Bones, ligament, joints of the upper and lower limb Pelvisanat.lf1.cuni.cz/praktika/prak04.pdf ·...

Post on 08-Jun-2020

5 views 1 download

Transcript of Bones, ligament, joints of the upper and lower limb Pelvisanat.lf1.cuni.cz/praktika/prak04.pdf ·...

Bones, ligament, joints of

the upper and lower limb

Pelvis

Sternoclavicular joint

Articular disc

Anterior sternoclavicular ligament

Posterior sternoclavicular ligament

Costoclavicular ligament

Interclavicular ligament

Acromioclavicular joint

Acromioclavicular ligament

(Articular disc)

Coracoclavicular ligament

Trapezoid ligament

Conoid ligament

Glenohumeral joint; Shoulder joint

Glenoid labrum

Glenohumeral ligaments

Coracohumeral ligament

Transverse humeral ligament

Rotatory cuff

Coraco-acromial ligament

Superior transverse scapular ligament

Elbow joint

Humero-ulnar joint

Humeroradial joint

Proximal radio-

ulnar joint

Ulnar collateral

ligament

Radial collateral

ligament

Anular ligament of

radius

Distal radio-ulnar

joint

Articular disc

Sacciform recess

Radio-ulnar

syndesmosis

Interosseous

membrane of forearm

Oblique cord

Joints of hand

Wrist joint

Ulnar collateral ligament of wrist joint

Radial collateral ligament of wrist joint

Carpal joints; Intercarpal joints

Midcarpal joint

Radiate carpal ligament

Interosseus intercarpal ligaments

Pisiform joint

Pisohamate ligament

Pisometacarpal ligament

Carpal tunnel

Carpometacarpal joints

Dorsal carpometacarpal ligaments

Palmar carpometacarpal ligaments

Carpometacarpal joint of thumb

Intermetacarpal joints

Dorsal metacarpal ligaments

Palmar metacarpal ligaments

Interosseous metacarpal ligaments

Interosseous metacarpal spaces

Joints of hand

Wrist joint

Ulnar collateral ligament of wrist joint

Radial collateral ligament of wrist joint

Carpal joints; Intercarpal joints

Midcarpal joint

Radiate carpal ligament

Interosseus intercarpal ligaments

Pisiform joint

Pisohamate ligament

Pisometacarpal ligament

Carpal tunnel

Carpometacarpal joints

Dorsal carpometacarpal ligaments

Palmar carpometacarpal ligaments

Carpometacarpal joint of thumb

Intermetacarpal joints

Dorsal metacarpal ligaments

Palmar metacarpal ligaments

Interosseous metacarpal ligaments

Interosseous metacarpal spaces

Metacarpophalangeal joints

Collateral ligaments

Palmar ligaments

Interphalangeal joints of

hand, proximal and distal

Collateral ligaments

Palmar ligaments

True pelvis

4 planes, baby´s head

has to descend

during birth

The biggest

diameter of the

newborn´s

head fits into

the biggest

diameter of

each plane

Pelvic measurements in obsterics (and anatomy)

- straight, obligue and transverse diameter

1. pelvic inlet – promontory, iliopectineal lines,

symphysis/ transverse diameter –13 cm/

2. pelvic cavity

amplitudo – S2-3, acetabulum, center of symhysis/

oblique diameter.-13,5 cm/

3. angustia (narow)- spina ischiadica, sacrum, lower

end of symphysis / str. diameter –11,5 cm/

4. pelvic outlet - 2 triangles – pubic arch, ischial

tuberosities, coccyx / str. diameter 9–11,5 cm/

inlet

outletangustia

amplitudo

true (obstetric) conjugate – from retropubic eminence to promontory 10,5 cm

diagonal conjugate – lower edge of symphysis to promontory –13cm

external pelvic meauserments:

interspinous distance – 26 cm

intercristal distance – 29 cm

intertrochanteric distance – 31 cm

external conjugate (Badelocque) – upper edge of symphysis to spinous

process of L5, 18-20 cm

SI jointalmost immobile kloub (amphiarthrosis)

auricular surfaces of both bones

strong capsule –

sacroiliac lig. (ventr., dors., interosseous)

iliolumbar lig. connecting the ilium to the L4,L5

sacrotuberous and sacrospinous ligg.

