Chapter 2 The Arthrology

Section 3 Joints of limbs

陈龙菊 YunYang Medical College

【目的与要求】掌握 :

1. 肩关节、肘关节、腕关节、髋关节、膝 关节和 踝关节的构成、特点及运动。

2. 髋骨与脊柱间的韧带连结，骨盆的组成与分部。

了解 :

胸锁关节、肩锁关节、骶髂关节的构成，足弓的构成及功能。

The General Description

Owing to the erect standing of human

being,the upper limb has been freed and

more movable from weight bearing and be

come a laboring organ.The joints of the up

per limb are chiefly for the mobility in acti

on,whereas the joints of the lower limb are

for the stability.

Ⅰ. Joints of upper limb Ⅰ) Joints of the girdle of the upper limb 1.Sternoclavicular joint 胸锁关节

Joint formed by the sternal end of clavicle and clavicular notch of sternum and th

e first costal cartilage.

Its capsule is strengthed by several ligaments.

2.Acromioclavicular joint 肩锁关节

( plane joint)

3.Coracoacromial ligament 喙肩韧带

喙肩弓

Coracoclavicular lig.

喙锁韧带

Ⅱ)Joints of free upper limb

Incluing the shoulder joint, the elbow joint, the joints of the ulna and radius, the wrist joint and the joints of the ha

nd.

◆ Composition: Joint formed by the head of humerus and glenoid cavity of scapula.

◆Type of should joint Synovial joint, ball-and-socket type.

1.Shoulder joint 肩关节

◆ Feature:

Its capsule is thin and loose.

◆ Accessory structures :

◆ Glenoid labrum 盂唇 ◆ Coracohumeral ligament 喙肱韧带

◆ Movements of shoulder joint It is the most movable joint of the body.

flexion, extension, adduction, abduction

medial rotation, lateral rotation and

circumduction of the arm.

头大盂小囊松薄

最易发生前下脱

◆ Clinical application

Dislocation of the shoulder joint

2. Elbow joint 肘关节

Definition: Joint formed by the trochlea of the humerus, the trochlea notch of the ulna and the head of th

e radius.

□ Humeroulnar joint 肱尺关节□ Humeroradial joint 肱桡关节

□ Proximal radioulnar joint

桡尺近侧关节

◆ Feature:Compound joint Its capsule is thin and loose anteriorly and

posteriorly.

◆ Ligaments:1.Radial collateral ligament

桡侧副韧带 :

2. Ulnar collateral ligament

尺侧副韧带 :

3. Annular ligament of radius

桡骨环状韧带 :

◆ Movements: flexion and extension, rotation.

Dislocation of the radial head

◆ Clinical application

medial epicondyle of the humerus

lateral epicondyle of the humerus

tip of the olecranon

◆ Elbow landmarks

3.Joints between radius and ulnar Proximal radioulnar joint 桡尺近侧关节 Distal radioulnar joint 桡尺远侧关节 Interosseous membrane of forear

m 前臂骨间膜

◆ Movements:pronation and supination

◆ Definition: It is a typical ellipsoid joint. The articular fossa is formed by the distal end of radius and under surface of the articular disc beneath the head of ulna; and the articular head by the proximal surface of scaphoid, lunate, and triangular bones.

4.Joints of hand

1) Radiocarpal joint 桡腕关节

◆ Movements:(biaxial joint)

Flexion, extension, abduction, adduction and circumduction.

★ Carpometacarpal joint of thumb 拇指腕掌关节◆ Definition: Joint formed b

y trapezium and base of the first metacarpal.

◆ Feature:saddle joint

◆ Movement: flexion, extension, adduction, abduction, and opposition

Ⅱ.Joints of Lower limbⅠ) Joints of pelvic girdle 1.Sacroiliac joint 骶髂关节 ◆ Definition: It is formed by t

he auricular surfaces of the sacrum and the ilium.

◆ Feature:

Its capsule is very tight and strengthened by ligaments.

