Aristotle – “A change in the state of the soul results in a change in the state of the body and a change in the state of the body results in a change in the state of the soul.” Science



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AKA shoulder joint





  1. Synovial, diarthrodial, ball and socket, spheroid, multiaxial

  2. Components

  • head of the humerus and the glenoid fossa of the scapula, most freely moveable joint in the body. BUT: to get that kind of mobility, stability had to be sacrificed. The joint is pretected on 3 sides, but not inferiorly, therefore this is the most often dislocated joint in the body, usually inferiorly and anteriorly.

3. Ligaments

  • coracohumeral ligament - coracoid process to greater tubercle of humerus

  • superior and inferior glenohumeral ligaments - thickenings of joint capsule around the neck of the scapula to the anatomic neck of the humerus

  • transverse humeral retinaculum - retaining band of CT- from greater tubercle to lesser tubercle of humerus

( across intertubercular groove) , holds bicipital tendon in place, tendon attaches to supraglenoid tubercle.

Glenoid labrium - increases the surface area of the glenoid fossa.



4. Protected from trauma from above by:

  • acromion & coracoid process of the scapula, lateral aspect of the clavicle, BUT: no protection inferior, therefore most dislocations inferiroly.

5. Bursae

Serve to cushion and decrease friction


  • subdeltoid bursa - between deltoid m and joint capsule \ sometimes these 2

  • subacromial bursa - between acromion and joint capsule / can be just 1

6. Rotator cuff muscles - musculotendinous cuff – rotators of the shoulder, medial and lateral N 396

  • Supraspinatus m. - support from above – small lateral abductor – most commonly torn rotator cuff muscle

  • Infraspinatus m. - support from posterior – lateral rotator

  • Teres minor m. - support from posterior – lateral rotator

  • Subscapularis m. - support from anterior – medial rotator ( Dr. G’s wife tore this falling down the stairs )

The Elbow Joint N 408

AKA Humeroulnar and Humeroradial joint or

  1. Cubital joint - trochlea of humerus and trochlear notch of ulna and the capitulum of the humerus and the head of the radius ( primary between humerus and ulna)

  2. Synovial, diarthrodial, hinge, uniaxial

  3. Ligaments

  • Radial (lateral) collateral ligament – most often involved in “tennis elbow”

  • Ulnar (medial) collateral ligament

  • Anular ligament - encircles the head of the radius – provides circle for pivot joint

  • Olecranon bursa - on posterior side of elbow – if this bursa becomes inflammed, usually by trauma, it forms a hygroma.

Proximal Radioulnar Joint N 408

  • Formed by the head of the radius and the radial notch of the ulna, allows for supination and pronation

  • Synovial

  • Diarthrodial

  • Trochoid or pivot

  • Uniaxial

  • Anular Ligamentencircles head of radius and holds it tight into the radial notch


Metacarpophalangeal Joints N 427

AKA knuckle



  • Synovial, diarthrodial, biaxial

  • Condyloid – because of the shape of the surface



Interphalangeal Joints


  • Synovial, diarthrodial, uniaxial

  • Hinge

The Coxal (Hip) Joint N 454

  • Formed by the head of the femur and the acetabulum of the os coxae

  • Bears weight of the body - stable

  • Synovial, diarthrodial, spheroid, multiaxial

  • Acetabular labrum – fibrocartilage - rim

  1. Ligaments of the hip

  • Iliofemoral ligament - “Y” ligament of Bigelow - anterior

  • AIIS to intertrochanteric line, prevents hyperextension

  • Pubofemoral ligament – triangular in shape

  • pubis to intertrochanteric line, limits hyperextension and abduction

  • Ischiofemoral ligament – spiral in shape

  • ischium to greater trochanter, limits hyperextension

  • Round ligament - ligamentum teres - intrinsic ligament ( w/I joint capsule), from fovea capitis of femur to transverse acetabular ligament, bridges the gap formed by the acetabular notch

  • Transverse acetabular ligament - crosses the acetabular notch, connects joint capsule to ligamentum capitis femoris

There is a small artery, the acetabular branch of the obturator artery that goes into the head of the femur. When this little artery ruptures, it leads to avascular necrosis of the head of the femur, and a hip replacement may be necessary ( Bo Jackson ).
Tibiofemoral - Stifle Joint N 458, 476

  • Largest and most complex joint of body

  • Synovial, diarthrodial, “modified hinge”- but also biaxial ( there is some rotation )

