UPPER LIMB – BONES AND JOINTS - HUMERUS

DISTAL HUMERUS:

CONDYLE OF THE HUMERUS

Parts of condyle of humerus are:•  MEDIAL EPICONDYLE•  LATERAL EPICONDYLE•  TROCHLEA•  CAPITULUM•  OLECRANON•  COROID•  RADIAL FOSSA

HUMERUS (ARM BONE)

MEDIAL EPICONDYLE:•  gives origin to superficial flexor muscles of the forearm•  grooved posteriorly by ulnar nerve•   the ulnar nerve behind the medial epicondyle can be bumbed or compressed, causing

‘funny bone’, paresthesia

LATERAL EPICONDYLE:•  gives origin to superficial extensor muscles of the forearm

UPPER LIMB – BONES AND JOINTS - HUMERUS HUMERUS (ARM BONE)

DISTAL HUMERUS:

TROCHLEA:•   arTficial surface for arTculaTon with the proximal end (trochlear

notch) of the ulna

CAPITULUM:•   arTficial surface for arTculaTon with the head of the radius

OLECRANON:•   accomodates the olecranon of the ulna during full extension of the elbow

COROID:•   receives the coroid process of the ulna during full extension of the elbow

RADIAL FOSSA:•   accomodates the edge of the head of the radius when the forearm is fully flexedUPPER LIMB – BONES AND JOINTS - FOREARM

FOREARM – ULNA AND RADIUS

BONES OF FOREARM:

ULNA:•  is medial and longer of the two forearm bones

RADIUS:•  is the lateral and shorter bone

TWO PARALLEL BONESTHE RADIUS CAN PIVOT THE ULNASUPINATIONA AND PRONATION ARE POSSIBLE

ULNA•  medial bone

The ulna is specialized for arTculaTon with:•  the humerus proximally•  the head of the radius laterally

THE ULNA DOES NOT REACH AND DOES NOTPARTICIPATE IN THE WRIST JOINT

UPPER LIMB – BONES AND JOINTS - FOREARM

FOREARM – ULNA AND RADIUS

ULNA - PROXIMAL•  Olecranon is separated from skin by olecranon bursa•  Coronoid process is distal a]achment of brachialis muscle•  Radial notch is lateral facet for head of radius at proximal radioulnar joint

ULNA – DISTALAt the narrow distal end there are:•  head of the ulna (disc-like)•  with small conical ulnar styloid process

Distal ulna is separated from carpal bones by arTcular disc (triangular ligament) of radiocarpal joint.

The ulna does not reach the wrist joint.UPPER LIMB – BONES AND JOINTS - FOREARM

RADIUSis lateral of the two forearm bones

The radius bone includes:•  HEAD•  NECK

•  TUBEROSITY•  SHAFT•  ULNAR NOTCH•  RADIAL STYLOID PROCESS

FOREARM – ULNA AND RADIUSUPPER LIMB – BONES AND JOINTS - FOREARM

FOREARM – ULNA AND RADIUS

RADIUS:HEAD•   arTculates proximally with capitulum and medially with radial notch of ulna at

proximal radioulnar joint•   encircled by strong anular ligament except

at radial notch of ulna

NECK•   related to deep radial nerve as

it pierces supinator muscle

TUBEROSITY•   inserTon of biceps brachii tendon, just

lateral to brachial artery

ULNAR NOTCH•  medial facet for head of ulna at distal radioulnar joint

RADIAL STYLOID PROCESS•  lateral prolongaTon of radius palpable in anatomical snukoxUPPER LIMB – BONES AND JOINTS – BONES OF HAND

BONES OF HAND

BONES OF HAND

The bones of hand are following:•  THE WRIST composed of 8 CARPAL BONES – proximal and distal rows•  THE METACARPUS composed of 5 METACARPAL BONES•  THE DIGITS – each digit has 3 PHALANGES, except the thumb

CARPAL BONES•  arranged in proximal and distal rows of 4•  the carpus is concave anteriory

PROXIMAL ROW:lateral to medial: Scaphoid, Lunate, Triquetrum, and Pisiform

DISTAL ROW:lateral to medial: Trapezium, Trapezoid, Capitate, and HamateUPPER LIMB – BONES AND JOINTS – BONES OF HAND WRIST - CARPUS

