Connections of the bones of the free upper limb

Connections of the bones of the free upper limb

This group includes the connections of the bones of the free upper limb with the girdle of the upper limb (scapula), as well as with each other.

Shoulder joint , articulatio humeri

(Fig. 4.25).

Rice. 4.25. Shoulder joint, articulatio humeri

(frontal section).

1 – acromion; 2 – articulatio acromioclavicularis; 3 – caput humeri; 4 – cavitas articularis articulationis humeri; 5 – cavitas glenoidale (scapulae); 6 – clavicula; 7 – scapula; 8 – labrum glenoidale; 9 – recessus subaxilaris cavitae articularis; 10 – tendo m. bicipitis brachii (caput longum); 11 – vagina synovialis tendinis m. bicipitis brachii (caput longum); 12 – m.deltoideus; 13 – bursa subdeltoidea.

1. Shoulder joint, art. humeri.

2. Bones forming the joint: head of the humerus, caput humeri

, and the glenoid cavity of the scapula,
cavitas glenoidalis scapulae
;
The articular surface of the head of the humerus is one third of the surface of the ball. The glenoid cavity is oval in shape and covers only a quarter of the surface of the head. The articular surfaces are covered with hyaline cartilage and are complemented by the articular lip, labrum glenoidale.
3. The joint capsule is thin, loose, and gathers into folds when the limb is lowered. It is attached to the scapula along the edge of the articular labrum, and on the humerus along the anatomical neck, collum anatomicum

, while both tubercles remain outside the joint cavity.

4. In appearance – a simple joint, art. simplex.

5. The shape is typical spherical.

6. By the number of axes of rotation - multi-axis.

7. Movements:

– around the frontal axis – flexion and extension;

– around the sagittal axis – abduction to the horizontal level and adduction;

– around the vertical axis – rotation of the shoulder in and out;

– when moving from one axis to another – circular motion.

8. Fixing apparatus: coracohumeral ligament, lig. coracohumerale

;
articular-brachial ligaments, ligg.
glenohumeralia .

In addition to the ligaments, the joint capsule is strengthened by the fibers of the tendons of neighboring muscles: mm. supraspinatus

,
infraspinatus, teres minor, subscapularis.
9. Accessory elements of the joint: The joint is supplemented by a labrum that increases congruence.

Morpho-functional features:

– incongruent joint;

– auxiliary element – ​​articular labrum, labrum glenoidale;

– presence of an extra-articular ligament, lig. coracohumerale;

– the tendon of the long head of the brachialis muscle passes through the joint cavity , m. biceps brachii

;

– the synovial membrane forms the synovial bursa of the subscapularis muscle, bursa subtendinea m. subscapularis

.
In the axillary cavity, the joint capsule forms the axillary synovial bursa , bursa synovialis axillaris.
10. Blood supply, venous and lymphatic drainage, innervation:

Elbow joint , articulatio cubiti

(Fig. 4.26 – 4.28).

1. Elbow joint, art. cubeti

.

2. Bones forming the joint: humerus, humerus

;
ulna, ulna
;
radius, radius
.
Consists of three joints - humeroulnar, art.
humeroulnaris ;
brachioradialis, art.
humeroradialis ;
proximal radioulnar, art.
radioulnaris proximalis .
Articular surfaces: humeroulnar joint - block of the humerus, trochlea humeri
;
trochlear notch of the ulna, incisura trochlearis ulnae
;
humeroradial joint - head of the condyle of the humerus, capitulum humeri
;
fossa of the head of the radius, fossa capitis radii
;
proximal radioulnar joint - articular circumference of the radius, circumferentia articularis radii
, and radial notch of the ulna,
incisura radialis ulnae.
3. The joint capsule is attached along the edge of the articular surfaces: on the humerus the capsule captures the fossa olecrani, fossa coronoidea et fossa radialis,

leaving the epicondyles outside the joint cavity; on the ulna – along the edge of the articular surfaces; on the radius - along its neck.

4. Looks like a complex joint , art. composita

.

5. Shape – helical, art. сochlearis.

In this case, the shape of the articular surfaces of each of the joints that make up the elbow joint is as follows: at the humeroulnar joint - trochlear, at the humeroradial joint - spherical, at the proximal radioulnar joint - cylindrical.

6. Functionally – uniaxial.

7. Movements: around the frontal axis - flexion and extension, flexio et extensio.

8. Fixing device:

– collateral ulnar ligament , lig. collaterale ulnare

;

– collateral radial ligament , lig collaterale radiale

;

– annular ligament of the radius, lig. annulare radii.

9. There are no auxiliary elements of the joint, except for ligaments.

10. Blood supply, venous and lymphatic drainage, innervation:

Rice. 4.28. Elbow joint (vertical section).

1 – trochanter humeri; 2 – cavitas articulationis; 3 – olecranon; 4 – incisura trochlearis ulnae; 5 – processus coronoideus ulnae.

