Anatomie van de schoudergewricht

• Articulatio humeri (shoulder joint): ball-and-socket joint with center in head, limited abduction to 90° due to tuberculum majus and coraco-acromial ligament. Elevation requires involvement of other shoulder girdle joints. Adduction is restricted by body. Light antiflexion allows for only 30 degrees of adduction. Anteflexion is not limited by ligaments and can exceed 90 degrees of elevation. Retroflexion is strongly limited by glenohumeral ligaments in the front of the joint capsule. Exorotation (80°) and endorotation (100°) are limited by the capsule. Protractio and retractie can only occur when both other joints are involved. Glenohumeral joint is less mobile than hip joint. Shoulder girdle is more mobile due to two additional joints (sternoclavicularis and acromioclavicularis) that pull the shoulder blade forward and back. Increased mobility comes at the cost of stability.
• The center of pure abduction in the glenohumeral joint is 90° to 120°, but a limited lowering of the humerus head during this movement must be considered.
• The combination of ab- and adductiebewegingen (all ab- and adductive movements), ante- and retroflexies with an extended arm describes a line within the realm of the spherical surface. The center of this surface is the head of the humerus. At each point in the excursion range, the limb can describe rotation. When the joint becomes stiff, remaining mobility of the shoulder girdle (sternoclavicularis and acromioclavicularis joints) is preserved. This kind of stiffness can occur after fractures, luxations, or chronic shoulder pain and is a result of capsule retractive (scarring).
• The global shoulder girdle functions passively with the skeleton and its ligamentous bands carrying the arm without the intervention of muscles. The clavicle is horizontally fixed by the sternoclavicular joint, and the scapula hangs from the clavicle by the conoidal and trapezoid ligaments. The scapula rests against the 7th rib and has a 7-degree space underneath.
• The humerus is fixed posteriorly by muscles and anteriorly by ligaments. Actively, in each standing position of the glenoid cavity that is allowed by the clavicular joints, the articulatio humeri (shoulder joint) can describe its excursion range. Through changes in the position of the glenoid cavity, an excursion space is created. At each point in this space, rotation of the arm is possible. With each shoulder movement, all the joints in the system come into play, including those that could have been involved in a single joint movement alone.
• The elbow joint: three functional joints within one joint capsule. The articular surfaces are all covered with hyaline cartilage. 1. Articulatio humero-ulnaris (ulno-humeral joint): hinge joint. On the ulna: trochlea. On the humerus: trochlea. 2. Articulatio humero-radialis (radio-humeral joint): spherical joint. Humerus: round head. Radius: articulating surface: fovea on the head of the radius. 3. Articulatio radio-ulnaris proximalis (proximal radioulnar joint): pivot joint. Radius: circumferential articular surface. Ulna: radial notch. The number of joint axes equals 5. The joint capsule is common for the three joints. The fibrous membrane is abnormally attached to the humerus. The fossa olecrani, radialis, and coronoidea ligaments are found infra-articularly, as are the condyles of the humerus consisting of the trochlea, capitulum, and three fossae.
• The epicondyles remain free for muscle insertions. On the ulna, the attachment is almost normal at the bone edge. The olecranon and processus conoideus are still in the joint capsule. On the radius, the attachment is normal, but just distal from the border of the circumferential articular surface. This forms a sac-like pouch around the radius. The elbow joint is a hinge joint (with three parts). Between the synovial membrane and the fibrous membrane lies fatty tissue that has a dampening effect.
• The ligaments play a crucial role in the elbow joint: 1. Ligamentum anulare: this ligament holds the radius to the ulna in every position and only allows rotation along the long axis; it is centered in the circumferential ligament. 2. Ligamentum quadraturum: this ligament forms reinforcement of the sac-like pouch in the space between the radius and ulna. 3. Transverse bands run from the distal edge of the radial notch to the ulna-side of the collarbone. Close to the attachment on the ulna, circular fibers pass through the transverse bands. These fibers can be considered as the distal part of the ligamentum anulare. 4. Ligamentum collaterale ulnare: this broad triangular band is firmly fixed to the epicondyle medialis, with the front part consisting of strong parallel fibers that run to the ulna's radial side of the processus coronoideus, and the rear part runs to the ulna's side of the olecranon. Pars transversa connects both parts distally with transverse bundles. Function: it limits abduction; the front part checks extension, and the posterior part checks flexion.
• The ulnar nerve runs posterior to the elbow joint, and the radial nerve runs anterior to it. The brachial artery runs anterior to the elbow joint, and the posterior interosseous artery runs posterior to it. The ulnar artery and the radial artery form the anastomosis between the elbow and the distal forearm.
• In the elbow joint, the articular cartilage is thicker in the medial compartment than in the lateral compartment due to the greater load experienced by the medial compartment. The ligaments are less elastic on the medial side than on the lateral side.
• The ulnar collateral ligament is the primary stabilizer of the medial elbow joint, while the lateral collateral ligament provides stability in flexion and extension.
• The anterior band of the ligamentum teres functions as a rotator cuff for the humerus.
• The olecranon bursa is a synovial-lined sac that lies between the olecranon and the triceps muscle. It is a common site for bursitis.
• The elbow is a complex joint with a large number of muscles, ligaments, and nerves involved in its function. It is essential for movements such as flexion, extension, supination, and pronation of the forearm.
• The elbow joint is also involved in the transmission of forces during activities such as lifting, pushing, and pulling.
• The elbow joint is prone to injuries, including fractures, ligament ruptures, and dislocations. These injuries can result in chronic pain and loss of function if not treated promptly and properly.
• The elbow joint is susceptible to degenerative conditions such as osteoarthritis, which can cause pain and stiffness.
• The elbow joint is commonly used in daily life, and its health and functionality are crucial for maintaining a good quality of life.
• The elbow joint is the second most commonly used joint in the body, after the shoulder joint.
• The elbow joint is a synovial joint with a fibrocartilaginous meniscus in the trochlea, which provides stability and absorbs shock.
• The elbow joint is the most mobile joint in the upper limb, allowing for a wide range of motion.
• The elbow joint is often treated with conservative measures such as rest, ice, compression, and elevation, as well as physical therapy and medication.
• The elbow joint can also be treated with surgical intervention, such as arthroscopy or joint replacement, in cases of severe injury or degenerative conditions.
• The elbow joint is important for activities such as writing, playing musical instruments, and using tools, making its health and functionality crucial for various aspects of daily life.
• The elbow joint is a complex joint with a large number of muscles, ligaments, and nerves involved in its function. It is essential for movements such as flexion, extension, supination, and pronation of the forearm. It is also involved in the transmission of forces during activities such as lifting, pushing, and pulling.
• The elbow joint is prone to injuries, including fractures, ligament ruptures

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