关节学Arthrology教学课件

关节Arthrology

Arthrology

关节学

关节Arthrology

ClassificationTherearetwomajortypesofarticulationsorjoint.Continuousjoints

直接连结Fibrousjoints纤维连结:bonesareunitedbyfibrousconnectivetissueSyndesmosis韧带连结Suture缝Cartilaginousjoints软骨连结:bonesareunitedbycartilageSynchondrosis透明软骨结合:

bonesareunitedbyhyalinecartilageSymphysis纤维软骨联合:bonesareunitedbyfibrocartilageSynosteosis骨性结合Discontinuousjoints

间接连结－synovialjoints滑膜关节关节ArthrologySynovialjoints

滑膜关节BasicstructuresArticularsurface关节面:coveredbyarticularcartilage关节软骨Articularcapsule关节囊Fibrousmembrane纤维膜Synovialmembrane

滑膜Articularcavity关节腔:containingatraceofsynovialfluid;subatmosphericpressureinit关节ArthrologyAccessorystructuresLigaments韧带(lig.):extra-andintracapsularligaments囊外(内)韧带Articulardisc关节盘

andarticularlabrum

关节唇:Synovialfold滑膜襞

andsynovialbursa滑膜囊关节ArthrologyTermsmovementsofjoints

关节运动术语Translation移动Flexionandextension屈和伸Adductionandabduction收和展Rotation旋转Medialandlateralrotation旋内和旋外Pronationanssupination旋前和旋后Inversionandeversion足内翻和足外翻Circumduction环转关节ArthrologyClassificationofsynovialjoints

关节的分类Uniaxialjoints单轴关节:hingejoints屈戍关节trochoid(pivot)joints车轴关节Biaxialjoints双轴关节:ellipsoidjoints椭圆关节saddlejoints鞍状关节Multiaxialjoints多轴关节:ball-and-socketjoint球窝关节planejoints平面关节关节ArthrologyArticulationsofBonesofTrunk

躯干骨的连结Thevertebralcolumn脊柱

consistsof24vertebrae,thesacrum,andthecoccyx.

关节ArthrologyJointsofthevertebralbodies

椎体间的连结Intervertebraldiscs

椎间盘

betweenbodiesofadjacentvertebrae,composedof:Nucleuspulposus髓核,aninnersoft,pulpy,highlyelasticstructure(gelatinouscore)Annulusfibrosus纤维环

anouterfibrousringconsistingoffibrocartilage关节ArthrologyHeminationofnucleuspulposus

髓核脱出关节ArthrologyAnteriorlongitudinalligament

前纵韧带StrongbandcoveringtheanteriorpartofthevertebralbodiesandintervertebraldiscsrunningfromtheanteriormarginofforamenmagnumtotheS1~S2MaintainsstabilityoftheintervertebraldiscandpreventshyperextensionofthevertebralcolumnPosteriorlongitudinalligament后纵韧带AttachedtotheposterioraspectoftheintervertebraldiscsandposterioredgesofthevertebralbodiesfromC2vertebratosacrumPreventshyperflexionofthevertebralcolumnandposteriorprotrusionofthediscs关节Arthrology

Jointsofthevertebralarches

椎弓间的连结Ligamentaflava

黄韧带―elasticligament,unitelaminaeofadjacentvertebrae,andcompletetheposteriorwallofvertebralcanal;tendtopreventhyperflexionofthevertebralcolumnInterspinalligament棘间韧带Supraspinalligament棘上韧带Ligamentumnuchae项韧带

Intertansverseligament横突间韧带Zygapophysialjoint关节突关节关节ArthrologyAtlantooccipitaljoint

寰枕关节BetweensuperiorarticulatingsurfacesofatlasandoccipitalcondylesSupportedbymembrancesandligamentsthatjoinoccipitalboneandatlasAction―noddingofhead,lateraltiltingofhead关节ArthrologyAtlantoaxialjoint