  • Classified as a double condyloid joint, capable of flexion, extension and medial and lateral rotation

  • Hyperextension of knee - foot firmly on the ground, locking of the knee medial rotation of femur

Foot in the air like in kicking  lateral rotation of the tibia

  • Ligaments

  • Primary function ( keep femur and tibia together and aligned, allow for bending of the knee

  • control excessive knee extension

  • control abduction and adduction stresses

  • control anterior and posterior displacement of tibia on femur, so that the tibia doesn’t slide

  • control medial and lateral rotation of tibia beneath femur, so the tibia doesn’t twist off

  • give rotatory stabilization to the knee

  • Lateral and medial patellar retinacula – broad, flat band, tendinous insertion of quadriceps femoris m. Gives anterior stability. Attaches to patella and tibial tuberosity, gives anterior stability to the knee, this reinforces the joint since there is no anterior joint capsule.

  • Oblique popliteal ligament - posterior aspect of joint capsule, provides posterior stability and limits hyperextension.

  • Arcuate popliteal ligament – Extends from the head of fibula over tendon of popliteus muscle to insert to intercondylar area of tibia and lateral epicondyle of femur. Since this is on the posterior aspect of the knee, it limits hyperextension of knee.

  • Collateral Ligaments - provide medial and lateral stability N 473

  • Medial (tibial) collateral ligament – attaches to tibia

  • Lateral (fibular) collateral ligament – attaches to fibula



  • Cruciate ligaments N 476

  1. Anterior cruciate ligament ( ACL )

  • Anterior tibia to posterior medial aspect of the lateral condyle of the femur (support post. lateral)

  • Prevents anterior displacement of the tibia on the femur

  • During extension of the knee the ACL is pulled taut, PCL is lax  most ACL injuries occur when the knee is extended

  • Torn ACL = Anterior drawer sign ( flex knee  knee will slide anteriorly)

  1. Posterior cruciate ligament ( PCL )

  • Posterior tibia to lateral aspect of medial condyle of femur, prevents posterior displacement of the tibia with relationship to the femur.

  • Shorter and less oblique than ACL – more straight up and down

  • During flexion of the knee the PCL is pulled taut, the ACL is lax  most PCL injuries occur when the knee is flexed.

  • Torn PCL = Posterior drawer sign ( push tibia posteriorly )

Injuries to the ACL or PCL heal very slowly.

Bursa

  1. Popliteal bursa - between tendon of popliteus m. and lateral condyle of femur

  2. Prepatellar bursa - between patella and skin, more commonly damaged. This is why carpet layers etc. wear knee pads.

  3. Suprapatellar bursa - between quadriceps tendon and anterior femur

Menisci

  1. Medial meniscus – 2 fibrocartilaginous pads, semicircular, attached to medial collateral ligament and to semimembranosus muscle’s tendon of insertion. The anterior horn of this meniscus is the most commonly injured since it is thinner. Firm attachment.

  2. Lateral meniscus - 4/5’s of a circle, attached to posterior cruciate lig. And popliteus muscle via coronary lig. And posterior joint capsule. This meniscus is thicker, has more give, loose attachment. Its function is to distribute and absorb the weight of the femur of the tibia. The compressive forces are 5-6 times the body weight when walking. The lateral meniscus is C shaped, thick in the periphery, thin centrally, forms a cup. The horns attach to the intercondylar tubercles of the intercondylar eminence.

Talocrural (ankle) Joint ( not on tests ) N 491

  1. Synovial, diarthrodial, hinge, uniaxial – no rotation – straight hinge

  2. Ligaments

  • Deltoid

  • posterior tibiotalar ligament

  • tibiocalcaneal ligament

  • tibionavicular ligament

  • anterior tibiotalar ligament

  • Lateral collateral ligaments

  • anterior and posterior talofibular ligament

  • calcenofibular ligament

Terms Related to Joint Pathology

1. Strain - stretched or pulled tendon or ligament

  1. Sprain - hyperextension, with tearing of tendons or lig. Luxation - derangement of the articulating bones that compose a joint

  2. Subluxation - partial dislocation of a joint

  3. Bursitis - inflammation of a bursa

  4. Tendonitis - inflammation of a tendon

  5. Osteoarthritis - degenerative joint disease

  6. Rheumatoid arthritis - autoimmune disease

  7. Gouty arthritis - abnormal accumulation of uric acid




Marie Paas Page Anatomy TRI 1

4/22/2018


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