Download Arthrology - 山东大学医学院人体解剖学教研室

Arthrology 关节学
山东大学医学院 解剖学教研室
李振华
Classification
There are two major types of articulations or joint.
 Continuous joints 直接连结
 Fibrous joints 纤维连结: bones are
united by fibrous connective tissue
 Syndesmosis 韧带连结
 Suture 缝
 Cartilaginous joints 软骨连结:
bones are united by cartilage
 Synchondrosis 透明软骨结合:
bones are united by hyaline cartilage
 Symphysis 纤维软骨联合:
bones are united by fibrocartilage
 Synosteosis 骨性结合
 Discontinuous joints 间接连结－synovial
joints 滑膜关节
Synovial joints 滑膜关节
Basic structures

Articular surface关节面:
covered by articular cartilage
关节软骨

Articular capsule 关节囊



Fibrous membrane纤维膜
Synovial membrane 滑膜
Articular cavity关节腔:
containing a trace of synovial
fluid; subatmospheric pressure
in it
Accessory structures


Ligaments韧带(lig.):
extra- and intracapsular
ligaments 囊外(内)韧带
Articular disc关节盘
and articular labrum
关节唇:

Synovial fold滑膜襞
and synovial bursa滑
膜囊
Terms movements of joints
关节运动术语




Translation 移动
Flexion and extension 屈和伸
Adduction and abduction 收和展
Rotation 旋转




Medial and lateral rotation 旋内和旋外
Pronation ans supination旋前和旋后
Inversion and eversion 足内翻和足外翻
Circumduction 环转
Classification of synovial joints
关节的分类

Uniaxial joints单轴关节:



Biaxial joints双轴关节:



hinge joints 屈戍关节
trochoid (pivot) joints车轴关节
ellipsoid joints 椭圆关节
saddle joints 鞍状关节
Multiaxial joints多轴关节:


ball-and-socket joint 球窝关节
plane joints 平面关节
Articulations of Bones of Trunk
躯干骨的连结
The vertebral column脊柱
consists of 24 vertebrae,
the sacrum, and the
coccyx.
Joints of the vertebral bodies 椎体间的连结
Intervertebral discs
椎间盘


between bodies of adjacent
vertebrae, composed of:
Nucleus pulposus髓核, an
inner soft, pulpy, highly
elastic structure (gelatinous
core )
Annulus fibrosus纤维环
an outer fibrous ring
consisting of fibrocartilage
Hemination of nucleus pulposus
髓核脱出
Anterior longitudinal ligament
前纵韧带


Strong band covering the anterior part of the
vertebral bodies and intervertebral discs
running from the anterior margin of foramen
magnum to the S1~S2
Maintains stability of the intervertebral disc
and prevents hyperextension of the vertebral
column
Posterior longitudinal ligament
后纵韧带


Attached to the posterior aspect of the
intervertebral discs and posterior edges of
the vertebral bodies from C2 vertebra to
sacrum
Prevents hyperflexion of the vertebral column
and posterior protrusion of the discs
Joints of the vertebral arches 椎弓间的连结






Ligamenta flava 黄韧带― elastic
ligament, unite laminae of
adjacent vertebrae, and complete
the posterior wall of vertebral
canal; tend to prevent
hyperflexion of the vertebral
column
Interspinal ligament 棘间韧带
Supraspinal ligament 棘上韧带
Ligamentum nuchae项韧带
Intertansverse ligament横突间韧带
Zygapophysial joint 关节突关节
Atlantooccipital joint 寰枕关节



Between superior
articulating surfaces of
atlas and occipital
condyles
Supported by
membrances and
ligaments that join
occipital bone and atlas
Action ― nodding of
head, lateral tilting of
head
Atlantoaxial joint 寰枢关节

Three synovial joints
between atlas and axis



Laterally, paired joints
between articulating facets
Median joint between dens
of axis and anterior arch of
atlas
Supported by ligaments

apical ligament of dens 齿突
尖韧带

alar ligament 翼状韧带
transverse ligament of atlas

tectorial membrane 覆膜


寰椎横韧带
Action ― allow atlas (and
head) to pivot on the axis
and vertebral column
Normal Curves of vertebral
column