CARPAL BONES – how to memorize?! lateral to medial

Scaphoid, Lunate, Triquetrum, and Pisiform (PROXIMAL ROW)Trapezium, Trapezoid, Capitate, and Hamate (DISTAL ROW)

SENTENCE:Some Lovers Try PosiTons

That They Can't Handle

UPPER LIMB – BONES AND JOINTS – BONES OF HAND WRIST - CARPUS

CARPAL BONES

PROXIMAL ROW:•  arTculates at radiocarpal joint except for pisiform

DISTAL ROW:•   arTculates with proximal row of carpal bones at midcarpal joint and with

metacarpal bones at metacarpophalangeal joints

UPPER LIMB – BONES AND JOINTS – BONES OF HAND

WRIST - CARPUS

CARPAL BONES – PROXIMAL ROW

SCAPHOID:•   arTculates with radius

and with lunate, trapezium, trapezoid, capitate

•  largest bone in the proximal row

LUNATE:•   arTculates with radius

and with scaphoid, capitate, triquetrum

TRIQUETRUM:

•   arTculates with arTculardisc of the distal radio-ulnar joint and with pisiform, lunate, hamate

PISIFORM:•  arTculates with triquetrum

CARPAL BONES – DISTAL ROW

TRAPEZIUM:•   arTculates with 1st and

2nd metacarpals and with scaphoid, trapezoid

TRAPEZOID:•   arTculates with 2nd

metacarpal and with

scaphoid, trapezium, capitate

CAPITATE:•   arTculates with 3rd

metacarpal and with scaphoid, trapezoid, hamate, lunate

HAMATE:•   arTculates with 4th and

5th metacarpals and with capitate, triquetrum

UPPER LIMB – BONES AND JOINTS – BONES OF HAND

WRIST - CARPUS

CARPAL BONES

SCAPHOID•  lies in floor of anatomical snukox

•   scaphoid fractures may not show on radiographs for 10days to 2 weeks, but deep tenderness will be present in the anatomical snukox. Deep tenderness in anatomical snukox: scaphoid fracture

TRAPEZIUM•  forms a saddle joint with 1st and 2nd metacarpal bones

HAMATE•   on its palmar surface has prominent hook of

hamate. The hook of the hamate bone frequently isfractured in racket sports and golf.

UPPER LIMB – BONES AND JOINTS – BONES OF HAND

BONES OF HAND

BONES OF HANDTHE METACARPUS composed of 5 METACARPAL BONES

METACARPAL BONES - each metacarpal consists of:•  base•  shaU•  head

The first metacarpal (of the thumb) is the thickest and shortest of these bones

The third metacarpal is disTnguished by a styloid process on the lateral side of its base

UPPER LIMB – BONES AND JOINTS – BONES OF HAND

BONES OF HAND

BONES OF HANDTHE DIGITS – each digit has 3 PHALANGES, except the thumb

PHALANGES BONES - each phalanx has:•  base•  shaU (body)•  head

Two in thumb; three each in fingers 2-5

UPPER LIMB – BONES AND JOINTS – JOINTS

JOINTS OF UPPER LIMB

JOINTS OF UPPER LIMB

•   GLENOHUMERAL (SHOULDER) JOINT•   ELBOW JOINT•   JOINTS OF WRIST•   STERNOCLAVICULAR JOINTS•   ACROMIOCLAVICULAR JOINTS•   RADIO-ULNAR JOINTS: PROXIMAL AND DISTAL•   INTERCARPALS JOINTS•   CARPOMETACARPAL JOINTS•   INTERMETACARPAL JOINTS•   METACARPOPHALANGEAL JOINTS•   INTERPHALANGEAL JOINTS

UPPER LIMB – BONES AND JOINTS – JOINTS

GLENOHUMERAL (SHOULDER) JOINT

GLENOHUMERAL (SHOULDER) JOINT TYPE:•  synovial ball-and-socket joint

ARTICULAR SURFACES:•  between head of humerus and glenoid cavity of scapula•  glenoid cavity is deepened by glenoid labrum

The glenoid cavity acceptsli

]le more thana thirdof the

humeralhead.

