(2.6)--系统解剖学6-四肢骨连结.ppt

思考题思考题1 1、骨连结的概念和分类、骨连结的概念和分类2 2、各种直接连结的分类、各种直接连结的分类3 3、关节的概念和特点、关节的概念和特点4 4、关节的基本构造和辅助结构、关节的基本构造和辅助结构5 5、关节的运动方式、关节的运动方式6 6、椎骨的连结结构、椎骨的连结结构7 7、椎间盘的结构与功能、椎间盘的结构与功能8 8、脊柱的整合观及运动、脊柱的整合观及运动9 9、胸廓的连结结构、胸廓的连结结构1010、胸廓的整体观及运动、胸廓的整体观及运动1111、颞下颌关节的结构及运动、颞下颌关节的结构及运动Locomotive System第三节第三节 附肢骨连结附肢骨连结The joints of the bones of limbs The joints of the bones of limbs 一、上肢骨连结一、上肢骨连结The joint of upper limbThe joint of upper limb（一）（一）The joints of shoulder girdle The joints of shoulder girdle 上肢带骨连结上肢带骨连结1、Sternoclavicular Joint 胸锁关节：胸锁关节：Characteristic：关节囊坚韧，腔内有关节盘关节囊坚韧，腔内有关节盘Composition:锁骨的胸骨端、胸骨的锁切迹、第一锁骨的胸骨端、胸骨的锁切迹、第一肋软骨的上面肋软骨的上面Locomotive System一、上肢骨连结一、上肢骨连结The joint of upper limbThe joint of upper limb（一）（一）The joints of shoulder girdle The joints of shoulder girdle 上肢带骨连结上肢带骨连结Movements:前后运动前后运动(20-30)，上下运动，上下运动(60)，环转运动，环转运动 1、Sternoclavicular Joint 胸锁关节：胸锁关节：Locomotive System（一）（一）The joints of shoulder girdle The joints of shoulder girdle 上肢带骨连结上肢带骨连结Composition:由锁骨的肩峰端与肩峰的关节面构成由锁骨的肩峰端与肩峰的关节面构成3、Coracoacromial Ligament 喙肩韧带喙肩韧带Coracoacromial arch 喙肩弓：喙肩弓：Coracoacromial Ligament2、Acromioclavicular Joint 肩锁关节肩锁关节Acromion喙肩韧带喙肩韧带喙突喙突肩峰肩峰防止肩关节向上脱防止肩关节向上脱位位Coracoid processLocomotive System（二）（二）The joints of free upper limb The joints of free upper limb 自由上肢骨连结自由上肢骨连结1、Shoulder Joint 肩关节肩关节：典型的球窝关节：典型的球窝关节Characteristic：head of humerus 肱骨头肱骨头 glenoid cavity of scapula 关节盂关节盂Composition：头大，盂小，囊松头大，盂小，囊松关节盂小而浅；关节盂小而浅；关节囊薄而松弛；关节囊薄而松弛；囊内有肱二头肌肌腱通过囊内有肱二头肌肌腱通过Locomotive System（二）（二）The joints of free upper limb The joints of free upper limb 自由上肢骨连结自由上肢骨连结1、Shoulder Joint 肩关节肩关节Accessory structures 辅助结构辅助结构 1)Glenoid labrum 盂唇盂唇:2)Coracohumeral ligament 喙肱韧带喙肱韧带肩锁关节肩锁关节 喙肩韧带喙肩韧带 关节囊关节囊 肱二头肌长头腱肱二头肌长头腱 喙锁喙锁韧带韧带 盂唇盂唇喙肱韧带喙肱韧带Locomotive SystemMovements:flexion and extention屈屈伸伸adduction and bduction 内收内收外展外展 medial and lateral rotation旋内和旋外旋内和旋外 circumduction环转环转（二）（二）The joints of free upper limb The joints of free upper limb 自由上肢骨连结自由上肢骨连结1、Shoulder Joint 肩关节肩关节Locomotive System2、Elbow Joint 肘关节Composition:Humeroulnar joint 