Guo-Fang Tseng, p.1 of 3
Joints of shoulder girdle and upper limb
Shoulder girdle
1) Sternoclavicular joint: articular disc
sternoclavicular lig
costo-clavicular lig
interclavicular lig
2) Coracoclavicular lig: no articular surface
conoid lig
trapezoid lig
3) Acromioclavicular joint: joint capsule
Shoulder joint:
Ball and socket: head of humerus + glenoid cavity of scapula
Supraglenoid tubercle: biceps-long head
Infraglenoid tubercle: triceps-long head
Glenoid labrum: fibrocartilage
Fibrous capsule and ligaments: loose capsule to allow great movement
Coracohumeral ligament:
top of capsule: prevents inf. dislocation of the adducted humerus and also limits
lateral rotation.
Posterior part blends with fibrous capsule.
Synovial membrane: lines the fibrous capsule
Interior of joint:
thickening of fibrous capsule; visible when capsule is relaxed
Glenohumeral lig: (posterior view) superior; middle: most prominent; inferior
Long head of biceps: synovial bursa communicates with the joint space
@ Transverse humeral ligament: across intertubercular sulcus
@ Rotator cuff or guardian muscles, or Accessory dynamic ligaments:
sup.: Supraspinatus (tendon fuses with joint capsule)
post.: Infraspinatus, Teres Minor
ant.: Subscapularis
@ Bursae:
Subscapularis bursa----subscapularis tendon (front)
Biceps synovial sheath
Subacromial (subdeltoid) bursa
@ Coracoacromial arch: Coracoid process + Coracoacromial lig. + Acromion
Secondary socket for head of humerus, prevent upward displacement.
@ Summary of muscle innervation around the shoulder joint:
C5, 6: flexion, abduction, and lateral rotation
C5-T1: extension, adduction, and medial rotation
 damage of C5-6:  "tip-taking" position of upper limb
(upper trunk)
Guo-Fang Tseng, p.2 of 3
Elbow Joint:
Hinge joint (with collateral ligaments); continuous with proximal radioulnar joint
Bones:
1) Humeroulnar part:
A) Distal humerus: trochlea; coronoid fossa; olecranon fossa
@ Medial epicondyle
B) Proximal Ulna: coronoid process; olecranon; trochlear notch
@ Olecranon bursa: underneath skin
@ Radial notch of Ulna: facet on the lat. surface of coronoid process
@ Brachialis inserts on the ant surface of coronoid process (ulnar tuberosity)
2) Humeroradial part:
A) Distal humerus: capitulum
@ Lateral epicondyle
B) Proximal Radius: fovea: facet
Ligaments and Capsule:
Radial collateral ligament: lat. epicondyle  side of annular ligament
Ulnar collateral ligament: med. epicondyle  medial margin of trochlear notch
Fibrous capsule:
Proximal radioulnar joint:
Annular ligament: attaches to radial notch of the Ulna; cup-shaped
Carrying angle: with the joint fully extended,
humerus not in a straight line with ulna
distal end of Ulna lies lateral to the axial line of humerus
Radioulnar joint:
Proximal: included in elbow joint
Intermediate: interosseous membrane; note orientation of fibers
Distal:
Head of Ulna slides on the ulnar notch of Radius
Articular disc at the end of the head of Ulna
Articular disc: Pit (base, styloid process of Ulna) lower border of ulnar notch of Radius
@ Test: fixing shoulder joint: pronation + supination = 180°
free shoulder joint: pronation + supination = 270°
Bones and Joints of Wrist and Hand
2 rows of carpal bones (from radial  ulnar)
Distal row: Trapezium, Trapezoid, Capitate, Hamate
Proximal row: Scaphoid, Lunate, Triquetrum, Pisiform
Guo-Fang Tseng, p.3 of 3
Facts:
Carpal bones:
1) Pisiform sits in front of Triquetrum and articulates with it only.
2) Scaphoid + Lunate + Triquetrum  convex, ovoid articular surface
Movement: flexion, extension, abduction, adduction, circumduction
3) Capitate, the largest, with its head fits into the proximal row
4) Scaphoid elongated distally
6) Mid (transverse) carpal joint: sinuous, between prox. & distal rows of carpal bones
Movement: most of the apparent flexion of the wrist (radiocarpal) joint,
but not much abdution or adduction
Carpo-metacarpals:
1) Saddle joint between Trapezium and 1st metacarpal  great mobility
2) 2nd metacarpal fits tightly to Trapezium, Trapezoid & Capitate
3) 3rd metacarpal fits on Capitate
4) 4&5th metacarpals fit on Hamate: slight degree of flexion
5) Articulation between the lateral side of the bases of 2nd, 3rd, 4th & 5th metacarpals
Wrist (Radiocarpal) Joint:
Articular disc: attaches to fossa at the base of the styloid process of ulna,
covers the surface of the head of ulna
Socket: inferior articular surface of radius + articular disc
Convex surface: proximal articular surface of Scaphoid, Lunate & Triquetrum + interosseous
ligament binding these three bones.
Ligaments: runs obliquely & inferomedially
Palmar radiocarpal ligament
Palmar ulnocarpal ligament
Dorsal radiocarpal ligament: strong
Dorsal ulnocarpal ligament: weak
Radial (lateral) collateral ligament: radial styloid process  scaphoid
Ulnar (medial) collateral ligament: ulnar styloid process  triquetrum
Metacarpophalangeal joints: 2-5th digits,
Condyloid joint (biaxial): flexion, extension, abduction, adduction.
Collateral ligament
Extensor expansion covers the posterior capsule
Anteriorly, palmar ligament (plate)
Deep transverse metacarpal ligament: connects the palmar ligaments of 4 digits.
@ abd & add only when joints are extended.
d.
Phalanges and their joints:
Extensor expansion on dorsal surface of proximal phalanx
Osseofibrous tunnel: on palmar surface; flexor tendon slides in it
Interphalangeal joint: hinge joint: flexion/extension