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The bigger joints

Overview.

Vertebral column. The vertebrae are connected with each-other by 3 kind of connections of bones: syndesmoses, synchondroses and synovial joints. 1. Syndesmoses (ligaments): - lig. longitudinale anterius - runs by anterior surface of the corpus vertebrae from atlas to os sacrum - lig. longitudinale posterius - runs by posterior surface of the corpus vertebraes - lig. supraspinale - runs by the tips of the proc. spinosuses from the 7. cervical vertebra to os sacrum - lig. nuchae - widened part of the lig. supraspinale, extends from the 7. cervical vertebra up to os occipitale - ligg. interspinalia - between proc. spinosuses - ligg. intertransversaria - between proc. transversuses - ligg. flava - between arcus vertebraes

2. Sybchondroses: Discus intervertebralis - between the corpus vertebraes (in some books it is named symphysis intervertebralis!) 2 parts: - nucleus pulposus - central part from soft cartilage - anulus fibrosus - outer part from fibrous cartilage Functions of discus intervertebralis: 1. connection of bones 2. making possible movements between the bones 3. making possible growth of bones 4. to work as a shock- absorbers

3. Artt. intervertebrales ( also: artt. zygapophysiales). Articulating surfaces: facies articularis superiores of the lower vertebra + facies articularis inferiores of the upper vertebra Type:.plana (left and right combined!) Axes and movements: limited movements around all axes: - cervical part - ante- and retroflexio, lateroflexio, rotatio - thoracal part - lateroflexio and limited rotatio - lumbar part - ante- and retroflexio, limited lateroflexio

Lig. longitudinale anterius

Lig. supraspinale

1 lig. longitudinale anterius 8 ligg. interspinalia 7 ligamenta intertransversaria

Lig. longitudinale posterius Ligg. flava

4 disci intervertebrales

5 ligg. flava

Head joint. I Art. atlantooccipitalis (upper head joint, upper nuchal joint). II Art. atlantoaxialis (lower head joint, lower nuchal joint). Art. atlantooccipitalis. Surfaces: 2 condylus occipitalis + 2 fovea articularis superior atlantis Type: art. ellipsoidea Axes and movements: - frontal axis - ante- et retroflexio - sagital axis - lateroflexio - circumductio - 2 axes!!

Art. atlantoaxialis. Consists of 4 part: 1. art. atlantoaxialis mediana a) pars anterior - fovea dentis (atlas) + facies articularis anterior (dens axis) b) pars posterior - lig. transversum atlantis + facies articularis posterior (dens axis) Type: art. trochoidea 2. art. atlantoaxialis lateralis ( 2 - left and right!) - facies articularis inferiores (atlas) + facies articularis superiores (axis) Type:art. plana Art. atlantoaxialis mediana and both art. atlantoaxialis laterales are combined, functionally they work together as one art. trochoidea (trochoidea + 2 plana = trochoidea). Axis and movements for all art atlantoaxialis: the cardinal axis is vertical (longitudinal axis of the dens axis!) and main movement is rotatio (to left and right).

NB! Art. atlantooccipitalis (ellipsoidea) + art. atlantoaxialis (trochoidea) = art. spheroidea! Ligaments of the head joints: - lig. apicis dentis - from apex dentis to anterior edge of the foramen magnum - ligg. alaria - from sides of the dens axis to lateral edges of the foramen magnum - lig. cruciforme atlantis - fasciculi longitudinales - from corpus axis to inner surface of the foramen magnum - lig. transversum atlantis - between massae laterales atlantis - membrana tectoria - from axis to inner surface of the foramen magnum, covers all complex from inside - membrana atlantooccipitalis anterior - from arcus anterior atlantis to anterior edge of the foramen magnum - membrana atlantooccipitalis posterior - from arcus posterior atlantis to posterior edge of the foramen magnum

Art. sacroiliaca. Surfaces: facies auricularis ossis sacri + facies auricularis ossis ilii Type: amphiarthrosis (the biggest one in human body!) Ligaments: - ligg. sacroiliaca dorsalia - ligg. sacroiliaca ventralia - ligg. sacroiliaca interossea between tuberositas sacralis and tuberositas iliaca -lig. iliolumbale from crista iliaca to 4. ja 5. vertebra lumbalis This joint is also strengthened by 2 independent syndesmoses: - lig. sacrospinale - from os sacrum and os coccygis to spina ischiadica - lig. sacrotuberale from os sacrum to tuber ischiadicum

ligg sacroiliaca anteriora

ligg sacroiliaca interossea

lacuna musculorum lacuna vasorum lig inquinale membrana obturatoria

foramen ischiadicum majus

foramen ischiadicum minus

lig iliolumbale

ligg sacroiliaca posteriora

1 symphysis pubica 2 lig pubicum superius 3 lig arcuatum pubis

11 lig sacrotuberale 12 lig sacrospinale

Art. humeri. Surfaces: cavitas glenoidalis (scapula) + caput humeri cavitas glenoidali enlarged by labrum glenoidale Ttype: spheroidea Axes and movements: - frontal axis - anteflexio - retroflexio (anteversio - retroversio) - sagital axis - abductio - adductio - vertical axis - pronatio - supinatio + circumductio Ligaments: - lig. coracohumerale (the biggest!) runs from processus coracoideus towards the tuberculum majus, blendes into capsular ligaments - capsular ligaments (lig. coracoglenoidale; lig. semicirculare humeri; ligg. glenohumerale superius, medium, inferius et spirale; lig.glenocapsulare; lig. transversum humeri) NB! Art. humeri is strengthened by tendons of the surrounding muscles), which serve as a big ligaments!

