附肢骨连结学习资料.pptx

Joints of limbs山东大学医学院山东大学医学院 解剖教研室解剖教研室Joints of upper limb Joints of should girdle1.Sternoclavicular joint胸锁关节胸锁关节composition:sternal end of clavicle,clavicular notch of sternum,and first costal cartilage construction features:Articular capsule:strong and is reinforced by anterior and posterior sternoclavicular ligaments articular cavity has An articular disc,dividing the joint into two cavities.Movements:elevation and depression,forward and backward,rotation and circumduction of the acromial end of the clavicle.2.Acromioclavicular joint 肩锁肩锁关节关节composition:acromion and acromial end of clavicleMovement:3.Coracoacromial arch 喙肩弓喙肩弓 formed by coracoacromial ligament喙肩韧带喙肩韧带,coranoid process,and acromion,that prevents the shoulder joint from superior dislocation脱位coranoid processacromioncoracoacromial ligamentJoints of free upper limbShoulder joint 肩关节肩关节 (ball and socket)composition:head of humerus and glenoid cavity of scapulaconstruction features:head of humerus is great,glenoid cavity of scapula is shallowCapsule:Thin and lax,especially lower partAttachments:proximal to glenoid cavity;distal to anatomical neck of humerus,except medially where it is slightly distal to surgical neckTendon of long head of biceps brachii肱二头肌passes though the articular capsule.Accessory structuresGlenoid labrum盂唇盂唇:fibrocartilaginous ring on periphery of glenoid cavity.Coracohumeral ligament 喙肱韧带喙肱韧带：runs from coracoid process to greater tubercleMovements:flexion,extension,adduction,abduction,medial and lateral rotation,circumduction 左侧关节盂侧面观Glenoid labrumGlenoid cavity肩关节前脱位 Elbow joint 肘关节肘关节 composition:lower end of humerus,upper ends of radius and ulnaHumeroulnar joint 肱尺关节肱尺关节:formed by trochlear of humerus and troclear noch(hinge)Humeroradial joint肱桡关节肱桡关节:formed by capitulum of humerus and head of radius(ball and socket)Proximal radioulnar joint桡尺近侧关节桡尺近侧关节:formed by articular circumference of radius and radial notch of ulna（trochoid）construction features:Capsule:thin and lax anteriorly and posteriorly,strongly thickened on either side by collateral ligamentsLigaments:Radial collateral ligament桡侧副韧带桡侧副韧带:attached to lateral epicondyle and annular ligament of radiusUlnar collateral ligament尺侧副韧带尺侧副韧带:attached to medial epicondyle to medial border of trochlear notchMedial viewLateral view Elbow joint 肘关节肘关节Annular ligament of radius桡骨环状韧带桡骨环状韧带:attached to anterior and posterior margins of radial notch of ulna,surrounds the head of radiusMovements:flexion and extension,pronation and supinationDislocationJoints between radius and ulna Proximal radioulnar joint 桡尺近侧关节桡尺近侧关节Distal radioulnar joint桡桡尺远侧关节尺远侧关节:formed by head of ulna,ulnar notch of radius and articular disc below the ulnaInterosseous membrane of forearm 前臂骨间膜前臂骨间膜:a fibrous membrane between the shaft of radius and ulna腕关节的冠状切面（后面观）左前臂Joints of hand Radiocarpal joint桡腕关节桡腕关节(ellipsoid)composition:Carpal articular surface of radius and articular disc below the ulnaProximal row of carpal bones:scaphoid,lunate,and