Опорно-двигательный аппарат (ОДА) является весьма сложной системой, отвечающей за возможность перемещения тела человека в пространстве. Конструктивно она разделяется на две части – активную (мышцы, связки, сухожилия) и пассивную (кости и суставы).
Интересно! Скелет человека – своеобразный каркас, опора для всех остальных систем организма. У взрослого человека он состоит из 200 костей, соединения которых могут быть как неподвижные, так и подвижные.
Подвижное соединение костей обеспечивают суставы, которых насчитывается 360. По большей части они находятся в позвоночнике, где их количество достигает 147 штук; они обеспечивают сочленение позвонков между собой и с рёбрами.
Основное предназначение суставного соединения, кроме обеспечения подвижности костей, – амортизация, смягчение сотрясений и перегрузок, которые испытывает наш скелет.
Строение суставов человека
Все сочленения нашего организма разделяются на следующие основные типы:
- синовиальные (подвижные);
- фиброзные (ограничено подвижные);
- волокнистые (неподвижные).
Синовиальные
Обеспечивают максимально подвижное соединение между отдельными костями. Представляют собой самые сложные конструкции и состоят из нескольких основных частей. К синовиальным относятся суставные поверхности коленей, плеч, локтей, пальцев и т.д. Их анатомия, в зависимости от типа, выглядит следующим образом:
- Эпифиз кости. Расширенная часть трубчатой кости (бедро, голень, плечо, предплечье), служащая основанием для хрящевой ткани.
- Гиалиновый хрящ. Покрывает эпифиз и имеет упругую, плотную консистенцию. Толщина гиалиновых хрящей, в зависимости от того, где они расположены, составляет 1 – 5 мм.
- Суставная капсула. Окружает хрящи, создавая вокруг них герметичную оболочку – так называемую суставную сумку, заполненную синовиальной жидкостью.
- Синовиальная оболочка. Образует внутреннюю поверхность суставной капсулы. Главная её функция – повышение уровня подвижности и амортизации сочленения костей, а также биологическая защита суставной полости от проникновения патогенных микроорганизмов.
- Синовиальная жидкость. Заполняет полость суставной сумки, представляет собой вязкую, прозрачную или слегка мутную массу. Играет роль смазки, предотвращающей трение хрящевых поверхностей друг об друга при движении.
- Связки. Прочная ткань, которая подвижно соединяет между собой соседние кости, одновременно регулируя амплитуду их движения. Располагаются снаружи и внутри суставной капсулы.
Фиброзные
В данном случае отдельные кости скреплены друг с другом с помощью хрящевой ткани. В результате соединение получается хоть и малоподвижным, но более прочным.
По-латыни «фибра» означает волокно, от чего и получил своё название этот тип соединения. Фиброзным способом сочленяются грудина, рёбра, межпозвонковые диски, а также кости таза и некоторые кости черепа.
Волокнистые
В данном случае кости соединяются между собой настолько жёстко, что практически составляют монолитную поверхность. При этом соединительная хрящевая ткань отвердевает так сильно, что теряет всякую эластичность. Подобным образом сочленяются крупные кости свода черепа (лобная, теменная, височная).
Классификация суставов человека
Синовиальные суставы человеческого скелета делятся на несколько типов. По причине большого количества различных суставных сочленений, для их дифференциации в биологии разработана «таблица суставов». В современной анатомии человека сочленения классифицируются по нескольким признакам:
- По количеству поверхностей.
- По форме поверхностей.
- По степеням свободы при движении.
Число поверхностей
Соединение костей может иметь несколько поверхностей суставного сочленения, в зависимости от чего они разделяются на следующие типы.
Простой сустав (симплекс)
Простые сочленения имеют всего две подвижные суставных поверхности, между которыми нет дополнительных включений. Пример подобных соединений – фаланги пальцев, плечевые или тазобедренные суставы. Так, простое соединение образуют суставная впадина лопатки и головка плечевой кости.
