颅骨的连结. Joints of skull 正常人体学讲义 :P137 -

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1 颅骨的连结 Joints of skull 正常人体学讲义 :P137 -

2 缝 Sutures 软骨结合 Synchondrosis 骨性结合 Synosteosis

3 Composition 颞下颌关节 Temporomandibular joint 下颌骨的下颌头与颞骨的下颌窝和关节结节构成 Mandibular fossa and articular tubercle, Head of mandibule 结构特点 CHARACTERISTICS 1. 关节囊松驰 ; 囊外有韧带加强 ; 关节囊前份薄弱, 下颌关节易向前脱位 Capsule is thin and lax in front and behind; strengthened by the lateral ligament

4 2. 关节腔内有关节盘, 将关节腔分成上下两部 Articular disc dividing the joint into two cavities

5 Movement 张口 闭口 前伸 后退及侧方运动 elevated or depressed mandible protruded or retracted mandible side to side movement

6 Movement elevated or depressed mandible protruded or retracted mandible side to side movement

7 Movement elevated or depressed mandible protruded or retracted mandible side to side movement

8 Movement elevated or depressed mandible protruded or retracted mandible side to side movement

9 Movement elevated or depressed mandible protruded or retracted mandible side to side movement

10 Movement elevated or depressed mandible protruded or retracted mandible side to side movement

11 Movement elevated or depressed mandible protruded or retracted mandible side to side movement

12 Movement elevated or depressed mandible protruded or retracted mandible side to side movement

13 Movement elevated or depressed mandible protruded or retracted mandible side to side movement

14 上肢骨的连结 Joints of the bones of upper limb

15 1. Joints of the girdle of upper limb 胸锁关节 Sternoclavicular joint

16 肩锁关节 Acromioclavicular joint 喙肩弓 Coracoacromial arch 喙肩韧带为连结喙突与肩峰之间的韧带, 它与肩峰 喙突共同构成喙肩弓, 架于肩关节上方, 有防止肱骨头向上脱位的作用 acromion coracoacromial ligament coranoid process formed by coracoacromial ligament, coranoid process, and acromion, that prevents the shoulder joint from superior dislocation

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18 2 肩关节 Shoulder joint Composition 由肱骨头与肩胛骨的关节盂构成 formed by glenoid cavity and head of humerus Type 属球窝关节 ball and soket joint

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20 CHARACTERISTICS: 头大盂小, 有盂唇加深关节窝 the shallow glenoid cavity, Glenoid labrum 关节囊薄而松弛 ; 关节囊的前 上 后壁有韧带和肩袖加强, 但下壁较为薄弱, 肱骨头易向前下方脱位 The capsule is loose and strengthened superiorly by the coracohumeral lig. The inferior part of the capsule is the weakest portion and dislocation of the humeral head usually occurs anteroinferiorly. 关节囊内有肱二头肌长头腱通过 Tendon of long head of biceps brachii passes though the cavity.

21 Movements: 可作三轴性运动 flexion, extension, adduction, abduction, medial and lateral rotation, circumduction

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24 3. 肘关节 Elbow joint Composition 包括三个关节, 即肱尺关节 ( 肱骨滑车与尺骨滑车切迹 ) 肱挠关节 ( 肱骨小头与桡骨头关节凹 ) 和桡尺近侧关节 ( 桡骨头环状关节面与尺骨的桡切迹 ) three distinct joints: humeroulnar joint, trochlea and trochlear notch. Humeroradial joint, capitulum of humerus and upper concave surface of radial head. Proximal radioulnar joint,head of radius and radial notch of ulna.

25 CHARACTERISTICS: 三个关节包在一个关节囊内 ; 关节囊前后部松弛, 有尺侧副韧带 桡侧副韧带加强两侧壁 ; 在桡骨头周围有桡骨环状韧带 肘关节易发生桡 尺骨后脱位和桡骨头半脱位 The capsule is thin and loose anteriorly and posteriorly, strongly thickened on either side by radial and ulnar collateral ligaments. The head of radius is held in place by the annular ligament of radius.

