This document provides an overview of the anatomy and physiology of joints, including their classification, structure, and types of movement. It begins by defining joints and their main functions. It then classifies joints based on their connecting tissue and degree of movement. The document proceeds to describe the three major types of joints - fibrous, cartilaginous, and synovial - providing examples of each. It concludes by discussing common joint injuries, disorders, and conditions like arthritis.

1. Anatomy and Physiology, Seventh Edition
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*See PowerPoint Image Slides for all figures and tables pre-inserted into PowerPoint without notes.
8-1
Rod R. Seeley
Idaho State University
Trent D. Stephens
Idaho State University
Philip Tate
Phoenix College
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

2. Articulations or Joints
8-2
• Ar ticulation or Joint
– Place where two bones (or bone and car tilage)
come together
• Ar thrology = study of the joints
• Kinesiology = study of musculoskeletal
• Functions of joints
– Give the skeleton mobility
– Hold the skeleton together
• Structure cor related with movement

3. Classification of Joints
• Structural classes: based on type of
connective tissue type that binds bones and
whether or not a joint cavity is present
8-3
– Fibrous
– Cartilaginous
– Synovial
• Functional classes: based on degree of motion
– Synarthrosis: non-movable
– Amphiarthrosis: slightly movable
– Diarthrosis: freely movable

4. 8-4
Fibrous Joints
• Characteristics
– United by fibrous connective tissue
– Have no joint cavity
– Move little or none
• Types:
– Sutures
– Syndesmoses
– Gomphoses

5. Fibrous Joints: Sutures
8-5
• Types of sutures
– Ser rated: Opposing bones interdigitate (Sagittal suture)
– Lap: Over lapping beveled edges (Squamosal suture)
– Plane: Straight, non-over lapping edges (Intermaxillary suture)
• Per iosteum of one bone is continuous with the
per iosteum of the other .
• In adults may ossify completely: synostosis.
• Fontanels: membranous areas in the suture between
bones. Allow change in shape of head dur ing bir th and
rapid growth of the brain after bir th.

6. 8-6
Types of Sutures

7. Fibrous Joints: Syndesmoses
• Two bones joined by
ligament
– Interosseous membrane
• Most moveable of
fibrous joints
• Examples: radioulnar
joint and tibiofibular
joints
8-7

8. Fibrous Joints: Gomphoses
• Specialized joints
• Pegs that fit into sockets
• Periodontal
ligaments: hold teeth
in place
• Inflammations
– Gingivitis leads to…
– Periodontal disease
8-8

9. 8-9
Cartilaginous Joints
• Bones are joined by
car tilage
• Lack a joint cavity
• Types
– Synchondroses: bound
by hyaline car tilage
– Symphyses: bound by
fibrocar tilage

10. 8-10
Cartilaginous Joints:
Synchondroses
• Joined by hyaline
cartilage
• Little or no movement
• Some are temporary
and are replaced by
synostoses
• Some are permanent
• Some like
costochondral joints
develop into synovial
joints
• Examples: Epiphyseal
plates, 1st sternocostal

11. 8-11
Cartilaginous Joints:
Symphyses
• Fibrocartilage
uniting two bones
• Slightly movable
• Examples:
symphysis pubis,
between the
manubrium and the
body of the sternum,
intervertebral disks.

12. 8-12
Synovial Joints
• Contain synovial fluid in a joint cavity
called the synovial cavity
• Allow considerable movement
(diarthroses)
• Most joints that unite bones of
appendicular skeleton reflecting greater
mobility of appendicular skeleton
compared to axial

13. 8-13
Structure of
Synovial
Joints
• Articular cartilage: hyaline;
provides smooth surface on epiphysis
• Joint cavity: synovial; encloses
articular surfaces
• Articular Capsule encloses joint
cavity
– Fibrous capsule:
• dense irregular connective tissue
• continuous with periosteum.
• Portions may thicken to form ligaments.
– Synovial membrane and fluid:
• Thin, delicate membrane
• lines inside of joint capsule.
• Synovial fluid:
– complex mixture of polysaccharides,
proteins, fat and cells. Hyaluronic acid-slippery.
• No blood vessels or nerves in articular
cartilages; nutrients derived from
nearby blood vessels and synovial fluid
• Nerves in capsule help brain know
position of joints (proprioception)

14. 8-14
Accessory Structures
• Bursae
– Pockets of synovial membrane and fluid that extend from the
joint. Found in areas of friction
– Bursitis
• Ligaments and tendons: stabilization
• Articular discs: temperomandibular,
sternoclavicular, acromioclavicular
• Menisci: fibrocartilaginous pads in the knee.
• Tendon sheaths: synovial sacs that surround
tendons as they pass near or over bone

