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CONNECTIONS OF THE UPPER AND
LOWER EXTREMITY
(juncturae ossium membri superioris et inferioris)
Articulatio cubiti (elbow joint)
Articulatio composita:
1. Articulatio humeroradialis (articulatio spheroidea)
capitulum humeri, fovea capitis radii
2. Articulatio humeroulnaris (articulatio trochlearis)
trochlea humeri, incisura trochlearis ulnae
3. Articulatio radioulnaris proximalis (articulatio trochoidea)
circumferentia articularis capitis radii,
incisura radialis ulnae
Articulatio cubiti
Articulation capsule:
Epicondyles of the humerus EXTRACAPSULAR, foveae of the humerus
INTRACAPSULAR
recessus sacciformis
Apparatus:
lig. anulare radii
lig. collaterale radiale
lig. collaterale ulnare
Articulatio cubiti - movements
flexion and extension
Pronation and supination of forearm
Juncturae radioulnares
Membrana interossea antebrachii
Fixation of the radius and ulna, origin of the muscles
Limitation of supination
chorda obliqua
Facets: incisura ulnaris radii, circumferentia articularis capitis ulnae
Capsule: thin and tough
Apparatus: ligamentum radioulnaris palmare, dorsale
Type: articulatio trochoidea
Movements: pronation and supination of the hand
Articulatio radioulnaris distalis
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Articulationes manus
Articulatio radiocarpalis
Articulatio mediocarpalis
Articulatio ossis pisiformis
Articulatio carpometacarpalis pollicis
Articulationes carpometacarpales II.-V.
Articulationes metacarpophalangeales
Articulationes interphalangeales
Facets:
facies articularis carpalis radii, discus articularis
os scaphoideum, os lunatum, os triquetrum (lig. intercarpalia interossea)
Morphologic and functional unit with articulatio mediocarpea
Common with mediocarpal joint:
capsule
apparatus
movements
Type - articulatio elipsoidea
Articulatio radiocarpalis
Facets: proximal and distal row of the carpaal bones except for os pisiforme
Articulatio mediocarpalis
Radial:
head: os scaphoideum
pit: os trapezium, trapezoideum, capitatum
Ulnar:
head:os capitatum, hamatum
pit: os scaphoideum, lunatum, triquetrum
Communication with art. carpometacarpalis II.-V.
(between os trapezium and trapezoideum)
Articulatio mediocarpalis - apparatus
ligg. intercarpea dorsalia, palmaria et interossea
lig. radiocarpeum dorsale et palmare
lig. ulnocarpeum palmare et dorsale
lig. carpi radiatum
Functional unit with articulatio radicarpalis – ellipsoid joint
Movements:
palmar and dorsal flexion
radial and ulnar duction
circumduction
Articulatio mediocarpalis
Facets:
os pisiforme, os triquetrum
Capsule:
Margines of the art. facets
Apparatus:
lig. pisohamatum
lig. pisometacarpeum
(m. flexor carpi ulnaris)
Articulatio ossis pisiformis
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Canalis carpi
Canalis carpi: tendons of flexors and nervus medianus
Canal of Guyon: nervus et vasa ulnaria
(between hamulus osis hamati and os pisiforme, above retinaculum flexorum
Facets: os trapezium, base of I. metacarp
Capsule: free
Type: articulatio sellaris
Movements: abduction and adduction, oposition and reposition
Articulatio carpometacarpalis pollicis
Facets: base of the II. - V. metacarpal bones with distal row of the capal bones
adjecent metacrpal bones
Capsule: tough, communication with mediocarpal joint
Apparatus:
ligg. metacarpea palmaria, dorsalia et interossea,
ligg. carpometacarpea palmaria, dorsalia et interossea
Type: amfiarthrosis
Articulationes carpometacarpales II. – V. Articulationes metacarpophalangeae
Facets: head of the metacarpal bones, base of proximal phalanges
Capsule: margines of the facets
Apparatus:
laminae fibrocartilagineae palmares
(thumb - 2 ossa sesamoidea)
lig. collaterale radiale et ulnare
lig. metacarpeum transversum profundum
(palmar side of the heads of II. - V. metacarpal bones)
Type: articulatio ellipsoidea
Movements: flexion, extension, abduction, adduction
Articulationes interphalangeae manus
Facets:
trochlea phalangis of the proximal and base of the distal phalanges
Capsule: margines of the facets
Apparatus:
lamina fibrocartilaginea palmaris
lig. collaterale radiale et ulnare
Type: articulatio trochlearis
Movements: flexion and extension
Connections of the lower extremity girdle
(juncturae ossium cinguli extremitatis inferioris))
Articulatio sacroiliaca
Symphysis pubica
Ligaments of the pelvis
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Facets:
facies auricularis ossis sacri
facies auricularis ossis ilii
Capsule: tough, margines of the facets
Apparatus:
ligg. sacroiliaca ventralia, dorsalia, interossea
lig. iliolumbale
Type: amfiarthrosis
Movements: limited
Articulatio sacroiliaca
synchondrosis
discus interpubicus (4,5 – 5 cm)
eminentia retropubica.