26 Movements:

27 Dislocation

28 Dislocation

29 4. Joints between radius and ulna 前臂骨间膜 Interosseous membrane of forearm a fibrous membrane between the shaft of radius and ulna 桡尺远侧关节 Distal radioulnar joint

30 桡尺近侧关节和桡尺远侧关节 Proximal & distal radioulnar joint 属于联合关节或车轴关节 前臂旋内, 手背向前, 桡 尺骨交叉, 称为旋前 前臂旋外, 手背向后, 桡 尺骨平行, 称为旋后

31 Trochoid (pivot) joints Pronation the palm of the hand is turned backward radius and ulna crossed with each other Supination the palm is turned forward radius and ulna paralleled to one another

32 5. Joints of hand 桡腕关节 wrist joint ( Radiocarpal joint ) Composition 桡骨腕关节面 尺骨下方的关节盘与手舟骨 月骨 三角骨构成 Carpal articular surface of radius and articular disc, 2scaphoid, lunate, and triquetral bones

33 Type 椭圆关节 ellipsoid CHARACTERISTICS 关节囊松驰, 关节囊的前 后 内侧 外侧均有韧带加强 Capsule is lax and strengthened by surrounding ligament

34 Movements 作屈 伸 收 展及环转 flexion, extension, adduction, abduction, and circumduction

35 flexion, extension, adduction, abduction, and circumduction

36 6. Intercarpal joints 7.Carpometacarpal joints 拇指腕掌关节 Carpometacarpal joint of thumb Composition 由大多角骨与第 1 掌骨底构成, 为鞍状关节, 作屈伸收展以及对掌和环转运动 trapezium and base of first metacarpal Type saddle-shaped Movement flexion, extension, adduction, abduction, and opposition

37 8. 掌指关节 Metacarpophalangeal joints 由掌骨头与近节指骨底组成, 属球窝关节, 但由于侧副韧带的限制, 只能作双轴运动 ball-and-socket joint 9. 指骨间关节 Interphalangeal joints 属滑车关节, 能作屈 伸运动 hinge joints

38 下肢骨的连结 Joints of Lower limb

39 1. 下肢带骨连结 Joints of girdle of lower limb 耻骨联合 Pubic symphysis interpubic disc 闭孔膜 Obturator membrane 闭膜管 obturator canal

40 骶髂关节 Sacroiliac joint 由骶骨和髂骨的耳状面构成 关节囊紧张, 周围有坚强的韧带, 连结牢固, 活动范围小 formed by auricular surface of sacrum and ilium Capsule is very tight and strengthened by ligaments

41 骶结节韧带 Sacrotuberous ligament sacrum and coccyx to ischial tuberosity greater sciatic notches 骶棘韧带 Sacrospinous ligament ischial spine to sacrum and coccyx lesser sciatic notches 坐骨大孔 greater sciatic foramina 坐骨小孔 lesser sciatic foramina

42 骨盆 Bony pelvis 由左右髋骨和骶 尾骨及其骨连结构成 formed by two hip bones, sacrum, coccyx, and their articulations.

43 界线 terminal line 以界线为标志 骶骨岬 弓状线 耻骨梳 耻骨结节和耻骨联合上缘 terminal line formed by promontory of the sacrum, arcuate line,pecten pubis, pubic tubercle, and upper border of pubic symphysis

44 分为大骨盆和小骨盆 Pelvis divided into a greater and a lesser pelvis 大骨盆 greater pelvis (false pelvis) above terminal line, 小骨盆 lesser pelvis (true pelvis) below terminal

45 骨盆下口 由尾骨尖 骶结节韧带 坐骨结节 坐骨支 耻骨下支和耻骨联合下缘围成 inferior pelvic aperture (Pelvic outlet) bounded by apex of coccyx, sacrotuberous ligament, ischial tuberosity, ramus of ischium, pubic arch and lower border of pubic symphysis.

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47 性别差异 Main difference between male and femal pelvis

48 女性骨盆与妊娠 分娩有关, 故其外形短而宽, 骨盆上口近似圆形, 较宽大, 骨盆下口和耻骨下角较大 male pelvis Narrow and long Outlet Small Subpubic angle (about 70~75 0 ) female pelvis Wide and short Outlet Larger Subpubic angle (about 90~100 0 )

49 Fracture of pelvis

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51

52 2. 髋关节 Hip joint FORMATION 由股骨头与髋骨的髋臼 the femoral head and acetabulum TYPE 球窝关节 ball and socket Joint

53 CHARACTERISTICS 1) 有髋臼唇加深了关节窝, 使股骨头深嵌于窝内 the acetabulum is deepened by the acetabular labrum

54 2) 关节囊坚韧致密, 一端附于髋臼周缘, 另一端达股骨颈, 在前壁附于转子间线, 包绕股骨颈全长, 后壁仅包绕股骨颈内侧 2/3, 故股骨颈骨折分为囊内骨折 囊外骨折和混合骨折 The capsule is thicker and attached proximally to the margins of the acetabulum and the transverse acetebutor ligament, distally, it is attached to the intertrochanteric line anteriorly, and to the medial 2/3 neck posteriorly. So the fracture of neck of femur may be the intracapsuler, extracapsular or the mixed type.

