Артрология


О.В. КАЛМИН
О.А. КАЛМИНА
Т.Н. ГАЛКИНА
И.В. БОЧКАРЕВА
Д.В. НИКИШИН






АРТРОЛОГИЯ


Учебное пособие













Москва ИНФРА-М 2019

УДК 611.72 (075.8)
ББК 55.5я73

            ФЗ № Издание не подлежит маркировке 436-ФЗ   в соответствии с п. 1 ч. 2 ст. 1

          К17


Рекомендовано к изданию методической комиссией
Медицинского института Пензенского государственного университета (протокол № 8 от 09.04.2015)

      Рецензенты:
           Р.М. Хайруллин — доктор медицинских наук, профессор, заведующий кафедрой анатомии человека Ульяновского государственного университета;
           И.Н. Чаиркин — доктор медицинских наук, профессор, заведующий кафедрой нормальной анатомии с курсами судебной медицины, топографической анатомии и оперативной хирургии Мордовского государственного университета имени Н.П. Огарева



        Калмин О.В.

К17        Артрология : учеб. пособие / О.В. Калмин, О.А. Калмина, Т.Н. Галкина,

       И.В. Бочкарева, Д.В. Никишин. — М. : ИНФРА-М, 2019. — 101 с.


       ISBN 978-5-16-107897-6 (online)


               Работа содержит в кратком систематизированном виде сведения о соединениях костей, о строении отдельных суставов, их функции, иннервации и кровоснабжении. Пособие иллюстрировано подробными схемами и рисунками.
               Издание предназначено для аудиторной и внеаудиторной работы студентов медицинских специальностей вузов.

               The manual contains a brief systematic form information on the joint of the bone. The manual contains information on the structure of individual joints, their function, nerve and blood supply. The manual is illustrated with detailed diagrams and drawings.
               The manual is intended for classroom and extracurricular work of students of medical specialties.


УДК 611.72 (075.8)
ББК 55.5я73






ISBN 978-5-16-107897-6 (online)

        © Калмин О.В., Калмина О.А., Галкина Т.Н., Бочкарева И.В., Никишин Д.В., 2019

            CONTENTS



   General arthrology..................................................3
   Special arthrology..................................................6
     Head..............................................................6
     Trunk.............................................................9
     Upper extremity..................................................21
     Lower extremity .................................................41
   References.........................................................71
     Recommended literature...........................................71
     Artwork..........................................................71
   Appendix............................................................1

                GENERAL ARTHROLOGY




Connection types of bones
       1.   Continuous articulations (synarthroses) - there is a layer of tissue between the bones; the gap or space between the bones is missing.
            А)   fibrous joints (articulationes fibrosae):
                 1)   ligaments (ligamenta);
                 2)   membranes (membranae);
                 3)   sutures (suturae):
                      a)   serrate (sutura serrata);
                      b)   squamous (sutura squamosa);
                      c)   plane (sutura plana);
                 4)   gomphosis (socket) (gomphosis);
                 5)   fontanels (fonticuli);
            B)   cartilaginous joints (articulationes cartilagineae), synchondroses (synchondrosis):
                 1)   bystructure: hyaline, fibrous;
                 2)   bylifetime: permanent, temporary;
            C)   bony unions, synostoses (synostosis).
       2.   Semi-joints, symphyses (symphysis) - have a small gap in the cartilage or connective tissue sheet between the bones.
       3.   Discontinuous, synovial joints (articulationes synoviales), diarthroses (diarthrosis) -are characterized by the presence of the cavity between the bones and synovial membrane, lining the inside of articular cavity.

Structure of the joint
       1.   The main elements of the joints:
            1)   articular surfaces of bones (facies articulares);
            2)   articular cartilage (cartilago articularis);
            3)   joint capsule (articular capsule) (capsula articularis):
                 a)   fibrous membrane (membrana fibrosa);
                 b)   synovial membrane (membrana synovialis);
            4)   articular cavity (cavum articulare);
            5)   synovial fluid (synovia).
       2.   The auxiliary elements of the joint:
            1)   articular disks (disci articulares);
            2)   articular menisci (menisci articulares);
            3)   articular labium (labrum articulare);
            4)   ligaments (ligamenta):
                 а)   extracapsular ligaments (ligamenta extracapsularia);
                 b)   capsular ligaments(ligamenta capsularia);
                 c)   intracapsular ligaments (ligamenta intracapsularia);
            5)   synovial folds (plicae synoviales);

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        6)  adipose folds (plicae adiposae);
        7)  synovial bursae (bursae synoviales);
        8)  sesamoid bones (ossa sesamoidea).


