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Joints
Aditya.D
OBJECTIVES
•Definition of Joint and functions of joints
•Classification of Joints
•General Structure of a Synovial Joint
•Types of Synovial Joints
•Types of Joint Movements
•Diseases of joints
INTRODUCTION
Joint - Joints are the regions of the skeleton where two or more bones
meet and articulate
Junctions are supported by a variety of soft tissue structures
Arthrology???
Prime functions
1. Facilitate growth
2. Transmit forces between bones – movements & weight transfer
• Def. ar·tic·u·la·tion
1 : the action or manner in which the parts come together at a
joint
• a joint between bones or cartilages that is
immovable/synarthrotic, bones are directly united
• slightly movable/amphiarthrotic when they are united by
an intervening substance, or
• more or less freely movable/diarthrotic when the
articular surfaces are covered with smooth cartilage and
surrounded by an articular capsule that holds the synovial fluid
http://www.nlm.nih.gov/medlineplus/mplusdictionary.html
Classifications of joints
• Simplest classifications of joints are
a) Nature of the intervening soft tissues
b) Range of movement
c) Based on no. of articulating bone
FIBROUS JOINTS
• Lack intervening cartilage
• Articulation - Fixed
• Movements - very restricted
1.Suture
2.Gomphosis
3.Syndesmosis
* schindylesis
Sutures
• Restricted to the skull
• On completion of growth
Synostose
(synarthrotic or immovable)
Gomphosis
peg-and-socket junction between a
tooth and its Socket
Dentoalveloar joint
Syndesmosis
True fibrous connection between
bones.
Represented by an interosseous
ligament
*Schindylesis
specialized suture
ridged bone fits into a groove on a neighbouring element
e.g. cleft between the alae of the vomer receives the rostrum of the
sphenoid.
Pgi, Chandigarh -2010
CARTILAGINOUS JOINTS
•Classified as primary (synchondrosis) or
secondary (symphysis), depending upon the
nature of the intervening cartilage
•Degree of admixture
•Less rigid than the fibrous articulations and
some permit movement
• Contain either hyaline or fibrocartilage
Primary cartilaginous joints
or
Synchondrosis
Hyaline cartilage joins
-the epiphyses to the diaphysis at the epiphyseal plate of long bone
(synarthrotic joint)
-sternocostal joint, Ex: Articulation between the first rib and the
manubrium of the sternum
Secondary cartilaginous joints
or
Symphyses
• Presence of a disc of fibrocartilage interposed between the articular
hyaline cartilage that covers the ends of two bones
General Synovial Joint Structure
• Articular cartilage: thin layer of hyaline cartilage lining the
ends of the epiphyses.
• Joint capsule: two layer capsule, outer layer is dense regular
connective tissue.
• Synovial membrane: Inner layer of the joint capsule, vascular
loose connective tissue.
• Ligaments: collagenous fibers of dense regular connective
tissue that reinforce the joint capsule.
• Synovial cavity: closed sac surrounded by the synovial
membrane.
• Synovial fluid: clear, viscous fluid that moistens and lubricates
articular surfaces.
• Menisci: fibrocartilage located between articular surfaces.
• Bursae: fluid-filled sacs between the skin and underlying bony
prominences.
Sprain - ligament
Strain - tendon
Classification of Synovial Joints
• Uni-axial
Hinge joint - resemble hinges
movements - one plane
e.g. – interphalangeal
humero-ulnar joints
talocrural joint
Pivot joint - rotation around a central axis
e.g. - atlas rotates around the dens of the axis
(Median Atlanto-axial)
Superior Radio-ulnar Jt.
