9.4 Synovial joints  (Page 6/38)

Chapter review

Synovial joints are the most common type of joints in the body. They are characterized by the presence of a joint cavity, inside of which the bones of the joint articulate with each other. The articulating surfaces of the bones at a synovial joint are not directly connected to each other by connective tissue or cartilage, which allows the bones to move freely against each other. The walls of the joint cavity are formed by the articular capsule. Friction between the bones is reduced by a thin layer of articular cartilage covering the surfaces of the bones, and by a lubricating synovial fluid, which is secreted by the synovial membrane.

Synovial joints are strengthened by the presence of ligaments, which hold the bones together and resist excessive or abnormal movements of the joint. Ligaments are classified as extrinsic ligaments if they are located outside of the articular capsule, intrinsic ligaments if they are fused to the wall of the articular capsule, or intracapsular ligaments if they are located inside the articular capsule. Some synovial joints also have an articular disc (meniscus), which can provide padding between the bones, smooth their movements, or strongly join the bones together to strengthen the joint. Muscles and their tendons acting across a joint can also increase their contractile strength when needed, thus providing indirect support for the joint.

Bursae contain a lubricating fluid that serves to reduce friction between structures. Subcutaneous bursae prevent friction between the skin and an underlying bone, submuscular bursae protect muscles from rubbing against a bone or another muscle, and a subtendinous bursa prevents friction between bone and a muscle tendon. Tendon sheaths contain a lubricating fluid and surround tendons to allow for smooth movement of the tendon as it crosses a joint.

Based on the shape of the articulating bone surfaces and the types of movement allowed, synovial joints are classified into six types. At a pivot joint, one bone is held within a ring by a ligament and its articulation with a second bone. Pivot joints only allow for rotation around a single axis. These are found at the articulation between the C1 (atlas) and the dens of the C2 (axis) vertebrae, which provides the side-to-side rotation of the head, or at the proximal radioulnar joint between the head of the radius and the radial notch of the ulna, which allows for rotation of the radius during forearm movements. Hinge joints, such as at the elbow, knee, ankle, or interphalangeal joints between phalanx bones of the fingers and toes, allow only for bending and straightening of the joint. Pivot and hinge joints are functionally classified as uniaxial joints.

Condyloid joints are found where the shallow depression of one bone receives a rounded bony area formed by one or two bones. Condyloid joints are found at the base of the fingers (metacarpophalangeal joints) and at the wrist (radiocarpal joint). At a saddle joint, the articulating bones fit together like a rider and a saddle. An example is the first carpometacarpal joint located at the base of the thumb. Both condyloid and saddle joints are functionally classified as biaxial joints.

Plane joints are formed between the small, flattened surfaces of adjacent bones. These joints allow the bones to slide or rotate against each other, but the range of motion is usually slight and tightly limited by ligaments or surrounding bones. This type of joint is found between the articular processes of adjacent vertebrae, at the acromioclavicular joint, or at the intercarpal joints of the hand and intertarsal joints of the foot. Ball-and-socket joints, in which the rounded head of a bone fits into a large depression or socket, are found at the shoulder and hip joints. Both plane and ball-and-sockets joints are classified functionally as multiaxial joints. However, ball-and-socket joints allow for large movements, while the motions between bones at a plane joint are small.

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