Part 45

The =joint capsule= is strong and tight. It is reinforced by two ligaments. The =external ligament= (Ligamentum laterale) extends obliquely across the anterior part of the outer surface of the capsule, from which it is not distinctly separable. The =posterior ligament= (Ligamentum posterius) is an elastic band which is attached above to the postglenoid process, and below to a line on the posterior face of the neck of the mandible.

=Movements.=—The chief movements take place around a transverse axis passing through both joints. Associated with this hinge-like action is slight gliding movement, as in opening and shutting the mouth. When the mouth is shut, the condyle lies under the glenoid cavity. When the mandible is depressed, the condyle moves forward under the articular eminence of the temporal bone, carrying the disc with it. In protrusion and retraction of the lower jaw the gliding movement just described occurs without the hinge-like rotation of the condyle. These movements are similar in both joints. In the lateral movements (as usually performed in mastication) the action consists of rotation of the condyles around a vertical axis, while the disc glides forward on one side and backward on the other.

THE SYNARTHROSES OF THE SKULL

Most of the bones of the skull are united with the adjacent bones by =sutures=; a few are united by cartilage. The difference in the uniting medium depends on the fact that most of these bones are developed in membrane, but some are preformed in cartilage. Most of these joints are temporary, and are obliterated at various periods during development and growth. Their importance rests on the fact that so long as they persist, continuous growth is possible. They are usually designated according to the bones which enter into their formation, e. g., spheno-squamous, naso-frontal, internasal, etc. Special names (borrowed from human anatomy) are sometimes used; thus the interparietal, the parieto-occipital, and the parieto-frontal sutures are often called the sagittal, lambdoid, and coronal respectively.

Detailed description of the sutures has not sufficient clinical value to justify much addition to the statements made in the osteology in this connection. The obliteration or closure of the sutures is, however, worthy of brief mention. The cranial sutures are usually all closed at seven years, but the apex only of the petrous temporal is fused with the occipital and squamous temporal. Most of the facial sutures are practically closed at ten years, although complete synostosis may in some be delayed for years or may not occur at all; the nasal suture, for example, often persists even in advanced age, so far as its anterior part is concerned.

The principal =synchondroses= are: (1) That between the basioccipital and the body of the sphenoid (Synchondrosis sphenooccipitalis); (2) that between the presphenoid and postsphenoid (Synchondrosis intersphenoidalis); (3) those between the parts of the occipital bone (Synchondroses intraoccipitales). The first is usually ossified at four years, the second at three years, and the occipital bone is consolidated at two years.

The =symphysis= of the lower jaw (Symphysis mandibulæ) ossifies at one to six months.

THE HYOIDEAN ARTICULATIONS

The =temporo-hyoid articulation= is an amphiarthrosis, in which the dorsal angle of the proximal end of the great cornu (Stylo-hyal) is attached by a short bar of cartilage to the hyoid process of the petrous temporal bone. The cartilage (Arthrohyal) is about half an inch (ca. 1 to 1.5 cm. ) in length. The chief movement is hinge-like, the axis of motion passing transversely through both joints.

The =intercornual articulation= is an amphiarthrosis formed by the junction of the distal extremity of the great cornu with the proximal end of the small cornu (kerato-hyal). They are united by a very short piece of cartilage, in which there is usually a small nodule of bone in the young subject. This nodule, the epihyal or middle cornu, is usually fused with the great cornu in the adult. The chief movement here is also hinge-like, the angle between the cornua being increased or diminished.

The =basi-cornual articulation= is a diarthrosis formed by the junction of each small cornu (kerato-hyal) with the body (basi-hyal). The small cornu has a concave facet which articulates with the convex facet on either end of the dorsal surface of the body. The capsule is ample enough to allow considerable movement, which is chiefly hinge-like. The movements of the hyoid bone are concerned chiefly in the acts of mastication and swallowing. In the latter the distal parts of the hyoid bone are moved forward and upward, carrying the root of the tongue and the larynx with them, and then return to their former position.

THE ARTICULATIONS OF THE THORACIC LIMB

In the absence of the clavicle the thoracic limb forms no articulation with the trunk, unless we regard as such the union by muscles. The movement of the shoulder on the chest-wall is chiefly rotation around a transverse axis passing through the scapula behind the upper part of the spine.