GLENOHUMERAL (SHOULDER) JOINT

LIGAMENTS:•  GLENOHUMERAL LIGAMENTS – INTRINSIC•  CORACOHUMERAL LIGAMENT – INTRINSIC•  TRANSVERSE HUMERAL LIGAMENT•  CORACO-ACROMIAL LIGAMENTUPPER LIMB – BONES AND JOINTS – JOINTS

GLENOHUMERAL (SHOULDER) JOINT

GLENOHUMERAL (SHOULDER) JOINTLIGAMENTS:•   intrinsic, glenohumeral ligaments are 3 fibrous bands, reinforce

the anterior part of the joint capsule, spanning between the glenoid labrum and the anatomical neck

GLENOHUMERAL (SHOULDER) JOINTLIGAMENTS:•   intrinsic, glenohumeral ligaments are 3 fibrous bands, reinforce

the anterior part of the joint capsule, spanning between the glenoid labrum and the anatomical neck

•   intrinsic, coracohumeral ligament reinforces superior part of the joint capsule, between coracoid process and the greater tubercle

•   transverse humeral ligament: runs obliquely from thegreater to the lesser tubercle (extends between tubercles

of the humerus), converts the groove into the canal fortendon of long head of biceps

•  coraco-acromial ligament spanning between acromion and coracoid process

UPPER LIMB – BONES AND JOINTS – JOINTS

GLENOHUMERAL (SHOULDER) JOINT

GLENOHUMERAL (SHOULDER) JOINTMOVEMENTS:•  joint has more freedom of movement than any other joint in the body•   freedom results from the laxity of its joint capsule and large size

of the humeral head compared with the small size of the glenoidcavity

The glenohumeral joint allows movements:•  around three axes•  and permits flexion-extension, abducTon-adducTon, rotaTon and circumducTon

Responsible for two-thirds (120°) of possible shoulder flexion and abducTon; upward rotaTon of scapula by serratus anterior and trapezius responsible for other 60°UPPER LIMB – BONES AND JOINTS – JOINTS

ELBOW JOINT

ELBOW JOINT

TYPE:•  hinge type of synovial joint, consisTng of humeroradial and humeroulnar joints

ARTICULAR SURFACES:•  the spool-shaped trochlea and spheroidal capitulum of the humerus arTculate•  with the trochlear notch (of the ulna) and concave head of the radius (radial arTculate)

ELBOW JOINT ELBOW JOINT

LIGAMENTS: MOVEMENTS:•  radial collateral ligament •   flexion and extension occur at the•  ulnar collateral ligament elbow joint•   anular ligament of the radius •   the fully extended ulna makes an angle

of approximately 1700

•   carrying angle of the elbow joint: men 10-

150, women

>150

UPPER LIMB – BONES AND JOINTS – JOINTS

WRIST JOINT

WRIST JOINT (RADIOCAR

PAL JOINT) TYPE:•  condyloid (ellipsoid) type of synovial jointARTICULAR SURFACES:•  the ulna does not parTcipate in the wrist joint•   distal end of the radius and the arTcular disc of the distal radio-

ulnar joint arTculate with the proximal row of carpal bones (except pisiform)

WRIST JOINT (RADIOCARPAL JOINT)LIGAMENTS:•  palmar radiocarpal ligaments•  dorsal radiocarpal ligaments•   and the ulnar collateral

ligaments, radial collateral ligaments

WRIST JOINT (RADIOCARPAL JOINT)MOVEMENTS:•  flexion-extension•  abducTon-adducTon•  circumducTon

UPPER LIMB – BONES AND JOINTS – JOINTS

ACROMIOCLAVICULAR JOINT

ACROMIOCLAVICULAR JOINT TYPE:•  plane type of synovial jointARTICULAR SURFACES:•  formed between acromion and lateral end of clavicle•  are separated by an incompleted wedge-shaped arTcular disc

ACROMIOCLAVICULAR JOINT (AC JOINT)MOVEMENTS:•  the acromion (of the scapula) rotates on the acromial end (of the clavicle)•  movements are associated with moTon of the physiological scapulothoracic joint•  no muscle connect the arTculaTng bone to move AC joint

Falling on an outstretched hand or apoint of the shoulder oUen dislocates the acromioclavicular joint (shoulder separaTon). Shoulder separaTon: acromioclavicular joint dislocates with tearing of the coracoclavicular ligament.

