Joints of upper limb Joints of should girdle

Joints of upper limb 上肢骨的连接

Joints of should girdle 上肢带骨的连接 Sternoclavicular joint 胸锁关节 n n 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 上肢带骨的连接 Coracoacromial Acromioclavicular joint 肩锁关节 n n Bones: acromion and acromial end of clavicle Movement: rotation of scapula on clavicle Coracoacromial arch 喙肩弓 n Composition q q q n coracoacromial ligament 喙肩韧带 coranoid process Acromion Prevents the shoulder joint from superior dislocation Acromion ligament Coranoid proce

Joints of free upper limb 自由上肢骨的连接

★Shoulder joint 肩关节 n n n Type: ball and socket Bones: head of humerus and glenoid cavity of scapula Capsule: q q q 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 肩关节 Tendon of long head of biceps brachii

n Accessory structures q Glenoid labrum 盂唇: fibrocartilaginous ring on periphery of glenoid cavity q Coracohumeral ligament 喙肱韧带: runs from coracoid process to greater tubercle n 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 肘关节 n n Bones: lower end of humerus, upper ends of radius and ulna q Humeroulnar joint 肱尺关节: formed by trochlear of humerus and troclear noch (hinge) q Humeroradial joint 肱桡关节: formed by capitulum of humerus and head of radius (ball and socket) q Proximal radioulnar joint 桡尺近侧关节: 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 肘关节 n Ligaments: q Radial collacteral ligament 桡侧副韧带: attached to lateral epicondyle and annular ligament of radius q Ulnar collacteral ligament 尺侧副韧带: attached to medial epicondyle to medial border of trochlear notch q Annular ligament of radius 桡骨环状韧带: attached to anterior and posterior margins of radial notch of ulna, surrounds the head of radius n 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.

n In extension, the medial and lateral epicondyles and the top of the olecranon process are in a straight line; n in flexion, the bony point form the boundaries of an equilateral triangle.

Joints between radius and ulna n n Proximal radioulnar joint 桡尺近侧关节 Interosseous membrane of forearm 前臂骨间膜: a fibrous membrane between the shaft of radius and ulna n Distal radioulnar joint 桡尺远侧关节 formed by head of ulna, ulnar notch of radius and an articular disc

Joints of hand ★ Radiocarpal joint 桡腕关节 (ellipsoid) n n n Bones q Carpal articular surface of radius and articular disc below the ulna q 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 n n Intercarpal joints 腕骨间关节 Carpometacarpal joints 腕掌关节 q Carpometacarpal joint of thumb 拇指腕掌关节 n n n Bones: trapezium and base of first metacarpal Movement: flexion, extension, adduction, abduction, and opposition Intermetacarpal joints 掌骨间关节 Metacarpophalangeal joints 掌指关节 Interphalangeal joints 指间关节

Joints of hand n n n Intermetacarpal joints 腕骨间关节 Metacarpophalangeal joints 掌指关节 Interphalangeal joints 指间关节

Joints of Lower limb 下肢骨的连接

Joints of pelvic girdle下肢带连接 Sacroiliac joint 骶髂关节 n n Bones: auricular surface of sacrum and ilium Capsule: very tight and strengthened by ligaments

Ligaments of the gluteal region n Sacrotuberous ligament 骶结节韧带 Connects the lateral margins of sacrum and coccyx to the ischial tuberosity n Sacrospinous ligament 骶棘韧带 Connects the lateral margins of sacrum and coccyx to the spine of the ischium

Foramina of the gluteal region Greater sciatic foramen n n 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 n n 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下肢带连接 n Pubic symphysis 耻骨联合 q q n n Articulation: symphysial surface and interpubic disc (fibrocartilage) Ligaments: superior pubic ligament and arcuate pubic ligament Obturator membrane 闭孔膜 Obturator canal 闭膜管

Bony pelvis骨盆 n Composition: formed by paired hip bones, sacrum, coccyx, and their articulations n 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 n Terminal line界线: formed by promontory of sacrum, arcuate line, pecten of pubis, pubic tubercle, upper border of pubic symphysis n Two portions: q q greater pelvis lesser pelvis

