Αρθρώσεις - Joints & Ligaments

8/10/2019 - Joints & Ligaments

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Joints & ligaments

1. Name: Joints of foot Tarsometatarsal joints - Metatarsophalangeal joints - Interphalangeal joints -

1) Bones that take part:

Tarsometatarsal joints- metatarsal bones medial, intermediate and lateral cuneiforms

and the cuboid bone in the foot.

Metatarsophalangeal joints metatarsal bones, phalanges Interphalangeal joints- distal phalanx, proximal phalanx

2) Articular surfaces:

Tarsometatarsal joints- The areas between the bases of the first through fifth

metatarsal bonesand their connection with the medial, intermediate and lateral

cuneiforms and the cuboid bone in the foot.


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Metatarsophalangeal joints - The joints between the heads of the metatarsal bones

and the bases of the proximal phalanges

Interphalangeal joints- The joint that joins the distal phalanx to the proximal phalanx

3) Joint capsule:

4) Ligaments

5) Mechanics:Inversion and eversion

2. Name: Tibiofibular joint (Distal)(fibrous joint of the syndesmosis type)

1) Bones that take part: Inferior ends of the tibia and fibula

2) Articular surfaces:The rough, convex, triangular articular area on the medial surface of the

inferior end of the fibulaarticulates with a facet on the inferior end of the tibia.

A small superior projection of the synovial capsule of the ankle joint extends into the

inferior part of the distal tibiofibular joint.

A strong interosseous ligament continuous superiorly with the interosseous membrane,

forms the principal connection between the tibia and fibula at this joint.

It consists of strong bands that extend from the fibular notch of the tibia to the medial

surface of the distal end of the fibula.

The strong anterior and posterior tibiofibular ligaments also strengthen the distal

tibiofibular joint anteriorly and posteriorly.

They extend from the border of the fibular notch of the tibia to the anterior and posterior

surfaces of the lateral malleolus, respectively, respectively.

The inferior, deep part of the posterior tibiofibular ligament is called the transverse

tibiofibular ligament. This strong band closes the posterior angle between the tibia and fibula.

3) Joint capsule: This is a fibrous joint of the syndesmosis type

4)

Ligaments

5) Mechanics: Slight movement of the distal tibiofibular joint occurs to accommodate the talus

during dorsiflexion of the foot at the ankle joint.


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3. Name: Tibiofibular joint (Proximal)(plane type of synovial joint)

1) Bones that take part: Head of the fibula and lateral condyle of the tibia

2) Articular surfaces:The flat, oval-to-circular facet on the head of the fibulaarticulates with a

similar facet located posterolaterally on the inferior aspect of the lateral condyle of the tibia.

3) Joint capsule:The fibrous capsule surrounds the joint and is attached to the margins of the

articular facets on the fibula and tibia.It is strengthened by the anterior and posterior ligaments of the head of the fibula. The

fibres of these ligaments run superomedially from the fibula to the tibia. The tendon of the

popliteus muscle is intimately related to the posterosuperior aspect of the proximal

tibiofibular joint.

The synovial membrane lines the fibrous capsule. The pouch of synovial membrane

passing under the tendon of the popliteus muscle, known as the popliteus bursa, sometimes

communicates with the synovial cavity of the proximal tibiofibular joint though an opening in

the superior part of the synovial capsule.

Consequently, the proximal tibiofibular joint may be indirectly in communication with thesynovial cavity of the knee joint.

4) Ligaments

5) Mechanics:Slight movement occurs at the superior tibiofibular joint during dorsiflexionof the

foot at the ankle joint.

This presses the lateral malleolus laterally and causes movement of the body and head of the

fibula. Some movement of the joint also occurs during plantarflexion of the foot.

4. Name: Talocrural JoinAnkle joint (Hinge type of synovial joint)

1)

Bones that take part: Tibia, fibula and talus bone

2) Articular surfaces:The inferior ends of the tibia and fibula form a deep socket or box-like

mortise into which the pulley-shaped trochlea of the talus fits.

The two malleoli and the inferior end of the tibia form the three-sided mortise.

The fibula has an articular facet on its lateral malleolus, which faces medially and

articulates with the facet on the lateral surface of the talus.

The tibia articulates with the talus in two places: (1) its inferior surface forms the roof of

the mortise, which is wider anteriorly than posteriorly; and (2) the lateral surface of its medial

malleolus articulates with the talus.

The talus has three articular facets, which articulate with the inferior surface of the tibia

and malleoli.

The trochlea of the talus is wider anteriorly than posteriorly and slightly concave side to side.

3) Joint capsule:The fibrous capsule is thin anteriorly and posteriorly, but it is supported one

each side by strong collateral ligaments (medial or deltoid and lateral ligaments).

It is attached superiorly to the borders of the articular surfaces of the tibia and malleoli.

