Joints of limbs

Bagian Anatomi FK Unsri

 Vignette ►
Content: Learning outcomes ►
Types of joint ►
Joints of the limbs ►
Shoulder joint ►
Elbowjoint ►
Radioulnar joints ►
Wrist joint ►
Hip joint ►
Knee joint ►
Ankle joint ►
Joints of the foot and toes ►
Life-Span Changes ►
 Vignette
A 61-year-old woman has a history of
– Joint pain & stiffness affecting ADL’s (Activities
of daily living)
– Increased pain with activity – decreases with rest
• What is the diagnosis and pathophysiology?
• Pathophysiology
– Degeneration of joint cartilage & bone ends
– Narrowing of joint space with formation of spurs
– Results in
• Deformity
• Pain
• Immobility
 Learning outcomes
After studying this section you should be able to:
• state the characteristics of fixed and fibrous
joints
• state the different types of synovial joints
• outline the movements possible at synovial
joints
• describe the structure and functions of a
typical synovial joint.
 TYPES OF JOINT
• There are three types of joints
• Immovable
• Partially movable
• synovial
• Immovable – edges that tightly interlock
• Partially movable – allow some flexibility
• Synovial – most movable joints
Joint Classes
Fibrous Joints
Cartilagenous Joints
Synovial Joints
• Articulating bones are
separated by a joint cavity
containing fluid
• All are freely movable
diarthroses

• Examples:
– all limb joints and most joints
of the body
Synovial Joints: Movement
The muscle attachments across a joint are:
• Origin – attachment to the immovable (or less
movable) bone
• Insertion – attachment to the movable bone
When a muscle contracts, the insertion moves
toward the origin.
Rotation
The turning of a bone around its own long axis
Examples:
• Between first two vertebrae
• Hip and shoulder joints
Special Movements
• Supination and Pronation – refer to movements
of radius around the ulna (also applied to foot
movements)
Special Movements
• Inversion and Eversion

• Protraction and
Retraction
• Special Movements
• Elevation and Depression

• Opposition
 MAIN SYNOVIAL JOINTS OF THE LIMBS

Learning outcome
After studying this section you should be able to:
• describe the structure and movements of the
following synovial joints: shoulder, elbow, wrist,
hip, knee, ankle.
 Shoulder joint
Ball-and-Socket Joint
• A spherical or hemispherical
head of one bone articulates with
a cuplike socket of another
• Multiaxial joint that is the most
movable synovial joint.
• Universal movement (in all
planes and axes, including
rotation)
• Examples:
 shoulder joint
 hip joint
Extracapsular structures consist of:
• the coracohumeral ligament, extending from the
coracoid process of the scapula to the humerus
• the glenohumeral ligaments, which blend with
and strengthen the capsule
• the transverse humeral ligament, retaining the
biceps tendon in the intertubercular groove.
The stability of the joint may be reduced if these
structures, together with the tendon of the biceps
muscle, are stretched by repeated dislocations of
the joint.
Movements
• Flexion: coracobrachialis, anterior fibres of deltoid
and pectoralis major.
• Extension: teres major, latissimus dorsi and posterior
fibres of deltoid.
• Abduction: deltoid.
• Adduction: combined action of flexors and extensors.
Circumduction: flexors, extensors, abductors and
adductors acting in series.
• Medial rotation: pectoralis major, latissimus dorsi,
teres major and anterior fibres of deltoid.
• Lateral rotation: posterior fibres of deltoid.
 Elbow joint

Elbow joint (Fig. 407A)

• This hinge joint is
formed by the trochlea
and the capitulum of the
humerus and the trochlear
notch of the ulna and the
head of the radius.
Extracapsular structures consist of
anterior, posterior, medial and lateral
strengthening ligaments.

Movements
Flexion: biceps and brachialis.
Extension: triceps.
 Proximal and distal radioulnar joints

• The proximal radioulnar joint, formed by the

rim of the head of the radius rotating in the
radial notch of the ulna, is in the same
capsule as the elbow joint. (Fig. 409A)
• The distal radioulnar joint is a pivot joint
between the distal end of the radius and the
head of the ulna.
Movements
• Pronation: pronator teres.
• Supination: supinator and biceps.
 Proximal and distal radioulnar joints

