Roentgen Anatomy of the Normal Bones and Joints (1970)

basic to most activity in work play and ordinary existence is movement to the structures of the body this movement is accomplished through the joints the Junctions are attachments of two or more bones or cartilages the varieties of joints throughout the body may be divided into three major types fibrous cartilaginous and sovial Joints each has specific characteristics and subtypes a fibrous joint consists of two or more bones United by fibrous tissue two subtypes are found the syn asmosis where connective tissue of the joint is a ligament or ligaments as in the Coro clavicular articulation and the suture such as the union of the large flat bones of the skull here the bone are connected by several fibrous layers the second group of joints the cartilaginous consists of three main types Highland cartilage joints involving the union of two bones by Highland cartilage and exemplified by the joint between the epiphysis and diaphysis in a long bone these are modified in later Life by replacement of Highland cartilage by bone as growth ceases the second type fibrocartilaginous joints in which the skeletal elements are united by fibrocartilage during some phase of their existence fibrocartilagenous joints include the pubic symphysis and the joints between the successive vertebral bodies finally the sovial joints which are the most numerous they are structurally complex and freely movable all sovial articulations share basic structural characteristics the contact surfaces of the bones are covered by a thin Highland cartilage and articular cavity between the bones is surrounded by a capsule of fibrous tissue this capsule in its simplest form is an envelope of fibrous tissue lined with sovial membrane the membrane has a secreting epithelium which provides the joint fluid for lubrication the capsule is reinforced externally and in some joints internally by supporting ligaments these may be free or fused completely with the capsule in some synovial joints and articulate dis or meniscus of fibrocartilage divides The Joint cavity the sovial joints are classified by the form of the contact surfaces and the types of movement there are seven types of sovial joints in a plain joint the two surfaces are flat or nearly so and slide or Glide over one another in any direction as exemplified by The chromio clavicular Joint a ball and socket joint presents a spheroid surface articulating in a saucer shaped socket as seen in the scapulo humeral joint an ellipsoidal joint is one in which an ovoid convexity fits into an ovoid concavity an example of an ellipsoidal joint is the radiocarpal joint a closely related type is the cond joint in which two processes of one bone fit into depressions in another bone the knee is a condol joint a hinge joint is a cylindrical convexity fitting into a corresponding concavity this permits action in only one plane as in the humal owner articulation a saddle joint exemplified by The carpo metacarpo Joint of the thumb has a concave convex surface fitting into a convexo concave surface of the opposing bone this allows by aial motion in a pivot joint a cylindrical head of bone is held within a ring of bone or bone and ligament movement is limited to rotation about the long axis of the cylindrical portion the proximal radio oler articulation is a typical pivot joint these then are the three basic kinds of joints in the human body and their specific subtypes e we will begin with the temporal mandibular articulation and go from there to the upper and then to the lower limb the temporal mandibular articulation is an ellipsoidal joint with mixed gliding rolling and rotary movements the hinge movement of the jaw is accompanied by a gliding Motion in opening or closing the mouth this allows tearing and cutting action the second movement is a transverse gliding action in an anterior posterior Direction here the mandible is thrust forward and drawn back again the third movement is an oblique rotary movement of grinding and chewing actions movement of the shoulder involves the clavicle and scapula as well as the humorous the acromio clavicular joint permits elevation of the Upper Limb above the horizontal this is a simple joint permitting gliding and rotation the glenohumeral or shoulder joint is one of the most symmetrical and movable of all joints a large spherical humoral head moves in a shallow concave glenoid cavity it is a ball and socket joint with mixed gliding rolling and rotary movements the head of the humorus and its loose capsule are retained in position mainly by muscles and less so by ligaments in flexion and extension the head of the humoris moves upon the center of the glenoid cavity flexion has greater motion than extension in abduction and adduction the scapula is fixed and the head of the humoris rolls and Glides within the glenoid cavity in circumduction the head describes a cone with its apex at the glenoid in rotation the head of the humorous turns medially or laterally in the glenoid in a gliding motion the next joint the elbow is a hinge joint with mixed gliding and rolling movements there are two articulations the humal oler and the humoral radial the bones involved are the distal end of the humorus and the proximal portions of the the radius and Ola flexion and extension are limited respectively by the coronoid process and the electron process and their corresponding fosi of the humoris in flexion and extension the depression of the dis- like head of the radius Glides upon the capitellum the medial margin of the head of the radius moves in a Groove between the capitellum and the Trum at the elbow is also the proximal radi oler joint here the head of the radius fits into the radial Notch of the olna to form a pivot joint the articulations of the forearm and hand are divided into two groups a proximal or radiocarpal joint and the intercarpal articulations the radiocarpal or wrist joint is lipoidal with mixed rolling and gliding movements the distal end of the radius and its articular cartilage provide a smooth smooth concave surface for articulation with