Junctura Extremitatum Thoracicarum (Upstream Junction Joints)
Art. acromioclavicularis et al. It has two as sternoclavicularis. Both of these joints are planar type (synovial) joints; art. capsule of sternoclavicularis lig. supported by sternoclaviculare anterius et posterius. Art. The capsule of acromioclavicularis is lig. supported by acromioclaviculare. Art. lig, an extrinsic ligament of the acromioclavicularis. coracoclaviculare (it has two divisions as lig. trapezoideum and lig. conoideum) plays a role in stabilizing this tendons joint.
Free Topside Joints
l. Shoulder joint (art. humeri.glenohumeral joint): It is a synovial, spheroid joint formed between the humeral head and the glenoidal pit in the scapula. The shallow glenoidal depression is augmented by the labrum glenoidale.
The shoulder joint has a loose and locally thinned joint capsule. The weakest part of the capsule is the lower part. The capsule is supported posteriorly by the tendons of four short muscles (m. supraspinatus, m. infraspinatus, m. teres minor, .m. subscapularis). These four muscles are called “rotator cuff” (Sits muscles). The tendon of the caput longum of M. biceps brachii passes through the joint space and attaches to the scapula.
The joint capsule is also supported by glenohumeral and coracohumeral ligaments. There are many bursae (bursa subacromialis. bursa subdeltoidea, etc.) around the joint
2. Elbow joint (art.cubiti): It consists of three joints with common capsule, formed between the lower end of the humerus and the upper ends of the radius and ulna. Although the three joints in the joint are of different types, the elbow joint is functionally ginglimus type
The humero-radial joint within the elbow joint is spheroid type, the humero-ulnar joint is ginglimus type, and the upper radio-ulnar joint is They are trochoid type joints.The joint has ulnar and radial colloteral ligaments (lig. collaterale ulnaire et radiale) in addition to the ligaments that stabilize it (lig. anulare radii, lig quadrate and lig obliqua).
A tr. Cubiti Clinical Information
1. Dislocations and fractures are common because the elbow joint is a wide joint that is open to external influences. There are some factors other than x-ray films that show whether the elements forming the joint are in normal condition.
a. With the forearm fully extended, the apex of the olecranon is tangential to the line joining the inner and outer epicondyles.
b. When the forearm is flexed 90°, the inner epicondyle, olecranon, and outer epiconyl most triangular emerge. In cases other than these two criteria, there are fractures or dislocations in the joint.
2. The posterior surface of the olecranon is very superficial under the skin. Between this face and the subcutaneous tissue is a synovial kesew called bursa subcutanea olecrani. This bursa can become inflamed and swell when falling on the elbow and continuous friction of the sac on the hard surface (in students).
3. Proximal radial epiphysis fracture is seen in young people in falls that force the elbow joint to abduct excessively. This epiphysis fuses with the diaphysis between the ages of 14-17.
4. Inner epicondyle detachment is seen in children with internal falls that will force excessive abduction while the elbow joint is in extension. Flours that are overstretched disengage the colletral ligament from the epiphysis and pull it down. Because the inner epicondyle epiphysis does not fuse with the distal end of the humerus until the age of 20. Beware of this late merger. n. The ulna may be damaged.
5. Posterior dislocation of the elbow joint: It is seen when children fall on their hands while the elbow joint is flexed. The proximal ends of the ulna and radius diverge posteriorly.
6. Carrying angle: Information about this angle is important when correcting arm and forearm fractures. In addition, narrowing of this angle is one of the clinical characteristics of Turner Syndrome. The extreme rotation of the forearm to the radial side, which is seen in women with XO sex chromosomes, is called the cubitus valgus condition.
3. Radioulnar joints: There are three joints between the radius and the ulna. While two of them (art. radioulnaris proximalis and art. radioulnaris distalis) are in the form of diarthrosis (trochoid type), one of them is synarthrosis (syndesmosis radioulnaris) and functionally amphiarthrosis type. In the distal radio-ulnar joint, proc. There is a strong connecting discus articularis extending from the base of the styloideus ulnae to the incisura ulnaris radii. This disc increases the joint. separates it from radio-carpea.
4. Radiocarpal (wrist joint) joint: It is an ellipsoid (biaxial) joint formed between the lower end of the radius and the upper row of the wrist bones (excluding os pisiforme). Radiocarpal joint can perform flexion, extension, abduction and adduction movements.