15. 8-15
Synovial Joints:
Friction-Reducing Structures
Figure 8.4

16. 8-16
Types of Movement
• Gliding: in plane joints; slight movement
• Angular
– Flexion and Extension
• Hyperextension
• Plantar and Dorsiflexion
– Abduction and Adduction
• Circular
– Rotation
– Pronation and Supination
– Circumduction

17. Flexion and Extension
• Flexion: movement of a body part anterior to
the coronal plane
• Extension: movement of a body part
posterior to the coronal plane
8-17

18. Dorsiflexion and Plantar
8-18
Flexion
• Exceptions to
definition
– Plantar flexion:
standing on the toes
– Dorsiflexion: foot
lifted toward the shin

19. Abduction and Adduction
• Abduction: movement
away from the midline
• Adduction: movement
toward the midline
8-19

20. Circular Movements: Rotation,
Pronation and Supination
• Rotation: turning of a
structure on its long axis
– Examples: rotation of the
head, humerus, entire body
– Medial and lateral rotation;
example, the rotation of the
arm
• Pronation/Supination:
refer to unique rotation of
the forearm
– Pronation: palm faces
posteriorly
– Supination: palm faces
anteriorly
8-20

21. 8-21
Circular Movement:
Circumduction
• Combination of
flexion, extension,
abduction,
adduction
• Appendage
describes a cone

22. 8-22
Special Movements
• Unique to only one or two joints
• Types
–Elevation and Depression
–Protraction and Retraction
–Excursion
–Opposition and Reposition
–Inversion and Eversion

23. Elevation and Depression
• Elevation: moves a
structure superior
• Depression: moves
a structure inferior
• Examples:
shrugging the
shoulders, opening
and closing the
mouth
8-23

24. Protraction and Retraction
8-24
• Protraction:
gliding motion
anteriorly
• Retraction: moves
structure back to
anatomic position or
even further
posteriorly
• Examples: scapulae
and mandibles

25. 8-25
Excursion
• Lateral: moving
mandible to the right or
left of midline
• Medial: return the
mandible to the midline

26. Opposition and Reposition
• Opposition:
movement of thumb
and little finger
toward each other
• Reposition: return
to anatomical
position
8-26

27. Inversion and Eversion
8-27
• Inversion: turning
the ankle so the
plantar surface of
foot faces medially
• Eversion: turning
the ankle so the
plantar surface of
foot faces laterally

28. Movements at Synovial joints
• Monoaxial: occurring around one axis
• Biaxial: occurring around two axes at
right angles to each other
• Multiaxial: occurring around several
axes
• See Table 8.2 in text
8-28

29. 8-29
Types of Synovial Joints:
Plane Joints
• Plane or gliding joints
– Monaxial. One flat bone
surface glides or slips over
another similar surface
– Sometimes considered an
amphiarthrosis
– Examples: intervertebral,
intercarpal, intertarsal
acromioclavicular,
carpometacarpal,
tarsometatarsal,

30. Hinge and Pivot Joints
• Hinge joints
– Monaxial
– Convex cylinder in one
bone; corresponding
concavity in the other
– Example: elbow, ankle,
interphalangeal
• Pivot joints
– Monaxial. Rotation around
a single axis.
– Cylindrical bony process
rotating within a circle of
bone and ligament
– Example: articulation
between dens of axis and
atlas (atlantoaxial),
proximal radioulnar
8-30

31. Saddle joints
• Each articular surface is
shaped like a saddle;
• Trapeziometacarpal joint
at base of the thumb
8-31
Types of Synovial Joints:

32. Ball-and-Socket and Ellipsoid
8-32
Joints
• Ball-and-socket
– Smooth heispherical head fits
within a cuplike depression
– Multiaxial
– Examples: shoulder and hip joints
• Condyloid (ellipsoid) joint
– Oval convex surface on one bone
fits into a similarly shaped
depression on the next
• Atlantooccipital joint (C1-C2)
• Metacarpophalangeal joints

33. 8-33
Shoulder
(Glenohumeral)
Joint
• Most freely moveable joint in body
– Shallowness and looseness
– Stability is reduced
– Deepened by glenoid labrum, a rim of
cartilage built up around glenoid cavity
• Supported by rotator cuff musculature
– tendons fuse to joint capsule
– Stabilize and strengthen it
– supraspinatus, infraspinatus, teres
minor and subscapularis,
• Bursae: subacromial and subscapular
• Tendon of biceps brachii passes
through the joint capsule
• Flexion/extension,
abduction/adduction, rotation,
circumduction

34. Tendons of Rotator Cuff
8-34
Muscles

35. 8-35
The Knee Joint
• Most complex diarthrosis
– patellofemoral = gliding joint
– tibiofemoral = gliding with slight
rotation and gliding possible in
flexed position
• Joint capsule anteriorly consists
of patella and extensions of
quadriceps femoris tendon
• Capsule strengthened by
extracapsular and intracapsular
ligaments