55 3) 关节囊周围有韧带加强 其髂股韧带 ( 髂前下棘 转子间线 ), 可限制髋关节过伸 关节囊内有股骨头韧带 ( 髋臼横韧带 股骨头凹 ) 和髋臼横韧带 ( 架于髋臼切迹 ) The iliofemoral ligament is a very strong, thick band that covers the anterior aspect of the joint. and the acetabular notch is bridged inferiorly by the transverse acetabular ligament. From this notch is given off the ligament of head of femur, passing to the fovea of femoral head.

56 MOVEMENTS multiaxial

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61 3. 膝关节 Knee joint FORMATION 由股骨下端 胫骨上端和髌骨组成 lower end of femur, upper end of tibia and patella TYPE 滑车关节 hinge joint

62 CHARACTERISTICS 1) 关节囊薄而松弛 囊外韧带有髌韧带 胫侧副韧带 腓侧副韧带 腘斜韧带等 The capsule is thicker and reinforced of each side by the tibial and fibular collateral ligaments. Anteriorly the capsule is considerably strengthened by the patellar ligament Posteriorly it is strengthened by oblique popliteal ligament

63 Patellar lig. Fibular collateral lig. Tibial collateral lig.

64 2) 囊内韧带有 : 前叉韧带 ( 防止胫骨沿股骨向前移位 ) 后叉韧带 ( 防止胫骨沿股骨向后移位 ), 有内侧半月板 ( 较大, 呈 C 形, 其周缘与胫侧副韧带紧连 ) 和外侧半月板 ( 呈 O 形 ) The intraarticular structures of the knee joint consist of the anterior & posterior cruciate ligaments of knee, the medial meniscus which is larger and "c" shaped,and the lateral meniscus which is "o" shaped.

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69 3) 有翼状襞 髌上囊 The synovial membrane, alar folds and suprapatellar bursa

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71 MOVEMENT 屈伸 ; 在半屈膝时, 可作旋转运动 flexion extension rotation when this joint is in the flexed position

72 4. 胫腓连结 Tibiofibular syndesmosis 胫腓关节 Tibiofibular joint 小腿骨间膜 Crural interosseous membrane 胫腓连结 Tibiofibular symdesmosis

73 5. 足部关节 Joint of foot 踝关节 The ankle joint ( 距小腿关节 talocrural joint) FORMATION 胫 腓骨下端和距骨滑车构成 distal end of tibia and fibula the trochlea of talus TYPE 滑车关节 hinge joint

74 MOVEMENT 背屈 ( 即伸, 足尖向上 ) 和跖屈 ( 即屈, 足尖向下 ) 运动 dorsiflexion plantar flexion

75 CHARACTERISTICS 1. 距骨滑车关节面前宽后窄 The articular surfaces is wider in front than behine. 2. 关节囊前后松驰, 有内 外侧副韧带加强 The joint capsule is thickened on each side by the medial or deltoid ligament and lateral ligament

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77 距跟舟关节 Talocalcaneonavicular joint 跟骰关节 Calcaneocuboid joint transverse tarsal joint (chopart ) 跗横关节 跗跖关节 Tarsometatarsal joints 跖骨间关节 Intermetatarsal joints 跖趾关节 Metatarsophalangeal joints 趾间关节 Interphalangeal joints

78 跗骨间关节 Intertarsal joints 距跟关节 Talocalcaneal joint 距跟舟关节 Talocalcaneonavicular joint 足内翻 ( 足内侧缘上提, 足底朝内 ) 和足外翻 ( 足外侧缘上提, 足底朝外 )

79 6. 足弓 Arches of foot 由跗骨 跖骨及足底的韧带 肌腱共同组成, 分为内侧纵弓 外侧纵弓和横弓 Medial longitudinal arch Lateral longitudinal arch Tranverse arch 保证直立时稳定性和弹性 ; 保护足底的血管 神经免受压迫 give to foot strength stability and resilience; protect plantar vessels and nerves

80 Normal arch Flat foot

81 Review 肩关节的组成, 结构特点和运动方式

82 膝关节的组成 结构特点及运动方式

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