Transcript Arthrology 关节学

Arthrology 关节学
山东大学医学院 解剖学教研室
李振华
Classification
two major types
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Continuous joints 直接连结
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Discontinuous joints 间接连结 －synovial joints 滑膜关节
Continuous joints 直接连结
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Fibrous joints 纤维连结
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Syndesmosis 韧带连结
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Suture 缝
Cartilaginous joints
软骨连结
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Synchondrosis
透明软骨结合
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Symphysis
纤维软骨联合
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Synosteosis 骨性结合
Synovial Joints 滑膜关节
Basic structures
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Articular surface 关节面: covered
by articular cartilage 关节软骨
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Articular capsule 关节囊
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Fibrous membrane 纤维膜
Synovial membrane 滑膜
Articular cavity 关节腔:
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Containing a trace of synovial fluid
Subatmospheric pressure in it
Synovial Joints 滑膜关节
Accessory structures
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Ligaments 韧带 (lig.)
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Extracapsular ligaments 囊外韧带
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intracapsular ligaments 囊内韧带
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Articular disc 关节盘 and
articular labrum 关节唇
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Synovial fold 滑膜襞 and
synovial bursa 滑膜囊
Joint Movement Terminology
关节运动术语
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Translation 移动
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Flexion and extension 屈和伸
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Adduction and abduction 收和展
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Rotation 旋转
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Medial and lateral rotation 旋内和旋外
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Pronation ans supination
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Inversion and eversion
Circumduction 环转
旋前和旋后
足内翻和足外翻
flexion(屈)\ extension(伸)
adduction(内收)\ abduction(外展)
Rotation （旋转）
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Bone revolves around its
own longitudinal axis
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medial rotation is turning of
anterior surface in towards
the midline
lateral rotation is turning of
anterior surface away from
the midline
Pronation 旋前
Supination 旋后
Inversion 足内翻
Eversion 足外翻
Circumduction（环转）
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Movement of a distal end of a body part in a circle
Combination of flexion, extension, adduction and
abduction
Occurs at ball and socket, saddle and condyloid joints
Classification of synovial joints
关节的分类
1. Uniaxial joints 单轴关节:
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hinge joints 屈戍关节:
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cylindrical end of 1 bone fits into trough
shape of other
angular movement-1 plane (eg) elbow,
ankle, interphalangal
trochoid (pivot) joints 车轴关节
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round end fits into ring of bone + ligament
rotation on long axis (eg) prox. radius/ulna,
atlas/dens
Classification of synovial joints
关节的分类
2. Biaxial joints 双轴关节:
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ellipsoid joints 椭圆关节
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egg-shape articular surface +
oval concavity
side-to-side, back+forth
movement (eg)
metacarpophalangeal (knuckle)
saddle joints 鞍状关节
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articular surface both concave +
convex
side-to-side, back-forth
movement (eg)
carpometacarpal jt of thumb
Classification of synovial joints
关节的分类
3. Multiaxial joints 多轴关节:
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ball-and-socket joint 球窝关节
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spherical head + round socket
multiaxial movement(eg)
shoulder, femur
plane joints 平面关节
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articular surface in flat plane
Short gliding movement
(eg) intertarsal, articular
processes of vertebrae
Sprains
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Torn or stretched
ligaments.
Spine, ankle & knee are
common sites.
Completely torn
ligaments must be
repaired. Edema
associated with injury
can further degrade the
ligament.
Dislocations
Arthritis
Joints of Bones of Trunk
躯干骨的连结
Vertebral column 脊柱
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consists of 24 vertebrae, the
sacrum, and the coccyx.
