Download Joints of the Upper limb ( A complementary sheet )

Joints of the Upper limb ( A complementary sheet)
 The elbow Joint :
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It’s a synovial hinge joint in which the
trochlea and capitulum articulate with
the trochlear notch of ulna and the head
of radius , the articulate surfaces are
covered by hyaline cartilage.
- The fibrous capsule :
Anteriorly it’s attached above to the
upper margins of radial radial and
coronoid fossae and to the front of
medial and lateral epicondyles , below
it’s attached to the anular ligament and
coronoid process .
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To Remind You
Joints are classified structurally into
three types:
1- synovial joints: the bones forming the
joint have a synovial cavity and are
united by a capsule of CT and often by
accessory ligaments ( eg : knee and hip
joints )
2- Cartilaginous joints: there’s no
synovial cavity and bones are held
together by cartilage (e.g :
intervertebral joints )
3- fibrous joints: no synovial cavity ,
bone are held together by dense
Irregular CT rich in collagen fibers ( e.g :
sutures of the skull bones )
Joints of the Upper limb ( A complementary sheet)
posteriorly it’s attached above to the margins of olecranon fossa , below to the olecranon
process and anular ligament.
- The synovial capsule ( membrane ) :
It covers the radial, coronoid and olecranon fossae , and lines the inner surface of the
fibrous capsule , and then continues below with the synovial membrane of the proximal
radioulnar joint.
- Ligaments of the elbow
joint :
1- Medial “ ulnar “ collateral
ligament :
It’s a thick and triangular
ligament , consists of three
strong bands , extending the
medial epicondyle to the
coronoid process and
olecranon of ulna.
- This ligament is crossed by
ulnar Nerve.
2- Lateral “ radial “ collateral
ligament :
It’s a weak and triangular
ligament , attached by it’s
apex the lateral epicondyle
extending to the anular
ligament.
- Nerve supply :
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Radial nerve.
Ulnar nerve,
Musculocutaneous nerve.
Median nerve.
Joints of the Upper limb ( A complementary sheet)
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Relations :
1- Anteriorly : brachialis , biceptal tendon , brachial artery and the median nerve
( BBBM )
2- Posteriorly : the triceps muscle and bursa in between.
3- Laterally : the common extensor tendons and supinator muscle .
4- Medially : the ulnar nerve , which crosses the medial ligament and passes behind
the medial epicondyle.
- Movements :
It allows flexion and extension of the forearm , while flexion coronoid process
articulates with the coronoid fossa , and while extension olecranon process articulates
with the olecranon fossa .
 The proximal radioulnar Joint :
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It’s a synovial pivot joint in which the radial head
articulates with the radial notch of ulna .
-
fibrous capsule of this joint continues with that of
the elbow joint and it covers the whole joint .
- Synovial membrane :
continues with the synovial membrane of the elbow
joint and it lines the fibrous capsule.
-
Ligament :
there’s a single ligament which is the anular ligament ,
extends from the anterior to posterior margins of
radial notch like a tie around the head , it continues
above with the capsule of elbow joint ,
[ Remember that supinator muscle is originated form
this ligament ]
-
Nerve supply : ( the same as elbow joint )
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Median nerve.
Ulnar nerve.
Radial nerve.
Musculocutaneous nerve.
Joints of the Upper limb ( A complementary sheet)
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Movement :
Pronation and supination of the forearm.
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Relations :
1- Anteriorly : supinator muscle and the radial nerve.
2- Posteriorly : supinator muscle and the common extensor tendons.
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The distal radioulnar joint :
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Articulation: Between the rounded
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head of the ulna and the ulnar notch on
the radius.
Type : Synovial pivot joint.
Capsule : The capsule encloses the joint
but is deficient superiorly.
Ligaments : Weak anterior and
posterior ligaments strengthen the
capsule.
Articular disc :
This is triangular and composed of fibrocartilage. It is attached by its apex to the lateral
side of the base of the styloid process of the ulna and by its base to the lower border of
the ulnar notch of the radius. It shuts off the distal radioulnar joint from the wrist and
strongly unites the radius to the ulna.
Synovial membrane:
This lines the capsule passing from the edge of one articular surface to that of the other.
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Nerve supply:
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1-Anterior interosseous nerve
2-the deep branch of the radial.
movements : pronation and supination ( the same as the proximal one )
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Relation :
1- Anteriorly: The tendons of flexor digitorum profundus.
2- Posteriorly: The tendon of extensor digiti minimi.
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Joints of the Upper limb ( A complementary sheet)
 Wrist Joint
(Radiocarpal Joint) :
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Articulation:
Between the distal end of the
radius and the articular disc
above and the scaphoid, lunate,
and triquetral bones below . The
proximal articular surface forms an ellipsoid concave surface, which is adapted to the
distal ellipsoid convex surface.
Type: Synovial ellipsoid joint.
Capsule:
The capsule encloses the joint and is attached above to the distal ends of the radius and
ulna and below to the proximal row of carpal bones.
Ligaments:
Anterior and posterior ligaments strengthen the capsule. The medial ligament is
attached to the styloid process of the ulna and to the triquetral bone. The lateral
ligament is attached to the styloid process of the radius and to the scaphoid bone.
Synovial membrane:
This lines the capsule and is attached to the margins of the articular surfaces. The joint
cavity does not communicate with that of the distal radioulnar joint or with the joint
cavities of the intercarpal joints.
Nerve supply: ( the same as the distal radioulnar joint )
1- Anterior interosseous nerve
2-the deep branch of the radial nerve.
Movements :
flexion, extension, abduction, adduction, and circumduction.
Notice that the elbow and the proximal radioulnar joints
have the same innervation , and the same about the
wrist and distal radioulnar joints.
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Joints of the Upper limb ( A complementary sheet)

Relations :
1-Anteriorly: The tendons of the flexor digitorum profundus and superficialis, the flexor
pollicis longus, the flexor carpi radialis, the flexor carpi ulnaris, and the median and
ulnar nerves.
2-Posteriorly: The tendons of the extensor carpi ulnaris, the extensor digiti minimi, the
extensor digitorum, the extensor indicis, the extensor carpi radialis longus and brevis,
the extensor pollicis longus and brevis, and the abductor pollicis longus .
3-Medially: The posterior cutaneous branch of the ulnar nerve.
4-Laterally: The radial artery.
Types of the synovial joints ( the Dr didn’t talk about that but we should know
what’s meant by each type since he just mentioned them )
1- Planar : articulated surfaces are flat or slightly curved ( intercarpal joint )
2- Hinge : convex surface fits into a concave surface ( elbow and
interphalangeal joints )
3- Pivot : rounded or pointed surfaces fits into a rong formed partly by bone
and partly by ligament ( radioulnar joints )
4- Ball-and-socket : ball like surface fits into a cuplike depression ( shoulder
and hip joints )
5- Condyloid : oval-shaped projection fits into an oval-shaped depression
( radiocarpal and metacarpophalangeal joints)
6- Saddle : Articular surface of one bone is saddle-shaped , and the articular
surface of the other bone sits in the saddle ( carpometacarpal joint between
trapezium and the thumb )
Note : this Sheet is written according to snell’s book , Hope you find it useful
‫أيا صاحبي إن رمت أن تكسب العال و ترقى إلى العلياء غير مزاحم‬
‫عليك بحسن الصبر في كل ّ حال ٍة فما صابر بما يروم بنادم‬
 Done by :
Majd Al-majali
Yasmeen Aljade
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