Part 24

Extension is checked mainly by tension of the crucial and lateral ligaments. In extreme extension, which is accompanied by slight outward rotation of the leg, the patella can be pushed upward and inward so that its fibro-cartilage hooks over the upper end of the inner ridge of the trochlea, but it will not remain there unless held in position. When pressure is removed, the base of the patella tips forward and the cartilage lies upon the most prominent part of the trochlear ridge. During flexion, which is accompanied by slight inward rotation of the leg, the condyles of the femur and the semilunar cartilages glide backward on the tibia; the movement of the external condyle and cartilage is greater than that of the inner one. In extreme flexion the patellar and posterior crucial ligaments are tense; the other ligaments are relaxed. The movement of the patella is gliding with coaptation, _i. e._, different parts of the opposing articular surfaces come into contact successively. Only a narrow transverse strip (ca. 1.5 to 2 cm. wide) of the patella is in contact with the trochlea at a time.

TIBIO-FIBULAR ARTICULATION

The head of the fibula articulates with a crescentic facet just below the outer margin of the external condyle of the tibia. The =joint capsule= is strong and close. The shaft of the fibula is attached to the external border of the tibia by the =interosseous membrane= of the leg (Membrana interossea cruris); this is perforated about an inch from its proximal end by an opening which transmits the anterior tibial vessels to the front of the tibia. A fibrous cord usually extends from the distal end of the shaft of the fibula to the external malleolus. The latter is the distal end of the fibula which has fused with the tibia. No appreciable movement occurs in this joint.

THE HOCK JOINT

This is a composite joint made up of a number of articulations (Articulationes tarsi). These are: (1) The tibio-tarsal articulation; (2) the intertarsal articulations; (3) the tarso-metatarsal articulation.

The =tibio-tarsal articulation= (Articulatio talo-cruralis) is a typical ginglymus formed by the trochlea of the tibial tarsal bone (astragalus or talus) and the corresponding surface of the distal end of the tibia. The ridges and grooves of these surfaces are directed obliquely forward and outward at an angle of about 12° to 15°, with a sagittal plane. The trochlear surface is about twice as extensive as that on the tibia, and its ridges have a spiral curvature. The other articulations are arthrodia, which have joint surfaces and ligaments of such a nature as to allow only a minimal amount of gliding motion.

As in the case of the carpal joints, it is convenient to describe first the common capsule and ligaments, which are the more important practically, and then to consider very briefly the special ligaments.

The fibrous part of the =joint capsule= is attached around the margin of the tibial articular surface above and the metatarsal surfaces below; it is also attached in part to the free surface of the bones which it covers, and blends with the lateral ligaments. Its anterior part (anterior ligament) is rather thin; in distention of the capsule, as in “bog-spavin,” its antero-internal part, which is not bound down by the tendons passing over the joint, forms a fluctuating swelling over the inner ridge of the trochlea. The posterior part (posterior and tarso-metatarsal ligaments) is very thick, and is intimately attached to the tarsal bones. Its superficial face is in part cartilaginous, and forms a smooth surface for the perforans tendon. Superiorly, it pouches upward behind the distal end of the tibia for a distance of about two inches (ca. 5 cm.). Interiorly, it is continued downward, forming the =subtarsal= or =check ligament=, which unites with the perforans tendon about the middle of the metatarsus.

There are four =synovial sacs=: 1. The =tibio-tarsal sac= lubricates the proximal joint, and is much the largest and most important. It is chiefly involved in the swelling produced by excess of fluid in the joint cavity, when the capsule bulges antero-internally and postero-superiorly. 2. The =first intertarsal sac= lines the joints formed by the tibial and fibular tarsal bones above, and the central and fourth tarsals below; it communicates in front with the proximal synovial capsule. 3. The =second intertarsal sac= lubricates the joints formed between the central tarsal and the bones below and on either side. 4. The =tarso-metatarsal sac= lubricates the joints formed between the tarsal and metatarsal bones, those between the proximal ends of the metatarsal bones, and those formed by the third tarsal with the bones on either side.