寰枢关节ThreesynovialjointsbetweenatlasandaxisLaterally,pairedjointsbetweenarticulatingfacetsMedianjointbetweendensofaxisandanteriorarchofatlasSupportedbyligamentsapicalligamentofdens齿突尖韧带alarligament翼状韧带transverseligamentofatlas寰椎横韧带tectorialmembrane覆膜Action―allowatlas(andhead)topivotontheaxisandvertebralcolumn关节ArthrologyNormalCurvesofvertebralcolumnCervicalcurvature颈曲

convexforwardThoraciccurvature胸曲

convexbackwardLumbarcurvature腰曲

convexforwardSacralcurvature骶曲

convexbackwardMovementofthevertebralcolumn

flexionextensionlateralflexionrotation关节Arthrology关节ArthrologySpinabifidacystica脊柱裂关节ArthrologyThoraciccage胸廓CompositionBones―consistsoftwelvethoracicvertebrae,twelvepairsofribsandcostalcartilages,andsternum关节ArthrologyJointsCostovertebraljoints

肋椎关节Jointsofcostalhead肋头关节Costotransversejoints肋横突关节Sternocostaljoints胸肋关节Sternocostalsynchondrosisoffirstrib第一胸肋结合Sternocostaljoints胸肋关节:Interchondraljoints肋软骨连结:betweencostalcartilages8,9,and10toformthecostalarch肋弓关节ArthrologyGeneralfeaturesofthoraciccageRoughlycone-shape,narrowaboveandbroadbelow,flattenedfrombefore-backwards,longerbehindthaninfrontInletofthorax胸廓上口:boundedbyupperborderofmanubrium,firstrib,andvertebraT1Outletofthorax胸廓下口:boundedbyvertebraT12,12thand11thribs,costalarchandxiphoidprocessInfrasternalangle胸骨下角:formedbythecostalarchofbothsideIntercostalspaces肋间隙:liebetweentheribs关节ArthrologyFunction:

protectstheorgansinthethoraciccavityandupperabdominalcavity;playsavitalroleintheprocessofbreathingInspirationExpiration关节ArthrologyJointsofskull颅骨的连结Continuousjoints:sutures,synchondrosisorsynosteosis关节ArthrologyTemporomandibularjoint颞下颌关节AticulatingsurfacesMandibularfossaandarticulartubercle,aboveHeadofmandibule,belowCapsule:thinandlaxinfrontandbehind;strengthenedbythelateralligament外侧韧带Articulardisc:separatessurfaces,formingupperandlowercompartmentswithinjointMovement:mandiblemaybeelevatedordepressed,protrudedorretracted;rotationmayalsooccursasinchewing(aslightamountofsidetosidemovementisalsopermitted)关节ArthrologyJointsoflimbs

山东大学医学院解剖教研室李振华关节ArthrologyJointsofupperlimb

JointsofshouldgirdleSternoclavicularjoint胸锁关节Bones:sternalendofclavicle,clavicularnotchofsternum,andfirstcostalcartilageArticularcapsule:strongandisreinforcedbyanteriorandposteriorsternoclavicularligamentsAnarticulardiscisattachedtothecapsule,dividingthejointintotwocavities.Movements:elevationanddepression,forwardandbackward,rotationandcircumductionoftheacromialendoftheclavicle关节ArthrologyAcromioclavicularjoint肩锁关节Bones:acromionandacromialendofclavicleMovement:rotationofscapulaonclavicleCoracoacromialarch喙肩弓

formedbycoracoacromialligament喙肩韧带,coranoidprocess,andacromion,thatpreventstheshoulderjointfromsuperiordislocationcoranoidprocessacromioncoracoacromialligament关节ArthrologyJointsoffreeupperlimb★Shoulderjoint

