1.Joints of upper limb Done by : Mohammed A Qazzaz

2. Joints of clavicle (collarbone) 1) Sternocalvicular joint ( medially) 2) Acromioclavicular joiny ( laterally) 3. 1) Sternoclavicualr joint The sternoclaviculararticulation is a synovial double-plane joint composed of two portions separated by an articular disc which is made from fibrocartilage. The sternoclavicular joint is a saddle-type joint that allows movement of the clavicle, predominantly in anteroposterior and vertical planes, although some rotation also occurs. 4. Cont.. Sternoclavicualr joint Ligaments of sternoclavicular joint : The anterior and posterior sternoclavicular ligaments are found anterior and posterior to the joint. The interclavicular ligament links the ends of the two clavicles to each other and to the superior surface of the manubrium of the sternum. The costoclavicular ligament is positioned laterally to the joint and links the proximal end of the clavicle to the first rib and related costal cartilage. 5. 2) Acromioclavicular joint The AC joint is located at the tipof the shoulder where the acromion portion of scapula and clavicle join together. The AC joint is not as mobile as the large main shoulder joint and only moves when the shoulder is overhead or across the chest (adducted). The joint is partly filled with a thick pad of cartilage, known as the meniscus, wich allows the joint to move.Synovial plane joint 6. Cont.. Acromioclavicualr joint Ligaments of acromioclavicular joint : The acromioclavicular ligament,which attaches the clavicle to the acromion of the scapula. The coracoclavicular ligament,which consists of two ligaments, the conoid and the trapezoid ligaments. 7. Glenohumeral joint (a.k.a. Shoulder joint ) The glenoid fossa of the scapulais a depression on the head of the scapula, between the acromion and coracoid processes. It joins with the head of the humerus. The glenoid fossa is shallow and contains the glenoid labrum which deepens it and aids in stability. The glenohumeral joint is a multiaxial synovial ball and socket joint. Due to the very limited interface of the humerus and scapula, it is 8. Cont.. Glenohumeral joint The glenoid labrum is afibrocartilaginous rim attached around the margin of the glenoid cavity in the scapula. It deepens the articular cavity, and protects the edges of the bone. It is continuous above with the tendon of the long head of the Biceps brachii. 9. Cont.. Glenohumeral joint Capsule of acromioclavicular joint : Capsule surrounds the joint and isattached medially to the margin of the glenoid cavity outside the labrum; laterally it is attached to the anatomic neck of the humerus. The capsule is thin and lax, allowing a wide range of movement. It is strengthened by fibrous slips from the tendons of the subscapularis, supraspinatus, infraspinatus, and teres minor muscles (the rotator cuff muscles). 10. Cont.. Glenohumeral joint Synovial membrane of acromioclavicular joint :This lines the capsule and is attached to the margins of the cartilage covering the articular surfaces. It forms a tubular sheath around the tendon of the long head of the biceps brachii. It extends through the anterior wall of the capsule to form the subscapularis bursa beneath the subscapularis muscle. 11. Cont.. Glenohumeral joint Bursae of acromioclavicular joint : The bursa are formed by thesynovial membrane of the joint capsule. A number of bursae in the capsule aid mobility: Subacromial bursa (between joint capsule and acromion of scapula). Subscapular bursa (between joint capsule and tendon of subscapularis muscle, also known as subtendinous bursa of subscapularis muscle). 12. Cont.. Glenohumeral joint Bursae of acromioclavicular joint : 13. Cont.. Glenohumeral joint Ligaments of glenohumeral joint : Three glenohumeral ligamentsexist: (1) The superior glenohumeral ligament (SGHL). This ligament resists inferior translation of the humeral head in the adducted shoulder. (2) The middle glenohumeral ligament (MGHL). This ligament resists inferior translation in the adducted and externally rotated shoulder. (3) The inferior glenohumeral ligamentThe glenohumeral ligaments are three (IGHL). This resists humeral head weak bands of fibrous tissue that anterior and posterior translation. strengthen the front of the capsule 14. Cont.. Glenohumeral joint Ligaments of glenohumeral joint : The transverse humeral ligamentstrengthens the capsule and bridges the gap between the two tuberosities. The coracohumeral ligament strengthens the capsule above and stretches from the root of the coracoid process to the greater tuberosity of the humerus. 15. The Elbow Joint The human elbow is thesummation of 3 articulations: 1) Humeroulnar joint: the synovial hinge joint with articulation between the trochlea of the humeral condyle and the trochlear notch of the ulna. 2) Humeroradial joint: the articulation between the capitulum of the humeral condyle and the concavity on the superior aspect of the head of the radius 3) Radioulnar joint: it is a pivottype synovial joint with articulation between the head of the radius and the radial notch ofThese 3 articulations, forming 2 different aspects, allow flexion and extension of the elbow, as well as supination and pronation of the forearm and wrist at the elbow. 