1、.Chapter 2 The Arthrology Section 3 Joints of limbs主讲人主讲人 冯冯 娜娜.【目的与要求】【目的与要求】1.掌握掌握肩关节、肘关节、腕关节、髋关节、膝肩关节、肘关节、腕关节、髋关节、膝 关节和踝关节的构成、特点及运动。关节和踝关节的构成、特点及运动。2.掌握掌握髋骨与脊柱间的韧带连结，骨盆的组成髋骨与脊柱间的韧带连结，骨盆的组成与分部。与分部。3.了解胸锁关节、肩锁关节、骶髂关节的构成，了解胸锁关节、肩锁关节、骶髂关节的构成，足弓的构成及功能。足弓的构成及功能。.The General Description Owing to the ere
2、ct standing of human being,the upper limb has been freed and more movable from weight bearing and become a laboring organ.The joints of the upper limb are chiefly for the mobility in action,whereas the joints of the lower limb are for the stability.Joints of upper limb)Joints of the girdle of the up
3、per limb 1.Sternoclavicular joint胸锁关节胸锁关节*Composition:clavicular notch of sternum,and the first costal cartilage,sternal end of clavicle.*Feature:Articular capsule:strong *Movements(poly-axial joint)Interclavicular lig.anterior sternoclavicular lig.costoclavicular lig.2.Acromioclavicular joint 肩锁关节肩
4、锁关节 (plane joint)3.Coracoacromial ligament喙肩韧带喙肩韧带 Coracoacromial arch 喙肩弓喙肩弓Coracoid process acromion.)Joints of free upper limb1.Shoulder joint 肩关节肩关节 (ball-and-socket)Composition:head of humerus and glenoid cavity of scapula Feature:Type of joint:Capsule:Thin and loose.Accessory structures:Glenoi
5、d labrum盂唇盂唇 Coracohumeral ligament 喙肱韧带喙肱韧带 Movements of shoulder joint flexion and extension;adduction and abduction;medial and lateral rotation;circumduction.头大盂小囊松薄头大盂小囊松薄最易发生前下脱最易发生前下脱.2.Elbow joint 肘关节肘关节(compound joint)Composition:lower end of humerus,upper ends of radius and ulna1.Humeroulna
6、r joint 肱尺关节肱尺关节2.Humeroradial joint肱桡关节肱桡关节3.Proximal radioulnar joint 桡尺近侧关节桡尺近侧关节 Feature:Type of joint:compound joint Capsule:thin and loose anteriorly and posteriorly.Ligaments:1.Radial collacteral ligament 桡侧副韧带桡侧副韧带2.Ulnar collacteral ligament 尺侧副韧带尺侧副韧带3.Annular ligament of radius 桡骨环状韧带桡骨环状
7、韧带Movements:flexion and extension,pronation and supination.Dislocation.medial epicondyle of the humerus lateral epicondyle of the humerustip of the olecranon.3.Joints between radius and ulnar 1)Proximal radioulnar joint 桡尺近侧关节桡尺近侧关节 2)Distal radioulnar joint 桡尺远侧关节桡尺远侧关节 3)Interosseous membrane of f
8、orearm 前臂骨间膜前臂骨间膜.4.Joints of hand1)Radiocarpal joint桡腕关节桡腕关节(wrist joint)CompositionJoint formed by the distal end of radius,articular disc below ulnar and scaphoid,lunate,and triquetrum of carpus.FeatureType of joint:ellipsoid joint Capsule:lax,strengthened by surrounding ligaments Movements:flexi
9、on,extension,adduction,abduction,circumduction .2)Carpometacarpal joints Carpometacarpal joint of thumb 拇指腕掌关节拇指腕掌关节 Composition:trapezium and base of the first metacarpal Type of joint:saddle joint Movement:flexion,extension,adduction,abduction,and opposition3)The others:自学自学.Joints of Lower limb)J
10、oints of pelvic girdle 1.Sacroiliac joint 骶髂关节骶髂关节 Composition:auricular surface of sacrum and ilium Feature:Capsule:very tight and strengthened by ligaments.2.Vertebro-pelvic ligaments 1)Iliolumbar ligament髂腰韧带髂腰韧带 2)Sacrotuberous ligament 骶结节韧带骶结节韧带 3)Sacrospinous ligament 骶棘韧带骶棘韧带 These two ligam