肱尺关节肱尺关节：formed by trochlear of humerus and troclear noch Humeroradial joint 肱桡关肱桡关节节：formed by capitulum of humerus and head of radius Proximal radioulnar joint 桡桡尺近侧关节尺近侧关节：formed by articular circumference of radius and radial notch of ulnaLocomotive System2、Elbow Joint 肘关节Character:capsule:capsule:前后壁薄而松弛，两侧壁厚而紧张前后壁薄而松弛，两侧壁厚而紧张ligament：Radial collacteral ligament 桡侧副韧带、桡侧副韧带、Ulnar collacteral ligament 尺侧副韧带、尺侧副韧带、Annular ligament of radius 桡骨环状韧带桡骨环状韧带桡侧副韧带桡侧副韧带 尺侧副韧带尺侧副韧带 Locomotive System2、Elbow Joint 肘关节桡骨小头半脱位桡骨小头半脱位Locomotive System2、Elbow Joint 肘关节Movements:flexion and extension屈伸；屈伸；pronation旋前，旋前，supination旋后旋后Locomotive System3、Joints between radius and ulna桡尺骨连结桡尺骨连结前臂骨骨折复位：前臂骨间膜在半旋前时最紧张。（1）Interosseous membrane of forearm 前臂骨间膜（2）Proximal radioulnar joint桡尺近侧关节（3）Distal radioulnar joint桡尺远侧关节运动：Pronation旋前 supination 旋后Locomotive System4、Joints of Hand 手关节（1）Radiocarpal Joint 桡腕关节Composion 桡骨腕关节面，尺骨下端的关节盘桡骨腕关节面，尺骨下端的关节盘 Characteristic：关节囊松弛，周围有韧带加强。Movements：flexion屈，extension伸，adduction收，abduction 展 circumduction环转手舟骨，月骨，三角骨手舟骨，月骨，三角骨Locomotive System4、Joints of Hand 手关节（2）Intercarpal joints 腕骨间关节腕骨间关节（4）Metacarpophalangeal joints 掌指关节掌指关节（5）Interphalangeal joints 指骨间关节指骨间关节（3）Carpometacarpal joints 腕掌关节：腕掌关节：Carpometacarpal joint of thum拇指腕掌关节拇指腕掌关节Locomotive System二、二、Joints of Lower limbJoints of Lower limb下肢骨连结下肢骨连结（一）（一）The joints of pelvic girdle The joints of pelvic girdle 下肢带连结下肢带连结1、Sacroiliac Joint 骶髂关节骶髂关节：特点：其周围有多条韧带加强 稳固性强Composition：auricular surface of ilium 髂骨耳状面、auricular surface of sacrum骶骨耳状面Locomotive System1、Sacroiliac Joint 骶髂关节骶髂关节：（一）（一）The joints of pelvic girdle The joints of pelvic girdle 下肢带连结下肢带连结髂腰韧带髂腰韧带 骶髂背侧韧带骶髂背侧韧带 骶髂腹侧韧带骶髂腹侧韧带 Locomotive System2、髋骨与脊柱间的韧带连结髋骨与脊柱间的韧带连结（1 1）Sacrotuberous Ligament Sacrotuberous Ligament 骶结节韧带骶结节韧带 （2 2）Sacrospinous Ligament Sacrospinous Ligament 骶棘韧带骶棘韧带 greater sciatic foramengreater sciatic foramen 坐骨大孔：坐骨大孔：lesser sciatic foramenlesser sciatic foramen坐骨小孔坐骨小孔:Sacrospinous Ligament骶棘韧带骶棘韧带Sacrotuberous Ligament骶结节韧带骶结节韧带greater sciatic