Analysis

Bone connections briefly. Types of connection of skeletal bones. There are three types of bone joints

All bone joints are divided into continuous, discontinuous and semi-joints (symphyses), (Fig. 105).

Continuous connections of bones, formed with the participation of connective tissue are fibrous, cartilaginous and bone compounds.

TO fibrous joints (junctura fibrosa), or syndesmoses, include ligaments, membranes, sutures, fontanelles and “impacts”. Ligaments(ligamenta) in the form of bundles of dense fibrous connective tissue connect adjacent bones. Interosseous membranes(membranae interossei) are stretched, as a rule, between the diaphyses of tubular bones. Sutures (suturae)- these are connections in the form of a thin connective tissue layer between the bones. Distinguish flat seams(sutura plana), which are located between the bones of the facial part of the skull, where

Rice. 105.Types of bone connections (diagram).

A - joint, B - syndesmosis, C - synchondrosis, D - symphysis.

1 - periosteum, 2 - bone, 3 - fibrous connective tissue, 4 - cartilage, 5 - synovial membrane, 6 - fibrous membrane, 7 - articular cartilage, 8 - articular cavity, 9 - gap in the interpubic disc, 10 - interpubic disc.

The straight edges of the bones are connected. Serrated seams(suturae serratae) are characterized by ruggedness of the connecting bone edges (between the bones of the medulla of the skull). Example scaly sutures (suturae squamosae) is the connection of the scales of the temporal bone with the parietal bone. Injection (gomphosis), or dental-alveolar junction (articulatio dentoalveolaris) called the connection of the tooth root with the walls of the dental alveoli, between which there are connective tissue fibers.

The connections between bones and cartilage are called cartilage joints, or synchondrosis (juncturae cartilagineae, s. synchondroses). There are permanent synchondroses that exist throughout life, for example, intervertebral discs, and temporary ones. Temporary synchondrosis, which at a certain age is replaced by bone tissue, for example, epiphyseal cartilage of tubular bones. Symphyses (half-joints) (symphyses), which have a narrow slit-like cavity in the cartilaginous layer between the bones, occupy an intermediate position between continuous and discontinuous joints (joints). An example of a semi-joint is the pubic symphysis

Bone fusions (synostoses, synostoses) are formed as a result of replacement of synchondrosis with bone tissue.

Discontinuous bone connections are joints, or synovial joints(articulatio, s. articulatioms synoviales). Joints are characterized by the presence of articular surfaces covered with cartilage, an articular cavity with synovial fluid, and an articular capsule. Some joints have additional formations in the form of articular discs, menisci or labrum. Articular surfaces (facies articulares) can match each other in configuration (be congruent) or differ in shape and size (be incongruent). Articular cartilage(cartilago articularis) (0.2 to 6 mm thick) has superficial, intermediate and deep zones.

Joint capsule (capsula articularis) is attached to the edges of the articular cartilage or at some distance from it. The capsule has a fibrous membrane on the outside and a synovial membrane on the inside. Fibrous membrane(membrana fibrosa) is strong and thick, formed by fibrous connective tissue. In some places, the fibrous membrane thickens, forming ligaments that strengthen the capsule. Some joints in the articular cavity have intra-articular ligaments covered with synovial membrane. Synovial membrane(membrana synovialis) is thin, it lines the fibrous membrane from the inside, forms microgrowths - synovial villi. Articular cavity(cavum articulare) is a closed slit-like space limited by the articular surfaces of the bones and the articular capsule. In the articular cavity there is synovial fluid, mucus-like, which wets the articular surfaces. Articular discs And menisci(disci et menisci articulares) are intra-articular cartilaginous plates of various shapes that eliminate or reduce incongruence of articular surfaces. (For example, at the knee joint). Articular labrum(labrum articulare) is present in some joints (shoulder and hip). It is attached along the edge of the articular surface, increasing the depth of the articular fossa.

Classification of joints. There are anatomical and biomechanical classification of joints. According to the anatomical classification, joints are divided into simple, complex, complex and combined joints. Simple joint(artimlatio simplex) is formed by two articulating surfaces. Complex joint(artimlatio composita) is formed by three or more articular surfaces of bones. A complex joint has an intraarticular disc or meniscus. Combined joints are anatomically isolated, however, they function together (for example, temporomandibular joints), (Fig. 106).

Joints are classified according to the number of axes of rotation. There are uniaxial, biaxial and multiaxial joints. Uniaxial joints have one axis around which flexion occurs.

Rice. 106.Types of joints (diagram). A - block-shaped, B - ellipsoidal, C - saddle-shaped, D - spherical.

extension-extension or abduction-adduction, or outward (supination) and inward (pronation) rotation. Uniaxial joints based on the shape of the articular surfaces include block-shaped and cylindrical joints. Biaxial joints have two axes of rotation. For example, flexion and extension, abduction and adduction. These joints include ellipsoidal and saddle-shaped joints. Examples of multi-axis joints are ball-and-socket joints, planar joints, in which different types of movements are possible.

Connections of the skull bones

The bones of the skull are connected to each other mainly using continuous connections - sutures. The exception is the temporomandibular joint.

Adjacent bones of the skull are connected using sutures. The medial edges of the two parietal bones are connected by the serratus sagittal suture (sutura sagittalis), frontal and parietal bones - dentate coronal suture (sutura coronalis), parietal and occipital bones - using the serratus lambdoid suture (sutura lambdoidea). The scales of the temporal bone are connected to the greater wing of the sphenoid bone and to the parietal bone scaly suture (sutura squamosa). The bones of the facial part of the skull are connected flat (harmonious) seams (sutura plana). Flat sutures include internasal, lacrimal-conchaal, intermaxillary, palatoethmoidal and other sutures. The names of the sutures are usually given by the name of the two connecting bones.

At the base of the skull there are cartilaginous connections - synchondrosis. Between the body of the sphenoid bone and the basilar part of the occipital bone there is sphenoid-occipital synchondrosis (synchondrosis sphenopetrosa), which is replaced by bone tissue with age.

Temporomandibular joint (art. temporomandibularis), paired, complex (has an articular disc), ellipsoidal in shape, formed by the articular head of the lower jaw, the mandibular fossa and the articular tubercle of the temporal bone, covered with fibrous cartilage (Fig. 107). Head of the mandible(caput mandibulae) has the shape of a roller. Mandibular fossa(fossa mandibularis) of the temporal bone does not completely enter the cavity of the temporomandibular joint, therefore its extracapsular and intracapsular parts are distinguished. The extracapsular part of the mandibular fossa is located behind the petrosquamous fissure, the intracapsular part is anterior to this fissure. This part of the fossa is enclosed in an articular capsule, which extends to the articular tubercle (tuberculum articulae) of the temporal bone. Joint capsule

Rice. 107.Temporomandibular joint, right. Outside view. The joint was opened with a sagittal cut. The zygomatic arch has been removed.

1 - mandibular fossa, 2 - upper floor of the articular cavity, 3 - articular tubercle, 4 - upper head of the lateral pterygoid muscle, 5 - lower head of the lateral pterygoid muscle, 6 - tubercle of the maxillary bone, 7 - medial pterygoid muscle, 8 - pterygomandibular suture, 9 - angle of the lower jaw, 10 - stylomandibular ligament, 11 - branch of the lower jaw, 12 - head of the lower jaw, 13 - lower floor of the articular cavity of the temporomandibular joint, 14 - articular capsule, 15 - articular disc.

wide, free, on the lower jaw it covers its neck. The articular surfaces are covered with fibrous cartilage. Inside the joint there is articular disc(discus articularis), biconcave, which divides the articular cavity into two sections (floors), upper and lower. The edges of this disc are fused with the articular capsule. The cavity of the upper floor is lined superior synovial membrane(membrana synovialis superior), lower floor of the temporomandibular joint - inferior synovial membrane(membrana synovialis inferior). Part of the tendon bundles of the lateral pterygoid muscle is attached to the medial edge of the articular disc.

The temporomandibular joint is strengthened by intracapsular (intra-articular) and capsular ligaments, as well as extracapsular ligaments. In the cavity of the temporomandibular joint there are the anterior and posterior disco-temporal ligaments, running from the upper edge of the disc upward, anteriorly and posteriorly and to the zygomatic arch. Intra-articular (intracapsular) lateral and medial disco-mandibular ligaments run from the lower edge of the disc down to the neck of the mandible. Lateral ligament(lig. laterale) is a lateral thickening of the capsule; it has the shape of a triangle, with the base facing the zygomatic arch (Fig. 108). This ligament begins at the base of the zygomatic process of the temporal bone and on the zygomatic arch, going down to the neck of the mandible.