肩关节

(ballandsocket)Bones:headofhumerusandglenoidcavityofscapulaCapsule:Thinandlax,especiallylowerpartAttachments:proximaltoglenoidlabrum;distaltoanatomicalneckofhumerus,exceptmediallywhereitisslightlydistaltosurgicalneckTendonoflongheadofbicepsbrachiipassesthoughthecavity关节ArthrologyAccessorystructuresGlenoidlabrum盂唇:fibrocartilaginousringonperipheryofglenoidcavityCoracohumeralligament喙肱韧带：runsfromcoracoidprocesstogreatertubercleMovements:flexion,extension,adduction,abduction,medialandlateralrotation,circumduction关节Arthrology关节Arthrology★Elbowjoint

肘关节Bones:lowerendofhumerus,upperendsofradiusandulnaHumeroulnarjoint肱尺关节:formedbytrochlearofhumerusandtroclearnoch(hinge)Humeroradialjoint肱桡关节:formedbycapitulumofhumerusandheadofradius(ballandsocket)Proximalradioulnarjoint桡尺近侧关节:formedbyarticularcircumferenceofradiusandradialnotchofulnaCapsule:thinandlaxanteriorlyandposteriorly,stronglythickenedoneithersidebycollateralligaments关节ArthrologyLigaments:Radialcollacteralligament桡侧副韧带:attachedtolateralepicondyleandannularligamentofradiusUlnarcollacteralligament尺侧副韧带:attachedtomedialepicondyletomedialborderoftrochlearnotchAnnularligamentofradius桡骨环状韧带:attachedtoanteriorandposteriormarginsofradialnotchofulna,surroundstheheadofradiusMovements:flexionandextension,pronationandsupination关节ArthrologyDislocation关节ArthrologyJointsbetweenradiusandulna

Proximalradioulnarjoint

桡尺近侧关节Distalradioulnarjoint桡尺远侧关节:formedbyheadofulna,ulnarnotchofradiusandanarticulardiscInterosseousmembraneofforearm

前臂骨间膜:afibrousmembranebetweentheshaftofradiusandulna关节ArthrologyJointsofhand★Radiocarpaljoint桡腕关节

(ellipsoid)BonesCarpalarticularsurfaceofradiusandarticulardiscbelowtheulnaProximalrowofcarpal:scaphoid,lunate,andtriquetralbones,butnotpisiformCapsule:laxandstrengthenedbysurroundingligamentMovements:flexion,extension,adduction,abduction,andcircumduction关节ArthrologyIntercarpaljointsCarpometacarpaljoints:★

Carpometacarpaljointofthumb拇指腕掌关节Bones:trapeziumandbaseoffirstmetacarpalMovement:flexion,extension,adduction,abduction,andoppositionIntermetacarpaljointsMetacarpophalangealjointsInterphalangealjoints关节Arthrology

JointsofLowerlimb

JointsofpelvicgirdleSacroiliacjoint骶髂关节Bones:auricularsurfaceofsacrumandiliumCapsule:verytightandstrengthenedbyligaments关节ArthrologyVertebropelvicligamentsIliolumballigament髂腰韧带:runsfromtransverseprocessofL5totheposterosuperiorpartofiliaccrest★

Sacrotuberousligament

骶结节韧带:runsfromlateralmarginsofsacrumandcoccyxtotheinnermarginofischialtuberosity★

Sacrospinousligament

骶棘韧带:runsfromischialspinetolateralmarginsofsacrumandcoccyxThesetwoligamentsconvertthesciaticnotchesthegreaterandlessersciaticforamina坐骨大、小孔关节ArthrologyPubicsymphysis

耻骨联合Articulation:symphysialsurfaceandinterpubicdisc(fibrocartilage)Ligaments:superiorpubicligamentandarcuatepubicligamentObturatormembrane

闭孔膜

obturatorcanal闭膜管关节ArthrologyBonypelvis骨盆Composition:formedbypairedhipbones,sacrum,coccyx,andtheirarticulationsInanatomicalposition,anteriorsuperioriliacspinesandpubictuberclesonsameverticalplane,whilethetipofcoccyxandsuperiorborderofpubicsymphysisonsamehorizontalplaneTerminalline界线:formedbypromontoryofsacrum,arcuateline,pectinofpubis,pubictubercle,upperborderofpubicsymphysisTwoportions:agreaterpelvisandalesserpelvis关节ArthrologyLesserpelvis

