JOINT VENTURES

Movement is a result of the end or ends of bones changing position in relation to one another. The union of bones is called an articulation. Many articulations are held together via a joint capsule which is turn encloses a fluid filled joint cavity. The type of movement permitted depends upon the type of joint. In this section we will look the structure and function of joints. We will also examine the types of movement that our joints allow.

Articulations
Martini, page 214, Table 8.1
The term articulation comes from a Latin infinitive meaning to join. Recall that when two bones join together they form articulations. They can do so three ways. Joints may be non-movable, slightly movable, or freely movable. Lets first examine the non-movable joints, or synarthroses. . Syn (pronounced sin) means to come together. Its not quite the same as living in sin but you get the picture. The suffix arthorsis comes from the Greek word for joint. There are a few variations on this theme. First, non-movable joints may simple line up together like pieces in a jigsaw. Our skull bones do this. Because they are locked together they essentially do not move. This type of non-movable joint is called a suture. We will study some sutures in detail we study the skull. I should note that even though we consider the sutures to be non-movable, there is excellent evidence that suggests some slight movement probably occurs. Cranio-sacral therapy, a recent development from Physcial Therapy, involves the realignment of the sutures. Still, we will continue to call the suture joints, synarthroses, at least for present.

The next type of non-movable joint is a peg-in-hole joint called a gomphosis. Our teeth are joined to our skull via gomphoses. The term is derived from another Greek word meaning a bolt or a nail. Still another synarthosis is a temporary joint called a synostosis. Here, bones join together and then fuse so that the suture joints never form. This fusion occurs in the bone of the forehead, the frontal bone, and the bones of the pelvis, the ilium, ischium and pubis. Fusion of bones occurs during development, either in the fetal stage or in childhood. The suffix -ostosis comes from the Greek word for bone . Some synarthoses result from a cartilage strip that rests between two bones. These articulations are called synchondroses. Chondros is a Greek term meaning cartilage. Our first rib joins our sternum via a synchrondrosis. Developing bone also contains a synchondrosis in the form of the epiphyseal plate. We will discuss this more when we cover bone in a future lab.

The next major type of joints are the slightly movable joints or amphiarthroses. Amphi means both sides, implying that one side doesnt have freer movement that the other. There are two types of amphiarthroses, one that involves fibrocartilage, and one that involved ligaments. Lets explore the cartilaginous amphiarthroses first. Not all cartilage is alike; there are three types of cartilage, and only two of them form joints. (hyaline cartilage and fibrocartilage). Well study these cartilages closer when we examine connective tissues. All cartilaginous amphiarthroses are formed from fibrocartilage. These specialized fibrocartilaginous joints are called symphyses (symphysis, singular). Symphyses are bound between the vertebrae and between the pubic bones. We also find a modified symphysis within ball and socket joints which we will discuss shortly.

The second type of amphiarthrosis is a syndesmosis. Here ligaments that hold bones together permit a limited movement. Examples of syndesmoses are the ligamentous connections between the tibia and fibula of the leg, and between the radius and ulna of the forearm. The final major type of joint is the freely movable joint. Most of the time when we think of joints, we think of the these, the diarthroses. The bones that move your arms, legs, fingers, wrists, jaws, etc. are diarthrosis. Im typing now thanks to my diarthroses in my hands! Di means two and indeed it does take two to tango as well as form a freely moveable joint. We will examine the various diarthroses by their structures and functions in the paragraphs to come. First, lets look at the anatomy of a generic diarthrosis, or more simply put, a synovial joint.