It is fixed at the radiocarpal joint by the dorsal, palmar, radier and collateral ligaments.
5. Carpal joints: The joints between the carpal bones in the same row are called intercarpal, and the joint between the upper and lower carpal bone groups is called the mediocarpai joint. All of the carpal bones are synovial and planar type and can make sliding movements.
Carpal joints are strengthened by intercarpal dorsal and palmar ligaments and radier and interosseus ligaments.
Art. Carpalia Clinical Information
1-Severe infections (tenosynovitis) may occur in perforations of the sheath because the synovial fluid creates a very suitable environment for bacteria.
Bursa radialis: It is the synovial sheath surrounding the M. flexor pollicis longus tendon. This sheath is league from the tip of the thumb. 2.5cm of carpi transversum. extends proximally.
Bursa ulnaris: M. flexor digitorum superficialis (sublimis) and m. The flexor digitorum is a synovial sac that jointly surrounds the profundus tendons. On the other side, the digital cover of the little finger joins with this cover. The parts surrounding the tendons of the index, middle and ring fingers end by closing in the middle of the palm. At the proximal end of this common synovial sheath lig. 3-4 cm of carpi transversum. extends to the top.
2-Since there is usually a connection between the radial and unlar bursae in the wrist, infections of the thumb may spread to the tip of the little finger and may cause horse-shoe abscesses in the hand.
3-Dupuytren’s contracture (Aponeurosis palmaris): Pathological thickening and contraction (fibrosis) of the longitudinal fibers creates permanent flexion in one or more fingers. This is called Dupuytren’s contracture. This is rarely seen in the thumb. Because the aponeurosis does not extend to the free part of the thumb. The ring and little fingers are involved first. The index finger can be held less frequently. The cause is unknown.
6. Hand comb and hand finger skeleton joints: To the joints between the bases of the metecarpal (hand comb) bones and the lower row of wrist bones carpometacarpal joints, to the joints between the heads of the metacarpal bones and the bases of the proximal phalanxes, to the metacarpophalengeal joints, to the joints between the phalanges Also called interphalangeal joints.
Junctura Extremitatum Pelvinarum (Lower extremity joints-Lower members)
l. Art. Sacroiliaca: It is a synovial-plana type joint formed between the auricular faces in the os sacrum and os ilium. Functionally, it is accepted as amphiarthrosis. The joint is supported by very strong ligaments (dotsal sacroiliac and interosseus ligaments). Sacotuberal and sacrospinal ligaments also play a role in stabilizing the joint.
Symphysis pubica: It is a cartilaginous joint formed by the fusion of the right and left os pubis anteriorly, in the midline. Ligaments extend from the upper and lower sides of the joint. The ligaments and disc of the symphysis pubica soften with the effect of hormones in the last months of pregnancy in women and contribute to childbirth.
Art. Sacroiliacus Clinical Information
1. In the case of falling from a height, the sacroiliac joints transmit the body weight to the hip bones. Flexion of the lower extremity protects the spine from injury. The elasticity of the sacrotuberal and sacrospinal ligaments are also the elements that protect the spine.
2. In the last stages of pregnancy, the sacroiliac and interosseal ligaments soften and loosen due to hormonal effects. This allows for rotational movements of the joint. The same situation occurs in the symphysis pubis, making it easier for the fetal head to pass through the birth canal.
3. The posterior iliac spine, where the crista iliaca terminates, is often difficult to palpate. However, just above these spinae are small skin depressions marking them. They are about 8 cm apart from each other. These skin pits are a good sign for a doctor who wants to extract bone marrow from the ilium. The bone marrow is taken by inserting it into the ilium 1 cm from the lower-outer side of the needle pit.
2. Art. coxae: It is a spheroid joint formed between the femoral head and the acetebulum in the os coxae. The hip joint is one of the most mobile joints in our body. The hip joint has a solid and tightly knit capsule.
The main ligaments of the joint are lig. iliofemorale, lig. pubofemorale and lig. ischiofemorale.
Apart from these, the league is not effective in the mechanics of the joint. transversum acetebuli and lig. capitis femoris (lig teres femoris). League. The capitis femoris contains vessels that go to the femoral head.
