Bones, , of the upper and lower limb

Pelvis Sternoclavicular Articular disc Anterior sternoclavicular ligament Posterior sternoclavicular ligament Costoclavicular ligament Acromioclavicular joint Acromioclavicular ligament (Articular disc)

Coracoclavicular ligament

Trapezoid ligament

Conoid ligament Glenohumeral joint; joint Glenoid labrum Glenohumeral Transverse humeral ligament

Rotatory cuff

Coraco-acromial ligament Superior transverse scapular ligament joint Humero-ulnar joint Proximal radio- ulnar joint Ulnar collateral ligament Radial collateral ligament Anular ligament of Radio-ulnar syndesmosis Interosseous membrane of Oblique cord

Distal radio-ulnar joint Articular disc Sacciform recess Joints of joint Ulnar collateral ligament of wrist joint Radial collateral ligament of wrist joint Carpal joints; Radiate carpal ligament Interosseus intercarpal ligaments Pisiform joint Pisohamate ligament Pisometacarpal ligament Carpometacarpal joints Dorsal carpometacarpal ligaments Palmar carpometacarpal ligaments Carpometacarpal joint of thumb Intermetacarpal joints Dorsal metacarpal ligaments Palmar metacarpal ligaments Interosseous metacarpal ligaments Interosseous metacarpal spaces Wrist joint Ulnar collateral ligament of wrist joint Radial collateral ligament of wrist joint Carpal joints; Intercarpal joints Midcarpal joint Radiate carpal ligament Interosseus intercarpal ligaments Pisiform joint Pisohamate ligament Pisometacarpal ligament Carpal tunnel Carpometacarpal joints Dorsal carpometacarpal ligaments Palmar carpometacarpal ligaments Carpometacarpal joint of thumb Intermetacarpal joints Dorsal metacarpal ligaments Palmar metacarpal ligaments Interosseous metacarpal ligaments Interosseous metacarpal spaces Metacarpophalangeal joints

Collateral ligaments

Palmar ligaments

Interphalangeal joints of hand, proximal and distal

Collateral ligaments

Palmar ligaments True pelvis 4 planes, baby´s head has to descend during birth The biggest diameter of the newborn´s head fits into the biggest diameter of each plane Pelvic measurements in obsterics (and anatomy) - straight, obligue and transverse diameter

1. pelvic inlet – promontory, iliopectineal lines, symphysis/ transverse diameter –13 cm/

2. pelvic cavity amplitudo – S2-3, acetabulum, center of symhysis/ oblique diameter.-13,5 cm/

3. angustia (narow)- spina ischiadica, sacrum, lower end of symphysis / str. diameter –11,5 cm/

4. pelvic outlet - 2 triangles – pubic arch, ischial tuberosities, coccyx / str. diameter 9–11,5 cm/ inlet amplitudo

angustia outlet true (obstetric) conjugate – from retropubic eminence to promontory 10,5 cm diagonal conjugate – lower edge of symphysis to promontory –13cm external pelvic meauserments: interspinous distance – 26 cm intercristal distance – 29 cm intertrochanteric distance – 31 cm external conjugate (Badelocque) – upper edge of symphysis to spinous process of L5, 18-20 cm SI joint almost immobile kloub (amphiarthrosis) auricular surfaces of both bones strong capsule – sacroiliac lig. (ventr., dors., interosseous) iliolumbar lig. connecting the ilium to the L4,L5 sacrotuberous and sacrospinous ligg. symphysis pubis

-cartilagineous interpubic disk with small nonsynovial cavity superior and inferior pubic ligament

obturator membrane -obturator canal for obturator blood vessels and nerve angle of inclination 125-130

coxa valga

coxa vara

Hip joint ball and socket joint femoral head–lunate surface of acetabulum additional features: acetabular lip (labrum), transverse acetabular lig.

reinforcing ligg.: iliofemoral lig. pubofemoral lig. ischiofemoral lig. zona orbicularis lig. of the head of F Movements

flexion/extension abduction/adduction rotation circumduction

Knee joint complex joint: femorotibial +femoropatellar

femoral condyles – tibial condyles incongruence of their surfaces is compensated by menisci med. + lat. patellar surface of F -articular surface of P Ligaments 1 patellar lig. med. + lat. patellar retinaculum tibial collateral lig. fibular collateral lig. oblique popliteal lig. arcuate politeal lig.

Ligaments 2 anterior cruciate lig. posterior cruciate lig. transverse lig. of the knee ant. + post. meniscofemoral lig.

infrapatellar fat pad

synovial and fibrous layer of capsule are separated - cruciate ligg are intracapsular but extra-articularly movements

flexion/extension combined with rotation gliding and rolling movements extended knee is in locked position (medial rotation of F)- initial phase of flexion is unlocking (untwisting) process (lateral rotation of F)

forced abduction/adduction arthroscopy

subtalar joint (post.articular facets of T and C) talocalcaneonavicular calcaneocuboid form functional complex allowing eversion/inversion of foot proximal T-F joint head of F- fib.art.facet of lat.tib.condyle interosseous membrane dist. T-F joint = tibiofibular syndesmosis - special kind of connection allowing minimal movement essential for proper ankle joint function ant. + post.tibiofibular ligg.

Joints of foot art. talocruralis - talocrural joint– (upper) ankle joint

lower ankle art. subtalaris – subtalar joint + art. talocalcaneonavicularis

art. cuneonavicularis art. tarsometatarsales art. metatasophalangealee art. interphalangeales Ankle (talocrural) joint trochlea(pulley) of T - malleolar mortise (deep socket) medial = deltoid lig.(4 parts) lateral lig. (3 parts) movement: plant.flexion/dors. flexion

Deltoid (medial) ligament - tibionavicular part - ant. tibiotalar part - tibiocalcaneari part - post. tibiotalar part

Lateral ligament - ant. talofibular ligament -post. talofibular lig. -calcaneofibular lig.

.

Inversion= Plantar flexion+adduction + supination

Eversion= Dorsal flexion+abductiom + pronation Rtg ATC

Chopart´s joint line = transverse tarsal joint complex of C-C and T-N joint bifurcate lig. (calcaneonavicular + calcaneocuboid)

Lisfranc´s joint line - complex of tarsometatarsals and intermetatarsals joints MTT2 projects proximally !

Great number of short ligg. connecting leg bones to tarsals, connecting tarsals between themselves, connecting tarsals and metatarsals Chopart´s joint Lisfranc´s joint plantar aponeurosis, long plantar lig., plantar calcaneonavicular (spring) lig., short plantar ligg. Foot (plantar) arches tarsal and MTT bones are arranged in longitudinal (med. , lat.) and transverse arches with shock absorbing, weight bearing function are maintained by: 1. Shape of interlocking bones 2. Strength of the plantar ligg. + plantar aponeurosis 3. Action of tendons of muscles – tibialis ant. and post., peroneus longus and btrevis, flexors of the foot Transverse arch Longitudinal arch

Drawings for the next week

Scheme of joints of hand Scheme of joints of foot, complete the line of Chopart´s and Lisfranc´s joint

Frontal section through the . Complete the ligaments and joint capsule of hip

Frontal section through the hip joint. Complete the ligaments and joint capsule of hip

Scheme of upper surfaces of tibia with menisci. Complete the cruciate and collateral ligaments and insertion of layers of joint capsule.