Cervical curvature颈曲
convex forward
Thoracic curvature胸曲
convex backward
Lumbar curvature腰曲
convex forward
Sacral curvature骶曲 convex
backward
Movement of the
vertebral column




flexion
extension
lateral flexion
rotation
Spina bifida cystica 脊柱裂
Thoracic cage 胸廓
Composition
Bones ― consists of
twelve thoracic
vertebrae, twelve pairs
of ribs and costal
cartilages, and sternum
Joints

Costovertebral joints
肋椎关节


Joints of costal head 肋头关节
Costotransverse joints 肋横突
关节

Sternocostal joints 胸肋关节



Sternocostal synchondrosis
of first rib 第一胸肋结合
Sternocostal joints胸肋关节:
Interchondral joints肋软骨连结:
between costal cartilages 8, 9,
and 10 to form the costal
arch肋弓
General features of thoracic cage





Roughly cone-shape, narrow
above and broad below, flattened
from before-backwards, longer
behind than in front
Inlet of thorax胸廓上口: bounded
by upper border of manubrium,
first rib, and vertebra T1
Outlet of thorax胸廓下口:
bounded by vertebra T12, 12th
and 11th ribs, costal arch and
xiphoid process
Infrasternal angle胸骨下角: formed
by the costal arch of both side
Intercostal spaces肋间隙: lie
between the ribs

Function:


protects the organs in the thoracic cavity and upper
abdominal cavity;
plays a vital role in the process of breathing
Inspiration
Expiration
Joints of skull 颅骨的连结

Continuous joints:
sutures, synchondrosis
or synosteosis
Temporomandibular joint 颞下颌关节

Aticulating surfaces





Mandibular fossa and articular
tubercle, above
Head of mandibule, below
Capsule: thin and lax in front and
behind; strengthened by the
lateral ligament 外侧韧带
Articular disc: separates
surfaces, forming upper and
lower compartments within joint
Movement: mandible may be
elevated or depressed,
protruded or retracted; rotation
may also occurs as in
chewing( a slight amount of side
to side movement is also
permitted)
Joints of limbs
山东大学医学院 解剖教研室
李振华
Joints of upper limb
Joints of should girdle

Sternoclavicular joint胸锁关节




Bones: sternal end of clavicle,
clavicular notch of sternum, and
first costal cartilage
Articular capsule: strong and is
reinforced by anterior and posterior
sternoclavicular ligaments
An articular disc is attached to the
capsule, dividing the joint into two
cavities.
Movements: elevation and
depression, forward and backward,
rotation and circumduction of the
acromial end of the clavicle

Acromioclavicular joint 肩锁关节



Bones: acromion and
acromial end of clavicle
Movement: rotation of
scapula on clavicle
Coracoacromial arch 喙肩弓
formed by coracoacromial
ligament喙肩韧带, coranoid
process, and acromion, that
prevents the shoulder joint
from superior dislocation
acromion
coracoacromial
ligament
coranoid process
Joints of free upper limb
★Shoulder joint 肩关节


(ball and socket)
Bones: head of humerus and
glenoid cavity of scapula
Capsule:



Thin and lax, especially lower
part
Attachments: proximal to glenoid
labrum; distal to anatomical neck
of humerus, except medially
where it is slightly distal to
surgical neck
Tendon of long head of biceps
brachii passes though the cavity

Accessory structures



Glenoid labrum盂唇:
fibrocartilaginous ring on
periphery of glenoid
cavity
Coracohumeral ligament
喙肱韧带：runs from
coracoid process to
greater tubercle
Movements: flexion,
extension, adduction,
abduction, medial and
lateral rotation,
circumduction
★ Elbow joint 肘关节

Bones: lower end of humerus, upper
ends of radius and ulna




Humeroulnar joint 肱尺关节:
formed by trochlear of humerus and
troclear noch (hinge)
Humeroradial joint肱桡关节:
formed by capitulum of humerus and
head of radius (ball and socket)
Proximal radioulnar joint桡尺近侧关节:
formed by articular circumference of
radius and radial notch of ulna
Capsule: thin and lax anteriorly and
posteriorly, strongly thickened on either
side by collateral ligaments

