joints general anatomy of human body and

joints general anatomy of human body and

1. JOINTS (ARTICULATIONS) DR.BHARAT SARVAIYA

2. Introduction Synonyms : Arthron (G), Articulatio & Junctura (L) Definition : Joint / A rticulation – junction between two or more bones and/or cartilage -Simple -Compound Functions : Hold the skeleton together Give the skeleton mobility

3. Classification of Joints : (A) Structural Structural classification based on the material binding bones together and whether a joint cavity is present or not The three structural classifications are: (1) Fibrous (2) Cartilaginous (3) Synovial

4. (B) Functional Functional classification is based on the amount of movement allowed by the joint The three functional classes of joints are: (1) Synarthroses – immovable (2) Amphiarthroses – slightly movable (3) Diarthroses – freely movable

5. (C) Regional classification Regio nal classification is based on the position of joint in body The three functional classes of joints are: (I) Skull type – immovable (II) Vertebral type – slightly movable (III) Limb type – freely movable Fibrous = Synarthroses = Skull type Cartilaginous = Amphiarthroses = Vertebral type Synovial = Diarthroses = Limb type

6. (D) According to number of bones articulating Simple joint :- two bones articulate. 2. Compound Jont :- more then two bones articulate 3. Complex Joint :- cavity devided by articular disc

7. Structural Classification (I) Fibrous Joint – 1. Sutures Sutural ligament (sutural membrane) Skull bone margin

8. Sutural ligament (sutural membrane) Pericranium Endocranium Skull bone Plain Suture - Internasal Squamous Suture - TemporoParietal Serrate Suture – Interparietal Denticulate Suture – Lambdoid Schindylesis (Wedge & groove suture) Rostrum of sphenoid Ala of vomer

9. Plain Suture – Internasal Serrate Suture – Interparietal Squamous Suture - TemporoParietal Denticulate Suture – Lambdoid

10. 2. Syndesmoses Interosseous ligament Tibia Fibula Inferior Tibiofibular joint

11. Tibia/fibula Radius/ulna

12. 3. Gomphosis ( Peg & Socket ) Peridontal ligament (Cement material)

13. Costochondral joint (1 st -Chondro-sternal Joint) Epiphyseal Plate (Hyaline Cartilage) Epiphysis Diaphysis Rib Costal cartilage (II) Cartilaginous Joints: 1 . Primary cartilaginous joint ( Synchondroses / Hyaline cartilaginous joint) temporary Spheno-Occipital Joint

14. SYNOSTOSIS

15. 2. Secondary c artilaginous j oint ( Symphyses /fibrocartilagenous joint) permanent Pubic Symphyses Hyaline Cartilage Intervertabral joint Manubrio-Sternal Joint

16. (III) Synovial Joints:- characters Periosteum Ligament Joint cavity (contains Synovial Fluid / Synovia) Articular (Hyaline) cartilage Fibrous capsule Synovial membrane Articular capsule Watch-dog action Capsular / True Ligament Accessory Ligament (intracapsular / extracapsular)

17. Temporomandibular joint

18. Articular disc / Menisci COMPLEX JOINT

19. Synovial Joints:- Range of Motion / Degrees of freedom Nonaxial / Plane – Gliding / translation movements only Uniaxial – movement in one plane Hinge :- Pivot :-

20. PLANE SYNOVIAL JOINT

21. Biaxial – movement in two planes Condylar :- Transverse & Vertical axis Ellipsoid :- Transverse & AP Axix Multiaxial – movement in or around all three planes Saddle :- concavo-convex surface Ball & socket :-

22. Movements & Mechanism of joints

23. Flexion vs. Extension

24. Abduction vs. Adduction

25. Adjunct Conjunct

26. Rotation

27. Circumduction Cone formation

28. Subtypes of Synovial Joints Subtypes of synovial joint (according to the shape of articular surfaces ) Movement Examples Plane/Gliding Nonaxial Gliding / translations Hinge/Ginglymus Uniaxial Acromioclavicular Intercarpal Intertarsal Costovertabral Costotransvers Zygapophyeal Chondrosternal (except 1 st ) Sacroiliac Elbow Ankle Interphalangeals Flexion Extension Dorsiflexion Planterflexion

29. Subtypes of synovial joint Movement Examples Pivot/Trochoid Uniaxial Rotatory Pronation Supination -Median Atlanto-axial -Proximal & distal radioulnar Pivot/Peg Ring

30. KING PRONATES & BEGGER SUPINATES

31. Subtypes of synovial joint Movement Examples Condylar/Bicondylar Biaxial Knee Temporo- mandibular Flexion Extension Partial rotation Elevation Depression Protraction Retraction

32. Subtypes of synovial joint Movement Examples Ellipsoid Biaxial Flexion Extension Abduction Adduction Circumduction Wrist Metacarpo- phalangeal (2-5) Metatarso- phalangeal Atlanto-occipital

33. Subtypes of synovial joint Movement Examples Saddle/Sellar Multiaxial Flexion Extension Abduction Adduction Rotation Circumduction Opposition Carpo- metacarpal (1 st ) Sterno-clavicular Calcaneo-cuboid Incudo-malleolar (smallest)

34. Ball & socket/Spheroidal Multiaxial Shoulder Hip Talo-calcaneo- navicular Incudo-stapedial (smallest) Flexion Extension Abduction Adduction Rotation Circumduction Inversion Eversion Subtypes of synovial joint Movement Examples

35. Mechanism of lubrication of a synovial j oint Haversian fatty pads / Haversian glands Hyaluronic acid (Mucopolysaccharide)

36. Blood supply of synovial joints PERIARTICULAR ARTERIAL PLEXUS. CIRCULUS VASCULOSUS / CIRCULUS ARTICULARIS VASCULOSUS NOTE: Articular cartilages are avascular.

37. Nerve supply of synovial joints Hilton’s law Capsule & ligaments- rich nerve supply Synovial membrane – poor nerve supply Articular cartilage – (no nerves) is non-nervous & totally insensitive Articular nerve contain Sensory fibres ( Pain & proprioceptive ) 2. Autonomic fibres (Vasomotor or vasosensory )

38. Stability of joints MUSCLES :- IMPORTANT & INDISPENSABLE FACTOR LIGAMENTS :- PREVENT OVER MOVEMENT GUARD AGAINST SUDDEN STRESSES BONES :- FIRM TYPE JOINT HIP ,ANKLE,

39. Applied anatomy 1. Dislocation / Subluxation

40. 2. Sprain

41. i. Osteoarthritis Degenerative joint disease aging, wear & tear Articular cartilage degenerates Restricts movement Pain 3. Arthritis

42. ii. Rheumatoid Arthritis Autoimmune disorder Synovial membrane attacked Inflammation, swelling & pain Final step is fusion in joint

43. iii. Gouty Arthritis Uric crystals build up in joints—pain waste products of DNA & RNA metabolism builds up in blood deposited in cartilage causing inflammation and swelling Bones fuse

44. 4. A r throscopy Examination of Joint                                                              

45. 5. A r throplasty Hip Replacement

46. THANK YOU