JOINTS OF THE UPPER LIMB Hand and Wrist Joint Classification ...
JOINTS OF THE UPPER LIMB Hand and Wrist Joint Radiocarpal
Midcarpal
Classification Syn, biaxial, ellipsoid
Syn, biaxial, condyloid
Common Carpometacarpal
Syn, multiaxial, plane
Carpometacarpal (thumb)
Syn, biaxial, saddle
Metacarpophalangeal
Syn, biaxial, condyloid
Interphalangeal
Syn, uniaxial, hinge
Movements Palmar / Dorsiflexion Radial / ulnar deviation
Palmar / Dorsiflexion Radial / ulnar deviation
↑mobility as move lat to med 2nd CMC least mobile 5th CMC most mobile Palmer / Dorsiflexion – AP Radial / Ulnar deviation – Transverse Opposition – longitudinal Flexion / extension Abduction / adduction
Flexion / extension
Articular surfaces Proximal surface of scaphoid, lunate + triquetrum Distal surface of radius + inf. RU jt disc Articular Capsule - Attaches to articular margins of bones - Reinforced by capsular lig at sides, ant + post Synovial membrane - Restricted to radiocarpal joint space - Communicates with synovial cavity of inf R-U joint
Ligaments Radial collateral Ulnar collateral Dorsal + palmer radiocarpal Dorsal
Actions Limits adduction Limits abduction Fibres run inf. + med = moves both R + U during pro/supination Limits flexion
Palmar
Limits extension
Distal surface of scaphoid, lunate and triquetrum
Radial collateral Ulnar collateral Dorsal intercarpal Palmar intercarpal
Limits adduction Limits abduction Limits flexion Limits extension, converge on the capitate
Dorsal CMC Palmar CMC
Limits flexion Limits extension? (From carpals to base of metacarpal – commonly two bands to each metacarpal)
Collateral Palmar Deep transverse metacarpal
Limits flex, prevents ad/ab in flexion Limits ext. form part of articular surface Keep metatarsal heads together, imp, for weight bearing
Collateral Palmar
Limits flexion Limits extension
Proximal surface of trapezium, trapezoid, capitate + hamate Base of metacarpal 2 with trapezoid Base of metacarpal 3 with capitate Base of metacarpal 4 with hamate Base of metacarpal 5 with hamate
Head of the metacarpal Base of the adjacent phalanx
Elbow + RU: Joint Elbow Joint
Classification Syn, uniaxial, hinge
Movements Flexion / extension
Superior radioulnar
Syn, uniaxial, pivot
Inferior radioulnar
Syn, uniaxial, pivot
Pronation / supination on longitudinal axis Pronation / supination
Intermediate radioulnar
Fibrous syndesmosis
Shoulder: Joint Glenohumeral
Sternoclavicular
Acromioclavicular
Classification Syn, multiaxial, ball + socket
Syn, multiaxial, plane
Syn, multiaxial, plane
Articular surfaces Head of radius articulates with capitulum of humerus Trochlear of notch of ulna articulates with trochlea of humerus Articular Capsule - Attach to art margins of humerous + ulna - Thickest + strongest at sides, weakest ant + post Synovial membrane - Lines capsule Extra synovial fat pads - occupy the fossae when bony projections do not Head of radius Radial notch of ulna Ulnar notch of radius Head of the ulna
Ligaments Annular (Both attachments of ulna, surrounds head of radius)
Actions Allows pronation / supination Prevents inferior dislocation of the head of the radius.
Collateral Radial collateral Ulnar collateral Articular discs from styloid of ulna to margin of ulnar notch of radius
Tense throughout flexion / extension range Prevents adduction Prevents abduction Limits certain movements – properties like ligaments
Fibres pass downwards from radius to ulna
Movements Flexion / extension Abduction / Adduction Internal / External rot
Flexion / extension Abduction / Adduction Internal / External rot
Flexion / extension Abduction / Adduction Internal / External rot
Articular surfaces Humeral head Glenoid fossa Glenoid Labrum Articular Capsule - Thin + lax (↑ mment) - Attaches to glenoid labrum - Reflected inf onto med shaft of humerus - Reinforced by RC tend + gleno/coraco lig - Communicated with subscapular bursa + intertubercular groove Sternal end of clavicle Clavicular notch of sternum Costal cartilage of rib 1 Articular Capsule - Strong - Reinforced by capsular ligaments Synovial membrane - Shock absorber - Prevents superior dislocation of clavicle Acromial end of clavicle Anterior, medial acromion Articular Capsule - Loose - Reinforced by capsular ligaments Intra articular disc – shock absorber
Angle of fibres is important for force distribution
Ligaments Coracoacromial Coracohumeral Sup. Glenohumeral Middle Glenohumeral Inferior Glenohumeral Transverse humeral Costoclavicular – bilaminar (2 layers)
Actions Prevents superior dislocation of humerus, provides roof over top of humerus Prevents lat + inf. dislocation of humerus Prevents lat +inf. dislocation of humerus Limits extension Limits external rotation Prevents anterior dislocation of humerus when fully flexed/abducted Holds long head of biceps brachii in bicipital groove Limits elevation of clavicle Limits protraction and retraction Acts as fulcrum /pivot about which mment occur
Anterior sternoclav
Limits retraction
Posterior sternoclav
Limits protraction
Interclavicular Coracoclavicular Conoid part
Trapezoid part
Vertical, limits protraction of scapula, produces axial rotation of clavicle Oblique, limits retraction of scapula, prevents medial dislocation of scapula
