Anatomy Tables - Joints of the Upper & Lower Limbs

Anatomy Tables - Joints of the Upper & Lower Limbs

Osteology
Bone	Structure	Description
os coxae (pelvic or innominate bone)		three fused bones: ischium, ilium & pubis
	acetabulum	socket for head of femur (Latin, acetabulum = a shallow wide-mouthed vessel or cup)
	acetabular notch	notch in the inferior margin of the acetabulum
	lunate surface of acetabulum	smooth articular surface within the acetabulum
	obturator foramen	large foramen surrounded by the superior and inferior pubic rami, the ischial ramus and the acetabulum; obturator means to occlude or stop up, a reference to the fact that the obturator membrane closes the obturator foramen almost completely; a site of attachment for the obturator externus m. and the obturator internus m.
femur		(Latin, femur = thigh)
	body	long cylindrical central part of femur; also known as: shaft
	head	smooth, rounded proximal end; articulates with acetabulum
	fovea capitis femoris	pit in the femoral head; attachment site of ligamentum capitis femoris (Latin, fovea = a pit + capitis = head)
	neck	constricted area distal to head
	intertrochanteric line	on anterior surface; ridge coursing between greater and lesser trochanters
	intertrochanteric crest	on posterior surface; heavy ridge coursing between greater and lesser trochanters
	medial condyle	located at distal end; articulates with medial condyle of tibia (Greek, kondyle = the knob formed by the knuckle of any joint)
	lateral condyle	located at distal end; articulates with lateral condyle of tibia (Greek, kondyle = the knob formed by the knuckle of any joint)
	intercondylar fossa	between the condyles at distal end; accommodates cruciate ligaments
	patellar surface	the smooth anterior surface at the inferior end of the femur; it articulates with the posterior surface the patella
patella		a sesamoid bone in the quadriceps femoris tendon; articulates with anterior surface of inferior femur
tibia
	medial condyle	at proximal end; articulates with medial condyle of femur; larger than lateral condyle (Greek, kondyle = the knob formed by the knuckle of any joint)
	lateral condyle	at proximal end; articulates with lateral condyle of femur; smaller than medial condyle (Greek, kondyle = the knob formed by the knuckle of any joint)
	intercondylar eminence	projection between condyles; attachment site of cruciate ligaments & medial & lateral meninsci (Greek, kondyle = the knob formed by the knuckle of any joint)

Joints - Pectoral Girdle & Shoulder
Joint	Description	Significance
sternoclavicular joint	the joint what connects the clavicle with the sternum	a synovial joint; its joint capsule is subdivided by a fibrous articular disc; it is strengthened by the sternoclavicular, interclavicular and costoclavicular ligaments; the sternoclavicular joint has the range of movement, but not the form, of a ball and socket joint
acromioclavicular joint	the joint between the distal end of the clavicle and the acromion of the scapula	a plane synovial joint; the shape of the articulation encourages the acromion to slide inferior to the clavicle during dislocation (shoulder separation) a condition that occurs when the coracoclavicular ligament is torn; a small articular disk occurs within this joint capsule
articular disc of sternoclavicular joint	fibrocartilage	serves as a shock absorber of forces transmitted along the clavicle from the upper limb and divides the SC joint into two compartments
coracoclavicular ligament	syndesmosis	connects upper surface of coracoid process to under surface of clavicle; often subdivided into conoid (posteromedial) & trapezoid ligaments
coracoacromial ligament	syndesmosis	connects coracoid process with acromion; passes superior to humeral head & supraspinatus tendon
transverse scapular ligament, superior	syndesmosis	passes across scapular notch, converting it into a foramen containing suprascapular nerve
sternoclavicular ligament	capsular ligament	connects clavicle with sternum; described as separate anterior & posterior ligaments
glenohumeral ligament, inferior	capsular ligament	connects humerus to scapula; represents an anteroinferior thickening of the shoulder joint capsule
glenohumeral ligament, middle	capsular ligament	connects humerus to scapula; represents an anterointermediate thickening of the shoulder joint capsule
glenohumeral ligament, superior	capsular ligament	connects humerus to scapula; represents an anterosuperior thickening of the shoulder joint capsule
glenoid labrum	fibrocartilage	a part of the glenohumeral joint (Greek, glene = a shallow socket + eidos = appearence)
shoulder joint	synovial, ball & socket, diarthrosis	connects humerus & scapula; glenoid labrum deepens the socket, glenohumeral ligaments/bands add strength anteriorly; tendon of long head of biceps passes through shoulder joint
subscapular bursa	extension of glenohumeral cavity	protects the subscapular tendon where it passes inferior to the coracoid process and over the scapular neck
tendon of the long head of the biceps	tendon enlosed by a synovial sheath	moves back and forth in the intertubercular groove of the humerus
transverse humeral ligament	syndesmosis	passes from the lesser to greater tubercle and holds the tendon of the long head of the biceps in the intertubercular groove

