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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
2、 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 upper limb 1.Sternoclavicular joint胸锁关节 *Composition: clavicular notch of sternum, and t
3、he 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 ( plane joint) 3.Coracoacromial ligament喙肩韧带 Coracoacromial arch 喙肩弓,Coracoid p
4、rocess,acromion,)Joints 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 e
5、xtension; adduction and abduction; 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 ulna 1.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 joi
6、nt: compound joint Capsule: thin and loose anteriorly 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,later
7、al epicondyle of the humerus,tip of the olecranon,3.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 hand 1) Radiocarpal joint桡腕关节 (wrist joint) Composition Joint formed by the distal end of ra
8、dius ,articular disc below ulnar and scaphoid, lunate , and triquetrum of carpus. Feature Type 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
9、关节 Composition : trapezium and base of the first metacarpal Type of joint: saddle joint Movement: flexion, extension, adduction, abduction, and opposition 3)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 Featur
10、e: Capsule: very tight and strengthened by ligaments,2.Vertebro-pelvic ligaments 1) Iliolumbar 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
11、membrane 闭孔膜 obturator canal 闭膜管,5. Pelvis骨盆 1)Composition: 2)Terminal line界线:formed by promontory 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)Pel
12、vic outlet 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 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
13、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: acetabulum 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
14、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 orbicularis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)Compositio
15、n: lower end of femur, upper end of tibia and patella 2)Feature: Articular capsule: thin and loose 3)Accessory structures Patellar lig. 髌韧带,Patellar lig,Tibial collateral lig.,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
16、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 meniscus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
