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Chapter 9
Joints
Lecture Presentation by
Lee Ann Frederick
University of Texas at Arlington
© 2015 Pearson Education, Inc.
An Introduction to Joints
• Learning Outcomes
• 9-1 Contrast the major categories of joints, and
explain the relationship between structure
and function for each category.
• 9-2 Describe the basic structure of a synovial
joint, and describe common synovial joint
accessory structures and their functions.
• 9-3 Describe how the anatomical and functional
properties of synovial joints permit
movements of the skeleton.
• 9-4 Describe the joints between the vertebrae of
the vertebral column.
© 2015 Pearson Education, Inc.
An Introduction to Joints
• Learning Outcomes
• 9-5 Describe the structure and function of the
shoulder joint and the elbow joint.
• 9-6 Describe the structure and function of the
hip joint and the knee joint.
• 9-7 Describe the effects of aging on joints, and
discuss the most common age-related
clinical problems for joints.
• 9-8 Explain the functional relationships between
the skeletal system and other body systems.
© 2015 Pearson Education, Inc.
An Introduction to Joints
• Articulations
• Body movement occurs at joints (articulations)
where two bones connect
• Joint Structure
• Determines direction and distance of movement
(range of motion or ROM)
• Joint strength decreases as mobility increases
© 2015 Pearson Education, Inc.
9-1 Classification of Joints
• Two Methods of Classification
Functional classification is based on range of
motion of the joint
• Synarthrosis (immovable joint)
• Amphiarthrosis (slightly movable joint)
• Diarthrosis (freely movable joint)
Structural classification relies on anatomical
organization of the joint
• Bony
• Fibrous
• Cartilaginous
• Synovial
© 2015 Pearson Education, Inc.
9-1 Classification of Joints
• Synarthroses (Immovable Joints)
• Are very strong
• Edges of bones may touch or interlock
• Four types of synarthrotic joints
1.
2.
3.
4.
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Suture
Gomphosis
Synchondrosis
Synostosis
9-1 Classification of Joints
• Suture
• Bones interlocked and are bound by dense fibrous
connective tissue which found only in skull
• Gomphosis
• Fibrous connection (periodontal ligament)
• Binds teeth to sockets
© 2015 Pearson Education, Inc.
Table 9-1 Functional and Structural Classifications of Joints (Part 1 of 3).
9-1 Classification of Joints
• Synchondrosis
• Is a rigid cartilaginous bridge between two bones
• Epiphyseal cartilage of long bones and between
vertebrosternal ribs and sternum
• Synostosis
• Fused bones, immovable in metopic suture of
skull and epiphyseal lines of long bones
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9-1 Classification of Joints
• Amphiarthroses
• More movable than synarthrosis
• Stronger than freely movable joint
• Two types of amphiarthroses
1. Syndesmosis: Bones connected by ligaments
2. Symphysis: Bones separated by fibrocartilage
© 2015 Pearson Education, Inc.
Table 9-1 Functional and Structural Classifications of Joints (Part 2 of 3).
9-1 Classification of Joints
• Synovial Joints (Diarthroses)
• Also called movable joints are at ends of long
bones, within articular capsules which lined with
synovial membrane
© 2015 Pearson Education, Inc.
Table 9-1 Functional and Structural Classifications of Joints (Part 3 of 3).
9-2 Synovial Joints
• Articular Cartilages
• Pad articulating surfaces within articular
capsules which prevent bones from touching
• Smooth surfaces lubricated by synovial fluid will
reduce friction
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9-2 Synovial Joints
• Synovial Fluid
• Contains slippery proteoglycans secreted by
fibroblasts
• Functions of synovial fluid
1. Lubrication
2. Nutrient distribution
3. Shock absorption
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9-2 Synovial Joints
• Accessory Structures
•
•
•
•
•
Cartilages
Fat pads
Ligaments
Tendons
Bursae
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9-2 Synovial Joints
• Cartilages: Cushion the joint
• Fibrocartilage pad called a meniscus (or articular
disc; plural, menisci)
• Fat Pads: Superficial to the joint capsule and
Protect articular cartilages
• Ligaments: Support, strengthen joints
• Sprain – ligaments with torn collagen fibers
© 2015 Pearson Education, Inc.
