Joints

Dr. K . Ajay Babu Ph.D.

Professor
Department of Anatomy
Faculty of Medicine
Jagannath Gupta Institute of Medical
sciences & Hospital
(JIMSH)
Budge Budge
Kolkata
Joints

2
 Joints (Joint Classification)
• The structural classification of joints
– Fibrous joints (bones held together by dense
collagen fibers)
– Cartilaginous joints (bones held together by
cartilage)
– Synovial joints (bones held together by ligaments)

• The functional classification of joints

– Synarthrosis (an immovable joint)
– Amphiarthrosis (a slightly movable joint)
– Diarthrosis (a freely movable joint)

Copyright 2009, Ajay Winsent

 Joints (Fibrous Joints)
• Lack a synovial cavity
• The articulating bones are held very closely
together by dense irregular connective tissue
• Fibrous joints permit little or no movement
• Three types of fibrous joints
– Sutures
– Syndesmoses
– Gomphoses

Copyright 2009, Ajay Winsent

 Joints (Fibrous Joints)
• Sutures
– Occur only between bones of the
skull
• Syndesmoses
– Permits slight movement
– Interosseous membrane
• Between the tibia and fibula in
the leg
• Gomphoses
– Immovable joint
– Joint in which a cone-shaped peg
fits into a socket
– Articulations of the teeth with
the sockets of the maxillae and
mandible

Copyright 2009, Ajay Winsent

.
 Joints (Cartilaginous Joints)
• Lacks a synovial cavity
• Allows little or no movement
• Joint is tightly connected by either cartilage
• Two types of cartilaginous joints
– Synchondroses
– Symphyses

Copyright 2009, Ajay Winsent

Synchondrosis

• Synchondroses
– Connecting tissue is
hyaline cartilage
– Epiphyseal (growth)
plate
• Connecting material is
hyaline cartilage
• Immovable (synarthrosis)

8
Epiphyseal plate or joints
between ribs and sternum
 Joints (Cartilaginous Joints)
• Synchondroses
– Connecting tissue is hyaline cartilage
– Epiphyseal (growth) plate
• Symphyses
– Slightly movable joint
– Ends of the articulating bones are covered with
hyaline cartilage, but a disc of fibrocartilage
connects the bones
• Pubic symphysis
– Between the anterior surfaces of the hip bones
– Intervertebral joints between the vertebrae
Copyright 2009, Ajay Winsent
 Symphysis
• Fibrocartilage is
connecting material
• Slightly movable
(amphiarthroses)
• Intervertebral
discs and pubic
symphysis

11
 Joints (Synovial Joints)
• Synovial cavity allows a joint to be freely movable
• Ligaments hold bones together in a synovial joint
• Articular Capsule
– A sleeve-like capsule encloses the synovial cavity
– The articular capsule is composed of two layers
• an outer fibrous capsule
• an inner synovial membrane
• Synovial Fluid
– The synovial membrane secretes synovial fluid
– Functions to reduce friction by:
• lubricating the joint
• absorbing shocks
• supplying oxygen and nutrients to the cartilage
• removing carbon dioxide and metabolic wastes from the
cartilage
Copyright 2009, Ajay Winsent
Joints (Synovial Joints)

Copyright 2009, Ajay Winsent

 Joints (Synovial Joints)
• Accessory Ligaments and Articular Discs

– Collateral ligaments of the knee joint

– Anterior and posterior cruciate ligaments of the

knee joint

– Menisci
• Pads of cartilage lie between the articular surfaces of the bones
• Allow bones of different shapes to fit together more tightly

Copyright 2009, Ajay Winsent

 Joints (Synovial Joints)
• Nerve and Blood Supply
– Nerve endings convey information about pain from
the joint to the spinal cord and brain

– Nerve endings respond to the degree of movement

and stretch at a joint

– Arterial branches from several different arteries

merge around a joint before penetrating the
articular capsule

Copyright 2009, Ajay Winsent

 Joints (Synovial Joints)
• Bursae and Tendon Sheaths
– Bursae
• Sac-like structures containing fluid similar to
synovial fluid
• Located between tendons, ligaments and bones
• Cushion the movement of these body parts
– Tendon sheaths
• Wrap around tendons
• Reduce friction at joints

Copyright 2009, Ajay Winsent

 TYPES OF SYNOVIAL
JOINTS
• Planar joints permit mainly side-to-
side and back-and-forth gliding
movements.
• These joints are non axial.

