Department of Human Anatomy KNMU ARTICULAR SYSTEM GENERAL INFORMATION Slide-lecture for students of the 6 Faculty of Medicine Leсktor – associate professor.

Department of Human AnatomyDepartment of Human Anatomy KNMUKNMU

ARTICULAR ARTICULAR SYSTEMSYSTEMGENERAL GENERAL INFORMATIONINFORMATIONSlide-lecture for students of the 6 Faculty of MedicineLeсktor – associate professor Zharova Nataliya

2015

PLAN:PLAN:

1.1. Development of joints.Development of joints.2.2. Classification of bone articulations.Classification of bone articulations.3.3. Continuous bone articulations.Continuous bone articulations.4.4. Synovial joints.Synovial joints.5.5. The most typical features of the joints.The most typical features of the joints.6.6. Accessory structures of joints.Accessory structures of joints.7.7. Congruent and incongruent joints.Congruent and incongruent joints.8.8. Movements in the joints.Movements in the joints.9.9. Classification of the joints based on the number of articulating Classification of the joints based on the number of articulating

surfaces.surfaces.10.10. Classification of the joints based on the shape of articulating Classification of the joints based on the shape of articulating

surfaces.surfaces.11.11. Clinical applications.Clinical applications.

Development of joints Development of joints

Embryonic development of the joints is Embryonic development of the joints is greatly dependent on the bone development. In the greatly dependent on the bone development. In the areas, where discontinuous articulations will form areas, where discontinuous articulations will form between the developing bones, the mesenchyme is between the developing bones, the mesenchyme is resorbed in the center of the primordium forming a resorbed in the center of the primordium forming a cleft-like cavity of the future joint. On the contrary, cleft-like cavity of the future joint. On the contrary, peripheral regions of the mesenchyme, which peripheral regions of the mesenchyme, which surround the cavity, condense, giving rise to the surround the cavity, condense, giving rise to the fibrous capsule and ligaments of the joint. fibrous capsule and ligaments of the joint. Cartilaginous epiphyses ossify in such away that a thin Cartilaginous epiphyses ossify in such away that a thin layer of articular cartilage remains on their surfaces layer of articular cartilage remains on their surfaces for life, which provides the smoothness of articular for life, which provides the smoothness of articular surfaces.surfaces.

CLASSIFICATION OF BONE CLASSIFICATION OF BONE ARTICULATIONSARTICULATIONS

Continuous articulations(synarthroses)Continuous articulations(synarthroses) are are characterized by the presence of an uninterrupted characterized by the presence of an uninterrupted articulating tissue -connective, cartilaginous, or osseous. articulating tissue -connective, cartilaginous, or osseous. Such articulations are either slightly movable or completely Such articulations are either slightly movable or completely fixed.fixed.

Discontinuous (synovial) articulationsDiscontinuous (synovial) articulations contain a cavity contain a cavity lined with the synovial membrane. They possess a great lined with the synovial membrane. They possess a great mobility. They are called mobility. They are called joints.joints.

Intermediate formsIntermediate forms between the continuous and between the continuous and discontinuous articulations are symphyses (or discontinuous articulations are symphyses (or hemiarthroses). They are represented by the cartilaginous hemiarthroses). They are represented by the cartilaginous articulations with the cleft-like cavity lacking a fibrous articulations with the cleft-like cavity lacking a fibrous capsule and without synovial membrane.capsule and without synovial membrane.

CONTINUOUS BONE CONTINUOUS BONE ARTICULATIONSARTICULATIONS

Depending on the tissue type, Depending on the tissue type, which articulates two bones, which articulates two bones, continuous articulations are divided continuous articulations are divided intointo

fibrousfibrous, , syndesmoses, syndesmoses, cartilaginouscartilaginous, , synchondroses,synchondroses, osseousosseous, , synostosessynostoses..

SyndesmosesSyndesmoses,, syndesmosis, (juncturae fibrosae) are syndesmosis, (juncturae fibrosae) are formed from the fibrous connective tissue and are divided into the formed from the fibrous connective tissue and are divided into the following groups:following groups: gomphosis,gomphosis, gomphosis, dentoalveolar syndesmosis, a fibrous gomphosis, dentoalveolar syndesmosis, a fibrous

articulation between the periodontium of alveolar socket and the articulation between the periodontium of alveolar socket and the root of the tooth;root of the tooth;

sutures,sutures, sutura, fibrous articulations between the bones of the sutura, fibrous articulations between the bones of the skull, which contain a thin layer of connective tissue;skull, which contain a thin layer of connective tissue;

