Transcript Lecture Joints UE 2008

Joints of the Upper Limb
How many articulations does
the scapula have with the
axial skeleton? None.
The only articulation AT ALL that the scapula has is at the Acromioclavicular joint.
The clavicle is attached to the skeleton at the SC (sternoclavicular) joint.
Sternoclavicular Joint
-Articular disc
-Synovial cavity on either side
-Ant/post sternoclavicular ligaments
-Costoclavicular ligament, inner clavicular lig’s…
-Synovial, plane
Acromioclavicular Joint
-Synovial, plane
-Sup/inf acromioclavicular ligaments
-Coracoclavicular ligaments: Main stabilizers of the joint: STRONG; conoid/trapezoid ligaments
-Fibrocartilaginous articular disc in the A/C joint itself to separate & cusion it
-Shoulder separation if coracoclavicular lig’s tear or have lesions in them.
-Fibrocartilaginous articular disc- can be in AC joint (small, sup. Region of joint space)
Shoulder Separation: Occurs at the AC
joint. ..due to any violent force to the tip
of the shoulder
3 Grades:
Grade 1- AC joint capsule /lig. injury
Grade 2-Coracoclavicular lig’s injured,
Tear of AC ligaments
Grade 3-Tear of both AC and
coracoclavicular ligaments
Clavicular fracture…medial aspect
moves superiorly and lateral
aspect moves inferiorly. See
radiograph.
Shoulder Joint
-a.k.a. – glenohumeral
-Synovial, ball – socket
-Glenoid labrum- fibrocartilaginous ring around the glenoid fossa, makes it
“deeper”
-Transverse humeral ligament- btwn. The two tubercles keeps long head of Biceps
In the intertubercular groove.
-Coracoacromial ligament- Prevents superior dislocation.
Capsule folds up when
you abduct.
Inferior, middle, and superior
glenohumeral lig. Are
thickenings in the joint
capsule that help provide
structure to the
glenohumeral joint.
Inferiorly is the most weak
part of the joint. This is why
most dislocations move
anterior and inferior.
Deltoid m.
suprapinatus
acromion
Subacromial bursa:
allows freedom of
mov’t for
supraspinatus and
deltoid.
Above: Internal view of the inf.,
middle, sup. Glenohumeral
ligaments.
On the Right: The glenoid labrum is
on the tip of the glenoid fossa.
Shoulder Muscles – Rotator Cuff
S
I
T
S
Elbow joint
-synovial, hinge (movement in one plane)
-the joint of the angle differs between the sexes…
”carrying angle”: male=~170, female=~167
Between the humerus and the ulna.
This is the joint capsule of
the elbow. Collateral lig.’s
are always on the side of
joints, one on radial side
and one on the ulnar side.
Anular means ring…so the
Anular ligament goes
around the head of the
radius (allows pronation &
supination). Radial
tuberosity is good for
biceps
Biceps tendon
Annular
UCL
Proximal joint of
Radius/Ulna: As pronate and
supinate (near elbow)
Tethers head of
radius to the ulna
Proximal Radioulnar Joint
-synovial, pivot
-annular ligament keeps the radius
Attached to the head of the humerus.
Distal Radioulnar Joint
Where radius and ulna meet at the wrist
-synovial, pivot
Both styloid processes are distal
-articular disc
(TFC disc), btwn. Ulna and the wrist
Radial side  Pisoform,
Then back up and over
again.
“Some Ladies Try Positions
That They Can’t Handle”
Radiocarpal Joint (Wrist)
-synovial, ellipsoid (condyloid)
-articular disc (TFC disc)
Midcarpal and Intercarpal Joints
Between the carpals
-ALL are synovial, plane joints
Carpometacarpal and Intermetacarpal Joints
-synovial, plane
1st Carpometacarpal Joint
-synovial, saddle (sellar)
Metacarpophalangeal (M-P) Joints
-synovial, condyloid
Interphalangeal (I-P) Joints
-synovial, hinge (moves in one plane)
PIP
DIP