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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 Copyright © 2011 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 (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 Copyright © 2011 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 Copyright © 2011 Pearson Education, Inc. Copyright © 2011 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 Copyright © 2011 Pearson Education, Inc. 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) Copyright © 2011 Pearson Education, Inc. Symphyses Figure 9.2a Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Joint between first rib and sternum (immovable) Hyaline cartilage Pubic symphysis Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Figure 9.3a • Fluid is squeezed out as opposing cartilages touch • Cartilages ride on the slippery film Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Angular Movements Figure 9.6a Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. Figure 9.6b 4 Angular Movements Angular Movements Extension Flexion Extension Flexion Flexion Extension (c) Angular movements: flexion and extension of the trunk Copyright © 2011 Pearson Education, Inc. (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 Copyright © 2011 Pearson Education, Inc. Movement of the pectoral girdle (a) Circumduction (e) Angular movements: abduction, adduction, and circumduction of the upper limb at the shoulder Figure 9.6e Copyright © 2011 Pearson Education, Inc. Rotation Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Figure 9.6f Copyright © 2011 Pearson Education, Inc. (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 Copyright © 2011 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 9.7b Special Movements Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Special Movements Figure 9.7c (d) Opposition Moving the thumb to touch the tips of the other fingers Figure 9.7d Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Synovial Joints Classified by Shape Plantar flexion Depressing the foot elevating the heel Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Synovial Joints Classified by Shape Nonaxial movement Metacarpals Carpals Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Synovial Joints Classified by Shape Figure 9.8c Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Synovial Joints Classified by Shape Anterior/ posterior axis Medial/ lateral axis Adduction and abduction Figure 9.8d Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Selected Synovial Joints Adduction and abduction Rotation Movement of the glenohumeral joint (a) Figure 9.8f Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Elevation Copyright © 2011 Pearson Education, Inc. (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 Copyright © 2011 Pearson Education, Inc. (b) Enlargement of a sagittal section through the joint (arrows indicate movement in each part of the joint cavity) Figure 9.10 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Glenohumeral Joint Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Elbow Joint Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Wrist Joint Radiocarpal joint Radial collateral ligament Distal radioulnar joint Articular disc Ulnar collateral ligament Intercarpal joint (b) Wrist joints, coronal section Copyright © 2011 Pearson Education, Inc. Figure 9.12c, d Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Medial patellar retinaculum Knee Joint Figure 9.15c Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. 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) Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. Figure 9.17 The Ankle Joint Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 1st metatarsal Tendon of flexor digitorum longus Figure 9.18a Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. Talus Posterior talofibular ligament Calcaneofibular ligament Calcaneus Figure 9.18c (d) Right ankle, posterior view Copyright © 2011 Pearson Education, Inc. 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 Copyright © 2011 Pearson Education, Inc. 15