LECT 8
• JOINTS
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•3
             INTRODUCTION
•   JOINTS
•   TYPES OF JOINTS
•   SYNOVIAL JOINT
•   TYPES/VARIETY OF SYNOVIAL JOINT
                                      •4
JOINTS
    BY
DR TAMKNAT
Allah has bestowed human beings with a
          wide variety of joints.
 `A'ishah (R.A) narrated that the Prophet
(S.A.W) said: "Everyone has been created
   with three hundred and sixty joints.
                  DEFINITION
• The point where two or more bones meet is called a
  joint.
• The other name of joints is arthroses.
                                                   •7
                MEANING
• Arthrology: Study of joints
• Synonyms: Articulation (Latin)
               Arthron (Greek)
• Joint: a junction between two or more bones
  or cartilages.
                                                •8
              FUNCTIONS
• Give the skeleton
  mobility.
• Hold the skeleton
  together.
                          •9
 Classification of joints
1) On the basis of structure
2) On the basis of function
3) On the basis of movement
                               •10
  1)Classification on the basis of structure:
I.    Solid joints: the joints without a cavity .
II.   Synovial joints: the joints with a cavity
      between them.
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Types of solid joints
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                                          I.           Solid joints
     1)   Fibrous joints: the bones are held together by fibrous
          connective tissue that is rich in collagen fibers. No
          synovial cavity
a.    Sutures
                –   Skull only
                –   Bony fusion
                –   Bound by dense fibrous connective tissue
                –   TYPES:
                •   Serrate edges are saw-like
                •   Denticulate: tooth like processes
                •   Squamous suture: bone margins overlap
                •   Plane suture: apposition of flat surfaces
                                                                      •14
    Fibrous joints……………continued
b.Gomphosis
        – Teeth to gums
        – Peg and socket
          joint
c.Syndesmoses
        – bones
          connected by
          ligaments
                                   •15
                    Types of solid joints....continued
2)Cartilaginous joints:
     The bones are held together by
      cartilage.
a.    Synchondroses/primary
      cartilaginous joints
             –   On completion of
                 growth hyaline
                 cartilage is replaced by
                 bone
             e.g
             – epiphyseal cartilage of
                 long bones
             – between
                 vertebrosternal ribs
                 and sternum
                                                     •16
                Types of cartilagenous joints…continued
b. Symphyses/ secondary
     cartilaginous joints
         –   bones separated by fibro
             cartilage
         –   Mostly permanent
         e.g.
         –   pubic symphysis
         –   Intervertebral discs
         –   Some joints e.g.
             between sacrum and
             coccyx undergo partial
             or complete synostosis
                                                     •17
                               II. Synovial joints
– more movement
– within articular capsules
   • lined with synovial
     membrane
   • where synovial fluid is
     found
                                                     •18
Accessory structures of synovial joint…continued
  • Articular/Hyaline Cartilage
   Smooth cartilage at the end of bones at joint
  • Two-Layered Joint Capsule
   Outer Layer       – Tough fibrous capsule
   Inner Layer       – Synovial Membrane
  • Synovial Fluid
   Slippery fluid in joint capsule
  • Ligament
   A band of strong fibrous tissue
                                                   •19
Accessory structures of synovial joint…continued
  • Articular/Hyaline Cartilage
    Prevent friction between articulating bones
  • Two-Layered Joint Capsule
    Outer Layer      – Strengthen joint
    Inner Layer      – To secrete synovial fluid
  • Synovial Fluid
    Reduce friction between articular cartilages
    Nourish articular cartilage
  • Ligament
    To connect one bone to another
                                                   •20
     Accessory structures of synovial joint…continued
•     Tendons–
 Strong connective tissue that attaches muscle to bone.
Connect muscle to muscle.
•         Bursa
Fluid filled sacs
Cushion the joint and act as shock absorbers
•     Meniscus
White fibrocartilage
Improves the fit between bone ends
Increases joint stability
Reduces wear and tear at joint                            •21
SYNOVIAL JOINT
                 •22
Types of synovial joints
                           •23
        Types of synovial joints…continued
• Plane joints :the articulating
  surfaces are flat or slightly
  curved.
• e.g are intercarpal joints,
  intertarsal joints,
  sternoclavicular joints,
  acromioclavicular joints,
  sternocostal joints,
  vertebrocostal joints.etc.
                                             •24
Examples of plane joint
                          •25
   Types of synovial joints…continued
• Hinge Joints-the
  convex surface of
  one fits into the
  concave surface of
  another.
• e.g. elbow joint,
  ankle joint,
  interphalangeal
  joints,etc.
                                    •26
   Types of synovial joints…continued
• Pivot Joints-here the
  rounded or pointed
  surface of one bone
  articulates with a ring
  formed partly by
  another bone and
  partly by a ligament.
• e.g atlanto-axial joint,
  radioulnar joint etc.
                                    •27
                 Types of synovial joints…continued
• Condyloid Joints-also
  called ellipsoidal joint.
  The convex oval-shaped
  projection of one fits
  into the oval-shaped
  depression of another
• e.g
  metacarpophalangeal
  joints.
                                                  •28
           Types of synovial joints…continued
• Saddle Joints-here the
  articular surface of one
  bone is saddle-shaped
  and the articular
  surface of the other fits
  into the “saddle”.
• e.g. Carpometacarpal
  joint.
                                                •29
               Types of synovial joints…continued
• Ball-and-Socket
  Joints- this consists
  of the ball-like
  surface of one bone
  fitting into a cuplike
  depression of
  another bone
• e.g Shoulder and hip
  joints.