Anatomy of a Synovial Joint

See Martini, page 216, figure 8.1
Synovial joints are bathed in a lubricating bath of synovial fluid which fills the joint cavity. The fluid itself is produced by the interior lining of the articular capsule, which is the joints enclosure. (see figure 8.1). The interior lining is called the synovial membrane for obvious reasons. The outer lining of the articular capsule does not produce synovial fluid, but is composed of a strong fabric that holds the joint in place. This outer wall is called the fibrous joint capsule. Ligaments contribute to the strength of the joint as well and reinforce the fibrous joint capsule. In addition, tendons from skeletal muscle contribute to the integrity of the joint. You can distinguish a tendon from a ligament by remembering a ligament connects bone to bone while a tendon connects muscle to bone. The ends of bones within the joint cavity are covered with hyaline cartilage, which makes them distinct from their shafts. These bony ends are called epiphyses and their hyaline cartilage is called articular cartilage. By contrast,

the shafts, or diaphyses are coated by an external layer of connective tissue which is continuous with the articular capsule, the ligaments, and the tendons. This covering is called the periosteum. The periosteum indirectly contributes to the strength of the joint because it helps anchor the connective tissues that are directly associated with the joint. Now lets examine the function of the articular cartilage. The articular cartilages have nothing to do with the strength of the joint, but serve to provide a cushion between the epiphyses. If the articular cartilage is worn or absent, the epiphyses rub together and that hurts! It also results in a bone deformity called osteoarthritis. Articular cartilages also serve as a sponge for synovial fluid. They absorb the synovial fluid when the joints are inactive, but once activity ensues, the articular cartilages rub together forcing the stored synovial fluid into the joint cavity. It takes some time to this, which is why we are a little stiff in the morning when we rise. It seems

the older we get, the longer this takes. If you arent stiff in the morning now, you have something to look forward to. In complex joints, synovial fluid may be found in little packets outside the joint that are either free of the joint cavity or loosely attached to it. These packets are found where either tendons or ligaments rub against the periosteum or dermis of the skin. If the packet is pillow-shaped, it is called a bursa; if it resembles a hot dog bun and wraps around a tendon, it is called a synovial tendon sheath. Inflammation of either of these structures is called bursitis. Bursitis has a number causes including trauma, overuse, infection, or other diseases. Occasionally bursae develop in abnormal places due to extra localized stress. A bunion, for example, is a bursa that develops on the toe, a result of wearing pointed shoes. Such bursae are called adventitious bursae and are usually up to no good. When it comes to shoes, never substitute comfort for style!

Movement
(Martini, pages 217-220; figures 8.3-8.5)

There are four general classifications of movement: gliding, angular, rotation, and special movements. Isnt that special. In this section we will examine examples of each type of movement. We will review movement when we study musculature. The following is a brief summary of the various movements of the body. Note that for most types of movements, there is an opposite movement.

Circumduction. Moving an appendage in a circle is circumduction. Note the word circle is part of the term, circumduction. You can do this with your arm, leg, fingers and head.

Rotation
When you twist an appendage or your head from side to side, the movement is rotation. There are a few variations on this theme. Left vs. right rotation: This rotation is restricted to the head. Turning your head to the left is left rotation; turning it to the right is right rotation. No big deal. Medial vs. Lateral Rotation: Sometimes medial and lateral rotation are called internal and external rotation respectively. Turning an appendage inward is medial rotation; turning it outward is lateral rotation. Pronation vs. supination. When we lie prone, we lie face down; when we lie supine, we lie face up. Imagine the palms of your hands are your body. When you hold a bowl of soup, your palms are up. To achieve palms up, we supinate the forearm. Supination (perhaps it should be spelled, soupination) is a type of rotation. Likewise, when the palms go down, the forearm pronates, as if your were to place your hands on someones head. Pronation and supination are achieved by the movement of the radius bone over the ulna. Sometimes we refer to pronation of the foot. The foot is angled slightly outward at the talonavicular joint. Its a big Madison

Linear movements
Linear movements, or gliding movements, occur when one bone slides over another. This motion occurs in bone clusters such as the carpal and tarsal bones. Essentially, one bone glides over another.

