Download from the upper limb to the axial skeleton

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Transcript
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UPPER LIMB:ability to place the hand in the
proper position in space by movements at the
scapulothoracic, glenohumeral, elbow, radioulnar, and wrist joints
LOWER LIMB: support, stability, and
locomotion
Pectoral girdle& bones of the free part of the upper limb
superior appendicular skeleton
Pelvic girdle & bones of the free part of the lower limb
inferior appendicular skeleton
The clavicles and scapulae of the pectoral girdle are supported,
stabilized, and moved by axio-appendicular muscles that attach to the
relatively fixed ribs, sternum, and vertebrae of the axial skeleton.
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only bony attachment between trunk & upper limb
palpable along its entire length
has a gentle S-shaped contour
forward-facing convex part medial
forward-facing concave part lateral
Although designated as a long bone, the clavicle has no medullary
(marrow) cavity.
It consists of spongy (trabecular) bone with a shell of compact bone.
(Click on the key in the previous slide and read the first sentence)
Functions of the clavicle
• Serves as a moveable, rigid support from which the scapula and free
limb are suspended, keeping them away from the trunk so that the limb
has maximum freedom of motion. The support formed by the clavicle is
movable and allows the scapula to move on the thoracic wall at the
“scapulothoracic joint,” increasing the range of motion of the limb. Fixing
the point of the support in position, especially after its elevation,
enables elevation of the ribs for deep inspiration.
• Forms one of the bony boundaries of the cervico-axillary canal
(passageway between the neck and the arm), affording protection to the
neurovascular bundle supplying the upper limb.
• Transmits shocks (traumatic impacts) from the upper limb to the axial
skeleton.
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posterolateral aspect of the thorax, on the 2nd-7th ribs
three angles (lateral, superior, and inferior)
three borders (superior, lateral, and medial)
two surfaces (costal and posterior)
three processes (acromion, spine, and coracoid process)
 largest bone in the upper limb
 articulates with the scapula at the glenohumeral joint
 articulates with the radius and ulna at the elbow joint
In cross-section, the shaft of the humerus is somewhat triangular with:
 anterior, lateral, and medial borders
 anterolateral, anteromedial, and posterior surfaces
Fossae
Coronoid fossa
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adjacent to the radial fossa superior to the trochlea.
receives the coronoid process of the ulna during full flexion of the elbow.
Olecranon fossa
 largest fossa
 immediately superior to trochlea on the posterior surface of the distal end of humerus
 accommodates the olecranon of the ulna during full extension of the elbow.
Radial fossa
 a shallow fossa
 immediately superior to the capitulum on the anterior surface of the humerus
 accommodates the edge of the head of the radius when the forearm is fully flexed.
The two forearm bones serve together to form the second unit of
an articulated mobile strut (the first unit being the humerus),
with a mobile base formed by the shoulder, that positions the
hand. However, because this unit is formed by two parallel
bones, one of which (the radius) can pivot about the other (the
ulna), supination and pronation are possible. This makes it
possible to rotate the hand when the elbow is flexed.
Lateral to Medial
Proximal-Distal
SLTP
TTCH
Carpal arch
The carpal bones do not lie in a flat plane; rather, they form an arch, whose base is
directed anteriorly.
Lateral side of this base is formed by tubercles of the scaphoid and trapezium.
Medial side is formed by the pisiform and the hook of hamate.
JOINT
Sternoclavicular
TYPE
MOVEMENT
Saddle, fxn: ball-and-socket Raising (60°) & rotating the
clavicle
Anterior and posterior movements of the clavicle
Acromioclavicular
Plane
Shoulder
Ball and socket
Circumduction
Elbow
Hinge
Flexion and extension
Prox. radioulnar
Pivot
Pronation & supination
Distal radioulnar
Pivot
Pronation & supination
Anteroposterior and vertical planes
together with some axial rotation
JOINT
Wrist
TYPE
MOVEMENT
Condyloid (ellipsoid) type
Intercarpal
Plane
Circumduction
Gliding
Flexion & extension of the hand
Abduction & adduction of the hand
Carpometacarpal Plane
Thumb- Saddle
Circumduction, some axial rotation,
Opposition [thumb]
Intermetacarpal Plane
Metacarpophalangeal Condyloid
Interphalangeal
Hinge
Flexion-extension-abduction-adduction
Flexion-extension
Anterior and posterior sternoclavicular ligaments
Costoclavicular ligament
Interclavicular ligament
Acromioclavicular ligament
Coracoclavicular ligament-conoid ligament & trapezoid ligament
Glenohumeral ligaments
Coracohumeral ligament
Transverse humeral ligament
Coracoacromial ligament
Medial (ulnar) and lateral (radial) collateral ligaments
Sternoclavicular joint
Acromioclavicular joint
Shoulder joint
Elbow joint
Annular ligament
Anterior and posterior ligaments of the distal radio-ulnar joint
Wrist joint
Dorsal and palmar radiocarpal ligaments
Ulnar collateral ligament
Radial collateral ligament
Intercarpal joints
Anterior, posterior, and interosseous ligaments
Palmar and dorsal carpometacarpal and palmar and dorsal intermetacarpal ligaments
Carpometacarpal &
Interosseus metacarpal ligaments
Intermetacarpal joints
Superficial and deep transverse metacarpal ligaments
Metacarpophalangeal &
Medial and lateral collateral ligaments
interphalangeal joints
Palmar ligaments
Anterior & posterior sternoclavicular ligaments reinforce the joint capsule anteriorly & posteriorly.
Interclavicular ligament strengthens the capsule superiorly.
Sternoclavicular
joint
Costoclavicularligament limits elevation of the pectoral girdle.
Acromioclavicular ligament strengthens the acromioclavicular joint superiorly. However, the integrity
of the joint is maintained by extrinsic ligaments, distant from the joint itself.
coracoclavicular ligament
Acromioclaviular
joint
Glenohumeral ligaments strengthen the anterior aspect of the joint capsule.
Coracohumeral ligament strengthens thecapsulesuperiorly.
Transverse humeral ligament holds the synovial sheath and tendon of the
biceps brachiiin place during movements of the glenohumeral joint.
Shoulder joint
Lateral collateral ligament complex doesn't contribute as much to
elbow stability as does the medial collateral ligament complex.
Elbow joint
Anularligament of the radius, which encircles and holds the head of
the radius in the radial notch of the ulna.
permits pronation and supination of the forearm.
Palmarradiocarpal ligaments
strong and directed so that the hand follows the radius during supination of the
forearm.
Dorsalradiocarpal ligaments take the same direction so that the hand follows the
radius during pronation of the forearm.
The joint capsule is also strengthened medially by the ulnar collateral ligament. T
The joint capsule is also strengthened laterally by the radial collateral ligament. S
Proximal radioulnar joint
Wrist joint