JOINTS AND MOVEMENTS
bone and temporal bone
JOINT
• A joint, also called an articulation, is
any place where adjacent bones or bone
and cartilage come together to form a
connection
• Joints are commonly named according
to the bones or portions of bones that
join together; for example,
temporomandibular joint
• Some joints are simply given the Greek
or Latinequivalent of the common
name, such as cubital joint
• Joints can be classified structurally as
fibrous, cartilaginous, or synovial.
• Joints are also be classified in
functional categories according to their
degree of motion as synarthroses,
amphiarthroses, or diarthroses
FIBROUS JOINT
• Fibrous joints consist of two bones that
are united by fibrous connective tissue,
have no joint cavity, and exhibit little or
no movement.
• Joints in this group are further
subdivided on the basis of structure as
sutures, syndesmoses, or gomphoses
SUTURES
• Fibrous joints consist of two bones that
are united by fibrous connective tissue,
have no joint cavity, and exhibit little or
no movement.
• Joints in this group are further
subdivided on the basis of structure as
sutures, syndesmoses, or gomphoses
MAJOR SKULL SUTURES
• Coronal suture - between the frontal
bone and the parietal bone
• Sagittal suture - between two parietal
bones
• Squamous suture - between the parietal
• Lambdoid suture - between the parietal
bone and occipital bone
FONTANELS
• In a newborn, some of the sutures have a
membranous area called a fontanel. The
fontanels make the skull flexible during
the birth process and allow for growth of
the head after birth.
SYNDEMOSIS
• Syndesmosis is a fibrous joint in which
the bones are farther apart than in a
suture and are joined by ligaments.
• Some movement may occur at
syndesmoses because the ligaments are
flexible; this occurs in the radioulnar
syndesmosis and tibiofibular
syndesmosis.
GOMPHOSES
• Gomphoses are specialized joints
consisting of pegs that fit into sockets
and are held in place by fine bundles of
regular collagenous connective tissue.
• The only gomphoses in the human body
are the joints between the teeth and the
sockets of the mandible and maxillae.
• The connective tissue bundles between
the teeth and their sockets are called
periodontal ligaments; they allow a
slight amount of “give” to the teeth
during mastication.
CARTILAGINOUS JOINTS
• Cartilaginous joints unite two bones by
means of either hyaline cartilage or
fibrocartilage.
• Joints containing hyaline cartilage are
called synchondroses; joints containing
fibrocartilage are called symphyses.
SYNCHONDROSIS
 • Synchondrosis consists of two bones
joined by hyaline cartilage where little
or no movement occurs.
• Most synchondroses are temporary. In
the case of epiphyseal plates, the
synchondrosis is converted to a
synostosis as bone replaces the existing
cartilage.
• Other synchondroses are converted to
synovial joints, whereas others persist
throughout life. An example is the
sternocostal synchondrosis between the
first rib and the sternum by way of the
first costal cartilage
SPHENOOCCIPITAL
SYMPHESES
• Symphyses consists of fibrocartilage
uniting two bones.
• Examples of symphyses include the
junction between the manubrium and
the body of the sternum, the symphysis
pubis, and the intervertebral disks.
• Some of these joints are slightly
movable because of the somewhat
flexible nature of fibrocartilage.
SYNOVIAL JOINTS
• Synovial joints contain synovial fluid
and allow considerable movement
between articulating bones.
• Most joints that unite the bones of the
appendicular skeleton are synovial
joints.
• The articular surfaces of bones within
synovial joints are covered with a thin
layer of hyaline cartilage called
articular cartilage, which provides a
smooth surface where the bones meet.
• The articular surfaces of bones within
synovial joints are covered with a thin
layer of hyaline cartilage called
articular cartilage, which provides a
smooth surface where the bones meet.
• The articular surfaces of the bones that
meet at a synovial joint are enclosed
within a synovial joint cavity, which is
surrounded by a joint capsule.
• The joint capsule consists of two layers:
an outer fibrous capsule and an inner
synovial membrane.
TYPES OF SYNOVIAL
JOINT
• Synovial joints are classified according
to the shape of the adjoining articular
surfaces.
• The six types of synovial joints are
plane, saddle, hinge, pivot, ball-and-
socket, and ellipsoid.
• Movements at synovial joints are
described as uniaxial, biaxial, or
multiaxial.
SADDLE JOINT
• Saddle joint consists of two saddle-
shaped articulating surfaces oriented at
right angles to each other so that their
complementary surfaces articulate.
 • Saddle joints are biaxial joints.
Example, the carpometacarpal joint of
the thumb.
HINGE JOINT
• Hinge joint is a uniaxial joint in which
a convex cylinder in one bone is
applied to a corresponding concavity in
the other bone.
• Examples include the elbow and knee
joints.
TYPES OF MOVEMENT
PIVOT JOINT
• Pivot joint is a uniaxial joint that
restricts movement to rotation around a
single axis.
• A pivot joint consists of a relatively
cylindrical bony process that rotates
within a ring composed partly of bone
and partly of ligament.
• Example: Proximal radioulnar, Distal
radioulnar, Atlantoaxial.
ATLANTOAXIAL JOINT
• Another example of pivot joint is the
articulation between the dens, a process
on the axis, and the atlas is
BALL AND SOCKET JOINT
• Ball-and-socket joint consists of a ball
at the end of one bone and a socket in
an adjacent bone into which a portion of
the ball fits.
• This type of joint is multiaxial,
allowing a wide range of movement in
almost any direction.
• Examples are the shoulder and hip
joints.
ELLIPSOID JOINT
• Ellipsoid joint (condyloid joint) is a
modified ball-and socket joint.
• The articular surfaces are ellipsoid in
shape, rather than spherical as in regular
ball-and-socket joints.