=Common Ligaments.=—The =external lateral ligament= (Ligamentum collaterale fibulare longum et breve) consists of two distinct bands which cross each other. The =long= (superficial) =ligament= arises on the posterior part of the external malleolus, is directed almost straight downward, and is attached to the fibular and fourth tarsal bones and the large and external small metatarsal bones. It forms a canal for the lateral extensor tendon. The =short= (deep) =ligament= arises on the anterior part of the external malleolus, is directed chiefly backward, and ends on the rough excavation on the external surface of the tibial tarsal and the adjacent surface of the fibular tarsal bone.

The =internal lateral ligament= (Ligamentum collaterale tibiale longum et breve) also consists of two parts which cross each other. The =long ligament= arises on the posterior part of the internal malleolus, becomes wider below, and is attached on the lower tuberosity of the tibial tarsal, the large and outer small metatarsal bones, and the inner surface of the lower tarsal bones which it covers. The =short ligament= lies largely under cover of the long one. It extends from the anterior part of the internal malleolus, runs backward and somewhat downward, and divides into two branches; one of these ends on the upper tuberosity on the inner surface of the tibial tarsal bone, the other on the sustentaculum tali.

The =plantar= or =calcaneo-metatarsal ligament= (Ligamentum tarsi plantare) is a very strong flat band which covers the outer part of the posterior surface of the tarsus. It is attached to the posterior surface of the fibular and fourth tarsal bones and the proximal end of the external metatarsal bone.

The =dorsal= or =oblique ligament= (Ligamentum tarsi dorsale) is a triangular sheet which is attached above to the lower tuberosity on the inner face of the tibial tarsal bone, and spreads out below on the central and third tarsal bones, and the proximal ends of the large and inner small metatarsal bones, to all of which it is attached.

=Special Ligaments.=—A considerable number of short bands which connect adjacent bones of the tarsus and metatarsus are described by various authors; some of these are quite distinct; others are difficult to isolate. Most of them are not of sufficient importance to justify detailed description.

(1) The =tibial= and =fibular tarsal= bones are united by four bands (astragalo-calcaneal ligaments). The =internal ligament= extends from the sustentaculum tali to the adjacent part of the tibia tarsal, blending with the short lateral ligament. The =external ligament= extends from the anterior process of the fibular tarsal to the adjacent part of the external ridge of the trochlea. The =superior ligament= extends from the posterior margin of the trochlea to the fibular tarsal. The =interosseous ligament= is deeply placed in the sinus tarsi between the two bones, and is attached in the rough areas of the opposed surfaces.

(2) The smaller bones are attached to each other as follows: The central and third tarsal are united by an interosseous and an oblique anterior ligament (scaphoido-cunean ligaments). The central and fourth tarsal are united by an interosseous and a transverse external ligament (cuboido-scaphoid ligament). The third and fourth tarsals are similarly connected (cuboido-cunean ligaments). The third tarsal is joined by an interosseous (intercunean) ligament to the (fused) first and second tarsals; the latter are connected with the fourth tarsal by a transverse posterior ligament.

(3) The smaller bones are connected with the upper row as follows: The central is attached to the tibial tarsal by posterior and interosseous (astragalo-seaphoid) ligaments, and to the fibular tarsal by a short oblique (calcaneo-scaphoid) band. The fourth is attached to the fibular tarsal by interosseous and posterior (calcaneo-cuboid) ligaments. The (fused) first and second tarsals are connected with the fibular tarsal by a posterior (calcaneo-cunean) ligament.

(4) The lower tarsal bones are connected with the metatarsus by tarso-metatarsal ligaments, which are not distinct from the common ligaments, except in the case of the interosseous ligament between the third tarsal and metatarsal bones.

=Movements.=—These are flexion and extension, which take place at the tibio-tarsal joint. The movements between the tarsal bones, and between the latter and the metatarsus, are so limited as to be negligible so far as the action of the joint as a whole is concerned. In the standing position the articular angle (in front) is about 150° to 160°. Complete extension is prevented by tension of the lateral ligaments. Flexion is checked only by contact of the metatarsus with the leg, provided the stifle joint is also flexed. Owing to the fact that the axis of motion is slightly oblique, the lower part of the limb deviates somewhat outward during flexion.

The movements of the hock joint must correspond with those of the stifle on account of the tendinous bands in front and behind (peroneus tertius and flexor perforatus), which extend from the lower part of the femur to the tarsus and metatarsus.

