THIS IS FOCUSED ON THE SECOND PRACTICAL

GENERAL LIMB

ARTHROLOGY, JOINTS OF THE UPPER

Continuous joints between bones: syndesmosis, synchondrosis, synostosis examples. Synovial (discontinuous) joints between bones: Detailed description of synovial joint (articular surfaces, capsule, joint cavity.). Additional features (ligaments, disci and menisci, articular lips ..). Types of synovial joints (number of axes, number of articular surfaces, shape of atricular surfaces ball and socket, plane, hinge).

Synovial joints of the upper limb: Sternoclavicular j.,acromioclavicular j. shoulder j., elbow j. (cubital j.) distal radioulnar j. radiocarpal j. (wrist j.); intercarpal, mediocarpal, carpometacarpal, metacarpophalangeal (I V) proximal and distal interphalangeal joint.

Movements of the upper limb. How to describe the joints:

English and Latin name, classification of joint (simple composed, number of axes), type of joint shape of articular surfaces, articular capsule and ligaments, additional intracapsular features (disks, menisci), palpable landmarks, movements,

anatomical position and midposition.

PREPARATION FOR PRACTICAL CLASS: Kahle, Platzer: Locomotor System (Vol. 1): pp. 22-29, 114-133 (4th Ed.); pp. 22-29, 116-135 (4th Ed.). Grants Atlas: pp. 379, 383, 402-9, 446-450

General arthrology joints of the upper limb

Study of connection among the bones Joints = articulations movable or non-movable Passive movement We have two types of interconnections between bones: 1. Continous joint a. No or minimal movement b. Bones are firmly connected by fibrous connective tissue 2. Discontinous joint a. Movable contact in two ends i. Called synovial joints 1. The only contact goes through surfaces, but there is no contact between them ii.The bones has a external covering without opening of the bone 1. Passive movement they have to wait for muscles to move Quote Zlizova

Continous joint
No or minimal movement Syndesmosis fibrousjoint (Synd= something which is in common) A syndesmosis of two bones is a joint where two bones are joined by collagenous or elastic tissue E.g.: The intraosseous membrane Between the radius and ulna is a very taut (tight) syndesmosis consisting of collagenous connective tissue Only allows a very little movement

Go along the bodies of the bones and keep them in place (Also where muscles originate)

E.g.: Ligament (ligament flava) Between the vertebral arches / vertebral column More elastic syndesmosis These are strips of connective tissue, some long, some very short. Most lay around the joint, which can help to keep the joint in position during movement. A strengthening ligament not so soft, but softer than bones and cartilage. E.g.: Sutures of the skull - Very thin strips of connective tissue Three types: Serrate suture Saw-like edges Sagittal / squamous suture Two bones are sutured together Typical for calvaria, the upper part of cranium In newborns these sutures are larger due to better movement. Plane suture As between nasal bones E.g.: Gomphosis Root of the teeth are interconnected with fossa of bone. Mandible (jaw) or maxilla (upper jaw) Between the borders / margins and fossa, there are small interconnective fibres This is very short ligaments. They are not locked, but their function is to aabsorb pressure, so the teeth will not fracture that easily. Small movements is therefore allowed.

Synchondrosis cartilaginous joint Two bones that are interconnected by cartilage Hyaline cartilage which is very strong, but also very flexible and elastic. For example: Epiphysial disks (growth cartilage in long bones) Between 1,6 and 7th ribs, and the sternum Intervertebral disks Hard-fusion of cartilage and vertebrae Can move because we press it in the course of movement Firmly attached Trachea, larynx, tip of nose

Symphisis Similar to cartilage, but also consist of fibrocartilage and connective tissue. In adult human body: Connective tissue + cartilage interconnect right and left pelic bone In newborns we can find small symphesis of the middle jaw which later will be mental protuberance. Syntosis Bony tissue the firmest joints The bones start to develop as different bones in embryonical stages, but fuse together. E.g.: Pelvis, coccygeal, sternum bone. Clin.tip: Ankylosis stiffened joint. Was movable but not anymore. A syntosis of bones.