fontanelles,fontanelles, fonticuli, between bones of skull of the new-born;fonticuli, between bones of skull of the new-born;

interosseous membranes,interosseous membranes, membranae interosseae;membranae interosseae;

ligaments,ligaments, ligamenta, most of the ligaments consist of a dense ligamenta, most of the ligaments consist of a dense regular connective tissue. Fibers in the ligaments run obliquely and regular connective tissue. Fibers in the ligaments run obliquely and cross over like in the rope. Therefore, ligaments are quite resilient. cross over like in the rope. Therefore, ligaments are quite resilient. Collagen fibers of the ligaments, besides resiliency, provide great Collagen fibers of the ligaments, besides resiliency, provide great elasticity. Some ligaments, besides collagen fibers, contain a elasticity. Some ligaments, besides collagen fibers, contain a considerable amount of elastic tissue yellow in color. They are considerable amount of elastic tissue yellow in color. They are characterized by lower resilience but greater elasticity. They characterized by lower resilience but greater elasticity. They perform a shock-absorbing function (e.g. yellow ligaments of the perform a shock-absorbing function (e.g. yellow ligaments of the vertebral column). Because of their low resilience, elastic ligaments vertebral column). Because of their low resilience, elastic ligaments are not very common in the body. are not very common in the body.

SYNCHONDROSES:SYNCHONDROSES:

ACCORDING TO ACCORDING TO THE DURATION THE DURATION OF THE OF THE EXISTENCEEXISTENCE : : 1—TEMPORARY— 1—TEMPORARY—

exist only to the exist only to the definite age.definite age.

2—PERMANENT— 2—PERMANENT— exist exist throughout the life.throughout the life.

ACCORDING TO THE ACCORDING TO THE PROPERTY OF THE PROPERTY OF THE CARTILAGINOUS CARTILAGINOUS TISSUES :TISSUES : 1—HYALINE— 1—HYALINE—

between I rib and between I rib and sternum.sternum.

2—FIBROUS—2—FIBROUS—between between vertebral bodies.vertebral bodies.

These cartilages have These cartilages have no vessels and nerves.no vessels and nerves.

When ossified, synchondrosis can When ossified, synchondrosis can be transformed into the osseous be transformed into the osseous articulation articulation synostosis synostosis (synostosis).(synostosis).

SynostosesSynostoses or bone articulations or bone articulations (junctura ossea)(junctura ossea) is contiguous joining is contiguous joining of bones by means of bone tissue, for of bones by means of bone tissue, for instance, synostoses between three instance, synostoses between three bones of the hip bone in an adult.bones of the hip bone in an adult.

SYNOVIAL JOINTSSYNOVIAL JOINTS

TheThe synovial articulations synovial articulations (juncturae synoviales, articulatio, (juncturae synoviales, articulatio, diarthrosis) are discontinuous joints diarthrosis) are discontinuous joints characterized by the presence of the characterized by the presence of the synovial membrane. They are also synovial membrane. They are also characterized by a variety of characterized by a variety of movement amplitudes. Consequently movement amplitudes. Consequently these joints are most common in these joints are most common in higher vertebrates and humans.higher vertebrates and humans.

THE MOST TYPICAL THE MOST TYPICAL FEATURES FEATURES OF THE JOINTSOF THE JOINTS

Each joint possesses Each joint possesses four basic four basic elementselements::

articular surfacesarticular surfaces, , facies articulares; facies articulares; articular capsulearticular capsule, , capsula articularis;capsula articularis; articular cavityarticular cavity, , cavitas articularis cavitas articularis

hermetically sealed, cleft-like cavity; hermetically sealed, cleft-like cavity; between the articulating bones.between the articulating bones.

synovial fluidsynovial fluid

Articular surfaces.Articular surfaces. The articular surfaces of the The articular surfaces of the bones are covered with the hyaline cartilage (sometimes bones are covered with the hyaline cartilage (sometimes fibrous), which is 2.5 mm thick on average. The thickness of fibrous), which is 2.5 mm thick on average. The thickness of the cartilage depends on the amount of compression the cartilage depends on the amount of compression experienced by the joint. The surface of the cartilage is not experienced by the joint. The surface of the cartilage is not covered with the perichondrium. The surface is smooth covered with the perichondrium. The surface is smooth lubricated with the synovial fluid which reduces friction to lubricated with the synovial fluid which reduces friction to minimum and facilitates the movement. minimum and facilitates the movement.

