Victoria Gugenheim Body Art JOINTS OF THE UPPER LIMB Victoria Gugenheim Body Art Kaan Yücel M.D., Ph.D. 03.March.2014 Monday

JOINTS OF THE UPPER LIMB Acromioclavicular joint & Sternoclavicular joint Glenohumeral (Shoulder) joint Elbow joint Proximal (Superior) and Distal (Inferior) radio-ulnar joints Radiocarpal (Wrist) joint Intercarpal joints Carpometacarpal and intermetacarpal Interphalangeal

STERNOCLAVICULAR JOINT the only articulation between upper limb & axial skeleton Articulation between Sternum & clavicle Saddle type functions as a ball-and-socket joint Articular disc Sternal end of clavicle v.s. Manubrium & 1st costal cartilage

LIGAMENTS OF THE STERNOCLAVICULAR JOINT Anterior and posterior sternoclavicular ligaments Interclavicular ligament Costoclavicular ligament

STERNOCLAVICULAR JOINT MOVEMENTS OF THE STERNOCLAVICULAR JOINT Strong but mobile Raising the clavicle (60°) during full elevation of the limb Once elevation is completed via flexion; rotation of the clavicle around its longitudinal axis Anterior and posterior movements of the clavicle

ACROMIOCLAVICULAR JOINT 2-3 cm from the “point” of the shoulder formed by the lateral part of the acromion Articulation between Acromion of scapulae & clavicle Plane type Articular disc Acromial end of clavicle v.s. Acromion of scapula

LIGAMENTS OF THE ACROMIOCLAVICULAR JOINT Intrinsic ligament Acromioclavicular ligament Extrinsic ligament Coracoclavicular ligament conoid ligament (medial) trapezoid ligament (lateral)

MOVEMENTS OF THE ACROMIOCLAVICULAR JOINT Acromion rotates on the acromial end of the clavicle. associated with motion @ physiological scapulothoracic joint

GLENOHUMERAL (SHOULDER) JOINT more freedom of movement than any other joint in the body Articulation between humeral head v.s. glenoid cavity of the scapula Ball-and-socket type Glenoid labrum (L., lip) MORE IMAGES 114-122

GLENOHUMERAL (SHOULDER) JOINT LIGAMENTS OF THE GLENOHUMERAL (SHOULDER) JOINT Glenohumeral ligaments Coracohumeral ligament Transverse humeral ligament 4. Coracoacromial ligament Joint stability coraco-acromial arch

GLENOHUMERAL (SHOULDER) JOINT MOVEMENTS OF THE GLENOHUMERAL (SHOULDER) JOINT Flexion & extension of the humerus Abduction & adduction of the humerus Medial & lateral rotation of the humerus Circumduction

GLENOHUMERAL (SHOULDER) JOINT BURSAE AROUND THE GLENOHUMERAL (SHOULDER) JOINT

ELBOW JOINT 2-3 cm inferior to the epicondyles of the humerus Articulation between Humerus, ulna and radius Hinge type Trochlea of humerus v.s. Trochlear notch of ulna Capitilum of humerus v.s. Head of radius

LIGAMENTS OF THE ELBOW JOINT Medial (ulnar) and lateral (radial) collateral ligaments

MOVEMENTS OF THE ELBOW JOINT Flexion and extension occur at the elbow joint. The long axis of the fully extended ulna makes an angle with the long axis of the humerus. forearm angles away from the body when something is carried. more pronounced in women than in men

BURSAE AROUND THE ELBOW JOINT

Head of radius v.s. Radial notch of ulna PROXIMAL (SUPERIOR) RADIO-ULNAR JOINT Articulation between Radius and ulna proximally Pivot type Head of radius v.s. Radial notch of ulna Anular ligament Supination & pronation MORE IMAGES 133 -134

head of ulna v.s. ulnar notch of radius DISTAL (INFERIOR) RADIO-ULNAR JOINT Articulation between Radius and ulna distally Pivot type Articular disc head of ulna v.s. ulnar notch of radius Anterior and posterior ligaments Supination & pronation Radius moves around relatively fixed distal end of ulna.

WRIST (RADIOCAPRAL) JOINT Articulation between Radius and proximal row of carpal bones Condyloid (ellipsoid) type Articular disc Distal end of the radius ,disc of the distal radio-ulnar joint v.s. proximal row of carpal bones, except for the pisiform

LIGAMENTS OF THE WRIST JOINT Dorsal and palmar radiocarpal ligaments Ulnar collateral ligament Radial collateral ligament

MOVEMENTS OF THE WRIST JOINT Proximal & Distal Radioulnar joints Most adduction @ wrist joint Abduction from the neutral position occurs @ midcarpal joint. Flexion of the hand> Extension of the hand Adduction of the hand > Abduction of the hand

Anterior, posterior, and interosseous ligaments INTERCARPAL JOINTS Plane type Joints between carpal bones of the proximal row Joints between carpal bones of the distal row Midcarpal joint between proximal &distal rows of carpal bones Anterior, posterior, and interosseous ligaments

CARPOMETACARPAL & INTERMETACARPAL JOINTS carpometacarpal joint of the thumb between trapezium & base of 1st metacarpal

INTERPHALANGEAL JOINTS METACARPOPHALANGEAL & INTERPHALANGEAL JOINTS MORE IMAGES 135-138 Metacarpophalangeal joints condyloid type biaxial plane : flexion-extension and adduction-abduction Interphalangeal joints hinge type uniaxial flexion-extension only