Pivot Joints
Pivot joints allow rotation around an axis. The
neck and forearms have pivot joints. In the
neck the occipital bone spins over the top of
the axis. In the forearms the radius and ulna
twist around each other.
 Wrist joint
• This is a condyloid joint between the distal
end of the radius and the proximal ends of the
scaphoid, lunate and triquetral. (Fig. 422A)
• Extracapsular structures consist of medial and
lateral ligaments and anterior and posterior
radiocarpal ligaments.
Ellipsoid Joints (condyloid joint)
Ellipsoid joints are similar to a ball and socket
joint. They allow the same type of movement
to a lesser magnitude. The wrist is an
ellipsoid joint.
Movements
• Flexion: flexor carpi radialis and the flexor
carpi ulnaris. (Fig. 423C)
• Extension: extensors carpi radialis (longus
and brevis) and the extensor carpi ulnaris.
• Abduction: flexor and extensors carpi
radialis. (Fig. 423A)
• Adduction: flexor and extensor carpi ulnaris.
(Fig. 423B)
Joints of the hands and fingers
• There are synovial joints between the carpal
bones, between the carpal and metacarpal
bones, between the metacarpal bones and
proximal phalanges and between the
phalanges.
Saddle Joints
• A saddle joint allows
movement back and forth
and up and down, but
does not allow for rotation
like a ball and socket
joint.
Gliding Joints &
Plane Joints
• In a gliding or plane
joint bones slide past
each other. Metacarpal
and metatarsal joints
are gliding joints
 Hip joint
Hip joint (Fig.
454C)
• This ball and
socket joint is
formed by the
cup-shaped
acetabulum of
the innominate
bone and the
almost spherical
head of the
femur.
 Hip joint
Hip joint (Fig. 454C)
• The cavity is deepened by the acetabular labrum, a
ring of fibrocartilage attached to the rim of the
acetabulum. This adds stability to the joint without
limiting its range of movement.
• There are three important ligaments: the iliofemoral,
ischiofemoral and pubofemoral ligaments.
Movements
• Flexion: psoas, iliacus, rectus femoris and sartorius.
Extension: gluteus maximus and the hamstrings.
• Abduction: gluteus medius and minimus, sartorius
and others.
• Adduction: adductor group.
• Lateral rotation: mainly gluteal muscles and adductor
group.
• Medial rotation: gluteus medius and minimus and
others.
 Knee joint
Knee joint (Fig. 476B)
• This is the largest and most complex joint. It
is a hinge joint formed by the condyles of the
femur, the condyles of the tibia and the
posterior surface of the patella.
 The tendon of the quadriceps femoris muscle
which also supports the patella.
 two cruciate ligaments that cross each other,
extending from the intercondylar notch of the
femur to the intercondylar eminence of the tibia.
They help to stabilise the joint.
• Semilunar cartilages or menisci are incomplete
discs of white fibrocartilage lying on top of the
articular condyles of the tibia. They are wedge-
shaped, being thicker at their outer edges.
They help to stabilise the joint by preventing
lateral displacement of the bones. (Fig. 474B)
• Bursae and pads of fat are numerous. They
prevent friction between a bone and a ligament
or tendon and between the skin and the patella.
The most important strengthening ligaments
are the medial and lateral ligaments. (Fig. 476B)
Movements
• Flexion (bending
backwards):
gastrocnemius and
hamstrings.
• Extension
(straightening):
quadriceps femoris
muscle.
 Ankle joint
Ankle joint
• This hinge joint is formed by the distal end of
the tibia and its malleolus (medial malleolus),
the distal end of the fibula (lateral malleolus)
and the talus.
• There are four important ligaments
strengthening this joint. They are the deltoid
and anterior, posterior, medial and lateral
ligaments.
Movements
• Flexion (dorsiflexion): anterior tibialis assisted
by the muscles which extend the toes.
• Extension (plantarflexion): gastrocnemius and
soleus assisted by the muscles which flex the
toes.
• The movements of inversion and eversion
occur between the tarsal bones and not at the
ankle joint.
 Joints of the foot and toes

• There are a number of synovial joints between

the tarsal bones, between the tarsal and
metatarsal bones, between the metatarsals and
proximal phalanges and between the
phalanges.
• Movements are produced by muscles in the leg
with long tendons which cross the ankle joint,
and by muscles of the foot.
• In addition to moving the joints of the foot
these muscles support the arches of the foot
and help to maintain body balance.
 Life-Span Changes
• Joint stiffness
occurs due to a
change in
collagen
structure with
age.
• Synovial joints
become
infiltrated with
fibrous material
and cartilage;
they stiffen and
loose elasticity
over a lifetime.
 Life-Span Changes (Fig. 8.22)
• Synchondroses
disappear over
time as part of
skeletal growth
and
development.
• Symphysis
joints may lose
water.
Flexibility
may decrease.
 Life-Span Changes (Fig. 8.22)
• Osteoarthritis of fingers.
Note narrowing of
interphalangeal joints
with spurring and
erosions.
 Created by:
Bagian Anatomi
FK Unsri
Palembang
Fig. 407A
Fig. 409A
Fig. 422A
Fig. 423C
Fig. 423A
Fig. 423B
Fig. 454C
Fig. 476B
Fig. 474B