Joints - Elbow & Wrist
Joint	Description	Significance
elbow joint	synovial; hinge (gingylmus), gliding and pivot	complex joint consisting of humeroulnar, humeroradial and proximal radioulnar articulations; strengthened primarily by radial & ulnar collateral ligaments
radial collateral ligament, elbow	lateral fanlike ligament	extends from the lateral epicondyle of the humerus and blends distally with the anular ligament of the radius
ulnar collateral ligament, elbow	anterior band - strong posterior - fanlike, weak oblique - slender, deepens the socket for the trochlea of the humerus	extends from the medial epicondyle of the humerus to the coronoid process and olecranon of the ulna (Latin, ulna = elbow)
radioulnar joint, proximal	synovial, pivot	connects radial head with ulna; annular ligament holds radial head against radial notch of ulna (Latin, ulna = elbow)
annular ligament	the ligament that encircles the head of the radius	it forms 4/5 of a circle - the radial notch of the ulna forms the other 1/5; it attaches to the margins of the radial notch; it holds the head of the radius against the ulna and cups in distal to the head to provide restraint against distal dislocation of the radius (Latin, annulus = ring)
radioulnar joint, intermediate	syndesmosis	interosseous membrane connects radius to ulna; forces transferred from radius to ulna
interosseous membrane, forearm	a fibrous membrane that connects the interosseous borders located on the shafts of the radius and the ulna	a syndesmosis; its fibers are oriented obliquely downward from the radius toward the ulna; the interosseous membrane is the classic example of a syndesmosis; proximally directed forces from the hand pass through the radius and are transferred to the ulna through the interosseous membrane; marked proximally by the oblique cord
radioulnar joint, distal	synovial, pivot	characterized by an intracapsular articular disk (Latin, ulna = elbow)
radiocarpal (wrist) joint	synovial, ellipsoidal	characterized by an intracapsular articular disk; radius articulates with the proximal row of carpals
radial collateral ligament, wrist	it connects the styloid process of the radius with the scaphoid and trapezium	it reinforces the articular capsule on the lateral side of the wrist
ulnar collateral ligament, wrist	it connects the styloid process of the ulna to the pisiform and triquetrum	it reinforces the articular capsule on the medial side of the wrist (Latin, ulna = elbow)
distal radioulnar articulation	synovial, pivot	the rounded head of the ulna articulates with the ulnar notch on the medial distal end of the radius
dorsal radiocarpal ligament	capsular ligament	allows the hand to follow the radius during pronation of the forearm
palmar radiocarpal ligament	capsular ligament	allows the hand to follow the radius during supination of the forearm

