chapter 2 the arthrology section 3 joints of limbs 陈龙菊 yunyang medical college
TRANSCRIPT
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Chapter 2 The Arthrology
Section 3 Joints of limbs
陈龙菊 YunYang Medical College
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【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。
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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.
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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.
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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
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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.
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◆ 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.
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◆ Accessory structures :
◆ Glenoid labrum 盂唇 ◆ Coracohumeral ligament 喙肱韧带
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◆ 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.
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头大盂小囊松薄
最易发生前下脱
◆ Clinical application
Dislocation of the shoulder joint
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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
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◆ Feature:Compound joint Its capsule is thin and loose anteriorly and
posteriorly.
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◆ 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.
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Dislocation of the radial head
◆ Clinical application
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medial epicondyle of the humerus
lateral epicondyle of the humerus
tip of the olecranon
◆ Elbow landmarks
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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
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◆ Movements:pronation and supination
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◆ 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
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◆ Movements:(biaxial joint)
Flexion, extension, abduction, adduction and circumduction.
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★ 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
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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.
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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
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3. Pubic symphysis
耻骨联合4.Obturator membrane
闭孔膜 obturator canal
闭膜管
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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
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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
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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
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The fracture of the pelvis.
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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
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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
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Acetabulum labrum 髋臼唇 transverse acetebular
ligament 髋臼横韧带
Feature:
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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.
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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
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◆ Movements of hip joint: flexion and extension
adduction and abduction medial and lateral rotatio
ncircumduction
◆ Clinical application
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The dislocation of the hip joint.
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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
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◆ 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
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□ Articular discs(menisci)
Medial meniscus 内侧半月板 (C-shaped)
Lateral meniscus 外侧半月板 (O-shaped)
lateral
Medial
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□ Suprapatellar bursa 髌上囊 Infrapatellar bursa 髌下囊Alar folds 翼状襞
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◆ Movements of knee joint
flexion and extension slight medial rotation lateral rotation of the leg in flexed position
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◆ Clinical application
Knee injuryMedial collateral ligamentAnterior cruciate ligament
Medial meniscus
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Knee injury
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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
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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
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◆ Movements
Dosiflexion (extension) and plantar flexion (flexion)
2)The others: 自学
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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
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Normal arch Flatfoot
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【 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?
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Summary