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1、Chapter 2 The Arthrology,Section 3 Joints of limbs,主讲人 冯 娜,【目的与要求】,1.掌握肩关节、肘关节、腕关节、髋关节、膝 关节和踝关节的构成、特点及运动。2.掌握髋骨与脊柱间的韧带连结，骨盆的组成与分部。3.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。,The General Description,Owing to the erect standing of human being,the upper limb has been freed and more movable from weight bearing and
2、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 upper limb 1.Sternoclavicular joint胸锁关节*Composition:clavicular notch of sternum,and the first cos
3、tal 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(plane joint)3.Coracoacromial ligament喙肩韧带 Coracoacromial arch 喙肩弓,Coracoid process,acromion,)Joi
4、nts of free upper limb,1.Shoulder joint 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:Glenoid labrum盂唇 Coracohumeral ligament 喙肱韧带,Movements of shoulder joint flexion and extension;adduction and abducti
5、on;medial and lateral rotation;circumduction.,头大盂小囊松薄最易发生前下脱,2.Elbow joint 肘关节(compound joint)Composition:lower end of humerus,upper ends of radius and ulna1.Humeroulnar joint 肱尺关节2.Humeroradial joint肱桡关节3.Proximal radioulnar joint 桡尺近侧关节 Feature:Type of joint:compound joint Capsule:thin and loose a
6、nteriorly and posteriorly.,Ligaments:1.Radial collacteral ligament 桡侧副韧带2.Ulnar collacteral ligament 尺侧副韧带3.Annular ligament of radius 桡骨环状韧带Movements:flexion and extension,pronation and supination,Dislocation,medial epicondyle of the humerus,lateral epicondyle of the humerus,tip of the olecranon,3.
7、Joints between radius and ulnar 1)Proximal radioulnar joint 桡尺近侧关节 2)Distal radioulnar joint 桡尺远侧关节 3)Interosseous membrane of forearm 前臂骨间膜,4.Joints of hand1)Radiocarpal joint桡腕关节(wrist joint)CompositionJoint formed by the distal end of radius,articular disc below ulnar and scaphoid,lunate,and triq
8、uetrum of carpus.FeatureType of joint:ellipsoid joint Capsule:lax,strengthened by surrounding ligaments Movements:flexion,extension,adduction,abduction,circumduction,2)Carpometacarpal joints Carpometacarpal joint of thumb 拇指腕掌关节 Composition:trapezium and base of the first metacarpal Type of joint:sa
9、ddle joint Movement:flexion,extension,adduction,abduction,and opposition3)The others:自学,.Joints of Lower limb,)Joints of pelvic girdle 1.Sacroiliac joint 骶髂关节 Composition:auricular surface of sacrum and ilium Feature:Capsule:very tight and strengthened by ligaments,2.Vertebro-pelvic ligaments 1)Ilio
10、lumbar ligament髂腰韧带 2)Sacrotuberous ligament 骶结节韧带 3)Sacrospinous ligament 骶棘韧带 These two ligaments convert the sciatic notches the greater and lesser sciatic foramen 坐骨大、小孔,3.Pubic symphysis 耻骨联合4.Obturator membrane 闭孔膜 obturator canal 闭膜管,5.Pelvis骨盆1)Composition:2)Terminal line界线:formed by promont
11、ory of sacrum,arcuate line,pecten pubis,pubis tuberosity and upper border of pubic symphysis.3)Two portions Greater pelvis Lesser pelvis,4)Lesser pelvis 小骨盆(1)pelvic inlet 骨盆上口(terminal line):(2)Pelvic outlet 骨盆下口:formed by tip of coccyx,sacrotuberous ligament,ischial tuberosity,ramus of ischium,inf
12、erior ramus of pubis,lower border of pubic symphysis(3)Pelvic cavity(4)Pubic arch,subpubic angle,subpubic angle,骨盆的性差 男性 女性 骨盆形状 窄而长 宽而短 骨盆上口 呈心形 椭圆形 骨盆下口 狭小 宽大 骨盆腔 呈漏斗形 圆筒形 骶骨 窄长，宽短，曲度大 曲度小 骶骨岬 突出 突出 明显 不明显 耻骨下角 70 75 90 100,男性,女性,7075,90100,)Joints of free lower limb,1.Hip joint 髋关节 Composition:ac
13、etabulum and femoral head Feature:(1)Articular capsule Strengthened and thick intra-capsular fracture extra-capsular fracture,Acetabular labrum 髋臼唇 transverse acetabular ligament髋臼横韧带 Ligament of head of femur 股骨头韧带 Iliofemoral lig.髂股韧带 Pubofemoral lig.耻股韧带 Ischiofemoral ligament 坐股韧带Zona orbiculari
14、s轮匝带,(2)Accessory structures,Movements of hip joint:flexion and extension adduction and abduction rotation and circumduction,Clinical application,2.Knee joint 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
15、lig.髌韧带,Patellar lig,Tibial collaterallig.,Fibular collateral ligment 腓侧副韧带 Tibial collateral ligment 胫侧副韧带 Anterior cruciate ligment 前交叉韧带 Posterior cruciate ligment 后交叉韧带,Posterior cruciate lig.,Anterior cruciate lig.,Suprapatellar bursa 髌上囊,alar folds翼状襞,Medial meniscus内侧半月板(C-shaped)Lateral meni
16、scus外侧半月板(O-shaped)3)Movements:flexion and extension;flexed knee joint can do some rotated movements.,lateral,Medial,knee injury(three Cs,unhappy triad)Tibial collateral lig.Anterior cruciate lig.Medial meniscus,3)Tibiofibular syndesmosis 胫腓连结 Tibiofibular joint 胫腓关节 Crural interosseous membrane 小腿骨
17、间膜 Anterior and posterior tibiofibular ligaments 胫腓前、后韧带,4)Joints of foot:1)Talocrural joint 距小腿关节(ankle joint)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 fle
18、xion(flexion)2)The others:自学,Arches of foot 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?,