Midcarpal
Classification Syn, biaxial, ellipsoid
Syn, biaxial, condyloid
Common Carpometacarpal
Syn, multiaxial, plane
Carpometacarpal (thumb)
Syn, biaxial, saddle
Metacarpophalangeal
Syn, biaxial, condyloid
Interphalangeal
Syn, uniaxial, hinge
Movements Palmar / Dorsiflexion Radial / ulnar deviation
Palmar / Dorsiflexion Radial / ulnar deviation
↑mobility as move lat to med 2nd CMC least mobile 5th CMC most mobile Palmer / Dorsiflexion – AP Radial / Ulnar deviation – Transverse Opposition – longitudinal Flexion / extension Abduction / adduction
Flexion / extension
Articular surfaces Proximal surface of scaphoid, lunate + triquetrum Distal surface of radius + inf. RU jt disc Articular Capsule - Attaches to articular margins of bones - Reinforced by capsular lig at sides, ant + post Synovial membrane - Restricted to radiocarpal joint space - Communicates with synovial cavity of inf R-U joint
Ligaments Radial collateral Ulnar collateral Dorsal + palmer radiocarpal Dorsal
Actions Limits adduction Limits abduction Fibres run inf. + med = moves both R + U during pro/supination Limits flexion
Palmar
Limits extension
Distal surface of scaphoid, lunate and triquetrum
Radial collateral Ulnar collateral Dorsal intercarpal Palmar intercarpal
Limits adduction Limits abduction Limits flexion Limits extension, converge on the capitate
Dorsal CMC Palmar CMC
Limits flexion Limits extension? (From carpals to base of metacarpal – commonly two bands to each metacarpal)
Collateral Palmar Deep transverse metacarpal
Limits flex, prevents ad/ab in flexion Limits ext. form part of articular surface Keep metatarsal heads together, imp, for weight bearing
Collateral Palmar
Limits flexion Limits extension
Proximal surface of trapezium, trapezoid, capitate + hamate Base of metacarpal 2 with trapezoid Base of metacarpal 3 with capitate Base of metacarpal 4 with hamate Base of metacarpal 5 with hamate
Head of the metacarpal Base of the adjacent phalanx
Elbow + RU: Joint Elbow Joint
Classification Syn, uniaxial, hinge
Movements Flexion / extension
Superior radioulnar
Syn, uniaxial, pivot
Inferior radioulnar
Syn, uniaxial, pivot
Pronation / supination on longitudinal axis Pronation / supination
Intermediate radioulnar
Fibrous syndesmosis
Shoulder: Joint Glenohumeral
Sternoclavicular
Acromioclavicular
Classification Syn, multiaxial, ball + socket
Syn, multiaxial, plane
Syn, multiaxial, plane
Articular surfaces Head of radius articulates with capitulum of humerus Trochlear of notch of ulna articulates with trochlea of humerus Articular Capsule - Attach to art margins of humerous + ulna - Thickest + strongest at sides, weakest ant + post Synovial membrane - Lines capsule Extra synovial fat pads - occupy the fossae when bony projections do not Head of radius Radial notch of ulna Ulnar notch of radius Head of the ulna
Ligaments Annular (Both attachments of ulna, surrounds head of radius)
Actions Allows pronation / supination Prevents inferior dislocation of the head of the radius.
Collateral Radial collateral Ulnar collateral Articular discs from styloid of ulna to margin of ulnar notch of radius
Tense throughout flexion / extension range Prevents adduction Prevents abduction Limits certain movements – properties like ligaments
Fibres pass downwards from radius to ulna
Movements Flexion / extension Abduction / Adduction Internal / External rot
Flexion / extension Abduction / Adduction Internal / External rot
Flexion / extension Abduction / Adduction Internal / External rot
Articular surfaces Humeral head Glenoid fossa Glenoid Labrum Articular Capsule - Thin + lax (↑ mment) - Attaches to glenoid labrum - Reflected inf onto med shaft of humerus - Reinforced by RC tend + gleno/coraco lig - Communicated with subscapular bursa + intertubercular groove Sternal end of clavicle Clavicular notch of sternum Costal cartilage of rib 1 Articular Capsule - Strong - Reinforced by capsular ligaments Synovial membrane - Shock absorber - Prevents superior dislocation of clavicle Acromial end of clavicle Anterior, medial acromion Articular Capsule - Loose - Reinforced by capsular ligaments Intra articular disc – shock absorber
Angle of fibres is important for force distribution
Ligaments Coracoacromial Coracohumeral Sup. Glenohumeral Middle Glenohumeral Inferior Glenohumeral Transverse humeral Costoclavicular – bilaminar (2 layers)
Actions Prevents superior dislocation of humerus, provides roof over top of humerus Prevents lat + inf. dislocation of humerus Prevents lat +inf. dislocation of humerus Limits extension Limits external rotation Prevents anterior dislocation of humerus when fully flexed/abducted Holds long head of biceps brachii in bicipital groove Limits elevation of clavicle Limits protraction and retraction Acts as fulcrum /pivot about which mment occur
Anterior sternoclav
Limits retraction
Posterior sternoclav
Limits protraction
Interclavicular Coracoclavicular Conoid part
Trapezoid part
Vertical, limits protraction of scapula, produces axial rotation of clavicle Oblique, limits retraction of scapula, prevents medial dislocation of scapula
