Chapter 9 Opener 1

Table 9-1 Functional and Structural Classifications of Articulations (Part 1 of 3) 2

Table 9-1 Functional and Structural Classifications of Articulations (Part 2 of 3)

Table 9-1 Functional and Structural Classifications of Articulations (Part 3 of 3) 4

Figure 9-1 The Structure of a Synovial Joint Medullary cavity Spongy bone Periosteum Quadriceps tendon Bursa Joint capsule Femur Patella Fibrous joint capsule Synovial membrane Articular cartilage Synovial membrane Meniscus Fat pad Articular cartilages Patellar ligament Joint cavity (containing synovial fluid) Intracapsular ligament Tibia Joint cavity Meniscus Compact bone Synovial joint, sagittal section Knee joint, sagittal section 5

Figure 9-1a The Structure of a Synovial Joint Medullary cavity Spongy bone Periosteum Fibrous joint capsule Synovial membrane Articular cartilages Joint cavity (containing synovial fluid) Compact bone Synovial joint, sagittal section 6

Figure 9-1b The Structure of a Synovial Joint Quadriceps tendon Bursa Joint capsule Femur Patella Synovial membrane Articular cartilage Meniscus Fat pad Patellar ligament Intracapsular ligament Joint cavity Tibia Meniscus Knee joint, sagittal section 7

Figure 9-2 A Simple Model of Articular Movement Initial position Gliding movement Angular movement Circumduction Rotation Initial position of the model. The pencil is at right angles to surface. Possible movement 1, showing gliding, an example of linear movement. The pencil remains vertical, but tip moves away from point of origin. Possible movement 2, showing angular movement. The pencil tip remains stationary, but shaft changes angle relative to the surface. Possible movement 2, showing a special type of angular movement called circumduction. Pencil tip remains stationary while the shaft, held at an angle less than 90º, moves in a conical pattern to complete a circle. Possible movement 3, showing rotation. With tip at same point, the angle of the shaft remains unchanged as the shaft spins around its longitudinal axis. 8

Figure 9-2a A Simple Model of Articular Movement Initial position Initial position of the model. The pencil is at right angles to surface. 9

Figure 9-2b A Simple Model of Articular Movement Gliding movement Possible movement 1, showing gliding, an example of linear movement. The pencil remains vertical, but tip moves away from point of origin. 10

Figure 9-2c A Simple Model of Articular Movement Angular movement Possible movement 2, showing angular movement. The pencil tip remains stationary, but shaft changes angle relative to the surface. 11

Figure 9-2d A Simple Model of Articular Movement Circumduction Possible movement 2, showing a special type of angular movement called circumduction. Pencil tip remains stationary while the shaft, held at an angle less than 90º, moves in a conical pattern to complete a circle. 12

Figure 9-2e A Simple Model of Articular Movement Rotation Possible movement 3, showing rotation. With tip at same point, the angle of the shaft remains unchanged as the shaft spins around its longitudinal axis. 13

Figure 9-3 Angular Movements Extension Flexion Hyperextension Abduction Flexion Abduction Flexion Hyper- extension Adduction Adduction Extension Extension Abduction Flexion Hyperextension Abduction Adduction Adduction Extension Flexion/extension Abduction/adduction Adduction Abduction Adduction/abduction Circumduction 14

Figure 9-3a Angular Movements Extension Flexion Hyperextension Flexion Flexion Hyper- extension Extension Extension Flexion Hyperextension Extension Flexion/extension 15

Figure 9-3b Angular Movements Abduction Abduction Adduction Adduction Abduction Adduction Abduction Adduction Abduction/adduction 16

Figure 9-3c Angular Movements Adduction Abduction Adduction/abduction 17

Figure 9-3d Angular Movements Circumduction 18

Figure 9-4 Rotational Movements Head rotation Right rotation Left rotation Lateral (external) rotation Medial (internal) rotation Supination Pronation Supination Pronation 19

Figure 9-4a Rotational Movements Head rotation Right rotation Left rotation Lateral (external) rotation Medial (internal) rotation 20

Figure 9-4b Rotational Movements Supination Pronation Supination Pronation 21

Figure 9-5 Special Movements Dorsiflexion (ankle flexion) Plantar flexion (ankle extension) Eversion Inversion Opposition Retraction Protraction Depression Elevation Lateral flexion 22

