Arthrology 关节学

山东大学医学院 解剖学教研室
李振华
 Classification
There are two major types of articulations or joint.
 Continuous joints 直接连结
 Fibrous joints 纤维连结 : bones are

united by fibrous connective tissue

 Syndesmosis 韧带连结

 Suture 缝

 Cartilaginous joints 软骨连结 :

bones are united by cartilage

 Synchondrosis 透明软骨结合 :

bones are united by hyaline cartilage

 Symphysis 纤维软骨联合 :

bones are united by fibrocartilage

 Synosteosis 骨性结合

 Discontinuous joints 间接连结－ synovia

l joints 滑膜关节
Synovial joints 滑膜关节
Basic structures
 Articular surface 关节面 : cov
ered by articular cartilage 关
节软骨
 Articular capsule 关节囊
 Fibrous membrane 纤维膜
 Synovial membrane 滑膜
 Articular cavity 关节腔 : contai
ning a trace of synovial fluid; s
ubatmospheric pressure in it
Accessory structures
 Ligaments 韧带 (lig.): e
xtra- and intracapsular l
igaments 囊外 ( 内 ) 韧
带
 Articular disc 关节盘
and articular labrum
关节唇 :
 Synovial fold 滑膜襞 a
nd synovial bursa 滑膜
囊
Terms movements of join
Translation 移动
ts
 关节运动术语
Flexion and extension 屈和伸
 Adduction and abduction 收和展
 Rotation 旋转
 Medial and lateral rotation 旋内和旋外
 Pronation ans supination 旋前和旋后
 Inversion and eversion 足内翻和足外翻
 Circumduction 环转
Classification of synovial joints
关节的分类
 Uniaxial joints 单轴关节 :
 hinge joints 屈戍关节
 trochoid (pivot) joints 车轴关节
 Biaxial joints 双轴关节 :
 ellipsoid joints 椭圆关节
 saddle joints 鞍状关节
 Multiaxial joints 多轴关节 :
 ball-and-socket joint 球窝关节
 plane joints 平面关节
Articulations of Bones of Trunk
躯干骨的连结

The vertebral column 脊柱

consists of 24 vertebrae,
the sacrum, and the coc
cyx.
Joints of the vertebral bodies 椎体
间的连结
Intervertebral discs
椎间盘
between bodies of adjacent v
ertebrae, composed of:
 Nucleus pulposus 髓核 , an
inner soft, pulpy, highly elast
ic structure (gelatinous core
)
 Annulus fibrosus 纤维环
an outer fibrous ring consisti
ng of fibrocartilage
Hemination of nucleus pulposus
髓核脱出
Anterior longitudinal ligament

 前纵韧带
Strong band covering the anterior part of the
vertebral bodies and intervertebral discs runn
ing from the anterior margin of foramen mag
num to the S1~S2
 Maintains stability of the intervertebral disc a
nd prevents hyperextension of the vertebral c
olumn
Posterior longitudinal ligamen
t 后纵韧带
 Attached to the posterior aspect of the interv
ertebral discs and posterior edges of the vert
ebral bodies from C2 vertebra to sacrum
 Prevents hyperflexion of the vertebral colum
n and posterior protrusion of the discs
 Joints of the vertebral arches 椎弓间
的连结
 Ligamenta flava 黄韧带― elasti
c ligament, unite laminae of adjac
ent vertebrae, and complete the p
osterior wall of vertebral canal; te
nd to prevent hyperflexion of the v
ertebral column
 Interspinal ligament 棘间韧带
 Supraspinal ligament 棘上韧带
 Ligamentum nuchae 项韧带
 Intertansverse ligament 横突间韧
带
 Zygapophysial joint 关节突关节
Atlantooccipital joint 寰枕关
节
 Between superior articu
lating surfaces of atlas
and occipital condyles
 Supported by membran
ces and ligaments that j
oin occipital bone and a
tlas
 Action ― nodding of he
ad, lateral tilting of head
Atlantoaxial joint 寰枢关节
 Three synovial joints betwe
en atlas and axis
 Laterally, paired joints betw
een articulating facets
 Median joint between dens
of axis and anterior arch of
atlas
 Supported by ligaments
 apical ligament of dens 齿突
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 h
ead) to pivot on the axis and
vertebral column
Normal Curves of vertebral
column
 Cervical curvature 颈曲 conv
ex forward
 Thoracic curvature 胸曲 con
vex backward
 Lumbar curvature 腰曲
convex forward
 Sacral curvature 骶曲 convex
backward
Movement of the verteb
ral column
 flexion
 extension
 lateral flexion
 rotation
Spina bifida cystica 脊柱裂
Thoracic cage 胸廓

