Henry Gray (18251861). Anatomy of the Human Body. 1918.
is hence termed synovia. In the fetus this membrane is said, by Toynbee, to be continued over the surfaces of the cartilages; but in the adult such a continuation is wanting, excepting at the circumference of the cartilage, upon which it encroaches for a short distance and to which it is firmly attached. In some of the joints the synovial membrane is thrown into folds which pass across the cavity; they are especially distinct in the knee. In other joints there are flattened folds, subdivided at their margins into fringe-like processes which contain convoluted vessels. These folds generally project from the synovial membrane near the margin of the cartilage, and lie flat upon its surface. They consist of connective tissue, covered with endothelium, and contain fat cells in variable quantities, and, more rarely, isolated cartilage cells; the larger folds often contain considerable quantities of fat.
Closely associated with synovial membrane, and therefore conveniently described in this section, are the mucous sheaths of tendons and the mucous bursæ.
Mucous sheaths (vaginæ mucosæ) serve to facilitate the gliding of tendons in fibroösseous canals. Each sheath is arranged in the form of an elongated closed sac, one layer of which adheres to the wall of the canal, and the other is reflected upon the surface of the enclosed tendon. These sheaths are chiefly found surrounding the tendons of the Flexor and Extensor muscles of the fingers and toes as they pass through fibroösseous canals in or near the hand and foot.
Bursæ mucosæ are interposed between surfaces which glide upon each other. They consist of closed sacs containing a minute quantity of clear viscid fluid, and may be grouped, according to their situations, under the headings subcutaneous, submuscular, subfacial, and subtendinous
2. Development of the Joints
The mesoderm from which the different parts of the skeleton are formed shows at first no differentiation into masses corresponding with the individual bones. Thus continuous cores of mesoderm form the axes of the limb-buds and a continuous column of mesoderm the future vertebral column. The first indications of the bones and joints are circumscribed condensations of the mesoderm; these condensed parts become chondrified and finally ossified to form the bones of the skeleton. The intervening non-condensed portions consist at first of undifferentiated mesoderm, which may develop in one of three directions. It may be converted into fibrous tissue as in the case of the skull bones, a synarthrodial joint being the result, or it may become partly cartilaginous, in which case an amphiarthrodial joint is formed. Again, it may become looser in texture and a cavity ultimately appear in its midst; the cells lining the sides of this cavity form a synovial membrane and thus a diarthrodial joint is developed.
The tissue surrounding the original mesodermal core forms fibrous sheaths for the developing bones, i. e., periosteum and perichondrium, which are continued between the ends of the bones over the synovial membrane as the capsules of the joints. These capsules are not of uniform thickness, so that in them may be recognized especially strengthened bands which are described as ligaments. This, however, is not the only method of formation of ligaments. In some cases by modification of, or derivations from, the tendons surrounding the joint, additional ligamentous bands are provided to further strengthen the articulations.
In several of the movable joints the mesoderm which originally existed between the ends of the bones does not become completely absorbeda portion of it persists and forms an articular disk. These disks may be intimately associated in their development with the muscles surrounding the joint, e. g., the menisci of the knee-joint, or with cartilaginous elements, representatives of skeletal structures, which are vestigial in human anatomy, e. g., the articular disk of the sternoclavicular joint.