1. SHANDONG UNIVERSITY Liu Zhiyu
Joints of limbs
SHANDONG UNIVERSITY
Liu Zhiyu

2. Joints of upper limb

3. Joints of should girdle
Sternoclavicular joint
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
Articular disc: 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

4. Joints of should girdle
Coracoacromial
ligament
Acromioclavicular joint
Bones: acromion and acromial end of clavicle
Movement: rotation of scapula on clavicle
Coracoacromial arch
Composition
coracoacromial ligament
coranoid process
Acromion
Prevents the shoulder joint from superior dislocation
Acromion
Coranoid process

5. Joints of free upper limb

6. ★Shoulder joint Type: 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

7. ★Shoulder joint
Tendon of long head
of biceps brachii

8. ★Shoulder joint Accessory structures
Glenoid labrum : fibrocartilaginous ring on periphery of glenoid cavity
Coracohumeral ligament : runs from coracoid process to greater tubercle
Movements: flexion, extension, adduction, abduction, medial and lateral rotation, circumduction

9. Radiograph of shoulder in a young female of 18 years in anteroposterior view (A) and axillary view with the arm abducted (B).

10. dislocation

11. Dislocation of Shoulder joint

12. ★ Elbow joint
Bones: lower end of humerus, upper ends of radius and ulna
Humeroulnar joint :
formed by trochlear of humerus and troclear noch (hinge)
Humeroradial joint :
formed by capitulum of humerus and head of radius (ball and socket)
Proximal radioulnar joint : 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

13. ★ Elbow joint Ligaments:
Radial collacteral ligament : attached to lateral epicondyle and annular ligament of radius
Ulnar collacteral ligament : attached to medial epicondyle to medial border of trochlear notch
Annular ligament of radius : attached to anterior and posterior margins of radial notch of ulna, surrounds the head of radius
Movements: flexion and extension, pronation and supination

14. Dislocation
of elbow joint

15. Anteroposterior (A) and lateral (B) radiographs of an adult elbow joint. The joint is semiflexed in B.

16. In extension, the medial and lateral epicondyles and the top of the olecranon process are in a straight line;
in flexion, the bony point form the boundaries of an equilateral triangle.

17. Joints between radius and ulna
Proximal radioulnar joint
Interosseous membrane of forearm: a fibrous membrane between the shaft of radius and ulna
Distal radioulnar joint formed by head of ulna, ulnar notch of radius and an articular disc

18. Joints of hand ★ Radiocarpal joint (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

19. Joints of hand Intercarpal joints Carpometacarpal joints
Carpometacarpal joint of thumb
Bones: trapezium and base of first metacarpal
Movement: flexion, extension, adduction, abduction, and opposition
Intermetacarpal joints
Metacarpophalangeal joints
Interphalangeal joints

20. Joints of hand Intermetacarpal joints 腕骨间关节
Metacarpophalangeal joints 掌指关节
Interphalangeal joints 指间关节

21. Joints of Lower limb

22. Joints of pelvic girdle
Sacroiliac joint
Bones: auricular surface of sacrum and ilium
Capsule: very tight and strengthened by ligaments

23. Ligaments of the gluteal region
Sacrotuberous ligament
Connects the lateral margins of sacrum and coccyx to the ischial tuberosity
Sacrospinous ligament
Connects the lateral margins of sacrum and coccyx to the spine of the ischium

24. Foramina of the gluteal region
Greater sciatic foramen
Formed by the greater sciatic notch of the hip bone and the sacrospinous ligament.
It provides an exit from the pelvis into the gluteal region.
Lesser sciatic foramen
Formed by the lesser sciatic notch of the ischium and the sacrospinous and sacrotuberous ligaments.
It provides an entrance into the perineum from the gluteal region

25. Joints of pelvic girdle
Pubic symphysis
Articulation: symphysial surface and interpubic disc (fibrocartilage)
Ligaments: superior pubic ligament and arcuate pubic ligament
Obturator membrane
Obturator canal

26. Bony pelvis
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: formed by promontory of sacrum, arcuate line, pecten of pubis, pubic tubercle, upper border of pubic symphysis
Two portions:
greater pelvis
lesser pelvis