It is attached inferiorly to the talus close to the superior articular surface, except

anteroinferiorly, where it is attached to the dorsum of the neck of the talus.


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4) Ligaments


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5) Mechanics:The talocrural joint is uniaxial. its main movements are dorsiflexionand

plantarflexion.

When the foot is plantarflexed, some rotation, abduction, and adductionof the ankle joint is

possible.

5. Name: Knee joint(hinge type of synovial joint)

1)

Bones that take part:Femur, tibia, and patella

2) Articular surfaces: The articular surfaces are the large curved condyles of the femur, the

flattened condyles of the tibia, and the facets of the patella.

The knee joint is relatively weak mechanically because of the configurations of its articular

surfaces. It relies on the ligaments that bind the femur to the tibia for strength.

On the superior surface of each tibial condyle, there is an articular area for the corresponding

femoral condyle.

These areas, commonly referred to as the medial and lateral tibial plateaux, are separated

from each other by a narrow, nonarticular area, which widens anteriorly and posteriorly into

anterior and posterior intercondylar areas, respectively.3) Joint capsule:The articular capsule has a synovial and a fibrous membrane separated by fatty

deposits.

Anteriorly, the synovial membrane is attached on the margin of the cartilage both on the

femur and the tibia, but on the femur, the suprapatellar bursa or recess extends the joint

space proximally.

The suprapatellar bursa is prevented from being pinched during extension by the

articularis genu muscle. Behind, the synovial membrane is attached to the margins of the two

femoral condyles which produces two extensions similar to the anterior recess. Between

these two extensions, the synovial membrane passes in front of the two cruciate ligaments at

the center of the joint, thus forming a pocket direct inward.

4) Ligaments: Patellar ligament, tendon femur quadriceps


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5) Mechanics: Flexion and extension as well as a slight medial and lateral rotationbut rotation

occurs in the flexed position.

6. Name:Hip joint (& ligaments of pelvis)(multilaxial ball and socket type of synovial joint)(+ Sacroiliac

joint)

1) Bones that take part:Femur and Hip bone

2) Articular surfaces:The globular head of the femurarticulates with the cup-like acetabulum of

the hip bone.

The wider superior part of the articular surface is the weight bearing area. Thus it is the

ilium that bears the weight.

The rim of the acetabulum is defective inferiorly at the acetabular notch, which is bridged

by the transverse acetabular ligament. The head of the femur forms about two-thirds of asphere and is covered with hyaline cartilage, except over the roughened fovea or pit, to which

the ligaments of the head of the femur is attached.

More than half of the femoral surface is contained within the acetabulum.

The articular or lunate surface of the acetabulum is horseshoe-shaped.

The acetabulum has a centrally located nonarticular fossa, which is occupied by a fatpad

that is covered with synovial membrane.

This nonarticular bone is paper thin and translucent.

3) Joint capsule: The capsule attaches to the hip bone outside the acetabular lip which thus

projects into the capsular space. On the femoral side, the distance between the head'scartilaginous rim and the capsular attachment at the base of the neck is constant, which

leaves a wider extracapsular part of the neck at the back than at the front.


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The strong but loose fibrous capsule of the hip joint permits the hip joint to have the

second largest range of movement (second only to the shoulder) and yet support the weight

of the body, arms and head.

4) Ligaments


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5) Mechanics:Lateral or external rotation, Medial or internal rotation, Extensionor retroversion,

Flexionor anteversion, Abduction, Adduction

7. Name: Temporomandibular joint(ginglymoarthrodial joint)

1) Bones that take part:Temporal bone,mandible

2) Articular surfaces:The TMJ is a ginglymoarthrodial joint, referring to its dual compartment

structure and function (ginglymo- and arthrodial).The condylearticulates with the temporal bone in the mandibular fossa. The mandibular

fossa is a concave depression in the squamous portion of the temporal bone.


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3) Joint capsule:The capsule is a fibrous membrane that surrounds the joint and incorporates

the articular eminence. It attaches to the articular eminence, the articular disc and the neck of

the mandibular condyle.

The articular disc is a fibrous extension of the capsule in between the two bones of the

joint. The disc functions as articular surfaces against both the temporal bone and the condyles

and divides the joint into two sections, as described in more detail below. It is biconcave in

structure and attaches to the condyle medially and laterally. The anterior portion of the discsplits in the vertical dimension, coincident with the insertion of the superior head of the

lateral pterygoid. The posterior portion also splits in the vertical dimension, and the area

between the split continues posteriorly and is referred to as the retrodiscal tissue. Unlike the

disc itself, this piece of connective tissue is vascular and innervated, and in some cases of

anterior disc displacement, the pain felt during movement of the mandible is due to the

condyle compressing this area against the articular surface of the temporal bone.