Bicondylar joint
main movement in one plane
limited rotation about a second axis
named as bicondylar as they are formed of two convex condyles which
articulate with concave or flat surfaces
e.g. knee joint
Bi-axial
Saddle joint –
1. concavoconvex surfaces
2. convexity of the larger surface is apposed to the concavity of the
smaller surface and vice versa
3. Primary movements occur in two planes
4. articular shape causes axial rotation of the moving bone
e.g. Carpometacarpal joint of the thumb
Calcaneo-cuboid Joint
Sterno-clavicular Joint
Incudo malleolar Joint
Ellipsoid joints
Oval, convex surface apposed to an elliptical concavity
Primary movements occur around two axes
Combined as circumduction
e.g. metacarpophalangeal joints
metatarsophalangeal joints
radiocarpal joint
atlanto-occipital joint
Multi-axial
Ball and socket joints
Globoid head into an opposing cup
e.g. Hip and shoulder joints
Incudo-stapedial Joint
UNCLASSIFIED
Plane joints or Gliding joints
appositions of almost flat surfaces
movements are considered to be pure sliding
e.g. Intercarpal & Intertarsal
Intermetacarpal
Intermetatarsal
Zygapophyseal
3. Based on no. of articulating bone
I Simple joint: only 2 bones take part in formation of a
joint.
II Compound joint: > 2 bones take part in formation of a
joint.
III Complex joint: joint cavity is divided into 2 by the intra-
articular disc or meniscus, eg. TM joint, knee joint.
BLOOD SUPPLY
Periarticular arterial plexuses– circulus articularis vasculosus
Articular cartilage: avascular
Fibrous capsule & ligaments: poor blood supply
Synovial membrane: rich blood supply
HILTON’S LAW
The nerves supplying the joint capsule also supply the
muscles regulating the movement of the jt & skin over the
joint.
NERVE SUPPLY
Types of joint movements
Diseases of joints called as ?????
• Arthropathy
• Spondylarthropathy is any form of arthropathy of the vertebral
column.
• Reactive arthropathy is caused by an infection
• Enteropathic arthropathy is caused by colitis and related conditions.
• Crystal arthropathy (also known as crystal arthritis)
• Diabetic arthropathy
• Neuropathic arthropathy
• Includes joint conditions caused by physical trauma to joints
Inflammation of joints..????
ARTHRITIS
• Inflammation of one or more joints, synovial membrane.
• > 100 different forms of arthritis.
• Symptoms: swollen jt, tender, warm, stiffness limits the
movements.
• Main complaint: jt pain ( due to inflammation that occurs
around the jt, damage to the jt from disease, daily wear
and tear of the jt, muscle strains caused by forceful
movement)
• Most common: osteoarthritis
OSTEOARTHRITIS
• Most common form of arthritis
• Cause: mechanical stress, overweight, hereditary, developmental
deficits
• Symptoms: jt pain, tenderness, stiffness, locking and
sometimes an effusion.
• T/t : - exercise
- lifestyle modification
- analgesics
- jt replacement surgery used to improve
quality of life .
RHEUMATOID ARTHRITIS
• Is an autoimmune disease that results in a chronic, systemic
inflammatory disorder that may affect many tissues ,organs and jts.
• Women 2-3 times more affected than men.
• Onset is frequent during middle age.
• Pathology: destruction of articular cartilage and ankylosis of the
joints.
• Commonly involved parts: hands, feet and cervical spine but larger jt
can also be involved.
• Symptoms: -pain ( lasts for more than 1 hour)
-stiffness mainly occurs in the morning
-disabling & painful condition can lead to loss of function
RHEUMATOID ARTHRITIS
• T/t: - physical therapy
-nutritional therapy
-analgesia/ anti-inflammatory (NSAIDS)
-steroids
-DMARDS (disease- modifying anti -
rheumatic drugs)
JOINT REPLACEMENT SURGERY
• Is a procedure of orthopedic surgery in which the arthritic or
dysfunctional joint surface is replaced with an orthopedic prosthesis.
• Indication: severe joint pain or dysfunction, not alleviated by less-
invasive therapies.