17
 Planar Joint
• Bone surfaces are flat or
slightly curved
• Side to side movement only
• Rotation prevented by
ligaments
• Examples
– intercarpal or intertarsal
joints
– sternoclavicular joint
– vertebrocostal joints

18
 TYPES OF SYNOVIAL
JOINTS
• A hinge joint contains the convex
surface of one bone fitting into a
concave surface of another bone .
• Movement is primarily flexion or
extension in a single plane..

19
Hinge Joint
• Convex surface of one bones fits
into concave surface of 2nd bone
• Uniaxial like a door hinge
• Examples
– Knee, elbow, ankle,
interphalangeal joints
• Movements produced
– flexion = decreasing the joint
angle
– extension = increasing the
angle
– hyperextension = opening the
joint beyond the anatomical
position 20
 TYPES OF SYNOVIAL
JOINTS
• In a pivot joint, a round or pointed
surface of one bone fits into a ring
formed by another bone and a
ligament.
• Movement is rotational and monaxial.

Principles of Human 21
Anatomy and
 Pivot Joint
• Rounded surface of bone articulates
with ring formed by 2nd bone &
ligament
• Monoaxial since it allows only
rotation around longitudinal axis
• Examples
– Proximal radioulnar joint
• supination
• pronation
– Atlanto-axial joint
• turning head side to side “no”

Principles of Human Anatomy and Physiology, 11e 22

 TYPES OF SYNOVIAL
JOINTS
• In an condyloid joint, an oval-shaped
condyle of one bone fits into an
elliptical cavity of another bone
(Figure 9.10d). Movements are
flexion-extension, abduction-
adduction, and circumduction.

Principles of Human 23
Anatomy and
 Condyloid or Ellipsoidal Joint

• Oval-shaped projection fits into oval depression

• Biaxial = flex/extend or abduct/adduct is possible
• Examples
– wrist and metacarpophalangeal joints for digits 2 to 5

Principles of Human Anatomy and Physiology, 11e 24

 TYPES OF SYNOVIAL
JOINTS
• A saddle joint contains one bone
whose articular surface is saddle-
shaped and another bone whose
articular surface is shaped like a
rider sitting in the saddle.
Movements are flexion-extension,
abduction-adduction, and
circumduction (Figure 9.10e).
Principles of Human 25
Anatomy and
 Saddle Joint

• One bone saddled-shaped; other bone fits as a person would sitting in

that saddle
• Biaxial
– Circumduction allows tip of thumb travel in circle
– Opposition allows tip of thumb to touch tip of other fingers
• Example
– trapezium of carpus and metacarpal of the thumb

Principles of Human Anatomy and Physiology, 11e 26

 TYPES OF SYNOVIAL
JOINTS
• In a ball-and-socket joint, the ball-
shaped surface of one bone fits into
the cuplike depression of another
(Figure 9.10f). Movements are
flexion-extension, abduction-
adduction, rotation, and
circumduction.

Principles of Human 27
Anatomy and
 Ball and Socket Joint

• Ball fitting into a cuplike

depression
• Multiaxial
– flexion/extension
– abduction/adduction
– rotation
• Examples (only two!)
– shoulder joint
– hip joint

Principles of Human Anatomy and Physiology, 11e 28

SELECTED JOINTS OF
THE BODY

Principles of Human 29
Anatomy and
 Tempromandibular Joint
(TMJ) (Exhibit 9.1 and
Figure 9.11)
• The TMJ is a combined hinge and
planar joint formed by the condylar
process of the mandible, the
mandibular fossa, and the articular
tubercle of the temporal bone.
• Movements include opening and
closing and protraction and
retraction of the jaw.
• When dislocation occurs,
Principles of Human 30
the mouth
remains
Anatomy and
open.
 Temporomandibular
Joint

• Synovial joint
• Articular disc
lateral • Gliding above
medial
disc
• Hinge below
disc
• Movements
– depression
– elevation
Principles of Human Anatomy and Physiology, 11e 31
 Temporoman-dibular
Joint
• Synovial joint
• Articular disc
• Gliding above disc
• Hinge below disc
• Movements
– depression
– elevation
– protraction
– retraction

Principles of Human Anatomy and Physiology, 11e 32

 Shoulder Joint (Exhibit
9.2 and Figure 9.12).
• This is a ball-and-socket joint
formed by the head of the humerus
and the glenoid cavity of the scapula.
• Movements at the joint include
flexion, extension, abduction,
adduction, medial and lateral
rotation, and circumduction of the
arm .
• This joint shows extreme
Principles of Human 33
freedom of
movement
Anatomy and
at the expense of
 Shoulder
Joint
• Head of humerus
and glenoid cavity
of scapula
• Ball and socket
• All types of
movement

