joints

Question 1

3 types of joints

Answer 1

• fibrous
• cartilaginous
• synovial

Question 2

menisci in knee

Answer 2

• medial and lateral
• fibrocartilaginous structures on the tibial articular surfaces
• broaden area of articulation and distribute weight, increase stability and act as shock absorbers
• attached at both ends to intercondylar area of tibia
• lateral is smaller
• medial is connected to tibial collateral ligament
• transverse ligament: medial meniscus to lateral: keeps in place during extension
• meniscofemoral ligaments: lateral meniscus to the medial femoral condyle

Question 3

bursae of knee joint

Answer 3

• suprapatellar: above knee
• prepatellar: in front of knee
• deep and superficial infrapatella - below knee
• semimembranous: behind knee

Question 4

bursae in shoulder joint

Answer 4

• subscapular
• subacromial
• subdeltoid

Question 5

6 types of synovial joints

Answer 5

• ball and socket: shoulder
• plane: carpals
• hinge: elbow
• pivot : atlas and axis
• condylar: wrist
• saddle : thumb

Question 6

antlanto-occipital joint

Answer 6

• occipital condyles on occipital bone and superior articular facets of atlas
• pair of condylar joints
• movements: flexion, extension, limited lateral flexion
• ligaments: Posterior atlantooccipital ligament, anterior atlantooccipital ligament

Question 7

atlas-axis joint

Answer 7

• 2 lateral plane joints between articular facets
• 1 median pivot joint between dens and anterior arch of atlas
• ligaments:
• apical ligament:from apex of dens to occipital foramen
• alar ligament:lateral from dens to occipital foramen
• cruciate ligament: contains joint: superior+inferior longitudinal band, trasverse ligament of atlas
• tectorial membrane

Question 8

costo-vertebral joints and costo-transverse joints

Answer 8

• heads of ribs articulate with vertebral bodies
• ribs heads withe facets on bodies of two close thoracic vertebrae
• synovial plane joints
• 1,11,12 articulate with a single vertebra
• tubercle with transverse processes
• facet of a costal tubercle articulates with the transverse process of its corresponding vertebra by a plane joint
• ribs 11 and 12 lack this articulation

Question 9

intervertebral joints

Answer 9

• joints between vertebral bodies
• symphysis
• fibrocartilaginous intervertebral discs with an outer anulus fibrosus and inner nucleus pulposus
• facet (zygapophyseal) joints: between vertebral articular processes are plane joints: only synovial joints in the spine, with hyaline cartilage: plane synovial joints between the superior and inferior articular processes

Question 10

sacroiliac joint

Answer 10

• between ilium of pelvis and sacrum: irregular surfaces lined with hyaline cartilage
• a plane joint with a synovial membrane and an articular disc
• weight bearing joints to transfer forces from lower limb to vertebral column, small gliding and rotational movements
• During pregnancy, the ligaments of the sacroiliac joint become slightly lax : movement within the joint in childbirth
• anterior sacroiliac ligament:From the anterior surface of the sacrum to the medial side of ilium
• posterior sacroiliac ligament: From the posterior surface of the sacrum to the lateral side of ilium
• interosseous sacroiliac ligament: From the posterior surface of the sacrum to the iliac tuberosity
• Iliolumbar ligament: From the transverse process of L4 and L5 to the anterior sacroiliac ligament
• Sacrotuberous ligament: From the lateral border of sacrum and coccyx to the ischial tuberosity
• Sacrospinous ligament: From the lateral margins of the sacrum and coccyx to the ischial spine

Question 11

acromioclavicular joint

Answer 11

1. Bones: scapula and clavicle
2. Articular facets: Oval facet on medial surface of the acromion of scapula and facet on flat acromial end of clavicle
3. Type of joint: synovial plane joint
4. Movements: sliding movements to change the wideness of the angle between scapula and clavicle
5. Ligaments: small acromioclavicular ligament, large coracoclavicular ligament (trapezoid + conoid)

Question 12

sternoclavicular joint

Answer 12

1. Bones: clavicle + sternum
2. Articular facets: proximal end of clavicle, clavicular notch of manubrium, small part of first costal cartilage
3. Type of joint: synovial saddle joint
4. Movements: elevation, depression, protraction, retraction, some rotation
5. Ligaments: anterior and posterior sternoclavicular ligaments, interclavicular ligament, costoclavicular ligament