lig. pubicum superius
lig. arcuatum pubis
Symphysis pubica
Ligaments of the pelvis
Ligamentum sacrospinale
Ligamentum sacrotuberale
Foramen ischiadicum majus et minus
(foramen suprapiriforme et infrapiriforme)
Ligamentum inguinale
Membrana obturatoria (canalis obturatorius)
Pelvis
Pelvis - os sacrum, hip bones, symphysis pubica
Linea terminalis (promontorium, linea arcuata, upper margine of os pubis and
symphysis)
Pelvis major et minor
Inclinatio pelvis
Pelvic planes
apertura pelvis superior (aditus pelvis)
(promontorium, linea terminalis, upper margine of the symphysis)
amplitudo pelvis
(S2 – S3, center of the acetabulum and symphysis)
apertura pelvis inferior (exitus pelvis)
(lower margin of the symphysis, tuber ischiadicum, apex coccygis)
angustia pelvis
(lower margin of the symphysis, spina ischiadica, apex of os sacrum)
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External diametres of the pelvis
Distantia bispinalis (app 26 cm)
Distantia bicristalis (app 29 cm)
Distantia bitrochanterica (app 31 cm)
Conjugata externa (min. 18 cm)
Articulatio coxae
Connections of the free lower extremity
(juncturae ossium extremitatis inferioris liberae)
Facets: facies lunata acetabuli, caput femoris
Capsule: ventrally linea intertrochanterica, dorsally collum femoris
Apparatus: labrum acetabulare, lig. transversum acetabuli,
pulvinar acetabuli, lig. capitis femoris
Apparatus:
lig. iliofemorale, lig. pubofemorale, lig. ischiofemorale,
(zona orbicularis), bursa iliopectinea
Type: art. spheroidea - enarthrosis
Movements: flexion, extension, abduction, adduction, supination, pronation
Articulatio coxae (hip joint) Articulatio genus (knee joint)
Articulatio composita: femur, tibia, patella
Facets:
condyli femoris, facies patellaris femoris, facies articularis patellae,
facies articularis superior medialis et lateralis tibiae
Meniscus medialis et lateralis
Articulatio genus - capsula articularis
Attachment: margines of the facets, femur app 1cm proximally
Capsula fibrosa
Capsula synovialis - plica synovialis patellaris, plicae alares
(ligg. cruciata - EXTRACAPSULAR )
Meniscus medialis et lateralis
Meniscus medialis – „C“, area intercondylaris ant. et post.
(connected with lig. collaterale med.)
Meniscus lateralis –„O“, anteriorly and posteriorly from tuberculum intercondylare laterale
(connected with m. popliteus)
(lig. transversum genus)
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Lig. cruciatum anterius: condylus lat. femoris – area intercondylaris ant. tibiae
(Limitation of extension and medial rotation)
Lig. cruciatum posterius: condylus med. femoris – area intercondylaris post. tibiae
(Limitation of extension and keep the stability of the joint)
Ligamenta cruciata genus Articulatio genus - ligaments
lig. patellae
retinaculum patellae mediale et laterale
lig. collaterale mediale et laterale
lig. popliteum obliquum
Bursae synoviales
Bursa suprapatellaris (mm. articulares)
Bursa praepatellaris (subcutanea)
Bursa infrapatellaris
Bursae mucosae under insertion of the muscles
(m. biceps femoris, m. semitendinosus,
m. semimembranosus, m. popliteus,
m. gastrocnemius)
Type: trochoginglimus
Movements: flexion and extension, in flexion limited rotatory movements (50-60o),
patella moves proximally and distally
Middle position: mild flexion
Articulatio genus
Facets: facies articularis fibularis tibiae,
facies articularis capitis fibulae
Capsule: margins of the facets
Apparatus: lig. capitis fibulae ant. et post.