9-2 Synovial Joints
• Tendons
• Attach to muscles around joint and help support
joint
• Bursae
• Singular, bursa, a pouch
• Pockets of synovial fluid
• Cushion areas where tendons or ligaments rub
© 2015 Pearson Education, Inc.
Figure 9-1a The Structure of a Synovial Joint.
Medullary cavity
Spongy bone
Periosteum
Components of
Synovial Joints
Joint capsule
Synovial membrane
Articular cartilages
Joint cavity containing
synovial fluid
Metaphysis
Compact bone
a Synovial joint, sagittal section
© 2015 Pearson Education, Inc.
Figure 9-1b The Structure of a Synovial Joint.
Quadriceps
tendon
Patella
Joint capsule
Femur
Synovial
membrane
Accessory Structures
of a Knee Joint
Bursa
Fat pad
Joint cavity
Articular
cartilage
Meniscus
Tibia
Ligaments
Extracapsular
ligament (patellar)
Intracapsular
ligament (cruciate)
b Knee joint, sagittal section
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9-2 Synovial Joints
• Injuries
• Dislocation (luxation)
• Articulating surfaces forced out of position
• Damages articular cartilage, ligaments, joint
capsule
• Subluxation
• A partial dislocation
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9-3 Movements
• Three Types of Dynamic Motion
1. Linear movement (gliding)
2. Angular movement
3. Rotation
• Planes (Axes) of Dynamic Motion
• Monaxial (1 axis)
• Biaxial (2 axes)
• Triaxial (3 axes)
© 2015 Pearson Education, Inc.
Figure 9-2 Joint Movement (Part 1 of 12).
SIMPLE MODEL OF ARTICULAR MOTION
Take a pencil as your model and stand it
upright on the surface of a desk.
The pencil represents a bone, and the
desk is an articular surface.
A lot of twisting, pushing, and pulling will
demonstrate that there are only three
ways to move the pencil.
© 2015 Pearson Education, Inc.
Figure 9-2 Joint Movement (Part 2 of 12).
Moving the Point
Linear motion (glinding)
Possible movement 1 shows the pencil can
move.
If you hold the pencil upright, without
securing the point, you can push the pencil
across the surface which is called gliding.
You could slide the point forward or
backward, from side to side, or diagonally.
Two surfaces slide past each other
Between carpal or tarsal bones
© 2015 Pearson Education, Inc.
Figure 9-2 Joint Movement (Part 3 of 12).
Changing the Shaft Angle
Angular motion
Possible movement 2 shows the
pencil shaft can change its angle
with the surface.
With the tip held in position, you can
move the eraser end of the pencil
forward and backward, from side to
side, or at some intermediate angle.
© 2015 Pearson Education, Inc.
Figure 9-2 Joint Movement (Part 4 of 12).
Changing the Shaft Angle
Circumduction
Possible movement 3 shows a complex angular
movement.
Grasp the pencil eraser and move the pencil in
any direction until it is no longer vertical.
Now, swing the eraser through a complete
circle in a movement called circumduction.
© 2015 Pearson Education, Inc.
Figure 9-2 Joint Movement (Part 5 of 12).
Rotating the Shaft
Rotation
Possible movement 4 shows that the pencil shaft
can rotate.
If you keep the shaft vertical and the point at one
location, you can still spin the pencil around its
longitudinal axis in a movement called rotation.
No joint can freely rotate because this would
tangle blood vessels, nerves, and
muscles as they crossed the joint.
© 2015 Pearson Education, Inc.
Figure 9-3a Angular Movements.
Extension
Angular
motion in
anterior–
posterior
plane reduces
angle between
elements
increases
angle
between
elements
Flexion
Hyperextension
Flexion
Flexion
Extension
Extension
Flexion
Hyperextension
Extension
a
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Hyperextension
Flexion/extension
Angular motion
in extension
past anatomical
position
Figure 9-3b Angular Movements.