Angular movements
Abduction vs. adduction. When appendages are drawn away from the body, or when they spread apart, the action is abduction. To abduct, means to take away. By contrast, adduction brings appendages closer to the body or closer together. (See Martini, page 219, figure 8.3). Flexion vs. Extension. When we move our bodies or limbs as to decrease an angle, it is flexion. Bending your elbow is flexion; taking a bow is flexion. When we stand tall, it is extension. Straightening your arm is extension. If we increase the angle beyond 1800, it is hyperextension. Bending backwards is hyperextension, as is tilting your head back.

Avenue term right now. The palm is the better example.

Special movements
Eversion vs. Inversion When the foot cults out laterally so that the little toe is up, the movement is eversion; when the foot curls medially so the big to is up, the movement is inversion. Dorsiflexion vs. Plantarflexion. Some anatomy students ask why movement of the foot is always considered some form of flexion. Im not sure why that is, but moving the foot toward the shin decreases the angle and pointing the foot decreases the angle between the foot and the back of the leg. I have yet to read a satisfactory definition, but we can hang our hats on my explanation for now. When one points the toes upward, imagine kicking a football, you are in dorsiflexion. When you point your toes outward, imagine a ballerina in a toe stand, you are in plantar flexion. This may also help. The back of the foot is the dorsal region or dorsum; the sole of the foot is the plantar region. Recall the anatomical regions. Perhaps that will help you distinguish between these two flexions. Protraction vs. Retraction. Thrusting a body part forward, like sticking out your tongue or sticking out your chin is protraction. Pulling the tongue back in or pulling your chin in is retraction. Elevation vs. Depression. Raising your shoulders or standing on your toes is elevation; slumping your shoulders or come down off your toes is depression.

Opposition. One of the reasons for our success as a species is that we can manipulate tools well with our hands. This is because we have an opposable thumb. By opposition, we mean the ability of the thumb to touch the fingers. It is proposed by a few rabble rousers that whales and dolphins may be more intelligent than we are, but youll never see a dolphin fixing a car or writing a letter or running for President. What a shame.

Structural Classification of Synovial Joints

(Martini, page 214,Table 8.1; page 221, figure 8.6)
We can classify the joints by both structure and movement. The two are very inter-related because like all things in anatomy, form fits function. The are six types of synovial joints: gliding joints, hinge joints, pivot joints, ellipsoidal or condylar joints, saddle joints and balland-socket joints. Each will be reviewed briefly here. Gliding joints Gliding joints are found in bony clusters or where movement is limited. Here the bones travel over one another in one plane. Carpal and tarsal bones are examples. See Martini, figure 8.6a, Hinge joints Hinge joints perform like the hinges on a door, where an appendage is allowed to flex or extend but on a single plane. The fingers, toes, elbow and knee are examples of hinge joints, the latter are complex enough to also be pivot joints, which we will discuss below. See Martini, figure 8.6b Pivot joints The pivot joint is designed for rotation. Examples include the axis bone of the neck, the elbow and the knee. Rotation is uni-planar and usually cannot exceed a 180 degree angle. See Martini, figure 8.6c. Ellipsoidal (condylar) joints The ellipsoidal joint requires both a concave and a convex surface. Flexion and extension as well as circumduction are possible. The first bones of the wrist and the metacarpophalangeal joints at the base of the fingers are examples. See Martini figure 8.6d. Saddle joints The saddle joint is an elaboration of the ellipsoidal joint, but the union between the bones is much more pronounced. The base of the joint resembles a saddle, while the distal epiphysis looks more like a wrench. They fit together offering a wide range of movement. The carpometacarpal joint of the thumb is the best example in the human body. Some argue that the sternoclavicular joint is also a saddle joint, but its movement is very limited. Lets stick with the thumb and let it go at that. See Martini, figure 8.6e. Ball-and-socket joints The most freely moveable joints are the ball-and- socket joints. They are able to achieve the entire range of movement including rotation, flexion, extension and circumduction. The upper arm and thigh bones articulating with the scapula and pelvic bones respectively are examples of ball-and-socket joints. Each are very complex joints and we will study these in more detail in future labs. See Martini, figure 8.6f.