Connection of the bones of the forearm. The epiphyses of the ulna and radius are connected to each other by means of the proximal and distal radioulnar joints, artt.radioulnaris proximalis et distalis

.
The proximal radioulnar joint is enclosed within the elbow joint capsule and has been described above. In addition, the bones of the forearm are connected to each other through syndesmosis: the interosseous membrane of the forearm, membrana interossea antebrachii
(Fig. 4.29).

Rice. 4.29. Elbow joint and joints of the bones of the forearm (the cavity of the elbow joint is opened).

1 – humerus; 2 – capitulum humeri; 3 – trochanter humeri; 4 – cavitas articularis; 5 – tuberositas ulnae; 6 – corpus ulnae; 7 – membrana interossea antebrachii; 8 – art. radioulnaris distalis; 9 – corpus radii; 10 – chorda obliqua; 11 – tendo m.bicipitis brachii (cut off); 12 – lig. anulare radii; 13 – caput radii; 14 – capsula articularis.

Distal radioulnar joint , art. radiaulnaris distalis

(Fig. 4.29, 4.30).

1. Distal radioulnar joint, art. radioulnaris distalis.

2. Bones forming the joint: ulna, ulna

;
radius, radius
;
articular surfaces: articular circumference of the ulna, circumferentia articularis ulnae
, and ulnar notch of the radius,
incisura ulnaris radii.
3. Joint capsule: free, strong, attached to the edges of the articular surfaces and articular disc.

4. In appearance – combined, art. combinatoria (with proximal),

rotator cuff.

5. Shape – cylindrical, art. trochoidea,

Rice. 4.30. Wrist joint, art. radiocarpea

; joints and ligaments of the hand, right (incision in the frontal plane).

1 – ossa metacarpea; 2 – ligg. interosseaе intermetacarpeae; 3 – artt. carpometacarpeae; 4 – art. carpometacarpea pollicis; 5 – os trapezium; 6 – os trapezoideum; 7 – os capitatum; 8 – lig. collaterale carpi radiale; 9 – os scaphoideum; 10 – art. radiocarpeum; 11 – os lunatum; 12 – radius; 13 – ulna; 14 – recessus sacciformis; 15 – art. radiocarpeum distalis; 16 – discus articularis; 17 – lig. collaterale carpi ulnare; 18 – os triquetrum; 19 – os pisiforme; 20 – ligg. intercarpeae interosseae; 21 – os hamatum; 22 – ligg. intercarpeae.

6. By the number of axes of rotation - uniaxial.

7. Movements: around a vertical axis - rotation, rotatio

(inward rotation - pronation,
pronatio
, and outward rotation - supination,
supina-tio
).

8. Fixing device:

– radial collateral ligament of the wrist, lig. collaterale carpi radiale

;

– ulnar collateral ligament of the wrist, lig. collaterale carpi ulnare

;

– palmar radiocarpal ligament, lig. radiocarpeum palmare

;

– dorsal radiocarpal ligament, lig. radiocarpeum dorsale.

9. Auxiliary elements of the joint: articular disc, discus articularis

, separating the cavity of the distal radioulnar joint from the cavity of the radiocarpal joint.

10. Blood supply, venous and lymphatic drainage, innervation:

Wrist joint, art. radiocarpea

(Fig. 4.30).

1. Wrist joint, art. radiocarpea.

2. Bones forming the joint: radius, radius

, and the proximal row of carpal bones (scaphoid,
os scaphoideum
, lunate,
os lunatum
, triquetrum,
os triquetrum
);
articular surfaces: carpal articular surface of the radius and triangular disc, facies carpalis radii et discus triangularis
;
radial articular surface of the scaphoid, lunate, triquetrum bones, facies articularis radialis ossa scaphoideum, lunatum, triquetrum.
3. Joint capsule: attached along the edge of the articular surfaces, elastic, reinforced on all sides by powerful ligaments.

4. By type: complex joint, art. composita

;

5. Shape – ellipsoidal, art. ellipsoidea.

6. By the number of axes of rotation - biaxial.

7. Movements: around the frontal axis - flexion and extension, flexio et extensio

;
around the sagittal axis - abduction and adduction, adductio et abductio
;
transition from the frontal axis to the sagittal - circular (conical) movement, circumductio.
8. Fixing apparatus: radial collateral ligament of the wrist, lig collaterale carpi radiale;

ulnar collateral ligament of the wrist,
lig.
collaterale carpi ulnare ;
palmar wrist ligament, lig.
radiocarpeum palmare ;
dorsal radiocarpal ligament, lig.
radiocarpeum dorsale. 9. The auxiliary apparatus of the joint, except for ligaments, is absent.

Feature: the ulna does not take part in the formation of this joint, since it is separated from it by a triangular disc, discus triangularis

.

10. Blood supply, venous and lymphatic drainage, innervation:

Connections of the bones of the hand (Fig. 4.31, 4.32).