the carpal bones radiocarpal joint movements are free the multiple articulations allow all angular movements including circumduction abduction and adduction are restricted by the Bony radial and Aller styloid processes and the strong ligamentous bindings the intercarpal articulations also are involved in movements of the hand there are three articulations articulations of the proximal row of carpal bones articulations of the distal row of carpal bones and midcarpal articulations of the two rows with each other the first two are lipoidal joints their bones are connected by Palmer dorsal and Inter oous ligaments The Joint between the scaffo lunate triquetrum and the distal row of carpo Bones is the The midcarpal Joint it is bound by Palmer dorsal radial collateral and oler collateral ligaments the intercarpal articulations are surrounded by a capsule with an extensive and irregular sovial membrane extending to the carpo metacarpal joint the carpo metacarpal joint of the thumb is a saddle joint combining mixed gliding rolling and rotary movements the bones are the first metacard in the trapezium they have reciprocal saddle shapes movements are controlled by the shape of the articular surfaces in flexion and extension the first metacarpal moves back and forth on a transverse axis on the trapesium in adduction and abduction it slides from side to side on the anterior posterior axis of the trapesium the metacarpo fangel joints are ellipsoidal articulation formed by the rounded heads of the metacarpal bones and the shallow cavities of the proximal fanges each is bound by a Palmer and two collateral ligaments the interanal joints are hinged with mixed gliding and rolling movements they have an articular capsule collateral ligaments and an accessory Palmer ligament movement in these joints is limited to flexion and extension on a single transverse axis in considering the lower limb we can start with the hip and then proceed to the knee ankle and joints of the foot the hip is a ball and socket joint formed by the head of the femur in the cup-shaped cavity of the acetabulum the articular capsule of the hip is strong and dense and is more extensive and stronger anteriorly and superiorly than post interiorly and inferiorly the capsule itself contains the ilal isop femoral and pubofemoral ligaments movements at the hip joint correspond to the freely movable shoulder joint there is limitation because of the more complete socket this is a triaxial joint capable of a variety of movements flexion extension abduction adduction circumduction and rotation any non-antagonistic movements can be combined the knee is a modified and complicated cular joint combining mixed gliding rolling and rotary movements it is the largest and one of the most superficial joints of the body and because of the in congruity of its bony surfaces it is one of the weakest its strength lies in the ligaments and its powerful muscles two articulations are present the patellofemoral and the tibio feral the patella is an irregularly shaped sesamoid bone contained within the tendon of the quadriceps femoris it lies outside the capsule of the knee the patellofemoral articulation is between the patella and the Condes of the femur with the knee extended the patella is anterior to the condil of the femur superior to the axis of the joint as the knee is flexed the patella moves into the groove between the condil of the femur filling This Groove and protecting the condil the tibiofemoral articulation is essentially Two Joints with the two convex Condes of the femur articulating with the two concave Condes of The Tib I because the tibial concavity is very shallow maintaining the knee joint at rest and in motion depends upon the surrounding articular capsule the ligaments and muscles also helping are two wedg shaped semicircular fibrocartilagenous menisa They are thicker laterally and posteriorly movements at the knee are flexion extension and in certain positions slight medial and lateral rotation the movements differ from a typical H joint in that the axis of motion is not fixed it shifts forward during extension and backward during flexion movement of the ankle and foot in Walking is ankle motion and motion between the tarsel metatarsals and fanges the ankle is a hinge joint formed by the distal end of the tibia the Malia the tibia and fibula and the medial and lateral facets of the taus along with its upper convex surface the ankle has an articular capsule and sovial membrane the support of the ankle is from the deltoid anterior taof fibular posterior taof fibular and calcano fibular ligaments motion is almost entirely confined to flexion and extension by the closely fitting bony structures and the very strong ligaments the taoc calcano navicular joint resembles a ball and socket joint the head of the taus fits into a socket formed by the calanus and navicular with mixed rotary and gliding motion the bones are bound by strong ligaments articular capsules and sovial membranes they allow inversion ersion abduction and adduction of the foot the taro metatarsal articulations are between the cuboid the medial intermediate and lateral Cana forms and the bases of the five metatarsal bones these are plain joints and the bones are held together by dorsal planter and Inter oous ligaments movements are limited to slight gliding of the bones the metot tarof angal articulations are ellipsoidal formed by the rounded heads of the metatarsal bones in Shallow cavities on the proximal ends of the proximal fanges these joints also have articular capsules and copal membranes and are each held together by two strong ligaments movements at the metatarsal fial articulations are flexion extension abduction and adduction together with some rotary motion interial articulations are hinges each has an articular capsule synovial membrane and platter and collateral ligaments functioning similarly to those of the interanal joints motions are confined to flexion and extension only through careful and intensive study can the student appreciate the complexities an interesting variety of movements of the human body for