The bigger joints

Overview.

Vertebral column.The vertebrae are connected with each-other by 3 kind of connections of bones: syndesmoses, synchondroses and synovialjoints.1. Syndesmoses (ligaments):

- lig. longitudinale anterius - runs by anterior surface of the corpus vertebrae from atlas to os sacrum

- lig. longitudinale posterius - runs by posterior surface of the corpus vertebraes

- lig. supraspinale - runs by the tips of the proc. spinosuses from the 7. cervical vertebra to os sacrum

- lig. nuchae - widened part of the lig. supraspinale, extends from the 7. cervical vertebra up to osoccipitale

- ligg. interspinalia - between proc. spinosuses- ligg. intertransversaria - between proc. transversuses- ligg. flava - between arcus vertebraes

2. Sybchondroses:Discus intervertebralis - between the corpus vertebraes (in some books it is named symphysisintervertebralis!)

2 parts: - nucleus pulposus - central part from soft cartilage

- anulus fibrosus - outer part from fibrous cartilage

Functions of discus intervertebralis:1. connection of bones2. making possible movements between the bones3. making possible growth of bones4. to work as a shock- absorbers

3. Artt. intervertebrales ( also: artt. zygapophysiales).Articulating surfaces: facies articularis superiores of the lower vertebra + facies articularis inferiores of the upper vertebra

Type:.plana (left and right combined!)

Axes and movements: limited movements around all axes:

- cervical part - ante- and retroflexio, lateroflexio, rotatio

- thoracal part - lateroflexio and limited rotatio

- lumbar part - ante- and retroflexio, limited lateroflexio

1 lig. longitudinale anterius8 ligg. interspinalia

Lig. longitudinale posterius

Lig. longitudinale anterius Lig. supraspinale

Ligg. flava

7 ligamenta intertransversaria

4 disci intervertebrales5 ligg. flava

“Head joint”.I Art. atlantooccipitalis (“upper head joint, upper nuchal joint”).II Art. atlantoaxialis (“lower head joint, lower nuchaljoint”).

Art. atlantooccipitalis.Surfaces: 2 condylus occipitalis + 2 fovea articularissuperior atlantisType: art. ellipsoideaAxes and movements:

- frontal axis - ante- et retroflexio- sagital axis - lateroflexio

- circumductio - 2 axes!!

Art. atlantoaxialis.Consists of 4 part:1. art. atlantoaxialis mediana

a) pars anterior - fovea dentis (atlas) + faciesarticularis anterior (dens axis)

b) pars posterior - lig. transversum atlantis + faciesarticularis posterior (dens axis)Type: art. trochoidea2. art. atlantoaxialis lateralis ( 2 - left and right!) - faciesarticularis inferiores (atlas) + facies articularis superiores(axis)Type:art. planaArt. atlantoaxialis mediana and both art. atlantoaxialis lateralesare combined, functionally they work together as one art. trochoidea (trochoidea + 2 plana = trochoidea).Axis and movements for all art atlantoaxialis: the cardinal axis is vertical (longitudinal axis of the dens axis!) and main movement is rotatio (to left and right).

NB! Art. atlantooccipitalis (ellipsoidea) + art. atlantoaxialis(trochoidea) = art. spheroidea!Ligaments of the “head joints”:- lig. apicis dentis - from apex dentis to anterior edge of the

foramen magnum- ligg. alaria - from sides of the dens axis to lateral edges of the

foramen magnum- lig. cruciforme atlantis

- fasciculi longitudinales - from corpus axis to inner surface of the foramen magnum

- lig. transversum atlantis - between massae lateralesatlantis

- membrana tectoria - from axis to inner surface of the foramen magnum, covers all complex from inside

- membrana atlantooccipitalis anterior - from arcus anterior atlantis to anterior edge of the foramen magnum

- membrana atlantooccipitalis posterior - from arcus posterior atlantis to posterior edge of the foramen magnum

Art. sacroiliaca.Surfaces: facies auricularis ossis sacri + facies auricularisossis ilii

Type: amphiarthrosis (the biggest one in human body!)

