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JOINTS OF THE UPPER LIMB

Victoria Gugenheim Body Art

Kaan Yücel M.D., Ph.D. 03.March.2014 Monday

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JOINTS OF THE UPPER LIMB

Acromioclavicular joint & Sternoclavicular jointGlenohumeral (Shoulder) jointElbow jointProximal (Superior) and Distal (Inferior) radio-ulnar jointsRadiocarpal (Wrist) jointIntercarpal jointsCarpometacarpal and intermetacarpalInterphalangeal

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STERNOCLAVICULAR JOINT

Articulation between Sternum & clavicleSaddle type functions as a ball-and-socket jointArticular disc

Sternal end of clavicle v.s. Manubrium & 1st costal cartilage

the only articulation between upper limb & axial skeleton

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LIGAMENTS OF THE STERNOCLAVICULAR JOINT

1.Anterior and posterior sternoclavicular ligaments2.Interclavicular ligament3.Costoclavicular ligament

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Strong but mobileRaising the clavicle (60°) during full elevation of the limb

Once elevation is completed via flexion; rotation of the clavicle

around its longitudinal axisAnterior and posterior movements of the clavicle

MOVEMENTS OF THESTERNOCLAVICULAR JOINT

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ACROMIOCLAVICULAR JOINT

Articulation between Acromion of scapulae & claviclePlane type Articular disc

Acromial end of clavicle v.s. Acromion of scapula

2-3 cm from the “point” of the shoulder formed by the lateral part of the acromion

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LIGAMENTS OF THE ACROMIOCLAVICULAR JOINT

Intrinsic ligament Acromioclavicular ligamentExtrinsic ligament Coracoclavicular ligamentconoid ligament (medial) trapezoid ligament (lateral)

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Acromion rotates on the acromial end of the clavicle. associated with motion @ physiological scapulothoracic joint

MOVEMENTS OF THE ACROMIOCLAVICULAR JOINT

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GLENOHUMERAL (SHOULDER) JOINT

Articulation between humeral head v.s. glenoid cavity of the scapulaBall-and-socket type

Glenoid labrum (L., lip)

more freedom of movement than any other joint in the body

MORE IMAGES114-122

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LIGAMENTS OF THE GLENOHUMERAL (SHOULDER) JOINT

1. Glenohumeral ligaments2. Coracohumeral ligament3. Transverse humeral ligament

coraco-acromial arch

4. Coracoacromial ligamentJoint stability

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MOVEMENTS OF THEGLENOHUMERAL (SHOULDER) JOINT

Flexion & extension of the humerusAbduction & adduction of the humerus Medial & lateral rotation of the humerusCircumduction

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BURSAE AROUND THE GLENOHUMERAL (SHOULDER) JOINT

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ELBOW JOINT

Articulation between Humerus, ulna and radius Hinge typeTrochlea of humerus v.s. Trochlear notch

of ulnaCapitilum of humerus v.s. Head of radius

2-3 cm inferior to the epicondyles of the humerus

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LIGAMENTS OF THE ELBOW JOINT

Medial (ulnar) and lateral (radial) collateral ligaments

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MOVEMENTS OF THE ELBOW JOINTFlexion and extension occur at the elbow joint.

The long axis of the fully extended ulna makes an angle with the long axis of the humerus.

forearm angles away from the body when something is carried. more pronounced in women than in men

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BURSAE AROUND THE ELBOW JOINT

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Articulation between Radius and ulna proximallyPivot type

Head of radius v.s. Radial notch of ulna

Anular ligamentSupination & pronation

PROXIMAL (SUPERIOR) RADIO-ULNAR JOINT

MORE IMAGES133 -134

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DISTAL (INFERIOR) RADIO-ULNAR JOINTArticulation between Radius and ulna distallyPivot typeArticular disc

head of ulna v.s. ulnar notch of radius

Anterior and posterior ligaments

Radius moves around relatively fixed distal end of ulna.

Supination & pronation

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WRIST (RADIOCAPRAL) JOINTArticulation between Radius and proximal row of carpal bones Condyloid (ellipsoid) typeArticular disc

Distal end of the radius ,disc of the distal radio-ulnar joint v.s.

proximal row of carpal bones, except for the pisiform

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LIGAMENTS OF THE WRIST JOINT

1. Dorsal and palmar radiocarpal ligaments2. Ulnar collateral ligament3. Radial collateral ligament

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MOVEMENTS OF THE WRIST JOINT

Proximal&DistalRadioulnarjoints

Flexion of the hand> Extension of the handAdduction of the hand > Abduction of the hand

Most adduction @ wrist joint

Abduction from the neutral position occurs @ midcarpal joint.

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INTERCARPAL JOINTS

Joints between carpal bones of the proximal rowJoints between carpal bones of the distal rowMidcarpal joint between proximal &distal rows of carpal bones

Plane type

Anterior, posterior, and interosseous ligaments

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CARPOMETACARPAL & INTERMETACARPAL JOINTS

carpometacarpal joint of the thumbbetween trapezium & base of 1st metacarpal

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METACARPOPHALANGEAL &

INTERPHALANGEAL JOINTSMetacarpophalangeal joints condyloid type biaxial plane : flexion-extension and adduction-abductionInterphalangeal joints hinge type uniaxial flexion-extension only

MORE IMAGES135-138