Articular capsule.Articular capsule. The capsule of the joint attaches The capsule of the joint attaches to the edges of articular surfaces or somewhat over them. to the edges of articular surfaces or somewhat over them. The articular capsule hermetically seals the articular cavity The articular capsule hermetically seals the articular cavity and consists of two layers - and consists of two layers - external fibrous layer, external fibrous layer, membrana fibrosa, membrana fibrosa, and and internal synovial layer, internal synovial layer, membrana synovialis.membrana synovialis.

The fibrous layer of the capsule The fibrous layer of the capsule has a mechanical has a mechanical function. It consists of bundles of resilient connective tissue function. It consists of bundles of resilient connective tissue fibers, which attach to the bone penetrating it in the form of fibers, which attach to the bone penetrating it in the form of Sharpie's fibers. Sharpie's fibers.

Synovial membrane. Synovial membrane. This layer of the articular capsule is a This layer of the articular capsule is a thin connective tissue membrane, which is lined on the thin connective tissue membrane, which is lined on the inside with squamous synovial cells of mesenchymatous inside with squamous synovial cells of mesenchymatous origin. Consequently, the synovial membrane can form folds origin. Consequently, the synovial membrane can form folds and protrusions.and protrusions.

Synovial folds and bursae.Synovial folds and bursae. The synovial membrane is well The synovial membrane is well developed and, in the majority of the joints forms large developed and, in the majority of the joints forms large folds, folds, plicae plicae synoviales, synoviales, which contain adipose tissue. They go into the articular which contain adipose tissue. They go into the articular cavity, filling its potential spaces and forming cushions, which absorb cavity, filling its potential spaces and forming cushions, which absorb shock during motion. In certain regions, most frequently in the areas shock during motion. In certain regions, most frequently in the areas of muscular tendons, the synovial membrane protrudes through the of muscular tendons, the synovial membrane protrudes through the clefts in the fibrous layer and forms synovial bursae. They serve to clefts in the fibrous layer and forms synovial bursae. They serve to reduce friction during tendons' movement and can be attributed to reduce friction during tendons' movement and can be attributed to the accessory muscular apparatus.the accessory muscular apparatus.

Synovial villi.Synovial villi. The synovial layer bears numerous, microscopic, The synovial layer bears numerous, microscopic, synovial villi, synovial villi, villi synoviales, villi synoviales, which significantly increase its surface which significantly increase its surface area, contain capillary networks, and produce the synovial fluid.area, contain capillary networks, and produce the synovial fluid.

Synovial fluid.Synovial fluid. In the articular cavity there is a small amount of In the articular cavity there is a small amount of pale, thick, synovial fluid. It is produced by the synovial membrane. pale, thick, synovial fluid. It is produced by the synovial membrane. The synovial fluid lubricates the articular surfaces and reduces The synovial fluid lubricates the articular surfaces and reduces friction between them. friction between them.

Synovial cavity.Synovial cavity. Under normal circumstances, the synovial cavity is Under normal circumstances, the synovial cavity is a thin cleft, bounded by the synovial membrane and the articular a thin cleft, bounded by the synovial membrane and the articular surfaces. Between the latter, there is a thin layer of synovial fluid, surfaces. Between the latter, there is a thin layer of synovial fluid, which separates articulating surfaces. In the pathological processes, which separates articulating surfaces. In the pathological processes, the synovial cavity can accumulate large amounts of inflammatory the synovial cavity can accumulate large amounts of inflammatory liquidliquid and greatly increases in size. and greatly increases in size.

Accessory structures of joints Accessory structures of joints Synovial joints may possess several accessory elements, Synovial joints may possess several accessory elements,

which facilitate movement to a certain extent:which facilitate movement to a certain extent:

articular disc,articular disc, discus articularis, discus articularis, a cartilaginous plate, a cartilaginous plate, which completely separates the joint into two regions;which completely separates the joint into two regions;

articular meniscus,articular meniscus, meniscus articularis, meniscus articularis, cartilaginous cartilaginous semilunar plate, which partially separates the synovial semilunar plate, which partially separates the synovial cavity;cavity;

articular liparticular lip, , labrum articularis, labrum articularis, a cartilaginous rim or lip, a cartilaginous rim or lip, which deepens the articular socket;which deepens the articular socket;

intraarticular ligamentsintraarticular ligaments, , ligg. intraarticularia, ligg. intraarticularia, connect connect bones within the joint; they are covered with the synovial bones within the joint; they are covered with the synovial membrane.membrane.

Auxiliary strengthening apparatus of Auxiliary strengthening apparatus of jointsjoints – ligaments and tendons of muscles. There are – ligaments and tendons of muscles. There are extra-articular and intra- articular ligaments, covered by extra-articular and intra- articular ligaments, covered by synovial membranes.synovial membranes.