Principles of Human Anatomy and Physiology, 11e 34

 Glenohumeral (Shoulder)
Joint

• Articular capsule from glenoid cavity to

anatomical neck
• Glenoid labrum deepens socket
• ManyPrinciples
nearby bursa
of Human Anatomy (subacromial)
and Physiology, 11e 35
 Supporting Structures at
Shoulder

• Associated ligaments strengthen joint

capsule
• Transverse humeral ligament holds
Principles of Human Anatomy and Physiology, 11e 36
 Rotator Cuff Muscles

• Attach humerus to scapula

• Encircle the joint supporting the capsule
• Hold head of humerus in socket

Principles of Human Anatomy and Physiology, 11e 37

 Elbow Joint (Exhibit 9.3
and Figure 9.13)
• This is a hinge joint formed by the
trochlea of the humerus, the
trochlear notch of the ulna, and the
head of the radius.
• Movements at this joint are flexion
and extension of the forearm.
• Tennis elbow, little elbows, and
dislocation of the radial head are
common injuries to this
Principles of Human 38
joint.
Anatomy and
 Articular Capsule of the Elbow
Joint
lateral aspect

medial aspect

• Radial annular ligament hold head of

radius in place
• Collateral ligaments
Principles of Human maintain
Anatomy and Physiology, 11e integrity of 39
 Hip Joint (Exhibit 9.4
and Figure 9.14)
• This ball-and-socket joint is formed
by the head of the femur and the
acetabulum of the hipbone.
• Movements at this joint include
flexion, extension, abduction,
adduction, circumduction, and medial
and lateral rotation of the thigh.
• This is an extremely stable joint due
toPrinciples
theofbones
Human
making40up the joint and
the accessory ligaments and muscles.
Anatomy and
Hip Joint

• Head of
femur and
acetabulum
of hip bone
• Ball and
socket
type of
joint
• All types
of Principles of Human Anatomy and Physiology, 11e 41
 Hip Joint Structures

• Acetabular labrum
• Ligament of the head of the femur
• Articular capsule
Principles of Human Anatomy and Physiology, 11e 42
 Hip Joint Capsule

• Dense, strong capsule reinforced by

ligaments
– iliofemoral ligament
– ischiofemoral ligament
– pubofemoral ligament
Principles of Human Anatomy and Physiology, 11e 43
 Knee Joints (Exhibit 9.5
and Figure 9.15)
• This is the largest and most complex
joint of the body and consists of
three joints within a single synovial
cavity.
• Movements at this joint include
flexion, extension, slight medial
rotation, and lateral rotation of the
leg in a flexed position.
• Some common injuries
Principles of Human 44
are rupture of
the tibial colateral ligament and a
Anatomy and
 Tibiofemoral Joint
• Between femur,
tibia and patella
• Hinge joint
between tibia and
femur
• Gliding joint
between patella
and femur
• Flexion, extension,
Principles of Human Anatomy and Physiology, and
11e slight rotation 45
 Tibiofemoral Joint

• Articular capsule
– mostly ligs &
tendons
• Lateral & medial
menisci = articular
discs
• Many bursa
• Vulnerable joint
• Knee injuries
damage ligaments
Principles of Human Anatomy and Physiology, 11e 46
 External Views of Knee
Joint

• Patella is part of joint capsule anteriorly

• Rest of articular capsule is extracapsular ligaments
– Fibular and tibial collateral ligaments

Principles of Human Anatomy and Physiology, 11e 47

Intracapsular Structures of
Knee

• Medial meniscus
– C-shaped
fibrocartilage
• Lateral meniscus
– nearly circular
• Posterior
cruciate ligament
• Anterior
cruciate ligament
Principles of Human Anatomy and Physiology, 11e 48
FACTORS AFFECTING CONTACT
AND RANGE OF MOTION AT
SYNOVIAL JOINTS
• Structure and shape of the articulating bone
• Strength and tautness of the joint ligaments
» Arrangement and tension of the muscles

• Contact of soft parts

• Hormones
• Disuse
• x

Principles of Human 49
Anatomy and
 TYPES OF SYNOVIAL
JOINTS
• Planar joints permit mainly side-to-
side and back-and-forth gliding
movements (Figure 9.10a). These
joints are nonaxial.

