Joints of the upper extremity JOINTS OF THE UPPER EXTREMITY •Joints of girdle bones: •scapula + clavicle– art. acromioclavicularis •clavicle+ sternum– art. sternoclavicularis • • • • •Joints of bones of free upper extremity: •humerus+ scapula – art. humeri •humerus+ radius + ulna – art. cubiti •radius+ ulna – membrana interossea antebrachii • – art. radioulnaris distalis •radius+ carpal bones– art. radiocarpea •carpal bones between themselves– art. mediocarpea •carpal + metacarpal bones– art. carpometacarpea •metacarpal bones+ proximal phalanges– art. metacarpophalangea •phalanges between themselves – art. interphalangea manus Joints of girdle bones •I. Articulatio sternoclavicularis •Type: composed joint- discus articularis is inserted Type of joint: spherical joint (is bound to movements of scapula) •Articular head: facies articularis sternalis claviculae articular pit: incisura clavicularis manubrii sterni articular capsule: tough, short Ligaments: •lig. sternoclaviculare anterius •lig. sternoclaviculare posterius •lig. interclaviculare •lig. costoclaviculare • • • • • • •Movements: in all directions but in a small range • •Type: spherical joint, sometimes discus articularis is inserted articular surfaces: facies art. acromialis (clavicula) + facies art. acromii articular capsule: touhg, short Ligaments: •lig. acromioclaviculare •lig. coracoclaviculare •lig. trapezoideum •lig. conoideum •lig. coracoacromiale - fornix humeri •lig. transversum scapulae •Movements: restricted • •II. Articulatio acromioclavicularis •Syndesmoses: -lig. transversum scapulae -lig. coracoacromiale- fornix humeri • •Movements of scapula: -Retraction -Protraction -Elevation -Depression -Rotation • Joints of bones of free upper extremity •Articulario humeri (shoulder joint) •Type: spherical, free articular head: caput humeri articular pit: cavitas glenoidalis , enlarged by labrum glenoidale articular capsule: collum anatomicum humeri On the ventral side of the capsule, there appears the tendon of long head of biceps. •Ligaments: •lig. coracohumerale •ligg. glenohumeralia •lig. coracoacromiale •Bursa subacromialis, subcoracoidea, subdeltoidea •movements: flexion and extension abduction (from horizontal line only together with movement of scapula) •adduction rotation- supination, pronation •Type: composed joint • •Articulatio humeroulnaris Type: trochlear joint articular head: trochlea humeri •Articular pit: incisura trochlearis ulnae • •Articulatio humeroradialis Type: spherical joint articular head : capitulum humeri Articular pit : fovea articularis radii • •Articulatio radioulnaris proximalis Type: wheel joint articular head : circumferentia articularis radii Articular pit : incisura radialis ulnae •Articulario cubiti (elbow joint) •Articular capsule: it covers all three articulations •It is attached to the margins of articular surfaces, on radius reaches to collum- recessus sacciformis •Ligaments: •lig. collaterale radiale •lig. collaterale ulnare •lig. obliquum •lig. anulare radii • • • • • • • • •Movements: flexion,extension Art. radioulnaris proximalis together with art. radioulnaris distalis - pronation, supination • •Syndesmosis radioulnaris • •membrana interossea antebrachii • •Fibrous membrane which is stretched between •margo interosseus radii •and margo interosseus ulnae • •chorda obliqua • Articulatio radioulnaris distalis • • • •Type: wheel joint •Articular head: caput ulnae Articular pit: incisura ulnaris radii Articular capsule: free, it allows rotation of radius around caput ulnae •movements: together with rotation in art. radioulnaris proximalis supination and pronation •pronatio dolorosa – common injury in childhood– •Radial head subluxation, the head falls out from lig. anulare radii through a stroke in pronation • • •ARTICULATIO RADIOCARPALIS •Between radius and carpal bones • •ARTICULATIO MEDIOCARPALIS between proximal and distal row of carpal bones • •ARTICULATIONES INTERCARPALES between single carpal bones • •ARTICULATIONES CARPOMETACARPALES between distal row of carpal bones and metacarpal bones •ARTICULATIONES INTERMETACARPALES • between bases of neighbouring metacarpal bones • •ARTICULATIONES METACARPOPHALANGEALES heads of metacarpal bones with proximal phalanges • •ARTICULATIONES INTERPHALANGEALES •Between phalanges • •retinaculum musculorum flexorum (lig. carpi transversum) between eminentia carpi radialis et ulnaris -> canalis carpi •Joints of the hand Articulationes manus •Articulatio radiocarpalis •Type: composed, elipsoidal articular head: os scaphoideum, os lunatum, os triquetrum articular head: facies articularis carpalis radii, discus articularis articular capsule: tough and short Ligaments: are common with articulatio mediocarpalis movements: functional unit wit mediocarpal, intercarpal and •carpometacarpal joints •palmar and dorsal flexion radial and ulnar duktion cirkumduction •Articulatio mediocarpalis • •Type: elipsoidal, composed, articular head on ulnar side: os hamatum, os capitatum articular head on radial side : os scaphoideum •articular pit on ulnar side : os scaphoideum, os lunatum, • os triquetrum articular pit on radial side : os trapezium, os trapezoideum articular capsule : tough and short •Ligaments: •lig. intercarpea dors., ventr., interossea •lig. radiocarpale palmare et dorsale •lig. ulnocarpale palmare et dorsale •lig. carpi radiatum •lig. collaterale carpi radiale et ulnare • •movements: functional unit with mediocarpal, intercarpal and carpometacarpal joints •palmar and dorsal flexion, •radial and ulnar duction, cirkumduction •Articulatio ossis pisiformis: tough joint between os pisiforme and os triquetrum - amfiarthrosis •lig. pisohamatum •lig. pisometacarpeum (both are continuation of tendon of m. flexor carpi ulnaris) •Articulationes intercarpales • •Connections between the single carpal bones •ligg. intercapalia dorsalia •ligg. intercarpalia palmaria •ligg. intercarpalis interossea • • • • • • • •Articulationes carpometacarpales II.-V. • •Type: composed joint, amphiarthrosis articular surfaces: basis of 2nd metacarpal bone - os trapezium, os trapezoideum a os capitatum basis of 3rd metacarpal bone - os capitatum bases of 4th and 5th metacarpal bone - os hamatum •Bases of metacarpal none between themselves articular capsules: tough, short Ligaments: •ligg. carpometacarpea dorsalia •ligg. carpometacarpea palmaria •ligg. carpometacarpea interossea •ligg. metacarpea palm., dors., interossea •movements: minimal •Articulatio carpometacarpalis pollicis • Type: sellar joint articular head: basis ossis metacarpale I articular pit: os trapezium articular capsule: free movements: abduction, adduction oposition, repozition •Articulationes intermetacarpales •Ligg.intermetacarpalia • •Art. metacarpophalangeales • • • •Type: intermediate between cylindroidal and spherical joint articular head: caput ossis metacarpalis articular pit: basis phalangis articular capsule: free Ligaments: •ligg. collateralia •fibrocartilago palmaris •lig. metacarpale transversum profundum •movements: flexion and extension abduction and adduction- only in straightened finger •Type: trochlear articular head: caput (trochlea) phalangis articular pit: basis phalangis articular capsule: free Ligaments: •ligg. collateralia •fibrocartilagines palmares •movements: flexion and extension •Articulationes interphalangeales • Thank you for your attention! •Pictures: •Atlas der Anatomie des Menschen/Sobotta. Putz,R., und Pabst,R. 20. Auflage. München:Urban & Schwarzenberg, 1993 •Netter: Interactive Atlas of Human Anatomy. •Naňka, Elišková: Přehled anatomie. Galén, Praha 2009. •Čihák: Anatomie I, II, III. •Drake et al: Gray´s Anatomy for Students. 2010