The remaining joints differ in no material respect from those of the thoracic limb.

COMPARATIVE ARTHROLOGY[39]

JOINTS AND LIGAMENTS OF THE VERTEBRÆ

=Ox.=—The ligamentum nuchæ is better developed than in the horse. The funicular part is clearly divided into two lateral halves, which are round at their occipital attachment, but from the axis backward become rapidly wider and flat. This wide portion is almost sagittal, lies on either side of the vertebral spines, and is covered by the trapezius and rhomboideus muscles. From the highest part of the withers (third thoracic spine) it gradually diminishes in size and fades out in the lumbar region. The lamellar part is thick, and consists of anterior and posterior parts. The anterior part is double; its fibers proceed from the funicular part to the second, third, and fourth cervical spines. The posterior part is single; its fibers extend from the first thoracic spine to the fifth, sixth, and seventh cervical spines.

The inferior common ligament is very strong in the lumbar region.

The intervertebral fibro-cartilages are thicker than in the horse.

The interspinous ligaments of the back and loins consist largely of elastic tissue.

There are no intertransverse joints in the lumbar region.

=Pig.=—The ligamentum nuchæ is represented by a fibrous raphé and thin layers of elastic tissue which extend between the cervical spines.

The atlanto-occipital and atlanto-axial joints resemble those of the dog.

The interspinous ligaments of the neck are elastic.

=Dog.=—The ligamentum nuchæ consists of a small fibrous band which extends from the spine of the axis to the anterior thoracic spines; it may be regarded as a mere fibrous raphé between the right and left muscles.

There are interspinous muscles instead of ligaments in the neck.

There are three ligaments in connection with the odontoid process. The two alar ligaments (Ligamenta alaria) arise on either side of the odontoid process, diverge, and end on either side of the foramen magnum. The transverse ligament of the atlas (Ligamentum transversum atlantis) stretches across the dorsal surface of the odontoid process and binds it down on the ventral arch of the atlas, a bursa being interposed. It is attached on either side to the lateral masses of the atlas.

The two capsules of the atlanto-occipital joint communicate with each other, and usually with the capsule of the atlanto-axial joint also.

ARTICULATIONS OF THE THORAX

=Ox.=—The second to the eleventh costo-chondral joints inclusive are diarthroses with close capsules, reinforced externally. (They are synchondroses in the sheep.) The upper parts of the cartilages are attached to each other by distinct elastic ligaments (Ligamenta intercostalia).

The first pair of chondro-sternal joints are separate from each other; intercrossing fibers unite the costo-chondral junctions above the joints.

The first segment of the sternum forms a diarthrosis with the body. The anterior joint surface is concave, the posterior convex. The joint (Articulatio intersternalis) is surrounded by a close capsule, and the joint surfaces are attached to each by a small intraarticular ligament. Limited lateral movement is possible. (In the sheep the joint is a synchondrosis.)

Both surfaces of the sternum are covered by a layer of fibrous tissue.

=Pig.=—The second to the fifth or sixth costo-chondral joints are diarthroses. The intersternal articulation and the sternal ligaments resemble those of the ox.

=Dog.=—The first chondro-sternal joints do not coalesce.

The internal sternal ligament divides into three bands.

TEMPORO-MANDIBULAR ARTICULATION

=Ox.=—The articular surfaces are of such a character as to permit more extensive lateral movement than in the horse.

The condyle of the mandible is relatively small and is concave transversely. The temporal articular surface is extensive and is convex in both directions. The postglenoid process is small.

=Pig.=—The considerable longitudinal diameter of the temporal articular surfaces and the very small size of the postglenoid process allow great freedom of protraction and retraction of the lower jaw. Lateral movement is limited. The posterior ligament is absent.

=Dog.=—The articular surfaces allow extremely little lateral or gliding movement. They are cylindrical in curvature, and the interarticular disc is very thin. The posterior ligament is absent.

The other articulations of the skull are sufficiently described in the Osteology.

Articulations of the Thoracic Limb

SHOULDER JOINT

=Ox.=—The articular angle is about 100°.