Question 13

glenohumeral joint

Answer 13

1. Bones: humerus + scapula
2. Articular facets: large spherical head of humerus + smaller glenoid cavity of scapula
3. Type of joint: synovial ball and socket
4. Movements: adduction, abduction, flexion,extension, internal rotation, external rotation, circumduction
   - allows for scapular protraction, retraction, elevation, and depression
5. Ligaments: glenohumeral (superior,inferior,medialis), coracohumeral, coracoacromial
   - tendon of biceps femoris in bicipital groove: transverse ligament bridges groove
   - rotator cuff: supraspinatus, infraspinatus, subscapularis, teres minor
   - glenoid labrum: fibrocartilaginous complex that attaches as a rim to the articular cartilage of the glenoid fossa

Question 14

proximal and distal radioulnar joint

Answer 14

1. Bones: radius + ulna
2. Articular facets: proximal: head of radius with radial notch of ulna, distal: head of ulna with ulnar notch of radius
3. Type of joint:
4. Movements: pronation and supination of forearm: rotation of radius at elbow moves distal end over ulna as ulnar notch of radius slides anteriorly over convex head of ulna, while head spins on capitulum
5. Ligaments: anular ligament of radius
   - Fibrous disk separates from wrist joint
   - Interosseous membrane: fibrous sheet (collagen fibres) connecting medial border of radius and lateral border of ulna. Oblique cord: free upper margin inferior to radial tuberosity

Question 15

elbow joint: humeroulnar, humeroradial, proximal radioulnar

Answer 15

1. Bones: humerus, radius, ulna
2. Articular facets: trochlear notch of ulna with trochlea of humerus, head of radius with capitulum of humerus: principle articulation + head of radius with radial notch of ulna
   - Radius slides into radial fossa and ulna into coronoid at flexion
   - compound joint sharing capsule and membrane
   - hyaline cartilage
3. Type of joint:
   - humeroulnar: hinge joint
   - humeroradial: condylar
   - PRU: pivot
4. Movements: flexion + extension,
5. Ligaments: anular ligament of radius, radial and ulnar collateral ligament, quadrate ligament: from inferior border of the radial notch on the ulna and to the neck of the radius

Question 16

wrist joint

Answer 16

1. Bones: radius + ulna + scaphoid, lunate, triquetrum
2. Articular facets: distal end of radius, articular disc over end of ulna, + carpal articular surfaces form convex shape
3. Type of joint: synovial condylar
4. Movements: hand adduction, abduction, flexion, extension: greater degree of adduction as radial styloid process extends further
5. Ligaments:
   - radial collateral: styloid process to scaphoid
   - ulnar radiocarpal from styloid process to pisiform and triquietrum
   - palmar radiocarpal: capitate, lunate
   - dorsal radiocarpal ligament to triquetrum

Question 17

carpal joints

Answer 17

1. Bones: carpal bones
   - plane joints between bones of proximal row
   - plane between bones of distal row
   - lateral midcarpal plane joint between scaphoid, trapezium and trapezoid
   - medial condylar midcarpal joint between scaphoid, lunate and triquetrum to form concave part wit capitate and hamate forming condyle
2. Movements: limited movements but contribute to positioning of hand especially during extension
3. Ligaments:

Question 18

carpometacarpal joints

Answer 18

1. Bones: 5 metacarpals + related distal row of carpal bones
2. Type of joint: plane except base of thumb: saddle
3. Movements: 1: trapezium + MC 1: flexion, extension, abduction, adduction, rotation, circumduction, MC2-4: limited gliding movements increasing medially

Question 19

joints between C2-S1

Answer 19

• cartilaginous joints between bodies: symphyses
• synovial joints between articular processes (plane)

Question 19

ligaments of vertebral column

Answer 19

• anterior longitudinal ligament: strong band along anterior surfaces of vertebral bodies from basilar part of occipital bone to front of sacrum
• posterior longitudinal ligament: on posterior surfaces of vertebral bodies inside the canal: from C2 to sacrum
• interspinous: connect consecutive spinous process
• intertransverse ligaments: between adjacent transverse processes
• ligamenta flava: laminae of adjacent vertebrae: yellow elastic tissue
• supraspinous ligament:connects tips of spinous processes from C7-L3/4: thicker from occipital to C7: ligamentum nuchae

Question 20

finger joints

Answer 20

• intermetacarpal joints: plane
• metacarpophalangeal joints: condylar
• interphalangeal: hinge

Question 21

pubic symphysis

Answer 21

• fibrocartilaginous disc between pubic bones
• withstand pressure and compressive forces
• superior pubic ligament: connects bones above from tubercles
• arcuate pubic ligament: connects lower borders of the symphysial pubic surfaces

