Joints Of Upper Extremities

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Joints Of Upper Extremities
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Sternoclavicular Joint

• a saddle joint - the only bony joint between
  axial skeleton upper limb
• clavicle sits in a saddle socket formed by
  superolateral manubrium 1st costal cartilage

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Sternoclavicular Joint

• 1. fibrous capsule - surrounds entire joint,
  reinforced by ligaments
• a. synovial capsule - lines fibrous capsule
  both sides of disc
• b. lateral medial synovial membranes line 2
  cavities on either side of disc
• 2. articular disc - mostly fibrocartilage -
  strong, thick, very dense
• a. attached superiorly - to medial end of
  clavicle        inferiorly - to junction btw
  manubrium 1st costal cartilage
• b. continuous with sternoclavicular ligament
• c. absorbs shock prevents medial displacement
  of clavicle

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Sternoclavicular Joint

• 3. anterior, posterior sternoclavicular ligaments
  - thickenings of the fibrous capsule
• 4. Interclavicular ligament - also a thickening
  of fibrous capsule - across the jugular notch
• 5. costoclavicular ligament - extracapsular a.
  extends from 1st rib cartilage to inferior
  medial end of clavicleb. limits elevation of
  clavicle at medial end
• 6. Nervous input - medial supraclavicular
  branches nerve to the subclavius (C5, C6)
• 7. Circulatory supply - branches of internal
  thoracic suprascapular arteries

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Acromioclavicular Joint

• A plane gliding joint between lateral clavicle
  anterior, medial end of acromion
• Fibrocartilage covers both articulating surfaces

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Acromioclavicular Joint

• 1. fibrous capsule - surrounds joint, reinforced
  by acromioclavicular ligament trapezius
• synovial capsule - lines fibrous capsule
• 2. acromioclavicular lig - from superior, lateral
  end of clavicle to superior surface of acromion
• 3. coracoclavicular lig - extrinsic to capsule
• reinforces lateral clavicle to coracoid process
  of scapula, 2 parts
• a. conoid ligament - medial, twisted
• b. trapezoid ligament - lateral to the conoid

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Acromioclavicular Joint

• 4. articular disc - fibrocartilage wedge projects
  down from articular capsule into joint
• 5. Nervous input - branches of axillary, lateral
  pectoral, supraclavicular nerve (C5, C6)
• 6. Circulatory supply - branches of suprascapular
  thoracoacromial arteries

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Shoulder Joint

• humerus in glenoid fossa - hyaline cartilage
  covers articulating surfaces
• a ball socket joint - spheroidal - highly
  mobile (not terribly stable)

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Shoulder Joint

• 1. glenoid labrum - fibrocartilaginous rim -
  enlarges effective size of glenoid
• 2. fibrous capsule - surrounds joint, from base
  of coracoid to neck of humerus
• fairly loose thin, reinforced by ligaments
  rotator cuff muscle group
• synovial membrane - lines capsule, surrounds head
  of biceps long head in groove
• 3. glenohumeral ligaments - superior, middle,
  inferior thickenings of anterior capsule
• extend from supraglenoid tubercle (scapula) to
  neck lesser tubercle of humerus
• 4. transverse humeral ligament from greater to
  lesser tubercle (humerus) holds biceps long head

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Shoulder Joint

• 5. coracohumeral ligament from lateral coracoid
  to anterior neck of humerus, by greater tubercle
• 6. coracoacromial arch coracoid acromion
  processes coracoacromial ligament
• prevents superior displacement of humerus
• 7. coracoacromial ligament D shape - base on
  coracoid, apex at acromion, covered by deltoid

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Shoulder Joint

• 8. bursae cushion between skin bony
  prominences, or between tendons bone, ligament,
  other tendon
• a. subscapular bursa - between subscapularis
  tendon neck of scapula
• communicates with cavity thru an opening in the
  capsule
• b. subacromial/subdeltoid bursa between deltoid,
  supraspinatus tendon fibrous capsule
• 9. Nervous input - branches of axillary, lateral
  pectoral, supraclavicular nn (C5, C6)
• 10. Circulatory supply - branches of ant post
  circumflex humeral, suprascapular arteries

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Shoulder Dislocation
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Glenoid Labrum Tears
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Elbow Joint

• a hinge joint - uniaxial - flexion/ extension
  movement

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Elbow Joint

• 1. articulations - hyaline cartilage covers
  articular surfaces
• a. humeroulnar btw trochlea of humerus
  trochlear notch of ulna - hinge joint
• b. humeroradial btw capitulum of humerus head
  of radius - gliding joint
• c. proximal radioulnar joint btw head of radius
  radial notch of ulna - pivot joint
• 2. fibrous capsule - encloses joint from coronoid
  process in front to olecranon posteriorly
• reinforced especially on sides by collateral
  ligaments
• lined by synovial membrane - protrudes between
  annular ligament head of radius as sacciform
  recess

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Elbow Joint

• 3. collateral ligaments - intrinsic, thickenings
  of capsule
• a. radial apex from lateral epicondyle of
  humerus to base at annular ligament of radius
• b. ulnar a big D - apex from medial epicondyle
  of humerus to     anterior band - base at
  coronoid process tubercle (ulna)     posterior
  band - base at medial edge of olecranon     the
  two bands are joined by oblique band
• 4. annular ligament U-shaped band from ant to
  post sides of radial notch holds radius to ulna
• 5. nervous input branch of musculocutaneous,
  radial ( ulnar, median, ant interosseous) (C5-7)
  
• 6. circulatory supply elbow anastomosis - formed
  by ulnar radial recurrents, collaterals

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Wrist

• condyloid/ellipsoidal joint
• between radius, articular disc (binds ends of
  radius ulna) scaphoid, lunate, triquetral

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Wrist

• 1. radiocarpal ligaments - dorsal palmar -
  strengthen fibrous capsule
• 2. collateral ligaments
• a. radial - along lateral side from radius, over
  scaphoid, trapezium to metacarpal I
• b. ulnar - along medial side from ulna, over
  trequetral, pisiform, hamate to metacarpal V
• 3. Nervous ant inteross br of median post
  inteross br of radial dorsal deep branches of
  ulnar
• 4. Circulatory supply dorsal palmar carpal
  arterial arches (anterior posterior
  interosseous artery, to distal radioulnar joint)

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Wrist

• Intercarpal, Carpometacarpal Intermetacarpal
  Joints - gliding plane joints

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Fingers

• Metacarpophalangeal Interphalangeal Joints -
  condyloid hinge joints

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Finger

• 1. collateral ligaments - obliquely across sides
  of joints
• 2. palmar ligaments plates - transversely across
  center of joints
• deep transverse metacarpal ligaments - hold
  together 2-5 metacarpals - between plates
• 3. extensor expansion hoods - dorsal side of
  fingers
• 4. Nervous digital nerve from median ulnar
• 5. Circulatory supply digital a. from
  superficial palmar arterial arches