Joints of the vertebral bodies
椎体间的连结
Intervertebral discs 椎间盘
Lie between bodies of adjacent
vertebrae, composed of:
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Nucleus pulposus 髓核
an inner soft, pulpy, highly elastic
structure (gelatinous core )
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Annulus fibrosus 纤维环
an outer fibrous ring consisting of
fibrocartilage
Joints of the vertebral bodies
椎体间的连结
Anterior longitudinal ligament
前纵韧带
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Strong band covering the anterior part of
the vertebral bodies and intervertebral
discs running from the anterior margin of
foramen magnum to the S1~S2
Maintains stability of the intervertebral
disc and prevents hyperextension of the
vertebral column
Joints of the vertebral bodies
椎体间的连结
Posterior longitudinal ligament
后纵韧带
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Attached to the posterior aspect of the
intervertebral discs and posterior edges of the
vertebral bodies from C2 vertebra to sacrum
Prevents hyperflexion of the vertebral column
and posterior protrusion of the discs
Hemination of nucleus pulposus
髓核脱出
Joints of the vertebral arches
椎弓间的连结
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Ligamenta flava 黄韧带
― elastic ligament, unite laminae of
adjacent vertebrae, and complete the
posterior wall of vertebral canal; tend to
prevent hyperflexion of the vertebral
column
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Interspinal ligament 棘间韧带
Supraspinal ligament 棘上韧带
Ligamentum nuchae 项韧带
Intertansverse ligament 横突间韧带
Zygapophysial joint 关节突关节
Atlantooccipital joint 寰枕关节
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Between superior articulating
surfaces of atlas and occipital
condyles
Supported by membrances and
ligaments that join occipital bone
and atlas
Action ― nodding of head, lateral
tilting of head
Atlantoaxial joint 寰枢关节
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Three synovial joints between atlas
and axis
 Laterally, paired joints between
articulating facets
 Median joint between dens of
axis and anterior arch of atlas
Supported by ligaments
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apical ligament of dens 齿突尖韧带
alar ligament 翼状韧带
transverse ligament of atlas
寰椎横韧带
tectorial membrane 覆膜
Action ― allow atlas (and head) to
pivot on the axis and vertebral
column
The vertebral column as a whole
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Anterior aspect:
the breadth of vertebral bodies
increases from C2 to S2, then
diminishes rapidly
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Dorsal aspect:
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the spinous processes of cervical
vertebrae are short and bifid;
the spinous processes of thoracic
vertebrae are long, point obliquely
downward and overlapped each other;
the spinous processes of lumber
vertebrae are nearly horizontally.
Lateral aspect:
shows four physiological curves
The vertebral column as a whole
Four physiological curves
Cervical curvature
convex forward
Thoracic curvature
Lumbar curvature
Sacral curvature
convex backward
The vertebral column as a whole
Movement of the vertebral column
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flexion
extension
lateral flexion
rotation
Lateral radiograph of the
neck. The cervical curve of
the vertebral column is well
shown.
Sagittal MRI of cervicothoracic spine.
Sagittal MRI of thoracolumbosacral spine.
Spina bifida cystica 脊柱裂
Thoracic cage 胸廓
Composition
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twelve thoracic vertebrae
twelve pairs of ribs and
costal cartilages
sternum
Thoracic cage 胸廓
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Costovertebral joints 肋椎关节
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Joints of costal head 肋头关节
Costotransverse joints 肋横突关节
Sternocostal joints 胸肋关节
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Sternocostal synchondrosis of first rib
第一胸肋结合
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Sternocostal joints 胸肋关节
Interchondral joints 肋软骨连结
between costal cartilages 8, 9, and 10
to form the costal arch 肋弓
General features of thoracic cage
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Roughly cone-shape, narrow above and
broad below, flattened from beforebackwards, longer behind than in front
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Inlet of thorax 胸廓上口:
bounded by upper border of manubrium,
first rib, and vertebra T1
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Outlet of thorax 胸廓下口:
bounded by vertebra T12, 12th and 11th
ribs, costal arch and xiphoid process
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Infrasternal angle 胸骨下角:
formed by the costal arch of both side
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Intercostal spaces 肋间隙:
lie between the ribs
Thoracic cage 胸廓
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Function:
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protects the organs in the thoracic cavity and upper
abdominal cavity
plays a vital role in the process of breathing
Inspiration
Expiration
Joints of skull 颅骨的连结
Continuous joints:
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Sutures
Synchondrosis or synosteosis
Temporomandibular joint
Temporomandibular joint 颞下颌关节
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Aticulating surfaces
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Capsule:
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thin and lax in front and behind;
strengthened by the lateral ligament 外侧韧带
Articular disc:
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Mandibular fossa and articular tubercle,
above
Head of mandibule, below
separates surfaces
forming upper and lower compartments within
joint
Movement:
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mandible may be elevated or depressed
protruded or retracted
rotation may also occurs as in chewing( a
slight amount of side to side movement is
also permitted)