Joints - Hand
Joint	Description	Significance
midcarpal joint	synovial, ball & socket	the joint between the proximal and distal rows of carpal bones; assists in flexion and extension at wrist
intermetacarpal articulation	synovial, plane	the metacarpals articulate with each other at their bases
carpometacarpal articulation	synovial, saddle (thumb)	the CMC joint of the thumb is located between the trapezium and the base of the 1st metacarpal and has a separate joint cavity
carpometacarpal joint, thumb	synovial, saddle (concavoconvex)	connects trapezium with metacarpal of thumb; flexion/extension, abduction/adduction
carpometacarpal joints, fingers	synovial, plane	connects distal carpal bones with metacarpals of fingers; tightly bound by ligaments to limit motion
metacarpophalangeal joints	synovial, condyloid or ellipsoid	connects metacarpal head to base of proximal phalanx; strengthened by collateral ligaments; heads of metacarpals are firmly joined by transverse metcarpal ligaments to provide a stable platform for finger movements
transverse metacarpal ligament, deep	a ligament that connects the metacarpophalangeal joints 2-5 on their palmar surface	limited motion is permitted between the distal ends of adjacent metacarpal bones due to the presence of the deep transverse metacarpal ligaments; the metacarpal bones are bound together to form a solid foundation for finger movements
interphalangeal joints	synovial, hinge	connect proximal & middle phalanges (proximal interphalangeal joint) and middle & distal phalanges (distal interphalangeal joint); strengthened by collateral ligaments

Joints - Hip
Joint	Description	Significance
acetabular labrum	fibrocartilage	fibrocartilage forming rim of acetabulum; deepens the acetabulum (Latin, acetabulum = a shallow wide-mouthed vessel or cup + labrum = lip)
transverse acetabular ligament		bridges the acetabular notch; forms a bridge over the artery in the ligament of the femoral head (ligamentum capitis femoris) (Latin, acetabulum = a shallow vessel or cup)
ligamentum capitis femoris		intracapsular ligament connecting transverse acetabular ligament with fovea capitis femoris; also known as: ligament of the femoral head (Latin, capitis = head)
zona orbicularis	fibrous	capsular fibers fromthe hip bone to the intertrochanteric line, forming a collar to help hold the femoral head in place
pubofemoral ligament		capsular ligament of hip joint connecting superior pubic ramus to medial surface of femoral neck
iliofemoral ligament		capsular ligament of the hip joint connecting anterior inferior iliac spine to intertrochanteric line
ischiofemoral ligament		capsular ligament of the hip joint connecting body of ischium to posterior femoral neck (Latin, ischion = hip joint)
hip joint	synovial	acetabulum of os coxae articulates with femoral head; reinforced by capsular ligaments (iliofemoral, pubofemoral, ischiofemoral, zona orbicularis) and containing acetabular labrum & ligamentum capitis femoris
iliopectineal bursa	bursa	lies deep to the iliopsoas tendon as it crosses the neck of the femur and the capsule of the hip joint

Joints - Knee
Joint	Description	Significance
infrapatellar synovial fat pads	synovial	masses of loose fatty tissue on both sides of the patellar ligament
knee joint	synovial	femoral condyles articulate with tibial condyles; reinforced by intracapsular ligaments (anterior cruciate & posterior cruciate), a capsular ligament (tibial collateral ligament), and an extracapsular ligament (fibular collateral ligament); contains medial & lateral menisci
patellar ligament	tendon	connects quadriceps femoris muscle group to the tibial tuberosity; patella is a sesamoid bone within the quadriceps tendon
tibial collateral ligament		capsular ligament of the knee joint connecting medial epicondyle of femur with medial surface of medial tibial condyle; its attachment to the medial meniscus is clinically relevant
fibular collateral ligament		extracapsular ligament, not part of the fibrous capsule of the knee; connects lateral epicondyle of femur with fibular head
anterior cruciate ligament		intracapsular ligament connecting anterior aspect of intercondylar eminence of tibia with medial surface of lateral femoral condyle
posterior cruciate ligament		intracapsular ligament connecting posterior aspect of intercondylar eminence of tibia with lateral surface of medial femoral condyle
medial meniscus	fibrocartilage	C-shaped intra-articular disc within knee joint between medial femoral condyle & medial tibial condyle; attached to tibial collateral ligament, coronary ligament, & intercondylar eminence (Greek, meniskos = crescent)
lateral meniscus	fibrocartilage	C-shaped intra-articular disc within knee joint between lateral femoral condyle & lateral tibial condyle; attached to coronary ligament & intercondylar eminence (Greek, meniskos = crescent)
posterior meniscofemoral ligament		intracapsular ligament connects posterior part of lateral meniscus with lateral surface of medial femoral condyle
suprapatellar bursa	bursa	superior extension of the synovial membrane of the knee joint; passes deep to the quadriceps tendon
prepatellar bursa	bursa	subcutaneous bursa overlying patella
infrapatellar bursa, superficial	bursa	subcutaneous bursa overlying patellar tendon
infrapatellar bursa, deep	bursa	bursa lying between patellar tendon & tibia

