Synovial Joint
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A synovial joint, also known as diarthrosis, joins bones or cartilage with a fibrous
joint capsule In anatomy, a joint capsule or articular capsule is an envelope surrounding a synovial joint.periosteum The periosteum is a membrane that covers the outer surface of all bones, except at the articular surfaces (i.e. the parts within a joint space) of long bones. Endosteum lines the inner surface of the medullary cavity of all long bones. Structu ...
of the joined bones, constitutes the outer boundary of a synovial cavity, and surrounds the bones' articulating surfaces. This joint unites long bones and permits free bone movement and greater mobility. The synovial cavity/joint is filled with synovial fluid. The joint capsule is made up of an outer layer of fibrous membrane, which keeps the bones together structurally, and an inner layer, the synovial membrane, which seals in the synovial fluid. They are the most common and most movable type of
joint A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw ...
in the body of a mammal. As with most other joints, synovial joints achieve movement at the point of contact of the articulating
bone A bone is a Stiffness, rigid Organ (biology), organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red blood cell, red and white blood cells, store minerals, provid ...
s.


Structure

Synovial joints contain the following structures: * Synovial cavity: all diarthroses have the characteristic space between the bones that is filled with synovial fluid *
Joint capsule In anatomy, a joint capsule or articular capsule is an envelope surrounding a synovial joint.fibrous Fiber or fibre (from la, fibra, links=no) is a #Natural fibers, natural or Fiber#Artificial fibers, artificial substance that is significantly longer than it is wide. Fibers are often used in the manufacture of other materials. The stronge ...
membrane that may contain ligaments and (2) the inner synovial membrane that secretes the lubricating, shock absorbing, and joint-nourishing synovial fluid; the joint capsule is highly innervated, but without blood and lymph vessels, and receives nutrition from the surrounding blood supply via either diffusion (a slow process) or by
convection Convection is single or multiphase fluid flow that occurs spontaneously due to the combined effects of material property heterogeneity and body forces on a fluid, most commonly density and gravity (see buoyancy). When the cause of the conve ...
, a far more efficient process achieved through exercise. *
Articular cartilage Hyaline cartilage is the glass-like (hyaline) and translucent cartilage found on many joint surfaces. It is also most commonly found in the ribs, nose, larynx, and trachea. Hyaline cartilage is pearl-gray in color, with a firm consistency and has ...
: the bones of a synovial joint are covered by this layer of hyaline cartilage that lines the epiphyses of joint end of bone with a smooth, slippery surface that does not bind them together; articular cartilage functions to absorb shock and reduce friction during movement. Many, but not all, synovial joints also contain additional structures: *
Articular disc The articular disk (or disc) is a thin, oval plate of fibrocartilage present in several joints which separates synovial cavities. This separation of the cavity space allows for separate movements to occur in each space. The presence of an articula ...
s or menisci - the fibrocartilage pads between opposing surfaces in a joint * Articular fat pads -
adipose tissue Adipose tissue, body fat, or simply fat is a loose connective tissue composed mostly of adipocytes. In addition to adipocytes, adipose tissue contains the stromal vascular fraction (SVF) of cells including preadipocytes, fibroblasts, vascular ...
pads that protect the articular cartilage, as seen in the infrapatellar fat pad in the knee *
Tendons A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability ...
- cords of
dense regular connective tissue Dense regular connective tissue (DRCT) provides connection between different tissues in the human body. The collagen fibers in dense regular connective tissue are bundled in a parallel fashion. DRCT is divided into white fibrous connective tissue ...
composed of parallel bundles of
collagen fibers Type I collagen is the most abundant collagen of the human body. It forms large, eosinophilic fibers known as collagen fibers. It is present in scar tissue, the end product when tissue heals by repair, as well as tendons, ligaments, the endo ...
* Accessory ligaments (extracapsular and intracapsular) - the fibers of some fibrous membranes are arranged in parallel bundles of dense regular connective tissue that are highly adapted for resisting strains to prevent extreme movements that may damage the articulation * Bursae - saclike structures that are situated strategically to alleviate friction in some joints (shoulder and knee) that are filled with fluid that is similar to synovial fluid The bone surrounding the joint on the proximal side is sometimes called the ''plafond'', especially in the
talocrural joint The ankle, or the talocrural region, or the jumping bone (informal) is the area where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular join ...
. A damage to this occurs in a
Gosselin fracture The Gosselin fracture is a V-shaped fracture of the distal tibia which extends into the ankle joint and fractures the tibial plafond into anterior and posterior fragments. The fracture was described by Leon Athanese Gosselin, chief of surgery at ...
.