Rice. 108.Lateral ligament of the temporomandibular joint, right. Outside view. 1 - zygomatic arch, 2 - zygomatic bone, 3 - coronoid process of the mandible, 4 - maxillary bone, 5 - second molar, 6 - mandible, 7 - third molar, 8 - masticatory tuberosity, 9 - ramus of the mandible, 10 - stylomandibular ligament, 11 - condylar process of the mandible, 12 - anterior (outer) part of the lateral ligament of the temporomandibular joint, 13 - posterior (inner) part of the lateral ligament of the temporomandibular joint, 14 - mastoid process of the temporal bone, 15 - outer ear canal

Medial ligament (lig. mediale) runs along the ventral side of the capsule of the temporomandibular joint. This ligament begins on the inner edge of the articular surface of the mandibular fossa and the base of the spine of the sphenoid bone and is attached to the neck of the mandible.

Outside the articular capsule of the joint there are two ligaments (Fig. 109). Sphenomandibular ligament(lig. sphenomandibulare) begins on the spine of the sphenoid bone and attaches to the uvula of the lower jaw. Stylomandibular ligament(lig. stylomandibulare) goes from the styloid process of the temporal bone to the inner surface of the lower jaw, near its angle.

The following movements are performed in the right and left temporomandibular joints: lowering and raising the lower jaw, corresponding to opening and closing the mouth, moving the lower jaw forward and returning to its original position; movement of the lower jaw to the right and left (lateral movements). Lowering of the lower jaw occurs when the heads of the lower jaw rotate around a horizontal axis in the lower floor of the joint. The lateral movement of the lower jaw occurs with the participation of the articular disc. In the right temporomandibular joint, when moving to the right (and in the left joint, when moving to the left), the head of the lower jaw rotates under the articular disc (around the vertical axis), and in the opposite joint, the head with the disc moves forward (sliding) onto the articular tubercle.

Rice. 109.Extra-articular ligaments of the temporomandibular joint. Inside view. Sagittal cut. 1 - sphenoid sinus, 2 - lateral plate of the pterygoid process of the sphenoid bone, 3 - pterygospinous ligament, 4 - spine of the sphenoid bone, 5 - neck of the mandible, 6 - sphenomandibular ligament, 7 - styloid process of the temporal bone, 8 - condylar process of the mandible, 9 - stylomandibular ligament, 10 - opening of the mandible, 11 - pterygoid hook, 12 - pterygoid tuberosity, 13 - angle of the mandible, 14 - mylohyoid line, 15 - molars, 16 - premolars, 17 - fangs, 18 - hard palate, 19 - medial plate of the pterygoid process, 20 - inferior turbinate, 21 - sphenopalatine foramen, 22 - middle turbinate, 23 - superior turbinate, 24 - frontal sinus.

Joints of the trunk bones

Vertebral connections

There are different types of joints between the vertebrae. The bodies of adjacent vertebrae are connected by intervertebral discs(disci intervertebrales), processes - with the help of joints and ligaments, and arches - with the help of ligaments. The intervertebral disc has a central part

Rice. 110.Intervertebral disc and facet joints. View from above.

1 - lower articular process, 2 - articular capsule, 3 - articular cavity, 4 - upper articular process, 5 - costal process of the lumbar vertebra, 6 - fibrous ring, 7 - nucleus pulposus, 8 - anterior longitudinal ligament, 9 - posterior longitudinal ligament, 10 - inferior vertebral notch, 11 - ligamentum flavum, 12 - spinous process, 13 - supraspinous ligament.

takes nucleus pulposus(nucleus pulposus), and the peripheral part - annulus fibrosus(annulus fibrosus), (Fig. 110). The nucleus pulposus is elastic, and when the spine bends, it shifts towards extension. The annulus fibrosus is made of fibrous cartilage. There is no intervertebral disc between the atlas and the axial vertebra.

The connections of the vertebral bodies are reinforced by the anterior and posterior longitudinal ligaments (Fig. 111). Anterior longitudinal ligament(lig. longitudinale anterius) runs along the anterior surface of the vertebral bodies and intervertebral discs. Posterior longitudinal ligament(lig. longitudinale posterius) runs inside the spinal canal along the posterior surface of the vertebral bodies from the axial vertebra to the level of the first coccygeal vertebra.

Between the arches of adjacent vertebrae are located yellow ligaments(ligg. flava), formed by elastic connective tissue.

The articular processes of adjacent vertebrae form arcuate, or intervertebral joints(art. zygapophysiales, s. intervertebrales). The articular cavity is located according to the position and direction of the articular surfaces. In the cervical region, the articular cavity is oriented almost in a horizontal plane, in the thoracic region - in the frontal plane, and in the lumbar region - in the sagittal plane.

The spinous processes of the vertebrae are connected to each other using the interspinous and supraspinous ligaments. Interspinous ligaments(ligg. interspinalia) located between adjacent spinous processes. Supraspinous ligament(lig. supraspinale) is attached to the tips of the spinous processes of all vertebrae. In the cervical region this ligament is called nuchal ligament(lig. nuchae). Between the transverse processes are located intertransverse ligaments(ligg. intertransversaria).

lumbosacral junction, or lumbosacral the joint (articulatio lumbosacralis), located between the V lumbar vertebra and the base of the sacrum, is strengthened by the iliopsoas ligament. This ligament runs from the posterior superior edge of the ilium to the transverse processes of the IV and V lumbar vertebrae.

Sacrococcygeal joint (art. sacrococcygea) represents the connection of the apex of the sacrum with the first coccygeal vertebra. The connection of the sacrum with the coccyx is strengthened by the paired lateral sacrococcygeal ligament, which runs from the lateral sacral crest to the transverse process of the first coccygeal vertebra. The sacral and coccygeal horns are connected to each other using connective tissue (syndemosis).

Rice. 111.Connections of the cervical vertebrae and occipital bone. View from the medial side. The spinal column and occipital bone are sawed in the midsagittal plane.

1 - basilar part of the occipital bone, 2 - tooth of the axial vertebra, 3 - upper longitudinal fascicle of the cruciate ligament of the atlas, 4 - integumentary membrane, 5 - posterior longitudinal ligament, 6 - posterior atlanto-occipital membrane, 7 - transverse ligament of the atlas, 8 - lower longitudinal bundle of the cruciate ligament of the atlas, 9 - yellow ligaments, 10 - interspinous ligament, 11 - intervertebral foramen, 12 - anterior longitudinal ligament, 13 - articular cavity of the median atlanto-axial joint, 14 - anterior arch of the atlas, 15 - ligament of the apex of the tooth, 16 - anterior atlanto-occipital membrane, 17 - anterior atlanto-occipital ligament.

Rice. 112.Atlanto-occipital and atlanto-axial joints. Back view. The posterior parts of the occipital bone and the posterior arch of the atlas are removed. 1 - clivus, 2 - ligament of the apex of the tooth, 3 - pterygoid ligament, 4 - lateral part of the occipital bone, 5 - tooth of the axial vertebra, 6 - transverse foramen of the atlas, 7 - atlas, 8 - axial vertebra, 9 - lateral atlanto-axial joint , 10 - atlanto-occipital joint, 11 - canal of the hypoglossal nerve, 12 - anterior edge of the foramen magnum.

Connections between the spinal column and the skull

Between the occipital bone of the skull and the first cervical vertebrae there is atlanto-occipital joint(art. atlanto-occipitalis), combined (paired), condylar (ellipsoidal or condylar). This joint is formed by two condyles of the occipital bone, connecting with the corresponding superior articular fossae of the atlas (Fig. 112). The articular capsule is attached along the edge of the articular cartilages. This joint is strengthened by two atlanto-occipital membranes. Anterior atlanto-occipital membrane(membrana atlanto-occipitalis anterior) is stretched between the anterior edge of the occipital foramen of the occipital bone and the anterior arch of the atlas. Posterior atlanto-occipital membrane(membrana atlantooccipitalis posterior) is thinner and wider, located between the posterior semicircle of the occipital foramen and the upper edge of the posterior arch of the atlas. The lateral parts of the posterior atlanto-occipital membrane are called lateral atlanto-occipital ligaments(lig. atlantooccipitale laterale).

At the right and left atlanto-occipital joints, the head is tilted forward and backward around the frontal axis (nodding movements), abduction (tilt of the head to the side) and adduction (reverse movement of the head to the middle) around the sagittal axis.