foramen坐骨大孔坐骨大孔lesser sciatic foramen坐骨小孔坐骨小孔（一）（一）The joints of pelvic girdle The joints of pelvic girdle 下肢带连结下肢带连结Locomotive System3、Pubic SymphysisPubic Symphysis 耻骨联合4、Obturator MembraneObturator Membrane闭孔膜耻骨间盘耻骨间盘闭孔膜闭孔膜Composition symphysial surface 耻骨联合面 interpubic disc 耻骨间盘（一）（一）The joints of pelvic girdle The joints of pelvic girdle 下肢带连结下肢带连结Locomotive System5、Pelvis 骨盆骨盆 Composition:paired hip bones 髋骨、髋骨、sacrum骶骨骶骨和和coccyx尾骨尾骨（一）（一）The joints of pelvic girdle The joints of pelvic girdle 下肢带连结下肢带连结Terminal line界线：界线：promontory of sacrum骶岬骶岬,arcuate line弓状线弓状线,pecten of pubis耻骨梳耻骨梳,pubic tubercle耻骨结节耻骨结节,upper border of pubic symphysis耻骨联合上缘耻骨联合上缘以界线为标志，分为：以界线为标志，分为：greater pelvis 大骨盆大骨盆lesser pelvis小骨盆小骨盆Locomotive System5、Pelvis 骨盆骨盆 Pelvic inlet 骨盆上口:界线 Pelvic outlet 骨盆下口：lesser pelvis 小骨盆尾骨尖尾骨尖坐骨结节坐骨结节坐骨支坐骨支,耻骨下支耻骨下支耻骨联合耻骨联合（一）（一）The joints of pelvic girdle The joints of pelvic girdle 下肢带连结下肢带连结Locomotive System骨盆的性别差异骨盆的性别差异 项目项目 男性骨盆男性骨盆 女性骨盆女性骨盆骨盆外形骨盆外形 窄而长窄而长 宽而短宽而短骨盆上囗骨盆上囗 心形心形 近似圆形近似圆形骨盆下囗骨盆下囗 较窄小较窄小 较宽大较宽大骨盆腔骨盆腔 漏斗形漏斗形 圆桶形圆桶形骶骨、骶骨、窄而长，曲度大窄而长，曲度大 宽而短，曲度大宽而短，曲度大骶骨岬骶骨岬 突出明显突出明显 突出不明显突出不明显耻骨下角耻骨下角 70757075度度 9010090100度度 （一）（一）The joints of pelvic girdle The joints of pelvic girdle 下肢带连结下肢带连结5、Pelvis 骨盆骨盆 Locomotive System(二）二）joints of free lower limbjoints of free lower limb自由下肢骨连结自由下肢骨连结1、Hip Joint 髋关节髋关节(1)Composition：Acetabulum 髋臼femoral head 股骨头股骨头股骨头股骨头韧带股骨头韧带髋臼唇髋臼唇轮匝带轮匝带髂骨髂骨髋臼横韧带髋臼横韧带 Locomotive System(二）二）joints of free lower limbjoints of free lower limb自由下肢骨连结自由下肢骨连结1、Hip Joint 髋关节髋关节(2)Characteristic：髋臼深，周围有髋臼唇髋臼深，周围有髋臼唇acetabulum labrum 加深加深 关节囊紧张坚韧，后部窄（股骨颈骨关节囊紧张坚韧，后部窄（股骨颈骨折）折）Locomotive System1、Hip Joint 髋关节髋关节髋臼唇髋臼唇股骨头韧带股骨头韧带髋臼横韧带髋臼横韧带髂股韧带髂股韧带耻股韧带耻股韧带坐股韧带坐股韧带(2)Characteristic：ligaments韧带：韧带：Ligament of head of femur股骨头韧带、股骨头韧带、transverse acetebular ligament 髋臼横韧带、髋臼横韧带、iliofemoral ligament髂股韧带、髂股韧带、Pubofemoral lig.耻股韧带、耻股韧带、Ischiofemoral ligament 坐股韧带坐股韧带Locomotive System(3)movement：Flexion 屈屈Extention 伸伸Medial and lateral rotation 内旋、外旋内旋、外旋Circumdution 环转环转Addution 内收内收Abdution 外展外展(二）二）joints of free lower limbjoints of free lower limb自由下肢骨连结自由下肢骨连结1、Hip Joint 髋关节髋关节Locomotive System2、Knee Joint 膝关节膝关节(2)Characteristic：ligaments 韧带韧带：(1)Composition：股骨下端、胫骨上端、髌骨构成 (最大最复杂的关节)patellar lig.