36. 8-36
Knee, cont.
• Cruciate ligaments:
extend between
intercondylar eminence
of tibia and fossa of the
femur
– Anterior cruciate
ligament (ACL). Prevents
anterior displacement of
tibia
– Posterior cruciate
ligament (PCL). Prevents
posterior displacement of
tibia
• Collateral and
popliteal ligaments:
along with tendons of
thigh muscles strengthen
the joint
•

37. Knee Joint – Anterior and
8-37
Posterior Views
• Anterior and lateral cruciate ligaments limit anterior and
posterior sliding movements
• Medial and lateral collateral ligaments prevent rotation of
extended knee

38. Knee Joint – Superior View
• Medial and lateral meniscus absorb shock and shape
joint
8-38

39. Knee Injuries and Disorders
• Football injuries: often tear
the tibial collateral
ligament, the anterior
cruciate ligament, and
damage the medial
meniscus
• Bursitis
• Chondromalacia:
softening of cartilage due to
abnormal movement of the
patella or to accumulation
of fluid in fat pad posterior
to patella
• Hemarthrosis: acute
accumulation of blood in
joint
8-39

40. Effects of Aging on Joints
• Tissue repair slows; rate of new blood vessel
development decreases
• Articular cartilages wear down and matrix
becomes more rigid
• Production of synovial fluid declines
• Ligaments and tendons become shorter and
less flexible: decrease in range of motion
(ROM)
• Muscles around joints weaken
• A decrease in activity causes less flexibility
and decreased ROM
8-40

41. 8-41
Sprains
• The ligaments reinforcing a joint are
stretched or torn
• Partially torn ligaments slowly repair
themselves
• Completely torn ligaments require
prompt surgical repair

42. 8-42
Cartilage Injuries
• The snap and pop of overstressed
cartilage
• Common aerobics injury
• Repaired with arthroscopic surgery

43. 8-43
Dislocations
• Occur when bones are forced out of
alignment
• Usually accompanied by sprains,
inflammation, and joint immobilization
• Caused by serious falls and are common
sports injuries
• Subluxation – partial dislocation of a
joint

44. 8-44
Inflammatory and
Degenerative Conditions
• Bursitis
– An inflammation of a bursa, usually caused by a
blow or friction
– Symptoms are pain and swelling
– Treated with anti-inflammatory drugs; excessive
fluid may be aspirated
• Tendonitis
– Inflammation of tendon sheaths typically caused
by overuse
– Symptoms and treatment are similar to bursitis

45. 8-45
Arthritis
• More than 100 different types of
inflammatory or degenerative diseases that
damage the joints
• Most widespread crippling disease in the U.S.
• Symptoms – pain, stiffness, and swelling of a
joint
• Acute forms are caused by bacteria and are
treated with antibiotics
• Chronic forms include osteoarthritis,
rheumatoid arthritis, and gouty arthritis

46. 8-46
Osteoarthritis (OA)
• Most common chronic arthritis; often
called “wear-and-tear” arthritis
• Affects women more than men
• 85% of all Americans develop OA
• More prevalent in the aged, and is
probably related to the normal aging
process

47. Osteoarthritis: Course
• OA reflects the years of abrasion and
compression causing increased production of
metalloproteinase enzymes that break down
cartilage
• As one ages, cartilage is destroyed more
quickly than it is replaced
• The exposed bone ends thicken, enlarge, form
bone spurs, and restrict movement
• Joints most affected are the cervical and
lumbar spine, fingers, knuckles, knees, and
hips
8-47

48. Rheumatoid Arthritis (RA)
• Chronic, inflammatory, autoimmune disease
of unknown cause, with an insidious onset
• Usually arises between the ages of 40 to 50,
but may occur at any age
• Signs and symptoms include joint tenderness,
anemia, osteoporosis, muscle atrophy, and
cardiovascular problems
– The course of RA is marked with exacerbations
and remissions
8-48

49. Rheumatoid Arthritis: Course
• RA begins with synovitis of the affected joint
• Inflammatory chemicals are inappropriately released
• Inflammatory blood cells migrate to the joint, causing
swelling
• Inflamed synovial membrane thickens into a pannus
• Pannus erodes cartilage, scar tissue forms,
articulating bone ends connect
• The end result, ankylosis, produces bent, deformed
fingers
8-49

50. Rheumatoid Arthritis
8-50

51. Rheumatoid Arthritis:
8-51
Treatment
• Conservative therapy – aspirin, long-term
use of antibiotics, and physical
therapy
• Progressive treatment – anti-inflammatory
drugs or
immunosuppressants

52. 8-52
Gouty Arthritis
• Deposition of uric acid crystals in joints and
soft tissues, followed by an inflammation
response
• Typically, gouty arthritis affects the joint at
the base of the great toe
• In untreated gouty arthritis, the bone ends
fuse and immobilize the joint
• Treatment – colchicine, nonsteroidal anti-inflammatory
drugs, and glucocorticoids