=Pig and Dog.=—The joint capsule communicates freely with the bicipital bursa. There is a rudimentary marginal cartilage around the rim of the glenoid cavity. In the dog there is usually a strong band extending from the acromion to the outer part of the capsule; another band (Ligamentum coraco-acromiale) often stretches between the scapular tuberosity and the acromion.

ELBOW JOINT

=Ox.=—No important differences exist. The upper part of the interosseous radio-ulnar ligament is commonly ossified in the adult.

=Pig.=—There are no important differences. The radius and ulna are so firmly united by the interosseous ligament as to prevent any appreciable movement between them.

=Dog.=—The joint capsule is reinforced in front by an oblique ligament which arises on the front of the external condyle of the humerus above the joint surface, and joins the terminal part of the biceps and brachialis below. The external lateral ligament is thick and divides into two parts; the anterior part is attached to the radius and blends with the annular ligament; the posterior part widens below, forming a sort of cap, and is attached to the ulna. The internal lateral ligament also divides into two branches; the anterior branch ends on the inner surface of the neck of the radius; the posterior enters the interosseous space and is attached to both bones. An elastic band (Ligamentum olecrani) extends from the outer surface of the internal epicondyle to the anterior border of the ulna.

There are two radio-ulnar joints. The proximal radio-ulnar joint is included in the capsule of the elbow, but is provided with an annular ligament which extends from the lower part of the external ligament across the front of the proximal end of the radius to the ulna, blending with the biceps and brachialis tendons. The distal joint is formed by a concave facet on the radius and a convex one on the radius, and is surrounded by a tight capsule. The interosseous membrane unites the shafts of the two bones. The movements consist of limited rotation of the radius (ca. 20°), carrying the paw with it. The ordinary position is termed pronation; outward rotation is supination.[40]

THE CARPAL JOINTS

These have the same general arrangement as in the horse. Numerous minor differences naturally exist, but must be excluded from this brief account, which contains only important special features.

The lateral movements are freer, especially in the dog, but flexion is not so complete: the anatomical explanation of these facts lies in the nature of the articular surfaces and certain ligamentous differences. The lateral ligaments are much weaker, the long external one being especially small in the ox. Two oblique, somewhat elastic, bands cross the front of the radio-carpal and intercarpal joints. The proximal one is attached to the distal end of the radius and passes downward and outward to the ulnar carpal bone; the other one connects the radial and fourth carpal bones in a similar fashion.

In the ox the short lateral ligaments are well defined, a ligament connects the accessory carpal with the distal end of the ulna, and strong bands connect the distal bones with the metacarpus.

The interosseous and interordinal ligaments vary with the number of carpal bones present in the different species.

INTERMETACARPAL JOINTS

In the ox the small (fifth) metacarpal bone articulates with the large metacarpal, but not with the carpus. The joint cavity is connected with that of the carpo-metacarpal sac. The proximal end of the small metacarpal bone is attached by a ligament to the fourth carpal, and another band extends from its distal part to the side of the large metacarpal. There is also an interosseous ligament, which is permanent and allows a small amount of movement.

The chief metacarpal bones of the pig, and the second to the fifth of the dog, articulate with each other at their proximal ends, and are connected by interosseous ligaments, which do not, however, unite them closely, as in the horse.

METACARPO-PHALANGEAL JOINTS

=Ox.=—There are two joints, one for each digit. The two capsules communicate posteriorly. The two interdigital lateral ligaments (Ligamenta collateralia interdigitalia) result from the bifurcation of a band which arises in the furrow between the divisions of the distal end of the large metacarpal bone; they spread out and end on the proximal ends of the first phalanges. A strong =superior interdigital ligament= (Ligamentum interdigitale), consisting of short intercrossing fibers, unites the middles of the interdigital surfaces of the first phalanges.

Crucial ligaments (Ligamenta phalango-sesamoideæ) connect the sesamoids with the proximal end of the opposite first phalanx.

The intersesamoid ligament connects all four sesamoids, and extends upward much less than in the horse.

The lateral sesamoidean ligaments end almost entirely on the first phalanges.

The superficial inferior sesamoidean ligament is absent. The middle inferior sesamoidean ligaments of each digit are two short strong bands which extend from the distal margins of the sesamoids to the proximal ends of the first phalanges. The deep inferior sesamoidean ligaments are strong and distinctly crucial.