Joints

Joints

Joints are the articulations between two or more bones. Classification depends on the structure and the function. (movement)

1.Fibrous joints

synarthrosis immovable Articular surfaces of bones are connected by fibrous tissue. Three types- Sutures Syndesmosis Gomphosis

Sutures

Fibrous tissue connecting bones are sutural ligaments Several types depending on the shape of the articular margins

SuturesPlane articular margins are plane. Joint between palatine processes of maxilla. Serrate margins are like teeth of a saw eg. Superior sagittal suture. Squamous parietal bones with squamous temporal bone

Fibrous joints
Syndesmosis Two bones are connected by interosseous membrane persist throughout life. Inferior tibio-fibular joint, middle radioulnar joint Gomphosis Peg shaped process fit into a socket united by a fibrous tissue. Roots of teeth in alveolar socket

2.Cartilagenous joints

slightly movable articulating bones are intervened by a cartilage which unites bones. Two types- Primary cartilagenous ( synchondrosis) Secondary cartilagenous( symphysis)

Cartilagenous jointsPrimary temporary joint Intervening cartilage will ossify sphenoid with basilar part of occipital bone Secondary intervening cartilage connect bony surfaces covered by hyaline cartilage. midline joints between bodies of vertebrae Symphysis pubis

3.Synovial joints

freely movable most of the joints of the body,especially the joint of the limbs. has wide range of movement

Synovial jointsCharacteristic features: Contiguous bony surfaces are covered with hyaline cartilage Joint cavity reduced to a potential space. Surrounded by a articular capsule outer fibrous capsule Inner synovial membrane. a cavity filled with synovial membrane.

Synovial joints

Synovial membrane covers the whole of interior joint Except cartilage covered end of articulating bones. Bones are kept by accessory ligaments outside the capsule. Movements are always possible from simple gliding to a wide range. presence of articular disc of fibrocartilage.

Classification of synovial jointssimple joint contains a single pair of articular surfaces interphalangeal joints Compound more than a pair of articular surfaces. radiocarpal joint, ankle joint

Based on axis of movement

Plane joint no axis, allows only gliding movements sternoclavicular joint intercarpal intertarsal joints

Uniaxial
Hinge: Moves in one axis around a transverse axis strong collateral ligaments prevent other movements ankle joint elbow joint interphalangeal joints

Uniaxial
pivot joint one axis vertical one movement takes place in a rotational way Pivot surrounded by a ring. either pivot moves and the ring is fixed or pivot is fixed and the ring moves. radioulnar joint- former type atlanto-axial joint-latter type

Biaxial jointsEllipsoid having movements in two axes. flexion and extension- transverse axis abduction and adduction around anteroposterior axis combination of movements may produce circumduction but no rotational movement around a third axis wrist joint, atlanto occipital joint

Biaxial joints
condyloid joint articular surfaces are condyles flexion and extension mainly in transverse axis partly rotation occurs in transverse axis knee joint, temporo-mandibular joint

Polyaxial joints
Saddle joints articular surfaces of opposing bones are concavo-convex movements occur in two axes flexion, extension and abduction, adduction Additional movement rotation around a third axis carpo- metacarpal joints sterno-clavicular joints

Polyaxial joints
Ball and socket joints distal articular surface is a globular head fits into a proximal articular socket movements occur around a number of axes having a common centre

Polyaxial joints

Movements are: flexion and extension abduction and adduction medial and lateral rotation circumduction All are free movements Shoulder joint Hip joint Talo-calcaneo navicular joint

Movements
Movements are combination of spinning, sliding, rolling. Movement of a joint can be of four kinds. 1. Sliding 2.Angular 3. Rotating 4. Circumduction

Movements
Sliding simple movement of sliding of one surface over another Carpal and tarsal bones Angular Diminution of increase of angle between adjoining bones

Movements
Rotatory Movement occurs around a long axis which may lie in a separate bone pivot formed by dens of Axis Circumduction movement takes place between head and articular cavity Hip joint.

Mechanism of limitation of movements

Bony configuration and disproposionate articular surfaces Tension of the ligaments Tension of muscles agonists to movement Approximation of soft parts

Stability of joints
1. 2. bony configurationacetabulum and head of femur in hip joint Ligamentsprevent over movement strengthen the weakest and deficient parts of the capsule

Stability of joints
3. Muscles most important and indispensable for stability strengthen the capsule. Shoulder joint knee joint - most unstable if not for muscles Arches of foot may collapse.

Blood supply

Articular and epiphyseal branches form a periarticular plexus Branches pierce the capsule form a rich vascular plexus in the synovial membrane. Blood vessels from this terminate at the articular margin form circular vasculosus supplies the capsule, synovial membrane and epiphyseal union. Communicate with metaphyseal arteries

Nerve supply

capsule and ligaments rich nerve supplysensitive to pain Synovial membrane least nerve supplyinsensitive to pain Hiltons Law- A nerve which supplies a joint also supplies the group of muscles acting on the joint and skin covering it. This is why in joint diseases the nerves reflexly contract muscles and fix the joint in a comfortable position and also reason for the referred pain