UPPER LIMB – BONES AND JOINTS – JOINTS

RADIO-ULNAR JOINTS

PROXIMAL (SUPERIOR) RADIO-ULNAR JOINT TYPE:•  pivot type of synovial joint, that allows movement of the head of the radius on the ulnaARTICULAR SURFACES:•   joints allows head of radius to rotate in ring formed by radial

notch of ulna and anular ligament, its main stabilizer•  joint shares arTcular cavity with elbow joint

Necessaryfor

pronaTonand

supinaTon offorearm,

compensaTng for lack of

rotaTon atwrist

UPPER LIMB – BONES AND JOINTS – JOINTS

RADIO-ULNAR JOINTS

PROXIMAL (SUPERIOR) RADIO-ULNAR JOINTMOVEMENTS:•  pronaTon and supinaTon of the forearm

•  supinaTon turns the palm anteriorly•  pronaTon turns the palm posteriorly

During pronaTon and supinaTon, the radius rotates.

The end of radius rotates around the head of the ulna.

LiUing a preschool child by the forearm or hand may dislocate the head of the radius from the anular ligament.

UPPER LIMB – BONES AND JOINTS – JOINTS

RADIO-ULNAR JOINTS

DISTAL (INFERIOR)

RADIO-ULNAR JOINT TYPE:•   pivot type of synovial joint, the radius moves around the

relaTvely fixed distal end of the ulnaARTICULAR SURFACES:•  joint between head of ulna and ulnar notch of radius•   fibrocarTlaginous arTcular disc (reffered as the triangular

ligament) separaTng it from radiocarpal joint

Necessary for pronaTon and supinaTon of forearm, compensaTng for lack of rotaTon at wrist

DISTAL (INFERIOR) RADIO-ULNAR JOINTMOVEMENTS:

•   pronaTon – during pronaTon of the forearm and hand, distal end of the radius rotates anteriorly and medially, crossing over the ulna anteriorly

•   supinaTon – during supinaTon, the radius uncrosses from the ulna – bones become parallel.

UPPER LIMB – BONES AND JOINTS – JOINTS

INTERCARPAL JOINTS

INTERCARPAL JOINTS (IC JOINTS) TYPE:•  plane type of synovial joints, which may be summarized as follows:

•  joints between the carpal bones of the proximal row•  joints between the carpal bones of the distal row

•   the midcarpal joint – complex joint between the proximal and distal rows of carpal bones

•  pisotriquetral joint – arTculaTon of the pisiform with the triquetrum

MOVEMENTS:•  occur with movements at the wrist joint,•  augmneTng them and increasing the overall range of movementUPPER LIMB – BONES AND JOINTS – JOINTS

JOINTS OF THE HAND

CARPOMETACARPAL JOINTS (CMC JOINTS)INTERMETACARPAL JOINTS(IM JOINTS) TYPE:•  plane type of synovial joint, except CMC joints of the thumb – it’s a saddle typeARTICULAR SURFACES:

•   CMC joint of the thumb is between the trapezium and the base of the first metacarpal – it has separate arTcular cavity

•  IM joints occur between the radial and ulnar aspects of the base of the metacarpalsMOVEMENTS:•  CMC joint of the thumb permits: flexion-extension, abducTon-adducTon or circumducTon•  the movement essenTal to opposiTon of the thumb occurs here•  2nd, 3rd, 4th digit is slightly mobile•  5th digit is moderately mobileUPPER LIMB – BONES AND JOINTS – JOINTS

JOINTS OF THE HAND

METACARPALPHARYNGEAL JOINTS (MP JOINTS)INTERPHARYNGEAL JOINTS (IP JOINTS) TYPE:

•  the metacarpalpharyngeal joints are the condyloid type of synovial joint•  the interpharyngeal joints are the hinge type of synovial jointARTICULAR SURFACES:•  MP joints: the heads of the metacarpals arTculate with the base of the proximal phalanges•  IP joints: the heads of the phalanges arTculate with the bases of distally phalangesMOVEMENTS:•  the MP joints permit movement in two planes: flexion-extensionand adducTon-abducTon•  the IP joints permit in one plane: flexion-extension