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The shoulder joint is the most mobile joint in the human body with a wide range of motion including flexion, extension, abduction, adduction, external rotation, internal rotation and a range of motion of 360 degrees.
The shoulder joint is considered to be the least secure joint of a bony nature, but the presence of ligaments, muscles and tendons provides additional stability.
The shoulder joint consists of three bones: shoulder bone (humerus), shoulder blade (scapula) and collarbone (clavicle).
The top of the humerus forms the head of the shoulder joint. An uneven and shallow cavity in the scapula called the glenoid fossa forms a cavity where the humerus resides. The two bones together form the shoulder joint, the main articulation of the shoulder joint. The scapula is a flat bone with a triangular shape that forms the shoulder. It serves as an attachment point for some of the muscles that provide movement and stability in the joint.
The scapula has four bony processes: the acromion, the vertebral column, the coracoid, and the glenoid. The acromion and coracoid process are attachment sites for ligaments and tendons.
The collarbone is an S-shaped bone that connects the shoulder blade to the breastbone. It forms two joints: the acromioclavicular joint, where it articulates with the acromion, and the sternoclavicular joint, where it articulates with the sternum. The collarbone serves as a bony barrier for important nerves and blood vessels that run underneath
The end of all articulation surfaces is covered by articular cartilage, which allows movement of the individual bones with minimal friction. Articular cartilage relieves the bones and serves as shock absorbers during movements.
Additional stability in the glenohumeral joint is provided by the glenoid labrum, a ring of fibrocartilage that provides additional seal, surface area and stability in the hemispherical shoulder joint.
Ligaments are thick bundles of fibers that connect bones together. The ligaments of the shoulder joint include:
The rotator cuff is the main muscle group of the shoulder joint and is made up of 4 muscles. The rotator cuff forms a sheath around the humerus and glenoid cavity that provides additional stability to the humerus while allowing a wide range of motion.
The deltoid forms the outer layer of the rotator cuff and is the largest and strongest muscle in the shoulder joint.
Tendons are strong tissues that connect muscles to bones. They make it possible to transfer the movement of the muscles to the bones and thus to carry out the movement in the corresponding joint. Two important groups of tendons in the shoulder joint area are the biceps tendons and the rotator cuff tendons.
The biceps tendons are two sets of four tendons that connect the humeral head to the deep muscles of the rotator cuff. These tendons contribute to stability and movement in the shoulder joint.
Nerves carry messages from the brain to direct movement (motor) and send information from the muscles to the brain (sensory) about various sensations such as touch, temperature, and pain. The nerves of the arm run through the shoulder joint in the brachial plexus area.
These nerves form a network around the shoulder joint called the brachial plexus. The main nerves of the plexus are the radial, ulnar, medial, axillary and musculocutaneous nerves.
Blood vessels run along with the nerves to supply blood to the upper extremity. Oxygenated blood for the shoulder region is provided by the subclavicular artery, which runs behind the collarbone. When it runs through the armpit, it is called the axillary artery and below that, the brachial artery. The main veins that carry deoxygenated blood are:
- Axillary vein (Vena axillaris): empties into the subclavicular vein
- Head vein (Vena cephalica): located in the area of the armpit and branches off in the area of the elbow joint. It empties into the axillary vein.
- Basilar vein (Vena basilica): goes back to the V. cephalica in the area of the triceps. It empties into the axillary vein.
The elbow joint is a complex joint formed by the articulation of three bones - the humerus, radius and ulna. The elbow joint helps flex or straighten the arm up to 180 degrees and is involved in lifting and moving objects.
The bones of the elbow joint are strengthened by:
The elbow joint is made up of three bones:
Articular cartilage borders the articular surfaces of the humerus, radius, and ulna. It is smooth, strong, and flexible, and its slippery surface acts as a shock absorber during loading and reduces friction between bones during movement. Articular cartilage is lubricated by synovial fluid, allowing smooth movement between bones.
The main muscles of the elbow joint are:
The elbow joint is surrounded by ligaments and tendons that add extra stability to the joint.
The main muscles of the elbow joint are:
All ligaments form a joint capsule filled with synovial fluid.
Any damage to these ligaments can lead to instability of the elbow joint.
Tendons are strands of connective tissue that connect muscles to bones. The tendons surrounding the elbow joint include:
The main nerves in the elbow joint are the ulnar, radial, and medial nerves. These nerves carry signals from the brain to the muscles that move the elbow joint. They also relay signals from sensory endings, such as touch, pain, and temperature, back to the brain. Any damage to these nerves causes pain, weakness, or instability of the joint.
Arteries carry oxygen-rich blood from the heart to the arm. The main artery of the elbow joint is the brachial artery, which runs along the inner surface of the elbow joint and divides into two smaller branches below the elbow to form the ular and radial arteries. The network of veins transports the blood back to the heart.
The ankle and foot are made up of 22 bones, 33 joints, a series of muscles, tendons and ligaments.
The ankle joint connects the lower limb to the foot and is made up of 3 bones: the tibia, fibula and talus. The tibia or tibia and the fibula or tibia are bones of the lower extremity that articulate with the talus and allow the foot to move up and down.
