Joints of limbs

SHANDONG UNIVERSITY

Liu ZhiyuLiu Zhiyu

Joints of upper limb

Joints of should girdle

Sternoclavicular joint 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 Bones: acromion and acromial

end of clavicle Movement: rotation of scapula

on clavicleCoracoacromial arch Composition

coracoacromial ligament coranoid process Acromion

Prevents the shoulder joint from superior dislocation

Coranoid processAcromion

Coracoacromial ligament

Joints of free upper limb

★Shoulder joint Type: ball and socket Bones: head of humerus and

glenoid cavity of scapula Capsule:

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 Accessory structures

Glenoid labrum : fibrocartilaginous ring on periphery of glenoid cavity

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 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 Ligaments:

Radial collacteral ligament : attached to lateral epicondyle and annular ligament of radius

Ulnar collacteral ligament : attached to medial epicondyle to medial border of trochlear notch

Annular ligament of radius : attached to anterior and posterior margins of radial notch of ulna, surrounds the head of radius

Movements: flexion and extension, pronation and supination

Dislocationof 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

Proximal radioulnar joint Interosseous membrane of

forearm: a fibrous membrane between the shaft of radius and ulna

Distal radioulnar joint formed by head of ulna, ulnar notch of radius and an articular disc

Joints of hand

★ Radiocarpal joint (ellipsoid)

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

Intercarpal joints Carpometacarpal joints

Carpometacarpal joint of thumb Bones: trapezium and base of first

metacarpal Movement: flexion, extension,

adduction, abduction, and opposition

Intermetacarpal joints Metacarpophalangeal joints Interphalangeal joints

Joints of hand

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 Bones: auricular

surface of sacrum and ilium

Capsule: very tight and strengthened by ligaments

Ligaments of the gluteal region

Sacrotuberous ligament

Connects the lateral margins of sacrum and coccyx to the ischial tuberosity

Sacrospinous ligament

Connects the lateral margins of sacrum and coccyx to the spine of the ischium

Foramina of the gluteal region

Greater sciatic foramen 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 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

Pubic symphysis Articulation: symphysial

surface and interpubic disc (fibrocartilage)

Ligaments: superior pubic ligament and arcuate pubic ligament

Obturator membrane Obturator canal

Bony pelvis Composition: formed by paired hip

bones, sacrum, coccyx, and their articulations

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

Terminal line: formed by promontory of sacrum, arcuate line, pecten of pubis, pubic tubercle, upper border of pubic symphysis

Two portions: greater pelvis lesser pelvis

Bony pelvis

Lesser pelvis pelvic inlet (terminal line): Pelvic outlet : formed by tip

of coccyx, sacrotuberous ligament, ischial tuberosity, ramus of ischium, inferior ramus of pubic, symphysis

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

Pelvic inlet

Pelvic outet

Pelvic cavity

Pubic arch

90~1000 70~750

Main difference between male and femal

pelvis

Anteroposterior radiograph of adult female pelvis.

Joints of free lower limb

★ Hip joint

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 Accessory structures

Acetabulum labrum ; transverse acetebular ligament

Ligaments Iliofemoral lig. Ligament of head of femur Pubofemoral lig. Ischiofemoral ligament

Zona orbicularis

Movement: flexion, extention, adduction, abduction, medial and lateral rotation, circumduction

Acetabulum labrum

Transverse acetebular lig.

Ligament of head of femur

★ Hip joint

Ischiofemoral lig.

Zona orbicularis

Iliofemoral lig.

Pubofemoral lig.

Head of femur is driven posteriorly, out of acetabulumPoterior dislocation of the hip bone

★Knee joint

Bones:

lower end of femur

upper end of tibia

patella

Articular capsule:

Superapatellar bursa

Deep infrapatellar bursa

Ala folds

★Knee joint

Accessory structures ligaments

Patellar lig. Fibular collateral lig. Tibial collateral lig. Anterior

cruciate ligment Posterior cruciate ligament Oblique popliteal ligament

Meniscus Medial meniscus (C-shaped) lateral meniscus (O-shaped)

★Knee joint

Oblique popliteal lig.

Anterior cruciate lig.

Posterior cruciate lig.

Fibular collateral lig.

Tibial collateral lig.

★Knee joint Movements: flexion and

extension; flexed knee joint may be passively rotated through 700

lateralMedial

Hip joint Knee joint

Radiograph

Coronal T1-weighted magnetic resonance image (MRI) of the knee in an adult male.

Tibiofibular syndesmosis

Tibiofibular joint Crural interosseous membrane Anterior and posterior tibiofibular

ligaments

Joint of foot

Talocrural joint (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 Medial lig. Lateral lig.

Anterior talofibular lig. Calcaneofibular lig. Posterior talofibular lig.

Joint of foot

Medial lig.

Calcaneofibular lig.

Anterior talofibular lig.

Posterior talofibular lig.

Joint of foot

Talocrural joint Movements:

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 Intertarsal joints

Talocalcaneal joint Talocalcaneonavicular joint Calcaneocuboid joint

Tarsometatarsal joints Intermetatarsal joints

Metatarsophalangeal joints Interphalangeal joints

Inversion and eversion of foot

transverse tarsal joint

Arches of foot

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

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