Ligaments:




Radial collacteral ligament桡侧副韧带:
attached to lateral epicondyle and annular
ligament of radius
Ulnar collacteral ligament尺侧副韧带:
attached to medial epicondyle to medial
border of trochlear notch
Annular ligament of radius桡骨环状韧带:
attached to anterior and posterior margins
of radial notch of ulna, surrounds the head
of radius
Movements: flexion and extension,
pronation and supination
Dislocation
Joints between radius and ulna



Proximal radioulnar joint 桡尺近侧关节
Distal radioulnar joint桡尺远侧关节:
formed by head of ulna, ulnar notch of
radius and an articular disc
Interosseous membrane of forearm
前臂骨间膜: a fibrous membrane between
the shaft of radius and ulna
Joints of hand
★ Radiocarpal joint桡腕关节

(ellipsoid)
Bones




Carpal articular surface of radius
and articular disc below the ulna
Proximal row of carpal: scaphoid,
lunate, and triquetral bones, but
not pisiform
Capsule: lax and strengthened by
surrounding ligament
Movements: flexion, extension,
adduction, abduction, and
circumduction
Intercarpal joints
 Carpometacarpal joints:
★ Carpometacarpal joint
of thumb 拇指腕掌关节






Bones: trapezium and
base of first metacarpal
Movement: flexion,
extension, adduction,
abduction, and
opposition
Intermetacarpal joints
Metacarpophalangeal
joints
Interphalangeal joints
Joints of Lower limb
Joints of pelvic girdle
 Sacroiliac joint 骶髂关节
 Bones: auricular surface of sacrum and ilium
 Capsule: very tight and strengthened by ligaments
Vertebropelvic ligaments
 Iliolumbal ligament髂腰韧带:
runs from transverse process
of L5 to the posterosuperior
part of iliac crest
★ Sacrotuberous ligament
骶结节韧带: runs from lateral
margins of sacrum and coccyx
to the inner margin of ischial
tuberosity
★ Sacrospinous ligament
骶棘韧带: runs from ischial
spine to lateral margins of
sacrum and coccyx
 These two ligaments convert
the sciatic notches the greater
and lesser sciatic foramina
坐骨大、小孔

Pubic symphysis
耻骨联合



Articulation: symphysial
surface and interpubic
disc (fibrocartilage)
Ligaments: superior
pubic ligament and
arcuate pubic ligament
Obturator membrane
闭孔膜
obturator canal 闭膜管
Bony pelvis骨盆
Composition: formed by paired hip
bones, sacrum, coccyx, and their
articulations
 In anatomical position, anterior
superior iliac spines and pubic
tubercles on same vertical plane,
while the tip of coccyx and superior
border of pubic symphysis on same
horizontal plane
 Terminal line界线: formed by
promontory of sacrum, arcuate line,
pectin of pubis, pubic tubercle, upper
border of pubic symphysis
 Two portions: a greater pelvis and a
lesser pelvis
Lesser pelvis 小骨盆
 pelvic inlet 骨盆上口
(terminal line):
 Pelvic outlet 骨盆下口:
formed by tip of coccyx,
sacrotuberous ligament,
ischial tuberosity,
ramus of ischium,
inferior ramus of pubic,
symphysis
 Pelvic cavity
 Pubic arch, subpubic
angle
Main difference between male and femal pelvis
Main difference between male and femal pelvis
Female
Male
Pelvic inlet
Pelvic outet
Pelvic cavity
Pubic arch
90~1000
70~750
Main difference between male and femal pelvis
Male
Female
Overall
Narrow and long
Wide and short
Iliac ala
More vertical
More horizontal
Inlet
Oval or heart shaped
Round
Subpubic
angle
Acute angle (about
70~750)
Right angle (about
90~1000)
Pelvic cavity
Deep narrow
Shallower, wide
Outlet
Small
Larger
Joints of free lower limb
★ Hip joint 髋关节


Bones: acetabulum and
femoral head
Articular capsule attachments


Above: margins of acetabulum
and transverse acetebular
ligament
Below: in front to
intertrochanteric line; behind, to
the neck of femur above 1 cm
above the intertrochanteric
crest