Ligaments:- ligg. sacroiliaca dorsalia- ligg. sacroiliaca ventralia- ligg. sacroiliaca interossea – between tuberositas sacralis and

tuberositas iliaca-lig. iliolumbale – from crista iliaca to 4. ja 5. vertebra lumbalis

This joint is also strengthened by 2 independent syndesmoses:- lig. sacrospinale - from os sacrum and os coccygis to spina

ischiadica- lig. sacrotuberale – from os sacrum to tuber ischiadicum

ligg sacroiliaca anteriora

ligg sacroiliaca interossea

foramen ischiadicum majus

foramen ischiadicum minus

lacuna musculorum

lacuna vasorumlig inquinale

membrana obturatoria

lig iliolumbale

ligg sacroiliaca posteriora

1 symphysis pubica2 lig pubicum superius3 lig arcuatum pubis

11 lig sacrotuberale12 lig sacrospinale

Art. humeri.Surfaces: cavitas glenoidalis (scapula) + caput humeri

cavitas glenoidali enlarged by labrum glenoidaleTtype: spheroideaAxes and movements: - frontal axis - anteflexio - retroflexio

(anteversio - retroversio)- sagital axis - abductio - adductio- vertical axis - pronatio - supinatio

+ circumductioLigaments:- lig. coracohumerale (the biggest!) – runs from processuscoracoideus towards the tuberculum majus, blendes into capsular ligaments- capsular ligaments (lig. coracoglenoidale; lig. semicircularehumeri; ligg. glenohumerale superius, medium, inferius et spirale; lig.glenocapsulare; lig. transversum humeri)NB! Art. humeri is strengthened by tendons of the surrounding muscles), which serve as a big ligaments!

Art coxae.Surfaces: facies lunata acetabuli (os coxae), labrum acetabulare + caput femorisType: spheroideaAxes and movements: - frontal axis - anteflexio - retroflexio(anteversio - retroversio)

- sagital axis - abductio - adductio- vertikal axis - rotatio (pronatio -

supinatio)+ circumductio

Ligaments: - lig. iliofemorale- lig. pubofemorale- lig. ischiofemorale- zona orbicularis – in the capsule around the collum femoris- lig. capitis femoris – from fovea capitis femoris to fossa

acetabuli- lig. transversum acetabuli – in the incisura acetabuli

Art. cubiti.3 parts:

1. Art. humeroulnaris2. Art. humeroradialis3. Art. radioulnaris proximalis

1. Art. humeroulnaris.Surfaces: trochlea humeri + incisura trochlearis ulnaeType: ginglymus

2. Art. humeroradialisSurfaces: capitulum humeri + fovea articularis (capitis) radiiType: spheroidea (but very limited by other 2 joints!)

3. Art. radioulnaris proximalisSurfaces: circumferentia articularis radii + incisura radialisulnaeType: trochoidea

Axes and movements for all art cubiti:Art. cubiti consists of 2 functional floors:

- upper floor - art. humeroulnaris + art. humeroradialis= ginglymus- frontal axis , flexio - extensio

- lower floor - art. radioulnaris proximalis + art. humeroradialis = trochoidea- vertical axis, pronatio - supinatio

Art. cubiti as a whole: trocho-ginglymus!

Ligaments:- lig. collaterale radiale – from epicondylus lateralis humeri (as 2

branches!) to lig. anulare radii and ulna- lig. anulare radii – from anterior edge of incisura radialis ulnae

around caput (and collum) radii to posterior edge of incisura radialis ulnae

- lig. collaterale ulnare- from epicondylus medialis humeri to upper lateral side of ulna

Art. genus.