Discontinous joints synovial joints

Movable contact of two ends of bone Also called diarthroses

Consists of: 1. Articular surfaces (cartilage) 2. Articular capsule 3. A joint cavity + synovial fluid 1. Articular surfaces a. Articular end of bones (cartilage) i. Always two articular surfaces 1. Usually covered by Hyaline cartilage, and occasionally by fibrous cartilage or connective tissue b. Nourished by the synovial fluid and by diffusion from capillaries in the synovial membrane 2. Articular capsule (joint capsule) a. Fixed to bones, go always over two ends. i. Is completely closed, and the cavity is filled by fluid. b. Can be loose or taut i. Consist of two layers; 1. The inner synovial membrane 2. The outer fibrous membrane c. Contains elastic fibres, blood vessels and nerves 3. Joint cavity + synovial fluid a. Important for nutritions b. Normal supply is by vessels and arteries

i. The fluid is there because the cartilage has no arteries or vessels ii.Aslo there for lubrication of the joint ends c. Some nutrition can be taken from the surface of the bones i. The most important nutrition is from these synovial fluids: 1. Two layers of membrane in joint capsule a. Outside fibrous membrane b. Inside synovial membrane i. Which produce synovial fluid from capillaries etc

Additional features
Ligaments Extracapsular, capsular or intracapsular. Describes where the ligaments are placed on outside, or inside of capsule Can be: Reinforcing ligaments for joint capsule Guiding ligaments in movements Restrictive ligaments to restrict movements E.g.: ACL anterior cruciate ligament (ligaments in cross in the knee) Articular disks (Menisci articulares) Structure that helps moving the joint Consist of collagenous connective tissue with fibrocartilage A disk divides the joint cavity completely A meniscus divides the joint cavity partly Articular libs (labra) Labra articularia Consist of collagenous connective tissue Helps to enlarge the joint surface Synovial bursae and synovial pockets Lined with the synovial membrane Form small or large sacks Weak point in joint, but enlarge the joint space Articular muscles Muscles that guarantee a certain degree of contact between the articular surfaces Small muscles attached directly to capsule Not necessary for movement, only for reinforcing.

Main movements of the synovial joints:

Flexion extension (Elbow opposite movement along one axis) Abduction - adduction (Along one axis) Rotation (supination pronation) Depression elevation Circumduction (is not a simple movement!!) When you swing your arm around, or your wrist around, its a sircular movement, and a compound movement.

Classification of the synovial joints (in the whole body!!)

Related to: 1. Numer of axes a. Mono-, bi-, three-axial joints 2. Degrees of freedom a. Mobility of bones against each other. b. Divided into two- or three degrees of freedome. c. Free or limited joints. Can be same terminology as 1,2,3 axes, but theoretically if a joint have 3 axes. E.g. clavicle. Function of the joints is limited. Degree of freedome in clavicle is TWO AXIS. d. E.g. mandible if one of the joints in jaw are blocked, other one cant move. e. Similar in the elbow radius have 3 axisbut is limited because of the trochlea, and its own attachment to ulnar 3. Number of articular surfaces a. Simple joints i. 2 bones two articular surfaces are in contact lying in one capsule b. Compound joints i. 3 or more than three bones ii.Or with meniscie e.g. knee joint 4. Shape of articular surfaces a. Study and find out how many axises there is: i.Plane joints 1. Flat intervertebral joint 2. Two flat surfaces. Two degrees of freedome. 3. Bones between achromion and clavicle small flat bone.

ii.Hinge joints / ginglymus joints 1. Cylindrical articulation 2. A ledge shaped elevation fits into the convex one. 3. E.g. elbow trochlea into trochlear notch of ulna iii.Trochoid joints pivot and rotary joints 1. Moves by rotation 2. Along the axis one degree of freedom iv.Ellipsoidal joint 1. Radiocarpal joints 2. A convex and a concave elliptical joint surface 3. Two degrees of freedom two axes v.Saddle (sellar) joint 1. Two axis of movement, but multiaxial. a. Circumduction is possible 2. Surface is a line which is s-shaped from both sides 3. Carpometacarpal joint of the thumb vi.Ball and socket joint / spheroidal joints 1. Sholder and hip 2. Three degrees of freedome, three axis. vii.Amphiarthosis arthrosis joint without movement 1. A special type 2. Both ligaments and the capsule are taut and the articular surface is rough.

Joints of the upper limb

Sholder girdle: Scapula Clavicle Sternoclavicular joint Acromioclavicular joint Bracheum Sholder joint Elbow joint (cubital joint) Humeroradial joint Humeroulnar joint Proximal radioulnar joint Antebracheum Radius Ulna Distal radioulnar joint Radiocarpal joint (wrist joint) Manus Intercarpal joint Carpmetacarpal joint (I-V)

Metacarpophalangeal joint

Fingers Interphalangeal proximal joint Interphalangeal distal joint