• Most common: knee and hip replacement
Blade runner – Oscar Pistorius
Became the world record holder
of the 100- and 200-metre events
with times of 10.91 and
21.58 seconds respectively
THANK U

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Joints

  • 2. OBJECTIVES •Definition of Joint and functions of joints •Classification of Joints •General Structure of a Synovial Joint •Types of Synovial Joints •Types of Joint Movements •Diseases of joints
  • 3. INTRODUCTION Joint - Joints are the regions of the skeleton where two or more bones meet and articulate Junctions are supported by a variety of soft tissue structures Arthrology??? Prime functions 1. Facilitate growth 2. Transmit forces between bones – movements & weight transfer
  • 4. • Def. ar·tic·u·la·tion 1 : the action or manner in which the parts come together at a joint • a joint between bones or cartilages that is immovable/synarthrotic, bones are directly united • slightly movable/amphiarthrotic when they are united by an intervening substance, or • more or less freely movable/diarthrotic when the articular surfaces are covered with smooth cartilage and surrounded by an articular capsule that holds the synovial fluid http://www.nlm.nih.gov/medlineplus/mplusdictionary.html
  • 5. Classifications of joints • Simplest classifications of joints are a) Nature of the intervening soft tissues b) Range of movement c) Based on no. of articulating bone
  • 6. FIBROUS JOINTS • Lack intervening cartilage • Articulation - Fixed • Movements - very restricted 1.Suture 2.Gomphosis 3.Syndesmosis * schindylesis
  • 7. Sutures • Restricted to the skull • On completion of growth Synostose (synarthrotic or immovable)
  • 8. Gomphosis peg-and-socket junction between a tooth and its Socket Dentoalveloar joint Syndesmosis True fibrous connection between bones. Represented by an interosseous ligament
  • 9. *Schindylesis specialized suture ridged bone fits into a groove on a neighbouring element e.g. cleft between the alae of the vomer receives the rostrum of the sphenoid. Pgi, Chandigarh -2010
  • 10. CARTILAGINOUS JOINTS •Classified as primary (synchondrosis) or secondary (symphysis), depending upon the nature of the intervening cartilage •Degree of admixture •Less rigid than the fibrous articulations and some permit movement • Contain either hyaline or fibrocartilage
  • 11. Primary cartilaginous joints or Synchondrosis Hyaline cartilage joins -the epiphyses to the diaphysis at the epiphyseal plate of long bone (synarthrotic joint) -sternocostal joint, Ex: Articulation between the first rib and the manubrium of the sternum
  • 12. Secondary cartilaginous joints or Symphyses • Presence of a disc of fibrocartilage interposed between the articular hyaline cartilage that covers the ends of two bones
  • 13. General Synovial Joint Structure • Articular cartilage: thin layer of hyaline cartilage lining the ends of the epiphyses. • Joint capsule: two layer capsule, outer layer is dense regular connective tissue. • Synovial membrane: Inner layer of the joint capsule, vascular loose connective tissue. • Ligaments: collagenous fibers of dense regular connective tissue that reinforce the joint capsule. • Synovial cavity: closed sac surrounded by the synovial membrane. • Synovial fluid: clear, viscous fluid that moistens and lubricates articular surfaces. • Menisci: fibrocartilage located between articular surfaces. • Bursae: fluid-filled sacs between the skin and underlying bony prominences.
  • 15. Classification of Synovial Joints • Uni-axial Hinge joint - resemble hinges movements - one plane e.g. – interphalangeal humero-ulnar joints talocrural joint Pivot joint - rotation around a central axis e.g. - atlas rotates around the dens of the axis (Median Atlanto-axial) Superior Radio-ulnar Jt.