Composition
Bones ― consists of
twelve thoracic
vertebrae, twelve pairs
of ribs and costal
cartilages, and sternum
Joints
 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 :
 Interchondral joints 肋软骨连结
: between costal cartilages 8,
9, and 10 to form the costal ar
ch 肋弓
General features of thoracic cage
 Roughly cone-shape, narrow abo
ve and broad below, flattened fro
m before-backwards, longer behin
d than in front
 Inlet of thorax 胸廓上口 : bounded
by upper border of manubrium, fir
st rib, and vertebra T1
 Outlet of thorax 胸廓下口 : bound
ed by vertebra T12, 12th and 11th
ribs, costal arch and xiphoid proc
ess
 Infrasternal angle 胸骨下角 : forme
d by the costal arch of both side
 Intercostal spaces 肋间隙 : lie bet
ween the ribs
 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 颅骨的连结
 Continuous joints: sutur
es, synchondrosis or sy
nosteosis
Temporomandibular joint 颞下颌关
节Aticulating
 surfaces
Mandibular fossa and articular tu

bercle, above
 Head of mandibule, below
 Capsule: thin and lax in front and
behind; strengthened by the later
al ligament 外侧韧带
 Articular disc: separates surface
s, forming upper and lower comp
artments within joint
 Movement: mandible may be ele
vated or depressed, protruded or
retracted; rotation may also occu
rs as in chewing( a slight amount
of side to side movement is also
permitted)
Joints of limbs

山东大学医学院 解剖教研室
李振华
 Joints of upper limb
Joints of should girdle
 Sternoclavicular joint 胸锁关节
 Bones: sternal end of clavicle, clav
icular notch of sternum, and first co
stal cartilage
 Articular capsule: strong and is re
inforced by anterior and posterior s
ternoclavicular ligaments
 An articular disc is attached to the
capsule, dividing the joint into two
cavities.
 Movements: elevation and depres
sion, forward and backward, rotatio
n and circumduction of the acromia
l end of the clavicle
 coracoacromial
 Acromioclavicular joint 肩锁关节 acromion ligament
 Bones: acromion and acro coranoid process
mial end of clavicle
 Movement: rotation of sca
pula on clavicle
 Coracoacromial arch 喙肩弓
formed by coracoacromial lig
ament 喙肩韧带 , coranoid proc
ess, and acromion, that prevent
s the shoulder joint
from superior dislocation
Joints of free upper limb
★Shoulder joint 肩关节
(ball and socket)
 Bones: head of humerus and gl
enoid cavity of scapula
 Capsule:
 Thin and lax, especially lower par
t
 Attachments: proximal to glenoid
labrum; distal to anatomical neck
of humerus, except medially whe
re it is slightly distal to surgical n
eck
 Tendon of long head of biceps br
achii passes though the cavity
 Accessory structures
 Glenoid labrum 盂唇 : fibr
ocartilaginous ring on per
iphery of glenoid cavity
 Coracohumeral ligament
喙肱韧带： runs from cora
coid process to greater tu
bercle
 Movements: flexion, ext
ension, adduction, abduct
ion, medial and lateral rot
ation, circumduction
★ Elbow joint 肘关节
 Bones: lower end of humerus, upper en
ds of radius and ulna
 Humeroulnar joint 肱尺关节 :
formed by trochlear of humerus and trocle
ar noch (hinge)
 Humeroradial joint 肱桡关节 :
formed by capitulum of humerus and hea
d of radius (ball and socket)
 Proximal radioulnar joint 桡尺近侧关节 : for
med by articular circumference of radius
and radial notch of ulna
 Capsule: thin and lax anteriorly and pos
teriorly, strongly thickened on either side
by collateral ligaments
 Ligaments:
 Radial collacteral ligament 桡侧副韧带 : a
ttached to lateral epicondyle and annular li
gament of radius
 Ulnar collacteral ligament 尺侧副韧带 : att
ached to medial epicondyle to medial bord
er of trochlear notch
 Annular ligament of radius 桡骨环状韧带 :
attached to anterior and posterior margins
of radial notch of ulna, surrounds the head
of radius
 Movements: flexion and extension, pr
onation and supination
Dislocation
Joints between radius and ulna
 Proximal radioulnar joint 桡尺近侧关节
 Distal radioulnar joint 桡尺远侧关节 : for
med by head of ulna, ulnar notch of radiu
s and an articular disc
 Interosseous membrane of forearm
前臂骨间膜 : a fibrous membrane betwe
en the shaft of radius and ulna
Joints of hand
★ Radiocarpal joint 桡腕关节 (ell
ipsoid)
 Bones
 Carpal articular surface of radius a
nd articular disc below the ulna
 Proximal row of carpal: scaphoid, l
unate, and triquetral bones, but no
t pisiform
 Capsule: lax and strengthened by
surrounding ligament
 Movements: flexion, extension, a
dduction, abduction, and circumd
uction
 Intercarpal joints
 Carpometacarpal joints:

