Joints of the upper limb

This presentation describes Joints of the upper limb of human body

Transcript

1. Joints of the Upper Limb
2. To Describe a Joint ➢Type & Variety. ➢Articular surfaces. ➢Capsule. ➢Synovial membrane. ➢Intracapsular structure. ➢Ligaments. ➢Relations. ➢Movements. ➢Blood supply. ➢Nerve supply.
3. Joints of Shoulder Girdle 1- Acromio-clavicular joint. 2- Sterno-clavicular joint.
4. Sterno-clavicular joint Acromio-clavicular joint
5. Acromio-clavicular joint (Synovial – Plane)
6. Acromio-clavicular joint (Synovial-plane) Articular surfaces Dr. Sherif Fahmy
7. Capsule, ligaments & disc of acromio-clavicular joint Incomplete disc Articular cartilage
8. Acromio-clavicular ligament Coraco-clavicular ligament Ligaments of acromio-clavicular j.
9. Conoid part Trapezoid part Coraco-clavicular ligament Importance: ➢ It stabilizes acromio-clavicular joint. ➢ It suspends scapula to clavicle.
10. Functions (Importance) of Acromio-clavicular Joint • It shares a little in the movements of shoulder girdle. • It shares in transmitting forces from the upper limb to the clavicle. N.B. Transmitting weight from upper limb to clavicle depends mainly on coraco-clavicular ligament.
11. Dr. Sherif Fahmy Applied Anatomy
12. Sterno-clavicular Joint (Synovial – Modified saddle)
13. Medial end of the clavicle Clavicular notch of sternum & upper surface of 1st costal cartilage
14. Anterior sterno-clavicular lig. 1st costal cartilage Costo- clavicular lig. Articular disc Inter-clavicular ligament Ligaments of sterno-clavicular j.
15. Blood & Nerve Supply of Joints of Shoulder Girdle
16. Sterno-clavicular Acromio-clavicular Blood supply Nerve supply - Suprascapular. - Internal thoracic. - Suprascapular. - Acromio-thoracic. - N. to subclavius. - Medial supraclavicular n. - Suprascapular. - Lateral pectoral nerve. Movements of joints of shoulder girdle is the movements of scapula.
17. Shoulder Joint Synovial Polyaxial Ball and Socket
18. Head of humerus Glenoid cavity Capsule lined with synovial membrane Labrum glenoidal Articular Surfaces
20. Capsule
21. Capsule: -Attached medially around glenoid cavity outer to labrum and supra-glenoid tubercle. -Attached laterally to anatomical neck and medially it descends for 1 cm below anatomical neck till surgical neck. -It is weak because it has two anterior openings and its lower part is lax.
22. Lax lower part of the capsule Opening for exit of subscapular bursa Tendon of long head of biceps brachii m. with a covering of synovial sheath
23. Synovial Membrane
24. Opening for exit of subscapular bursa Tendon of long head of biceps brachii m. Synovial sheath
25. Bursae Around Shoulder Joint
26. Subscapular bursa
27. Subdeltoid bursa Deltoid m. Supraspinatus m. Greater tuberosity Acromion Subacromial bursa
28. Subacromial bursa Subdeltoid bursa Bursa between coracoid & capsule Subcutaneous bursa
29. Ligaments 1- Coraco-humeral. 2- Gleno-humeral. 3- Transverse humeral.
30. Coraco-acromial lig. Coraco-humeral lig. Superior Middle Inferior Gleno-humeral lig. Transverse humeral lig.
31. Intra-capsular structures 1- Tendon of long head of biceps brachii. 2- Articular surfaces of the joint. 3- Medial part of surgical neck of humerus. 4- Supraglenoid tubercle. 5-Labrum glenoidal. 6- Synovial membrane.
32. Shoulder Joint is Weak 1- Bad fitting articular surfaces. 2- Weak and lax capsule. 3- No rotator cuff muscle below the joint.
33. Stability of Shoulder Joint • Depends on: 1- Muscles around the joint. Above: Supraspinatus & tendon of long head of biceps. In front: Subscapularis m. Behind: Infraspinatus and teres minor ms. Below: Long head of triceps only during abduction. 2- Coraco-acromial arch.