Hip joint, extension-flexion. It allows abduction-adduction and rotation movements.
Art. Coxae Clinical Information:
1. The hip joint can be partially or completely removed and replaced with a prosthesis to prevent pain and deformities due to osteoarthritis. The new metal or plastic joint perfectly performs the functions of a normal joint.
2nd Division. Capitis femoris changes show variations in size and length in individuals. of a. capitis femoris passes.
3. Collum fractures that are very close to the femoral head often disrupt the blood circulation of the head. In some individuals a. The blood from the capitalis femoris may be the only source of nourishment to the tip of the femoral head. In such cases, the proximal part of the femoral head may undergo aseptic necrosis by rupture of the ligament.
4. Since the femoral, sciatic and obturator nerves that sense the hip joint sensations also innervate the knee joint, hip joint pain may also be reflected to the knee region.
5. Congenital hip dislocation of the hip joint occurs at a rate of 1.5 per 1000 births. In half of the cases, the dislocation is bilateral.
Congenital hip may go unnoticed for months. The joint capsule is loose. There is hypoplasia of the acetabulum and femoral head.
The typical clinical sign of conjunctival hip dislocation is non-abduction of the joint. In addition, the dislocated limb is shorter.
6. Later dislocations of the hip joint are rare. When the thigh is in flexion, adduction and internal rotation, if it is hit hard (in automobile accidents), the femoral head may come out of the acetabulum. In this case, the capsule ruptures posteriorly and the femoral head enters the tear.
7. Fractures on the sides of the acetabulum cause fracture dislocations of the femoral head. The femoral head also drags the labrum acetabulare along with the broken bone fragments.
8. Since the sciatic nerve is in close proximity to the hip joint, it can be damaged in fractures or dislocations of this joint.
9. The iscihiadica located on the surface of the tuber ischiadicum may become inflamed (ischial bursitis) due to excessive pressure.
10. Tuber ischiadicum carries almost all body weight while sitting. In debilitated or paralyzed patients, pressure sores may develop in this area if not well taken care of.
11. Inflammation of the bursa trochanterica causes widespread deep pain in the lateral parts of the hip and gluteal region. There is a complaint of tension sensation over the greater trochanter.
12. Due to injury to the N. gluteus superior, m. If the gluteus medius and minmus are paralyzed, the fixation mechanism of the pelvis is impaired while walking. When the foot is off the ground on the normal side, the pelvis tilts to this side. Because the patient’s gait resembles a duck’s gait, this situation is called “duck gait”. Towards the end of pregnancy, duck walking is seen physiologically because the sacral plexus is under pressure.
13. The gluteal region is a suitable site for drug absorption for intramuscular injection of drugs. Since its muscles are large and thick, it creates a suitable environment for drug absorption. A nurse or midwife should know the safe injection area in this area very well. If we divide a buttock ridge into four sections with straight lines intersecting each other in the middle, the safe injection site is the upper-outer section.
14. However, in young children, injections are given in the middle of the anterior-outer part of the thigh as this area can be dangerous.
3. Art. genus: It is the largest and most complicated joint of the human body, formed between the lower end of the femur and the upper end of the tibia and the patella. The harmony of the articular surfaces is provided by the menisci (internal and external meniscus).
Art. genus is a bicondylar type joint. The joint capsule is loose and partially thinned, completely lost anteriorly. Art.genus has two groups of ligaments, intracapsular and extracapsular. There are two cruciate and two meniscofemoral ligaments in the joint. Ligaments outside the joint are lig. patellae lig.collaterale fibulare et tibiale. League. popliteum obliquum and lig. poptiteuni arcuatum.
Art. genus.It allows extension-flexion and rotation movements.
Art. Genu Clinical Information:
1. During knee extension, most of the quadriceps pulls the patella outward-upward. This force tends to protrude the patella to the side. This oblique traction m. It is corrected by the effect of the vastus medialis pulling the patella upward-inward. If the vastus medialis is weak or paralyzed, forceful contraction of the quadriceps can protrude the patella.
2. In injuries of the knee joint, the quadriceps femoris becomes useless. When it is not working, the muscle is destroyed rapidly. This destruction delays the recovery of joint function. Therefore, quadriceps should be exercised regularly throughout the joint treatment.
It is a sufficient exercise for the patient lying on his back to flex his hip while his knee is extended.
