importance for MBBS And Bds 1st year students

1. SANJAY KUMAR YADAV
LECTURER
KMCTH

2. Articulation
Radial head and osseo-fibrous ring
Annular ligament and radial notch of the ulna
1/5th
Osseo-fibrous ring & 4/5th
by annular ligament
Superior radio-ulnar joint

3. Contd….
Annular ligament is strong fibrous band
Attached to the anterior and posterior margin of radial
notch
Upper border continuous with fibrous capsule

4. •Inferiorly, few fibers from lower margin of annular ligament passes
over the synovial membrane and attached to the neck of radius
•Thin fibrous ligament called quadrate ligament stretches between
the neck of the radius and the upper part of supinator fossa of ulnar
and closes joint cavity from below, between radius and ulna
•Externally blends with the radial collateral ligament

5. Applied anatomy
Nursemaid’s Elbow
Subluxation of joint
1-5 year of age
Girls- 20%

6. Contd….
• Blood supply: articular
branches derived from the
anastomoses around the
elbow joint
• Nerve supply: small
branches from the
musculocutaneous,
median, radial and ulnar
nerves
• Hilton’s Law

7. Distal radioulnal joint
Pivot joint
Head of ulna & ulnar notch of radius
Synovial membrane extremely loose
Extend up ward as recess between radius and ulna
Recessus sacciformis
Movement – pronation and suppination along vertical axis

8. Anterior radioulnar ligament
Posterior radioulnar ligament
Nerve supply
Anterior & posterior interrossius nerve
branch from Median and radial nerve
Radioulnar ligaments

9. Pronation
Pronator quadratus
Pronator teres
Supination
•Supinator
•Biceps brachii
Movement

10. Applied anatomy

11. Wrist joint
 Bi-axial/2 degree of freedom
 Ellipsoid joint
 (Condyloid) type of synovial
joint
 Articular surfaces
 Proximal articular surface
(Elliptical socket)-
 Distal articular surface of
radius & articular disc of distal
radio-ulnar joint
 Distal articular surface:
Scaphoid, Lunate & Triquetral.

12. Wrist joint
 Ligaments: possess capsular ligament with synovial membrane,
Radial and Ulnar collateral ligament
 Capsular ligament: attach close to the peripheral margin of the
proximal and distal articular surfaces including the articular disc

13. Wrist joint
 Capsule blends
 Palmar & dorsal radio-carpal
ligaments
 Palmar radio-carpal ligament
 Ant. margin of lower part of
radius to ant. Surface of
scaphoid, lunate, triquetral &
capitate
 Palmar ulno-carpal ligament
• Ant. Margin of articular disc &
styloid process of ulna to lunate
& triquetral

14. Dorsal radiocarpal
ligament
Wrist joint
 Attachment
 Posterior margin of lower end of radius
 dorsal surface of scaphoid, lunate & triquetral bones

15. Wrist joint
 Ulnar collateral ligament
 Styloid process of Ulna to triquetral and Pisiform bones
 Radial collateral ligament
 Styloid process of radius to scaphoid and trapezium

16. Arterial Supply and Nerve Supply Wrist joint
 Nerve supply: anterior and posterior interosseus nerves
 Hilton’s Laws
 Palmar and dorsal carpal arches
 Anterior interosseous artery
 Anterior and posterior carpal brances of radial & ulnar arteries, and
Recurrent branches of Deep palmar arches)

17. Movements
 Movement of wrist joint: the movements are accompanied by
the movements of intercarpal and midcarpal joint
 Flexion
• FCU, palmaris longus and FCR with assistance from the flexors
of the fingers and thumb
 Extension
• Extensor carpi radialis longus, extensor carpi radialis brevis and
extensor carpi ulnaris with assistance from the long extensor
tendons of finger and thumb
 Adduction
• Flexor carpi ulnaris, extensor carpi ulnaris
 Abduction
• Flexor carpi radialis,extensor carpi radialis longus and
brevis,abductor pollicis longus and extensor pollicis brevis

18. Applied anatomy

20. Monteggia's fracture
Proximal third of ulna
Anterior dislocation of head of radius

21. Galeazzi's fracture
Distal third of radius
Subluxation (partial
dislocation) of head of ulna
(distal ulna)