Transcript Joints of limbs

Joints of limbs
SHANDONG UNIVERSITY
Liu Zhiyu
Joints of upper limb
Joints of should girdle
Sternoclavicular joint
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Bones: sternal end of clavicle, clavicular
notch of sternum, and first costal
cartilage
Articular capsule: strong and is
reinforced by anterior and posterior
sternoclavicular ligaments
Articular disc: attached to the capsule,
dividing the joint into two cavities.
Movements: elevation and depression,
forward and backward, rotation and
circumduction of the acromial end of the
clavicle
Joints of should girdle
Acromioclavicular joint
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Bones: acromion and acromial
end of clavicle
Movement: rotation of scapula
on clavicle
Coracoacromial arch
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Composition
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coracoacromial ligament
coranoid process
Acromion
Prevents the shoulder joint
from superior dislocation
Acromion
Coracoacromial
ligament
Coranoid proce
Joints of free upper limb
★Shoulder joint
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Type: ball and socket
Bones: head of humerus and
glenoid cavity of scapula
Capsule:
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Thin and lax, especially lower part
Attachments: proximal to glenoid
labrum; distal to anatomical neck of
humerus, except medially where it is
slightly distal to surgical neck
Tendon of long head of biceps
brachii passes though the cavity
★Shoulder joint
Tendon of long head
of biceps brachii
★Shoulder joint
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Accessory structures
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Glenoid labrum :
fibrocartilaginous ring on
periphery of glenoid cavity
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Coracohumeral ligament :
runs from coracoid process to
greater tubercle
 Movements: flexion,
extension, adduction, abduction,
medial and lateral rotation,
circumduction
Radiograph of shoulder in a young female of 18 years in
anteroposterior view (A) and axillary view with the arm abducted (B).
dislocation
Dislocation of Shoulder joint
★ Elbow joint
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Bones: lower end of humerus, upper
ends of radius and ulna
 Humeroulnar joint :
formed by trochlear of humerus and
troclear noch (hinge)
 Humeroradial joint :
formed by capitulum of humerus and
head of radius (ball and socket)
 Proximal radioulnar joint : formed by
articular circumference of radius and
radial notch of ulna
Capsule: thin and lax anteriorly and
posteriorly, strongly thickened on either
side by collateral ligaments
★ Elbow joint
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Ligaments:
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Radial collacteral ligament :
attached to lateral epicondyle and annular
ligament of radius
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Ulnar collacteral ligament : attached
to medial epicondyle to medial border of
trochlear notch
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Annular ligament of radius :
attached to anterior and posterior margins of
radial notch of ulna, surrounds the head of
radius
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Movements: flexion and extension,
pronation and supination
Dislocation
of elbow joint
Anteroposterior (A) and lateral (B)
radiographs of an adult elbow joint.
The joint is semiflexed in B.
 In extension, the medial
and lateral epicondyles
and the top of the
olecranon process are in
a straight line;
 in flexion, the bony point
form the boundaries of an
equilateral triangle.
Joints between radius and ulna
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Proximal radioulnar joint
Interosseous membrane of
forearm: a fibrous membrane
between the shaft of radius and
ulna
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Distal radioulnar joint
formed by head of ulna, ulnar
notch of radius and an articular
disc
Joints of hand
★ Radiocarpal joint
(ellipsoid)
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Bones
 Carpal articular surface of
radius and articular disc below
the ulna
 Proximal row of carpal:
scaphoid, lunate, and triquetral
bones, but not pisiform
Capsule: lax and strengthened by
surrounding ligament
Movements: flexion, extension,
adduction, abduction, and
circumduction
Joints of hand
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Intercarpal joints
Carpometacarpal joints
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Carpometacarpal joint of thumb
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Bones: trapezium and base of first
metacarpal
Movement: flexion, extension,
adduction, abduction, and
opposition
Intermetacarpal joints
Metacarpophalangeal joints
Interphalangeal joints
Joints of hand
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Intermetacarpal joints 腕骨间关节
Metacarpophalangeal joints 掌指关节
Interphalangeal joints 指间关节
Joints of Lower limb
Joints of pelvic girdle
Sacroiliac joint
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Bones: auricular
surface of sacrum
and ilium
Capsule: very tight
and strengthened by
ligaments
Ligaments of the gluteal region
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Sacrotuberous
ligament
Connects the lateral
margins of sacrum and
coccyx to the ischial
tuberosity
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Sacrospinous
ligament
Connects the lateral margins
of sacrum and coccyx to the
spine of the ischium
Foramina of the gluteal region
Greater sciatic foramen
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Formed by the greater sciatic notch of
the hip bone and the sacrospinous
ligament.
It provides an exit from the pelvis into
the gluteal region.
Lesser sciatic foramen
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Formed by the lesser sciatic notch of
the ischium and the sacrospinous and
sacrotuberous ligaments.