Figure 9-5 Synovial Joints (Part 1 of 6) Eversion Inversion 23

Figure 9-5 Synovial Joints (Part 2 of 6) Dorsiflexion (ankle flexion) Plantar flexion (ankle extension) 24

Figure 9-5 Synovial Joints (Part 3 of 6) Opposition 25

Figure 9-5 Synovial Joints (Part 4 of 6) Retraction Protraction 26

Figure 9-5 Synovial Joints (Part 5 of 6) Depression Elevation 27

Figure 9-5 Synovial Joints (Part 6 of 6) Lateral flexion 28

Figure 9-6 Synovial Joints Synovial joints are described as gliding, hinge, pivot, condylar, saddle, or ball-and-socket on the basis of the shapes of the articulating surfaces. Each type permits a different range and type of motion. Gliding joint Movement: slight nonaxial or multiaxial Clavicle Examples: • Acromioclavicular and claviculosternal joints Manubrium • Intercarpal and intertarsal joints • Vertebrocostal joints • Sacro-iliac joints Hinge joint Movement: monaxial Humerus Examples: • Elbow joint • Knee joint Ulna • Ankle joint • Interphalangeal joint Pivot joint Movement: monaxial (rotation) Examples: Atlas • Atlanto-axial joint • Proximal radio-ulnar joint Axis Condylar joint Movement: biaxial Examples: • Radiocarpal joint Scaphoid bone • Metacarpophalangeal joints 2–5 • Metatarsophalangeal joints Ulna Saddle joint Movement: biaxial Examples: III II • First carpometacarpal joint Metacarpal bone of thumb Trapezium Ball-and-socket joint Movement: triaxial Examples: Scapula • Shoulder joint • Hip joint Humerus 29

Figure 9-6 Synovial Joints (Part 1 of 6) Gliding joint Movement: slight nonaxial or multiaxial Clavicle Examples: • Acromioclavicular and claviculosternal joints Manubrium • Intercarpal and intertarsal joints • Vertebrocostal joints • Sacro-iliac joints 30

Figure 9-6 Synovial Joints (Part 2 of 6) Hinge joint Movement: monaxial Examples: Humerus • Elbow joint • Knee joint • Ankle joint Ulna • Interphalangeal joint 31

Figure 9-6 Synovial Joints (Part 3 of 6) Pivot joint Movement: monaxial (rotation) Examples: Atlas • Atlanto-axial joint • Proximal radio-ulnar joint Axis 32

Figure 9-6 Synovial Joints (Part 4 of 6) Condylar joint Movement: biaxial Examples: • Radiocarpal joint Scaphoid bone • Metacarpophalangeal joints 2–5 • Metatarsophalangeal joints Ulna 33

Figure 9-6 Synovial Joints (Part 5 of 6) Saddle joint Movement: biaxial Examples: • First carpometacarpal joint III II Metacarpal bone of thumb Trapezium 34

Figure 9-6 Synovial Joints (Part 6 of 6) Ball-and-socket joint Movement: triaxial Examples: Scapula • Shoulder joint • Hip joint Humerus 35

Figure 9-7 Intervertebral Articulations Superior articular facet Intervertebral Disc Vertebral end plate Intervertebral foramen Anulus fibrosus Ligamentum flavum Nucleus pulposus Spinal cord Posterior longitudinal ligament Spinal nerve Interspinous ligament Supraspinous ligament Anterior longitudinal ligament 36

Figure 9-8 Damage to the Intervertebral Discs Normal intervertebral disc L1 Compressed area of spinal nerve Slipped disc Spinal nerve Spinal cord Nucleus pulposus of herniated disc L2 Anulus fibrosus A lateral view of the lumbar region of the spinal column, showing a distorted intervertebral disc (a “slipped” disc) A sectional view through a herniated disc, showing the release of the nucleus pulposus and its effect on the spinal cord and adjacent spinal nerves 37

Figure 9-8a Damage to the Intervertebral Discs Normal intervertebral disc L1 Slipped disc L2 A lateral view of the lumbar region of the spinal column, showing a distorted intervertebral disc (a “slipped” disc) 38

Figure 9-8b Damage to the Intervertebral Discs Compressed area of spinal nerve Spinal nerve Spinal cord Nucleus pulposus of herniated disc Anulus fibrosus A sectional view through a herniated disc, showing the release of the nucleus pulposus and its effect on the spinal cord and adjacent spinal nerves 39