Сложный (композитный)
Такое соединение имеет больше двух суставных поверхностей. К такому типу относится локтевой сустав, который устроен более сложно, по сравнению с тем же плечевым. Также они могут иметь дополнительные включения – хрящевые или костные. Подобные конструкции носят названия комплексных и комбинированных суставов. Схема их строения отличается от простых тем, что в их конструкцию могут входить какие-либо дополнительные компоненты:
- Комплексные – содержат в своей структуре внутрисуставный хрящевой элемент (мениск, или хрящевой диск). Он разделяет сустав изнутри на две изолированные части. Пример комплексного сочленения –коленный сустав, в котором мениск делит внутрисуставную полость на две половины.
- Комбинированные – являются комбинацией нескольких изолированных друг от друга суставов, которые, несмотря на это, работают как единый механизм. Пример – височно-нижнечелюстной сустав, отвечающий за подвижность нижней челюсти. При этом, благодаря сложному механизму соединения, обеспечивается её подвижность сразу в нескольких направлениях: вверх-вниз, вперёд-назад, вправо-влево.
Характер движения (степени свободы) суставов человека
Сочленения отдельных костей могут обеспечивать им различную подвижность относительно друг друга. По степени подвижности они подразделяются на:
Одноосные
Обеспечивают движение соединяемых костей только по одной оси (только вперёд-назад или вверх-вниз).
Двухосные
Движение в них происходит в двух перпендикулярных плоскостях (например, в вертикальном и горизонтальном, либо в продольном и поперечном).
Многоосные
Подобное соединение костей, благодаря конструктивным особенностям, даёт им возможность движения по нескольким осям. Многоосные сочленения могут быть трёхосными и четырёхосными.
Безосные
Имеют плоские суставные поверхности, что позволяет смежным костям совершать весьма ограниченные скользящие или вращательные движения. Как правило, они обеспечивают сочленение коротких костей или костей, требующих особо прочного соединения.
Форма суставной поверхности
В зависимости от своей формы, все суставы разделены на несколько групп. Каждая из них имеет свои особенности – в частности, их форма определяет характер движения соединяемых костей. Поэтому все группы суставов связаны со степенью их подвижности.
Одноосные сочленения разделяются по форме суставных поверхностей на такие виды:
Цилиндрический
Суставные поверхности в данном случае расположены продольно, причём одна из них имеет вид оси, а другая – вид цилиндра с продольно срезанным основанием. Классический пример цилиндрического суставного соединения – срединный атлантоосевой, расположенный в шейных позвонках. 
Блоковидный
Блоковидные соединения по своей форме напоминают цилиндрические, но суставные поверхности в них расположены не продольно, а поперечно. Для ограничения смещений костей в бок, они могут иметь специальные гребни и углубления, препятствующие свободе движения. К ним относятся соединения фаланг пальцев человека или локтевые сочленения копытных животных.
Винтообразный
По своей сути является разновидностью блоковидного сочленения. Рисунок винтообразной конструкции предполагает наличие на поверхностях эпифиза одной кости своеобразных борозд, входящих в соответствующие желоба на эпифизе второй кости. Благодаря этому, обеспечивается возможность движения по спирали, откуда и происходит второе наименование суставов такого типа – спиралевидные.
Двухосные соединения обеспечиваются следующими формами суставных конструкций.
Эллипсовидный
Соединяемая поверхность одной из костей имеет форму выпуклого, а другой – вогнутого эллипса. В скелете человека к эллипсовидным относятся атлантозатылочный сустав и сустав, соединяющий бедренную и большеберцовую кости.
Мыщелковый
Поверхность одной кости имеет форму сферы, а другой – вогнутую поверхность, в которой данная сфера и размещается. Мыщелковое сочленение обеспечивает подвижность костей в двух плоскостях: сгибание-разгибание и поворот вправо-влево. Этим мыщелковое соединение похоже на шаровидное. Но, в отличие от него, не позволяет совершать активные вращательные движения вокруг вертикальной оси. Пример – пястно-фаланговые и коленный сустав. 
Седловидный
Обе седловидно сочленяющиеся кости имеют на своих концах углубления в виде седла, при этом данные углубления расположены перпендикулярно друг к другу. Такое расположение даёт несколько больше возможностей при движении. Например, подобную конструкцию имеет пястно-запястный сустав большого пальца человека и приматов, что позволяет «противопоставлять» его остальным пальцам кистей рук.