Between the atlas and axial vertebrae there is an unpaired median atlanto-axial joint and a paired lateral atlanto-axial joint.

Median atlantoaxial joint (art. atlantoaxialis mediana)formed by the anterior and posterior articular surfaces of the tooth of the axial vertebra. The tooth in front is connected to the tooth fossa, which is located on the back side of the anterior arch of the atlas (Fig. 113). Posteriorly, the tooth articulates with transverse ligament of the atlas(lig. transversum atlantis), stretched between the inner surfaces of the lateral masses of the atlas. The anterior and posterior articulations of the tooth have separate articular cavities and articular capsules, but are considered as a single median atlanto-axial joint, in which rotation of the head relative to the vertical axis is possible: rotation of the head outward - supination, and rotation of the head inward - pronation.

Lateral atlantoaxial joint (art. atlantoaxialis lateralis), paired (combined with the median atlanto-axial joint), formed by the articular fossa on the lateral mass of the atlas and the superior articular surface on the body of the axial vertebra. The right and left atlantoaxial joints have separate articular capsules. The joints are flat in shape. In these joints, sliding occurs in the horizontal plane during rotation in the median atlanto-axial joint.

Rice. 113.Connection of the atlas with the tooth of the axial vertebra. View from above. Horizontal cut at the level of the tooth of the axial vertebra. 1 - tooth of the axial vertebra, 2 - articular cavity of the median atlanto-axial joint, 3 - transverse atlas ligament, 4 - posterior longitudinal ligament, 5 - integumentary membrane, 6 - transverse foramen of the axial vertebra, 7 - lateral mass of the atlas, 8 - anterior arch of the atlas.

The medial and lateral atlanto-axial joints are strengthened by several ligaments. Apex ligament(lig. apicis dentis), unpaired, stretched between the middle of the posterior edge of the anterior circumference of the foramen magnum and the apex of the tooth of the axial vertebra. Pterygoid ligaments(ligg. alaria), paired. Each ligament begins on the lateral surface of the tooth, is directed obliquely upward and laterally, and is attached to the inner side of the condyle of the occipital bone.

Posterior to the ligament of the apex of the tooth and the pterygoid ligaments is cruciate ligament atlas(lig. cruciforme atlantis). It is formed by the transverse ligament of the atlas and longitudinal beams(fasciculi longitudinales) fibrous tissue running up and down from the transverse ligament of the atlas. The upper bundle ends on the anterior semicircle of the foramen magnum, the lower – on the posterior surface of the body of the axial vertebra. At the back, from the side of the spinal canal, the atlanto-axial joints and their ligaments are covered with a wide and durable connective tissue membrane(membrana tectoria). The integumentary membrane is considered part of the posterior longitudinal ligament of the spinal column. At the top, the integumentary membrane ends on the inner surface of the anterior edge of the foramen magnum.

Spinal column (columna vertebralis)formed by vertebrae connected to each other by intervertebral discs (symphyses), joints, ligaments and membranes. The spine forms bends in the sagittal and frontal planes (kyphosis and lordosis), it has great mobility. The following types of movements of the spinal column are possible: flexion and extension, abduction and adduction (side bending), twisting (rotation) and circular movement.

Connections of the ribs to the spinal column and to the sternum.

The ribs are connected to the vertebrae by costovertebral joints(artt. costovertebrales), which include the joints of the rib head and costotransverse joints (Fig. 114).

Rib head joint (art. capitis costae) is formed by the articular surfaces of the upper and lower costal fossae (semi-fossae) of two adjacent thoracic vertebrae and the head of the rib. From the crest of the rib head to the intervertebral disc in the joint cavity there is an intra-articular ligament of the rib head, which is absent at the 1st rib, as well as at the 11th and 12th ribs. Externally, the capsule of the rib head is strengthened by the radiant ligament of the rib head (lig. capitis costae radiatum), which begins on the anterior side of the rib head and is attached to the bodies of adjacent vertebrae and to the intervertebral disc (Fig. 115).

Costotransverse joint (art. costotransversaria) is formed by the tubercle of the rib and the costal fossa of the transverse process. This joint is absent at the 11th and 12th ribs. Strengthens the capsule costotransverse ligament(lig. costotransversarium), which connects the neck of the underlying rib with the bases of the spinous and transverse processes of the overlying vertebra. Lumbar

Rice. 114.Ligaments and joints connecting the ribs to the vertebrae. View from above. Horizontal cut through the costovertebral joints.

1 - articular cavity of the facet joint, 2 - transverse process, 3 - lateral costotransverse ligament, 4 - tubercle of the rib, 5 - costotransverse ligament, 6 - neck of the rib, 7 - head of the rib, 8 - radiate ligament of the head of the rib, 9 - body vertebra, 10 - articular cavity of the rib head joint, 11 - articular cavity of the costotransverse joint, 12 - upper articular process of the VIII thoracic vertebra, 13 - lower articular process of the VII thoracic vertebra.

costal ligament(lig. lumbocostale) stretched between the costal processes of the lumbar vertebrae and the lower edge of the 12th rib.

The combined costotransverse and rib head joints produce rotational movements around the neck of the rib, raising and lowering the anterior ends of the ribs connected to the sternum.

Connections between the ribs and the sternum. The ribs are connected to the sternum through joints and synchondroses. The cartilage of the 1st rib forms a synchondrosis with the sternum (Fig. 116). The cartilages of the ribs from the 2nd to the 7th, connecting with the sternum, form sternocostal joints(artt. sternocostales). The articular surfaces are the anterior ends of the costal cartilages and the costal notches of the sternum. Joint capsules are strengthened radiate sternocostal ligaments(ligg. sternocostalia), which grow together with the periosteum of the sternum, form sternal membrane(membrana sterni). The joint of the 2nd rib also has intra-articular sternocostal ligament(lig. sternocostale intraarticulare).

The cartilage of the 6th rib is connected to the overlying cartilage of the 7th rib. The anterior ends of the ribs from the 7th to the 9th are connected to each other by their cartilages. Sometimes, between the cartilages of these ribs, intercartilaginous joints(art. interchondrales).

Rib cage (compages thoracis)is an osteochondral formation consisting of 12 thoracic vertebrae, 12 pairs of ribs and sternum, connected by joints and ligaments (Fig. 23). The chest has the appearance of an irregular cone, which has an anterior, posterior and two lateral walls, as well as an upper and lower opening (aperture). The anterior wall is formed by the sternum and costal cartilages, the posterior wall by the thoracic vertebrae and posterior ends of the ribs, and the lateral walls by the ribs. Ribs separated from each other

Rice. 115.Connections between the ribs and the sternum. Front view. On the left, the anterior part of the sternum and ribs were removed by a frontal cut.

1 - symphysis of the manubrium of the sternum, 2 - anterior sternoclavicular ligament, 3 - costoclavicular ligament, 4 - first rib (cartilaginous part), 5 - intra-articular sternocostal ligament, 6 - body of the sternum (spongy substance), 7 - sternum -costal joint, 8 - costochondral joint, 9 - intercartilaginous joints, 10 - xiphoid process of the sternum, 11 - costoxiphoid ligaments, 12 - symphysis of the xiphoid process, 13 - radiate sternocostal ligament, 14 - sternal membrane, 15 - external intercostal membrane, 16 - costosternal synchondrosis, 17 - first rib (bone part), 18 - clavicle, 19 - manubrium of the sternum, 20 - interclavicular ligament.

Rice. 116.Rib cage. Front view.

1 - upper aperture of the chest, 2 - angle of the sternum, 3 - intercostal spaces, 4 - costal cartilage, 5 - body of the rib, 6 - xiphoid process, 7 - XI rib, 8 - XII rib, 9 - lower aperture of the chest, 10 - infrasternal angle, 11 - costal arch, 12 - false ribs, 13 - true ribs, 14 - body of the sternum, 15 - manubrium of the sternum.

intercostal spaces (spatium intercostale). Top hole (aperture) chest(apertura thoracis superior) is limited to the 1st thoracic vertebra, the inner edge of the first ribs and the upper edge of the manubrium of the sternum. Inferior thoracic outlet(apertura thoracis inferior) is bounded behind by the body of the XII thoracic vertebra, in front by the xiphoid process of the sternum, and on the sides by the lower ribs. The anterolateral edge of the inferior aperture is called costal arch(arcus costalis). The right and left costal arches anteriorly limit infrasternal angle(angulus infrasternialis), open downwards.

