General Anatomy Of Joints By Dr Iram Iqbal

GENERAL ANATOMY OF JOINTS DR IRAM IQBAL

AIM To describe the common features of joints with their main differences ,their stabilizing factors, classification based on different criteria along with different type of movements occurring on these joints.

SEQUENCE 

Defination



Classification of joints



Classifications of fibrous joints



Classifications of cartilaginous joint



Structure of synovial joint



Classification of synovial joint



Movements around a synovial joint



Factors Stabilizing Synovial Joints



Blood supply of joints, Nerve supply and Lymphatic's of joints



Point of clinical significance



Conclusion

JOINT / ARTICULATIONS Joints are the regions of the skeleton where two or more bones meet and articulate.

CLASSIFICATION OF JOINTS 

SOLID JOINTS



CAVITATED JOINTS

SOLID JOINTS 

FIBROUS JOINTS



CARTILAGINOUS JOINTS



MIXED SOLID JOINTS



INTERCHONDRAL FIBROUS JOINTS



OSSEOCHONDRAL FIBROUS JOINTS

A:FIBROUS JOINTS SYNARTHROSES 

SUTURES



SYNDESMOSIS



GOMPHOSIS

1. SUTURES there are 33 officially recognized sutures 1.PLANE: INTERPALATINE SUTURE INTERMAXILLARY SUTURE

2.SQUAMOUS: TEMPOROPARIETAL SUTURE 3.SERRATE: SAGITTAL SUTURE 4.LIMBOUS: MODIFIED TEMPOROPARIETAL SUTURE

5.DENTICULATE: LAMBDOID SUTURE 6.SCHINDYLESIS: (WEDGE AND GROOVE) VOMEROSPHENOID 7.METOPIC: FRONTAL SUTURE

2. GOMPHOSIS “PEG AND SOCKET”

DENTOALVEOLAR ARTICULATIONS

3. SYNDESMOSIS 12 OFFICIALLY RECOGNIZED  MIDDLE RADIOULNAR JOINT  MIDDLE TIBIOPFIBULAR JOINT  DORSAL PART OF SACROILIAC JOINT (LIGAMENT)  CORACOCLAVICULAR JOINt  JOINT BETWEEN VERTEBRAL ARCHES

B:CARTILAGINOUS JOINTS AMPHHIARTHROSIS 1:PRIMARY CARTILAGINOUS JOINTS / SYNCHONDROSIS / TEMPORARY 

CRANIAL SYNCHONDROSES



POSTCRANIAL SYNCHONDROSES



2:SECONDARY CARTILAGINOUS JOINTS / SYMPHOSES / PERMANENT



FIBROCARTILAGE WITH CAVITY



FIBROCARTILAGE WITHOUT CAVITY

PRIMARY CARTILAGINOUS JOINTS

SYNCHONDROSIS CRANIAL 

SQUAMOUS PETROUS MASTOID AND TYMPANIC PARTS OF TEMPORAL BONES



PETROBASILAR JOINT

SYNCHINDROSIS POSTCRANIAL 

EPIPHSIODIAPHYSEAL/EPIPHYSIOMETAPHYSAL



EPIPHYSIOCORPOREAL



INTRAEPIPHYSEAL IN COMPOUND EPIPHYSIS



MULTIPLEX



STERNALES



MANUBRIOSTERNALIS



XYPHIOSTERNALIS

EPIPHSIODIAPHYSEAL/EPIPHYSIO METAPHYSIAL

INTRAEPIPHYSEAL IN COMPOUND EPIPHYSIS

MULTIPLEX

STERNALES / MANUBRIOSTERNALIS

MANUBRIOSTERNALIS

SECONDARY CARTILAGINOUS JOINTS

FIBROCARTILAGE WITH CAVITY 

PUBIC SYMPHYSIS



INTERVERTEBRAL DISC



MANUBRIOSTERNAL IN LATER YEARS OF LIFE

FIBROCARTILAGE WITHOUT CAVITY 

SYMPHYSIS MENTI



SYMPHYSIS MANUBRIOSTERNALIS IN EARLY YEARS OF LIFE

C:MIXED SOLID JOINTS



ISLANDS OF FIBROCARTILAGE MAY BE PRESENT IN SUTURAL TISSUE OF MANY SUTURES OF SKULL

D:INTERCHONDRAL FIBROUS JUNCTION BETWEEN CARTILAGES OF LARYNX  JUNCTION BETWEEN CARTILAGES OF NOSE 

D:INTERCHONDRAL FIBROUS

E:OSSEOCHONDRAL FIBROUS JUNCTION BETWEEN  BONY AND CARTILAGINOUS EXTERNAL AUDITORY MEATUS  LARYNX AND HYOID BONE  NASAL BONE AND CARTILAGES  COSTAL CARTILAGES RIBS AND STERNUM

BONY AND CARTILAGINOUS EXTERNAL AUDITORY MEATUS

NASAL BONE AND CARTILAGES COSTAL CARTILAGES RIBS AND STERNUM

SYNOVIAL JOINTS CHARACTERISTICS  HYALINE CARTILAGE AT ARTICULAR SURFACES  ARTICULAR CAPSULE  SYNOVIAL MEMBRANE CAVITY AND FLUID  FATTY PADS(HAVERSIAN GLANDS)