3. In case of quadriceps paralysis, the patient can stand as the body will force the painful knee extension. If the pelvis is tilted slightly forward, the patient can walk with short strides. These patients often press the lower part of the thigh with their hands to prevent knee flexion.
4. Quadriceps femoris is a muscle that is heavily injured in football. In direct trauma, muscle fibers can be broken and crushed (Contusion). In this case, local hematoma occurs (Charley horse).
5. Injuries to the knee joint are mostly related to excessive accumulation of blood or synovial fluid in the joint space. The joint space is at its widest when the knee is slightly flexed. The swelling spreads upwards and to the sides of the patella. If it is necessary to take fluid from the joint, it should be entered from the top or sides of the patella.
6. The patella may be dislocated or broken. Fractures of the patella occur in two ways. Fractures of the patella occur in two ways. In the blows of the bone from the front or falling on the bone, the bone is broken into pieces. However, m. The quadriceps tendon holds the pieces in place without falling apart. In most cases, the active axis of the knee is not impaired. Sometimes, usually in middle age, an individual contracts the quardriceps muscle strongly and suddenly in order to protect himself from falling. In this case, the patella can be broken transversely in the middle. The lateral retinacular ligaments are torn. The bone is divided into upper and lower two parts. In this type of fracture, active extension of the knee is lost.
7. Surgical removal of the patella causes almost no loss of function.
8. Quadriceps tendon pulls the patella upwards and outwards. Genu valgus deformity increases this effect of the muscle. In some individuals, the normally very prominent outer lip of the bone is weakly formed. In these individuals, the patella may protrude with the traction of the quadriceps.
9. The ligaments of the knee can be frequently injured. If a pedestrian is hit by the car bumper from the side, the knee is forced into hyperextension. tear the cruciatum anterior. League. rupture of the cruciatum posterior is less common. If the tuberositas tibia is dropped while the knee is flexed, this ligament may tear. In this case, the tibia goes backwards excessively.
10. Tear of the meniscus is one of the most common knee injuries.
The tibial collateral ligament is firmly attached to the inner meniscus. In this respect, the inner meniscus may also be torn due to excessive abduction or direct blows that damage this ligament. This phenomenon is very common in football matches. Injury to the internal meniscus typically occurs when the knee joint is in semi-flexion and the femur in internal rotation on the tibia is loaded onto the joint.
Meniscus pieces are stuck between the tibia and femoral articular surfaces, locking the joint in semi-flexion. There is evidence that the menisci are torn. When a torn meniscus is removed, a fibrous meniscus regenerates from the deep layers of the joint capsule.
The outer meniscus is smaller and more mobile. Fibular collateral ligament is easily injured because it does not attach. Between the outer meniscus and the fibular collateral ligament are the tendon of the popliteus muscle and the bursa poplitea.
If air or contrast material is injected into the cavity of the knee joint, the menisci may appear on the X-ray. Pneumoarthrogram and double concentration arthrograms are used to observe soft tissue lesions of the knee joint.
11. It can be injected into the knee joint space. Sitting at the edge of a table, flex your legs; a. Draw a triangle by connecting the points of Apex patella, 2. Tibia outer condyle, 3. Femur outer condyle anterior protrusion. The middle of this triangle is the injection point.
12. Since the bursa suprapatellaris space joins with the knee joint space, it is considered a part of the knee joint. Below the thigh, the knee joint becomes inflamed as a result of penetrating wounds reaching this bursa. Fractures of the distal end of the femur may collect blood in the joint space (hemarthrosis).
13. If the bursa prepatlaris is under constant pressure, it may become inflamed (prepaellar bursitis). In chronic infection, a large soft swelling appears in front of the knee (called maid knee).
14. The deep popliteal fascia is a strong and non-expandable fascia. That is why the pain of an abscess or tumor in the fossa is easily distinguished. Also, popliteal abscesses tend to spread up to the thigh and down to the back of the leg.
15. Since the floor of the fossa rests on the posterior aspect of the knee joint, in cases where fluid escapes from the synovial space, the fossa swells and contains a fluid-filled popliteal cyst. Popliteal cysts mostly develop in conjunction with the bursa semimembransus and bursa poplitea. This type is very common in children.