Возможность подобного противопоставления, с точки зрения биологов, и стала одной из главных причин превращения обезьяны в человека. Наличие седловидного сустава позволило использовать нашим предкам руки в качестве активного хватательного механизма для удержания различных инструментов. 
Многоосное сочленение осуществляется при помощи суставов следующей формы:
Шаровидный
В этом случае одна из костей имеет на своём окончании головку в виде шара, а противоположная кость – впадину. В результате движение возможно в любом направлении, что делает шаровидные суставы наиболее свободными в человеческом организме.
Другое их название – ореховидные, из-за схожести форм сферической головки с грецким орехом. Классический пример шаровидного соединения – плечевой сустав между лопаткой и плечевой костью. 
Чашеобразный
Является одной из частных форм шаровидного соединения. Подобным образом сочленяется наиболее крупный сустав человека – тазобедренный. При этом сферическая головка помещается в особую «чашу» – вертлюжную впадину. Такое соединение даёт возможность человеку осуществлять движение бедром в четырёх направлениях:
- по фронтальной оси – сгибание-разгибание (при приседании, подъёме ноги к животу);
- по сагиттальной оси – отведение ноги в сторону и возвращение её в исходное положение;
- по вертикальной оси – некоторое смещение бедра относительно таза при вытягивании ноги;
- круговое вращение бедра;
Плоский
Обращённые друг к другу поверхности обоих костей в этом случае имеют плоскую или близкую к ней форму. Более точное определение – не «плоскость», а «поверхность сферы большого сечения». Подобные суставы дают возможность костям совершать движения по всем трём осям; однако, вследствие особенностей их конструкции, все эти движения крайне ограничены по амплитуде. По большей части они играют вспомогательную, буферную роль. Пример подобной структуры – межпозвонковые сочленения, суставы стопы и кисти. 
Амфиартрозы
Они же – «тугие суставы». Особая разновидность соединения, возможна при любой форме поверхности. Отличительной её особенностью является наличие короткой и туго натянутой капсулы, которая окружена со всех сторон крепкими, практически не растягивающимися связками.
Суставные поверхности обоих смыкающихся костей очень плотно прижимаются друг к другу. Подобная особенность конструкции значительно ограничивает их способность к смещению относительно друг друга. Амфиартрозом, к примеру, является крестцово-подвздошный сустав. Предназначение таких жёстких конструкций – амортизация толчков и ударов, испытываемых костями.
Вывод
Итак, мы рассмотрели, что такое сустав человека, сколько их в нашем теле, какие бывают виды и характеристики каждого сочленения, а также где они находятся.
(articulatio), диартроз (diarthrosis), структура, обеспечивающая подвижное сочленение костей позвоночных. Простые С. образованы двумя костями, сложные С.— несколькими. Осн. элементы типичного С: поверхности сочленяющихся костей, покрытые хрящевой тканью, полость, частично разделяющая кости и заполненная синовиальной жидкостью, суставная капсула (сумка), изолирующая полость и являющаяся продолжением надкостницы. В С. часто имеются дополнит, элементы: связки, хрящевые мениски и др. С эволюцией животных и совершенствованием локомоции менялась форма, характер С. и их разнообразие. С. различают по форме суставных поверхностей (шаровидный, эллипсовидный, седловидный и т. п.), степени и направлению смещений (подвижные, малоподвижные, одно-, двух- и многоосевые). Степени свободы С. ограничиваются его формой, выступами костей, натяжением связок, капсулы. Синовиальная жидкость обеспечивает скольжение суставных поверхностей, а также выполняет тормозную роль. С. обеспечивают как простые, так и сложные формы локомоции. С. наз. также состоящее из неск. члеников подвижное сочленение элементов скелета членистоногих, иногда и др. беспозвоночных.
↑ А — схематическое изображение простого сустава: 1 — костномозговая полость; 2 — синовиальная мембрана: 3 — суставная полость; 4 — суставной хрящ; 5 — суставная капсула; 6 — губчатое костное вещество; 7 — надкостница; 8 — компактное костное вещество. Б — фронтальный распил тазобедренного сустава человека: 1 — головка берцовой кости; 2 — суставной хрящ; 3 — безымянная (тазовая) кость; 4 — суставная полость; 5 — связка головки бедренной кости; 6 — поперечная связка суставной впадины; 7 — суставная капсула; 8 — круговая зона (в толще суставной капсулы, охватывает шейку бедра); 9 — вертлужная губа (увеличивает глубину суставной впадины).