Connections of the bones of the upper limb (juncturae membri superioris)are divided into joints of the upper limb girdle (sternoclavicular and acromioclavicular joints) and joints of the free part of the upper limb.

Sternoclavicular joint (art. sterno-clavicularis) is formed by the sternal end of the clavicle and the clavicular notch of the sternum, between which there is an articular disc that fuses with the joint capsule (Fig. 117). The articular capsule is strengthened by the anterior and posterior sternoclavicular ligament(ligg. sternoclavicularia anterior et posterior). Between the sternal ends of the clavicles is stretched interclavicular ligament(lig. interclaviculare). The joint is also strengthened by the extracapsular costoclavicular ligament, which connects the sternal end of the clavicle and the upper surface of the 1st rib. In this joint, it is possible to raise and lower the clavicle (around the sagittal axis), move the clavicle (acromial end) forward and backward (around the vertical axis), rotate the clavicle around the frontal axis and circular movement.

AC joint (art. acromioclavicularis) is formed by the acromial end of the clavicle and the articular surface of the acromion. Capsule reinforced acromioclavicular

Fig. 117.The sternoclavicular joint. Front view. On the right, the joint is opened with a frontal incision. 1 - interclavicular ligament, 2 - sternal end of the clavicle, 3 - first rib, 4 - costoclavicular ligament, 5 - anterior sternoclavicular ligament, 6 - costal cartilage of the first rib, 7 - manubrium of the sternum, 8 - spongy substance of the sternum , 9 - costosternal synchondrosis, 10 - synchondrosis of the first rib, 11 - articular disc, 12 - articular cavities of the sternoclavicular joint.

bunch(lig. acromioclaviculare), stretched between the acromial end of the clavicle and the acromion. Near the joint there is a powerful coracoclavicular ligament(lig. coracoclaviculare), connecting the surface of the acromial end of the clavicle and the coracoid process of the scapula. The acromioclavicular joint allows movement in three axes.

Between the individual parts of the scapula there are ligaments that are not directly related to the joints. The coracoacromial ligament is stretched between the top of the acromion and the coracoid process of the scapula, the superior transverse scapular ligament connects the edges of the scapular notch, turning it into an opening, and the inferior transverse scapular ligament connects the base of the acromion and the posterior edge of the glenoid cavity of the scapula.

Joints of the free part of the upper limb connect the bones of the upper limb to each other - the scapula, humerus, bones of the forearm and hand, forming joints of various sizes and shapes.

Shoulder joint (art. humeri)formed by the articular cavity of the scapula, which is complemented at the edges by the articular lip, and the spherical head of the humerus (Fig. 118). The articular capsule is thin, free, and is attached to the outer surface of the articular labrum and to the anatomical neck of the humerus.

The articular capsule is reinforced at the top coracobrachial ligament(lig. coracohumerale), which begins at the base of the coracoid process of the scapula and attaches to the upper

Rice. 118.Shoulder joint, right. Front cut.

1 - acromion, 2 - articular labrum, 3 - supraglenoid tubercle, 4 - articular cavity of the scapula, 5 - coracoid process of the scapula, 6 - superior transverse ligament of the scapula, 7 - lateral angle of the scapula, 8 - subscapular fossa of the scapula, 9 - lateral edge of the scapula , 10 - articular cavity of the shoulder joint, 11 - articular capsule, 12 - long head of the biceps brachii, 13 - humerus, 14 - intertubercular synovial sheath, 15 - head of the humerus, 16 - tendon of the long head of the biceps brachii.

parts of the anatomical neck and to the greater tubercle of the humerus. The synovial membrane of the shoulder joint forms protrusions. The intertubercular synovial sheath surrounds the tendon of the long head of the biceps brachii muscle, which passes through the joint cavity. The second protrusion of the synovial membrane, the subtendinous bursa of the subscapularis muscle, is located at the base of the coracoid process.

In the shoulder joint, which is spherical in shape, flexion and extension, abduction and adduction of the arm, rotation of the shoulder outward (supination) and inward (pronation), and circular movements are carried out.

Elbow joint (art. cubiti)formed by the humerus, radius and ulna (complex joint) with a common articular capsule that surrounds three joints: humeroulnar, brachioradial and proximal radioulnar (Fig. 119). Shoulder-elbow joint(art. humeroulnaris), trochlear, formed by the connection of the trochlea of the humerus with the trochlear notch of the ulna. Humeroradialis joint(art. humeroradialis), spherical, is the connection of the head of the condyle of the humerus and the articular cavity of the radius. Proximal radioulnar joint(art. radioulnaris), cylindrical, formed by the articular circumference of the radius and the radial notch of the ulna.

The articular capsule of the elbow joint is strengthened by several ligaments. Ulnar collateral ligament(lig. collaterale ulnare) begins on the medial epicondyle of the humerus, attaches to the medial edge of the trochlear notch of the ulna. Radial collateral ligament(lig. collaterale radiale) begins on the lateral epicondyle of the humerus, attaches at the anterior outer edge of the trochlear notch of the ulna. Annular ligament of the radius(lig. annulare radii) begins at the anterior edge of the radial notch and attaches to the posterior edge of the radial notch, covering (surrounding) the neck of the radial bone.

In the elbow joint, movements around the frontal axis are possible - flexion and extension of the forearm. Around the longitudinal axis in the proximal and distal ray-local

Rice. 119.Elbow joint (right) and joints of the bones of the forearm. Front view. 1 - humerus, 2 - articular capsule,

3 - medial epicondyle of the humerus,

4 - humerus block, 5 - articular cavity of the elbow joint, 6 - oblique chord, 7 - ulna, 8 - interosseous membrane of the forearm, 9 - distal radioulnar joint, 10 - radius, 11 - annular ligament of the radius, 12 - head radius, 13 - head of the condyle of the humerus.

These joints rotate the radius along with the hand (inward - pronation, outward - supination).

Connections of the bones of the forearm and hand. The bones of the forearm are connected to each other using discontinuous and continuous connections (Fig. 119). A continuous connection is interosseous membrane of the forearm(membrana interossea antebrachii). It is a strong connective tissue membrane stretched between the interosseous edges of the radius and ulna. Down from the proximal radioulnar joint, a fibrous cord is stretched between both bones of the forearm - the oblique chord.

The discontinuous connections of the bones are the proximal (above) and distal radioulnar joints, as well as the joints of the hand. Distal radioulnar joint(art. radioulnaris distalis) is formed by the connection of the articular circumference of the ulna and the ulnar notch of the radius (Fig. 119). The articular capsule is free, attached along the edge of the articular surfaces. The proximal and distal radioulnar joints form a combined cylindrical joint. In these joints, the radius bone, together with the hand, rotates around the ulna (longitudinal axis).

Wrist joint (art. radiocarpea), complex in structure, elliptical in shape, is a connection of the bones of the forearm with the hand (Fig. 120). The joint is formed by the carpal articular surface of the radius, the articular disc (on the medial side), as well as the scaphoid, lunate and triquetral bones of the hand. The articular capsule is attached to the edges of the articulating surfaces and is strengthened by ligaments. Radial collateral ligament of the wrist(lig. collaterale carpi radiale) begins on the styloid process of the radius and attaches to the scaphoid bone. Ulnar collateral ligament of the wrist(lig. collaterale carpi ulnare) goes from the styloid process of the ulna to the triquetral bone and to the pisiform bone of the wrist. Palmar radiocarpal ligament(lig. radiocarpale palmare) runs from the posterior edge of the articular surface of the radius to the first row of carpal bones (Fig. 121). In the wrist joint, movements are performed around the frontal axis (flexion and extension) and around the sagittal axis (abduction and adduction), a circular movement.

The bones of the hand are connected to each other by numerous joints that have articular surfaces of different shapes.

Midcarpal joint (art. mediocarpalis) is formed by the articulating bones of the first and second rows of the wrist (Fig. 120). This joint is complex, the joint space has an S-reverse shape, continues into the articular spaces between the individual bones of the wrist and communicates with the carpometacarpal joints. The articular capsule is thin, attached to the edges of the articular surfaces.

Intercarpal joints (art. intercarpales) are formed by adjacent carpal bones. Articular capsules are attached to the edges of articulating surfaces.

The midcarpal and intercarpal joints are inactive, strengthened by many ligaments. Radiate ligament of the carpus(lig. carpi radiatum) goes on the palmar surface of the capitate bone to the adjacent bones. The adjacent carpal bones are also connected by the palmar intercarpal ligaments and the dorsal intercarpal ligaments.