In adults, popliteal cysts join the joint cavity through a narrow path that passes through the membrane. Since there will be synovial fluid effusion in rheumatism or degenerative joint diseases, popliteal cyst may grow up to the middle of the leg in case of a synovial hernia and impair joint function.
16. N. Tibialis is well preserved as it runs deep and is not easily damaged. However, it is injured in fossa popliteal lacerations and posterior dislocations of the knee joint. In this case, the back muscles and soles of the feet are paralyzed. The heel cannot be cut off the ground while walking. The patient brings the paralyzed extremity to him and uses it again as a support.
These patients also have loss of sensation in the skin of the soles of the feet. Pressure sores may occur on the soles of the feet.
5. Joints between tibia and fibula: Art. tibiofibularis (upper tibiofibular joint.synovial and plana type joint), membrana interossea cruris. There are three joints, namely syndesmosis tibiofibularis (art tibiofibular joint).
6. Art.talocruralis: It is a ginglimus (trochlear) type joint formed between the distal ends of the tibia and fibuia and the upper part of the talus. The thin joint capsule is reinforced on the sides by collateral ligaments.
Art. lig to the lateral ligament of the talocruralis. mediale (deltoideum), lig. It is called lateral (talofibular and calcaneofibular ligaments).
Art. Genus allows dorsoflexion and plantar flexion movements.
Art. Tarsii Clinical Information:
1.Lig. The tibiofibulare posterior is much stronger than the anterior ligament. In some ankle injuries, the posterior tibiofibular ligament of the tibia may rupture the posterior-lower part of the tibia. In these cases, the fracture enters the ankle joint. In addition, external and internal malleolus can also be fractured together. Such a fracture is called a trimalleolar fracture.
2.New bone tissue is formed on the upper surface of the talus neck and the anterior surface of the lower end of the tibia in football players who have to kick the soccer ball continuously. Due to the plantarflexion when kicking, the tibotalar ligament shows bony ridges at the attachment sites. This condition is called football player’s foot.
3. Inward dislocations of the ankle joint are rare because of the strength of the deltoid ligament.
In fracture-dislocations of the joint, the distal ends of the tibia and fibula are often broken. The most common Pott fracture occurs when the foot eversions with great force. The deltoid ligament is torn at the insertion site of the internal malleolus. The talus tilts to the side and breaks the fibula at its lower end.
4. The ankle joint is a frequently injured joint. By the way, mostly league. laterally damaged. Inversion injuries occur when the foot inverts with force. The event often develops as follows: a. The individual falls by pressing an unusually bumpy surface. b. This stretches the fibers of the lateral ligament, tearing some of them. c. A local swelling, pain and tension develops in the anterior-lower part of the external malleolus apex.
Tearing of some fibers of the lateral ligament destabilizes the ankle joint. The foot is kept in obligatory eversion until the ligament heals. If the foot is inverted without healing, fracture-dislocation may occur.
5. The synovial space of the ankle joint can sometimes extend up to both sides of the tendon calcaneus. In the case of arthritis of such a joint, swelling occurs on both sides of the tendon.
Fracture-dislocation can occur if the foot stuck under something stable (for example, under a rock) is forced into inversion. In this case, all the weight of the body is on the lateral ligament. Mostly league. The calcaneo-fibulare is torn. Sometimes league. talofibulare anterior joins it. Because the talofibular ligament attaches to the anterior portion of the joint capsule, the capsule may also tear together. Also, the tip of the external malleolus may break off.
The most important active factor that supports the lateral ligament and prevents innervation injuries is m. peroneus brevis.
6. In sudden and extreme eversions of the foot, m. The peroneus brevis tendon may rupture the tuberositas ossis metatarsi quinti. For this reason, radiologists first look at whether these tubersitas are ruptured in foot injuries.
7. Tarsal joints (Art. intertarseae): These are the joints between the ossa tarsi, and the important ones are the subtalar calcaneocuboidal, talocalcaneonauikular and transversal tarsal (Chopart’s joint) joints. These joints are supported by strong ligaments.
8. The metatarsal and toe skeleton joints (Art. metatarsi and phalengeallis): The planar joints between the distal row of the ankle bones and the bases of the metatarsal bones are called tarsometatarsal joints (collectively called the lisfranc joint). Other joints are named similarly to the hand. (such as metatarsophalangeal joints, interphalangeal joints).
Art. