Joints of the limbs

Learning outcomes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Shoulder ( glenohumeral) joint ,[object Object],[object Object],[object Object],Articular surfaces Glenoid fossa of scapula Head of the humerus Glenoid labrum ( fibro-cartilagenous rim) Increase the depth Only 1/3 of the humeral head is in contact with the glenoid fossa

Joint capsule Margin of the glenoid fossa ( outside the labrum) Anatomical neck of the humerus Synovial membrane lines the capsule, but not the articular surfaces

Ligaments Three bands of thickening of the anterior part of the capsule Superior, middle & inferior gleno-humeral ligaments Coraco-humeral ligament from the coracoid process to the anatomical neck of humerus Long head of biceps tendon is intra-capsular and comes out beneath the transverse humeral ligament

Musculo-tendinous rotator cuff ,[object Object],[object Object],[object Object],[object Object],No rotator cuff Inferior dislocations are commoner

Dislocation of the shoulder ,[object Object],[object Object],[object Object],[object Object]

Lateral rotation Infraspinatus Teres minor Movement Muscles Flexion Pectoralis major Deltoid anterior fibers Extension Deltoid posterior fibers Teres major Abduction Suprspinatus Deltoid middle fibers Adduction Deltoid anterior & posterior fibers Pectoralis major Teres major Lattisimus dorsi Medial rotation Deltoid anterior fibers Teres major Lattisimus dorsi

Elbow joint ,[object Object],[object Object],[object Object],Articular surfaces Trochlea of humerus Capitulum of humerus Trochlear notch of ulna Upper surface of the head of radius Proximally capsule is attached to the lower end of humerus Distally to the trochlear notch of the ulna & the annular ligament of the head of radius

Ligaments ,[object Object],[object Object],[object Object],[object Object],Ulna nerve runs posterior to the ulnar collateral ligament and it is palpable at this location

Pronation & supination are NOT movements of the elbow joint Muscles Movements Flexion Biceps & brachialis Extension Triceps

Dislocation of the elbow ,[object Object],[object Object]

Wrist ( radio-carpal) joint ,[object Object],[object Object],[object Object],Articular surfaces ,[object Object],[object Object],[object Object],[object Object],Scaphoid, lunate & triquetram

Joint capsule Peripheral margin of the radius and articular disc of the inferior radio-ulnar joint Peripheral margins of the scaphoid, lunate & triquetram Head of the ulnar is NOT a component of the wrist joint

Ligaments Palmar & dorsal radio-carpal ligaments are thickenings of the capsule ,[object Object],[object Object],[object Object],[object Object]

Midcarpal joint ,[object Object],[object Object],Articular surfaces ,[object Object],Distal: trapezium, trapezoid, capitate & hamate

Movements of the wrist Movement Joint Muscle Flexion Midcarpal Flexor carpi ulnaris, Flexor carpi radialis Extension Radio-carpal Extensor carpi radialis longus & brevis, Extensor carpi ulnaris Adduction Radio-carpal Flexor carpi ulnaris & extensor carpi ulnaris Abduction Midcarpal Flexor carpi radialis & extensor carpi radialis

1 st carpometacarpal joint ,[object Object],[object Object],[object Object],Articular surfaces Trapezium Base of 1 st metacarpal bone Movements Muscles Flexion Flexor pollicis brevis & longus Extension Extensor pollicis brevis & longus Abduction Abductor pollicis longus & brevis Adduction Adductor pollicis Opposition Opponens pollicis

Metacarpo - phalangeal joints ,[object Object],[object Object],Articular surfaces Head of metacarpal Base of proximal phalanx 1 st MP joint Flexion: Flexor pollicis longus Extension: Extensor pollicis longus & brevis Movements Muscles Flexion Lumbricals Extension Extensor digitorum Abduction Dorsal interossei Adduction Palmar interossei

Inter-phalangeal joints ,[object Object],[object Object],[object Object],IP joint: Thumb Flexion: Flexor pollicis longus Extension: Extensor pollicis longus Thumb: Inter-phalngeal joint (IP) Other fingers: Proxiaml & distal inter-phalangeal joints (PIP & DIP) Movements Joint Muscles Flexion PIP Flexor digitorum superficialis & profundus DIP Flexor digitorum profundus Extension PIP Lumbricals DIP Extensor digitorum

Hip joint ,[object Object],[object Object],[object Object],Articular surfaces Lunate surface of the acetabulum Head of the femur acetabular labrum ( fibro-cartilagenous rim) Increase the depth Non articular area of the actebular fossa contains fat ( Haversian fat)

Joint capsule Margin of the actabular fossa ( outside the labrum) Anteriorly: intertrochanteric line Posterirorly: middle of the neck Synovial membrane lines the capsule, but not the articular surfaces

Ligaments ,[object Object],[object Object],[object Object],Ilio-femoral ligament is the strongest of the three ligaments and prevents anterior dislocation of the joint

Ligaments ,[object Object],Blood vessels reach the head of the femur along ligament of the head of the femur & retinacular fibers From the inferior margin of the acetabulum to the fovea of the head of the femur Joint capsule is reflected along the neck of the femur as retinacular fibers

Movement Muscles Flexion Ilio-psoas Extension Gluteus maximus Adduction Adductor longus, brevis & magnus Abduction Gluteus mediaus & minimus Medial rotation Ilio-psoas, pectineus Lateral rotation Piriformis, obturator internus , obturator externus, gemmeli & quadratus femoris

Dislocation of the hip ,[object Object],[object Object],Shenton’s line

Knee joint ,[object Object],[object Object],Articular surfaces ,[object Object],Medial & lateral condyles of tibia Articular surface of patella

Joint capsule Above the condyles of the femur Articular margins of the tibial condyles

Ligaments ,[object Object],[object Object],[object Object],[object Object],Movements Muscles Flexion Semimembranosus, semitendinosus, biceps femoris Extension Quadreceps femoris

Ankle joint ,[object Object],[object Object],[object Object],Articular surfaces ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Tibio-fibular mortise Trochlea tali

Ligaments ,[object Object],[object Object],[object Object],Movements Muscles Dorsi flexion Tibialis anterior, extensor digitorum longus, extensor hallucis longus Plantar flexion Gastrocnemius & soleus ( tendo-calcaneus)

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Metatarso phalangeal joints ( flexion, extension, abduction & adduction) Interphalangeal joints ( flexion & extension)

Joints of the limbs

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Joints of the limbs