The foot is a single functional unit but can be divided into 3 parts: forefoot, midfoot and rearfoot.
The rear part of the foot forms the ankle and heel and consists of the talus and heel bone (calcaneus). The heel bone is the largest bone of the foot.
The middle foot connects the rear foot to the front foot and consists of several bones: the navicular bone, the cuboid bone (os cuboideum) and three cuneiform bones. The os naviculare is located in front of the heel bone. In front of the os naviculare are the sphenoid bone and the os cuboideum.
These bones are connected to 5 metatarsals of the front part of the foot,which form the arch of the foot. The arch of the foot distributes the load to the support points of the foot. The forefoot consists of 14 toe bones: 3 for each toe except the big toe (only 2). In addition, the thumb has two small and rounded sesamoids located on its underside. They support the movement of the thumb.
There are 33 joints in the ankle and foot. They include:
The bones of the foot are held in place by various soft tissues such as cartilage, ligaments, muscles, tendons and bursae.
Cartilage is a flexible, shiny, and smooth tissue found at the ends of the bones that form joints. Cartilage allows for smooth movement with little traction in the joint.
Ligaments are rope-like structures that connect individual bones. The plantar fascia is the largest tendon in the foot; It starts at the heel bone and ends in the forefoot. Located on the bottom of the foot, it plays a key role in maintaining the longitudinal arch of the foot. The tendon of the plantar fascia contributes to the balance and strength of the foot. The lateral straps on the outside of the foot and the medial straps on the inside provide additional stability and freedom of movement of the foot.
The foot is made up of 20 muscles responsible for its movement and stability.
The hip joint is the largest joint in the human body, transferring loads from the trunk and pelvis to the lower extremity. The femoral head and socket (acetabulum) are surrounded by a joint capsule, ligaments, muscles and tendons. Any damage or disease of the hip joint will affect the range of motion of the joint and its ability and bearing.
The hip joint consists of:
Bones and articular cartilage
The hip joint is the connection between the thigh and the pelvis. It consists of two bones: the thigh bone or femur and the pelvis, which consists of 3 bones: the ilium (Os. ilium), ischium (Os. ischii) and pubic bone (Os. pubis). The femoral head is fixed in a socket, the acetabulum. The acetabulum is a deep, hemispherical pocket formed at the outer edge of the pelvis by three bones: the ilium, ischium, and pubis. The lower part of the ilium is attached to the pubic bone, while the ischium lies relatively behind the pubic bone. The stability of the hip joint is provided by the joint capsule, or acetabulum, and the muscles and ligaments that surround and support the hip joint.
The femoral head rotates within the acetabulum. The depth of the acetabulum is further increased by a soft tissue seal, the labrum.
The femur is the largest bone in the human body. The upper part of the thigh consists of the femoral head, femoral neck, greater and lesser trochanter. The femoral head connects to the pelvis (acetabulum) to form the hip joint. Adjacent to the neck of the femur are two protrusions: the greater and lesser trochanter, which serve to capture the muscles.
Articular cartilage is thin, strong, flexible, and has a slippery surface that is moistened by synovial fluid. This construction allows the bones to move smoothly and reduces friction.
Ligaments of the hip joint
Ligaments are fibrous structures that connect one bone to another. The hip joint is surrounded by ligaments that provide stability to the hip joint by forming a dense fibrous structure around the hip joint. The ligaments around the hip joint include:
Muscles and tendons
A long tendon called the iliotibial ligament runs along the femur from the hip joint to the knee and serves as the attachment point for some of the hip joint muscles:
Gluteal: These are some of the muscles that make up the back of the thigh. They are gluteus medius, gluteus minimus and gluteus maximus.
Adductors: These muscles assist in adduction - pulling the limb toward its midline.
Iliopsoas: This muscle is located in front of the hip joint and performs flexion in the hip joint. It is a deep muscle that originates in the lower back and inserts at the top of the femur.
Rectus femoris: This is the largest group of fibers located on the front of the femur. They also serve as flexors in the hip joint.
Nerves and arteries
The nerves in the hip joint carry signals from the brain to perform movements in the hip joint. They also relay sensory signals like touch, pain, and temperature to the brain.
The major nerves in this anatomical region include the femoral nerve at the front of the thigh and the sciatic nerve at the posterior of the thigh. The hip joint is also innervated by a smaller nerve called the obturator nerve.
In addition to these nerves, there are also blood vessels that supply blood to the lower extremity. The femoral artery begins in the pelvis and is palpable on the front of the thigh.
Movements in the hip joint
All anatomical components work together to allow for various movements in the hip joint. These movements include flexion, extension, abduction, adduction, rotation.
Pediatric orthopedics and pediatric traumatology deals with orthopedic diseases and traumatic conditions in children and adolescents up to skeletal maturity. In contrast to adults, these diseases in children have different clinical and prognostic features. Diseases can be congenital, acquired during development, or traumatic.
The musculoskeletal system of children develops continuously (growth zones), their body reacts differently to injuries, infections and deformations than adults and is therefore treated in a more targeted manner.