★ Carpometacarpal joint
of thumb 拇指腕掌关节
 Bones: trapezium and ba
se of first metacarpal
 Movement: flexion, exten
sion, adduction, abductio
n, and opposition
 Intermetacarpal joints
 Metacarpophalangeal j
oints
 Interphalangeal joints
 Joints of Lower limb
Joints of pelvic girdle
 Sacroiliac joint 骶髂关节

 Bones: auricular surface of sacrum and ilium

 Capsule: very tight and strengthened by ligaments

Vertebropelvic ligaments
 Iliolumbal ligament 髂腰韧带 : r
uns from transverse process of
L5 to the posterosuperior part
of iliac crest
★ Sacrotuberous ligament
骶结节韧带 : runs from lateral
margins of sacrum and coccyx
to the inner margin of ischial tu
berosity
★ Sacrospinous ligament
骶棘韧带 : runs from ischial s
pine to lateral margins of sacru
m and coccyx
 These two ligaments convert t
he sciatic notches the greater
and lesser sciatic foramina
坐骨大、小孔
 Pubic symphysis
耻骨联合
 Articulation: symphysial s
urface and interpubic disc
(fibrocartilage)
 Ligaments: superior pubi
c ligament and arcuate p
ubic ligament
 Obturator membrane
闭孔膜
obturator canal 闭膜管
 Bony pelvis 骨盆
Composition: formed by paired hip bone
s, sacrum, coccyx, and their articulati
ons
 In anatomical position, anterior superi
or iliac spines and pubic tubercles on
same vertical plane, while the tip of c
occyx and superior border of pubic sy
mphysis on same horizontal plane
 Terminal line 界线 : formed by prom
ontory of sacrum, arcuate line, pectin
of pubis, pubic tubercle, upper border
of pubic symphysis
 Two portions: a greater pelvis and a l
esser pelvis
Lesser pelvis 小骨盆
 pelvic inlet 骨盆上口 (t

erminal line):
 Pelvic outlet 骨盆下口 :

formed by tip of coccyx,

sacrotuberous ligament
, ischial tuberosity, ram
us of ischium, inferior ra
mus of pubic, symphysi
s
 Pelvic cavity

 Pubic arch, subpubic a

ngle
 Main difference between male and femal pelv
is
Main difference between male and femal p
elvis Male
Female

Pelvic inlet

Pelvic outet

Pelvic cavity

Pubic arch

90~1000 70~750
 Main difference between male and femal p
elvis
Male Female
Overall Narrow and long Wide and short
Iliac ala More vertical More horizontal
Inlet Oval or heart shaped Round
Subpubic an Acute angle (about Right angle (about
gle 70~750) 90~1000)
Pelvic cavity Deep narrow Shallower, wide
Outlet Small Larger
 Joints of free lower limb
★ Hip joint 髋关节
 Bones: acetabulum and femor
al head
 Articular capsule attachments
 Above: margins of acetabulum
and transverse acetebular liga
ment
 Below: in front to intertrochante
ric line; behind, to the neck of f
emur above 1 cm above the int
ertrochanteric crest
 Accessory structures
 Acetabulum labrum 髋臼唇 ;
transverse acetebular ligam Acetabulum labrum
ent 髋臼横韧带
 Ligaments Ligament of head
 Iliofemoral lig. 髂股韧带 of femur
 Ligament of head of femu
r 股骨头韧带
 Pubofemoral lig. 耻股韧带
 Ischiofemoral ligament
坐股韧带
 Zona orbicularis 轮匝带
 Movement: flexion, extentio
n, adduction, abduction, me Transverse
dial and lateral rotation, circ acetebular lig.
umduction
 Pubofemoral li
g.