Intercarpal joints , are formed between the bones of the wrist . intercarpeae

, flat in shape and practically motionless.
From this group the midcarpal joint , art.
mediocarpea , S-shaped and located between the bones of the proximal and distal rows of the wrist.
When the midcarpal and radiocarpal joints are combined, the hand joint , art.manus,
.
These joints are strengthened by the radiate carpal ligament, lig.
carpi radiatum , as well as palmar intercarpal ligaments,
lig.
intercarpalia palmaria. The four bones of the second row of the wrist, the II-IV metacarpal bones are firmly connected to each other and mechanically form the solid base of the hand. Particularly important is the saddle carpometacarpal joint of the thumb , art. carpometacarpea pollicis

, in which various movements are performed, which plays an important role in work activity.

Rice. 4.31. Ligaments of the wrist joint and joints of the hand (dorsal surface).

1 – lig. collateralis ulnaris carpi; 2 – lig. collaterale radiale carpi; 3 – lig. radiocarpeum dorsale; 4 –ligg. carpometacarpalia dorsalia; 5 – ligg. metacarpalia dorsalia; 6 – ossa metacarpalia; 7 – ligg. collateralia; 8 – artt. metacarpophalangeae; 9 – ligg. collateralia art. interphalangeae.

Rice. 4.32 Ligaments of the wrist joint and joints of the hand (palmar surface):

1 – lig. collateralis ulnaris carpi; 2 – lig. radiocarpeum palmare; 3 –– lig. collaterale radiale carpi; 4 –lig. radiale metacarpeae; 5 – ligg. carpometacarpalia palmaria; 6 – ligg. metacarpalia palmaria; 7 – ossa matacarpalia; 8 –log. collateralia; 9 – art. metacarpophalangea digiti minimi; 10 – lig. metacarpale transversum profundum; 11 – ligg. collateralia art. interphalangeae

The necessary basic information about the connections of the bones of the hand, according to the scheme for describing the joints, is proposed in Table 4.8:

Table 4.8

Connections of the bones of the upper limb

1-ulna; 2-distal radioulnar joint; 3-ulnar collateral ligament of the wrist; 4-pisiform bone; 5-pisiform-uncinate ligament; 6-pisiform-metacarpal ligament; 7-hook of the hamate; 8-palmar carpometacarpal ligaments; 9-palmar metacarpal ligaments; 10-deep transverse metacarpal ligaments; 11th metacarpophalangeal joint of the fifth finger (opened); 12-interphalangeal joints of the fifth finger; 13-tendon of the muscle - deep flexor of the fingers; 14-fibrous sheath of the flexor of the third finger of the hand; 15-collateral ligaments of the metacarpophalangeal and interphalangeal joints of the first finger of the hand; 16th carpometacarpal joint of the first finger of the hand; 17-capitate bone; 18-radiate carpal ligament; 19-radial collateral ligament; 20-palmar radiocarpal ligament; 21-lunate bone; 22 radius bone; 23-interosseous membrane of the forearm.

Articulatio radiocarpea. Ligaments and joints of the hand, right.

Palm side.

1-ulna; 2-articulatio radioulnaris distalis; 3-ligamentum collateral carpi ulnare; 4-os pisiforme; 5-ligamentum pisohamatum; 6-ligamentum pisometacarpeum; 7-hamulus ossis hamati; 8-ligamenta carpometacarpea palmaria; 9-ligamenta metacarpea palmaria; 10-liga-menta metacarpea transversa profunda; 11-articulatio carpophalangea (opened); 12-articulationes interphalangeae manus; 13-tendo m.flexoris digitorum profundi; 14-vagina tendinis musculi flexorum digitorum (III); 15-ligamenta collateralia; 16-articulatio carpometacarpea; 17-os capitatum; 18-ligamentum carpi radiatum; 19- ligamentum col-laterale carpi radiale; 20-ligamentum carpometacarpea palmare; 21-os lunatum; 22-radius; 23-membrana interossea anterbrachii.

Radoicarpal joint, ligaments and joints of wrist, right.

Palmar view.

1-ulna; 2-distal radioulnar joint; 3-ulnar collateral carpal ligament; 4-pisiform bone; 5-pisohomote ligament; 6-pisometacarpal ligament; 7-hamulus of hamate bone; 8-palmar carpametacarpal ligament; 9-palmar metacarpal ligament; 10-deep transverse metacarpal ligaments; 11-metacarpopha-longeal joint of V finger (dissect); 12-interpholongeal joints of V finger; 13-tendon of flexor digitorum profundus; 14-tendinous sheath of flecar digitorum (III); 15-collateral ligaments of metacarpophalangeal and interphalangeal joints of thumb; 16-carpometacarpal joint of thumb; 17-capitate bone; 18-radiate carpal ligament; 19-radial collateral ligament of wrist joint; 20-palmar radiocarpal ligament; 21-lunate bone; 22-radius; 23-interosseous membrane of forearm.