Accessory structures


Acetabulum labrum髋臼唇;
transverse acetebular
ligament髋臼横韧带
Ligaments




Iliofemoral lig. 髂股韧带
Ligament of head of
femur 股骨头韧带
Pubofemoral lig. 耻股韧带
Ischiofemoral ligament
Acetabulum labrum
Ligament of head
of femur
坐股韧带


Zona orbicularis轮匝带
Movement: flexion,
extention, adduction,
abduction, medial and
lateral rotation,
circumduction
Transverse
acetebular lig.
Pubofemoral
lig.
Iliofemoral
lig.
Ischiofemoral
lig.
Zona orbicularis
★Knee joint 膝关节
 Bones: lower end of femur, upper end of tibia and patella
 Articular capsule: superapatellar bursa髌上囊, deep
infrapatellar bursa髌下深囊, ala folds翼状襞

Accessory structures

ligaments



Patellar lig. 髌韧带
Fibular collateral lig. 腓侧副韧带
Tibial collateral lig. 胫侧副韧带
Patellar lig.
Fibular
collateral
lig.
Tibial collateral
lig.



Oblique popliteal ligament腘斜韧带
Anterior cruciate ligment前交叉韧带
Posterior cruciateligament 后交叉韧带



Medial meniscus内侧半月板 (C-shaped)
lateral meniscus外侧半月板 (O-shaped)
Movements: flexion and extension; flexed knee joint
may be passively rotated through 700
lateral
Medial
Tibiofibular syndesmosis
胫腓连结



Tibiofibular joint 胫腓关节
Crural interosseous
membrane 小腿骨间膜
Anterior and posterior
tibiofibular ligaments
胫腓前、后韧带
Joint of foot
Talocrural joint 距小腿关节
(ankle joint) 踝关节
 Bones: lower ends of tibia
and fibula, trochlea of talus
 Articular capsule: thin and
lax in front and behind, and
supported on each side by
strong collateral ligaments

Ligments


Medial lig.内侧韧带
Lateral lig.外侧韧带

Anterior talofibular lig.
距腓前韧带


Calcaneofibular lig.跟腓韧带
Posterior talofibular lig.
距腓后韧带

Movements: dosiflexion
(extension) and plantar
flexion (flexion); when the
ankle joint is fully plantar
flexed, small amounts of
abduction, and adduction
are possible

Intertarsal joints跗骨间关节


Talocalcaneal joint 距跟关节
Talocalcaneonavicular joint距
跟舟关节

Calcaneocuboid joint
跟骰关节

Tarsometatarsal joints
跗跖关节

Intermetatarsal joints
跖骨间关节


Metatarsophalangeal
joints 跖趾关节
Interphalangeal joints
趾间关节
transverse tarsal joint跗横关节
Arches of foot 足弓

Medial longitudinal arch内侧纵弓: formed by
calcaneus, navicular, three cuneiforms and first to
third metatarsal bones, head of talus is the
keystone of this arch

Lateral longitudinal arch外侧纵弓:
formed by calcaneus, cuboid, fourth and fifth
metatarsals; cuboid is is the keystone of this arch


Tranverse arch横弓:
formed by cuboid, three cuniforms and all
metatarsals; the intermediate cuneiform is the
keystone of this arch
Function: give to foot strength stability and
resilience; protect plantar vessels and nerves
Normal arch
Flatfoot
Myology 肌学

Morphology



Muscle belly肌腹
Tendon肌腱
aponeurosis 腱膜
Classification




Long muscle 长肌
Short muscle 短肌
Broad muscle阔肌
Orbicular mucle 轮匝肌


Origin 起点
insertion 止点
position 位置
action 作用
Nomenclature of
mucles肌的命名:
shap, size,
location, and
their points of
attachment
Accessory structures
 Fascia



Superficial fascia
Deep fascia
Synovial bursa

Tendinous sheath


Fibrous layer
Synovial layer:
mesotendon, vincula
tendinum
Synovial cyst of wrist 腕部腱鞘囊肿