Angular motion in frontal plane
which moves away from
longitudinal axis
Abduction
Abduction
Adduction
Adduction
Abduction
Adduction
Abduction
Adduction
moves toward
longitudinal axis
b
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Abduction/adduction
9-3 Movements
• Angular Movement
• Circumduction
• Circular motion without rotation
• Angular motion
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Figure 9-4a Rotational Movements.
Head rotation
Right
rotation
Left
rotation
Left or right rotation
Medial rotation (inward rotation)
Rotates toward axis
Lateral
(external)
rotation
Lateral rotation
(outward rotation)
Rotates away
from axis
Medial
(internal)
rotation
a
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Figure 9-4b Rotational Movements.
Supination: Forearm
in anatomical position
Pronation
b
Supination
Pronation: Rotates forearm, radius over ulna
© 2015 Pearson Education, Inc.
9-3 Movements
• Special Movements
•
•
•
•
Inversion: Twists sole of foot medially
Eversion: Twists sole of foot laterally
Dorsiflexion: Flexion at ankle (lifting toes)
Plantar flexion: Extension at ankle (pointing toes)
Dorsiflexion
(Lifting up)
Eversion
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Inversion
Plantar flexion
(Pointing toes)
9-3 Movements
• Special Movements
• Opposition: Thumb movement toward fingers or
palm (grasping)
• Reposition: Opposite of opposition
• Protraction: Moves interiorly in the horizontal
plane (pushing forward)
• Retraction: Opposite of protraction which move
anteriorly (pulling back)
© 2015 Pearson Education, Inc.
9-3 Movements
• Special Movements
• Elevation: Moves in superior direction (up)
• Depression: Moves in inferior direction (down)
• Lateral flexion: Bends vertebral column from side
to side
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Figure 9-5 Special Movements (Part 3 of 6).
Opposition
Retraction
Protraction
Lateral flexion
Depression
Elevation
9-3 Movements
• Functional Classification of Synovial Joints
•
•
•
•
•
•
Gliding
Hinge
Pivot
Condylar
Saddle
Ball-and-socket
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9-3 Movements
• Gliding Joints
• Flattened or slightly curved faces
• Limited motion (nonaxial)
• Hinge Joints
• Angular motion in a single plane (monaxial)
• Condylar Joints
• Oval articular face within a depression
• Motion in two planes (biaxial)
© 2015 Pearson Education, Inc.
Figure 9-2 Joint Movement (Part 7 of 12).
Gliding joint
Gliding joints, or plane joints, have
flattened or slightly curved surfaces
that slide across one another, but the
amount of movement is very slight.
Manubrium
Movement:
Gliding.
Slight nonaxial
or multiaxial
Flattened or slightly curved faces and there is limited motion
(nonaxial)
© 2015 Pearson Education, Inc.
Figure 9-2 Joint Movement (Part 8 of 12).
Hinge joint
Hinge joints permit
angular motion in a
single plane, like the
opening and closing of
a door.
Movement:
Angular Monaxial
Humerus
Ulna
Angular motion in a single plane (monoaxial)
© 2015 Pearson Education, Inc.
Examples:
• Elbow joint
• Knee joint
• Ankle joint
• Interphalangeal
joint
Figure 9-2 Joint Movement (Part 9 of 12).
Condylar joint
Condylar joints, or ellipsoidal
joints, have an oval articular
face nestled within a
depression on the opposing
surface.
Movement:
Angular.
Biaxial
Scaphoid
bone
Radius
Examples:
• Radiocarpal joint
• Metacarpophalang
eal joints 2–5
• Metatarsophalange
al joint
Ulna
Oval articular face within a depression and motion in
two planes (biaxial)
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9-3 Movements
• Saddle Joints: Two concave, straddled (biaxial)
• Pivot Joints: Rotation only (monaxial)
• Ball-and-Socket Joints: Round articular face in
a depression (triaxial)
© 2015 Pearson Education, Inc.
Figure 9-2 Joint Movement (Part 10 of 12).
Saddle joint
Saddle joints have complex
articular faces and fit together
like a rider in a saddle.
Each face is concave along one
axis and convex along the other.
Movement:
Angular.
Biaxial
III
Examples:
First carpometacarpal
joint
II
Metacarpal
bone of thumb
Trapezium
Two concave, straddled (biaxial)
© 2015 Pearson Education, Inc.
