Arthrology 关节学

Classification

two major types

■ Continuous joints 直接连结(不动连接)
■ Discontinuous joints 间接连结 (可动连接，关节)
■ Fibrous joints 纤维连结
❑ Syndesmosis 韧带连结
❑ Suture 缝
■ Cartilaginous joints
软⻣连结
■ Synosteosis ⻣性结合
Discontinuous joints 间接连结
Synovial Joints 滑膜关节

Basic structures
■ Articular surface 关节⾯: covered
by articular cartilage 关节软⻣
■ Articular capsule 关节囊
❑ Fibrous membrane 纤维膜
❑ Synovial membrane 滑膜
■ 滑膜襞-滑膜突⼊关节囊
■ 滑膜囊-滑膜突出关节囊

■ Articular cavity 关节腔:

❑ Containing a trace of synovial fluid
❑ Subatmospheric pressure in it
 Synovial Joints 滑膜关节

Accessory structures
■ Ligaments 韧带 (lig.)
❑ Extracapsular ligaments 囊外韧带
❑ intracapsular ligaments 囊内韧带
■ Articular disc 关节盘 and
articular labrum 关节唇
■ Synovial fold 滑膜襞
synovial bursa 滑膜囊
 Joint Movement Terminology
关节运动术语
■ Translation 移动
■ Flexion and extension 屈和伸 – 沿冠状轴运动
踝关节的屈⼜称跖屈，伸⼜称背伸。
■ Adduction and abduction 收和展 -沿⽮状轴运动
■ Rotation 旋转 - 沿垂直轴
❑ Medial and lateral rotation 旋内和旋外
or Pronation ans supination 旋前和旋后
❑ Inversion and eversion ⾜内翻和⾜外翻
■ Circumduction 环转
MCP
Supination Pronation
flexion(屈)\ extension(伸)
adduction(内收)\ abduction(外展)
 Rotation （旋转）
■ Bone revolves around its
own longitudinal axis
❑ medial rotation is turning of
anterior surface in towards
the midline
❑ lateral rotation is turning of
anterior surface away from
the midline
■ Pronation 旋前
■ Supination 旋后
■ Inversion ⾜内翻
■ Eversion ⾜外翻
 Circumduction（环转）
■ Movement of a distal end of a body part in a circle
■ Combination of flexion, extension, adduction and abduction
■ Occurs at ball and socket, saddle and condyloid joints
 Classification of synovial joints
关节的分类

1. Uniaxial joints 单轴关节:

❑ hinge joints 屈戍关节:
■ cylindrical end of 1 bone fits into trough
shape of other
■ angular movement-1 plane (eg) elbow,
ankle, interphalangal
❑ trochoid (pivot) joints ⻋轴关节
■ round end fits into ring of bone + ligament
■ rotation on long axis (eg) prox. radius/ulna,
atlas/dens
 Classification of synovial joints
关节的分类

2. Biaxial joints 双轴关节:

❑ ellipsoid joints 椭圆关节
■ egg-shape articular surface + oval
concavity
■ side-to-side, back+forth movement
(eg) metacarpophalangeal
(knuckle)
❑ saddle joints 鞍状关节
■ articular surface both concave +
convex
■ side-to-side, back-forth movement
(eg) carpometacarpal jt of thumb
 Classification of synovial joints
关节的分类

3. Multiaxial joints 多轴关节:

❑ ball-and-socket joint 球窝关节
■ spherical head + round socket
■ multiaxial movement(eg)
shoulder, femur
❑ plane joints 平⾯关节
■ articular surface in flat plane
■ Short gliding movement
■ (eg) intertarsal, articular
processes of vertebrae
 Sprains扭伤
• Torn or stretched
ligaments.
• Spine, ankle & knee are
common sites.
• Completely torn ligaments
must be repaired. Edema
associated with injury can
further degrade the
ligament.
Dislocations
Arthritis
 Joints of Bones of Trunk
躯⼲⻣的连结

Vertebral column 脊柱
■ consists of 24 vertebrae, the
sacrum, and the coccyx.
 Joints of the vertebral bodies
椎体间的连结

Anterior longitudinal ligament

前纵韧带
■ Strong band covering the anterior part of
the vertebral bodies and intervertebral
discs running from the anterior margin of
foramen magnum to the S1~S2
■ Maintains stability of the intervertebral disc
and prevents hyperextension of the
vertebral column
 Joints of the vertebral bodies
椎体间的连结