Principles of Human 51
Anatomy and
 Planar Joint

• Bone surfaces are flat or slightly

curved
• Side to side movement only
• Rotation prevented by ligaments
• Examples
– intercarpal or intertarsal
joints
– sternoclavicular joint
– vertebrocostal joints

Principles of Human Anatomy and Physiology, 11e 52

 TYPES OF SYNOVIAL
JOINTS
• A hinge joint contains the convex
surface of one bone fitting into a
concave surface of another bone
(Figure 9.10b). Movement is primarily
flexion or extension in a single plane..

Principles of Human 53
Anatomy and
 Hinge Joint
• Convex surface of one bones fits into
concave surface of 2nd bone
• Uniaxial like a door hinge
• Examples
– Knee, elbow, ankle, interphalangeal
joints
• Movements produced
– flexion = decreasing the joint angle
– extension = increasing the angle
– hyperextension = opening the joint
beyond the anatomical position

Principles of Human Anatomy and Physiology, 11e 54

 TYPES OF SYNOVIAL
JOINTS
• In a pivot joint, a round or pointed
surface of one bone fits into a ring
formed by another bone and a
ligament (Figure 9.10c). Movement is
rotational and monaxial.

Principles of Human 55
Anatomy and
 Pivot Joint
• Rounded surface of bone articulates
with ring formed by 2nd bone &
ligament
• Monoaxial since it allows only
rotation around longitudinal axis
• Examples
– Proximal radioulnar joint
• supination
• pronation
– Atlanto-axial joint
• turning head side to side “no”

Principles of Human Anatomy and Physiology, 11e 56

 TYPES OF SYNOVIAL
JOINTS
• In an condyloid joint, an oval-shaped
condyle of one bone fits into an
elliptical cavity of another bone
(Figure 9.10d). Movements are
flexion-extension, abduction-
adduction, and circumduction.

Principles of Human 57
Anatomy and
 Condyloid or Ellipsoidal Joint

• Oval-shaped projection fits into oval depression

• Biaxial = flex/extend or abduct/adduct is possible
• Examples
– wrist and metacarpophalangeal joints for digits 2 to 5

Principles of Human Anatomy and Physiology, 11e 58

 TYPES OF SYNOVIAL
JOINTS
• A saddle joint contains one bone
whose articular surface is saddle-
shaped and another bone whose
articular surface is shaped like a
rider sitting in the saddle.
Movements are flexion-extension,
abduction-adduction, and
circumduction (Figure 9.10e).
Principles of Human 59
Anatomy and
 Saddle Joint

• One bone saddled-shaped; other bone fits as a person would sitting in

that saddle
• Biaxial
– Circumduction allows tip of thumb travel in circle
– Opposition allows tip of thumb to touch tip of other fingers
• Example
– trapezium of carpus and metacarpal of the thumb

Principles of Human Anatomy and Physiology, 11e 60

 TYPES OF SYNOVIAL
JOINTS
• In a ball-and-socket joint, the ball-
shaped surface of one bone fits into
the cuplike depression of another.
• Movements are flexion-extension,
abduction-adduction, rotation, and
circumduction.

Principles of Human 61
Anatomy and
 Ball and Socket Joint

• Ball fitting into a cuplike

depression
• Multiaxial
– flexion/extension
– abduction/adduction
– rotation
• Examples (only two!)
– shoulder joint
– hip joint

Principles of Human Anatomy and Physiology, 11e 62

SELECTED JOINTS OF
THE BODY

Principles of Human 63
Anatomy and
 Tempromandibular Joint
(TMJ)
• The TMJ is a combined hinge and planar joint
formed by the condylar process of the mandible,
the mandibular fossa, and the articular tubercle
of the temporal bone.
• Movements include opening and closing and
protraction and retraction of the jaw.
• When dislocation occurs, the mouth remains open.

Principles of Human 64
Anatomy and
 Temporomandibular
Joint

• Synovial joint
• Articular disc
• Gliding above
lateral disc
medial • Hinge below disc
• Movements
– depression
– elevation
– protraction
– retraction
Principles of Human Anatomy and Physiology, 11e 65
 Temporoman-dibular
Joint
• Synovial joint
• Articular disc
• Gliding above disc
• Hinge below disc
• Movements
– depression
– elevation
– protraction
– retraction

Principles of Human Anatomy and Physiology, 11e 66

 Shoulder Joint
• This is a ball-and-socket joint formed by the head
of the humerus and the glenoid cavity of the
scapula.
• Movements at the joint include flexion, extension,
abduction, adduction, medial and lateral rotation,
and circumduction of the arm .
• This joint shows extreme freedom of movement
at the expense of stability.
• Rotator cuff injury and dislocation or separated
shoulder are common injuries to this joint.

