Joints of the Upper limb ( A complementary sheet )

1

The elbow Joint :

- It’s a synovial hinge joint in which the

trochlea and capitulum articulate with

the trochlear notch of ulna and the head

of radius , the articulate surfaces are

covered by hyaline cartilage.

- The fibrous capsule :

Anteriorly it’s attached above to the

upper margins of radial radial and

coronoid fossae and to the front of

medial and lateral epicondyles , below

it’s attached to the anular ligament and

coronoid process .

To Remind You Joints are classified structurally into

three types: 1- synovial joints: the bones forming the

joint have a synovial cavity and are united by a capsule of CT and often by accessory ligaments ( eg : knee and hip

joints ) 2- Cartilaginous joints: there’s no synovial cavity and bones are held

together by cartilage (e.g : intervertebral joints )

3- fibrous joints: no synovial cavity , bone are held together by dense

Irregular CT rich in collagen fibers ( e.g : sutures of the skull bones )

Joints of the Upper limb ( A complementary sheet )

2

posteriorly it’s attached above to the margins of olecranon fossa , below to the olecranon

process and anular ligament.

- The synovial capsule ( membrane ) :

It covers the radial, coronoid and olecranon fossae , and lines the inner surface of the

fibrous capsule , and then continues below with the synovial membrane of the proximal

radioulnar joint.

- Ligaments of the elbow

joint :

1- Medial “ ulnar “ collateral

ligament :

It’s a thick and triangular

ligament , consists of three

strong bands , extending the

medial epicondyle to the

coronoid process and

olecranon of ulna.

- This ligament is crossed by

ulnar Nerve.

2- Lateral “ radial “ collateral

ligament :

It’s a weak and triangular

ligament , attached by it’s

apex the lateral epicondyle

extending to the anular

ligament.

- Nerve supply :

1- Radial nerve.

2- Ulnar nerve,

3- Musculocutaneous nerve.

4- Median nerve.

Joints of the Upper limb ( A complementary sheet )

3

- Relations :

1- Anteriorly : brachialis , biceptal tendon , brachial artery and the median nerve

( BBBM )

2- Posteriorly : the triceps muscle and bursa in between.

3- Laterally : the common extensor tendons and supinator muscle .

4- Medially : the ulnar nerve , which crosses the medial ligament and passes behind

the medial epicondyle.

- Movements :

It allows flexion and extension of the forearm , while flexion coronoid process

articulates with the coronoid fossa , and while extension olecranon process articulates

with the olecranon fossa .

The proximal radioulnar Joint :

- It’s a synovial pivot joint in which the radial head

articulates with the radial notch of ulna .

- fibrous capsule of this joint continues with that of

the elbow joint and it covers the whole joint .

- Synovial membrane :

continues with the synovial membrane of the elbow

joint and it lines the fibrous capsule.

- Ligament :

there’s a single ligament which is the anular ligament ,

extends from the anterior to posterior margins of

radial notch like a tie around the head , it continues

above with the capsule of elbow joint ,

[ Remember that supinator muscle is originated form

this ligament ]

- Nerve supply : ( the same as elbow joint )

1- Median nerve.

2- Ulnar nerve.

3- Radial nerve.

4- Musculocutaneous nerve.

Joints of the Upper limb ( A complementary sheet )

4

- Movement :

Pronation and supination of the forearm.

- Relations :

1- Anteriorly : supinator muscle and the radial nerve.

2- Posteriorly : supinator muscle and the common extensor tendons.

The distal radioulnar joint :

Articulation: Between the rounded

head of the ulna and the ulnar notch on the radius.

Type : Synovial pivot joint.

Capsule : The capsule encloses the joint

but is deficient superiorly.

Ligaments : Weak anterior and

posterior ligaments strengthen the capsule.

Articular disc : This is triangular and composed of fibrocartilage. It is attached by its apex to the lateral side of the base of the styloid process of the ulna and by its base to the lower border of the ulnar notch of the radius. It shuts off the distal radioulnar joint from the wrist and strongly unites the radius to the ulna.

Synovial membrane: This lines the capsule passing from the edge of one articular surface to that of the other.

Nerve supply: 1-Anterior interosseous nerve 2-the deep branch of the radial.

movements : pronation and supination ( the same as the proximal one )

Relation : 1- Anteriorly: The tendons of flexor digitorum profundus. 2- Posteriorly: The tendon of extensor digiti minimi.

Joints of the Upper limb ( A complementary sheet )

5

Wrist Joint (Radiocarpal Joint) :

Articulation:

Between the distal end of the radius and the articular disc above and the scaphoid, lunate, and triquetral bones below . The proximal articular surface forms an ellipsoid concave surface, which is adapted to the distal ellipsoid convex surface.

Type: Synovial ellipsoid joint.

Capsule:

The capsule encloses the joint and is attached above to the distal ends of the radius and ulna and below to the proximal row of carpal bones.

Ligaments:

Anterior and posterior ligaments strengthen the capsule. The medial ligament is attached to the styloid process of the ulna and to the triquetral bone. The lateral ligament is attached to the styloid process of the radius and to the scaphoid bone.

Synovial membrane: This lines the capsule and is attached to the margins of the articular surfaces. The joint cavity does not communicate with that of the distal radioulnar joint or with the joint cavities of the intercarpal joints.

Nerve supply: ( the same as the distal radioulnar joint )

1- Anterior interosseous nerve 2-the deep branch of the radial nerve.

Movements : flexion, extension, abduction, adduction, and circumduction.

Notice that the elbow and the proximal radioulnar joints

have the same innervation , and the same about the

wrist and distal radioulnar joints.

Joints of the Upper limb ( A complementary sheet )

6

Relations :

1-Anteriorly: The tendons of the flexor digitorum profundus and superficialis, the flexor

pollicis longus, the flexor carpi radialis, the flexor carpi ulnaris, and the median and

ulnar nerves.

2-Posteriorly: The tendons of the extensor carpi ulnaris, the extensor digiti minimi, the

extensor digitorum, the extensor indicis, the extensor carpi radialis longus and brevis,

the extensor pollicis longus and brevis, and the abductor pollicis longus .

3-Medially: The posterior cutaneous branch of the ulnar nerve.

4-Laterally: The radial artery.

Note : this Sheet is written according to snell’s book , Hope you find it useful

إلى العلياء غير مزاحم العلا و ترقىأيا صاحبي إن رمت أن تكسب

عليك بحسن الصبر في كلّ حالةٍ فما صابر بما يروم بنادم

Done by :

Majd Al-majali

Yasmeen Aljade

Types of the synovial joints ( the Dr didn’t talk about that but we should know

what’s meant by each type since he just mentioned them )

1- Planar : articulated surfaces are flat or slightly curved ( intercarpal joint )

2- Hinge : convex surface fits into a concave surface ( elbow and

interphalangeal joints )

3- Pivot : rounded or pointed surfaces fits into a rong formed partly by bone

and partly by ligament ( radioulnar joints )

4- Ball-and-socket : ball like surface fits into a cuplike depression ( shoulder

and hip joints )

5- Condyloid : oval-shaped projection fits into an oval-shaped depression

( radiocarpal and metacarpophalangeal joints)

6- Saddle : Articular surface of one bone is saddle-shaped , and the articular

surface of the other bone sits in the saddle ( carpometacarpal joint between

trapezium and the thumb )