MBS 212 Human Movement

1. MBS 212 Human Movement Lecture 7 Upper limb joints Prof. Thomas K. Monsees 2008 Prof. Monsees

2. Articulations or Joints • Articulation or Joint • Place where two bones come together • Structure correlated with movement • Classification by function (degree of movement) • Classification by structure (what is ‘between’ the articulating bones) Prof. Monsees

3. Joints: classification by function • i.e., by the degree of movement possible: • Synarthroses • Joints with little or no movement • Skull sutures, mental symphysis, teeth in sockets, 1st costosternal joint. • Amphiarthroses • Slightly moveable joints • Intervertebral discs, costosternal joints, pubic symphysis • Diarthroses • Freely moveable joints • Shoulder, knee, hip, elbow, interphalangeal, tarsal, and carpal joints Prof. Monsees

4. Classes of Joints • Structural: Based on major connective tissue type that binds bones • (Bone) • Fibrous • Cartilaginous • Synovial • Functional: Based on degree of motion • Synarthrosis: Nonmovable • Amphiarthrosis: Slightly movable • Diarthrosis: Freely movable (e.g. synovial joints) Prof. Monsees

5. Synovial joints • Most joints of the appendicular skeleton are synovial joints, reflecting the far greater mobility, compared with that of the axial skeleton Major synovial joints: • Shoulder, hip, elbow, knee, carpal, interphalangeal Prof. Monsees

6. Synovial joints • Articular cartilage on ends of bones • Bones separated by a joint cavity • Lubricated by synovial fluid secreted by synovial membrane • Enclosed in a fibrous joint capsule which holds bones together while permitting flexibility Prof. Monsees

7. Additional Synovial Structures • Articular disks: flat plate of cartilage located between articular cartilages of the bones; circumference is attached to fibrous capsule • Meniscus: incomplete, crescent-shaped fibrocartilage pad • Bursa: are basically bags of lubricant - fibrous membrane bags filled with synovial fluid. Bursitis: inflammation of bursa, may cause considerable pain around joint thus restricting movement • Tendon sheaths: some bursae extend along tendons • Accessory ligaments: Contribute to strength and stability of the joint while limiting movement - intrinsic lig are localized localized thickenings of the joint capsule. - - extrinsic lig are sepaerate from the joint capsule and may be located either inside or outside the fibrous capsule. Prof. Monsees

8. Structural classification of synovial joints • Synovial joints are described as gliding, pivot, saddle etc on the basis of the shape of the articulating surfaces • Each type of joint permits a different type and range of motion Prof. Monsees

9. Atlas & Axis Radiocarpal Prof. Monsees Hinge Ball & Socket

10. Types of Synovial Joints • Plane joints (gliding) • Articular surfaces are flat and allow short slipping or gliding movements. • Slight nonaxial or multiaxial • Intercarpal and intertarsal joints • Saddle joints • Each articular surface has convex and concave areas. Each articular surface is saddle-shaped. • biaxial • Carpometacarpal joints of the thumbs. Prof. Monsees

11. Sternoclavicular joint Prof. Monsees

12. Acromioclavicular joint Prof. Monsees

13. Coracoclavicular joint • Coracoid process of scapula + clavicle • Extremely powerful • 2 Parts • Conoid + trapezoid • Restrain opposite movements of scapula with respect to clavicle Prof. Monsees

14. a) Lat view glenoid fossa, head humerus removed coracoclavicular acromioclavicular b) Transverse humeral lig Prof. Monsees

15. Radio - Ulnar Articulations • As well as articulating independently with humerus at the elbow joint, radius and ulna also articulate with each other by 3 joints: • Proximal + distal ends by synovial joints superior + inferior radioulnar joints • Interosseous membrane as syndesmosis along their shafts (intermediate joint) Prof. Monsees

16. Radio – ulnar joints Trochlea Capitulum Head of Radius sup radioulnarj superior = proximal radioulnar j Inferior = distal Radius Ulna Interosseous M Head of Ulna Radial notch ulna inf radioulnar j Articular disc sup radioulnarj Prof. Monsees

17. Superior Inferior radio ulnar joint Prof. Monsees

18. Hand joints • Wrist • Carpal • Carpo metacarpal • Metacarpal phalangeal • Interphalangeal Prof. Monsees

19. Hand joints Radiograph MRT Prof. Monsees

20. Wrist joints Midcarpal Radiocarpal Prof. Monsees

21. Wrist joints (cont…) Metacarpal thumb Carpometacarpal Prof. Monsees

22. Wrist joints (cont…) Interphalangeal Metacarpophalangeal Prof. Monsees

23. Shoulder Joint Prof. Monsees

24. Movements of arm at shoulder joint • Abduction • Adduction • Flexion • Extension • Medial rotation • Lateral rotation • Circulation Prof. Monsees

25. M. supraspinatus • Origin • supraspinous fossa of scapula • Insertion • greater tubercle of humerus • Innervation • Suprascapular nerve (C5, C6) • Action • Rotator cuff • Initiation of abduction of arm to 15, than deltoid takes over posterior superior Prof. Monsees

26. M. Deltoideus (cont…) • Action • Major abductor of arm, abducts beyond initial 15 done by supraspinatus • Ant pt flexion + med rotation • post pt extension + lat rotation Prof. Monsees

27. Axes of movement at shoulder joint Scapula Humerus With respect to cardinal axis of body With respect to plane of glenoid fossa Prof. Monsees

28. Prof. Monsees

29. Ligaments of Shoulder Joint Prof. Monsees

30. Muscles which bind humerus to shoulder girdle • M. teres major • M. deltoideus • Rotator cuff muscles • M. Supraspinatus • M. Infraspinatus • M. Teres minor • M. Subscapularis Prof. Monsees

31. Stability of shoulder joint: action of rotator cuff muscles • Rotator cuff muscles attach very close to should joint • + fuse w lat pt capsule act as ligaments prevent lax capsule from being trapped between artic bones Prof. Monsees

32. Elbow joint Prof. Monsees

33. Synovial membrane (ant) Elbow Joint Capsule + ligaments Prof. Monsees

34. Movements of elbow joint Prof. Monsees

35. Elbow Joint • Arteriel blood supply derived from extensive anastomosis around the elbow involving brachial artery + its terminal branches: • Sup + inf ulnar collatetral branches of brachial artery • Rad + middle collateral of profunda brachii artery • Venous drainage, by vessels accompanying above arteries, is into radial, ulnar + brachial veins Prof. Monsees

36. Cubital fossa: deep (a) + superficial (b) structures Prof. Monsees

37. Prof. Monsees