Joints - Ankle
Joint	Description	Significance
interosseous membrane of the leg	syndesmosis	the membrane that connects the interosseous borders of the shafts of the tibia and fibula
distal tibiofibular joint	syndesmosis	tibia and fibula are bound together by anterior, posterior, and transverse tibiofibular ligaments
ankle joint	synovial, hinge	articulation between distal end of tibia, medial malleolus, lateral malleolus and talus; reinforced by deltoid ligament (anterior tibiotalar, tibionavicular, tibiocalcaneal, posterior tibiotalar), anterior talofibular, calcaneofibular & posterior talofibular ligaments
anterior tibiofibular ligament		connects distal ends of tibia & fibula anteriorly
posterior tibiofibular ligament		connects distal ends of tibia & fibula posteriorly
transverse inferior tibiofibular ligament		forms a strong connection between the distal ends of the tibia and fibula
deltoid ligament		connects medial malleolus with talus, navicular & calcaneus; its four parts arranged from anterior to posterior: anterior tibiotalar, tibionavicular, tibiocalcaneal, posterior tibiotalar; also known as: medial ligament of ankle
anterior tibiotalar ligament		part of deltoid ligament connecting medial malleolus with talus
posterior tibiotalar ligament		part of deltoid ligament connecting medial malleolus with talus posteriorly
tibiocalcaneal ligament		part of deltoid ligament connecting medial malleolus with sustentaculum tali
tibionavicular ligament		part of deltoid ligament connecting medial malleolus with navicular
anterior talofibular ligament		connects lateral malleolus with talus anterolaterally
posterior talofibular ligament		connects lateral malleolus with talus posterolaterally
calcaneofibular ligament		connects lateral malleolus with calcaneus

Joints - Foot
Joint	Description	Significance
plantar calcaneonavicular ligament	syndesmosis	connects sustentaculum tali with inferior surface of navicular; also known as: spring ligament
subtalar joint	synovial	articulation between talus and calcaneous, strengthened by the interosseous talocalcaneal ligament
interosseous talocalcaneal ligament	syndesmosis	connects the neck of the talus with calcaneus, filling the tarsal sinus
transverse tarsal joint	synovial	two joints in line, talonavicular and calcaneocuboid, allow most inversion/eversion to happen through this joint
plantar calcaneocuboid (short plantar) ligament	syndesmosis	connects calcaneus & cuboid inferiorly
long plantar ligament	syndesmosis	connects calcaneus with cuboid & bases of lateral 3 metatarsals
interosseous talocalcaneal ligament	fibrous	suppots fibrous capsule of subtalar joint (Latin, inter = between + os = bone)
tarsometatarsal joints	synovial	reinforced by dorsal & plantar ligaments
metatarsophalangeal joints (5)	synovial	chondyloid joint connecting head of metatarsal with proximal phalanx; reinforced by collateral ligaments
longitudinal arch of the foot	combination of synovial joints & syndesmoses	passes from calcaneus to talus to navicular to cuneiforms to metatarsals; supported by plantar calcaneonavicular ligament & many other ligaments; supported by tendons of tibialis anterior & tibialis posterior mm.
transverse arch of the foot	combination of synovial joints & syndesmoses	passes through distal row of tarsal bones; supported by shape of bones and many ligaments; supported by tendons of fibularis longus & tibialis anterior & tibialis posterior mm.

