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Joints & ligaments

1. Name: Joints of foot Tarsometatarsal joints - Metatarsophalangeal joints - Interphalangeal joints -
1) Bones that take part:
Tarsometatarsal joints - metatarsal bones medial, intermediate and lateral cuneiforms
and the cuboid bone in the foot.
Metatarsophalangeal joints metatarsal bones, phalanges
Interphalangeal joints - distal phalanx, proximal phalanx
2) Articular surfaces:
Tarsometatarsal joints - The areas between the bases of the first through fifth
metatarsal bones and their connection with the medial, intermediate and lateral
cuneiforms and the cuboid bone in the foot.

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Metatarsophalangeal joints - The joints between the heads of the metatarsal bones
and the bases of the proximal phalanges
Interphalangeal joints - The joint that joins the distal phalanx to the proximal phalanx
3) Joint capsule:
4) Ligaments
5) Mechanics: Inversion and eversion

2. Name: Tibiofibular joint (Distal) (fibrous joint of the syndesmosis type)
1) Bones that take part: Inferior ends of the tibia and fibula
2) Articular surfaces: The rough, convex, triangular articular area on the medial surface of the
inferior end of the fibula articulates with a facet on the inferior end of the tibia.
A small superior projection of the synovial capsule of the ankle joint extends into the
inferior part of the distal tibiofibular joint.
A strong interosseous ligament continuous superiorly with the interosseous membrane,
forms the principal connection between the tibia and fibula at this joint.
It consists of strong bands that extend from the fibular notch of the tibia to the medial
surface of the distal end of the fibula.
The strong anterior and posterior tibiofibular ligaments also strengthen the distal
tibiofibular joint anteriorly and posteriorly.
They extend from the border of the fibular notch of the tibia to the anterior and posterior
surfaces of the lateral malleolus, respectively, respectively.
The inferior, deep part of the posterior tibiofibular ligament is called the transverse
tibiofibular ligament. This strong band closes the posterior angle between the tibia and fibula.
3) Joint capsule: This is a fibrous joint of the syndesmosis type
4) Ligaments
5) Mechanics: Slight movement of the distal tibiofibular joint occurs to accommodate the talus
during dorsiflexion of the foot at the ankle joint.

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3. Name: Tibiofibular joint (Proximal) (plane type of synovial joint)
1) Bones that take part: Head of the fibula and lateral condyle of the tibia
2) Articular surfaces: The flat, oval-to-circular facet on the head of the fibula articulates with a
similar facet located posterolaterally on the inferior aspect of the lateral condyle of the tibia.
3) Joint capsule: The fibrous capsule surrounds the joint and is attached to the margins of the
articular facets on the fibula and tibia.
It is strengthened by the anterior and posterior ligaments of the head of the fibula. The
fibres of these ligaments run superomedially from the fibula to the tibia. The tendon of the
popliteus muscle is intimately related to the posterosuperior aspect of the proximal
tibiofibular joint.
The synovial membrane lines the fibrous capsule. The pouch of synovial membrane
passing under the tendon of the popliteus muscle, known as the popliteus bursa, sometimes
communicates with the synovial cavity of the proximal tibiofibular joint though an opening in
the superior part of the synovial capsule.
Consequently, the proximal tibiofibular joint may be indirectly in communication with the
synovial cavity of the knee joint.
4) Ligaments
5) Mechanics: Slight movement occurs at the superior tibiofibular joint during dorsiflexion of the
foot at the ankle joint.
This presses the lateral malleolus laterally and causes movement of the body and head of the
fibula. Some movement of the joint also occurs during plantarflexion of the foot.

4. Name: Talocrural Join Ankle joint (Hinge type of synovial joint)
1) Bones that take part: Tibia, fibula and talus bone
2) Articular surfaces: The inferior ends of the tibia and fibula form a deep socket or box-like
mortise into which the pulley-shaped trochlea of the talus fits.
The two malleoli and the inferior end of the tibia form the three-sided mortise.
The fibula has an articular facet on its lateral malleolus, which faces medially and
articulates with the facet on the lateral surface of the talus.
The tibia articulates with the talus in two places: (1) its inferior surface forms the roof of
the mortise, which is wider anteriorly than posteriorly; and (2) the lateral surface of its medial
malleolus articulates with the talus.
The talus has three articular facets, which articulate with the inferior surface of the tibia
and malleoli.
The trochlea of the talus is wider anteriorly than posteriorly and slightly concave side to side.
3) Joint capsule: The fibrous capsule is thin anteriorly and posteriorly, but it is supported one
each side by strong collateral ligaments (medial or deltoid and lateral ligaments).
It is attached superiorly to the borders of the articular surfaces of the tibia and malleoli.
It is attached inferiorly to the talus close to the superior articular surface, except
anteroinferiorly, where it is attached to the dorsum of the neck of the talus.

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4) Ligaments

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5) Mechanics: The talocrural joint is uniaxial. its main movements are dorsiflexion and
plantarflexion.
When the foot is plantarflexed, some rotation, abduction, and adduction of the ankle joint is
possible.

5. Name: Knee joint (hinge type of synovial joint)
1) Bones that take part: Femur, tibia, and patella
2) Articular surfaces: The articular surfaces are the large curved condyles of the femur, the
flattened condyles of the tibia, and the facets of the patella.
The knee joint is relatively weak mechanically because of the configurations of its articular
surfaces. It relies on the ligaments that bind the femur to the tibia for strength.
On the superior surface of each tibial condyle, there is an articular area for the corresponding
femoral condyle.
These areas, commonly referred to as the medial and lateral tibial plateaux, are separated
from each other by a narrow, nonarticular area, which widens anteriorly and posteriorly into
anterior and posterior intercondylar areas, respectively.
3) Joint capsule: The articular capsule has a synovial and a fibrous membrane separated by fatty
deposits.
Anteriorly, the synovial membrane is attached on the margin of the cartilage both on the
femur and the tibia, but on the femur, the suprapatellar bursa or recess extends the joint
space proximally.
The suprapatellar bursa is prevented from being pinched during extension by the
articularis genu muscle. Behind, the synovial membrane is attached to the margins of the two
femoral condyles which produces two extensions similar to the anterior recess. Between
these two extensions, the synovial membrane passes in front of the two cruciate ligaments at
the center of the joint, thus forming a pocket direct inward.
4) Ligaments: Patellar ligament, tendon femur quadriceps

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5) Mechanics: Flexion and extension as well as a slight medial and lateral rotation but rotation
occurs in the flexed position.

6. Name: Hip joint (& ligaments of pelvis) (multilaxial ball and socket type of synovial joint)(+ Sacroiliac
joint)
1) Bones that take part: Femur and Hip bone
2) Articular surfaces: The globular head of the femur articulates with the cup-like acetabulum of
the hip bone.
The wider superior part of the articular surface is the weight bearing area. Thus it is the
ilium that bears the weight.
The rim of the acetabulum is defective inferiorly at the acetabular notch, which is bridged
by the transverse acetabular ligament. The head of the femur forms about two-thirds of a
sphere and is covered with hyaline cartilage, except over the roughened fovea or pit, to which
the ligaments of the head of the femur is attached.
More than half of the femoral surface is contained within the acetabulum.
The articular or lunate surface of the acetabulum is horseshoe-shaped.
The acetabulum has a centrally located nonarticular fossa, which is occupied by a fatpad
that is covered with synovial membrane.
This nonarticular bone is paper thin and translucent.
3) Joint capsule: The capsule attaches to the hip bone outside the acetabular lip which thus
projects into the capsular space. On the femoral side, the distance between the head's
cartilaginous rim and the capsular attachment at the base of the neck is constant, which
leaves a wider extracapsular part of the neck at the back than at the front.

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The strong but loose fibrous capsule of the hip joint permits the hip joint to have the
second largest range of movement (second only to the shoulder) and yet support the weight
of the body, arms and head.
4) Ligaments

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5) Mechanics: Lateral or external rotation, Medial or internal rotation, Extension or retroversion,
Flexion or anteversion, Abduction, Adduction

7. Name: Temporomandibular joint (ginglymoarthrodial joint)
1) Bones that take part: Temporal bone, mandible
2) Articular surfaces: The TMJ is a ginglymoarthrodial joint, referring to its dual compartment
structure and function (ginglymo- and arthrodial).
The condyle articulates with the temporal bone in the mandibular fossa. The mandibular
fossa is a concave depression in the squamous portion of the temporal bone.

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3) Joint capsule: The capsule is a fibrous membrane that surrounds the joint and incorporates
the articular eminence. It attaches to the articular eminence, the articular disc and the neck of
the mandibular condyle.
The articular disc is a fibrous extension of the capsule in between the two bones of the
joint. The disc functions as articular surfaces against both the temporal bone and the condyles
and divides the joint into two sections, as described in more detail below. It is biconcave in
structure and attaches to the condyle medially and laterally. The anterior portion of the disc
splits in the vertical dimension, coincident with the insertion of the superior head of the
lateral pterygoid. The posterior portion also splits in the vertical dimension, and the area
between the split continues posteriorly and is referred to as the retrodiscal tissue. Unlike the
disc itself, this piece of connective tissue is vascular and innervated, and in some cases of
anterior disc displacement, the pain felt during movement of the mandible is due to the
condyle compressing this area against the articular surface of the temporal bone.
4) Ligaments
5) Mechanics: Normal movements of the mandible during function, such as mastication, or
chewing, are known as excursions. There are two lateral excursions (left and right) and the
forward excursion, known as protrusion. The reversal of protrusion is retrusion

8. Name: Costovertebral joints
1) Bones that take part: ribs with the bodies of the thoracic vertebrae.
2) Articular surfaces:

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3) Joint capsule:
4) Ligaments

5) Mechanisms: Extension, flexion

9. Name: Sternoclavicular joint (synovial double-plane joint)
1) Bones that take part: sternal end of the clavicle, the upper and lateral part of the manubrium
sterni
2) Articular surfaces: The sternoclavicular articulation is a synovial double-plane joint composed
of two portions separated by an articular disc. The parts entering into its formation are the
sternal end of the clavicle, the upper and lateral part of the manubrium sterni (clavicular
notch of the manubrium sterni), and the cartilage of the first rib, visible from the outside as
the suprasternal notch
3) Joint capsule:

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4) Ligaments
5) Mechanics: Elevation and depression, protraction and retraction, axial rotation

10. Name: Joints of hand - Carpometacarpal joint - Midcarpal joint - Metacarpophalangeal joint (Hinge
joints)
1) Bones that take part:
The Midcarpal Joint is formed by the scaphoid, lunate, and triquetral bones in the
proximal row, and the trapezium, trapezoid, capitate, and hamate bones in distal row
The carpometacarpal joints (CMC) are five joints in the wrist that articulates the distal
row of carpal bones and the proximal bases of the five metacarpal bones
The metacarpophalangeal joints - metacarpal bones.
2) Articular surfaces:
3) Joint capsule:

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4) Ligaments

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5) Mechanics:
Metacarpophalangeal joint - flexion, extension, adduction, abduction, and
circumduction
Carpometacarpal joint - In this articulation the movements permitted are flexion and
extension in the plane of the palm of the hand, abduction and adduction in a plane at
right angles to the palm, circumduction, and opposition
Midcarpal joint - extension/flexion, ulnar deviation/radial deviation, and
pronation/supination

11. Name: Wrist joint (condyloid type of synovial joint)
1) Bones that take part: Radius & bones of hand
2) Articular surfaces: The distal end of the radius and the articular disc of the distal radioulnar
joint articulate with the proximal row of carpal bones. The convex surfaces formed by the
carpal bones fit into the concave surfaces of the distal end of the radius and articular disc.
3) Joint capsule: The fibrous capsule encloses the joint and is attached proximally to the distal
ends of the radius and ulna, and distally to the proximal row of carpal bones.
It is strengthened by dorsal and palmar radiocarpal ligaments, which run obliquely distally
and medially from the radius.
Radial and ulnar collateral ligaments also strengthen the fibrous capsule.

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The synovial membrane lines the fibrous capsule and is attached to the margins of the
articular surfaces of the wrist joint. It presents numerous folds, especially dorsally.
4) Ligaments
5) Mechanics: Marginal movements: radial deviation (abduction, movement towards the thumb)
and ulnar deviation (adduction, movement towards the little finger).
Movements in the plane of the hand: flexion (palmar flexion, tilting towards the palm) and
extension

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(dorsiflexion, tilting towards the back of the hand).
Supination and pronation


12. Name: Elbow joint (hinge type of synovial joint)
1) Bones that take part: Humerus of the upper arm, and the paired radius and ulna of the
forearm
2) Articular surfaces: The trochlea and capitulum of the humerus articulates with the trochlear
notch of the ulna and the head of the radius, respectively.
3) Joint capsule: The fibrous capsule completely encloses the joint. Its anterior and posterior
parts are thin and weak, but collateral ligaments strengthen its sides.
The fibrous capsule is attached to the proximal margins of the coronoid and radial fossae
anteriorly, but not quite to the superior limit of the olecranon fossa posteriorly.
Distally the fibrous capsule is attached to the margins of the trochlear notch, the anterior
border of the coronoid process, and the anular ligament.
4) Ligaments
5) Mechanics: The hinge-like bending and straightening of the dynamite (flexion and extension)
("joint") between the humerus and the ulna.
The complex action of turning the forearm over (pronation or supination) happens at the
articulation between the radius and the ulna (this movement also occurs at the wrist joint).

