Medicine of The Ancient World

2) Formation of part of urinary bladder
Coronal (frontal) plane
Horizontal plane
Median (sagittal) plane

1) Median (sagittal) plane; vertical plane that passes in the midline of the body, dividing the body
longitudinally into right and left equal halves
2) Paramedian (parasagittal) plane; vertical plane parallel to the median plane, dividing the body
into right and left unequal parts
3) Coronal (frontal) plane; vertical plane that passes at right angle to the median plane, dividing
the body into anterior and posterior parts
4) Horizontal (transverse) plane; plane that passes at right angle to the median and coronal planes,
dividing the body into upper (superior) and lower (inferior) parts
Frontal Sagittal Horizontal Paramedian
(coronal) plane (median) plane (transverse) plane (parasagittal) plane
Sagittarius
Corona (crown)
Definition: a joint is the meeting of 2 bones or more, meeting of 2 cartilages or more, or
meeting of bone and cartilage
Classification of Joints
[1] Fibrous Joints: the bones are connected by dense fibrous tissue that allows no movement (fixed
immobile joint)
Sutures Gomphosis Syndesmosis

Present in the skull Present in the jaws Present in the inferior tibio-fibular
joint
Bones of skull are connected by a Root of the tooth is connected to Lower ends of tibia and fibula are
thin layer of dense fibrous tissue the socket in mandible and connected together by dense
called “sutural ligament” maxilla by dense fibrous tissue fibrous tissue called
(obliterates in old age) called “periodontal ligament” “interosseous ligament”
Gomphosis
Periodontal ligament
[2] Cartilaginous Joints : the bones are connected by cartilaginous tissue
Primary cartilaginous joint Secondary cartilaginous joint

• Bones are connected by hyaline cartilage that • Bones are connected by white fibrocartilage
disappears in adulthood by ossification, so it that does not ossify with age, so it is a
is a temporary joint permanent joint
• It allows no movement (immobile joint) • It allows slight movement (limited mobility)
• Example; epiphyseal plate between epiphysis • Example; inter-vertebral discs and symphysis
and diaphysis of long bones in children pubis (joints in the midline)
Epiphyseal plate
Inter-vertebral
disc
Symphysis pubis
[3] Synovial Joints: they are the most freely mobile joints, found mainly in the limbs
Characteristics (structure):
1) Fibrous capsule; the joint has a cavity that is

surrounded by a strong fibrous capsule, which is
supported by strong ligaments
2) Articular cartilage; articular surfaces are covered
by thin plates of hyaline cartilage (not visible in
X-ray);
 Smooth and lubricated by synovial fluid
 Has no blood vessels or nerves
 Receives its nutrition from synovial fluid
 In old age it shows erosions without repair
3) Joint cavity; it is a potential cavity that contains
very thin film of synovial fluid
4) Synovial membrane; it is a thin moist membrane
that lines the capsule and covers all structures
inside the joint except the articular surfaces, and
secretes and absorbs synovial fluid
5) Synovial fluid; it is a pale yellow viscous fluid,
having the following functions;
a) Lubrication of articular cartilage
b) Nutrition of articular cartilage
c) Shock absorption (non-Newtonian fluid that
condenses under pressure)
Articular disc of temporo-mandibular joint
6) Ligaments; the joint is supported by

extra- capsular and intra-capsular ligaments
7) Structures that may be present inside the
joint cavity;
a) Articular disc; a disc of fibrocartilage that
divides joint cavity into 2 compartments, e.g.
temporo-mandibular joint
b) Menisci (semilunar cartilages); inside knee
joint
c) Ligaments; e.g. cruciate ligament inside knee
joint Cruciate ligament
d) Tendon; e.g. long head of biceps inside
shoulder joint
Cruciate ligament
Menisci of knee joint

Long head of biceps
Long head of biceps
Long head of biceps

Characters:
• Intra-articular structures:
Some joints may contain:
a) Articular disc
b) Menisci
c) Ligaments
d) Tendons
Types and Varieties of Synovial Joints
(According to axis of movement and shape of articular surfaces)
[A] Non-axial (plane) Joints: the articular surfaces are flat (plane), allowing gliding movement e.g. superior
tibio-fibular joint, intervertebral joints, inter-carpal and inter-tarsal joints
Superior tibio-fibular joint
Intervertebral joints
B. Axial Joints:
(1) Uni-axial Joints: move around single
axis
Hinge joint Pivot joint
• Moves around transverse axis, • Moves around longitudinal axis, allowing
allowing flexion & extension rotation
• Articular surface is trochlea-like in shape • Articular surface is a central
pivot surrounded by fibro-osseous ring
• Example; elbow and ankle joints • Example; superior radio-ulnar joint
(2) Bi-axial Joints: move around two axes perpendicular to each
other
a) Condylar or bicondylar joint:
• Two convex surfaces (condyles) articulate with two concave surfaces, e.g. knee joint
• One convex surface (condyle) articulates with one concave surface, e.g. temporo-mandibular joint
Bicondylar joint Condylar joint

b) Ellipsoid joint: one oval convex surface articulates with one oval concave surface, e.g. wrist
joint
c) Saddle joint: articular surfaces are concavo-convex, e.g. carpo-metacarpal joint of thumb, and
sterno- clavicular joint
(3) Multi-axial Joints: move around the 3 axes, allowing flexion, extension, adduction, abduction,
medial rotation and lateral rotation
Ball and socket joint: globular or spherical surface (ball) articulates with a concave surface
(socket),
e.g. shoulder and hip joints (this type is the most freely mobile joint in the body)
Factors affecting stability of the joints
1) Shape and fitting of articular surfaces

2) Thickness and elasticity of the capsule
3) Position and strength of ligaments
4) Strength of muscles around the joint
Shoulder joint Hip joint

Self-assessment
A bone found embedded within the tendon of a

skeletal muscle is considered as:
A. Pneumatic bone
B. Irregular bone
C. Sesamoid bone
D. Irregular bone
The most freely mobile type of joints in the body
is:
A. Fibrous joint
B. Primary cartilaginous joint
C. Secondary cartilaginous joint
D. Synovial joint
The epiphyseal plate of a long bone is considered
as:
A. Fibrous joint
B. Primary cartilaginous joint
C. Secondary cartilaginous joint
D. Synovial joint
A synovial joint that rotates around a single vertical axis is described as:
A. Hinge joint
B. Plane joint
C. Ellipsoid joint
D. Pivot joint
A synovial joint that allows flexion and extension around a

single
horizontal axis is described as:
A. Hinge joint
B. Plane joint
C. Ellipsoid joint
D. Pivot joint
The synovial joint variety that has the widest range of movement
is:
A. Hinge joint
B. Saddle joint
C. Ball and socket joint
D. Condylar joint

Medicine of The Ancient World

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2) Formation of part of urinary bladder

Coronal (frontal) plane

Median (sagittal) plane

Sutures Gomphosis Syndesmosis

Primary cartilaginous joint Secondary cartilaginous joint

1) Fibrous capsule; the joint has a cavity that is

6) Ligaments; the joint is supported by

Menisci of knee joint

Long head of biceps

Superior tibio-fibular joint

Bicondylar joint Condylar joint

1) Shape and fitting of articular surfaces

Shoulder joint Hip joint

A bone found embedded within the tendon of a

A synovial joint that allows flexion and extension around a

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