FactorsFactors, , which aid in the which aid in the stabilization of articular stabilization of articular surfacessurfaces:: The fibrous capsule, which is reinforced by The fibrous capsule, which is reinforced by

the ligaments;the ligaments; Muscles, which surround the joint and Muscles, which surround the joint and

actively hold the bones together due to a actively hold the bones together due to a constant muscle tone;constant muscle tone;

Molecular attraction of articular surfaces, Molecular attraction of articular surfaces, lubricated by the synovial fluid.lubricated by the synovial fluid.

Congruent and incongruent Congruent and incongruent jointsjoints

In those cases, when articulating surfaces In those cases, when articulating surfaces entirely correspond to each other and appear as entirely correspond to each other and appear as imprints of one another, joints are called congruent imprints of one another, joints are called congruent (congruo - correspond). In such joints, articular surfaces (congruo - correspond). In such joints, articular surfaces are tightly joined together as, for example, in the hip are tightly joined together as, for example, in the hip joint, in which movements are largely restricted.joint, in which movements are largely restricted.

Incongruent joints have a greater degree of Incongruent joints have a greater degree of freedom in their movements due to the incomplete freedom in their movements due to the incomplete correspondence of the articulating surfaces. These correspondence of the articulating surfaces. These joints possess accessory structures such as disks, joints possess accessory structures such as disks, menisci, synovial folds, which fill the irregularities in menisci, synovial folds, which fill the irregularities in the articular surfaces and smooth out their the articular surfaces and smooth out their incongruence. The knee joint is an example of the incongruence. The knee joint is an example of the incongruent joint.incongruent joint.

Movements in the jointsMovements in the joints

The The frontal axisfrontal axis runs through the joint from right to runs through the joint from right to left. left. Flexion (flexio)Flexion (flexio) and and extension (extensio)extension (extensio) of the of the shoulder occur around the frontal axis.shoulder occur around the frontal axis.

The sagittal axisThe sagittal axis is drawn from front to back. is drawn from front to back. Abduction (abductio)Abduction (abductio) and and adduction (adductio)adduction (adductio) of the of the shoulder occur around this axis.shoulder occur around this axis.

The The vertical axisvertical axis runs through the joint and through runs through the joint and through the entire arm from the top to the bottom. Medial and the entire arm from the top to the bottom. Medial and lateral lateral rotations (rotatio)rotations (rotatio) of the humerus occur around of the humerus occur around this axis.this axis.

Circumduction (circumductio)Circumduction (circumductio) takes place when the takes place when the movement passes from one axis to another, as when movement passes from one axis to another, as when the hand moves in a circular path. Circular movements the hand moves in a circular path. Circular movements are possible in multi-axial and bi-axial joints.are possible in multi-axial and bi-axial joints.

CLASSIFICATION OF JOINTSCLASSIFICATION OF JOINTS

Classification of the joints based Classification of the joints based on theon the number of articulating surfaces: number of articulating surfaces:

simple simple - is composed of only two articulating surfaces;- is composed of only two articulating surfaces;

compound compound - contains more than two articulating - contains more than two articulating surfaces;surfaces;

complex joint complex joint - if a joint contains articular discs or - if a joint contains articular discs or menisci, which divide it into two parts;menisci, which divide it into two parts;

combined joints combined joints - two isolated joints, in which - two isolated joints, in which movements occur simultaneously.movements occur simultaneously.

Classification of the joints based Classification of the joints based on the shape of on the shape of articulating surfacesarticulating surfaces::

Uni-axial joints Uni-axial joints Bi-axial joints Bi-axial joints Multi-axial jointsMulti-axial joints

Uni-axial joints. Uni-axial joints. In these joints, movement is In these joints, movement is restricted to a single axis. There are two types of uni-axial restricted to a single axis. There are two types of uni-axial joints:joints:

hinge jointhinge joint, , ginglymus, ginglymus, contains articulating surfaces, contains articulating surfaces, which resemble hinges (for example, interphalangeal joints which resemble hinges (for example, interphalangeal joints of the hand and foot);of the hand and foot);

pivot jointpivot joint, , art. trochoidea (art. cylindrica), art. trochoidea (art. cylindrica), a cylindrical a cylindrical joint, formed by the convex and concave articulating joint, formed by the convex and concave articulating surfaces cylindrical in shape (for example, proximal and surfaces cylindrical in shape (for example, proximal and distal radio-ulnar joints).distal radio-ulnar joints).