Question 22

hip joint

Answer 22

• head of femur with lunate surface of the acetabulum of pelvic bone
• synovial ball and socket, multiaxial
• Flexion, extension, abduction, adduction, external rotation, internal rotation and circumduction
• abduction of pelvis on fixed femur
• Capsular:
• iliofemoral: from between AIIS to intertrochanteric line
• pubofemoral: from medially to iliopubic eminence to iliofemoral
• ischiofemoral: from posteroinferior to the acetabulum to the greater trochanter
• Intracapsular: transverse acetabular(completes acetabular notch), ligamentum teres

Question 23

knee joint

Answer 23

• femur, tibia, patella
• Extension, flexion, rotation but limited by cruciate ligaments
• medial and lateral tibial articular surfaces + corresponding femoral condyles
• synovial hinge joint: flexion and extension
• lack of of congruency: 2 meniscus to increase congruency (concavity)
• hyaline cartilage with small articular cavity filled with synovial fluid enclosed by synovial membrane
  patellofemoral:
• patella in quads tendon with oval articular surface on posterior aspect divided by vertical ridge sitting on intercondylar groove on anterior distal femur, each articulates with femoral condyles
• gliding plane joint
• diff degrees of contact: most at flexion
• thick hyaline cartilage
• aids extension: increases angle at which quads tendon acts on knee: mechanical advantage

Question 24

capsule of knee joint

Answer 24

posteriorly: - art. margins on femoral condyles and intercondylar fossa proximally and tibial condyles distally: - covers whole posterior aspect - blends with oblique and arcuate popliteal ligaments - small opening at posterior lateral tibial condyle for popliteus muscle tendon anteriorly - formed by quads tendon, patella, patellar ligament and patellar retinacula - retinacula: formed by vastus medialis and lateralis expansions overlying deep fascia

Question 25

anterior extracapsular ligaments of knee

Answer 25

- patellar ligament: continuation of quads tendon from apex of patella to tibial tuberosity joined by retinacula - fibular collateral: from lateral epicondyle of femur to the fibular head limits excessive sideways movement - tibial collateral: from medial epicondyle of femur to proximal medial tibial surface: continuous with capsule

Question 26

posterior extracapsular ligaments of knee

Answer 26

oblique popliteal: - expansion of semimembranosus tendon inserting into into lateral femoral condyle - blends with posterior capsule - additional support arcuate popliteal - arises from fibular head as single band then goes 2 separate ways - medial part passes over popliteus tendon and bends with post capsule - lateral part passes superiorly over knee and inserts into capsule at lateral femoral condyle

Question 27

intracapsular ligaments of knee

Answer 27

- anterior and posterior cruciate cross over - prevent femur and tibia from dislocation - in capsule but not membrane - internal rotation: wrap around each other -external rotation: two parallel bands anterior: - anterior intercondylar area of tibia to lateral femoral condyle - under tension when knee extended: prevents hyperextenison posterior: - posterior intercondylar area of tibia to medial femoral condyle - under tension when knee is flexed: prevents hyperflexion

Question 28

ankle: talocrural joint

Answer 28

- talus + tibia + fibula - medial malleolus of tibia and lateral malleolus of fibula, trochlea of talus and medial and lateral malleolar facets of talus - synovial hinge joint - movements: dorsiflexion and plantarflexion ligaments: - medial collateral (deltoid): posterior and anterior tibiotalar, posterior tibiocalcaneal, anterior tibionavicular - lateral collateral: from lateral malleolus: 3 branches: posterior and anterior talofibular, calcaneofibular

Question 29

joints in toes

Answer 29

- tarsometatarsal -plane - metatarsophalangeal - condylar? - interphalangeal - hinge - sesamoid bones at metatarsophalangeal joint of hallux to protect tendon of flexor hallucis longus/brevis from weight

Question 30

subtalar joint

Answer 30

- posterior calconeal surface + posterior talar surface - synovial plane joint - inversion and eversion - ligaments: Lateral, medial and posterior talocalcaneal ligaments, Interosseous talocalcaneal ligament

Question 31

transverse tarsal joint

Answer 31

talocalcaneonavicular joint: - synovial ball and socket - concave surface of posterior navicular with anterior articular surface of calcaneus + upper surface of calcaneonavicular ligament - convex head of plantar surface of neck of talus (rounded head) - gliding movements and some rotation - ligaments: Interosseous talocalcaneal ligament, Talonavicular ligament, Plantar calcaneonavicular ligament, Bifurcate ligament (calcaneonavicular part) calcaneocuboid - saddle joint - anterior calconeal surface and posterior cuboidal surface ligaments: Long and short plantar ligaments, Bifurcate ligament, (calcaneocuboid part) - least mobile: single rotation+some translation