symphysis pubis

-cartilagineous interpubic disk with small

nonsynovial cavity

superior and inferior pubic ligament

obturator membrane -obturator canal

for obturator blood vessels and nerve

coxa valga

coxa vara

angle of inclination 125-130

Hip jointball and socket joint

femoral head–lunate surface of acetabulum

additional features: acetabular lip (labrum),

transverse acetabular lig.

reinforcing ligg.: iliofemoral lig.

pubofemoral lig.

ischiofemoral lig.

zona orbicularis

lig. of the head of F

Movements

flexion/extension

abduction/adduction

rotation

circumduction

Knee jointcomplex joint: femorotibial +femoropatellar

femoral condyles – tibial condyles

incongruence of their surfaces is compensated by

menisci med. + lat.

patellar surface of F -articular surface of P

Ligaments 1

patellar lig.

med. + lat. patellar retinaculum

tibial collateral lig.

fibular collateral lig.

oblique popliteal lig.

arcuate politeal lig.

Ligaments 2

anterior cruciate lig.

posterior cruciate lig.

transverse lig. of the knee

ant. + post. meniscofemoral lig.

synovial and fibrous layer of capsule are separated

- cruciate ligg are intracapsular but extra-articularly

infrapatellar fat pad

movements

flexion/extension combined with rotation

gliding and rolling movements

extended knee is in locked position (medial rotation of

F)- initial phase of flexion is unlocking (untwisting)

process (lateral rotation of F)

forced abduction/adduction

arthroscopy

subtalar joint (post.articular

facets of T and C)

talocalcaneonavicular

calcaneocuboid

form functional complex

allowing

eversion/inversion of foot

proximal T-F jointhead of F- fib.art.facet of

lat.tib.condyle

interosseous membrane

dist. T-F joint = tibiofibular

syndesmosis - special kind

of connection allowing minimal

movement essential for proper

ankle joint function

ant. + post.tibiofibular ligg.

Joints of foot

art. talocruralis - talocrural joint–

(upper) ankle joint

lower ankle

art. subtalaris – subtalar joint

+ art. talocalcaneonavicularis

art. cuneonavicularis

art. tarsometatarsales

art. metatasophalangealee

art. interphalangeales

Ankle (talocrural) joint

trochlea(pulley) of T - malleolar mortise

(deep socket)

medial = deltoid lig.(4 parts)

lateral lig. (3 parts)

movement: plant.flexion/dors. flexion

Deltoid (medial) ligament- tibionavicular part

- ant. tibiotalar part

- tibiocalcaneari part

- post. tibiotalar part

Lateral ligament- ant. talofibular ligament

-post. talofibular lig.

-calcaneofibular lig.

.

Inversion=

Plantar flexion+adduction

+ supination

Eversion=

Dorsal flexion+abductiom

+ pronation

Rtg ATC

Chopart´s joint line = transverse tarsal joint

complex of C-C and T-N jointbifurcate lig. (calcaneonavicular + calcaneocuboid)

Lisfranc´s joint line - complex of

tarsometatarsals and intermetatarsals jointsMTT2 projects proximally !

Great number of short ligg. connecting leg bones to

tarsals, connecting tarsals between themselves,

connecting tarsals and metatarsals

Chopart´s joint

Lisfranc´s joint

plantar aponeurosis, long plantar lig., plantar

calcaneonavicular (spring) lig., short plantar ligg.

Foot (plantar) arches

tarsal and MTT bones are arranged in longitudinal

(med. , lat.) and transverse arches with shock absorbing,

weight bearing function

are maintained by:

1. Shape of interlocking bones

2. Strength of the plantar ligg. + plantar aponeurosis

3. Action of tendons of muscles – tibialis ant. and

post., peroneus longus and btrevis, flexors of the foot

Transverse arch

Longitudinal arch

Drawings for the next week

Scheme of joints of hand

Scheme of joints of foot, complete the line of Chopart´s and Lisfranc´s joint

Frontal section through the shoulder joint. Complete the ligaments and joint capsule of hip

Frontal section through the hip joint. Complete the ligaments and joint capsule of hip

Scheme of upper surfaces of tibia with menisci. Complete the cruciate and collateral ligaments and insertion of layers of joint capsule.