Figure 9-2 Joint Movement (Part 11 of 12).
Pivot joint
Pivot joints only permit
rotation.
Movement:
Rotation. Monaxial
Examples:
• Atlantoaxial joint
• Proximal radioulnar
joint
Atlas
Axis
Rotation only (monaxial)
© 2015 Pearson Education, Inc.
Figure 9-2 Joint Movement (Part 12 of 12).
Ball-and-socket joint
In a ball-and-socket joint, the
round head of one bone rests
within a cup-shaped depression
in another.
Movement:
Angular, circumduction,
and rotation.
Triaxial
Scapula
Humerus
Round articular face in a depression (triaxial)
© 2015 Pearson Education, Inc.
Examples:
• Shoulder joint
• Hip joint
9-3 Movements
• Joints
A joint cannot be both mobile and strong and the
greater the mobility, the weaker the joint will be ,
the mobile joints are supported by muscles and
ligaments, not bone-to-bone connections
• Intervertebral Joints
• C2 to L5 spinal vertebrae articulate:
• At inferior and superior articular processes (gliding
joints) and between adjacent vertebral bodies
(symphyseal joints)
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9-4 Intervertebral Joints
• Intervertebral Discs: are pads of fibrocartilage
and separate vertebral bodies
• Anulus fibrosus: are tough outer layer which
attaches disc to vertebrae
• Nucleus pulposus: are elastic, gelatinous core
which absorbs shocks
© 2015 Pearson Education, Inc.
Figure 9-6a Intervertebral joints.
Superior articular
process
Intervertebral
Ligaments
Ligamentum flavum
Posterior longitudinal
ligament
Anterior longitudinal
ligament
a Anterior view
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Figure 9-6b Intervertebral joints.
Superior
articular facet
Intervertebral Disc
Intervertebral
foramen
Vertebral end plate
Intervertebral
Ligaments
Anulus fibrosus
Ligamentum flavum
Nucleus pulposus
Spinal cord
Posterior longitudinal
ligament
Spinal nerve
Interspinous ligament
Supraspinous ligament
Anterior longitudinal
ligament
b Lateral and sectional view
© 2015 Pearson Education, Inc.
9-4 Intervertebral Joints
• Vertebral Joints called symphyseal joints
• As vertebral column moves:
• Nucleus pulposus shifts and disc shape conforms
to motion
• Intervertebral Ligaments
• Bind vertebrae together and stabilize the vertebral
column
© 2015 Pearson Education, Inc.
9-4 Intervertebral Joints
• Six Intervertebral Ligaments
1. Anterior longitudinal ligament: Connects anterior
bodies
2. Posterior longitudinal ligament: Connects
posterior bodies
3. Ligamentum flavum: Connects laminae
4. Interspinous ligament : Connects spinous
processes
5. Supraspinous ligament: Connects tips of spinous
processes (C7 to sacrum)
6. Ligamentum nuchae: Continues supraspinous
ligament (C7 to skull)
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9-4 Intervertebral Joints
• Damage to Intervertebral Discs
• Slipped disc
Bulging disc
• Bulge in anulus fibrosus
• Invades vertebral canal
• Herniated disc
• Nucleus pulposus breaks through anulus fibrosus
• Presses on spinal cord or nerves
showing the release of the nucleus pulposus and its effect on the spinal cord and
adjacent spinal nerves
© 2015 Pearson Education, Inc.
9-5 The Shoulder Joint
• Shoulder Joint (glenohumeral joint)
• Allows more motion than any other joint and is the
least stable joint and is supported by skeletal
muscles, tendons, ligaments
• Ball-and-socket diarthrosis is between head of
humerus and glenoid cavity of scapula
• Glenoid labrum is the deepens socket of glenoid
cavity in fibrocartilage lining
© 2015 Pearson Education, Inc.
9-5 The Shoulder Joint
• Shoulder Ligaments
•
•
•
•
•
Glenohumeral
Coracohumeral
Coracoacromial
Coracoclavicular
Acromioclavicular
• Shoulder Separation
• Dislocation of the shoulder joint
© 2015 Pearson Education, Inc.