Carpometacarpal joints (artt. carpometacarpales) (2-5 metacarpal bones), flat in shape, have a common joint space, inactive. The articular capsule is strengthened by the dorsal carpometacarpal and palmar carpometacarpal ligaments, which are stretched between the bones of the wrist and hand (Fig. 121). Carpometacarpal joint of the thumb bones(art. carpometacarpalis pollicis) is formed by the saddle-shaped articular surfaces of the trapezium bone and the base of the 1st metacarpal bone.

Intermetacarpal joints (artt. intermetacarpales) are formed by the lateral surfaces of the bases of 2-5 metacarpal bones adjacent to each other. Articular capsule at the intermetacarpal and carpal

Rice. 120.Joints and ligaments of the hand. View from the palm side.

1 - distal radioulnar joint, 2 - ulnar collateral ligament of the wrist, 3 - pisiform hamate ligament, 4 - pisiform metacarpal ligament, 5 - hamate hook, 6 - palmar carpometacarpal ligament, 7 - palmar metacarpal ligaments, 8 - deep transverse metacarpals ligaments, 9 - metacarpophalangeal joint (opened), 10 - fibrous sheath of the tendons of the fingers (opened), 11 - interphalangeal joints (opened), 12 - tendon of the deep flexor muscle of the fingers, 13 - tendon of the muscle of the superficial flexor of the fingers, 14 - collateral ligaments, 15 - carpometacarpal joint of the thumb, 16 - capitate bone. 17 - radiate carpal ligament, 18 - radial collateral ligament of the wrist, 19 - palmar radiocarpal ligament, 20 - lunate bone, 21 - radius bone, 22 - interosseous membrane of the forearm, 23 - ulna.

general metacarpal joints. The intermetacarpal joints are strengthened by transversely located dorsal and palmar metacarpal ligaments.

Metacarpophalangeal joints (artt. metacarpophalangeae), from the 2nd to the 5th are spherical in shape, and the 1st is block-shaped, formed by the bases of the proximal phalanges of the fingers and the articular surfaces of the heads of the metacarpal bones (Fig. 121). Articular capsules are attached to the edges of the articular surfaces and are strengthened by ligaments. On the palmar side the capsules are thickened due to the palmar ligaments, on the sides - by collateral ligaments. Deep transverse metacarpal ligaments are stretched between the heads of the 2nd-5th metacarpal bones. Therefore, movements in them are possible around the frontal axis (flexion and extension) and around the sagittal axis (abduction and adduction), small circular movements. In the metacarpophalangeal joint of the thumb - only flexion and extension

Interphalangeal joints of the hand (artt. interphalangeae manus) are formed by the heads and bases of adjacent phalanges of the fingers of the hand, block-shaped in shape. The joint capsule is strengthened

Rice. 121.Joints and ligaments of the hand, right. Longitudinal cut.

1 - radius bone, 2 - wrist joint, 3 - scaphoid bone, 4 - radial collateral ligament of the wrist, 5 - trapezium bone, 6 - trapezoid bone, 7 - carpometacarpal joint of the thumb, 8 - carpometacarpal joint, 9 - metacarpal bones. 10 - interosseous metacarpal ligaments, 11 - intermetacarpal joints, 12 - capitate bone, 13 - hamate bone, 14 - triquetral bone, 15 - lunate bone, 16 - ulnar collateral ligament of the wrist, 17 - articular disc of the radiocarpal joint, 18 - distal radioulnar joint , 19 - bag-shaped depression, 20 - ulna, 21 - interosseous membrane of the forearm.

lena palmar and collateral ligaments. Movements in the joints are only possible around the frontal axis (flexion and extension)

Connections of the bones of the lower limb

Joints of the bones of the lower extremities divided into joints of the bones of the lower limb girdle and the free part of the lower limb. The joints of the lower extremity girdle include the sacroiliac joint and the pubic symphysis (Fig. 122 A).

Sacroiliac joint (articulatio sacroiliac)formed by the ear-shaped surfaces of the pelvic bone and sacrum. The articular surfaces are flattened and covered with thick fibrous cartilage. According to the shape of the articular surfaces, the sacroiliac joint is flat, the articular capsule is thick, tightly stretched, and is attached to the edges of the articular surfaces. The joint is strengthened by strong ligaments. Anterior sacroiliac ligament(lig. sacroiliacum anterius) connects the anterior edges of the articulating surfaces. The back of the capsule is reinforced posterior sacroiliac ligament(lig. sacroiliacum posterius). Interosseous sacroiliac ligament(lig. sacroiliacum interosseum) connect both articulating bones. Movements in the sacroiliac joint are as limited as possible. The joint is stiff. The lumbar spine is connected to the ilium iliopsoas ligament(lig. iliolumbale), which begins on the anterior side of the transverse processes of the IV and V lumbar vertebrae and is attached to the posterior parts of the iliac crest and to the medial surface of the iliac wing. The pelvic bones are also connected to the sacrum with the help of two

Rice. 122A.Joints and ligaments of the pelvis. Front view.

1 - IV lumbar vertebra, 2 - intertransverse ligament, 3 - anterior sacroiliac ligament, 4 - ilium, 5 - sacrum, 6 - hip joint, 7 - greater trochanter of the femur, 8 - pubofemoral ligament, 9 - pubis symphysis, 10 - inferior pubic ligament, 11 - superior pubic ligament, 12 - obturator membrane, 13 - obturator canal, 14 - descending part of the iliofemoral ligament, 15 - transverse part of the iliofemoral ligament, 16 - greater sciatic foramen, 17 - inguinal ligament, 18 - superior anterior iliac spine, 19 - lumboiliac ligament.

powerful extra-articular ligaments. Sacrotuberous ligament(lig. sacrotuberale) goes from the ischial tuberosity to the lateral edges of the sacrum and coccyx. Sacrospinous ligament(lig. sacrospinale) connects the ischial spine with the sacrum and coccyx.

Pubic symphysis (symphysis pubica)formed by the symphysial surfaces of two pubic bones, between which is located interpubic disc(discus interpubicus), which has a sagittally located narrow slit-like cavity. The pubic symphysis is strengthened by ligaments. Superior pubic ligament(lig. pubicum superius) is located transversely upward from the symphysis, between both pubic tubercles. Arcuate ligament of the pubis(lig. arcuatum pubis) is adjacent to the symphysis from below, passes from one pubic bone to another.

Pelvis (pelvis)formed by the connecting pelvic bones and the sacrum. It is a bone ring, which is a container for many internal organs (Fig. 122 B). The pelvis has two sections - the large and small pelvis. Big pelvis(pelvis major) is limited from the lower pelvis by a boundary line that passes through the promontory of the sacrum, then along the arcuate line of the iliac bones, the crest of the pubic bones and the upper edge of the pubic symphysis. The large pelvis is limited from behind by the body of the V lumbar vertebra, from the sides by the wings of the ilium. The large pelvis does not have a bony wall in front. Small pelvis(pelvis minor) posteriorly formed by the pelvic surface of the sacrum and the ventral surface of the coccyx. On the side, the walls of the pelvis are the inner surface of the pelvic bones (below the boundary line), the sacrospinous and sacrotuberous ligaments. The anterior wall of the pelvis is the upper and lower rami of the pubic bones, and in front is the pubic symphysis. Small pelvis

Rice. 122B.Female pelvis. Front view.

1 - sacrum, 2 - sacroiliac joint, 3 - large pelvis, 4 - small pelvis, 5 - pelvic bone, 6 - pubic symphysis, 7 - subpubic angle, 8 - obturator foramen, 9 - acetabulum, 10 - border line .

Rice. 123.Hip joint, right. Front cut.

1 - acetabulum, 2 - articular cavity, 3 - ligament of the femoral head, 4 - transverse ligament of the acetabulum, 5 - circular zone, 6 - ischium, 7 - femoral neck, 8 - greater trochanter, 9 - articular capsule, 10 - acetabular lip, 11 - head of the femur, 12 - ilium.

has inlet and outlet openings. The upper aperture (opening) of the small pelvis is located at the level of the boundary line. The exit from the small pelvis (lower aperture) is limited from behind by the coccyx, on the sides by the sacrotuberous ligaments, branches of the ischial bones, ischial tuberosities, lower branches of the pubic bones, and in front by the pubic symphysis. The obturator foramen, located in the lateral walls of the pelvis, is closed by an obturator membrane. On the lateral walls of the pelvis there are large and small sciatic foramina. The greater sciatic foramen is located between the greater sciatic notch and the sacrospinous ligament. The lesser sciatic foramen is formed by the lesser sciatic notch, sacrotuberous and sacrospinous ligaments.