Posterior longitudinal ligament

后纵韧带
■ Attached to the posterior aspect of the
intervertebral discs and posterior edges of the
vertebral bodies from C2 vertebra to sacrum
■ Prevents hyperflexion of the vertebral column
and posterior protrusion of the discs
 Joints of the vertebral bodies
椎体间的连结

Intervertebral discs 椎间盘

Lie between bodies of adjacent
vertebrae, composed of:
■ Nucleus pulposus 髓核
an inner soft, pulpy, highly elastic
structure (gelatinous core )
■ Annulus fibrosus 纤维环
an outer fibrous ring consisting of
fibrocartilage
Hemination of nucleus pulposus
髓核脱出
 Joints of the vertebral arches
椎⼸间的连结

■ Ligamenta flava ⻩韧带

― elastic ligament, unite laminae of
adjacent vertebrae, and complete the
posterior wall of vertebral canal; tend to
prevent hyperflexion of the vertebral
column
■ Interspinal ligament 棘间韧带
■ Supraspinal ligament 棘上韧带
❑ Ligamentum nuchae 项韧带
Zygapophysial joint 关节突关节
 Atlantooccipital joint 寰枕关节

■ Between superior articulating surfaces of atlas and

occipital condyles
■ Supported by membrances and ligaments that join
occipital bone and atlas
■ Action ― nodding of head, lateral tilting of head
 Atlantoaxial joint 寰枢关节
■ Three synovial joints between atlas
and axis
❑ Laterally, paired joints between
articulating facets
❑ Median joint between dens of axis
and anterior arch of atlas
❑ 包括三个关节，分别为寰枢外侧关节和
寰枢正中关节。
■ Supported by ligaments
❑ apical ligament of dens ⻮突尖韧带
❑ alar ligament 翼状韧带
❑ transverse ligament of atlas 寰椎横韧带
❑ tectorial membrane 覆膜
■ Action ― allow atlas (and head) to
pivot on the axis and vertebral column
Health 8-year-old girl with Down syndrome
腰骶关节
 The vertebral column as a whole
■ Anterior aspect:
the breadth of vertebral bodies increases
from C2 to S2, then diminishes rapidly
■ Dorsal aspect:
❑ the spinous processes of cervical
vertebrae are short and bifid;
❑ the spinous processes of thoracic
vertebrae are long, point obliquely
downward and overlapped each other;
❑ the spinous processes of lumber
vertebrae are nearly horizontally.
■ Lateral aspect:
shows four physiological curves
The vertebral column as a whole

Four physiological curves

Cervical curvature
convex forward
Thoracic curvature
Lumbar curvature
Sacral curvature convex backward
The vertebral column as a whole
Movement of the vertebral column

■ flexion 屈
■ extension 伸
■ lateral flexion 侧弯
■ rotation 旋转
Lateral radiograph of the
neck. The cervical curve of
the vertebral column is well
shown.
Sagittal MRI of cervicothoracic spine. Sagittal MRI of thoracolumbosacral spine.
Spina bifida cystica 脊柱裂
 Thoracic cage 胸廓

Composition
■ twelve thoracic vertebrae
■ twelve pairs of ribs and
costal cartilages
■ sternum
 Thoracic cage 胸廓

■ Costovertebral joints 肋椎关节

❑ Joints of costal head 肋头关节
❑ Costotransverse joints 肋横突关节
■ Sternocostal joints 胸肋关节
❑ Sternocostal synchondrosis of first rib
第⼀胸肋结合
❑ Sternocostal joints 胸肋关节 (2 to 7)
❑ Interchondral joints 肋软⻣连结
between costal cartilages 8, 9, and 10
to form the costal arch 肋⼸
 General features of thoracic cage

■ Roughly cone-shape, narrow above and

broad below, flattened from before-
backwards, longer behind than in front
■ Inlet of thorax 胸廓上⼝: bounded by
upper border of manubrium, first rib, and
vertebra T1
■ Outlet of thorax 胸廓下⼝: bounded by
vertebra T12, 12th and 11th ribs, costal arch
and xiphoid process
■ Infrasternal angle 胸⻣下⻆: formed by the
costal arch of both side
■ Intercostal spaces 肋间隙: lie between the
ribs
 Thoracic cage 胸廓
■ Function:
❑ protects the organs in the thoracic cavity and upper
abdominal cavity
❑ plays a vital role in the process of breathing

Inspiration Expiration
 Joints of skull 颅⻣的连结

Continuous joints:
■ Sutures
■ Synchondrosis or synosteosis
■ Temporomandibular joint
Temporomandibular joint 颞下颌关节

下颌窝 关节结节
关节盘
关节囊

外⽿⻔

乳突

下颌头
翼外肌
翼内肌
颊肌