  • 16. Bicondylar joint main movement in one plane limited rotation about a second axis named as bicondylar as they are formed of two convex condyles which articulate with concave or flat surfaces e.g. knee joint
  • 17. Bi-axial Saddle joint – 1. concavoconvex surfaces 2. convexity of the larger surface is apposed to the concavity of the smaller surface and vice versa 3. Primary movements occur in two planes 4. articular shape causes axial rotation of the moving bone e.g. Carpometacarpal joint of the thumb Calcaneo-cuboid Joint Sterno-clavicular Joint Incudo malleolar Joint
  • 18. Ellipsoid joints Oval, convex surface apposed to an elliptical concavity Primary movements occur around two axes Combined as circumduction e.g. metacarpophalangeal joints metatarsophalangeal joints radiocarpal joint atlanto-occipital joint
  • 19. Multi-axial Ball and socket joints Globoid head into an opposing cup e.g. Hip and shoulder joints Incudo-stapedial Joint UNCLASSIFIED Plane joints or Gliding joints appositions of almost flat surfaces movements are considered to be pure sliding e.g. Intercarpal & Intertarsal Intermetacarpal Intermetatarsal Zygapophyseal
  • 20. 3. Based on no. of articulating bone I Simple joint: only 2 bones take part in formation of a joint. II Compound joint: > 2 bones take part in formation of a joint. III Complex joint: joint cavity is divided into 2 by the intra- articular disc or meniscus, eg. TM joint, knee joint.
  • 21. BLOOD SUPPLY Periarticular arterial plexuses– circulus articularis vasculosus Articular cartilage: avascular Fibrous capsule & ligaments: poor blood supply Synovial membrane: rich blood supply HILTON’S LAW The nerves supplying the joint capsule also supply the muscles regulating the movement of the jt & skin over the joint. NERVE SUPPLY
  • 22. Types of joint movements
  • 23. Diseases of joints called as ????? • Arthropathy • Spondylarthropathy is any form of arthropathy of the vertebral column. • Reactive arthropathy is caused by an infection • Enteropathic arthropathy is caused by colitis and related conditions. • Crystal arthropathy (also known as crystal arthritis) • Diabetic arthropathy • Neuropathic arthropathy • Includes joint conditions caused by physical trauma to joints
  • 25. ARTHRITIS • Inflammation of one or more joints, synovial membrane. • > 100 different forms of arthritis. • Symptoms: swollen jt, tender, warm, stiffness limits the movements. • Main complaint: jt pain ( due to inflammation that occurs around the jt, damage to the jt from disease, daily wear and tear of the jt, muscle strains caused by forceful movement) • Most common: osteoarthritis
  • 26. OSTEOARTHRITIS • Most common form of arthritis • Cause: mechanical stress, overweight, hereditary, developmental deficits • Symptoms: jt pain, tenderness, stiffness, locking and sometimes an effusion. • T/t : - exercise - lifestyle modification - analgesics - jt replacement surgery used to improve quality of life .
  • 27. RHEUMATOID ARTHRITIS • Is an autoimmune disease that results in a chronic, systemic inflammatory disorder that may affect many tissues ,organs and jts. • Women 2-3 times more affected than men. • Onset is frequent during middle age. • Pathology: destruction of articular cartilage and ankylosis of the joints. • Commonly involved parts: hands, feet and cervical spine but larger jt can also be involved. • Symptoms: -pain ( lasts for more than 1 hour) -stiffness mainly occurs in the morning -disabling & painful condition can lead to loss of function
  • 28. RHEUMATOID ARTHRITIS • T/t: - physical therapy -nutritional therapy -analgesia/ anti-inflammatory (NSAIDS) -steroids -DMARDS (disease- modifying anti - rheumatic drugs)
  • 29. JOINT REPLACEMENT SURGERY • Is a procedure of orthopedic surgery in which the arthritic or dysfunctional joint surface is replaced with an orthopedic prosthesis. • Indication: severe joint pain or dysfunction, not alleviated by less- invasive therapies. • Most common: knee and hip replacement
  • 30. Blade runner – Oscar Pistorius Became the world record holder of the 100- and 200-metre events with times of 10.91 and 21.58 seconds respectively