The bones of upper limb and their...

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The bones of upper limb and their junction The upper limb is characterized by considerable mobility and is adapted for grasping & manipulation.

Transcript of The bones of upper limb and their...

Page 1: The bones of upper limb and their junctionanatomy.sbm.pumc.edu.cn/mobile/files/pdf/RegionalAnatomy/... · 2016-02-29 · Bone of the upper limb-64. Carpal bones Proximal row (lateral

The bones of upper limb

and their junction

The upper limb is characterized by

considerable mobility and is adapted

for grasping & manipulation.

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Bones of Shoulder girdle

Clavicle 1

Scapula 1

Bones of free upper limb

Humerus 1

Ulna 1

Radius 1

Carpal bones 8

Metacarpal bones 5

Phalangeal bones 14

Bone of the upper limb-64

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Carpal bones

Proximal row(lateral to medial)

S-Scaphoid

L-Lunate

T-Triquetral

P-Pisiform

Distal row(lateral to medial)

Tm-Trapezium

Td-Trapezoid

C-Capitate

H-Hamate

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Joints of should girdle

Joints of the free upper limb bone

Joints of the upper limb

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Joints between clavicle and trunk bones

process

Sternoclavicular

joint

The medial end of the clavicle articulate with the manubrium

sterni and it is the only direct connection between the

shoulder girdle & axial skeleton.the lateral end articulates

with the acromion of the scapula.

Acromion

Coranoid

Coracoacroial lig

Acromioclavicular

joint

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sternoclavicular lig

Anterior

Articular

cavities

Manubrium

Stemoclavicular joint

Articular disc

Movements:

Elevation and depression,

Forward and backward,

Rotation and circumduction

Sternoclavicular joint Acromioclavicular joint

Coranoidprocess

AcromionCoracoacroial lig

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Joints of free upper limb bone

The Shoulder joint

The Elbow joint

The Joint of the ulna and the radius

The Wrist joint

The Joints of the hand

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Shoulder joint

Classification:

ball and socket joint

multiaxial synovial joint

the most flexible joint

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

Lower wall of capsule is lax

Tendon of long head of biceps

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• Accessory structures

– Glenoid labrum:

Coracohumeral lig

• Movements:

Flexion,extension,

Adduction,abduction,

Medial Rotation

Lateral Rotation,

Circumduction

Easy to dislacate to anterior andinferior direction

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Formed by trochlear of humerus &

troclear noch (hinge)

– Humeroradial joint-2

Formed by capitulum of humerus

& head of radius (ball and socket)

– Proximal radioulnar joint-3

– Formed by articular circumference

of radius and radial notch of ulna

Ant. view

Elbow joint

Bones:

lower end of humerus,upper

ends of radius and ulna

– Humeroulnar joint-1

1

2

3

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LigamentsRadial collateral lig-1.

Attached to lateral epicondyle &

annular ligament of radius

Ulnar collateral lig-2.

Attached to medial epicondyle to

medial border of trochlear notch

Annular lig.of radius-3

Attached to ant. & post.margins

of radial notch of ulna,surrounds

the head of radius

ulna

Elbow joint

Capsule: thin and lax

1

2

3

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Joints between radius and ulna

1-Proximal radioulnar joint

2-Distal radioulnar joint

Formed by head of ulna,

ulnar notch of radius

and an articular disc

3-Interosseous membrane

of forearm

1

A fibrous membrane between

the shaft of radius and ulna

2

3

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The movement of the forearm bones

Ant.view pronationAnt.view supination

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Joint of the hand

Radiocarpal joint

Carpometacarpal joint

Intercarpal joint

Matacarpophalangeal joint

Intermetacarpal joint

Interphalangeal joint

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Bones

Carpal articular surface of

radius & articular disc

below the ulna

Proximal row of carpal:

Scaphoid,lunate,triquetral

bones,but not pisiform

Capsule: Lax & strengthened

by surrounding lig.

Movements:

Flexion & extension,

Adduction & abduction,

& circumduction Ligaments of wristcoronal section-dorsal view

radiusulna

thumb

Joints of hand

Radiocarpal joint (ellipsoid)

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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

ulna radius

thumb

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Summary

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Muscle of rotator cuffAnterior view

Muscle of rotator cuffposterior view

Dislocation of should joint

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Elbow:lateral radiograph Elbow:anteroposterior radiograph

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Double fracture of the forearmThe fracture of the humerus

X-ray of upper limb bones-fracture

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Fracture of the distal end of the radius

Colles’fracture

Within 2.5cm distal

end of radius

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Wrist and hand; Metacarpal fracture

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Upper Limb X-ray

Ant.view(left)

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Surgical neck fracture Fracture of the ulnar

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kyphosis scoliosis scoliosis

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Master the name,number and location of

the upper limb bones

Master the morphological feature of the

scapular, humerus,ulna and radius

Master the arrangement of the hand bone

Master the structure and movement of the

shoulder joint, elbow joint and the wrist

joint.

The important contents today

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The lower limb bones

and their junctions

The lower limb is specialized for locomotion.bearing weight

& maintaining equilibrium. so far same reason.the bones of

lower limb are more massive than those of the upper limb.

