1. Joints Of Upper Extremities

2. 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

4. 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

5. 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

7. Acromioclavicular Joint
A plane gliding joint between lateral clavicle & anterior, medial end of acromion
Fibrocartilage covers both articulating surfaces

8. 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

10. 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

14. Shoulder Joint
humerus in glenoid fossa - hyaline cartilage covers articulating surfaces
a ball & socket joint - spheroidal - highly mobile (not terribly stable)

15. 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

16. 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

17. 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

18. Shoulder Dislocation

19. Glenoid Labrum Tears

20. Elbow Joint
a hinge joint - uniaxial - flexion/ extension movement

21. 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

23. 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

25. Wrist condyloid/ellipsoidal joint
between radius, articular disc (binds ends of radius & ulna) & scaphoid, lunate, triquetral

26. 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)

27. Wrist
Intercarpal, Carpometacarpal & Intermetacarpal Joints - gliding plane joints

28. Fingers
Metacarpophalangeal & Interphalangeal Joints - condyloid & hinge joints

29. 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