Bi-axial joints. Bi-axial joints. These joints permit movements These joints permit movements around two axes, which are perpendicular to each other. around two axes, which are perpendicular to each other. The following bi-axial joints are distinguished based on their The following bi-axial joints are distinguished based on their shape:shape:

ellipsoid joint,ellipsoid joint, art. ellipsoidea, art. ellipsoidea, contains elliptical (egg-contains elliptical (egg-shaped) articulating surfaces shaped) articulating surfaces

(for example, radiocarpal joint);(for example, radiocarpal joint);

bicondylar joint,bicondylar joint, art. bicondylaris, art. bicondylaris, consists of a pair of consists of a pair of convex, ellipsoid, articulating surfaces, which are rather convex, ellipsoid, articulating surfaces, which are rather prominent. Hence, they are known as condyles (for prominent. Hence, they are known as condyles (for example, knee joint);example, knee joint);

saddle joint,saddle joint, art. sellaris, art. sellaris, contains two articulating contains two articulating surfaces each of which resembles a saddle surfaces each of which resembles a saddle

(for example, carpometacarpal joint of the thumb).(for example, carpometacarpal joint of the thumb).

Multi-axial joints include spheroidal Multi-axial joints include spheroidal joints and their variations. joints and their variations.

Even though, in principle, movements in these Even though, in principle, movements in these joints arc possible around multiple axes drawn through the joints arc possible around multiple axes drawn through the joint, rotation occurs only around three axis:joint, rotation occurs only around three axis:

spheroidal jointspheroidal joint (ball-and-socket joint), (ball-and-socket joint), art. spheroidea, art. spheroidea, consists of a globular head and a corresponding concavity. consists of a globular head and a corresponding concavity. A typical example is the shoulder joint. Variation of the ball-A typical example is the shoulder joint. Variation of the ball-and-socket joint is the and-socket joint is the cotyloid jointcotyloid joint. Its head resides in a . Its head resides in a deep articular socket, consequently, it is known as the deep articular socket, consequently, it is known as the cup-cup-like joint like joint (art. cotylica);(art. cotylica);

plane joint,plane joint, art. plana, art. plana, contains two flat surfaces, which contains two flat surfaces, which can be viewed as sur faces of a sphere with a large can be viewed as sur faces of a sphere with a large diameter. Because of the small size difference of both diameter. Because of the small size difference of both articulating surfaces, only slight translations are possible in articulating surfaces, only slight translations are possible in plane joints (for example, sacroiliac joint).plane joints (for example, sacroiliac joint).

Clinical applicationsClinical applications

Pathological process can develop in the joints, Pathological process can develop in the joints, among which infectious arthritis is the most common among which infectious arthritis is the most common (particularly, rheumatic or tuberculous arthritis). (particularly, rheumatic or tuberculous arthritis). Inflammations of the synovial membrane — Inflammations of the synovial membrane — synovitissynovitis and and bursitisbursitis are also fairly common. Joint deformations, are also fairly common. Joint deformations, contraction of the synovial cleft, and restriction of contraction of the synovial cleft, and restriction of movements accompanied by pain syndrome can occur movements accompanied by pain syndrome can occur as a consequence of degenerative changes as a consequence of degenerative changes (arthrosis).(arthrosis). Traumas can cause various joint dislocations with Traumas can cause various joint dislocations with stretched and ruptured ligaments. Physician of different stretched and ruptured ligaments. Physician of different specialties often have to deal with the diseases of joints.specialties often have to deal with the diseases of joints.

Name of Name of jointjoint

ArticularArticularsurfacessurfaces

Attachment of Attachment of the articularthe articular

capsulescapsules

ShapeShapeandand

featuresfeatures

LigamentsLigaments MovementsMovements

1. 1. Atlanto-Atlanto-occipi-occipi-tal j.tal j.

Two Two condyles condyles of the of the occipital occipital bones; bones; concave concave articular articular surfaces of surfaces of the atlasthe atlas

Both pairs of Both pairs of articulating articulating surfaces are surfaces are enclosed in enclosed in separate separate capsules, capsules, moving moving simultaneouslysimultaneously

Biaxial, Biaxial, condyloidcondyloid, , combined combined jointjoint

The anterior The anterior atlantooccipital atlantooccipital membrane, the membrane, the posterior posterior atlantooccipital atlantooccipital membrane, the membrane, the lateral lateral atlantoccipital atlantoccipital ligamentsligaments

Bending the Bending the head backward head backward and forward, and forward, lateral bending lateral bending of the head to of the head to the right and the right and leftleft

Name Name of jointof joint

ArticularArticularsurfacesurface

Attachment Attachment of the of the

articulararticularcapsulescapsules

ShapeShapeandand

featuresfeatures

LigamentsLigaments MovementsMovements

2. 2. TempoTempo--roman-roman-dibular dibular j.j.