13. Name: Acromioclavicular Joint (Plane type of synovial joint)
1) Bones that take part: Scapula & clavicle

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2) Articular surfaces: The small oval articular facet on the lateral end of the clavicle articulates
with a similar facet on the anterior part of the medial surface of the medial end of the
acromion.
Both articular surfaces are covered with fibrocartilage and slope inferomedially so that the
clavicle tends to override the acromion and project over it.
A wedge-shaped, incomplete fibrocartilaginous articular disc projects into the joint from the
superior part of the joint and partially divides the joint cavity into two parts.
3) Joint capsule: The fibrous capsule enclosing the joint is attached to the margins of its articular
surfaces.
Although it is weak, it is strengthened superiorly by the acromioclavicular ligament and by
fibres from the trapezius muscle.
This ligament extends from the superior part of the lateral end of clavicle to the superior
surface of the acromion.
A synovial capsule lines the fibrous capsule.
4) Ligaments: Coracoclavicular Ligament - This ligament anchors the lateral part of the clavicle to
the coracoid process of the scapula. It is the strongest of the ligaments that binds the clavicle
to the scapula.
It consists of two parts, the conoid and the trapezoid ligaments, which are directed in such a
way that they enable the clavicle to hold the scapula and upper limb laterally.
5) Mechanics: Rotation - This articulation allows the acromion to rotate on the clavicle and to
move anteriorly and posteriorly.

14. Name: Radioulnar joint (Proximal) (pivot type of synovial joint)
1) Bones that take part: Radius, ulna
2) Articular surfaces: The radial head articulates with the radial notch of the ulna.
3) The head of the radius is held in position by the strong anular (annular) ligament, a U-shaped
fibrous collar which is attached to the anterior and posterior margins of the radial notch.
4) Joint capsule: The fibrous capsule enclosing the joint is continuous with the fibrous capsule of
the elbow joint.
The synovial capsule, which lines the fibrous capsule, is an inferior prolongation of the
synovial capsule of the elbow joint.
The deep surface of the anular ligament is lined with synovial membrane, which continues
distally as a sacciform recess on the neck of the radius.
This arrangement allows the radius to rotate within the anular ligament without tearing
the synovial capsule.
The synovial cavities of the elbow and proximal radioulnar joints are in free
communication with each other.
5) Ligaments:
6) Mechanics: Pronation, supination

15. Name: Radioulnar joint (Distal) (pivot type of synovial joint)
1) Bones that take part: Radius, ulna
2) Articular surfaces: The rounded side of the head of the ulna articulates with the ulnar notch in
the distal end of the radius.

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A fibrocartilaginous articular disc binds the ends of the ulna and radius together and is the
main uniting structure of the joint.
The base of the articular disc is attached to the medial edge of the ulnar notch of the
radius, and the apex of the disc is attached to the lateral side of the base of the styloid
process of the ulna.
The proximal surface of this triangular disc articulates with the distal aspect of the head of
the ulna.
Hence, the joint cavity is L-shaped in coronal section. The articular disc separates the
cavity of the distal radioulnar joint from the cavity of the wrist joint.
3) Joint capsule: The fibrous capsule encloses the joint. It is formed by relatively weak
transverse bands that extend from the radius to the ulna across the anterior and posterior
surfaces of the joint.
The synovial membrane lines the fibrous capsule and the proximal surface of the articular
disc. The synovial capsule extends proximally a short distance between the radius and ulna as
the sacciform recess.
The redundancy of the synovial capsule accommodates the twisting of the capsule that
occurs when the distal end of the radius travels around the relatively fixed distal end of the
ulna during pronation of the forearm.
4) Ligaments:
5) Mechanics: Pronation, supination

16. Name: Glenohumeral joint Shoulder joint (Multiaxial ball and socket type of synovial joint)
1) Bones that take part: Humerous, Scapula
2) Articular surfaces: The spheroidal head of the humerus (the ball) articulates with the shallow
glenoid fossa of the scapula (the socket).
The superior portion of the labrum blends with the tendon of the long head of the biceps
brachii muscle.
3) Joint capsule:
The capsule is attached medially to the glenoid fossa, beyond the glenoid labrum.
Superiorly, it encroaches on the root of the coracoid process so that the fibrous capsule
encloses the attachment of the long head of the biceps muscle within the joint.
Laterally the fibrous capsule is attached to the anatomical neck of the humerus.
The inferior part of the capsule is the weakest area. The capsule is lax and lies in folds
when the arm is adducted, but it becomes taut when the arm is abducted.
There are two apertures in the articular capsule. The opening between the tubercles of
the humerus is for the passage for the tendon of the long head of the biceps brachii muscle.
The other opening is situated anteriorly, inferior to the coracoid process. It allows
communication between the subscapular bursa and the synovial cavity of the joint.
The synovial membrane lines the fibrous capsule and is reflected from it onto the glenoid
labrum and the neck of the humerus, as far as the articular margin of the head.
The synovial capsule forms a tubular sheath for the tendon of the long head of the biceps
brachii muscle, where it passes into the joint cavity and lines in the intertubercular groove,
extending as far as the surgical neck of the humerus.
4) Ligaments: Superior, middle and inferior glenohumeral ligaments, Coracohumeral ligament,
Transverse humeral ligament

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5) Mechanics: Flexion, Extension, Abduction, Adduction, Lateral rotation, Medial rotation