        Classification of joints
        By the number of articular surfaces:

   1.   Simple joint (articulatio simplex)are formed by two articular surfaces.
   2.   Compound joint (articulatio composite)are formed by three or morear-ticular surfaces.


        Byfunctional feature:


   1.   Complex joint (articulatio complexa) - joint which cavity is wholly or partly divided into two parts by articular disk or meniscus.
   2.   Combination joints (articulationes combinatoriae) - are groups of articulations, which are isolated anatomically, but function simultaneously.


        By the number of the axes ofmovement and shapes of articular surfaces:
        1.   Uniaxial joints:

        1)   hinge joint (ginglymus);
        2)   cylindricaljoint (articulatio trochoidea).

        2.   Biaxial joints:

        1)   ellipsoid joint(articulatio ellipsoidea);
        2)   saddle joint (articulatio sellaris);
        3)   bicondylar joint (articulatio bicondylaris).

        3.   Multiaxial joints:

        1)   spheroidal joint (ball-and-socket joint) (articulatio spheroidea);
        2)   cotyloidjoint (articulatio cotylica);
        3)   plane joint (articulatio plana).


Table 1

Types of movements around the axes

                 Axis                             Movement          
                                        flexion (flexio),           
Frontal axis (axis frontalis)           extension (extensio)        
                                        abduction (abductio),       
Sagittal axis (axis sagittalis)         adduction (adductio)        
Vertical axis (axis verticalis)         rotation (rotatio)          
The transition from one axis to another circumduction (circumductio)

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            SPECIAL ARTHROLOGY
            Head



Articulatio temporomandibularis,

                       temporomandibular joint                                
Articulating surfaces: caput mandibulae,                                      
                       fossa mandibularis ossis temporalis.                   
Shape:                 ellipsoid, complex, combined with the joint from oppo- 
                       site side.                                             
Axes and movements:    1) frontal - depression and elevation of mandible      
                       (first movement in the lower storey, after that in     
                       the upper one of joint);                               
                       2) vertical - lateral movements (rotation around the   
                       axis in the lower storey of joint at the side of the   
                       turning, sliding in the upper storey of joint on the   
                       opposite side);                                        
                       3) movements along the sagittal axis to the forward    
                       and backward(movement in the upper storey of the       
                       joint).                                                
Ligaments:             ligamentum laterale,                                   
                       ligamentum sphenomandibulare,                          
                       ligamentum stylomandibulare.                           
Auxiliary elements:    discus articularis.                                    
Blood supply:          arteria auricularis profunda (from arteria maxillaris).
Venous drainage:       rete articulare mandibulae (into vena retromandibu-    
                       laris).                                                
Innervation:           nervus auriculotemporalis (from nervus mandibularis).  
Lymph drainage:        nodi lymphatici parotidei.                             

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3

Fig. 2. Temporomandibular joint (sagittal section) (Feneis H., 1998):

Fig. 1. Temporomandibular joint (Feneis H., 1998):

1 - ligamentum stylomandibulare; 2 -ligamentum laterale

1 - membrana synovialis inferior; 2 - discus articularis; 3 - membrana synovialis superior; 4 - articulatio temporomandibu-laris

Fig. 3.Temporomandibular joint (view from the medial side) (Feneis H., 1998):

1 - ligamentum pterygospinale; 2 - ligamentum mediale; 3 - ligamentum spheno-mandibulare; 4 - ligamentum stylomandibulare; 5 - ligamentum stylohyoideum