THE SHOULDER JOINT

The shoulder or scapulo-humeral joint (Articulatio scapulo-humeralis) is formed by the junction of the distal end of the scapula with the proximal end of the humerus. The =articular surfaces= are: (1) On the scapula, the glenoid cavity; (2) on the humerus, the head. Both surfaces are approximately spherical and similar in curvature, but the humeral surface is much more extensive than that of the scapula.

The =joint capsule= is ample enough to allow the bones to be drawn apart about an inch (ca. 2 to 3 cm.); but this requires a very considerable amount of force unless air is admitted into the joint cavity. The fibrous layer (or capsular ligament) is not attached to the margin of the joint surfaces, but at a distance of one to two centimeters from it. It is strengthened in front by two diverging elastic bands, which arise on the scapular tuberosity and end on the lips of the bicipital groove. A pad of fat is interposed between the capsule and the tendon of the biceps.

Ligaments are absent from this joint, but the muscles and tendons around it afford remarkable security, so that dislocation seldom or never occurs. The large extent of the head of the humerus is also of importance in this regard.

The principal muscles which are attached around the joint and act as ligaments are: externally, the supraspinatus, infraspinatus, and teres minor; internally, the subscapularis; in front, the biceps and supraspinatus; behind, the triceps.

=Movements.=—While it is a typical enarthrosis in structure, and capable of the various movements of the ball-and-socket joint, the chief normal movements are flexion and extension. In the position of rest the angle formed between the scapula and humerus posteriorly is about 110° to 120°; in flexion it is reduced to about 80°, and in extension it is increased to about 145°. Adduction and abduction are very restricted, the former being limited chiefly by the infraspinatus, the latter by the subscapularis and the low insertion of the superficial pectoral muscles. Rotation is somewhat freer, but does not exceed 33°, when all the muscles are removed (Franck).

THE ELBOW JOINT

This, the cubital articulation (Articulatio cubiti), is a ginglymus formed between the distal extremity of the humerus and the proximal ends of the bones of the forearm.

FIG. 143.—LEFT ELBOW JOINT OF HORSE, POSTERIOR VIEW. THE CAPSULE IS REMOVED. (After Schmaltz, Atlas d. Anat. d. Pferdes.) ]

The =articular surfaces= are: (1) A trochlear surface formed by the condyles of the humerus and the groove between them; (2) the corresponding glenoid cavities and ridge on the proximal extremity of the radius, together with the semilunar notch of the ulna.

The articular surface of the condyles does not extend upon the back of the extremity, but the groove which receives the semilunar notch of the ulna extends up into the olecranon fossa. In the fore part of the groove there is a synovial fossa. The surface on the outer condyle is smaller than that of the inner one, and is subdivided into two unequal parts by a shallow furrow. On the lower part of the semilunar notch and the adjacent part of the ridge on the radius are synovial fossæ.

The =joint capsule= is extremely thin behind, where it forms a pouch in the olecranon fossa under the anconeus muscle and a pad of fat. In front it is strengthened by oblique fibers (Ligamentum obliquum or anterior ligament), and laterally it fuses with the lateral ligaments. Small pouches of the =synovial membrane= lubricate the origins of the flexors of the carpus and digit and the small radio-ulnar joints. There are two lateral ligaments.

The =internal lateral ligament= (Ligamentum collaterale radiale) is attached above to an eminence on the internal epicondyle of the humerus, and divides into two parts: the long, superficial part ends on the inner border of the radius, just below the level of the interosseous space; the deep, short part is inserted into the internal tuberosity of the radius. (The superficial part represents the pronator teres muscle, which is only exceptionally present in the horse.)

The =external lateral ligament= (Ligamentum collaterale ulnare) is short and strong. It is attached above to a depression on the external epicondyle of the humerus, and below to the external tuberosity of the radius, just below the margin of the articular surface.

=Movements.=—This joint is a typical ginglymus, the only movements being flexion and extension around an axis which passes through the upper attachments of the lateral ligaments. In the standing position the articular angle (in front) is about 140° to 150°. The range of movement is about 55° to 60°. Complete extension is prevented chiefly by the tension of the lateral ligaments and the biceps muscle. (The axis of movement is slightly oblique, so that in flexion the forearm is carried somewhat outward.)