34. Coraco-acromial lig. Coracoid process Acromion Coraco-acromial arch
35. Blood & Nerve Supply Arterial Supply (anastomosis around surgical neck): 1- Circumflex humeral arteries. 2- Suprascapular artery. Nerve Supply: 1- Circumflex (axillary) nerve. 2- Suprascapular nerve.
36. Movements Muscles producing the movement Flexion Extension Adduction Abduction Medial rotation Lateral rotation Circumduction N.B.: Every 10 degrees of abduction (0 – 90) occurs at shoulder joint are associated with 5 degrees of abduction at shoulder girdle. After 90 degrees abduction occurs at shoulder girdle. Clavicular head of pectoralis major, anterior fibers of deltoid muscle. Coracobrachialis and short head of biceps assist. Latissimus dorsi, teres major & posterior fibers of deltoid. Sternocostal head of pectoralis major extends the flexed arm. Pectoralis major, latissimus dorsi, teres major, subscapularis, infraspinatus, teres minor and coracobrachialis. Supraspinatus (0 – 15), middle fibers of deltoid (15 – 90), lower 5 digitations of serratus anterior, upper and lower fibers of trapezius ( above 90) Pectoralis major, latissimus dorsi, teres major and anterior fibers of deltoid. Posterior fibers of deltoid, infraspinatus and teres minor. Circular movement around imaginary cone that is considered as a group of previous movements. Dr. Sherif Fahmy
37. Elbow Joint Synovial, Uniaxial Hinge
38. Bony Parts (Articular Surfaces)
39. Trochlea Capitulum Upper surface of head of radius Trochlear notch
40. Capsule
41. Capsule Annular ligament Articularis cubitii
42. Synovial Membrane ➢It lines the capsule and fossae at the lower end of humerus. ➢3 pads of fat are present opposite each fossa between capsule and synovial membrane. ➢It is continuous below with synovial membrane of superior radio-ulnar joint.
43. Pads of fat Capsule is removed Synovial membrane
44. Pad of fats between capsule and synovial membrane opposite olecranon & coronoid fossa
45. Ligaments of Elbow Joint
46. Radial collateral lig. Annular lig. Lateral epicondyle
47. Ulnar collateral lig.
48. Dislocation of Elbow
49. Radio-ulnar Joints Synovial Uniaxial pivot
51. Capsule of elbow & superior radio-ulnar joint
53. Quadrate ligament
54. Pronation & supination
55. Dr. Sherif Fahmy
56. Interosseous Membrane
60. Wrist Joint Synovial Biaxial Ellipsoid
61. Dr. Sherif Fahmy
62. Dr. Sherif Fahmy
63. Scaphoid Lunate Triquetral Lower end of radius Articular disc
65. Movement Muscles producing it Flexion Extension Abduction Adduction Flexor carpi radialis, flexor carpi ulnaris, flexor digitorum muscles and flexor pollicis longus. Extensor carpi ulnaris, extensor carpi radialis longus & brevis, Extensor carpi ulnaris, extensor digitorum, extensor digiti minimi and extensor indicis. Flexor carpi radialis, extensor carpi radialis longus and brevis Flexor carpi ulnaris, extensor carpi ulnaris Movements of wrist joint and muscles producing Dr. Sherif Fahmy
66. Hand Joints
67. Mid-carpal joint
69. Carpo-metacarpal J.
70. Dr. Sherif Fahmy
71. 1st carpo-metacarpal joint
72. Dr. Sherif Fahmy Carpo-metacarpal j Dr. Sherif Fahmy
73. Metacarpo- phalangeal Joints
74. Dr. Sherif Fahmy Dr. Sherif Fahmy
75. Inter-phalangeal Joints
77. Joint Variety Acromio-clavicular Plane Sterno-clavicular Modified saddle Shoulder Ball and socket Elbow Hinge Superior & Inferior Radio-ulnar joints Pivot Wrist Ellipsoid Mid-carpal Modified saddle Carpo-metacarpal of thumb Saddle Other carpo-metacarpal Plane Metacarpo-phalangeal of thumb and interphalangeal Hinge Variety of joints of upper limb Dr. Sherif Fahmy