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Table 2

Articulations of the bones of skull

Articulations of the bones of skull Articulations of the Articulations of the 
           to each other             skull withmandible  skull with CIvertebra
I. Syndesmosis:                     1. Articulatio tem-  1. Articulatio atlan1. Fonticuli:                       poromandibularis.    tooccipitalis.       
a) fonticulus anterior;             2. Ligamentum        2. Membranae atlan-  
b) fonticulus posterior;            sphenomandibu-       tooccipitales ante-  
c) fonticulus sphenoidalis;         lare.                rior et posterior.   
d) fonticulus mastoideus.           3. Ligamentum        3. Ligamentum at-    
2. Suturae:                         stylomandibulare     lantooccipitale      
a) sutura sagittalis;                                    laterale             
b) sutura coronalis;                                                          
c) sutura lambdoidea;                                                         
d) by the names of con-                                                       
necting bones (for ex-                                                        
ample, sutura sphen-                                                          
ofrontalis);                                                                  
e) byform (suturae serrata,                                                   
squamosa, plana).                                                             
3. Ligamenta:                                                                 
a) ligamentum ptery-                                                          
gospinale;                                                                    
b) ligamentum stylohy-                                                        
oideum.                                                                       
4. Gomphosis.                                                                 
II. Synchondrosis:                                                            
1. Temporary:                                                                 
a) synchondrosis                                                              
sphenooccipitalis;                                                            
b) synchondrosis intraoc-                                                     
cipitales anterior et                                                         
posterior.                                                                    
2. Permanent:                                                                 
a) synchondrosis                                                              
sphenopetrosa;                                                                
b) synchondrosis petrooc-                                                     
cipitalis;                                                                    
c) synchondrosis spheno-                                                      
ethmoidalis                                                                   

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            Trunk


                                    Articulationes zygapophysiales,              
                                          zygapophysial joints                   
Articulating surfaces: processus articularis inferior of superjacent vertebra,   
                       processus articularis superior of subjacent vertebra.     
Shape:                 plane, combined with the joint from opposite side.        
Axes and movements:    multiaxial - sliding.                                     
Blood supply:          arteria vertebralis (in the cervical region), arteriae in                       tercostales posteriores (in the thoracic region), arteriae
                       lumbales (in the lumbar region).                          
Venous drainage:       plexus venosi vertebrales interni et externi (into vena   
                       vertebralis, venae intercostales posteriores, venae lum-  
                       bales).                                                   
Innervation:           rami dorsales nervi spinales.                             
Lymph drainage:        nodi lymphatici occipitales, retroauriculares et cervi-   
                       cales laterales profundi (in the cervical region), inter- 
                       costales (in the thoracic region), lumbales (in the lum-  
                       bar region).                                              

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Table 3

Articulations of the vertebrae

           Short connections                       Long connections           
         (adjacent vertebrae)                (along the vertebral column)     
1. Of bodies (discus intervertebralis). 1. Ligamentum longitudinale anterius. 
2. Of arches (ligamenta flava).         2. Ligamentum longitudinale posterius.
3. Of processes:                        3. Ligamentum supraspinale.           
a) spinous (ligamenta                   4. Ligamentum nuchae                  
interspinalia);                                                               
b) transverse (ligamenta                                                      
intertransversaria);                                                          
c) articular (articulationes                                                  
zygapophysiales)                                                              

Table 4

Articulations of the sacrum andcoccyx (versus articulations of the vertebrae)

  Articulations of the vertebrae    Articulations of the sacrum and coccyx
1. Discus intervertebralis.         1. Symphysis sacrococcygea.           
2. Articulatio zygapophysialis.     2. Syndesmosis sacrococcygeus.        
3. Ligamentum intertransversarium.  3. Ligamentum sacrococcygeum lat-     
4. Ligamentum longitudinale ante-   erale.                                
rius.                               4. Ligamentum sacrococcygeum ven-     
5. Ligamenta flava et supraspinale. trale.                                
6. Ligamentum longitudinale poste-  5. Ligamentum sacrococcygeum dor-     
rius                                sale superficiale.                    
                                    6. Ligamentum sacrococcygeum dor-     
                                    sale profundum                        

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Fig. 4.Ligaments of cervical part of vertebral column (view from the medial side) (Feneis H., 1998):

1 - membrana tectoria; 2 - fasciculi longitudinales; 3 - membrana atlantooccipitalis posterior; 4 - protuberantia occipitalis externa; 5 - ligamentum nuchae; 6 - ligamenta interspinalia; 7 - ligamenta flava; 8 - ligamentum longitudinale posterius; 9 - liga-mentum longitudinale anterius; 10 - anulus fibrosus; 11 - nucleus pulposus; 12 - discus intervertebralis; 13 - membrana atlantooccipitalis anterior

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