Table 9-2 Articulations of the Axial Skeleton (Part 1 of 3) 40

Table 9-2 Articulations of the Axial Skeleton (Part 2 of 3) 41

Table 9-2 Articulations of the Axial Skeleton (Part 3 of 3) 42

Figure 9-9 The Shoulder Joint Acromioclavicular ligament Clavicle Coraco-acromial ligament Coracoclavicular ligaments Acromioclavicular ligament Coracoclavicular ligaments Tendon of supraspinatus muscle Tendon of biceps brachii muscle Tendon of supraspinatus muscle Coracohumeral ligament (cut) Clavicle Acromion Coracoid process Acromion Subacromial bursa Subcoracoid bursa Articular capsule Coraco-acromial ligament Tendon of infraspinatus muscle Subscapular bursa Subdeltoid bursa Coracoid process Scapula Subscapularis muscle Synovial membrane Articular cartilages Teres minor muscle Joint cavity Glenohumeral ligaments Humerus Articular capsule Glenoid labrum Articular capsule Glenoid cavity Scapula Glenoid labrum Anterior view, frontal section Lateral view of pectoral girdle 43

Figure 9-9a The Shoulder Joint Acromioclavicular ligament Coracoclavicular ligaments Tendon of supraspinatus muscle Clavicle Acromion Articular capsule Coraco-acromial ligament Subdeltoid bursa Coracoid process Scapula Synovial membrane Articular cartilages Joint cavity Humerus Glenoid labrum Articular capsule Anterior view, frontal section 44

Figure 9-9b The Shoulder Joint Acromioclavicular ligament Clavicle Coraco-acromial ligament Coracoclavicular ligaments Tendon of supraspinatus muscle Tendon of biceps brachii muscle Coracohumeral ligament (cut) Acromion Coracoid process Subacromial bursa Subcoracoid bursa Tendon of infraspinatus muscle Subscapular bursa Subscapularis muscle Teres minor muscle Glenohumeral ligaments Articular capsule Glenoid cavity Scapula Glenoid labrum Lateral view of pectoral girdle 45

Figure 9-10 The Right Elbow Joint Showing Stabilizing Ligaments Tendon of biceps brachii muscle Annular ligament Humerus Humerus Radial collateral ligament Radial tuberosity Antebrachial interosseous membrane Articular capsule Antebrachial interosseous membrane Medial epicondyle Radius Ulnar collateral ligament Radius Ulna Ulna Olecranon of ulna Capitulum Annular ligament (covering head and neck of radius) Lateral view Medial view 46

Figure 9-10a The Right Elbow Joint Showing Stabilizing Ligaments Humerus Radial collateral ligament Radial tuberosity Antebrachial interosseous membrane Radius Ulna Capitulum Annular ligament (covering head and neck of radius) Lateral view 47

Figure 9-10b The Right Elbow Joint Showing Stabilizing Ligaments Tendon of biceps brachii muscle Annular ligament Humerus Articular capsule Antebrachial interosseous membrane Medial epicondyle Ulnar collateral ligament Radius Ulna Olecranon of ulna Medial view 48

Figure 9-11 The Right Hip Joint Iliofemoral ligament Fibrocartilage pad Acetabular labrum Ligament of the femoral head Acetabulum Transverse acetabular ligament (spanning acetabular notch) Fat pad in acetabular fossa A lateral view with the femur removed Pubofemoral ligament Iliofemoral ligament Greater trochanter Ischiofemoral ligament Iliofemoral ligament Lesser trochanter Greater trochanter An anterior view Lesser trochanter Ischial tuberosity A posterior view, showing additional ligaments that add strength to the capsule 49

Figure 9-11a The Right Hip Joint Iliofemoral ligament Fibrocartilage pad Acetabular labrum Ligament of the femoral head Acetabulum Transverse acetabular ligament (spanning acetabular notch) Fat pad in acetabular fossa A lateral view with the femur removed 50

Figure 9-11b The Right Hip Joint Pubofemoral ligament Greater trochanter Iliofemoral ligament Lesser trochanter An anterior view 51