Surfaces: condylus medialis et lateralis femoris (+ meniscus medialis et lateralis) + facies articularis superior tibiae (+ patella)(In biomechanics sometimes described as independent joint “art. femoropatellaris” = facies articularis patellae + facies patellarisfemoris – art. plana)

Type, axes and movements: functionally is here 2 floors:-art. meniscofemoralis – upper floor, ginglymus –

frontal axis - flexio-extensio- art. meniscotibialis – lower floor, trochoidea – vertical

axis, rotation (very limited and possible only if the knee is flexed!)

Type of the art. genus as the whole: trocho-ginglymus

Ligaments:a) intraarticular:- lig. transversum genus- in front between the menisci- lig. cruciatum anterius- from area intercondylaris anterior to lateral wall of the fossa intercondylaris- lig. cruciatum posterius – from area intercondylaris posterior to medial wall of the fossa intercondylarisb) big capsular ligaments:- lig. collaterale tibiale – from epicondylus medialis femoris to condylus medialis tibiae- lig. collaterale fibulare – from epicondylus lateralis femoris to caput fibulae- lig. popliteum arcuatum- lig. popliteum obliquumc) extracapsular ligaments:- retinaculum patellae mediale et laterale- lig. patellae - NB! It is a part of the tendon of m. quadriceps femoris, extending from patella to tuberositas tibia!

“Art. manus” or “wrist joint” = art. radiocarpea + art. mediocarpea.

Art. radiocarpeaSurfaces: facies articularis carpea (inferior) radii + discus articularis + osscaphoideum, os lunatum et os triquetrum (NB! os pisiforme is not part of this joint!)Type: ellipsoideaAxes and movements: - frontal axis - flexio -extensio (flexio palmaris -

flexio dorsalis)- sagital axis - abductio - adductio

+ circumductioLigaments: - lig. collaterale carpi radiale- lig collaterale carpi ulnare- lig. radiocarpeum palmare-lig ulnocarpeum palmare etc.

Art. mediocarpea.Surfaces: the proximal row of ossa carpalia + the distal row of ossa carpaliaType: ~ ginglymusAxis and movements: ~ frontal axis, flexio palmaris - flexio dorsalisLigaments: see. art. radiocarpea!

“Art. pedis” = „upper jump joint (or upper ankle joint)“ + „lower jump joint (or lower ankle joint)“.

Art. talocruralis – “upper jump joint”.Surfaces: malleolus medialis (tibiae), facies articularis inferior tibiae, malleolus lateralis (fibulae) + trochlea taliType: ginglymusAxis and movements: - frontal axis - flexio plantaris - flexio dorsalis

(maximally extended foot can also move a little-bit to left and right)

Ligaments: (this ligaments stabilize particularly also the “lower jump joint”!)a) on the lateral side:- lig. talofibulare anterius- lig. talofibulare posterius- lig. calcaneofibulareb) on the medial side:- lig. deltoideum:

- pars tibionavicularis- pars tibiotalaris anterior- pars tibiocalcaneus- pars tibiotalaris posterior

“Art. talotarsalis” (“lower jump joint”) = art. subtalaris + art. talocalcaneonavicularis.

Art. subtalaris.Surfaces: facies articularis calcanea posterior (talus) + facies articularis

talaris posterior (calcaneus)Type: trochoideaAxis: oblique axis

Art. talocalcaneonavicularis.Surfaces: caput tali, facies articularis calcanea media et anterior (talus) + os naviculare, facies articularis talaris media et anterior (calcaneus)Type: spheroidea (very limited by other joints!)Special (“own”) ligaments for “lower jump joint”: - ligg. talocalcaneummediale, laterale et interosseum

Axis and movements in all ”lower jump joint”: art. subtalaris and art. talocalcaneonavicularis are combined – active movements are possible only around the oblique axis of the art. subtalaris. (Trochoidea + spheroidea = trochoidea!)Movements ~ pronatio - supinatio (+ little-bit also around other axes!)