triquetral bonesconstruction features:Capsule:thin and lax，strengthened by surrounding ligamentMovements:flexion,extension,adduction,abduction,and circumductionIntercarpal jointsCarpometacarpal joints:Carpometacarpal joint of thumb 拇指腕掌关节拇指腕掌关节composition:trapezium and base of first metacarpal boneMovement:flexion,extension,adduction,abduction,and opposition对掌对掌Intermetacarpal jointsMetacarpophalangeal jointsInterphalangeal joints Joints of Lower limbJoints of pelvic girdleSacroiliac joint 骶髂关节骶髂关节 composition:auricular surface of sacrum and iliumconstruction features:Capsule:very tight and strengthened by ligamentsJoints between hip bone andvertebral columnIliolumbal ligament髂腰韧带:runs from transverse process of L4 and L5 to the posterosuperior part of iliac crest Sacrotuberous ligament 骶结节韧带骶结节韧带:runs from lateral margins of sacrum and coccyx to the inner margin of ischial tuberosity Sacrospinous ligament 骶棘韧带骶棘韧带:runs from lateral margins of sacrum and coccyx to ischial spine These two ligaments convert the sciatic notches the greater and lesser sciatic foramina 坐骨大、小孔坐骨大、小孔 Pubic symphysis 耻骨联合耻骨联合composition:symphysial surface and interpubic disc(fibrocartilage)Ligaments:superior pubic ligament and arcuate pubic ligamentObturator membrane 闭孔膜 obturator canal 闭膜管Bony pelvis骨盆骨盆Composition:formed by paired hip bones,sacrum,coccyx,and their articulationsIn anatomical position,anterior superior iliac spines and pubic tubercles on samecoronal planewhile the tip of coccyx and superior border of pubic symphysis on same horizontal planeTerminal line界线界线:formed by promontory of sacrum,arcuate line of ilium,pecten of pubis,pubic tubercle,upper border of pubic symphysis Two portions:a greater pelvis and a lesser pelvis Lesser pelvis 小骨盆小骨盆pelvic inlet 骨盆上口骨盆上口(terminal line):Pelvic outlet 骨盆下口骨盆下口:formed by tip of coccyx,sacrotuberous ligament,ischial tuberosity,ramus of ischium,inferior ramus of pubis,inferior margin of pubic symphysisPelvic cavityPubic arch耻骨弓,subpubic angle耻骨下角 Main difference between male and femal pelvis Main difference between male and femal pelvisFemaleMale Pelvic inlet PelvicOutlet Pelvic cavityPubic arch90100070750 Main difference between male and femal pelvis Male Female 骨盆全形骨盆全形高而狭窄高而狭窄低而宽阔低而宽阔髂骨翼峭立峭立近似水平位近似水平位骨盆上口骨盆上口较小，呈心形较小，呈心形较大，近似圆形较大，近似圆形耻骨下角耻骨下角70750901000骨盆腔骨盆腔高而窄，漏斗形高而窄，漏斗形短而宽，圆桶形短而宽，圆桶形骨盆下口骨盆下口较小较小较大较大Joints of free lower limb Hip joint 髋关节髋关节Composition:acetabulum and femoral headconstruction features:Articular capsule is thick and strong.attachmentsAbove:margins of acetabulum and transverse acetabular ligament Below:in front to intertrochanteric line;behind,to the neck of femur above 1 cm above the intertrochanteric crest Accessory structures Acetabular labrum髋髋臼唇臼唇;transverse acetebular ligament髋臼横韧带髋臼横韧带LigamentsIliofemoral lig.髂股韧髂股韧带带Ligament of head of femur 股骨头韧带股骨头韧带Pubofemoral lig.