Detailed Notes: A.

1 Types of Joints

Introduction

A joint (or articulation) is a site where two or more bones meet. The structure of a joint
determines its function, specifically its range of motion (ROM) and stability. There is typically an
inverse relationship between the two: the more mobile a joint, the less stable it is, and vice-versa.

Joints are classified in two main ways: Structurally (based on the material binding the bones
together and the presence/absence of a joint cavity) and Functionally (based on the degree of
movement they permit).

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I. Structural Classification

This classification is based on the anatomical characteristics of the joint.

1. Fibrous Joints (Synarthroses)

· Bones connected by: Dense, irregular connective tissue rich in collagen fibers.
· Joint Cavity: No joint cavity.
· Mobility: Generally immovable (synarthrotic).

Types:

· Sutures:
· Description: Found only in the skull. The irregular edges of the bones interlock and are bound by
a minimal amount of fibrous tissue.
· Function: Provide protection for the brain.
· Fate: Most ossify in middle age and become synostoses (bony junctions).
· Syndesmoses:
· Description: Bones are connected by a ligament, cord, or band of fibrous tissue that is longer
than that in a suture.
· Example:
· Distal Tibiofibular Joint: Connected by the interosseous ligament. Allows slight
"give" (amphiarthrotic) which is crucial for ankle motion.
· Radioulnar Interosseous Membrane: Connects the radius and ulna.
· Gomphoses:
· Description: A peg-in-socket joint. The only example is the articulation of a tooth with its
alveolar socket in the mandible and maxilla.
· Connecting Material: The periodontal ligament holds the tooth in place.
2. Cartilaginous Joints (Amphiarthroses)

· Bones connected by: Cartilage.

· Joint Cavity: No joint cavity.
· Mobility: Slightly movable (amphiarthrotic).

Types:

· Synchondroses:
· Description: A bar or plate of hyaline cartilage connects the bones.
· Examples:
· Epiphyseal (Growth) Plates in long bones of children. These are temporary and become
synostoses after growth ceases.
· Joint between the first rib and the manubrium of the sternum (costochondral joint). This is a
permanent synchondrosis.
· Symphyses:
· Description: Articulating bone surfaces are covered with a layer of hyaline cartilage, which is
fused to a pad or plate of fibrocartilage. Fibrocartilage is compressible and resilient, acting as a
shock absorber.
· Examples:
· Intervertebral Discs (between vertebral bodies).
· Pubic Symphysis (anterior connection of the hip bones).

3. Synovial Joints (Diarthroses)

· Bones connected by: The bones are not connected by tissue. They are separated by a fluid-filled
joint cavity.
· Joint Cavity: Present.
· Mobility: Freely movable (diarthrotic). This is the most common and most important type of
joint for functional movement.

Characteristics:

1. Articular Cartilage: Glassy-smooth hyaline cartilage covers the ends of the articulating bones.
It absorbs compression and reduces friction.
2. Joint (Synovial) Cavity: A potential space containing a small amount of synovial fluid.
3. Articular Capsule: A two-layered envelope enclosing the joint.
· Fibrous Capsule (outer layer): Dense irregular connective tissue, continuous with the
periosteum. It strengthens the joint.
· Synovial Membrane (inner layer): Secretes synovial fluid.
4. Synovial Fluid: A viscous, slippery fluid that occupies all free space within the joint capsule. It
functions as:
· A lubricant to reduce friction.
· A shock absorber.
· A source of nutrients for the articular cartilage.
5. Reinforcing Ligaments: Capsular (thickened parts of the fibrous capsule) or extracapsular/
intracapsular ligaments that provide stability.
6. Nerves and Blood Vessels: Nerves detect pain and proprioception (sense of joint position);
vessels supply the capsule.

Additional Structures often present:

· Articular Discs (Meniscus): Fibrocartilage pads that improve the fit of articulating bones,
stabilize the joint, and allow for better force transmission (e.g., knee menisci, TMJ disc).
· Bursae: Fluid-filled sacs that reduce friction where ligaments, muscles, skin, tendons, or bones
rub together.
· Tendon Sheaths: Elongated bursae that wrap around tendons subject to friction (e.g., in the
wrist and ankle).

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II. Functional Classification

This classification is based on the amount of movement allowed.

1. Synarthroses: Immovable joints.

· Structural examples: Most sutures, gomphoses.
2. Amphiarthroses: Slightly movable joints.
· Structural examples: Syndesmoses, symphyses.
3. Diarthroses: Freely movable joints.
· Structural example: All synovial joints.

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III. Classification of Synovial Joints by Shape

Synovial joints are further classified based on the shape of their articulating surfaces, which
determines the axes of movement (uniaxial, biaxial, multiaxial).

Joint Type Shape Axes of Movement Examples Movements

Plane (Gliding) Flat articular surfaces Nonaxial (gliding) Intercarpal & Intertarsal joints, Facet
joints of vertebrae Gliding/sliding
Hinge Cylinder (convex) fits into trough (concave) Uniaxial Elbow (humeroulnar), Knee, Ankle
(talocrural), Interphalangeal joints Flexion, Extension
Pivot Rounded end of one bone fits into a sleeve or ring of bone Uniaxial Atlantoaxial joint (C1-
C2), Proximal Radioulnar joint Rotation
Condyloid (Ellipsoid) Oval articular surface of one bone fits into a complementary depression of
another Biaxial Radiocarpal (Wrist) joint, Metacarpophalangeal (knuckle) joints Flexion/
Extension, Abduction/Adduction, Circumduction
Saddle Each articular surface has both convex and concave areas (like a saddle) Biaxial
Carpometacarpal joint of the thumb Flexion/Extension, Abduction/Adduction, Circumduction,
Opposition (unique to thumb)
Ball-and-Socket Spherical head of one bone fits into a round socket of another Multiaxial
Shoulder (Glenohumeral) joint, Hip joint Flexion/Extension, Abduction/Adduction, Rotation,
Circumduction

Mnemonic for Synovial Joints: Please Help Clumsy Students Pass Their Boards (Plane, Hinge,
Condyloid, Saddle, Pivot, Ball-and-Socket)

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Clinical Correlation:

· Osteoarthritis: A degenerative disease primarily affecting articular cartilage of synovial joints.

· Rheumatoid Arthritis: An autoimmune disease that attacks the synovial membrane, leading to
joint destruction.
· Sprains: Involve damage to the ligaments reinforcing a joint.
· Dislocation (Luxation): Occurs when bones are forced out of their normal alignment at a joint,
often damaging the articular capsule and ligaments.
· Meniscal Tear: A common knee injury involving damage to the fibrocartilage meniscus.