Основой строения живого организма выступает скелет, в состав которого входят подвижные соединения, а также костная и хрящевая ткани. Суставы человека важны и нужны для того, чтобы ходить, выполнять сложные и слаженные движения в повседневной работе и профессиональной деятельности. Артрологией называется сложная наука, изучающая все виды анастомозов с костями, краткое общее разъяснение которой обязательно для всех.
Виды, их анатомия и строение
Наглядным примером изучения структуры костных анастомозов в человеческом теле выступает синовиальный сустав. Клиническая анатомия человека делит все структурные компоненты на 2 вида:
- Основные элементы:
- суставные поверхности — участки на костях, которым они соприкасаются (головка и впадина);
- суставной хрящ — защищает от разрушения в результате трения;
- капсула — является защитой, отвечает за выработку синовии;
- полость — щель между поверхностями, наполненная жидкостью;
- синовия — смягчает трение костей, питает хрящ, поддерживая обмен веществ.
Наиболее полное развитие получили суставы и связки конечностей, так как они берут на себя основные функциональные способности человека в жизни и адаптации в социуме. В процессе эволюции рука человека сформировалась из передней конечности млекопитающих.
Функции и задачи
Разные виды суставов человека, их разнообразная анатомическая конструкция имеют принципиальное значение для ряда функциональных обязанностей, выполняемых костными соединениями. Все действия делятся на выполнение таких функций, как:
- Комбинация костей, зубов и хрящей друг с другом, делает их прочным амортизатором движений.
- Предотвращение разрушения костной ткани.
- Выполнение осевых движений, среди которых:
- фронтальные — сгибание, разгибание;
- сагиттальные — приведение, отведение;
- вертикальные — супинация (движение кнаружи), пронация (внутрь);
- круговые движения — перемещение хода с оси на ось.
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Классификация, ее принципы
Соединений в организме много, каждое имеет свои особенности и выполняет конкретные функции. Наиболее удобной в клинической практике считается классификация суставов на виды и типы, что удачно изображает таблица. В нее не вошли непрерывные межхрящевые соединения ребер, начиная от 6-го и до 9-го.
Сочленения могут классифицироваться по степени подвижности. 
Сочленение имеет сложное строение и имеет самый большой размер в верхних конечностях.| Причина | Симптомы | |
|---|---|---|
| Артрит | Инфекция, аллергия, аутоиммунный процесс | Утренняя скованность, припухлость, сыпь на коже, температура |
| Артроз | Дегенеративные поражения, остеопорозы | Нарастающая боль от непродолжительной до постоянной |
| Дисплазия | Врожденные аномалии | Нарушения функций пораженного сочленения, невозможность самостоятельных движений, поражены мышцы |
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Диагностика суставных болезней
Базируется на следующих методах и приемах:
Гониометрия позволяет определить насколько человек может двигать сочленением.
- Жалобы.
- Анамнез болезни.
- Общее обследование, пальпация.
- Гониометрия — характеристика свободной амплитуды движений.
- Обязательные лабораторные исследования:
- общий анализ крови;
- биохимия крови, особенно важны С-реактивный белок, реакция оседания эритроцитов, антинуклеарные антитела, мочевая кислота;
- анализ мочи общий.
Вернуться к оглавлению
Лечение недугов
Терапия результативная только при правильно поставленном диагнозе и, если не опоздала диагностика. Таблица основных заболеваний выделяет причину, которую и следует лечить. Когда есть очаги инфекции, назначают антибиотики. При аутоиммунном процессе используют иммуносупрессоры — моноклональные антитела, кортикостероиды, цитостатики. Дегенеративные состояния корректируются хондропротекторами. Принимают нестероидные противовоспалительные средства, влияющие на уровень кальция и прочность костей. Реабилитация обеспечивается лечебной физкультурой и физиотерапией. Хирургическое лечение применяется после исчерпания консервативных методов, но и оно не гарантирует полное блокирование любого патологического процесса.
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