Hip joint (art. coxae), spherical in shape, formed by the lunate surface of the acetabulum of the pelvic bone, enlarged by the acetabulum and the head of the femur (Fig. 123). The transverse acetabular ligament extends over the notch of the acetabulum. The articular capsule is attached along the edges of the acetabulum, on the femur in front - on the intertrochanteric line, and behind - on the intertrochanteric ridge. The joint capsule is strong, reinforced by thick ligaments. In the thickness of the capsule there is a ligament - circular zone(zona orbicularis), covering the neck of the femur in the form of a loop. Iliofemoral ligament(lig. iliofemorale)

located on the anterior side of the hip joint, it begins on the inferior anterior iliac spine and attaches to the intertrochanteric line. Pubofemoral ligament(lig. pubofemorale) goes from the superior branch of the pubic bone to the intertrochanteric line on the femur. The ischiofemoral ligament (lig. ischiofemorale) begins on the body of the ischium and ends at the trochanteric fossa of the greater trochanter. In the joint cavity there is a ligament of the femoral head (lig. capitis femoris), connecting the fossa of the head and the bottom of the acetabulum.

In the hip joint, flexion and extension are possible - around the frontal axis, abduction and adduction of the limb - around the sagittal axis, outward rotation (supination) and inward (pronation) - relative to the vertical axis.

Knee joint (art. genus),a large and complex joint in structure, formed by the femur, tibia and patella (Fig. 124).

Inside the joint there are crescent-shaped intra-articular cartilages - lateral and medial menisci (meniscus lateralis et meniscus medialis), the outer edge of which is fused

Rice. 124.Knee joint, right. Front view. The joint capsule has been removed. The patella is down. 1 - patellar surface of the femur, 2 - medial condyle of the femur, 3 - posterior cruciate ligament, 4 - anterior cruciate ligament, 5 - transverse ligament of the knee, 6 - medial meniscus, 7 - tibial collateral ligament, 8 - tibia, 9 - patella, 10 - quadriceps femoris tendon, 11 - patellar ligament, 12 - head of the fibula, 13 - tibiofibular joint, 14 - biceps femoris tendon, 15 - lateral meniscus, 16 - fibular collateral ligament, 17 - lateral condyle of the femur.

with the joint capsule. The inner thinned edge of the meniscus is attached to the condylar eminence of the tibia. The anterior ends of the menisci are connected transverse knee ligament(lig. transversum genus). The articular capsule of the knee joint is attached to the edges of the articular surfaces of the bones. The synovial membrane forms several intra-articular folds and synovial bursae.

The knee joint is strengthened by several strong ligaments. Peroneal collateral ligament(lig. collaterale fibulare) goes from the lateral epicondyle of the femur to the lateral surface of the head of the fibula. Tibial collateral ligament(lig. collaterale tibiale) begins on the medial epicondyle of the femur and attaches to the upper part of the medial edge of the tibia. Located on the back of the joint oblique popliteal ligament(lig. popliteum obliquum), which begins on the medial

edge of the medial condyle of the tibia and is attached to the posterior surface of the femur, above its lateral condyle. Arcuate popliteal ligament(lig. popliteum arcuatum) begins on the posterior surface of the head of the fibula, bends medially and attaches to the posterior surface of the tibia. In front, the joint capsule is strengthened by the tendon of the quadriceps femoris muscle, which is called patellar ligament(lig. patellae). There are cruciate ligaments in the cavity of the knee joint. Anterior cruciate ligament(lig. cruciatum anterius) begins on the medial surface of the lateral condyle of the femur and attaches to the anterior intercondylar field of the tibia. Posterior cruciate ligament(lig. cruciatum posterius) is stretched between the lateral surface of the medial condyle of the femur and the posterior intercondylar field of the tibia.

The knee joint is complex (contains menisci), condylar. Flexion and extension occur in it around the frontal axis. With a bent shin, the shin can rotate outward (supination) and inward (pronation) around the longitudinal axis.

Joints of the leg bones. The bones of the lower leg are connected by the tibiofibular joint, as well as continuous fibrous connections - the tibiofibular syndesmosis and the interosseous membrane of the tibia (Fig. 125).

Tibiofibular joint (art. tibiofibularis)formed by the articulation of the articular fibular surface of the tibia and the articular surface of the head of the fibula. The articular capsule is attached along the edge of the articular surfaces, strengthened by the anterior and posterior ligaments of the head of the fibula.

Interfibular syndesmosis (syndesmosis tibiofibularis)formed by the fibular notch of the tibia and the rough surface of the base of the lateral malleolus of the fibula. Anteriorly and posteriorly, the tibiofibular syndesmosis is strengthened by the anterior and posterior tibiofibular ligaments.

Rice. 125.Joints of the leg bones. Front view. 1 - proximal epiphysis of the tibia, 2 - diaphysis (body) of the tibia,

3 - distal epiphysis of the tibia,

4 - medial malleolus, 5 - lateral malleolus, 6 - anterior tibiofibular ligament, 7 - fibula, 8 - interosseous membrane of the tibia, 9 - head of the fibula, 10 - anterior ligament of the head of the fibula.

Interosseous membrane of the leg (membrana interossea cruris) is a strong connective tissue membrane stretched between the interosseous edges of the tibia and fibula.

Connections of the bones of the foot. The bones of the foot connect with the bones of the lower leg (ankle joint) and with each other, forming joints of the tarsal bones, metatarsal bones, and also the joints of the toes (Fig. 126).

Rice. 126.Ankle and foot joints. View from the right, top and front.

1 - tibia, 2 - ankle joint, 3 - deltoid ligament, 4 - talus, 5 - talonavicular ligament, 6 - bifurcated ligament, 7 - dorsal cuneonavicular ligament, 8 - dorsal metatarsal ligaments, 9 - joint capsule I metatarsophalangeal joint, 10 - articular capsule of the interphalangeal joint, 11 - collateral ligaments, 12 - metatarsophalangeal joints, 13 - dorsal tarsometatarsal ligaments, 14 - dorsal sphenocuboid ligament, 15 - interosseous talocalcaneal ligament, 16 - calcaneus, 17 - lateral talocalcaneal ligament, 18 - anterior talofibular ligament, 19 - calcaneofibular ligament, 20 - lateral malleolus, 21 - anterior tibiofibular ligament, 22 - interosseous membrane of the leg.

Ankle joint (art. talocruralis),complex in structure, block-shaped in shape, formed by the tibia and the articular surfaces of the trochlea of the talus, the articular surfaces of the medial and lateral malleoli. Ligaments are located on the lateral surfaces of the joint (Fig. 127). On the lateral side of the joint there are front And posterior talofibular ligament(ligg. talofibulare anterius et posterius) and calcaneofibular ligament(lig. calcaneofibulare). They all begin on the lateral malleolus. The anterior talofibular ligament goes to the neck of the talus, the posterior talofibular ligament goes to the posterior process of the talus, the calcaneofibular ligament goes to the outer surface of the calcaneus. On the medial side of the ankle joint is located medial (deltoid) ligament(lig. mediale, seu deltoideum), starting on the medial malleolus. This ligament is inserted on the dorsum of the scaphoid, on the fulcrum and on the posteromedial surface of the talus. Flexion and extension are possible at the ankle joint (relative to the frontal axis).

The tarsal bones form the subtalar, talocaleonavicular and calcaneocuboid, as well as the cuneiform-navicular and tarsometatarsal joints.

Subtalar joint (art.subtalaris)formed by the connection of the talar articular surface of the calcaneus and the posterior calcaneal articular surface of the talus. The joint capsule is attached to the edges of the articular cartilages. The joint is strengthened lateral And medial talocalcaneal ligament(ligg. talocalcaneae laterale et mediale).

Rice. 127.Joints and ligaments of the foot in a longitudinal section. View from above.

1 - tibia, 2 - ankle joint, 3 - deltoid ligament, 4 - talus, 5 - talocaleonavicular joint, 6 - navicular bone, 7 - wedge-navicular joint, 8 - interosseous intersphenoid ligament, 9 - wedge-shaped bones, 10 - interosseous wedge-metatarsal ligament, 11 - collateral ligaments, 12 - interphalangeal joints, 13 - metatarsophalangeal joints, 14 - interosseous metatarsal ligaments, 15 - tarsometatarsal joints, 16 - cuboid bone, 17 - calcaneocuboid joint, 18 - bifurcated ligament, 19 - interosseous talocalcaneal ligament, 20 - lateral malleolus, 21 - interosseous membrane of the leg.

