Articulations of the the upper extremity
Important for the orientation of the hand in space. They gather five articulations: three drift true and two spaces.
Articulation sterno-costo-sclaviculaire
It articulates the médiale end clavicle with the manubrium sternal and the 1st coast. Synovial articulation in saddle (reciprocal fitment).
Articular surfaces
- The Clavicle: the médiale end have two articular surfaces. The médiale end presents two articular surfaces a facet for the sternum (in médial) a facet for the coast (into caudal)
- The Cranial Edge of the Sternum: incisure claviculaire
- The First Costal Cartilage
This articulation presents a meniscus, disc will intra articular constant made up of thick fibro-cartilage
Means of union
The Capsule: fibrous membrane
Ligaments:
- Sterno-claviculaire ventral and dorsal reinforce the capsule into ventral or dorsal. The dorsal one is more resisting and thick (less luxation into dorsal of the médiale end of the clavicle).
- Ligament interclaviculaire in cranial of the articulation. It passes in bridge of one clavicle to the other (little important for stability).
- Ligament costo-claviculaire (rhomboïde). Formed of two beams, extra articular, energy of the face craniale of the 1st costal cartilage to the caudal face of the clavicle. Powerful and important ligament for the stabilization of this articulation.
Functional anatomy
Three degrees of freedom (disc) plane frontal, sagittal plan and horizontal plane. This articulation is the only true articulation which links the thoracic member with the thorax.
The axis of the movements passes by insertions of the ligament costo-claviculaire. A small movement of this articulation is reflected into side at the end of the clavicle (arm of lever), amplification.
Articulation acromio-claviculaire
Articular surfaces
- The Clavicle
- Acromion
- The articular Disc
The clavicle rests on the acromion.
The Clavicle: side end ovalaire, its surface articular is directed into caudal and side.
Acromion: surface ovalaire with the face craniale acromion, it is directed in cranial and médial. These orientations of articular surfaces explain displacements in cranial clavicle at the time of luxation acromio-claviculaire.
The articular Disc is present in 1/3 of the cases, it can be
entirety or window.
Means of union
- The articular capsule membrane fibrous and synovial membrane
- The Ligaments are of two types : proximaux and distal.
Proximaux ligaments; acromio-claviculaires resistant they reinforce especially the capsule in cranial. (Reinforced by the muscular cap deltoïde-trapezoid).
The distal ligaments are far from the articulation. (extra-articular) Ligaments coraco claviculaires which link the clavicle (its caudal face) with the process coracoïde. They are three. Of side with médial: Bulky Trapezoidal ligament, in a sagittal plan, of trapezoidal form. Deep Conoïde ligament, in a frontal plan, of conical form. (At the time of the section of these ligaments there is a luxation acromio-claviculaire) Ligament Coraco-Claviculaire Médial not very important for lastability, simple thickening of the clavi-pectoral fascia.
Fonctioneelle anatomy
Articulation scapulo-humérale. (principal)
Articular surfaces
- The Humérale Head
- The Glénoïdale Cavity
- The Glénoïdal Pad
Means of union
- The capsule
- The ligaments there is not ligament into dorsal reinforcing the capsule.
Synovial articulation of spheroid type, links the humérus in Scapula. Very mobile articulation with three degrees of freedom, luxations are frequent.
Drift spaces
Space under acromio-deltoïdien
Synovial Stock Exchange being located under the acromion which is prolonged into side by the muscle deltoïde; this purse is located in cranial compared to the rotatory muscles at the tops of the head humérale. It is important for the movements of the shoulder which it facilitates, role in the pathology of the shoulder.
Scapulo-thoracic space
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