Iliofemoral li
g.

Ischiofemoral
lig.

Zona orbicularis
★Knee joint 膝关节
 Bones: lower end of femur, upper end of tibia and patella

 Articular capsule: superapatellar bursa 髌上囊 , deep infrapat

ellar bursa 髌下深囊 , ala folds 翼状襞
 Accessory structures
 ligaments
 Patellar lig. 髌韧带
 Fibular collateral lig. 腓侧副韧带
 Tibial collateral lig. 胫侧副韧带

Fibular
collateral
Patellar lig. lig.
Tibial collateral
lig.
 Oblique popliteal ligament 腘斜韧带
 Anterior cruciate ligment 前交叉韧带
 Posterior cruciateligament 后交叉韧带
  Medial meniscus 内侧半月板 (C-shaped)
 lateral meniscus 外侧半月板 (O-shaped)
 Movements: flexion and extension; flexed knee joint ma
y be passively rotated through 700

lateral
Medial
Tibiofibular syndesmosis
胫腓连结
 Tibiofibular joint 胫腓关节
 Crural interosseous mem
brane 小腿骨间膜
 Anterior and posterior tibi
ofibular ligaments
胫腓前、后韧带
Joint of foot
Talocrural joint 距小腿关节
(ankle joint) 踝关节
 Bones: lower ends of tibia

and fibula, trochlea of talus

 Articular capsule: thin and l

ax in front and behind, and

supported on each side by
strong collateral ligaments
 Ligments
 Medial lig. 内侧韧带
 Lateral lig. 外侧韧带
 Anterior talofibular lig.
距腓前韧带
 Calcaneofibular lig. 跟腓韧带
 Posterior talofibular lig.
距腓后韧带
 Movements: dosiflexion (ext
ension) and plantar flexion (fl
exion); when the ankle joint i
s fully plantar flexed, small a
mounts of abduction, and ad
duction
are possible
 Intertarsal joints 跗骨间关节
 Talocalcaneal joint 距跟关节
 Talocalcaneonavicular joint
距跟舟关节
transverse tarsal joint 跗横关节
 Calcaneocuboid joint
跟骰关节
 Tarsometatarsal joints
跗跖关节
 Intermetatarsal joints
跖骨间关节
 Metatarsophalangeal joint
s 跖趾关节
 Interphalangeal joints
趾间关节
Arches of foot 足弓
 Medial longitudinal arch 内侧纵弓 : formed by ca
lcaneus, navicular, three cuneiforms and first to th
ird metatarsal bones, head of talus is the keyston
e of this arch
 Lateral longitudinal arch 外侧纵弓 :
formed by calcaneus, cuboid, fourth and fifth metatarsa
ls; cuboid is is the keystone of this arch
 Tranverse arch 横弓 :
formed by cuboid, three cuniforms and all metatarsa
ls; the intermediate cuneiform is the keystone of this
arch
 Function: give to foot strength stability and resilienc
e; protect plantar vessels and nerves
Normal arch Flatfoot
 Myology 肌学
 Morphology
 Muscle belly 肌腹
 Tendon 肌腱
aponeurosis 腱膜
 Classification
 Long muscle 长肌
 Short muscle 短肌
 Broad muscle 阔肌
 Orbicular mucle 轮匝
肌
 Origin 起点 ins
ertion 止点
position 位置
action 作用
 Nomenclature of
mucles 肌的命名
: shap, size, loca
tion, and their po
ints of attachme
nt
Accessory structures
 Fascia
 Superficial fascia
 Deep fascia
 Synovial bursa
 Tendinous sheath
 Fibrous layer
 Synovial layer: mesoten
don, vincula tendinum
Synovial cyst of wrist 腕部腱
鞘囊肿