Talocaleonavicular joint (art. talocalcaneonavicularis) formed by the articular surface of the head of the talus, articulating with the scaphoid bone in front and the calcaneus below. Based on the shape of the articular surfaces, the joint is classified as spherical. The joint is strengthened interosseous talocalcaneal ligament(lig. talocalcaneum interosseum), which is located in the sinus of the tarsus, where it connects the surfaces of the grooves of the talus and calcaneus, plantar calcaneonavicular ligament(lig. colcaneonaviculare plantare), connecting the support of the talus and the lower surface of the scaphoid.

Calcaneocuboid joint (art. calcaneocuboidea)formed by the articular surfaces of the calcaneus and cuboid bones, saddle-shaped in shape. The articular capsule is attached to the edge of the articular cartilage and is stretched tightly. Strengthens the joint long plantar ligament(lig. plantare longum), which begins on the lower surface of the calcaneus, fan-shapedly diverges anteriorly and attaches to the bases of the 2nd-5th metatarsal bones. Plantar calcaneocuboid ligament(lig. calcaneocuboidea) connects the plantar surfaces of the calcaneus and cuboid bones.

The calcaneocuboid joint and the talonavicular joint (part of the talocaleonavicular joint) form a combined transverse tarsal joint (art. tarsi transversa), or Chopart's joint, which has common bifurcated ligament(lig. bifurcatum), consisting of the calcaneonavicular and calcaneocuboid ligaments, which begin on the superolateral edge of the calcaneus. The calcaneonavicular ligament is attached to the posterolateral edge of the scaphoid bone, and the calcaneocuboid ligament is attached to the dorsum of the cuboid bone. The following movements are possible in this joint: flexion - pronation, extension - supination of the foot.

Wedge-navicular joint (art. cuneonavicularis)formed by the flat articular surfaces of the scaphoid and three sphenoid bones. The articular capsule is attached to the edges of the articular surfaces. These joints are strengthened by the dorsal, plantar and interosseous tarsal ligaments. Movement in the sphenodvicular joint is limited.

Tarsometatarsal joints (artt. tarsometatarsales)formed by the cuboid, sphenoid and metatarsal bones. The joint capsules are stretched along the edges of the articulating surfaces. The joints are strengthened by the dorsal and plantar tarsometatarsal ligaments. The interosseous sphenometatarsal ligaments connect the sphenoid bones to the bones of the metatarsus. The interosseous metatarsal ligaments connect the bases of the metatarsal bones. Movement in the tarsometatarsal joints is limited.

Intermetatarsal joints (artt. intermetatarsales)formed by the bases of the metatarsal bones facing each other. The articular capsules are strengthened by transversely located dorsal and plantar metatarsal ligaments. Between the articular surfaces facing each other in the articular cavities there are interosseous metatarsal ligaments. Movement in the intermetatarsal joints is limited.

Metatarsophalangeal joints (artt. metatarsophalangeae),spherical, formed by the heads of the metatarsal bones and the bases of the proximal phalanges of the fingers. The articular surfaces of the phalanges are almost spherical, the articular fossae are oval. The articular capsule is strengthened on the sides by collateral ligaments, and from below by plantar ligaments. The heads of the metatarsal bones are connected by the deep transverse metatarsal ligament. In the metatarsophalangeal joints, flexion and extension of the fingers relative to the frontal axis is possible. Abduction and adduction are possible within small limits around the sagittal axis.

Interphalangeal joints of the foot (artt. interphalangeae pedis), block-shaped, formed by the base and head of adjacent phalanges of the toes. The articular capsule of each interphalangeal joint is strengthened by the plantar and collateral ligaments. In the interphalangeal joints, flexion and extension are performed around the frontal axis.

Continuous bone connections- earlier in development. They are characterized by significant strength, little flexibility, little elasticity and limited movement. Continuous bone connections, depending on the structure of the tissue that connects them, are divided into three types of synarthrosis (BNA).
1. Fibrous compounds, junctura fibrosa s. syndesmosis.
2. Cartilaginous joints, junctura cortilaginea s. synchondrosis.
3. Bone joints of Junctura ossea s. synostosis.
Fibrous compounds are formed after the birth of a child when there remains between the bones, which ensures the connection of the bones.
1 TO fibrous compounds(syndesmoses) include: interosseous membranes, membranae interosseae, ligaments, ligamenta, interosseous sutures, suturae cranii, herniations, gomphosis and fontanelles, fonticuli.
Interosseous fibrous membranes, membrana interossea fibrosae, connect adjacent bones. They are located between the bones of the forearm, membrana interossea antebrachii, and between the bones of the lower leg, membranae interosseae cruris, or cover holes in the bones: for example, the obturator foramen membrane, membranae obturatoria, the anterior and posterior atlanto-occipital membranes, membranae atlantooccipitalis anterior et posterior. The interosseous membranes connect the bones and provide a large surface for muscles to attach to them. They are formed predominantly by bundles of collagen fibers and have openings for the passage of blood vessels and nerves.
Ligaments, ligamenta, serve to secure bone joints. They can be very short, such as the dorsal intercarpal ligament, ligg. intercarpalia dorsalia, or, conversely, long, like the anterior and posterior longitudinal ligaments of the spinal column, ligg. longitudinale anterius et posterius.
Ligaments are strong fibrous cords consisting of longitudinal, oblique and crossed bundles of collagen and a small amount of elastic fibers. Ligaments can withstand high tensile loads. This group also includes ligaments formed only by elastic fibers. They are not as strong as fibrous syndesmoses, but they are very stretchy and flexible. These are the yellow ligaments, liggamenta flavae, which are located between the vertebral arches.
Interosseous sutures, suturae cranii occur only in the skull; they are a type of syndesmosis, in which the edges of the bones are firmly connected by small layers of fibrous connective tissue. The seams are characterized by extreme strength. Depending on the shape of the skull bones, the following sutures are distinguished:
- Serrated, sutura serrata s. dentata (BNA), in which the edge of one bone has teeth that fit into the recesses of the second bone (for example, at the connection of the frontal bone with the parietal bone);
- Scaly, sutura squamosa, has the peculiarity that the pointed end of one bone in the form of scales is superimposed on the pointed edge of another bone (for example, a combination of scales of the temporal bone with the parietal);
- Flat, sutura plana s. harmonia (BNA), in which the smooth edge of one bone is adjacent to the same edge of the second, without the formation of protrusions, which is typical for the bones of the facial skull (for example, between the nasal bones).
Herniation [gomphosis], gomphosis, is a type of fibrous connection of bones. It can be observed between the roots of the teeth and the dental cells (dental-collar junction, sindesmosis dento-alveolaris). Between the tooth and the bone tissue of the cell there is a layer of connective tissue - periodontium, periodontium.
2. B cartilage joints(synchondrosis) - the bones are combined with a layer of fibrous or hyaline cartilage. Hyaline cartilage harmoniously combines strength and elasticity. Synchondroses are quite strong and elastic, due to which they perform spring functions. The mobility of this connection is insignificant and depends on the thickness of the cartilaginous layer - the greater its thickness, the higher the mobility, and vice versa. An example of synchondrosis formed by fibrous cartilage is the intervertebral discs, discus intewertebrales, located between the vertebral bodies. They are strong and elastic, serving as a buffer during shocks and shocks. An example of synchondrosis formed by hyaline cartilage is the epiphyseal cartilage, located on the border of the epiphyses and metaphyses in long tubular bones, or the costal cartilages, connecting the ribs to the sternum. According to the duration of their existence, synchondrosis can be: temporary, existing until a certain age (for example, the cartilaginous connection of the diaphysis and epiphyses of long tubular bones and three pelvic bones), as well as permanent, remaining throughout a person’s life (for example, between the pyramid of the temporal bone and neighboring bones : sphenoid and occipital). A type of synchondrosis is the pubic symphysis, symphysis pubica. It also combines bones with the help of cartilage with a small cavity.
3. If a temporary continuous connection (fibrous or cartilaginous) is replaced by bone tissue, it is called synostosis (BNA). This type of connection is the most durable, but loses its elastic function. An example of synostosis in an adult is the connection between the body of the occipital and sphenoid bones, between

The human skeleton is a collection of bones connected to each other and is the passive part of the musculoskeletal system. It functions as a support for soft tissues, a point of application of muscles and a container for internal organs. The skeleton of a newborn child includes 270 bones. As you grow older, some of them fuse (mainly the bones of the pelvis, skull and spine), so in a mature person this figure reaches 205-207. Different bones connect to each other in different ways. An ordinary person, when asked: “What types of bone joints do you know?” remembers only the joints, but that’s not all. The branch of anatomy that studies this topic is called osteoarthrosisyndesmology. Today we will briefly get acquainted with this science and the main types of bone connections.