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Bones of Lower Limb-62

Pelvic girdle:

1-Hip bone 1

Bones of free lower limb:

2-Femur 1

3-Patella 1

4-Tibia

5-Fibula

1

1

6-Tarsal bone 7

7-Metatarsal bone 5

8-phalanges of toes 14

1

2

3

45

67

8

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Calcaneus

Cuboid bone

lateral

cuneiform

bone

Metatarsal

bone

Talus

Navicular bone

Intermediate

cuneiform bone

Medial

Cuneiform bone

Proximal phalanges

Middle phalanges

phalanges

Total bone

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Joints of the lower

limb bones

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Joints of Lower limb

Joints of pelvic girdle

1-Sacroiliac joint

2-Pubis symphysis

Bones: auricular surface of sacrum and ilium

Capsule: very tight and reinforced by ligaments

2

1

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Vertebropelvic lig.

1-Iliolumbal lig.(ant & pos)

2-Sacrotuberous lig.

3-Sacrospinous lig.

Two structure

Greater sciatic foramina

Lesser sciatic foramina

2

2

Ant.view Post.view

3

Iliolumbar

joints

Greater sciatic foramina

1

3

Lessersciaticforamina

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Pubis symphysis

Articulation:

Symphysial surface &

Interpubic disc (fibrocartilage)

Ligaments:

Superior pubic lig &

Arcuate pubic ligament

Obturator membrane

Obturator canal

Pubis symphysis

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The pelvis

Composition: formed by paired hip bones, sacrum, coccyx, and

their articulations

Terminal line: formed by promontory of sacrum, arcuate line,pectin of pubis, pubic tubercle, upper border of pubicsymphysis

Two portions: a greater pelvis and a lesser pelvis

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Main difference between male and female pelvis

Subpubic angle

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Pelvic inlet

Pelvic outlet

Pelvic cavity

Pubic arch

Female

90~1000

Male

70~750

Comparison between male & female pelvis

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Hip joints

Constitution: acetabulum & femoral head

Articular capsule:

Above: margins of acetabulum & transverse acetebular lig.

Below: in front to intertrochanteric line; behind, to the neck

of femur above 1 cm above the intertrochanteric crest

Ant.viewcoronal plane

Ant.view Post.view

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Articular capsule

Lig. of head of femur

Accessory structure of the hip joints

Acetabular labrum

Ant.viewArticular capsule (removed)

Ant.viewArticular capsule

Post.view

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Movement of the hip joints

Adduction-abduction Flexion-extension Circumduction

It’s movement are similar to shoulder joint

Flexion-extension

Adduction-abduction

Medial and lateral rotation

Circumduction

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Anterior view

Largest, most complex , most vulnerable joint

Constitution: lower end of femur,upper end of tibia & patella

with many ligaments

with special meniscus

characteristics - tense and strong

Knee joints

Lat view (Sagittal)

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Miniscus of

Knee joint

Right hip joint Ligaments

(ant.view)

Ant.view(right)

(PCL)

(ACL)

IdentifyStructures

by specimen

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P-post.cruciate lig.A-ant.cruciate lig.

Function of the cruciate lig.

Prevent the tibia forward

and backward

A

P

Lat.view

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Patellar lig & oblique

popliteal lig

Lat.collateral lig.Transverse lig.

of knee

Ant.view (capsule removed)

Patellar lig.

Ant.view

Movements

Flexion and extension;

Flexed knee joint may

be passively rotated

Post.view

Med.collateral lig.

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2 - Tibiofibular syndesmosis

Articulation between the tibia & fibula

1

1 - Tibiofibular joint

3 - Interosseous membrane of leg

2

3

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Medial lig.of ankle

Lig. and tendons of right

ankle (Medial view)Lig. and tendons of right

ankle (lateral view)

2

Lateral lig.of ankle

1-Anterior talogibular lig.

2-Calcaneofibular lig.

3-Posterior talofibular lig.

1

3

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Intertarsal joints

Talocalcaneal joint-距跟关节

Talocalcaneonavicular joint 距跟舟关节

Calcaneocuboid joint距骰关节

Intermetatarsal joints

1-Transverse tarsal joints

2-Tarsometarsal joint

3-Metatarsophalangeal joints

1

2

3

4-Interphalangeal joints

4

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Medial longitudinal arch:

Lateral longitudinal arch:

Flatfoot

Foot arch

Med.longitudinal arch

Transversearch

Lat.longitudinal archNormal arch

Transverse arch

Function: give to foot stability & resilience; protectplantar vessels and nerves

Normalarch

Flat

foot

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Master the name.number and location of the lower

limb bones.

Master the morphological feature of the hip,femur,

tibia and fibula.

Master the arrangement of the foot bone

Master the structure and movement of the hip joint,

knee joint and ankle joint.

Master difference of pelvis between the male & the

female.

The important contents today

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Summary

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Parachuting

Car accident

Car accident

Hip bone and the clinic

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artificial hip joint

dislocation of hip jointAnteroposterior radiograph

Radiograph of hip joint

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Blood supply to the head of the femur by the three sets of arteries

Poor Blood supply

Much cortical hormone

Necrosis of femoral head

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1-Subcapital neck fracture 2-Transcervical neck fracture3-Intertrochanteric fracture 4-Subtrochanter fracture5-Fracture of the greater trochanter 6-Fracture of the lesser trochanter

1

4

2

5

3

6

Classification of the femur neck fracture

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Fracture of the femoral neck

fracture fixation

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Artificial knee joint(prosthesis)

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Normal photo Fracture

X-ray of the lower limb

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Femur fracture

Tibia and fibularfracture

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The end !

Bye !