It provides an entrance into the
perineum from the gluteal region
Joints of pelvic girdle
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Pubic symphysis
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Articulation: symphysial
surface and interpubic
disc (fibrocartilage)
Ligaments: superior
pubic ligament and
arcuate pubic ligament
Obturator membrane
Obturator canal
Bony pelvis
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Composition: formed by paired hip
bones, sacrum, coccyx, and their
articulations
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In anatomical position: anterior
superior iliac spines and pubic tubercles
on same vertical plane, while the tip of
coccyx and superior border of pubic
symphysis on same horizontal plane
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Terminal line: formed by
promontory of sacrum, arcuate line,
pecten of pubis, pubic tubercle, upper
border of pubic symphysis
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Two portions:
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greater pelvis
lesser pelvis
Bony pelvis
Lesser pelvis
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pelvic inlet (terminal line):
Pelvic outlet : formed by tip
of coccyx, sacrotuberous
ligament, ischial tuberosity,
ramus of ischium, inferior
ramus of pubic, symphysis
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Pelvic cavity
Pubic arch
subpubic angle
Main difference between male and femal pelvis
Female
Male
Overall
Wide and short
Narrow and long
Iliac ala
More horizontal
More vertical
Inlet
Round
Oval or heart shaped
Outlet
Larger
Small
Pelvic cavity
Shallower, wide
Deep narrow
Subpubic angle
Right angle (90~1000)
Acute angle (70~750)
Main difference between male and femal pelvis
Female
Male
90~1000
70~750
Pelvic inlet
Pelvic outet
Pelvic cavity
Pubic arch
Main difference between male and femal pelvis
Anteroposterior radiograph of adult female pelvis.
Joints of free lower limb
★ Hip joint
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Bones: acetabulum and femoral
head
Articular capsule attachments
 Above: margins of acetabulum
and transverse acetebular
ligament
 Below: in front to
intertrochanteric line; behind, to
the neck of femur above 1 cm
above the intertrochanteric
crest
★ Hip joint
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Accessory structures
 Acetabulum labrum ; transverse
acetebular ligament
Acetabulum labrum
 Ligaments
 Iliofemoral lig.
 Ligament of head of femur
 Pubofemoral lig.
 Ischiofemoral ligament
Zona orbicularis
Movement: flexion, extention,
adduction, abduction, medial and
lateral rotation, circumduction
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Transverse
acetebular lig
Ligament of head
of femur
★ Hip joint
Pubofemoral lig.
Iliofemoral lig.
Ischiofemoral lig.
Zona orbicularis
Head of femur is driven posteriorly, out of acetabulum
Poterior dislocation of the hip bone
★Knee joint
Bones:
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lower end of femur
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upper end of tibia
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patella
Articular capsule:
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Superapatellar bursa
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Deep infrapatellar bursa
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Ala folds
★Knee joint
Accessory structures
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ligaments
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Patellar lig.
Fibular collateral lig.
Tibial collateral lig. Anterior
cruciate ligment
Posterior cruciate ligament
Oblique popliteal ligament
Meniscus
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Medial meniscus (C-shaped)
lateral meniscus (O-shaped)
★Knee joint
Posterior cruciate lig.
Anterior cruciate lig.
Oblique popliteal lig.
Tibial collateral lig.
Fibular collateral lig.
★Knee joint
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Movements: flexion and
extension; flexed knee joint
may be passively rotated
through 700
lateral
Medial
Hip joint
Knee joint
Radiograph
Coronal T1-weighted magnetic
resonance image (MRI) of the knee
in an adult male.
Tibiofibular syndesmosis
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Tibiofibular joint
Crural interosseous membrane
Anterior and posterior tibiofibular
ligaments
Joint of foot
Talocrural joint
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(ankle joint )
Bones: lower ends of tibia and fibula,
trochlea of talus
Articular capsule: thin and lax in front and
behind, and supported on each side by
strong collateral ligaments
Ligments
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Medial lig.
Lateral lig.
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Anterior talofibular lig.
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Calcaneofibular lig.
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Posterior talofibular lig.
Joint of foot
Medial lig.
Posterior talofibular lig.
Calcaneofibular lig.
Anterior talofibular lig.
Joint of foot
Talocrural joint
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Movements:
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dorsiflexion (extension)
plantar flexion (flexion);
when the ankle joint is fully
plantar flexed, small
amounts of abduction, and
adduction are possible
Torn fibers of anterior talofibular lig.
Joint of foot
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Intertarsal joints
 Talocalcaneal joint
 Talocalcaneonavicular joint
 Calcaneocuboid joint
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Tarsometatarsal joints
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Intermetatarsal joints
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Metatarsophalangeal joints
Interphalangeal joints
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Inversion and eversion of foot
transverse tarsal joint
Arches of foot
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Medial longitudinal arch formed by calcaneus, talus, navicular,
three cuneiforms and first to third metatarsal bones, head of talus is
the keystone of this arch
Lateral longitudinal arch:
formed by calcaneus, cuboid, fourth and fifth metatarsals; cuboid is is
the keystone of this arch
Arches of foot
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Tranverse arch:
formed by cuboid, three
cuniforms and all
metatarsals; the
intermediate cuneiform is
the keystone of this arch
Function: give to foot
strength stability and
resilience; protect plantar
vessels and nerves
Arches of foot
Normal arch
Flatfoot