Articulations
Introduction
An articulation, or joint, is where two or more bones meet. Joints are classified structurally or functionally.
Structural Classification of Joints
Based on anatomical characteristics:
- Presence/absence of a synovial cavity
- Type of connective tissue
Three types:
- Fibrous: Held by dense connective tissue; no synovial cavity.
- Cartilaginous: Held by cartilage; no synovial cavity.
- Synovial: Held by dense connective tissue of an articular capsule; possess a synovial cavity.
Functional Classification of Joints
Based on movement permitted:
- Synarthrosis: Immovable.
- Amphiarthrosis: Slightly movable.
- Diarthrosis: Freely movable.
Each structurally classified joint will also be classified by function.
Fibrous Joints
Articulating bones held closely together by dense connective tissue; permit little to no movement.
Three types:
- Suture
- Syndesmosis and gomphosis
- Interosseous membrane
Fibrous Joints: Examples
- Suture: Functionally synarthroses in adults, amphiarthroses in infants/children.
- Syndesmosis: Functionally amphiarthroses, except gomphoses (synarthroses).
- Interosseous Membrane: Functionally amphiarthroses.
Cartilaginous Joints
Articulating bones tightly connected by hyaline or fibrocartilage.
Two types:
- Synchondrosis
- Symphysis
Cartilaginous Joints: Examples
- Synchondrosis: Functionally synarthroses (e.g., epiphyseal plates).
- Symphysis: Functionally amphiarthroses (e.g., pubic symphysis).
Synovial Joints
All synovial joints have a synovial cavity, allowing function as a diarthrosis.
Distinguishing structures:
- Articular hyaline cartilage: Reduces friction, absorbs shock.
- Articular capsule.
- Synovial fluid.
Accessory structures:
- Ligaments and articular menisci.
- Bursae and tendon sheaths.
Articular Capsule
Two layers enclosing the synovial cavity:
- Outer fibrous membrane: Dense connective tissue, stabilizes joint.
- Inner synovial membrane: Areolar connective tissue, secretes synovial fluid. Articular fat pads cushion within some joints.
Synovial Fluid
Forms a thin film over articular joint structures; functions include:
- Reducing friction by lubrication.
- Absorbing shock.
- Supplying oxygen and nutrients to articular cartilage.
- Removing wastes. Phagocytic cells remove microbes and debris.
Accessory Structures
- Ligaments: Resist strain, hold bones together.
- Articular menisci: Stabilize joint, direct synovial fluid flow.
- Bursae: Cushion adjacent body parts, alleviate friction.
- Tendon sheaths: Tubelike bursae around tendons, prevent friction.
Synovial Joint Movement Terminology
Indicates direction/relationships during movement.
Four categories:
- Gliding movements.
- Angular movements.
- Rotation.
- Special movements.
Gliding Movements
Flat bone surfaces move back and forth or side to side; limited range, no significant angle alteration.
Angular Movements
Angle between articulating bones increases/decreases.
Principle movements:
- Flexion: decrease in angle
- Extension: increase in angle
- Lateral flexion: flexion along frontal plane
- Hyperextension: extension beyond anatomical position
- Abduction: movement away from midline
- Adduction: movement toward midline
- Circumduction: circular movement
Rotation
Bone revolves around its longitudinal axis; defined relative to midline.
- Medial rotation: anterior surface turned toward midline.
- Lateral rotation: anterior surface turned away from midline.
Special Movements
- Elevation: upward movement.
- Depression: downward movement.
- Protraction: anterior movement.
- Retraction: posterior movement.
- Inversion: soles of feet medially.
- Eversion: soles of feet laterally.
- Dorsiflexion: bending foot superiorly.
- Plantar flexion: bending foot inferiorly.
- Supination: palm anteriorly.
- Pronation: palm posteriorly.
- Opposition: thumb touching fingertips.
Categories of Synovial Joints
Shapes allow variety of movements.
Major categories:
- Plane joint
- Hinge joint
- Pivot joint
- Condyloid joint
- Saddle joint
- Ball-and-socket joint
Examples of Synovial Joints
- Plane: flat surfaces (e.g., intercarpal, intertarsal).
- Hinge: convex into concave (e.g., knee, elbow).
- Pivot: round into ring (e.g., atlanto-axial, radioulnar).
- Condyloid: oval into oval (e.g., wrist, metacarpophalangeal).
- Saddle: saddle-shaped (e.g., carpometacarpal of thumb).
- Ball-and-Socket: ball into cup (e.g., shoulder, hip).
Major Synovial Joints of Body
- Shoulder: Ball-and-socket (humerus and scapula). Stability from rotator cuff muscles. Permits flexion, extension, abduction, adduction, medial/lateral rotation, circumduction.
- Elbow: Hinge joint (humerus, ulna, radius). Permits flexion/extension.
- Hip: Ball-and-socket (femur and hip). Permits rotation and angular movement; strong ligaments limit range.
- Knee: Largest, most complex. Permits flexion, extension, slight rotation.