Head of the Head of the mandible, mandible, mandibular mandibular fossa of the fossa of the temporal bonetemporal bone

Along the Along the border of the border of the mandibular mandibular fossa of the fossa of the temporal temporal bone up to bone up to the the petrotympanipetrotympanic fissurec fissure

Biaxial, Biaxial, condyloid, condyloid, complex, complex, single single combined combined jointjoint

Lateral Lateral ligament, ligament, spheno-spheno-mandibular mandibular ligament, ligament, stylomandi-stylomandi-bular bular ligamentligament

Downward and Downward and upward upward movements with movements with opening and opening and closing the mouth; closing the mouth; forward and forward and backward; lateral backward; lateral movements, occur movements, occur in chewingin chewing

Name of Name of jointjoint

ArticularArticularsurfacesurface

Attachment of Attachment of the articularthe articular

capsulescapsules

ShapeShapeandand

featuresfeatures

LigamentsLigaments MovementsMovements

3. 3. Shoulder Shoulder j.j.

The head The head of of humerus, humerus, glenoid glenoid cavity of cavity of the the scapulascapula

Free and thin, Free and thin, attached to the attached to the bony edge of the bony edge of the scapular glenoid scapular glenoid cavity and to the cavity and to the anatomical neck anatomical neck of the humerusof the humerus

Ball-and-Ball-and-socket, socket, incongrueincongruent, nt, complex complex joint joint (glenoid (glenoid lip lip presents)presents)

Coracohumeral lig., Coracohumeral lig., Superior, Superior, medial and medial and inferior inferior glenohumeral ligg. glenohumeral ligg.

The flexion, The flexion, the extension, the extension, the adduction, the adduction, the abduction; the abduction; medial, lateral medial, lateral rotation or rotation or pronation, pronation, circumductioncircumduction

4. Elbow 4. Elbow j.j.

ArticulatinArticulating surfaces g surfaces of the of the humeroulnhumeroulnar ar articulatioarticulation, n, humeroradhumeroradial ial articulatioarticulation, n, proximal proximal radioulnar radioulnar articulatioarticulation.n.

Olecranon Olecranon fossa on the fossa on the posterior posterior surface of the surface of the humerus and humerus and the coronary the coronary and radial and radial fossae on its fossae on its anterior anterior surface; surface; attached on attached on the ulna to the the ulna to the adge of the adge of the trochlear trochlear notch and on notch and on the radius to the radius to its neckits neck

CompouCompound joint nd joint since 3 since 3 bones bones articulatarticulate in the e in the elbow elbow joint joint (humeru(humerus, ulna, s, ulna, radius)radius)

The medial The medial ligament, the ligament, the lateral ligament, lateral ligament, the anular the anular ligament of the ligament of the radius, radius, the square the square ligamentligament

Flexion and Flexion and extension of extension of the forearm the forearm on the frontal on the frontal axis and axis and flexion with flexion with the oblique the oblique direction direction towards towards opposite opposite shoulder shoulder joint, joint, pronation pronation and and supination supination are realized are realized in the in the proximal and proximal and distal distal radioulnar radioulnar joints.joints.

Name of joint

Articularsurface

Attachment of the articularcapsules

ShapeandFeatures

Ligaments Movements

5. Wrist j.

Carpal articular surface of the radius, the triangular disc and by the proximal surface of the first row of carpals.

Attached to the margins of the articular surfaces

Compound, complex, ellipsoid joint

The lateral ligament, the medial ligament, the anterior radiocarpal ligament, the posterior radiocarpal ligament, the anterior ulnocarpal ligament, the posterior ulnocarpal ligament

Flexion, extension on the frontal axis, adduction, abduction on the saggital axis, circumduction

6. Hip j.

Cup-like acetabulum of the hip bone and the femoral head fitting into it, a fibrocartilaginous ring presents.

Attached along the whole rim of the acetabulum and transverse ligament of the acetabulum, to the femur in front along the intertrochanteric line and behind to the femoral neck parallel to and medial of the intertrochanteric crest

Ball-and-socket joint of the limited type-cotyloid joint, complex joint.

Extraarticular ligaments: the iliofemoral lig., the pubofemoral lig.,the ischiofemoral lig., the orbicular zone.Intraarticular ligaments: the transversum acetabular lig.,the lig. of the femur`s head.

Flexion (to the front), extension (to the back); abduction, adduction; limited circumduction

7. Knee j.

The articular surfaces of the femoral condyles, the superior articular surfaces of the tibia, articular surface of the patella

Attached at some distance from the edges of the femoral, tibial and patellar articular surfaces. The epicondyles of the femur are left outside the capsule.