Art coxae. Surfaces: facies lunata acetabuli (os coxae), labrum acetabulare + caput femoris Type: spheroidea Axes and movements: - frontal axis - anteflexio - retroflexio (anteversio - retroversio) - sagital axis - abductio - adductio - vertikal axis - rotatio (pronatio supinatio) + circumductio Ligaments: - lig. iliofemorale - lig. pubofemorale - lig. ischiofemorale - zona orbicularis in the capsule around the collum femoris - lig. capitis femoris from fovea capitis femoris to fossa acetabuli - lig. transversum acetabuli in the incisura acetabuli

Art. cubiti. 3 parts: 1. Art. humeroulnaris 2. Art. humeroradialis 3. Art. radioulnaris proximalis 1. Art. humeroulnaris. Surfaces: trochlea humeri + incisura trochlearis ulnae Type: ginglymus 2. Art. humeroradialis Surfaces: capitulum humeri + fovea articularis (capitis) radii Type: spheroidea (but very limited by other 2 joints!) 3. Art. radioulnaris proximalis Surfaces: circumferentia articularis radii + incisura radialis ulnae Type: trochoidea

Axes and movements for all art cubiti: Art. cubiti consists of 2 functional floors: - upper floor - art. humeroulnaris + art. humeroradialis = ginglymus - frontal axis , flexio - extensio - lower floor - art. radioulnaris proximalis + art. humeroradialis = trochoidea - vertical axis, pronatio - supinatio Art. cubiti as a whole: trocho-ginglymus! Ligaments: - lig. collaterale radiale from epicondylus lateralis humeri (as 2 branches!) to lig. anulare radii and ulna - lig. anulare radii from anterior edge of incisura radialis ulnae around caput (and collum) radii to posterior edge of incisura radialis ulnae - lig. collaterale ulnare- from epicondylus medialis humeri to upper lateral side of ulna

Art. genus. Surfaces: condylus medialis et lateralis femoris (+ meniscus medialis et lateralis) + facies articularis superior tibiae (+ patella) (In biomechanics sometimes described as independent joint art. femoropatellaris = facies articularis patellae + facies patellaris femoris art. plana) Type, axes and movements: functionally is here 2 floors: -art. meniscofemoralis upper floor, ginglymus frontal axis - flexio-extensio - art. meniscotibialis lower floor, trochoidea vertical axis, rotation (very limited and possible only if the knee is flexed!) Type of the art. genus as the whole: trocho-ginglymus

Ligaments: a) intraarticular: - lig. transversum genus- in front between the menisci - lig. cruciatum anterius- from area intercondylaris anterior to lateral wall of the fossa intercondylaris - lig. cruciatum posterius from area intercondylaris posterior to medial wall of the fossa intercondylaris b) big capsular ligaments: - lig. collaterale tibiale from epicondylus medialis femoris to condylus medialis tibiae - lig. collaterale fibulare from epicondylus lateralis femoris to caput fibulae - lig. popliteum arcuatum - lig. popliteum obliquum c) extracapsular ligaments: - retinaculum patellae mediale et laterale - lig. patellae - NB! It is a part of the tendon of m. quadriceps femoris, extending from patella to tuberositas tibia!

Art. manus or wrist joint = art. radiocarpea + art. mediocarpea. Art. radiocarpea Surfaces: facies articularis carpea (inferior) radii + discus articularis + os scaphoideum, os lunatum et os triquetrum (NB! os pisiforme is not part of this joint!) Type: ellipsoidea Axes and movements: - frontal axis - flexio -extensio (flexio palmaris flexio dorsalis) - sagital axis - abductio - adductio + circumductio Ligaments: - lig. collaterale carpi radiale - lig collaterale carpi ulnare - lig. radiocarpeum palmare -lig ulnocarpeum palmare etc. Art. mediocarpea. Surfaces: the proximal row of ossa carpalia + the distal row of ossa carpalia Type: ~ ginglymus Axis and movements: ~ frontal axis, flexio palmaris - flexio dorsalis Ligaments: see. art. radiocarpea!

Art. pedis = upper jump joint (or upper ankle joint) + lower jump joint (or lower ankle joint). Art. talocruralis upper jump joint. Surfaces: malleolus medialis (tibiae), facies articularis inferior tibiae, malleolus lateralis (fibulae) + trochlea tali Type: ginglymus Axis and movements: - frontal axis - flexio plantaris - flexio dorsalis (maximally extended foot can also move a little-bit to left and right) Ligaments: (this ligaments stabilize particularly also the lower jump joint!) a) on the lateral side: - lig. talofibulare anterius - lig. talofibulare posterius - lig. calcaneofibulare b) on the medial side: - lig. deltoideum: - pars tibionavicularis - pars tibiotalaris anterior - pars tibiocalcaneus - pars tibiotalaris posterior

Art. talotarsalis (lower jump joint) = art. subtalaris + art. talocalcaneonavicularis. Art. subtalaris. Surfaces: facies articularis calcanea posterior (talus) + facies articularis talaris posterior (calcaneus) Type: trochoidea Axis: oblique axis Art. talocalcaneonavicularis. Surfaces: caput tali, facies articularis calcanea media et anterior (talus) + os naviculare, facies articularis talaris media et anterior (calcaneus) Type: spheroidea (very limited by other joints!) Special (own) ligaments for lower jump joint: - ligg. talocalcaneum mediale, laterale et interosseum Axis and movements in all lower jump joint: art. subtalaris and art. talocalcaneonavicularis are combined active movements are possible only around the oblique axis of the art. subtalaris. (Trochoidea + spheroidea = trochoidea!) Movements ~ pronatio - supinatio (+ little-bit also around other axes!)