posterior
cruciate
ligament
Lateral
meniscus
Anterior
cruciate
ligament
Tibia
Suprapatellar
bursa
Patella
Subcutaneous
prepatellar bursa
Synovial cavity
Lateral meniscus
Infrapatellar
fat pad
Deep infrapatellar
bursa
Patellar ligament
(a) Sagittal section through the right knee joint
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Figure 9.15a
12
Superior View of Knee Joint
Anterior View of Knee
Anterior
Quadriceps
femoris
muscle
Anterior
cruciate
ligament
Articular
cartilage on
lateral tibial
condyle
Articular
cartilage on
medial tibial
condyle
Tendon of
quadriceps
femoris
muscle
Patella
Lateral
patellar
retinaculum
Medial
meniscus
Lateral
meniscus
Posterior
cruciate
ligament
Fibular
collateral
ligament
Fibula
(b) Superior view of the right tibia in the knee joint, showing
the menisci and cruciate ligaments
Tibial
collateral
ligament
Patellar
ligament
Tibia
(c) Anterior view of right knee
Figure 9.15b
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Medial
patellar
retinaculum
Knee Joint
Figure 9.15c
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Posterior View of Knee Joint
Tendon of
adductor
magnus
•  Ligaments of the knee joint
•  Become taut when knee is extended
•  These extracapsular and capsular ligaments
are
•  Fibular and tibial collateral ligament
•  Oblique popliteal ligament
•  Arcuate popliteal ligament
Medial head of
gastrocnemius
muscle
Popliteus
muscle
(cut)
Tibial
collateral
ligament
Tendon of
semimembranosus
muscle
Femur
Articular
capsule
Oblique
popliteal
ligament
Lateral
head of
gastrocnemius
muscle
Bursa
Fibular
collateral
ligament
Arcuate
popliteal
ligament
Tibia
(d) Posterior view of the joint capsule, including ligaments
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Anterior View of Flexed Knee
Fibular
collateral
ligament
Lateral
condyle
of femur
Lateral
meniscus
Medial condyle
Anterior cruciate
ligament
Medial meniscus
Tibia
Patellar ligament
Fibula
Medial femoral
condyle
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)
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Knee Joint
Posterior cruciate
ligament
Tibial collateral
ligament
Figure 9.15d
Patella
(f) Photograph of an opened knee joint; view similar to (e)
Figure 9.15e, f
•  Intracapsular ligaments
•  Cruciate ligaments—prevent undesirable movements
at the knee
•  Anterior cruciate ligament—prevents anterior
sliding of the tibia
•  Posterior cruciate ligament—prevents forward
sliding of the femur or backward displacement of
the tibia
•  Cross each other like an “X”
•  Each cruciate ligament runs from the proximal tibia to
the distal femur
•  Anterior cruciate ligament
•  Posterior cruciate ligament
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13
Stabilizing function of cruciate ligaments
1 During movement of the knee the anterior
cruciate prevents anterior sliding of the tibia;
the posterior cruciate prevents posterior
sliding of the tibia.
The “Unhappy Triad”
2 When the knee is fully extended,
both cruciate ligaments are taut and
the knee is locked.
Quadriceps
muscle
Femur
•  Tibial collateral ligament and medial meniscus
•  Anterior cruciate ligament
Anterior
cruciate
ligament
Patella
Medial
condyle
Lateral
meniscus
Anterior
cruciate
ligament
Posterior
cruciate
ligament
•  Lateral blows to the knee can tear:
Posterior
cruciate
ligament
Tibia
(b)
(a)
Figure 9.16a, b
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The “Unhappy Triad”
Selected Synovial Joint
Lateral
•  Ankle joint
•  A hinge joint between
•  United inferior ends of tibia and fibula
•  The talus of the foot
•  Allows the movements
•  Dorsiflexion and plantar flexion only
•  Medially and laterally stabilized by ligaments
•  Medial (deltoid) ligament
•  Lateral ligament
•  Inferior ends of tibia and fibula are joined by ligaments
•  Anterior and posterior tibiofibular ligaments
Medial
Patella
(outline)
Latera
Tibial
collateral
ligament
(torn)
l forc
e
Medial
meniscus
(torn)
Anterior
cruciate
ligament
(torn)
Anterior view
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Figure 9.17
The Ankle Joint
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Ligaments of the Ankle Joint
Tibialis posterior muscle
Tibia
Calcaneal tendon
Tibia
Ankle (talocrural) joint
Talocalcaneal ligament
Talus
Talus
Talonavicular joint
Navicular
Cuneonavicular joint
Medial malleolus
Medial (deltoid)
ligament
Sustentaculum
tali
Tarsometatarsal joint
Metatarsal bone (II)
Metatarsophalangeal
joint
Interphalangeal
joint
Calcaneus
Subtalar
joint
Calcaneus
(b) Right ankle, medial view
Navicular
bone
Intermediate
cuneiform bone
(a) Cadaver photo of ankle and foot, sagittal section
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1st metatarsal
Tendon of flexor
digitorum longus
Figure 9.18a
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Figure 9.18b
14
Ligaments of the Ankle Joint
Fibula
Anterior tibiofibular
ligament
Ligaments of the Ankle Joint
Interosseous membrane
Tibia
Tibia
Posterior tibiofibular
ligament
Fibula
Lateral malleolus
Anterior talofibular
ligament
Lateral
Posterior talofibular
ligament ligament
Calcaneofibular
ligament
Calcaneus
Talus
Metatarsals
Posterior tibiofibular
ligament
Medial (deltoid)
ligament
Cuboid
(c) Right ankle, lateral view
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Talus
Posterior talofibular
ligament
Calcaneofibular
ligament
Calcaneus
Figure 9.18c
(d) Right ankle, posterior view
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Figure 9.18d
Disorders of Joints
• 
Structure of joints makes them prone to traumatic stress
• 
• 
• 
• 
• 
Function of joints makes them subject to friction and wear
Affected by inflammatory and degenerative processes
• 
• 
• 
• 
Torn cartilage—common injury to meniscus of knee joint
Sprains—ligaments of a reinforcing joint are stretched or torn
Dislocation—occurs when the bones of a joint are forced out of alignment
Bursitis—inflammation of a bursa due to injury or friction
Tendonitis—inflammation of a tendon sheath
Arthritis—describes over 100 kinds of joint-damaging diseases
•  Osteoarthritis—most common type of “wear and tear” arthritis
•  Rheumatoid arthritis—a chronic inflammatory disorder
•  Gouty arthritis (gout)—uric acid build-up causes pain in joints
Lyme disease—inflammatory disease often resulting in joint pain
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