2 Joints of Upper Extremity 1-SternoclavicularSynovial-saddle2- AcromioclavicularSynovial-plane3- Glenohumeral joint(shoulder)Synovial-ball&socket213
3 1- Sternoclavicular joint Articular surfaces:- sternal end of the clavicle.- clavicular notch of manubrium sterni.- first costal cartilage.Ligaments:- costoclavicular ligament.- interclavicular ligament.- ant. & post. Sternoclavicular ligaments.Blood supply: suprascapular artery & internal thoracic artery.Nerve supply: medial supraclavicular nerve & nerve to subclavius.NB: It is divided by articular disc into two cavities.
4 2- Acromioclavicular joint Articular surfaces :- acromial end of the clavicle- lateral side of acromion process.Ligaments:Acromioclavicular ligament.- coracoclavicular ligament ( conoid & trapezoid parts) .Blood supply : suprascapular & thoracoacromial arteries.Nerve supply : suprascapular & lateral supraclavicular nerves.NB: Incompletely divided by articular disc into two compartments.Movements of both joints allow scapular rotation up to 60 degrees.
6 Elbow joint Elbow Joint type: Synovial – hinge Articular surfaces: Humeroulnar ( trochla of humerus+ trochlear notch of ulna )Humeroradial (capitulum of humerus + upper surface of head of radius)Capsule and synovial membrane are common for elbow & SRUJCapsule is attached to humerus, ulna & unular ligament. It is not attached to radius.It includes the radial, coronoid & olecranon fossae of the humerus.
7 Ligaments of the Elbow 1- Ulnar Collateral Ligament medial side – connects humerus to ulna(3 bands ant. , post. And oblique bands)2- Radial Collateral LigamentLateral side – connects humerus to radius3- Annular LigamentSurrounds radial head/holds it tightto ulna
8 Movement Muscles Affecting the Elbow: Elbow Flexors 1. Brachialis 2. Biceps brachii3. BrachioradialisElbow Extensors1. Triceps2. Anconeus
12 The Elbow and Radioulnar Joints Radial head rotates around at proximal ulnaDistal radius rotates around distal ulnaAnnular ligament maintains radial head in its jointJoint between shafts of radius & ulna held tightly together between proximal & distal articulations by an interosseus membrane (syndesmosis)substantial rotary motion between the bonesManual of Structural KinesiologyThe Elbow and Radioulnar Joints
13 Joints of Upper Extremity Proximal Radioulnar jointSynovial - pivotDistal Radioulnar jointSynovial – pivotAllows pronation and supination of forearmMiddleRadioulnar joint
14 Radioulnar Joint Proximal (superior)radioulnar joint: articulation between circumference of head of radius and radial notch of ulna .not part of “hinge” jointSynovial (pivot) jointallows for forearm pronation/supinationDistal ( inferior) radioulnar joint:articulation between head of ulna and ulnar notch of radius.Not part of wrist joint separated from it by articular disc.Synovial pivot joint.Middle radioulnar joint : fibrous syndesmosis, connect radius & ulna by interosseous membrane,
15 Muscles of radioulnar joints Radioulnar pronatorsPronator teresPronator quadratusBrachioradialis( begin movement )Radioulnar supinatorsBiceps brachii(powerful supination for flexed elbow)Supinator muscleBrachioradialis( begin movement)
17 Joints of the Upper Extremity Radiocarpal joint(wrist):Synovial-ellipsoidDistal radius with proximal row of carpals(lunate & scaphoid)Intercarpal jointsSynovial-planeCarpal-metacarpal (2-5)Trapezium-metacarpal 1stSynovial-saddleMetacarpal-phalangealSynovial-condyloidInterphalangealSynovial-hinge
18 Wrist Articulations Radiocarpal Joint Proximal portion Distal portion Most surface contact found
19 Wrist (radiocarpal ) joint Articulation between (lower end of radius + scaphoid & lunate ), (triquetral +articular disc)=== the ulna not share in the wrist joint .Ligaments :1- Ulnar collateral (styloid process of ulna to triquetral & pisiform);2- Radial collateral ligament (styloid process of radius to scaphoid bone)3- Ant. & post. Radiocarpal ligaments= thickened capsule.Relations:Ant. : carpal tunnel ?Post. : Extensor compartments?Lat.: Anatomical snuff box?Med.: Dorsal branch of ulnar nerve.
20 Extensor Compartments Anatomic snuffbox:EPL and EPBScaphoid on floorRadial a. inside
33 Movement of wrist joint Flexion: flexor carpiradialis & ulnaris + palmaris longus helped by; FDS,FDP,FPL& ABD. P.L.Extension: extensor carpiradialis longus+ brevis & extensor carpiulnaris, helped by extensors of fingures.Abduction: flexor carpiradialis+extensor carpiradialis longus & brevis, helped by Abd. P.L. + Ext.P.L.& brevisAdduction: flexor & extensor carpiulnaris.Circumduction : combination of flexion , abduction, extension & adduction.Blood supply : palmar & dorsal carpal branches of radial and ulnar arteries & palmar arches.Nerve supply : ant. & post. Interosseus nerves.
34 Joints of hand and fingures Intercarpal: plane synovialCarpometacarpal joint of (2-5): plane synovialCarpometacarpal joint of thumb: synovila saddleIntermetacarpal joints: plane synovialMetacarpophalangeal joints: synovial condyloidInterphalangeal joints : synovial hinge
35 Interphalangeal Joints of 2-5 Fingers Hinge JointsMotions
41 Stability of radius to ulna Interosseus membrane.Annular ligament.Disc of inferior radioulnar joint.Oblique cord.Supinator & pronator quadratus muscles.
42 Forces transmitted from the upper limb to axial skeleton pass through: Glenoid cavity.Coracoid process.Clavicle.Costoclavicular ligament.1st rib & sternum.And neither through acromioclavicular joint nor through sternoclavicular joint.