9-5 The Shoulder Joint
• Shoulder Muscles (Rotator Cuff)
•
•
•
•
Supraspinatus
Infraspinatus
Subscapularis
Teres minor
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9-5 The Shoulder Joint
• Shoulder Bursae
•
•
•
•
Subacromial
Subcoracoid
Subdeltoid
Subscapular
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Figure 9-7a The Shoulder Joint.
Acromioclavicular Coracoacromial Coracoclavicular
ligament
ligaments
ligament
Tendon of
supraspinatus
muscle
Acromion
Clavicle
Articular
capsule
Subdeltoid
bursa
Coracoid
process
Scapula
Synovial
membrane
Articular cartilages
Humerus
Joint cavity
Glenoid labrum
Articular capsule
a Anterior view, frontal section
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Figure 9-7b The Shoulder Joint.
Ligaments
Stabilizing the
Shoulder Joint
Subcoracoid bursa
Clavicle
Tendon of biceps
brachii muscle
Subacromial bursa
Acromioclavicular
ligament
Coracoclavicular
ligaments
Muscles and
Tendons of the
Rotator Cuff
Coracoacromial
ligament
Coracohumeral
ligament (cut)
Tendon of
supraspinatus
muscle
Glenohumeral
ligaments
Tendon of
infraspinatus
muscle
Subscapular bursa
Glenoid cavity
Teres minor
muscle
Glenoid labrum
Subscapularis
muscle
Articular capsule
Scapula
b Lateral view of pectoral girdle
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9-5 The Elbow Joint
• The Elbow Joint
• Is a stable hinge joint, with articulations involving
humerus, radius, and ulna
• Humeroulnar joint
• Is the Largest joint, but trochlea of humerus and
trochlear notch of ulna have limited movement
• Humeroradial joint
• Is the smaller joint
• Capitulum of humerus and head of radius
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Figure 9-8a The Right Elbow Joint Showing Stabilizing Ligaments.
Humerus
Radial
collateral
ligament
Radial
tuberosity
Antebrachial
interosseous
membrane
Radius
Ulna
Capitulum
Annular ligament (covering
head and neck of radius)
a
© 2015 Pearson Education, Inc.
Lateral view
9-5 The Elbow Joint
• Supporting Structures of the Elbow
• Biceps brachii muscle : Attached to radial
tuberosity and controls elbow motion
• Elbow ligaments
• Radial collateral
• Annular
• Ulnar collateral
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Figure 9-8b The Right Elbow Joint Showing Stabilizing Ligaments.
Tendon of biceps
brachii muscle
Annular
ligament
Humerus
Articular
capsule
Antebrachial
interosseous
membrane
Medial
epicondyle
Ulnar
collateral
ligament
Radius
Ulna
Olecranon
of ulna
b Medial view
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9-6 The Hip Joint
• The Hip Joint (coxal joint): Are strong ball-andsocket diarthrosis, with wide range of motion
• Head of femur fits into hip joints.
• Ligaments of the Hip Joint
•
•
•
•
•
Iliofemoral
Pubofemoral
Ischiofemoral
Transverse acetabular
Ligamentum teres
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Figure 9-9a The Right Hip Joint.
Iliofemoral ligament
Articular cartilage
Acetabular labrum
Ligament of the
femoral head
Acetabulum
Transverse acetabular
ligament (spanning
acetabular notch)
Fat pad
in acetabular
fossa
a A lateral view with the femur removed
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Figure 9-9b The Right Hip Joint.
Pubofemoral
ligament
Greater
trochanter
Iliofemoral
ligament
Lesser
trochanter
b An anterior view
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Figure 9-9c The Right Hip Joint.
Iliofemoral
ligament
Ischiofemoral
ligament
Greater
trochanter
Lesser
trochanter
Ischial tuberosity
c A posterior view, showing additional
ligaments that add strength to the capsule
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9-6 The Knee Joint
• The Knee Joint
• A complicated hinge joint which transfers weight
from femur to tibia
• Articulations of the knee joint
• 2 femur–tibia articulations at medial and lateral
condyles
• 1 between patella and patellar surface of femur
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9-6 The Knee Joint
• Seven Major Supporting Ligaments
1. Patellar ligament (anterior)
2. & 3. Two popliteal ligaments (posterior)
4. & 5. Anterior and posterior cruciate ligaments
(inside joint capsule)
6. Tibial collateral ligament (medial)
7. Fibular collateral ligament (lateral)
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Figure 9-10a The Right Knee Joint.
