arthrology 关节学 山东大学医学院 解剖学教研室 李振华. classification two major...
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Arthrology 关节学
山东大学医学院 解剖学教研室李振华
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Classification
two major types Continuous joints 直接连结 Discontinuous joints 间接连结 - synovial joints 滑膜关
节
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Continuous joints 直接连结 Fibrous joints 纤维连结
Syndesmosis 韧带连结 Suture 缝
Cartilaginous joints 软骨连结 Synchondrosis
透明软骨结合 Symphysis
纤维软骨联合 Synosteosis 骨性结合
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Synovial Joints 滑膜关节Basic structures Articular surface 关节面 : covered
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 : Containing a trace of synovial fluid Subatmospheric pressure in it
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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 and synovial bursa 滑膜囊
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Joint Movement Terminology 关节运动术语
Translation 移动 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
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flexion( 屈 )\ extension( 伸 )
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adduction( 内收 )\ abduction( 外展 )
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Rotation (旋转) Bone revolves around its o
wn 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
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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
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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 车轴关节 round end fits into ring of bone + ligament rotation on long axis (eg) prox. radius/ulna,
atlas/dens
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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 movem
ent (eg) carpometacarpal jt of thumb
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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) should
er, femur plane joints 平面关节
articular surface in flat plane Short gliding movement (eg) intertarsal, articular process
es of vertebrae
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Sprains• 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.
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Dislocations
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Arthritis
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Joints of Bones of Trunk躯干骨的连结
Vertebral column 脊柱 consists of 24 vertebrae, the s
acrum, and the coccyx.
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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 str
ucture (gelatinous core ) Annulus fibrosus 纤维环 an outer fibrous ring consisting of fibr
ocartilage
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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 t
he 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
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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
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Hemination of nucleus pulposus 髓核脱出
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Joints of the vertebral arches 椎弓间的连结
Ligamenta flava 黄韧带 ― elastic ligament, unite laminae of adja
cent 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 Intertansverse ligament 横突间韧带 Zygapophysial joint 关节突关节
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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
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Atlantoaxial joint 寰枢关节 Three synovial joints between atlas
and axis Laterally, paired joints between
articulating facets Median joint between dens of a
xis 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 head) to pivot on the axis and vertebral column
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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 vert
ebrae are short and bifid; the spinous processes of thoracic vert
ebrae are long, point obliquely downward and overlapped each other;
the spinous processes of lumber vertebrae are nearly horizontally.
Lateral aspect:
shows four physiological curves
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The vertebral column as a whole
Four physiological curves
Cervical curvature
Thoracic curvature
Lumbar curvature
Sacral curvature
convex forward
convex backward
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The vertebral column as a whole
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Movement of the vertebral column
flexion extension lateral flexion rotation
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Lateral radiograph of the neck. The cervical curve of the vertebral column is well shown.
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Sagittal MRI of thoracolumbosacral spine. Sagittal MRI of cervicothoracic spine.
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Spina bifida cystica 脊柱裂
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Thoracic cage 胸廓
Composition twelve thoracic vertebrae twelve pairs of ribs and
costal cartilages sternum
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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 Interchondral joints 肋软骨连结 betwee
n costal cartilages 8, 9, and 10 to form the costal arch 肋弓
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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 胸骨下角 : formed by the costal arch of both side
Intercostal spaces 肋间隙 : lie between the ribs
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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
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Joints of skull 颅骨的连结
Continuous joints: Sutures Synchondrosis or synosteosis Temporomandibular joint
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Temporomandibular joint 颞下颌关节 Aticulating surfaces
Mandibular fossa and articular tubercle, above
Head of mandibule, below Capsule:
thin and lax in front and behind; strengthened by the lateral ligament 外侧韧带
Articular disc: separates surfaces forming upper and lower compartments within
joint Movement:
mandible may be elevated or depressed protruded or retracted rotation may also occurs as in chewing( a slig
ht amount of side to side movement is also permitted)