Principles of Human 67
Anatomy and
 Shoulder
Joint
• Head of
humerus and
glenoid cavity
of scapula
• Ball and socket
• All types of
movement

Principles of Human Anatomy and Physiology, 11e 68

 Glenohumeral (Shoulder)
Joint

• Articular capsule from glenoid cavity to

anatomical neck
• Glenoid labrum deepens socket
• ManyPrinciples
nearby bursa
of Human Anatomy (subacromial)
and Physiology, 11e 69
 Supporting Structures at
Shoulder

• Associated ligaments strengthen joint

capsule
• Transverse humeral ligament holds
Principles of Human Anatomy and Physiology, 11e 70
 Rotator Cuff Muscles

• Attach humerus to scapula

• Encircle the joint supporting the capsule
• Hold head of humerus in socket

Principles of Human Anatomy and Physiology, 11e 71

 Elbow Joint
• This is a hinge joint formed by the trochlea of
the humerus, the trochlear notch of the ulna, and
the head of the radius.
• Movements at this joint are flexion and extension
of the forearm.
• Tennis elbow, little elbows, and dislocation of the
radial head are common injuries to this joint.

Principles of Human 72
Anatomy and
Articular Capsule of the Elbow Joint
lateral aspect

medial aspect
• Radial annular ligament hold head of radius
in place
• Collateral ligaments maintain integrity of
joint 73
 Hip Joint
• This ball-and-socket joint is formed by the head
of the femur and the acetabulum of the hipbone.
• Movements at this joint include flexion,
extension, abduction, adduction, circumduction,
and medial and lateral rotation of the thigh.
• This is an extremely stable joint due to the bones
making up the joint and the accessory ligaments
and muscles.

Principles of Human 74
Anatomy and
Hip Joint
• Head of femur
and
acetabulum of
hip bone
• Ball and socket
type of joint
• All types of
movement
possible

Principles of Human Anatomy and Physiology, 11e 75

Hip Joint Structures

• Acetabular labrum
• Ligament of the head of the
femur
• Articular capsule 76
 Hip Joint Capsule

• Dense, strong capsule reinforced by ligaments

– iliofemoral ligament
– ischiofemoral ligament
– pubofemoral ligament
• One of strongest structures in the body
Principles of Human Anatomy and Physiology, 11e 77
 Knee Joints
• This is the largest and most complex joint of the
body and consists of three joints within a single
synovial cavity.
• Movements at this joint include flexion,
extension, slight medial rotation, and lateral
rotation of the leg in a flexed position.
• Some common injuries are rupture of the tibial
colateral ligament and a dislocation of the knee.

Principles of Human 78
Anatomy and
 Tibiofemoral Joint
• Between femur, tibia
and patella
• Hinge joint between
tibia and femur
• Gliding joint between
patella and femur
• Flexion, extension,
and slight rotation of
tibia on femur when
knee is flexed
Principles of Human Anatomy and Physiology, 11e 79
 Tibiofemoral Joint

• Articular capsule
– mostly ligs & tendons
• Lateral & medial
menisci = articular
discs
• Many bursa
• Vulnerable joint
• Knee injuries damage
ligaments & tendons
since bones do not fit
together well
Principles of Human Anatomy and Physiology, 11e 80
External Views of Knee Joint

• Patella is part of joint capsule anteriorly

• Rest of articular capsule is extracapsular ligaments
– Fibular and tibial collateral ligaments

Principles of Human Anatomy and Physiology, 11e 81

Intracapsular Structures of Knee

• Medial meniscus
– C-shaped
fibrocartilage
• Lateral meniscus
– nearly circular
• Posterior cruciate
ligament
• Anterior cruciate
ligament

Principles of Human Anatomy and Physiology, 11e 82

FACTORS AFFECTING CONTACT
AND RANGE OF MOTION AT
SYNOVIAL JOINTS
• Structure and shape of the articulating
bone
• Strength and tautness of the joint
ligaments
• Arrangement and tension of the muscles
• Contact of soft parts
• Hormones
• Disuse

Principles of Human 83
Anatomy and
 AGING AND JOINTS

• Various aging effects on joints include

decreased production of synovial fluid, a
thinning of the articular cartilage, and loss
of ligament length and flexibility.
• The effects of aging on joints are due to
genetic factors as well as wear and tear on
joints.