2.Vertebropelvic ligaments

1) Iliolumbal ligament 髂腰韧带 :

2) Sacrotuberous ligament

骶结节韧带 3) Sacrospinous ligament

骶棘韧带 These two ligaments convert the sciatic notches the greater and lesser sciatic foramen 坐骨大、小孔

3. Pubic symphysis

耻骨联合4.Obturator membrane

闭孔膜 obturator canal

闭膜管

5. Pelvis 骨盆1)Composition:

2)Terminal line 界线 :formed by promontory of sacrum, arcuate line, pecten pubis, pubis tuberosity and upper border of pubic

symphysis .

3)Two portions: ◆ Greater pelvis

◆ Lesser pelvis

4)Lesser pelvis 小骨盆(1)pelvic inlet 骨盆上口 (te

rminal line):

(2)Pelvic outlet 骨盆下口 : formed by tip of coccyx, sacrotuberous ligament, ischial tuberosity, ramus of ischium, inferior ramus of pubic, symphysis

(3)Pelvic cavity(4)Pubic arch, subpubic

angle

骨盆的性差 男性 女性 骨盆形状 窄而长 宽而短 骨盆上口 呈心形 椭圆形 骨盆下口 狭小 宽大 骨盆腔 呈漏斗形 圆筒形 骶骨 窄长， 宽短， 曲度大 曲度小 骶骨岬 突出 突出 明显 不明显 耻骨下角 70º ~ 75º 90º ~ 100º

男性

女性

70º~75º

90º~100º

The fracture of the pelvis.

Ⅱ) Joints of free lower limb

The joints of the free lower limb include the hip joint, the knee joint, the joints between the tibia and fibula and the joints of the foot.

1. hip joint 髋关节

Definition of hip joint Jointed formed by the head of the fumur and the ac

etabulum of the hipbone.

Type of hip joint Synovial, ball-and-socket(spheroid) type

Acetabulum labrum 髋臼唇 transverse acetebular

ligament 髋臼横韧带

Feature:

down

The articular capsule is strong and dense.

In the front the joint,it attaches to the intertrachanteric line;behind, to the 2/3 parts of the neck.

Iliofemoral lig. 髂股韧带Pubofemoral lig. 耻股韧带Ischiofemoral ligament

坐股韧带Ligament of head of

femur 股骨头韧带Zona orbicularis 轮匝带

down

◆ Movements of hip joint: flexion and extension

adduction and abduction medial and lateral rotatio

ncircumduction

◆ Clinical application

The dislocation of the hip joint.

2.Knee joint 膝关节 (the largest and the mos

t complicated joint)

◆ Composition: lower end of femur, upper end of tibia and patella

◆ Accessory structures

□ Ligments: Patellar lig. 髌韧带 Fibular collateral lig. 腓侧副韧带 Tibial collateral lig. 胫侧副韧带 Anterior cruciate lig. 前交叉韧带 Posterior cruciate lig 后交叉韧带 Obligue popliteal lig 膕斜韧带

down

□ Articular discs(menisci)

Medial meniscus 内侧半月板 (C-shaped)

Lateral meniscus 外侧半月板 (O-shaped)

lateral

Medial

□ Suprapatellar bursa 髌上囊 Infrapatellar bursa 髌下囊Alar folds 翼状襞

◆ Movements of knee joint

flexion and extension slight medial rotation lateral rotation of the leg in flexed position

◆ Clinical application

Knee injuryMedial collateral ligamentAnterior cruciate ligament

Medial meniscus

Knee injury

3)Tibiofibular syndesmosis

胫腓连结 ◆ Tibiofibular joint 胫腓关节 ◆ Crural interosseous membran

e 小腿骨间膜 ◆ Anterior and posterior tibiof

ibular ligaments

胫腓前、后韧带

4)Joints of foot: 1)Talocrural joint 距小腿关节 (a

nkle joint) 踝关节 ◆ Composition: lower ends

of tibia and fibula,

trochlea of talus

◆ Feature: Articular capsule: thin

and loose in front and behind

◆ Movements

Dosiflexion (extension) and plantar flexion (flexion)

2)The others: 自学

Arches of the foot 足弓 ◆ Composition : tarsals and metatarsals and l

igaments between them. ◆ Function: Give to foot strength stability and

resilience; protect plantar vessels and nerves

Normal arch Flatfoot

【 Questions 】 1. Which direction is easiest from the disloc

ation of the shoulder joint?

2 ． What are the composition and accessory structures of the knee joint?

Summary