ACCESSORY LIGAMENTS  ARTICULAR DISC AND MENISCI  BURSAE  LABRUM  TENDONS WITH SYNOVIAL MRMBRANES 

CLASSIFICATION OF SYNOVIAL JOINTS

A:GENERAL MORPHOLOGY 1.SIMPLE HOMOMORPHIC INTERMETATARSAL INTERMETACARPAL

HETEROMORPHIC ACROMIOCLAVICULAR JOINT SHOULDER JOINT

2.COMPOUND ELBOW JOINT KNEE JOINT 3.COMPLEX KNEE JOINT TEMPOROMANDIBULAR JOINT

1.SIMPLE JOINT

2.COMPOUND JOINT

3.COMPLEX JOINT

B:DEGREE OF FREEDOM a. Joints with translation/sliding movement b. Joint with angular movement 1.UNI-AXIAL  ELBOW JOINT  INTERPHALANGEAL JOINT 2.BI-AXIAL  WRIST JOINT 3.TRI/MULTI-AXIAL  SHOULDER JOINT  HIP JOINT

C. Joint with circumductory movement

1.UNI-AXIAL

UNI-AXIAL

2.BI-AXIAL

3.TRI/MULTI-AXIAL

C:GROSS MORPHOL0GICAL CLASSIFICATION 

PLANE INTERMETATARSAL SOME INTERCARPAL



HINGE JOINT ELBOW JOINT INTERPHALANGEAL JOINT



PIVOT JOINT MEDIAN ATLANTOAXIAL JOINT PROXIMAL RADIOULNAR JOINT

CONDYLOID KNEE JOINT TEMPOROMANDIBULAR JOINT ELLIPSOID RADIOCARPAL JOINT METACARPOPHALANGEAL JOINT SADDLE CARPOMETACARPAL JOINTS OF THUMB ANKLE JOINT CALCANEOCUBOID JOINT BALL AND SOCKET HIP JOINT SHOULDER

ELLIPSOID JOINT In Biaxial joints the articular surface of one bone is oval (ellipsoid) and it fits into an identically shaped socket on the other bone. All movements except rotation can occur in this shape of joint. Examples include the Radio carpal joint.

D:TYPES OF MOVEMENT: 

1. GLIDING/SLIDING/TRANSLATION: 



Plane joint

2. ANGULAR:  Flexion  Extension  Abduction  Adduction



Condyloid joint/Hinge/ellipsoid/…… 3. ROTATORY:  Medial

Rotation  Lateral Rotation  Pivot joints





Classification of rotation according to axis of a bone Classification of the rotation according to the causative factor Shape of the joint (conjunct,)  Muscle action ( adjunct)  Gravity “ 





External forces

4. CIRCUMDUCTORY: Ball and socket joints

”



OPPOSITION Caropetacarpal joint of thumb



Inversion & eversion Talocalcaneonavicular joint



Movement of mendible  Elevation  Depression  Protrusion  Retraction  Rotation



Movement of scapula



Movement of scapula  Elevation  Depression  Protraction  Retraction  Forward

rotation  Backward rotation

Movement of shoulder girdle  Pronation & supination 

BLOOD SUPPLY OF JOINTS 1.ARTERIAL SUPPLY: Epiphyseal arteries Periarticular plexus Circulus articularis vasculosus 2.VENOUS DRAINAGE: Veins follow arteries

LYMPHATIC DRAINAGE The lymphatics drain into the adjacent regional veins

NERVE SUPPLY Free nerve endings capsule and ligament are highly sensitive Synovial membrane less sensitive Articular discs and cartilages are anervous



HILTON’S LAW THE MOTOR NERVE TO A MUSCLE TENDS TO GIVE A BRANCH OF SUPPLY TO THE JOINT WHICH THE MUSCLES MOVES AND ALSO INNERVATES THE SKIN OVER THE JOINT

Gardner(1948) 

Each nerve innervates a specific region of capsule, which may overlap with each other. this part of fibrous capsule made taut on the contraction of a given muscle or a group of muscles is usually innervated by the nerve or nerves supplying their antagonists.

FACTORS STABILIZING SYNOVIAL JOINTS        

Nature of articulating surfaces (Shape,size and arrangfments) Tension of Ligaments Tendons Articular Discs Tension of muscles crossing joint Apposition of soft parts Force of cohesion Atmospheric pressure

SYNOSTOSIS “Fusion of any type of joint with aging” Can take place in all types of joints .eg; >FIBROUS JOINTS: Sutures >CARTILAGINOUS JOINTS: Manubriosternal joints >SYNOVIAL JOINTTS: Sacroiliac joints

 CLINICAL

CORELATION

Arthritis  Osteoarthritis  Joint injuries  Dislocations  Subluxation  Synovitis  Arthroscopy  Joint replacement 

REFERENCE Gray's Anatomy(40thedition)(36thedition). Grant’s method of Anatomy. (10thedition). Clinical Anatomy by Richard S. Snell, (7thedition). www.google.com

CONCLUSION