Muscles
Muscle	Origin	Insertion	Action	Innervation	Blood Supply	Notes
obturator externus	the external surface of the obturator membrane and the superior and inferior pubic rami	trochanteric fossa of the femur	laterally rotates the thigh	obturator nerve	obturator a.	the tendon of the obturator externus m. passes inferior to the neck of the femur to reach its insertion site

Arteries
Artery	Source	Branches	Supply to	Notes
obturator	internal iliac a., anterior division	pubic br., acetabular br., anterior br., posterior br.	medial thigh and hip	anterior and posterior brs. pass on the anterior and posterior sides of the adductor brevis m.; aberrant obturator a. arises from the inferior epigastric a. in 30% of cases

Clinical Terms
Term	Definition
separated shoulder	the acromioclavicular joint is weak even though it's external (coracoclavicular) ligament is strong. The injury often occurs from a hard fall on the shoulder with the impact taken by the acromion or from a fall on the outstretched upper limb. The injury is severe if the AC and the coracoclavicular ligaments are torn. When the coracoclavicular ligament tears, the shoulder separates from the clavicle because of the weight of the upper limb. Rupture of this ligament also allows the fibrous capsule of the joint to also be torn so that the acromion can pass inferior to the acromial end of the clavicle. Disolocation of the AC joint makes the acromion more prominent, and the clavicle may move superior to this process.
pulled elbow	transient subluxation (incomplete dislocation) of the head of the radius is called a "pulled elbow." Children are prone to this injury, as a parent may pull on a child's upper limb while the forearm is pronated causing tearing of the distal attachment of the anular ligament, where it is loosely attached to the neck of the radius. The radial head then moves distally, and the anular ligament may become pinched between the head of the radius and the capitulum of the humerus. The treatment is simple and involves supination of the forearm while the elbow is flexed, and the tear of the anular ligament will heal in a cast in 2 weeks. A.K.A. "nursemaid's elbow"
pitcher's elbow	disease of the elbow in which a piece of cartilage or bone is torn from the head of the radius due to the repetitive stress of throwing a baseball.
popliteal/Baker's cyst	a synovial cyst or pouch that occurs in the synovial lining of the knee. Presents in the popliteal fossa (area behind the knee). Synovial fluid escapes from the knee joint and into the cyst in individuals who suffer from degenerative and other joint disease. Typically these cysts are not painful unless swelling is extensive. Aspiration of the cyst is therapeutic only temporarily since recurrence is common. Most disappear spontaneously after several years. Larger cysts can be removed surgically. Rupture of a Baker's cyst can present with pain and swelling to the calf.
terrible triad	injury to the knee joint including: a torn anterior cruciate ligament, a torn tibial collateral ligament, and a torn medial meniscus.
drawer sign	rupture of the anterior cruciate ligament (common in skiing injuries) allows the tibia to slide anteriorly from the femur-called the anterior drawer sign. Rupture of the posterior cruciate ligament (harder, but happens in head-on collisions with no seatbelt and the tibia strikes the dashboard) allows the tibia to slide posteriorly from the femur-the posterior drawer sign.
Pott's fracture	dislocation of the ankle that occurs when the foot is forcibly everted. This pulls hard on the medial ligament (very strong) and often tears off the medial malleolus. The talus then moves laterally, shearing off the lateral malleolus or more commonly breaking the fibula superior to the inferior tibiofibular joint. If the tibia is carried anteriorly the posterior margin of the distal end of the tibia is also sheared off by the talus, producing a trimalleolar fracture.
knee prosthesis	replacement for a knee joint
genu valgus/varus	lateral angulation of the leg in relation to the thigh (exaggeration of the knee angle) is called genu valgum (knock-knee). Medial angulation of the leg in relation to thigh is a deformity called genu varum (bowleg). A valgus stress at the knee pushes it to create a knock-knee, testing the medial collateral ligament. A varus stress pushes the knee into bow-leg position, to test lateral collateral ligament.

The material presented in these tables is contained in the book:
MedCharts Anatomy by Thomas R. Gest & Jaye Schlesinger
Published by ILOC, Inc., New York
Copyright © 1995, unauthorized use prohibited.

The excellent editorial assistance of
Dr. Pat Tank, UAMS
is gratefully acknowledged.

Anatomy Tables - Joints of the Upper & Lower Limbs

Osteology

Joints - Pectoral Girdle & Shoulder

Joints - Elbow & Wrist

Joints - Hand

Joints - Hip

Joints - Knee

Joints - Ankle

Joints - Foot

Muscles

Arteries

Clinical Terms