16. Cont.. Elbow joint Capsule of elbow joint : Anteriorly it is attached above to the humerus along the upper marginsof the coronoid and radial fossae to the margin of the coronoid process of the ulna. Posteriorly it is attached above to the margins of the olecranon fossa of the humerus and below to the upper margin and sides of the olecranon process of the ulna. 17. Cont.. Elbow joint Synovial membrane and bursae of elbow joint : The elbow joint has a synovial membrane-lined joint capsule that is contiguous between the hinge and radioulnar aspects of the joint. The synovial lining covers the internal surface of the fibrous joint capsule and the nonarticular surfaces of the joint that are located intracapsularly. The major bursa in the elbow joint is the subcutaneous olecranon bursa, found in the connective tissue over the olecranon. 18. Cont.. Elbow joint Ligaments of elbow joint : Medially, the joint capsule thickensto form the medial or ulnar collateral ligament, which extends from the medial epicondyle of the humerus to the coronoid and olecranon of the ulna. The ulnar collateral ligament is a triangular thickening with 3 main bands: the anterior or cordlike band, the posterior fanlike band, and the oblique band.AOP 19. Cont.. Elbow joint Ligaments of elbow joint : Laterally, the lateral or radial collateralligament extends from the lateral humeral epicondyle and distally blends into the anular ligament of the radius. The anular ligament of the radius wraps around the head of the radius and attaches to the ulna anteriorly and posteriorly. The surface of the anular ligament is lined with synovial membrane and allows the head of the radius to rotate inward during supination and pronation, while maintaining stability of the radial ulnar joint. 20. The Radiocarbal joint (a.k.a. Wrist joint ) The wrist is a complex joint thatbridges the hand to the forearm. It is actually a collection of multiple bones and joints. The bones comprising the wrist include the distal ends of the radius, 8 carpal bones, and the proximal portions of the 5 metacarpal bones. All of these bones participate in complex articulations that allow variable mobility of the hand. The hand is capable of 2 degrees of freedom: (1) flexing and extending, and (2) deviating ulnarly or radially. 21. Cont.. Wrist joint Ulna is prevented fromarticulating with the carpal bones by a fibrocartilginous ligament, called the articular disk. Together, the carpal bones form a convex surface, which articulates with the concave surface of the radius and articular disk. The wrist is an ellipsoid type synovial joint, allowing for movement along two axes. This means that flexion, extension, The ulna is not part of the wrist joint, adduction and abduction can all it articulates with the radius, just proximal to occur at the wrist joint. the wrist joint, at the distal radioulnar joint. 22. Cont.. Wrist joint Capsule of wrist joint : The fibrous outer layer attachesto the radius, ulna and the proximal row of the carpal bones. The internal layer is comprised of a synovial membrane, secreting synovial fluid which lubricates the joint. Synovial membrane 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 23. Cont.. Wrist joint Ligaments of wrist joint : There are four ligaments in the wrist joint, one for each side of the joint: Palmar radiocarpal - It passes from the radius to both rows of carpalbones. Its function, apart from increasing stability, is to ensure that the hand follows the forearm during supination. Dorsal radiocarpal - It passes from the radius to both rows of carpal bones. It contributes to the stability of the wrist, but also ensures that the hand follows the forearm during pronation. Ulnar collateral - Runs from the ulnar styloid process to the triquetrum and pisiform. Works in union with the other collateral ligament to prevent excessive lateral joint displacement. Radial collateral - Runs from the radial styloid process to the scaphoid and trapezium. Works in union with the other collateral ligament to prevent excessive lateral joint displacement. 24. Cont.. Wrist joint Ligaments of wrist joint : 25. Distal Radioulnar joint This is a pivot-joint formedbetween the head of the ulna and the ulnar notch on the lower end of the radius. The synovial membrane of this articulation is extremely loose, and extends upward as a recess between the radius and the ulna. The movements of pronation and supination of the forearm involve a rotary movement around a vertical axis at the proximal and distal radioulnar joints. 26. Cont.. Distal Radioulnar joint Ligaments of distal radioulnar joint : Anterior radioulnar ligament: This ligament is a narrow band of fibersextending from the anterior margin of the ulnar notch of the radius to the front of the head of the ulna. Posterior radioulnar ligament: This ligament extends between corresponding surfaces on the dorsal aspect of the articulation. 27. Cont.. Distal Radioulnar joint 28. Thank you