Largest and the most structurally complicated joint.

Extraarticular ligaments: the medial collateral lig., the lateral collateral lig., the oblique lig., the arcuate lig.. the patellar lig.;Intraarticular ligaments: the anterior cruciate lig., the posterior cruciate lig., the transverse lig. of the knee, the anterior meniscofemoral lig., the posterior meniscofemoral lig.

Flexion, extension, rotation (slightly).

8. Ancle j.

Lower articular surfaces of the tibia and its malleolus, the articular surfaces of the malleolus of the fibula, the articular surfaces of the trochlea of the talus

Attached to the cartilaginous margins of the articular surfaces, covers part of the talus neck in front.

Compound joint, the shape is hinge

The lateral ligament consists of: the anterior talofibular lig., the posterior talofibular lig., the calcaneofibular lig.; The medial (deltoid) ligament consists of: the anterior and posterior tibiotalar lig., tibiocalcaneus lig., tibionavicular lig.

The foot raises with toes upwards (dorsiflexion or extension) or lowers (plantar flexion), slight side movements (on plantar flexion).

THE TEMPOROMANDIBULAR JOINTTHE TEMPOROMANDIBULAR JOINT

The temporomandibular joint, articulatio temporomandibularisThe temporomandibular joint, articulatio temporomandibularis, , is paired and formed by the articulation of the head of the is paired and formed by the articulation of the head of the mandible (ellipsoid in shape) with the mandibular fossa of the mandible (ellipsoid in shape) with the mandibular fossa of the temporal bone. temporal bone.

It belongs to the group of the bicondylar, combined joints.It belongs to the group of the bicondylar, combined joints. The articular surfaces are incongruent. Therefore, inside the The articular surfaces are incongruent. Therefore, inside the

joint there is the articular disk, joint there is the articular disk, discus articularis, discus articularis, which fuses which fuses with the fibrous capsule and divides the articular cavity of the with the fibrous capsule and divides the articular cavity of the joint into two isolated levels - the upper and the lower (complex joint into two isolated levels - the upper and the lower (complex joint).joint).

Fibrous capsule. Fibrous capsule. In the region of the temporal bone, the In the region of the temporal bone, the capsule is attached to the margins of the mandibular fossa, capsule is attached to the margins of the mandibular fossa, fossa mandibularis, fossa mandibularis, covers in the front the articular tubercle, covers in the front the articular tubercle, tuberculum articulare, tuberculum articulare, and in the back reaches the and in the back reaches the petrotympanic fissure. On the mandible, the capsule attaches to petrotympanic fissure. On the mandible, the capsule attaches to the edge of the articular surface of the head in the front (above the edge of the articular surface of the head in the front (above the pterygoid fossa), while in the back it inserts into the neck of the pterygoid fossa), while in the back it inserts into the neck of the mandible.the mandible.

Ligaments.Ligaments. The capsule is reinforced by the lateral ligament, lig. laterale, The capsule is reinforced by the lateral ligament, lig. laterale,

whose fibers run obliquely from the zygomatic process of the whose fibers run obliquely from the zygomatic process of the temporal bono to the neck of the mandible. Importantly, (ho temporal bono to the neck of the mandible. Importantly, (ho following fasciae (ligaments) thicken in order to stabilize the following fasciae (ligaments) thicken in order to stabilize the mandible: mandible:

1) lig. stylomandibular, which runs from the styloid process of the 1) lig. stylomandibular, which runs from the styloid process of the temporal bone to the posterior angle of the mandible; temporal bone to the posterior angle of the mandible;

2) lig. sphenomandibulare, which extends from the spine of the 2) lig. sphenomandibulare, which extends from the spine of the sphenoid towards the lingula of the mandible.sphenoid towards the lingula of the mandible.

Movements.Movements. The temporomandibular joint permits the following The temporomandibular joint permits the following movements:movements:

1) elevation and depression of themandible occurs around the 1) elevation and depression of themandible occurs around the frontal axis in the lower level of the joint. When the mandible is frontal axis in the lower level of the joint. When the mandible is exceedingly depressed, the articular disk with the head of the exceedingly depressed, the articular disk with the head of the mandible may be displaced onto the articular tubercle; mandible may be displaced onto the articular tubercle;

2) protrusion of the mandible occurs in the upper level of the joint 2) protrusion of the mandible occurs in the upper level of the joint in such a way that the head together with the articular disk are in such a way that the head together with the articular disk are drawn onto the articular tubercle; drawn onto the articular tubercle;

3) lateral movements of the mandible occur such that on one side 3) lateral movements of the mandible occur such that on one side the head remains in the fossa, whereas on the opposite side it: is the head remains in the fossa, whereas on the opposite side it: is drawn onto the articular tubercle together with the articular disc.drawn onto the articular tubercle together with the articular disc.