Bony pelvis骨盆 Lesser pelvis 小骨盆 n n pelvic inlet 骨盆上口(terminal line): Pelvic outlet 骨盆下口: formed by tip of coccyx, sacrotuberous ligament, ischial tuberosity, ramus of ischium, inferior ramus of pubic, symphysis n n n Pelvic cavity 骨盆腔 Pubic arch 耻骨弓 subpubic angle 耻骨下角

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 自由下肢骨连接

★ Hip joint 髋关节 n n Bones: acetabulum and femoral head Articular capsule attachments q Above: margins of acetabulum and transverse acetebular ligament q Below: in front to intertrochanteric line; behind, to the neck of femur above 1 cm above the intertrochanteric crest

★ Hip joint 髋关节 n Accessory structures q Acetabulum labrum 髋臼唇; transverse acetebular ligament 髋臼横韧带 q Acetabulum labrum Ligaments n Iliofemoral lig. 髂股韧带 n Ligament of head of femur 股骨头韧带 n n Pubofemoral lig. 耻股韧带 Ischiofemoral ligament 坐股韧带 Zona orbicularis 轮匝带 Movement: flexion, extention, adduction, abduction, medial and lateral rotation, circumduction n n Transverse acetebular lig Ligament of head of femur

★ Hip joint 髋关节 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 膝关节 Bones: n lower end of femur n upper end of tibia n patella Articular capsule: n Superapatellar bursa 髌上囊 n Deep infrapatellar bursa 髌下深囊 n Ala folds 翼状襞

★Knee joint 膝关节 Accessory structures n ligaments q q q n Patellar lig. 髌韧带 Fibular collateral lig. 腓侧副韧带 Tibial collateral lig. 胫侧副韧带 Anterior cruciate ligment 前交叉韧带 Posterior cruciate ligament 后交叉韧带 Oblique popliteal ligament 腘斜韧带 Meniscus 半月板 q q Medial meniscus 内侧半月板 (C-shaped) lateral meniscus 外侧半月板 (O-shaped)

★Knee joint 膝关节 Posterior cruciate lig. Anterior cruciate lig. Oblique popliteal lig. Tibial collateral lig. Fibular collateral lig.

★Knee joint 膝关节 n Movements: flexion and extension; flexed knee joint may be passively rotated through 700 lateral Medial

Hip joint Knee joint Radiograph

Coronal T 1 -weighted magnetic resonance image (MRI) of the knee in an adult male.

Tibiofibular syndesmosis胫腓连结 n n n Tibiofibular joint 胫腓关节 Crural interosseous membrane 小腿骨间膜 Anterior and posterior tibiofibular ligaments 胫腓前、后韧带

Joint of foot 足关节 Talocrural joint 距小腿关节 (ankle joint 踝关节) n n n 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 q q Medial lig. 内侧韧带 Lateral lig. 外侧韧带 n Anterior talofibular lig. 距腓前韧带 n Calcaneofibular lig. 跟腓韧带 n Posterior talofibular lig. 距腓后韧带

Joint of foot 足关节 Medial lig. Posterior talofibular lig. Calcaneofibular lig. Anterior talofibular lig.

Joint of foot 足关节 Talocrural joint 距小腿关节 n Movements: q q q 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 足关节 n Intertarsal joints跗骨间关节 q Talocalcaneal joint 距跟关节 q Talocalcaneonavicular joint 距跟舟关节 q Calcaneocuboid joint 跟骰关节 n Tarsometatarsal joints 跗跖关节 n Intermetatarsal joints 跖骨间关节 n Metatarsophalangeal joints 跖趾关节 n Interphalangeal joints 趾间关节 Inversion and eversion of foot transverse tarsal joint 跗横关节

Arches of foot 足弓 n n Medial longitudinal arch内侧纵弓: 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外侧纵弓: formed by calcaneus, cuboid, fourth and fifth metatarsals; cuboid is is the keystone of this arch

n Tranverse arch横弓: formed by cuboid, three cuniforms and all metatarsals; the intermediate cuneiform is the keystone of this arch n Function: give to foot strength stability and resilience; protect plantar vessels and nerves

Arches of foot 足弓 Normal arch Flatfoot