4) Ligaments

5) Mechanics: Normal movements of the mandible during function, such as mastication, or

chewing, are known as excursions. There are two lateral excursions (left and right) and the

forward excursion, known as protrusion. The reversal of protrusion is retrusion

8.

Name: Costovertebral joints1) Bones that take part:ribs with the bodies of the thoracic vertebrae.



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3) Joint capsule:

4) Ligaments

5) Mechanisms: Extension, flexion

9. Name: Sternoclavicular joint(synovial double-plane joint)

1) Bones that take part:sternal end of the clavicle, the upper and lateral part of the manubrium

sterni

2) Articular surfaces:The sternoclavicular articulation is a synovial double-plane joint composed

of two portions separated by an articular disc. The parts entering into its formation are the

sternal end of the clavicle, the upper and lateral part of the manubrium sterni (clavicular

notch of the manubrium sterni), and the cartilage of the first rib, visible from the outside asthe suprasternal notch

3) Joint capsule:


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4) Ligaments

5)

Mechanics:Elevation and depression, protraction and retraction, axial rotation

10.Name: Joints of hand- Carpometacarpal joint - Midcarpal joint - Metacarpophalangeal joint (Hinge

joints)

1) Bones that take part:

The MidcarpalJoint is formed by the scaphoid, lunate, and triquetralbones in the

proximal row, and the trapezium, trapezoid, capitate, and hamatebones in distal row

The carpometacarpal joints (CMC) are five joints in the wrist that articulates the distalrow of carpal bonesand the proximal bases of the five metacarpal bones

The metacarpophalangealjoints - metacarpal bones.


3) Joint capsule:


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4) Ligaments


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5) Mechanics:

Metacarpophalangeal joint- flexion, extension, adduction, abduction, and

circumduction

Carpometacarpal joint- In this articulation the movements permitted are flexion and

extensionin the plane of the palm of the hand, abduction and adductionin a plane at

right angles to the palm, circumduction, and opposition

Midcarpal joint - extension/flexion, ulnar deviation/radial deviation, andpronation/supination

11.Name: Wrist joint(condyloid type of synovial joint)

1) Bones that take part: Radius & bones of hand

2) Articular surfaces:The distal end of the radius and the articular disc of the distal radioulnar

jointarticulate with the proximal row of carpal bones. The convex surfaces formed by the

carpal bones fit into the concave surfaces of the distal end of the radius and articular disc.

3) Joint capsule:The fibrous capsule encloses the joint and is attached proximally to the distal

ends of the radius and ulna, and distally to the proximal row of carpal bones.It is strengthened by dorsal and palmar radiocarpal ligaments, which run obliquely distally

and medially from the radius.

Radial and ulnar collateral ligaments also strengthen the fibrous capsule.


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The synovial membrane lines the fibrous capsule and is attached to the margins of the

articular surfaces of the wrist joint. It presents numerous folds, especially dorsally.

4) Ligaments

5) Mechanics:Marginal movements: radial deviation (abduction, movement towards the thumb)

andulnar deviation (adduction, movement towards the little finger).

Movements in the plane of the hand: flexion(palmar flexion, tilting towards the palm) and

extension


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(dorsiflexion, tilting towards the back of the hand).

Supination and pronation

12.Name: Elbow joint(hinge type of synovial joint)

1) Bones that take part:Humerus of the upper arm, and the paired radius and ulna of the

forearm2) Articular surfaces:The trochlea and capitulum of the humerusarticulates with the trochlear

notch of the ulna and the head of the radius, respectively.

3) Joint capsule:The fibrous capsule completely encloses the joint. Its anterior and posterior

parts are thin and weak, but collateral ligaments strengthen its sides.

The fibrous capsule is attached to the proximal margins of the coronoid and radial fossae

anteriorly, but not quite to the superior limit of the olecranon fossa posteriorly.

Distally the fibrous capsule is attached to the margins of the trochlear notch, the anterior

border of the coronoid process, and the anular ligament.

4) Ligaments

5) Mechanics:The hinge-like bending and straightening of the dynamite (flexion and extension)

("joint") between the humerus and the ulna.

The complex action of turning the forearm over (pronation or supination) happens at the

articulation between the radius and the ulna (this movement also occurs at the wrist joint).

13.Name: Acromioclavicular Joint(Plane type of synovial joint)

1)

Bones that take part: Scapula & clavicle


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2) Articular surfaces: The small oval articular facet on the lateral end of the claviclearticulates

with a similar facet on the anterior part of the medial surface of the medial end of the

acromion.

Both articular surfaces are covered with fibrocartilage and slope inferomedially so that the

clavicle tends to override the acromion and project over it.

A wedge-shaped, incomplete fibrocartilaginous articular disc projects into the joint from the

superior part of the joint and partially divides the joint cavity into two parts.3) Joint capsule: The fibrous capsule enclosing the joint is attached to the margins of its articular

surfaces.