小骨盆pelvicinlet

骨盆上口(terminalline):Pelvicoutlet骨盆下口:formedbytipofcoccyx,sacrotuberousligament,ischialtuberosity,ramusofischium,inferiorramusofpubic,symphysisPelviccavityPubicarch,subpubicangle关节Arthrology

Maindifferencebetweenmaleandfemalpelvis

关节ArthrologyMaindifferencebetweenmaleandfemalpelvisFemaleMalePelvicinletPelvicoutetPelviccavityPubicarch90~100070~750

关节Arthrology

Maindifferencebetweenmaleandfemalpelvis

MaleFemaleOverallNarrowandlongWideandshortIliacalaMoreverticalMorehorizontalInletOvalorheartshapedRoundSubpubicangleAcuteangle(about70~750)Rightangle(about90~1000)PelviccavityDeepnarrowShallower,wideOutletSmallLarger关节Arthrology关节Arthrology关节ArthrologyJointsoffreelowerlimb★Hipjoint髋关节Bones:acetabulumandfemoralheadArticularcapsuleattachmentsAbove:marginsofacetabulumandtransverseacetebularligamentBelow:infronttointertrochantericline;behind,totheneckoffemurabove1cmabovetheintertrochantericcrest

关节ArthrologyAccessorystructuresAcetabulumlabrum髋臼唇;transverseacetebularligament髋臼横韧带LigamentsIliofemorallig.髂股韧带Ligamentofheadoffemur股骨头韧带Pubofemorallig.耻股韧带Ischiofemoralligament

坐股韧带Zonaorbicularis轮匝带

Movement:flexion,extention,adduction,abduction,medialandlateralrotation,circumductionTransverseacetebularlig.LigamentofheadoffemurAcetabulumlabrum关节ArthrologyIliofemorallig.Ischiofemorallig.Pubofemorallig.Zonaorbicularis关节Arthrology关节Arthrology关节Arthrology★Kneejoint膝关节Bones:lowerendoffemur,upperendoftibiaandpatellaArticularcapsule:superapatellarbursa髌上囊,deepinfrapatellarbursa髌下深囊,alafolds翼状襞关节ArthrologyAccessorystructuresligamentsPatellarlig.髌韧带Fibularcollaterallig.腓侧副韧带Tibialcollaterallig.胫侧副韧带Patellarlig.Fibularcollaterallig.Tibialcollaterallig.关节ArthrologyObliquepoplitealligament腘斜韧带Anteriorcruciateligment前交叉韧带Posteriorcruciateligament后交叉韧带关节ArthrologyMedialmeniscus内侧半月板

(C-shaped)lateralmeniscus外侧半月板

(O-shaped)Movements:flexionandextension;flexedkneejointmaybepassivelyrotatedthrough700

lateralMedial关节Arthrology关节ArthrologyTibiofibularsyndesmosis

胫腓连结Tibiofibularjoint胫腓关节Cruralinterosseousmembrane小腿骨间膜Anteriorandposteriortibiofibularligaments

胫腓前、后韧带关节ArthrologyJointoffootTalocruraljoint距小腿关节(anklejoint)踝关节Bones:lowerendsoftibiaandfibula,trochleaoftalusArticularcapsule:thinandlaxinfrontandbehind,andsupportedoneachsidebystrongcollateralligaments关节ArthrologyLigmentsMediallig.内侧韧带Laterallig.外侧韧带Anteriortalofibularlig.

距腓前韧带Calcaneofibularlig.跟腓韧带Posteriortalofibularlig.

距腓后韧带Movements:dosiflexion(extension)andplantarflexion(flexion);whentheanklejointisfullyplantarflexed,smallamountsofabduction,andadductionarepossible关节ArthrologyIn