JOINTS OF THE UPPER LIMB

1. JOINTS OF THE UPPER LIMB Victoria Gugenheim Body Art Kaan Yücel M.D., Ph.D. • 06.January.2014 Monday

2. JOINTS OF THE UPPER LIMB Joints of the pectoral girdle 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

3. JOINTS OF THE UPPER LIMB Joints of the pectoral girdle 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

4. STERNOCLAVICULAR JOINT the only articulation between upper limb & axial skeleton Articulation between Sternum & clavicle Saddle typefunctions as a ball-and-socket joint Articulardisc Sternalend of clavicle v.s. Manubrium& 1st costal cartilage

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

6. MOVEMENTS OF THE STERNOCLAVICULAR JOINT Strong but mobile Raising theclavicle(60°) duringfullelevation of thelimb Onceelevation is completedviaflexion; rotation of theclavicle arounditslongitudinalaxis Anterior and posterior movements of the clavicle

7. 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 Articulardisc Acromialend of clavicle v.s. Acromionof scapula

8. LIGAMENTS OF THE ACROMIOCLAVICULAR JOINT Intrinsic ligament Acromioclavicularligament Extrinsic ligament Coracoclavicular ligament conoid ligament (medial) trapezoid ligament (lateral)

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

10. 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 Glenoidlabrum(L., lip) • MORE IMAGES • 114-122

11. LIGAMENTS OF THE GLENOHUMERAL (SHOULDER) JOINT Glenohumeralligaments Coracohumeral ligament Transverse humeral ligament 4. Coracoacromialligament Jointstability coraco-acromialarch

12. MOVEMENTS OF THE GLENOHUMERAL (SHOULDER) JOINT Flexion & extensionof the humerus Abduction & adductionof the humerus Medial &lateral rotation of the humerus Circumduction

13. BURSAE AROUND THE GLENOHUMERAL (SHOULDER) JOINT

14. ELBOW JOINT 2-3 cm inferior to the epicondyles of the humerus Articulation betweenHumerus, ulna and radius Hinge type Trochleaof humerusv.s. Trochlearnotch of ulna Capitilum of humerusv.s. Head of radius

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

16. 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

17. BURSAE AROUND THE ELBOW JOINT

18. PROXIMAL (SUPERIOR) RADIO-ULNAR JOINT Articulation between Radius and ulna proximally Pivot type Headof radius v.s. Radialnotch ofulna Anularligament Supination & pronation • MORE IMAGES • 133 -134

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

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

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

22. MOVEMENTS OF THE WRIST JOINT Proximal & Distal Radioulnar joints Mostadduction @ wristjoint Abduction from the neutral position occurs @ midcarpaljoint. Flexion of thehand> Extension of thehand Adduction of thehand > Abduction of thehand

23. INTERCARPAL JOINTS Planetype • Joints between carpal bones of the proximal row • Joints between carpal bones of the distal row • Midcarpal jointbetween proximal &distal rows of carpal bones • Pisotriquetral jointpisiform with palmar surface of triquetrum Anterior, posterior, and interosseous ligaments

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

25. CARPOMETACARPAL & INTERMETACARPAL JOINTS Palmar and dorsal carpometacarpal ligaments Palmarand dorsal intermetacarpal ligaments Interosseus metacarpal ligaments Superficial and deep transverse metacarpal ligaments

26. METACARPOPHALANGEAL & INTERPHALANGEAL JOINTS • MORE IMAGES • 135-138 Metacarpophalangealjoints condyloidtype biaxialplane: flexion-extension and adduction-abduction Interphalangealjoints hinge type uniaxialflexion-extension only

27. IC Intercarpaljoints CMC Carpometacarpaljoints except of thethumb IM Intermetacarpaljoints AC Acromioclavicularjoint AC • CMC • IC IM