Although it is weak, it is strengthened superiorly by the acromioclavicular ligament and by

fibres from the trapezius muscle.

This ligament extends from the superior part of the lateral end of clavicle to the superior

surface of the acromion.

A synovial capsule lines the fibrous capsule.

4) Ligaments:Coracoclavicular Ligament- This ligament anchors the lateral part of the clavicle to

the coracoid process of the scapula. It is the strongest of the ligaments that binds the clavicleto the scapula.

It consists of two parts, the conoid and the trapezoid ligaments, which are directed in such a

way that they enable the clavicle to hold the scapula and upper limb laterally.

5) Mechanics:Rotation -This articulation allows the acromion to rotate on the clavicle and to

move anteriorly and posteriorly.

14.Name: Radioulnar joint (Proximal)(pivot type of synovial joint)

1) Bones that take part: Radius, ulna

2)

Articular surfaces: The radial headarticulates with the radial notch of the ulna.

3) The head of the radius is held in position by the strong anular (annular) ligament, a U-shaped

fibrous collar which is attached to the anterior and posterior margins of the radial notch.

4) Joint capsule: The fibrous capsule enclosing the joint is continuous with the fibrous capsule of

the elbow joint.

The synovial capsule, which lines the fibrous capsule, is an inferior prolongation of the

synovial capsule of the elbow joint.

The deep surface of the anular ligament is lined with synovial membrane, which continues

distally as a sacciform recess on the neck of the radius.

This arrangement allows the radius to rotate within the anular ligament without tearing

the synovial capsule.

The synovial cavities of the elbow and proximal radioulnar joints are in free

communication with each other.

5) Ligaments:

6) Mechanics:Pronation, supination

15.Name: Radioulnar joint (Distal)(pivot type of synovial joint)

1) Bones that take part: Radius, ulna

2)

Articular surfaces: The rounded side of the head of the ulnaarticulates with the ulnar notch in

the distal end of the radius.


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A fibrocartilaginous articular disc binds the ends of the ulna and radius together and is the

main uniting structure of the joint.

The base of the articular disc is attached to the medial edge of the ulnar notch of the

radius, and the apex of the disc is attached to the lateral side of the base of the styloid

process of the ulna.

The proximal surface of this triangular disc articulates with the distal aspect of the head of

the ulna.Hence, the joint cavity is L-shaped in coronal section. The articular disc separates the

cavity of the distal radioulnar joint from the cavity of the wrist joint.

3) Joint capsule: The fibrous capsule encloses the joint. It is formed by relatively weak

transverse bands that extend from the radius to the ulna across the anterior and posterior

surfaces of the joint.

The synovial membrane lines the fibrous capsule and the proximal surface of the articular

disc. The synovial capsule extends proximally a short distance between the radius and ulna as

the sacciform recess.

The redundancy of the synovial capsule accommodates the twisting of the capsule thatoccurs when the distal end of the radius travels around the relatively fixed distal end of the

ulna during pronation of the forearm.

4) Ligaments:

5) Mechanics: Pronation, supination

16.Name: Glenohumeral joint Shoulder joint (Multiaxial ball and socket type of synovial joint)

1) Bones that take part: Humerous, Scapula

2) Articular surfaces: The spheroidal head of the humerus(the ball) articulates with the shallow

glenoid fossa of the scapula(the socket).

The superior portion of the labrum blends with the tendon of the long head of the biceps

brachii muscle.

3) Joint capsule:

The capsule is attached medially to the glenoid fossa, beyond the glenoid labrum.

Superiorly, it encroaches on the root of the coracoid process so that the fibrous capsule

encloses the attachment of the long head of the biceps muscle within the joint.

Laterally the fibrous capsule is attached to the anatomical neck of the humerus.

The inferior part of the capsule is the weakest area. The capsule is lax and lies in folds

when the arm is adducted, but it becomes taut when the arm is abducted.

There are two apertures in the articular capsule. The opening between the tubercles of

the humerus is for the passage for the tendon of the long head of the biceps brachii muscle.

The other opening is situated anteriorly, inferior to the coracoid process. It allows

communication between the subscapular bursa and the synovial cavity of the joint.

The synovial membrane lines the fibrous capsule and is reflected from it onto the glenoid

labrum and the neck of the humerus, as far as the articular margin of the head.

The synovial capsule forms a tubular sheath for the tendon of the long head of the biceps

brachii muscle, where it passes into the joint cavity and lines in the intertubercular groove,

extending as far as the surgical neck of the humerus.

4) Ligaments:Superior, middle and inferior glenohumeral ligaments, Coracohumeral ligament,

Transverse humeral ligament


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5) Mechanics: Flexion, Extension, Abduction, Adduction, Lateral rotation, Medial rotation

Αρθρώσεις - Joints & Ligaments

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