Blood supply

The blood supply of a synovial joint is derived from the arteries sharing in the
anastomosis An anastomosis (, plural anastomoses) is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between blood vessels, leaf#Veins, leaf veins, or streams. Such a connection m ...
around the joint.


Types

There are seven types of synovial joints. Some are relatively immobile, but are more stable. Others have multiple degrees of freedom, but at the expense of greater risk of injury. In ascending order of mobility, they are:


Function

The movements possible with synovial joints are: * abduction: movement away from the mid-line of the body *
adduction Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relative ...
: movement toward the mid-line of the body *
extension Extension, extend or extended may refer to: Mathematics Logic or set theory * Axiom of extensionality * Extensible cardinal * Extension (model theory) * Extension (predicate logic), the set of tuples of values that satisfy the predicate * E ...
: straightening limbs at a joint *
flexion Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relativ ...
: bending the limbs at a joint *
rotation Rotation, or spin, is the circular movement of an object around a '' central axis''. A two-dimensional rotating object has only one possible central axis and can rotate in either a clockwise or counterclockwise direction. A three-dimensional ...
: a circular movement around a fixed point


Clinical significance

The ''joint space'' equals the distance between the involved bones of the joint. A ''joint space narrowing'' is a sign of either (or both)
osteoarthritis Osteoarthritis (OA) is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone which affects 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the w ...
and inflammatory degeneration. The normal joint space is at least 2 mm in the
hip In vertebrate anatomy, hip (or "coxa"Latin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) in medical terminology) refers to either an anatomical region or a joint. The hip region is ...
(at the superior acetabulum), at least 3 mm in the knee, and 4–5 mm in the
shoulder joint The shoulder joint (or glenohumeral joint from Greek ''glene'', eyeball, + -''oid'', 'form of', + Latin ''humerus'', shoulder) is structurally classified as a synovial ball-and-socket joint and functionally as a diarthrosis and multiaxial joint ...
., in turn citing: For the
temporomandibular joint In anatomy, the temporomandibular joints (TMJ) are the two joints connecting the jawbone to the skull. It is a bilateral synovial articulation between the temporal bone of the skull above and the mandible below; it is from these bones that it ...
, a joint space of between 1.5 and 4 mm is regarded as normal. Joint space narrowing is therefore a component of several radiographic classifications of osteoarthritis. In
rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involv ...
, the clinical manifestations are primarily synovial inflammation and joint damage. The fibroblast-like synoviocytes, highly specialized mesenchymal cells found in the synovial membrane, have an active and prominent role in the pathogenic processes in the rheumatic joints. Therapies that target these cells are emerging as promising therapeutic tools, raising hope for future applications in rheumatoid arthritis.


References

Tortora & Derrickson () ''Principles of Anatomy & Physiology'' (12th ed.). Wiley & Sons Rogers, Kara (2010) ''Bone and Muscle: Structure, Force, and Motion'
p.157
/ref> Sharkey, John (2008) ''The Concise Book of Neuromuscular Therapy'
p.33
/ref> Moini (2011) ''Introduction to Pathology for the Physical Therapist Assistant'
pp.231-2
/ref> Bruce Abernethy (2005) ''The Biophysical Foundations Of Human Movement'' pp.23
331
/ref>
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