27. Bony pelvis Lesser pelvis pelvic inlet (terminal line):
Pelvic outlet : formed by tip of coccyx, sacrotuberous ligament, ischial tuberosity, ramus of ischium, inferior ramus of pubic, symphysis
Pelvic cavity
Pubic arch
subpubic angle

28. Main difference between male and femal pelvis
Female
Male
Overall
Wide and short
Narrow and long
Iliac ala
More horizontal
More vertical
Inlet
Round
Oval or heart shaped
Outlet
Larger
Small
Pelvic cavity
Shallower, wide
Deep narrow
Subpubic angle
Right angle (90~1000)
Acute angle (70~750)

29. Main difference between male and femal pelvis
Female
Male
Pelvic inlet
Pelvic outet
Pelvic cavity
Pubic arch
90~1000
70~750

30. Main difference between male and femal pelvis

31. Anteroposterior radiograph of adult female pelvis.

35. Joints of free lower limb

36. ★ Hip joint 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

37. ★ Hip joint Accessory structures
Acetabulum labrum ; transverse acetebular ligament
Ligaments
Iliofemoral lig.
Ligament of head of femur
Pubofemoral lig.
Ischiofemoral ligament
Zona orbicularis
Movement: flexion, extention, adduction, abduction, medial and lateral rotation, circumduction
Acetabulum labrum
Transverse
acetebular lig.
Ligament of head of femur

38. ★ Hip joint Ischiofemoral lig. Zona orbicularis Pubofemoral lig.
Iliofemoral lig.
Ischiofemoral lig.
Zona orbicularis

40. Poterior dislocation of the hip bone
Head of femur is driven posteriorly, out of acetabulum
Poterior dislocation of the hip bone

41. ★Knee joint Bones: lower end of femur upper end of tibia patella
Articular capsule:
Superapatellar bursa
Deep infrapatellar bursa
Ala folds

42. ★Knee joint Accessory structures ligaments Meniscus Patellar lig.
Fibular collateral lig.
Tibial collateral lig. Anterior cruciate ligment
Posterior cruciate ligament
Oblique popliteal ligament
Meniscus
Medial meniscus (C-shaped)
lateral meniscus (O-shaped)

43. ★Knee joint Posterior cruciate lig. Anterior cruciate lig.
Oblique popliteal lig.
Tibial collateral lig.
Fibular collateral lig.

44. ★Knee joint
Movements: flexion and extension; flexed knee joint may be passively rotated through 700
lateral
Medial

45. Hip joint
Knee joint
Radiograph

46. Coronal T1-weighted magnetic resonance image (MRI) of the knee in an adult male.

48. Tibiofibular syndesmosis
Tibiofibular joint
Crural interosseous membrane
Anterior and posterior tibiofibular ligaments

49. Joint of foot Talocrural joint (ankle joint )
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.
Lateral lig.
Anterior talofibular lig.
Calcaneofibular lig.
Posterior talofibular lig.

50. Joint of foot Medial lig. Calcaneofibular lig.
Posterior talofibular lig.
Calcaneofibular lig.
Anterior talofibular lig.

51. Joint of foot Talocrural joint Movements: dorsiflexion (extension)
plantar flexion (flexion);
when the ankle joint is fully plantar flexed, small amounts of abduction, and adduction are possible

52. Torn fibers of anterior talofibular lig.

53. Joint of foot Intertarsal joints Talocalcaneal joint
Talocalcaneonavicular joint
Calcaneocuboid joint
Tarsometatarsal joints
Intermetatarsal joints
Metatarsophalangeal joints
Interphalangeal joints
Inversion and eversion of foot
transverse tarsal joint

54. Arches of foot
Medial longitudinal arch formed by calcaneus, talus, navicular, three cuneiforms and first to third metatarsal bones, head of talus is the keystone of this arch
Lateral longitudinal arch:
formed by calcaneus, cuboid, fourth and fifth metatarsals; cuboid is is the keystone of this arch

55. Arches of foot Tranverse arch:
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

56. Arches of foot
Normal arch
Flatfoot