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                  2)Classification on the basis of
                              function
• Functionally, joints are classified
  as one of the following:
   – Synarthrosis: an immovable joint.
   – Amphiarthrosis: a slightly movable
     joint. Most amphiarthrosis joints are
     cartilaginous.
   – Diarthrosis: a freely movable joint.
     All diarthroses are synovial joints.
                                                     •31
 3)CLASSIFICATION ON THE BASIS OF
            MOVEMENT
• Uniaxial joints e.g.
  the elbow joint
• Biaxial joints e.g.
  the wrist joint
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CLASSIFICATION ON THE BASIS OF MOVEMENT…
                    continued
       • Multiaxial joints: e.g. shoulder joint
                                                  •33
(B) According to plane of movements
            • Uniaxial: Hinge and Pivot
            • Biaxial: Condylar, ellipsoid, saddle
            • Multiaxial: Ball and socket
•Uniaxial             •Biaxial          •Multiaxial
(C) According to number of articulating bones
          • Simple (2 bones)
          • Compound (more than 2 bones)
        Movements of synovial joints  
     1. Gliding (slipping)
     2. Angular: flexion, extension, abduction,
      adduction
   3. Rotary (circular): rotation (supination,
     pronation),
                         circumduction     
   Factors affecting ROM at Synovial
                  Joints
• Structure or shape of
  the articulating bones
• Strength and tension of
  ligaments.
• Arrangement and
  tension of muscles
• Apposition of soft parts
• Hormones
• use
                                  •37
                   Vasculature of joints
•   Articular arteries from vessels
    around joints
•   Often these arteries form
    anastamoses around joints
•   Articular veins accompany
    arteries
•   Articular veins like articular
    arteries, are located inside a
    joint capsule, mostly in the
    synovial membranes
                                           •38
                         Innervation
• Rich nerve supply
• Most articular nerves are
  branches of cutaneous nerves
  supplying the muscles that
  cross and move the joint( obey
  Hiltons law)
• In distal parts of limbs( hands
  and feet) articular nerves are
  branches of cutaneous nerves
  supplying the overlying skin
                                       •39
       Innervation ……………continued
• Joints transmit a sensation called proprioception
• Synovial membrane is relatively insensitive
• Pain fibers are numerous in fibrous layer and
  associated ligaments causing pain when joints are
  injured
• Sensory nerve endings respond to twisting and
  stretching that occur during sport activities
                                                      •40
         Joints of new born
• The bones of the
  calvarium (skullcap)
  of a new born infant
  do not make full
  contact with each
  other
• At these sites, the
  sutures form wide
  areas of fibrous
  tissue called
  fontanelles
                              •41
             DEGENERATIVE JOINT DISEASES
• Risk factors include age ,heredity,
  injury and obesity
• Particularly those of hip, knee,
  vertebral column and hands
• Some destruction is inevitable
  during such activities as jogging,
  which wears away the articular
  cartilages and sometimes erodes the
  underlying articular surfaces
• Trauma to a joint may be followed
  by arthritis ,inflammation of joint
  and septicemia
                                        •42
                          Degenerative joint
                         diseases………..continued
Most common is
 osteoarthritis,
 which is often
 accompanied by
 stiffness, discomfort
 and pain.
                                                  •43
            Degenerative joint
           diseases………..continued
• Rheumatoid
  arthritis
  – Chronic
    inflammatory
    disorder
  – Marked by flare-ups
  – Autoimmune
    disease.
                                    •44
Degenerative joint diseases………..continued
                                        •45
               Examination of joint
1.   Clinical examination
2.   Imaging( MRI/CT)
3.   Arthroscopy
•    A cannula and
     arthroscope is inserted
     in joint cavity
•    For abnormalities such
     as torn articular discs
                                      •46
• https://www.youtube.com/watch?
  v=0cYal_hitz4
                                   •47
                        REFERENCES
1. Cunningham’s Manual of Practical Anatomy, Vol.1.
2. Grant’s Method of Anatomy, 11th Edition.
3. Vishram Singh. General Anatomy, 1st Edition.
                MCQs
1. All of the following are examples of the
   fibrous joint except:
  a) Suture
  b) Syndesmosis
  c) Symphysis
  d) Gomphosis
                    MCQs
2. All of the following are examples of the
   synovial joint except:
  a) Pivot
  b) Saddle
  c) Syndesmosis
  d)Ellipsoid
                    MCQs
3. Subtype gomphosis is classified under:
  a) Biaxial synovial joint
  b) Symphysis
 c) Fibrous joint
  d) Synchondrosis
                    MCQs
4. All of the following are characteristic features
   of a synovial joint except:
  a)Articular surfaces are covered by a articular
   cartilage
  b) Have a joint cavity filled with synovial fluid
  c)Mostly are freely movable joints
  d) Articular cartilage are covered by synovial
   membrane
                   MCQs
5. All of the following secondary cartilaginous
   joints belong to axial skeleton except:
  a)Manubriosternal joint
  b) Intervertebral discs
  c) Symphysis pubis
  d) Symphysis menti
Tell the type of joint?
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Tell the type of joint?
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Tell the type of joint?
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Tell the type of joint?
                          •57
Tell the type of joint?
                          •58
Tell the type of joint?
                          •59
                   Summary
•   Joints definition and meaning
•   Types of joints
•   Fibrous joint
•   Cartilaginous joint
•   Synovial joint
•   Types of synovial joint
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• JAZAKALLAH
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