11、ents convert the sciatic notches the greater and lesser sciatic foramen 坐骨大、小孔坐骨大、小孔.3.Pubic symphysis 耻骨联合耻骨联合4.Obturator membrane 闭孔膜闭孔膜 obturator canal 闭膜管闭膜管.5.Pelvis骨盆骨盆1)Composition:2)Terminal line界线界线:formed by promontory of sacrum,arcuate line,pecten pubis,pubis tuberosity and upper border o
12、f pubic symphysis.3)Two portions Greater pelvis Lesser pelvis.4)Lesser pelvis 小骨盆小骨盆(1)pelvic inlet 骨盆上口骨盆上口(terminal line):(2)Pelvic outlet 骨盆下口骨盆下口:formed by tip of coccyx,sacrotuberous ligament,ischial tuberosity,ramus of ischium,inferior ramus of pubis,lower border of pubic symphysis(3)Pelvic ca
13、vity(4)Pubic arch,subpubic anglesubpubic angle.骨盆的性差骨盆的性差 男性男性 女性女性 骨盆形状骨盆形状 窄而长窄而长 宽而短宽而短 骨盆上口骨盆上口 呈心形呈心形 椭圆形椭圆形 骨盆下口骨盆下口 狭小狭小 宽大宽大 骨盆腔骨盆腔 呈漏斗形呈漏斗形 圆筒形圆筒形 骶骨骶骨 窄长，窄长，宽短，宽短，曲度大曲度大 曲度小曲度小 骶骨岬骶骨岬 突出突出 突出突出 明显明显 不明显不明显 耻骨下角耻骨下角 70 75 90 100男性男性女性女性707590100.)Joints of free lower limb1.Hip joint 髋关节髋关节
14、Composition:acetabulum and femoral head Feature:(1)Articular capsule Strengthened and thick intra-capsular fracture extra-capsular fracture.Acetabular labrum 髋臼唇髋臼唇 transverse acetabular ligament髋臼横韧带髋臼横韧带 Ligament of head of femur 股骨头韧带股骨头韧带 Iliofemoral lig.髂股韧带髂股韧带 Pubofemoral lig.耻股韧带耻股韧带 Ischiof
15、emoral ligament 坐股韧带坐股韧带Zona orbicularis轮匝带轮匝带Ligament of head of femurAcetabular labrumTransverse acetebular lig.Ischiofemoral lig.(2)Accessory structures Iliofemoral lig.Pubofemoral lig.Movements of hip joint:flexion and extension adduction and abduction rotation and circumduction Clinical applica
16、tion.2.Knee joint 膝关节膝关节1)Composition:lower end of femur,upper end of tibia and patella2)Feature:Articular capsule:thin and loose 3)Accessory structures Patellar lig.髌韧带髌韧带Patellar lig.Tibial collaterallig.Fibular collateral ligment 腓侧副韧带腓侧副韧带 Tibial collateral ligment 胫侧副韧带胫侧副韧带 Anterior cruciate l
17、igment 前交叉韧带前交叉韧带 Posterior cruciate ligment 后交叉韧带后交叉韧带 Posterior cruciate lig.Anterior cruciate lig.Suprapatellar bursa 髌上囊髌上囊alar folds翼状襞翼状襞.Medial meniscus内侧半月板内侧半月板(C-shaped)Lateral meniscus外侧半月板外侧半月板(O-shaped)3)Movements:flexion and extension;flexed knee joint can do some rotated movements.lat
18、eralMedial从内向外，一氧化碳从内向外，一氧化碳(CO)(CO).knee injury(three Cs,unhappy triad)Tibial collateral lig.Anterior cruciate lig.Medial meniscus.3)Tibiofibular syndesmosis 胫腓连结胫腓连结 Tibiofibular joint 胫腓关节胫腓关节 Crural interosseous membrane 小腿骨间膜小腿骨间膜 Anterior and posterior tibiofibular ligaments 胫腓前、后韧带胫腓前、后韧带.4)J
19、oints of foot:1)Talocrural joint 距小腿关节距小腿关节(ankle joint)踝关节踝关节 Composition:lower ends of tibia and fibula,trochlea of talus Feature:Articular capsule:thin and loose in front and behind.Movements(uniaxial joint)Dorsiflexion(extension)and plantar flexion(flexion)2)The others:自学自学.Arches of foot 足弓足弓 Composition:tarsals and metatarsals and ligaments between them.Normal arch Flatfoot.【Question】1.Why is dislocation of the shoulder joint more commonly than dislocation of hip joint?2What are the composition and accessory structures of the knee joint?