Figure 9-11c The Right Hip Joint Iliofemoral ligament Ischiofemoral ligament Greater trochanter Lesser trochanter Ischial tuberosity A posterior view, showing addi- tional ligaments that add strength to the capsule 52

Figure 9-12 The Right Knee Joint Femur Quadriceps tendon Joint capsule Plantaris muscle Gastrocnemius muscle, medial head Gastrocnemius muscle, lateral head Patella Joint capsule Bursa Patellar retinaculae Fibular collateral ligament Tibial collateral ligament Cut tendon of biceps femoris muscle Fibular collateral ligament Patellar ligament Popliteal ligaments Popliteus muscle Tibia Fibula Tibia Anterior view, superficial layer Posterior view, superficial layer Patellar surface Femur Fibular collateral ligament Posterior cruciate ligament Fibular collateral ligament Lateral condyle Medial condyle Lateral condyle Lateral meniscus Tibial collateral ligament Lateral meniscus Cut tendon Medial meniscus Cut tendon Anterior cruciate ligament Tibia Fibula Fibula Tibia Deep anterior view, flexed Deep posterior view, extended 53

Figure 9-12ac The Right Knee Joint Patellar surface Quadriceps tendon Fibular collateral ligament Posterior cruciate ligament Patella Lateral condyle Joint capsule Patellar retinaculae Medial condyle Tibial collateral ligament Lateral meniscus Tibial collateral ligament Fibular collateral ligament Cut tendon Medial meniscus Patellar ligament Anterior cruciate ligament Tibia Fibula Tibia Anterior view, superficial layer Deep anterior view, flexed 54

Figure 9-12a The Right Knee Joint Quadriceps tendon Patella Joint capsule Patellar retinaculae Tibial collateral ligament Fibular collateral ligament Patellar ligament Tibia Anterior view, superficial layer 55

Figure 9-12bd The Right Knee Joint Femur Femur Joint capsule Plantaris muscle Gastrocnemius muscle, medial head Gastrocnemius muscle, lateral head Posterior cruciate ligament Fibular collateral ligament Bursa Fibular collateral ligament Medial condyle Lateral condyle Tibial collateral ligament Tibial collateral ligament Lateral meniscus Cut tendon of biceps femoris muscle Medial meniscus Cut tendon Popliteal ligaments Anterior cruciate ligament Popliteus muscle Tibia Fibula Fibula Tibia Posterior view, superficial layer Deep posterior view, extended 56

Figure 9-12b The Right Knee Joint Femur Joint capsule Plantaris muscle Gastrocnemius muscle, medial head Gastrocnemius muscle, lateral head Bursa Fibular collateral ligament Tibial collateral ligament Cut tendon of biceps femoris muscle Popliteal ligaments Popliteus muscle Tibia Fibula Posterior view, superficial layer 57

Figure 9-12c The Right Knee Joint Patellar surface Fibular collateral ligament Posterior cruciate ligament Lateral condyle Medial condyle Tibial collateral ligament Lateral meniscus Cut tendon Medial meniscus Anterior cruciate ligament Tibia Fibula Deep anterior view, flexed 58

Figure 9-12d The Right Knee Joint Femur Posterior cruciate ligament Fibular collateral ligament Medial condyle Lateral condyle Tibial collateral ligament Lateral meniscus Medial meniscus Cut tendon Anterior cruciate ligament Fibula Tibia Deep posterior view, extended 59

Table 9-3 Articulations of the Appendicular Skeleton (Part 1 of 2) 60

Table 9-3 Articulations of the Appendicular Skeleton (Part 2 of 2) 61

Clinical Note 9-1 Knee Injuries 62

Figure 9-13 System Integrator: The Skeletal System Body System Skeletal System Skeletal System Body System Synthesizes vitamin D3, essential for calcium and phosphorus absorption (bone maintenance and growth) Provides structural support Integumentary Page 165 The SKELETAL System The skeletal system provides structural support and protection for the body. The skeleton also stores calcium, phosphate, and other minerals necessary for many functions in other organ systems. In addition, the lipids in the yellow marrow serve as an energy reserve and blood cell production occurs in the red marrow. Muscular Page 369 Nervous Page 543 Endocrine Page 632 Cardiovascular Page 759 Lymphatic Page 807 Respiratory Page 857 Digestive Page 910 Urinary Page 992 Reproductive Page 1072 63

Review Question 9-1 Synovial Joint b c d 64