Type: art. plana
Movements: sliding
Articulatio tibiofibularis
Connection: distal end of fibula and tibia
–
Ligg.: Lig. tibiofibulare anterius et posterius
Movements: springy
Membrana interossea cruris
margo interosseus tibiae and fibula
Syndesmosis tibiofibularis
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Articulationes pedis
Facets: facies articularis inf. tibiae, facies articularis malleoli med. et lat.
Capsule: margins of the facets
Apparatus:
Lig. collaterale mediale (lig. deltoideum): pars tibionavicularis,
pars tibiotalaris ant. et post. pars tibiocalcanea
Lig. collaterale laterale: lig. talofibulare ant. et post., lig. calcaneofibulare
Type and movements: art. trochlearis, plantar and dorsal flexion, movements to the side
Articulatio talocruralis
Přední oddíl
Articulatio subtalaris
Facets: facies art. calcanea posterior + facies art. talaris post.
Capsule: margines of the facets
Apparatus: lig. talocalcaneum laterale et mediale
Movements: pronation and supination
Articulatio talocalcaneonavicularis
Facets:
facies art. calcanea media + ant. tali , facies art. talaris media + ant. calcanei,
caput tali + proximal facet on os naviculare
Apparatus: lig. calcaneonaviculare plantare (fibrocartilago navicularis),
lig. calcaneonaviculare (dorsale) – part of lig. bifurcatum
lig. talonaviculare
lig. talocalcaneum interosseum (inside sinus tarsi)
Movements: pronation and supination
Facets: facies artic. cuboidea calcanei, facies art. os cuboideum
Apparatus: lig. calcaneocuboideum plantare
lig. plantare longum
lig. bifurcatum = lig. calcaneocuboideum (dorsale)
Type: amfiarthrosis
Articulatio calcaneocuboidea
Facets: caput tali + os naviculare + os cuboideum and calcaneus
Apparatus:
lig.bifurcatum: lig. calcaneocuboideum dor. and lig. calcaneonaviculare dor.
(exarticulation of the foot)
Articulatio tarsi transversa (Chopart´s joint)
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Facets: ossa cuneiformia and os naviculare
Apparatus:
ligg. cuneonavicularia plantaria et dorsalia
ligg. intercuneiformia dorsalia, plantaria et interossea
Type: amfiartrosis
Articulatio cuneonavicularis
Facets: os cuneiforme laterale and os cuboideum
Apparatus: ligg. cuneocuboidea (dorsale, plantare et interosseum)
Type: amfiarthrosis
Articulatio cuneocuboidea
Articulationes intercuneiformes
Facets: cuneiform bones
Apparatus: ligg. intercuneiformia dorsalia, plantaria, interossea
Type: amfiarthrosis
Facets: bases of the metatarsal bones, ossa cuneiformia, os cuboideum
Apparatus: ligg. tarsometatarsea dorsalia, plantaria et interossea
Type: amphiarthrosis (exarticulation of the fingers)
Connection with artt. intermetatarseae
(ligg. metatarsea dorsalia, plantaria et interossea).
Articulationes tarsometatarsales (Lisfranc´s joint) Articulationes metatarsophalangeae
Facets: heads of metatarsal bones, bases of prox. phalanges
Apparatus:
fibrocartilagines plantares
ligg. collateralia
lig. metatarseum transversum profundum
Movements: flexion, extension, abduction, adduction
Articulationes interphalangeales
Facets: bases and heads of phalanges
Apparatus:
fibrocartilagines plantares
ligg. collateralia
Movements: flexion, extension
Foot vault
Longitudinal and transverse
Longitudinal - medial and lateral
Function:
Elastic walk
Protection of the vessels and nerves
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Longitudinal foot vault
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*
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Skeleton of the foot
aponeurosis plantaris
Plantar ligaments (lig. plantare
longum)
muscles
(m. tibialis ant. + post., flexors)
Transverse foot vault
m. fibularis longus
m. tibialis ant.
Transverse ligaments
Transverse vault - proximal (ossa cuneiformia)
Transverse vault - distal (heads metatarsal bones)
References:
Moore, K. L. (1992): Clinical oriented anatomy. Third edition.
Williams&Wilkins, A Waverly Company.
Gilroy, A. M. et all. (2009): Atlas of Anatomy. Thieme New York, Stuttgart.
Putz, R. (2008):
Atlas of Human Anatomy Sobotta. Elsevier Books.
Platzer, W., Kahle, W., Leonhardt H. (1992):
Locomotor system. Georg Thieme Verlag, Stuttgart,
New York, 4th edition.
Čihák, R. (1987): Anatomie 1. Avicenum, Zdravotnické nakladatelství.