Classification

Depending on the function of the bones, they can connect to each other in different ways. There are two main types of bone connections: continuous (synarthrosis) and discontinuous (diarthrosis). At the same time, they are further divided into subspecies.

Continuous connections can be:

Fibrous. This includes: ligaments, membranes, fontanelles, sutures, impactions.
Cartilaginous. They can be temporary (using hyaline cartilage) or permanent (using fibrocartilage).
Bone.

As for discontinuous joints, which can simply be called joints, they are classified according to two criteria: according to the axes of rotation and the shape of the articular surface; as well as by the number of articular surfaces.

According to the first sign, joints are:

Uniaxial (cylindrical and block-shaped).
Biaxial (ellipsoidal, saddle-shaped and condylar).
Multiaxial (spherical, flat).

And for the second:

Simple.
Complex.

There is also a type of block joint - the cochlear (helical) joint. It has a beveled groove and ridge that allows the articulated bones to move in a spiral manner. An example of such a joint is the humeroulnar joint, which also operates along the frontal axis.

Biaxial joints are called connections that operate around two axes of rotation out of the three existing ones. So, if the movement is carried out along the frontal and sagittal axes, then these connections can realize 5 types of movement: circular, abduction and adduction, flexion and extension. From the point of view of the shape of the articular surface, these are saddle-shaped (for example, the carpometacarpal joint of the thumb) or ellipsoidal (for example, the wrist joint) joints.

When movement is carried out along the vertical and frontal axes, the joint can realize three types of movements: rotation, flexion and extension. In shape, such joints are classified as condylar (for example, the temporomandibular and knee).

Multiaxial joints and are called connections in which movement occurs along three axes. They are capable of a maximum number of types of movement - 6 types. In terms of their shape, such joints are classified as spherical (for example, the shoulder joint). Varieties of the spherical type are: nut-shaped and cup-shaped. Such joints are characterized by a deep, durable capsule, a deep articular fossa and a relatively small range of motion.

When the surface of a ball is endowed with a large radius of curvature, it approaches an almost flat state. These types of bone joints are briefly called planar joints. They are characterized by: strong ligaments, a small difference between the areas of the articulated surfaces, and the absence of active movement. Therefore, flat joints are often called amphiarthrosis or sedentary.

Number of articular surfaces

This is the second sign for classifying open types of joints of skeletal bones. It divides simple and complex joints.

Simple joints have only two articular surfaces. Each of them can be formed by one or several bones. For example, the joint of the phalanges of the fingers is formed by only two bones, and in the wrist joint there are three bones on only one surface.

Complex joints may have several articular surfaces in one capsule at once. In other words, they are made up of a series of simple joints that can work together or separately. A prime example is the ulnar synovial joint, which has six distinct surfaces that form three joints: the humeroulnar, brachioradialis, and proximal joints. The knee joint is often classified as a complex joint, based on the fact that it has patellas and menisci. Thus, adherents of this opinion distinguish three simple joints in the knee synovial joint: meniscal-tibial, femoral-meniscal and femoral-patellar. In fact, this is not entirely correct, since the menisci and patellas still belong to the auxiliary elements.

Combined joints

Considering the types of joints of the body bones, it is also worth noting a special type of joints - combined. This term refers to those synovial joints that are located in different capsules (that is, anatomically separated) but work only together. These include, for example, the temporomandibular joint. It is worth noting here that in true combined synovial joints, movement cannot occur in only one of them. When combining joints with different surface shapes, movement begins at the joint that has fewer axes of rotation.

Conclusion

Types of bones, connection of bones, joint structure - all this and much more is studied by such a science as osteoarthrosisyndesmology. Today we got to know her superficially. This will be quite enough to feel confident when you hear the question: “What types of bone joints do you know?”

Summarizing the above, we note that bones can be connected by continuous and discontinuous connections, each of which performs its own special functions and has a number of subtypes. Scientists view bone as an organ, and the types of bone connections as a serious topic of research.

Continuous connections have greater elasticity, strength and, as a rule, limited mobility. Depending on the type of tissue connecting the bones, there are three types of continuous connections:

1) fibrous compounds,

2) synchondrosis (cartilaginous joints)

3) bone connections.

Fibrous connections

Articulationes fibrosae are strong connections between bones using dense fibrous connective tissue. Three types of fibrous joints have been identified: syndesmoses, sutures and impactions.

Types of bone connections (diagram).

A-joint. B-syndesmosis. B-synchondrosis. G-symphysis (hemiarthrosis). 1 - periosteum; 2 - bone; 3 - fibrous connective tissue; 4 - cartilage; 5 - synovial membrane; 6- fibrous membrane; 7 - articular cartilage; 8-articular cavity; 9-slit in the interpubic disc; 10-interpubic disc.

Syndesmosis, syndesmosis, is formed by connective tissue, the collagen fibers of which fuse with the periosteum of the connecting bones and pass into it without a clear boundary. Syndesmoses include ligaments and interosseous membranes. Ligaments, ligamenta, are thick bundles or plates formed by dense fibrous connective tissue. For the most part, ligaments spread from one bone to another and reinforce discontinuous joints (joints) or act as a brake that limits their movement. In the spinal column there are ligaments formed by elastic connective tissue that has a yellowish color. Therefore, such ligaments are called yellow, ligamenta flua. The yellow ligaments are stretched between the vertebral arches. They stretch when the spinal column bends anteriorly (spinal flexion) and, due to their elastic properties, shorten again, promoting extension of the spinal column.

Interosseous membranes, membranae interosseae, are stretched between the diaphyses of long tubular bones. Often, interosseous membranes and ligaments serve as the origin of muscles.

A suture, sutura, is a type of fibrous joint in which there is a narrow connective tissue layer between the edges of the connecting bones. The connection of bones by sutures occurs only in the skull. Depending on the configuration of the edges of the connecting bones, a serrated suture, sutura serrata, is distinguished; scaly suture, sutura squamosa, and flat suture, sutura plana. In a serrated suture, the jagged edges of one bone fit into the spaces between the teeth of the edge of another bone, and the layer between them is connective tissue. If the connecting edges of flat bones have obliquely cut surfaces and overlap each other in the form of scales, then a scaly suture is formed. In flat sutures, the smooth edges of two bones are connected to each other using a thin connective tissue layer.

A special type of fibrous joint is impaction, gomphosis (for example, dentoalveolar joint, articulatio dentoalueolaris). This term refers to the connection of the tooth with the bone tissue of the dental alveolus. Between the tooth and the bone there is a thin layer of connective tissue - periodontium, periodontum.

Synchondroses, synchondroses, are connections between bones using cartilage tissue. Such joints are characterized by strength, low mobility, and elasticity due to the elastic properties of cartilage. The degree of bone mobility and the amplitude of springing movements in such a joint depend on the thickness and structure of the cartilaginous layer between the bones. If the cartilage between the connecting bones exists throughout life, then such synchondrosis is permanent. In cases where the cartilaginous layer between the bones persists until a certain age (for example, sphenoid-occipital synchondrosis), this is a temporary connection, the cartilage of which is replaced by bone tissue. Such a joint replaced by bone tissue is called a bone joint - synostosis, synostosis (BNA).

DISCONTINUOUS OR SYNOVIAL JOINTS OF BONES (JOINTS)

Synovial joints (joints),

articulationes synoviales are the most advanced types of bone connections. They are distinguished by great mobility and a variety of movements. Each joint includes articular surfaces of bones covered with cartilage, an articular capsule, and an articular cavity with a small amount of synovial fluid. Some joints also have auxiliary formations in the form of articular discs, menisci and articular labrum.

The articular surfaces, fades articulares, in most cases of articulating bones correspond to each other - they are congruent (from the Latin congruens - corresponding, coinciding). If one articular surface is convex (articular head), then the second, articulating with it, is equally concave (glenoid cavity). In some joints these surfaces do not correspond to each other either in shape or size (incongruent).

Bone connections briefly. Types of connection of skeletal bones. There are three types of bone joints

Classification

Number of articular surfaces

Combined joints

Conclusion

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