髌韧带、Fibular collateral lig.腓侧副韧带TibiaL collateral lig.胫侧副韧带Cruciate lig.Of knee膝交叉韧带 anterior cruciate lig.posterior cruciate lig.胫侧副韧带胫侧副韧带腓侧副腓侧副韧带韧带前交叉韧带前交叉韧带后交叉韧带后交叉韧带髌韧带髌韧带Locomotive System2、Knee Joint 膝关节膝关节(2)Characteristic：meniscus 半月板半月板medial meniscus 内侧半月板：内侧半月板：C 形形Lateral meniscus 外侧半月板：外侧半月板：O 形形synovial membrane:Suprapatellar bursa髌上囊髌上囊Alar folds 翼状襞翼状襞Locomotive System2、Knee Joint 膝关节膝关节(3)movements：flexion屈、extention伸，在半屈位时可作旋转运动。半月板损伤Locomotive SystemTibiofibular joint 胫腓关节胫腓关节Crural interosseous membrane 小腿骨间膜小腿骨间膜Anterior and posterior tibiofibular lig.胫腓前、后韧带胫腓前、后韧带3、joints between tibia and fibula胫腓连结胫腓连结Locomotive SystemCharacteristic:关节囊前后壁松弛，关节囊前后壁松弛，两侧有韧带加强。两侧有韧带加强。Movement:dorsiflexion 背屈（伸）背屈（伸）Plantaflexion 跖屈（屈）跖屈（屈）Medial lig.内侧韧带内侧韧带Lateral lig.外侧韧带外侧韧带Composition4、Joints of Foot 足关节足关节（1）talocrural jiont 距小腿关节（距小腿关节（Ankle Joint 踝关节踝关节）Distal end of tibia and fibula胫、腓骨远端胫、腓骨远端Trochlea of talus 距骨滑车距骨滑车Locomotive System（2）Intertarsal joint 跗骨间关节跗骨间关节Transverse tarsal joint 跗横关节跗横关节Calcaneocuboid joint 跟骰关节 talocalcaneonavicular joint距跟舟关节距跟舟关节距跟舟关节（3）跗跖关节跗跖关节Tarsometatarsal joint（4）跖骨间关节跖骨间关节Intermetatarsal joint（5）跖趾关节跖趾关节Metatarsophalangeal joint（6）趾骨间关节趾骨间关节 Interphalangeal jointLocomotive System组组成成5、Arch of foot 足弓：足弓：跗骨和跖骨借韧带连结而形成的凸向上的弓。跗骨和跖骨借韧带连结而形成的凸向上的弓。Medial longitudinal arch 内侧纵弓内侧纵弓Lateral longitudinal arch 外侧纵弓外侧纵弓 transverse arch 横弓横弓意义：弹性；保护意义：弹性；保护扁平足扁平足内侧纵弓：距骨、跟骨、舟骨、内侧纵弓：距骨、跟骨、舟骨、3块楔骨和内侧块楔骨和内侧3块跖骨连结而成。块跖骨连结而成。外侧纵弓：跟骨、骰骨和外侧外侧纵弓：跟骨、骰骨和外侧2块跖骨连结而成。块跖骨连结而成。横弓：骰骨、横弓：骰骨、3块楔骨和跖骨连结而成。块楔骨和跖骨连结而成。思考题思考题1 1、肩关节的构成与特点，辅助结构与运动、肩关节的构成与特点，辅助结构与运动2 2、肘关节的构成与特点，辅助结构与运动肘关节的构成与特点，辅助结构与运动3 3、前臂骨间膜及前臂骨运动、前臂骨间膜及前臂骨运动4 4、腕关节的构成及运动，对掌运动、腕关节的构成及运动，对掌运动5 5、髋骨与脊柱的连结、髋骨与脊柱的连结6 6、界线及骨盆的性别差异、界线及骨盆的性别差异7 7、髋关节的构成及特点，辅助结构及运动、髋关节的构成及特点，辅助结构及运动8 8、膝关节的构成及特点，辅助结构及运动、膝关节的构成及特点，辅助结构及运动9 9、踝关节的构成及韧带、踝关节的构成及韧带1010、足弓的概念及功能、足弓的概念及功能