《系统解剖学》教学资料section3jointsoflimb

Chapter2TheArthrology,Section3Jointsoflimbs,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。,TheGeneralDescription,Owingtotheerectstandingofhumanbeing,theupperlimbhasbeenfreedandmoremovablefromweightbearingandbecomealaboringorgan.Thejointsoftheupperlimbarechieflyforthemobilityinaction,whereasthejointsofthelowerlimbareforthestability.,.Jointsofupperlimb,)Jointsofthegirdleoftheupperlimb1.Sternoclavicularjoint胸锁关节*Composition:clavicularnotchofsternum,andthefirstcostalcartilage,sternalendofclavicle.*Feature:Articularcapsule:strong*Movements(poly-axialjoint),Interclavicularlig.,anteriorsternoclavicularlig.,costoclavicularlig.,2.Acromioclavicularjoint肩锁关节(planejoint)3.Coracoacromialligament喙肩韧带Coracoacromialarch喙肩弓,Coracoidprocess,acromion,)Jointsoffreeupperlimb,1.Shoulderjoint肩关节(ball-and-socket)Composition:headofhumerusandglenoidcavityofscapulaFeature:Typeofjoint:Capsule:Thinandloose,Accessorystructures:Glenoidlabrum盂唇Coracohumeralligament喙肱韧带,Movementsofshoulderjointflexionandextension;adductionandabduction;medialandlateralrotation;circumduction.,头大盂小囊松薄最易发生前下脱,2.Elbowjoint肘关节(compoundjoint)Composition:lowerendofhumerus,upperendsofradiusandulna1.Humeroulnarjoint肱尺关节2.Humeroradialjoint肱桡关节3.Proximalradioulnarjoint桡尺近侧关节Feature:Typeofjoint:compoundjointCapsule:thinandlooseanteriorlyandposteriorly.,Ligaments:1.Radialcollacteralligament桡侧副韧带2.Ulnarcollacteralligament尺侧副韧带3.Annularligamentofradius桡骨环状韧带Movements:flexionandextension,pronationandsupination,Dislocation,medialepicondyleofthehumerus,lateralepicondyleofthehumerus,tipoftheolecranon,3.Jointsbetweenradiusandulnar1)Proximalradioulnarjoint桡尺近侧关节2)Distalradioulnarjoint桡尺远侧关节3)Interosseousmembraneofforearm前臂骨间膜,4.Jointsofhand1)Radiocarpaljoint桡腕关节(wristjoint)CompositionJointformedbythedistalendofradius,articulardiscbelowulnarandscaphoid,lunate,andtriquetrumofcarpus.FeatureTypeofjoint:ellipsoidjointCapsule:lax,strengthenedbysurroundingligamentsMovements:flexion,extension,adduction,abduction,circumduction,2)CarpometacarpaljointsCarpometacarpaljointofthumb拇指腕掌关节Composition:trapeziumandbaseofthefirstmetacarpalTypeofjoint:saddlejointMovement:flexion,extension,adduction,abduction,andopposition3)Theothers:自学,.JointsofLowerlimb,)Jointsofpelvicgirdle1.Sacroiliacjoint骶髂关节Composition:auricularsurfaceofsacrumandiliumFeature:Capsule:verytightandstrengthenedbyligaments,2.Vertebro-pelvicligaments1)Iliolumbarligament髂腰韧带2)Sacrotuberousligament骶结节韧带3)Sacrospinousligament骶棘韧带Thesetwoligamentsconvertthesciaticnotchesthegreaterandlessersciaticforamen坐骨大、小孔,3.Pubicsymphysis耻骨联合4.Obturatormembrane闭孔膜obturatorcanal闭膜管,5.Pelvis骨盆1)Composition:2)Terminalline界线:formedbypromontoryofsacrum,arcuateline,pectenpubis,pubistuberosityandupperborderofpubicsymphysis.3)TwoportionsGreaterpelvisLesserpelvis,4)Lesserpelvis小骨盆(1)pelvicinlet骨盆上口(terminalline):(2)Pelvicoutlet骨盆下口:formedbytipofcoccyx,sacrotuberousligament,ischialtuberosity,ramusofischium,inferiorramusofpubis,lowerborderofpubicsymphysis(3)Pelviccavity(4)Pubicarch,subpubicangle,subpubicangle,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，曲度大曲度小骶骨岬突出突出明显不明显耻骨下角707590100,男性,女性,7075,90100,)Jointsoffreelowerlimb,1.Hipjoint髋关节Composition:acetabulumandfemoralheadFeature:(1)ArticularcapsuleStrengthenedandthickintra-capsularfractureextra-capsularfracture,Acetabularlabrum髋臼唇transverseacetabularligament髋臼横韧带Ligamentofheadoffemur股骨头韧带Iliofemorallig.髂股韧带Pubofemorallig.耻股韧带Ischiofemoralligament坐股韧带Zonaorbicularis轮匝带,(2)Accessorystructures,Movementsofhipjoint:flexionandextensionadductionandabductionrotationandcircumduction,Clinicalapplication,2.Kneejoint膝关节1)Composition:lowerendoffemur,upperendoftibiaandpatella2)Feature:Articularcapsule:thinandloose3)AccessorystructuresPatellarlig.髌韧带,Patellarlig,Tibialcollaterallig.,Fibularcollateralligment腓侧副韧带Tibialcollateralligment胫侧副韧带Anteriorcruciateligment前交叉韧带Posteriorcruciateligment后交叉韧带,Posteriorcruciatelig.,Anteriorcruciatelig.,Suprapatellarbursa髌上囊,alarfolds翼状襞,Medialmeniscus内侧半月板(C-shaped)Lateralmeniscus外侧半月板(O-shaped)3)Movements:flexionandextension;flexedkneejointcandosomerotatedmovements.,lateral,Medial,kneeinjury(threeCs,unhappytriad)Tibialcollaterallig.Anteriorcruciatelig.Medialmeniscus,3)Tibiofibularsyndesmosis胫腓连结Tibiofibularjoint胫腓关节Cruralinterosseousmembrane小腿骨间膜Anteriorandposteriortibiofibularligaments胫腓前、后韧带,4)Jointsoffoot:1)Talocruraljoint距小腿关节(anklejoint)踝关节Composition:lowerendsoftibiaandfibula,trochleaoftalusFeature:Articularcapsule:thinandlooseinfrontandbehind,Movements(uniaxialjoint)Dorsiflexion(extension)andplantarflexion(flexion)2)Theothers