Download Joints Of Upper Extremities

Joints Of Upper Extremities
Sternoclavicular Joint
• a saddle joint - the only bony joint between
axial skeleton & upper limb
• clavicle sits in a saddle socket formed by
superolateral manubrium & 1st costal
cartilage
Sternoclavicular Joint
• 1. fibrous capsule - surrounds entire joint, reinforced by
ligaments
– a. synovial capsule - lines fibrous capsule & both sides
of disc
– b. lateral & medial synovial membranes line 2 cavities
on either side of disc
• 2. articular disc - mostly fibrocartilage - strong, thick, very
dense
– a. attached: superiorly - to medial end of clavicle
inferiorly - to junction btw manubrium & 1st costal
cartilage
– b. continuous with sternoclavicular ligament
– c. absorbs shock & prevents medial displacement of
clavicle
Sternoclavicular Joint
• 3. anterior, posterior sternoclavicular ligaments thickenings of the fibrous capsule
• 4. Interclavicular ligament - also a thickening of fibrous
capsule - across the jugular notch
• 5. costoclavicular ligament - extracapsular
a. extends from 1st rib & cartilage to inferior medial end
of clavicle
b. limits elevation of clavicle at medial end
• 6. Nervous input - medial supraclavicular branches &
nerve to the subclavius (C5, C6)
• 7. Circulatory supply - branches of internal thoracic &
suprascapular arteries
Acromioclavicular Joint
• A plane gliding joint between lateral
clavicle & anterior, medial end of acromion
• Fibrocartilage covers both articulating
surfaces
Acromioclavicular Joint
• 1. fibrous capsule - surrounds joint, reinforced
by acromioclavicular ligament & trapezius
– synovial capsule - lines fibrous capsule
• 2. acromioclavicular lig - from superior, lateral
end of clavicle to superior surface of acromion
• 3. coracoclavicular lig - extrinsic to capsule
– reinforces lateral clavicle to coracoid process of
scapula, 2 parts:
– a. conoid ligament - medial, twisted
– b. trapezoid ligament - lateral to the conoid
Acromioclavicular Joint
• 4. articular disc - fibrocartilage wedge
projects down from articular capsule into
joint
• 5. Nervous input - branches of axillary,
lateral pectoral, supraclavicular nerve (C5,
C6)
• 6. Circulatory supply - branches of
suprascapular & thoracoacromial arteries
Shoulder Joint
• humerus in glenoid fossa - hyaline
cartilage covers articulating surfaces
• a ball & socket joint - spheroidal - highly
mobile (not terribly stable)
Shoulder Joint
• 1. glenoid labrum - fibrocartilaginous rim - enlarges
effective size of glenoid
• 2. fibrous capsule - surrounds joint, from base of
coracoid to neck of humerus
– fairly loose & thin, reinforced by ligaments & rotator cuff muscle
group
– synovial membrane - lines capsule, surrounds head of biceps
long head in groove
• 3. glenohumeral ligaments - superior, middle, inferior =
thickenings of anterior capsule
– extend from supraglenoid tubercle (scapula) to neck & lesser
tubercle of humerus
• 4. transverse humeral ligament: from greater to lesser
tubercle (humerus) holds biceps long head
Shoulder Joint
• 5. coracohumeral ligament: from lateral coracoid
to anterior neck of humerus, by greater tubercle
• 6. coracoacromial arch: = coracoid & acromion
processes & coracoacromial ligament
– prevents superior displacement of humerus
• 7. coracoacromial ligament: D shape - base on
coracoid, apex at acromion, covered by deltoid
Shoulder Joint
• 8. bursae: cushion between skin & bony
prominences, or between tendons & bone,
ligament, other tendon
– a. subscapular bursa - between subscapularis tendon
& neck of scapula
– communicates with cavity thru an opening in the
capsule
– b. subacromial/subdeltoid bursa: between deltoid,
supraspinatus tendon & fibrous capsule
• 9. Nervous input - branches of axillary, lateral
pectoral, supraclavicular nn (C5, C6)
• 10. Circulatory supply - branches of ant & post
circumflex humeral, suprascapular arteries
Shoulder Dislocation
Glenoid Labrum Tears
Elbow Joint
• a hinge joint - uniaxial - flexion/ extension
movement
Elbow Joint
• 1. articulations - hyaline cartilage covers
articular surfaces
– a. humeroulnar: btw trochlea of humerus & trochlear
notch of ulna - hinge joint
– b. humeroradial: btw capitulum of humerus & head of
radius - gliding joint
– c. proximal radioulnar joint: btw head of radius &
radial notch of ulna - pivot joint
• 2. fibrous capsule - encloses joint from coronoid
process in front to olecranon posteriorly
– reinforced especially on sides by collateral ligaments
– lined by synovial membrane - protrudes between
annular ligament & head of radius as sacciform
recess
Elbow Joint
• 3. collateral ligaments - intrinsic, thickenings of capsule
– a. radial: apex from lateral epicondyle of humerus to base at
annular ligament of radius
– b. ulnar: a big D - apex from medial epicondyle of humerus to:
anterior band - base at coronoid process tubercle (ulna)
posterior band - base at medial edge of olecranon
the two bands are joined by oblique band
• 4. annular ligament: U-shaped band from ant to post
sides of radial notch holds radius to ulna
• 5. nervous input: branch of musculocutaneous, radial (+
ulnar, median, ant interosseous) (C5-7)
• 6. circulatory supply: elbow anastomosis - formed by
ulnar & radial recurrents, collaterals
Wrist
• condyloid/ellipsoidal joint
• between radius, articular disc (binds ends
of radius & ulna) & scaphoid, lunate,
triquetral
Wrist
• 1. radiocarpal ligaments - dorsal & palmar strengthen fibrous capsule
• 2. collateral ligaments
– a. radial - along lateral side from radius, over scaphoid,
trapezium to metacarpal I
– b. ulnar - along medial side from ulna, over trequetral,
pisiform, hamate to metacarpal V
• 3. Nervous: ant inteross br of median; post
inteross br of radial; dorsal & deep branches of
ulnar
• 4. Circulatory supply: dorsal & palmar carpal
arterial arches (anterior & posterior interosseous
artery, to distal radioulnar joint)
Wrist
• Intercarpal, Carpometacarpal &
Intermetacarpal Joints - gliding plane joints
Fingers
• Metacarpophalangeal & Interphalangeal
Joints - condyloid & hinge joints
Finger
• 1. collateral ligaments - obliquely across sides of
joints
• 2. palmar ligaments plates - transversely across
center of joints
– deep transverse metacarpal ligaments - hold together
#2-5 metacarpals - between plates
• 3. extensor expansion hoods - dorsal side of
fingers
• 4. Nervous: digital nerve from median & ulnar
• 5. Circulatory supply: digital a. from superficial
palmar arterial arches