Quadriceps
tendon
Joint
capsule
Patella
Patellar
retinaculae
Tibial collateral
ligament
Patellar
ligament
Fibula
Tibia
a Anterior view, superficial layer
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Ligaments that
Stabilize
the Knee Joint
Fibular collateral
ligament
Figure 9-10b The Right Knee Joint.
Patellar
surface
Ligaments that
Stabilize
the Knee Joint
Posterior cruciate
ligament
Anterior cruciate
ligament
Lateral
condyle
Medial
condyle
Tibial collateral
ligament
Menisci
Medial
Fibular collateral
ligament
Tibia
Cut tendon of
biceps femoris
muscle
Fibula
b Deep anterior view, flexed
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Lateral
Figure 9-10c The Right Knee Joint.
Plantaris muscle
Gastrocnemius muscle,
lateral head
Gastrocnemius
muscle,
medial head
Femur
Ligaments that
Stabilize
the Knee Joint
Bursa
Tibial collateral
ligament
Joint
capsule
Fibular collateral
ligament
Popliteal
ligaments
Popliteus
muscle
Tibia
Cut tendon of
biceps femoris
muscle
Fibula
c Posterior view, superficial layer
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Figure 9-10d The Right Knee Joint.
Ligaments that
Stabilize
the Knee Joint
Femur
Anterior cruciate
ligament
Fibular
collateral
ligament
Posterior cruciate
ligament
Medial
condyle
Lateral
condyle
Menisci
Lateral
Medial
Cut
tendon
Tibia
Fibula
d Deep posterior view, extended
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Table 9-3 Joints of the Appendicular Skeleton (Part 1 of 2).
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Table 9-3 Joints of the Appendicular Skeleton (Part 2 of 2).
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9-7 Effects of Aging on Joints
• Degenerative Changes
• Rheumatism: A pain and stiffness of skeletal and
muscular systems
• Arthritis: All forms of rheumatism that damage
articular cartilages of synovial joints
• Osteoarthritis
• Caused by wear and tear of joint surfaces, or
genetic factors affecting collagen formation
• Generally in people over age 60
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9-7 Effects of Aging on Joints
• Rheumatoid Arthritis
• An inflammatory condition which caused by
infection, allergy, or autoimmune disease
• Involves the immune system
• Gouty Arthritis
• Occurs when crystals (uric acid or calcium salts)
• Form within synovial fluid and due to metabolic
disorders
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9-7 Effects of Aging on Joints
• Joint Immobilization
• Reduces flow of synovial fluid, it can cause
arthritis symptoms and may treated by
continuous passive motion or CPM (therapy)
• Bones and Aging
• Bone mass decreases and weaken, it may
increases risk of hip fracture, hip dislocation, or
pelvic fracture
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9-8 Integration with Other Systems
• Bone Recycling
• Living bones maintain equilibrium between:
• Bone building (osteoblasts)
• And breakdown (osteoclasts)
• Factors Affecting Bone Strength
1.
2.
3.
4.
5.
Age
Physical stress
Hormone levels
Calcium and phosphorus uptake and excretion
Genetic and environmental factors
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9-8 Integration with Other Systems
• Bones Support Body Systems
• Support and protect other systems
• Store fat, calcium, and phosphorus
• Manufacture cells for immune system
Disorders in other body systems can cause:
•
•
•
•
Bone tumors
Osteoporosis
Arthritis
Rickets (vitamin D deficiency)
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https://www.youtube.com/watch?v=nAAnhJKDZ7g
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Quiz
Quiz
1-Most cartilage injuries tend to heal well by it selves _____
2-The hip joint is referred to as a ball and socket joint._________
3- What is another word for the term articulation?__________
4- A ligament connects bone tissue to? ________
Quiz
1-F
2- T
3- joints
4-bone