耻股耻股韧带韧带Ischiofemoral ligament 坐股韧带坐股韧带Movement:flexion,extention,adduction,abduction,medial and lateral rotation,circumductionTransverse acetebular lig.Ligament of head of femurAcetabulum labrum2 Knee joint 膝关节膝关节Composition:lower end of femur,upper end of tibia and patellaconstruction features:Articular capsule:thin and lax，superapatellar bursa髌上髌上囊囊,deep infrapatellar bursa髌下深囊髌下深囊,ala folds翼状襞翼状襞右侧膝关节Accessory structuresligamentsPatellar lig.髌韧带髌韧带Fibular collateral lig.腓侧副韧带腓侧副韧带Tibial collateral lig.胫侧副韧带胫侧副韧带 腘斜韧带腘斜韧带前交叉韧带前交叉韧带后交叉韧带后交叉韧带腓侧副韧带腓侧副韧带胫侧副韧带胫侧副韧带Oblique popliteal ligament腘斜韧带腘斜韧带Anterior cruciate ligament前交叉韧带前交叉韧带Posterior cruciate ligament 后交叉韧带后交叉韧带Medial meniscus内侧半月板内侧半月板(C-shaped)lateral meniscus外侧半月板外侧半月板(O-shaped)Movements:flexion and extension;flexed knee joint can rotate medially and laterally.lateralMedial3Tibiofibular syndesmosis 胫腓连结胫腓连结Tibiofibular joint 胫腓关节Crural interosseous membrane 小腿骨间膜Anterior and posterior tibiofibular ligaments 胫腓前、后韧带4 Joint of footTalocrural joint 距小腿关距小腿关节节(ankle joint)踝关节踝关节Composition:lower ends of tibia and fibula,trochlea of talusconstruction features:Articular capsule:thin and lax in front and behind,and supported on each side by strong collateral ligaments胫骨胫骨 距骨距骨 内侧韧带（三角韧带）内侧韧带（三角韧带）距腓前韧带距腓前韧带 跟腓韧带跟腓韧带 距腓后韧带距腓后韧带 距骨距骨 LigmentsMedial lig.内侧韧带内侧韧带Lateral lig.外侧韧带外侧韧带距腓前韧带距腓前韧带anterior talofibular lig.跟腓韧带跟腓韧带calcaneofibular lig.距腓后韧带距腓后韧带 talofibular lig.Movements:dosiflexion(extension)and plantar flexion(flexion);when the ankle joint is fully plantar flexed,small amounts of abduction,and adduction are possible.Intertarsal joints跗骨间关跗骨间关节节Talocalcaneal joint 距跟关距跟关节节Talocalcaneonavicular joint距跟舟关节距跟舟关节Tarsometatarsal joints 跗跖关节跗跖关节Intermetatarsal joints 跖骨间关节跖骨间关节Metatarsophalangeal joints 跖趾关节跖趾关节Interphalangeal joints 趾骨间关节趾骨间关节足内翻和足外翻Inversion and eversion5 Arches of foot 足弓足弓Medial longitudinal arch内侧纵弓内侧纵弓:formed by calcaneus,talus,navicular,three cuneiforms and first to third metatarsal bones,head of talus is the keystone of this arch.Lateral longitudinal arch外侧纵弓外侧纵弓:formed by calcaneus,cuboid,fourth and fifth metatarsal bones;cuboid is the keystone of this archTranverse arch横弓横弓:formed by cuboid,three cuniforms and all metatarsal bones;the intermediate cuneiform is the keystone of this archFunction:give to foot strength stability and resilience弹性;protect plantar vessels and nervesTeaching outline1.master the composition,structural features and the movement of the shoulder joint,elbow joint,radiocarpal joint,carpometacarpal joint of the thumb.2.Master the composition,portion of the pelvis,the composition of the pelvic inlet and outlet.3.master the composition,structural features and the movement of the hip joint,knee joint and the talocrural joint.4.Master the composition and function of the arches of foot.简答：简答：1 1 试述肩关节的构成、构造和运动。试述肩关节的构成、构造和运动。2 2 试述髋关节的构成、构造和运动。试述髋关节的构成、构造和运动。3 3 试述膝关节的构成、构造和运动。试述膝关节的构成、构造和运动。4 4 试述颞下颌关节特点和运动。试述颞下颌关节特点和运动。5 5 试述椎骨间的连接。试述椎骨间的连接。名词解释名词解释:椎间盘、椎间盘、Chopart Chopart 关节、半月板、覆膜关节、半月板、覆膜重点重点:肩关节、肘关节、腕关节、髋关节、肩关节、肘关节、腕关节、髋关节、膝关节、踝关节、椎间关节膝关节、踝关节、椎间关节Iliofemoral lig.Ischiofemoral lig.Pubofemoral lig.Zona orbicularis