MASTICATORY MUSCLESThe masticatory muscles are derived from the common mesenchymatous primordium of the first visceral (mandibular) arch, which is associated with the third branch of the trigeminal nerve. All of the masticatory muscles (four) act on the temporomandibular joint and move the mandible. They can be divided into the superficial and deep muscles .THE SUPERFICIAL MASTICATORY MUSCLESMasseter, m. masseter. Origin: zygomatic arch.Insertion: masseteric tuberosity and angle of the mandible. It consists of two parts — superficial (pars superficialis) and deep (pars profunda). Action. Elevates the mandible; the superficial part protracts the mandible.

Temporalis, m. temporalis.Origin: temporal and parietal bones, temporal fascia.Insertion: coronoid process of the mandible. The muscle fills the temporal fossa. It is flat and fan-shaped. The ante rior fibers of the temporalis are directed vertically, middle fibers — obliquely, and posterior fibers — almost horizontally. The fibers of the muscle converge below forming a thick tendon, which runs underneath the zygomatic arch and inserts into the coronoid process.Action. Elevates and retracts the mandible.

THE DEEP MASTICATORY MUSCLES

Medial pterygoid, m. pterygoideus medialis.Origin: pterygoid fossa of the pterygoid process.Insertion: pterygoid tuberosity of the mandible. Action. Elevates and pulls the mandible to the side. When the muscle contracts on both sides, it protracts the mandible.

Lateral pterygoid, m. pterygoideus lateralis.Origin: arises by two heads: from the infratemporal crest of the sphenoid bone (upper head) and lateral plate of the pterygoid process (lower head).Insertion: pterygoid fossa of the neck of the mandible and capsule of the temporomandibular joint.The muscle is triangular in shape. Its fibers are directed backward and laterally. It lies deep in the infratemporal fossa covered by the zygomatic arch and the ramus of the mandible as well as by the temporal muscle.Action. In unilateral contraction, the muscle moves the mandible to the opposite side; when the lateral pterygoid muscles of the two sides act together they protrude the mandible.

Nerve supply of the masticatory muscles. All masticatory muscles arc supplied by the third branch of the trigeminal nerve.

Muscles of the neck

Is divided into three groups: - Superficial - medial or muscles of the hyoid bone - deep

Superficial Muscles of the neck1. The platysma is subcutaneous muscle, which attached from the 2 rib to the mandible.Action: - pulling the skin of the neck; - depress the angle of the mouth.

2. The sternocleidomastoid muscle lies under the platysma.Attached: - the hilt of sternum - the sternal and of the clavicle - the mastoid process - the superior nuchae line.Action: - hold the head in a vertical position

Middle muscles of the neckIs divided into 2 groups: - above the hyoid bone and below.

Muscles located above the hyoid bone

1.The mylohyoid muscle is flat, connected to the mylohyoid muscle.

2. The digastric muscle consists of two bellies. Anterior arises from the digastrics fossa, posterior – the mastoid process.

3. The stylohyoid muscle – the styloid process of temporal bone.

4. The geniohyoid muscle – lies above the mylohoid muscle on the mental spine of mandible.

Muscles located below the hyoid bone

1. The sternohyoid muscle attached the hilt of the sternum, sterna and of the clavicle.Action: - pulls the hyoid bone downwards.

2. The sternothyroid muscle: - lies under the sternohyoid muscle, lowers the larynx.

3. The thyrohyoid muscle is continuated of the sternothyroid muscle, pulls the larynx upwards.

4. The omohyoid muscle – consists of two bellies, inferior and superior. Inferior arises of the subscapular notch and connected with superior belly.Action: pulls the hyoid bone downwards.

The Deep muscles of the neckIs divided into three groups: - lateral, attached to the ribs - prevertebral - suboccipitalThe Deep lateral muscles of the neck1. The anterior scalene muscle2. The medius scalene muscle3. The posterior scalene muscleThey attached the transverse processes of the cervical vertebrae.Action: raises the upper ribs, inspiration muscles.The Deep prevertebral muscles of the neck1. The long muscle of the neck2. The long muscle of the headAction: flex the head forward and laterallyThe Deep suboccipital muscles of the neck1, 2. The anterior and lateral straight muscles of the head – flex the head forward, spine – laterally.3, 4. The obliquus capitis superior and inferior muscles5, 6. The greater and lesser straight musclesAction: rotate the head and pull it backwards.

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