• Ellipsoid joints are biaxial.
• Example, the atlantooccipital joint of
the neck.
1. GLIDING
 Gliding movements are the
simplest of all the types of
movement. These movements
occur in plane joints between
two flat or nearly flat surfaces
that slide or glide over each
other.
 These joints often allow only
slight movement, as occurs
between carpal bones
2. ANGULAR MOVEMENTS
 Angular movements, one part of
a linear structure, such as the
trunk or a limb, bends relative to
another part of the structure,
thereby changing the angle
between the two parts.
 The most common angular
movements are flexion and
extension and abduction and
adduction.
3. FLEXION AND
EXTENSION
 Flexion is movement of a body
part anterior to the coronal
plane, or in the anterior
direction.
 Extension is movement of a
body part posterior to the
coronal plane, or in the
posterior direction.
 At the knee, flexion moves
(bends) the leg in a posterior
direction, and extension moves
(straightens) it in an anterior
direction.
4. PLANTAR FLEXION AND
DORSIFLEXION
  Movement of the foot toward
the plantar surface, as when
standing on the toes, is
commonly called plantar
flexion.
 Movement of the foot toward
the shin, as when walking on
the heels, is called dorsiflexion.
5. ABDUCTION AND
ADDUCTION
 Abduction is movement away
from the midline
 Adduction is movement toward
the midline
6. RADIAR DEVIATION AND
ULNAR DEVIATION
• Radial deviation is abduction of
the wrist
• Ulnar Deviation is adduction of
the wrist
7. CIRCULAR MOVEMENTS
• Rotation is the turning of a
structure around its long axis.
• Medial rotation of the
humerus with the forearm
flexed brings the hand toward
the body.
• Lateral rotation of the
humerus moves the hand away
from the body.
8. PRONATION AND
SUPINATION
• Pronation is rotation of the
forearm so that the palm faces
posteriorly in relation to the
anatomical position.
• Supination is rotation of the
forearm so that the palm faces
anteriorly in relation to the
anatomical position.
9. CIRCUMDUCTION
• Circumduction is a combination
of flexion, extension, abduction,
and adduction.
• It occurs at freely movable
joints, such as the shoulder.
• In circumduction, the arm
moves so that it describes a
cone, with the shoulder joint at
the apex, as occurs when
pitching a baseball.
10. ELAVATION AND
DEPRESSION
• Elevation moves a structure
superiorly
• Depression moves it inferiorly.
11. PROTACTION AND
RETRACTION
• Protraction is a gliding motion
that moves a structure in an
anterior direction.
• Retraction moves the structure
back to the anatomical position
or even more posteriorly.
12. EXCURSION
• Lateral excursion is moving the
mandible to either the right or
the left of the midline, as occurs
when grinding the teeth or
chewing. Medial excursion
returns the mandible to the
midline position.
13. OPPOSITION AND
REPOSITION
• Opposition is movement of the
thumb and little finger.
• It occurs when these two digits
are brought toward each other
across the palm of the hand.
• Reposition returns the thumb
and little finger to the neutral,
anatomical position.
14. INVERSION AND
EVERSION
• Inversion turns the ankle so that
the plantar surface of the foot
faces medially, toward the
opposite foot.
• Eversion turns the ankle so that
the plantar surface faces
laterally.
• Sometimes inversion of the foot
is called supination and
eversion is called pronation.
DISLOCATION
 • A dislocation, or luxation, of a joint
occurs when the articulating surfaces of
the bones are moved out of proper
alignment.
• A subluxation is a partial dislocation.
• Dislocations are often accompanied by
painful damage to the supporting
ligaments and articular cartilage.
SPRAIN
• A sprain occurs when ligaments are
damaged.
• The degree of damage can range from
stretched to completely torn ligaments.
• Sprains often result in inflammation,
swelling, and pain. Dislocations and
sprains are common sports injuries
RHEUMATOID ATHRITIS
• Rheumatoid Arthritis is a chronic
inflammatory disease that affects joints
and other organ systems. RA affects
0.5% to 1% of the population
worldwide.
• RA is a general connective tissue
disorder that affects the skin, vessels,
lungs, and other organs, but it is most
pronounced in the joints.
• RA is severely disabling and most
commonly destroys small joints, such
as those in the hands and feet.
ETIOLOGY
• The initial cause of RA is unknown but
may involve a transient infection or an
autoimmune disease that develops
against collagen.
• A genetic predisposition may also exist.
RA PATHOPHYSIOLOGY
• Immunologic processes result in
inflammation of synovium, the synovial
fluid and associated connective tissue
cells proliferate, forming a pannus,
which causes the joint capsule to
become thickened and destroys the
articular cartilage.
• Granulation tissue forms adhesions that
lead to decreased joint mobility.
• Similar adhesions can occur in
supporting structures, such as ligaments
and tendons, and cause contractures and
ruptures that further affect joint
structure and mobility.
• Immunologic processes result in
inflammation of synovium, the synovial
fluid and associated connective tissue
cells proliferate, forming a pannus,
which causes the joint capsule to
become thickened and destroys the
articular cartilage.
• Granulation tissue forms adhesions that
lead to decreased joint mobility.
• Similar adhesions can occur in
supporting structures, such as ligaments
and tendons, and cause contractures and
ruptures that further affect joint
structure and mobility.
SYMPTOMS
• Pain in more than one joint
• Stiffness in more than one joint
• Tenderness and swelling in more than
one joint
• Weight loss
• Fever
• Fatigue or tiredness
MEDICAL MOVEMENT
• NSAIDs to relieve pain and
inflammation
• Corticosteroids to reduce inflammatory
process
• Surgery: Synovectomy, Arthrodesis,
Total join replacement.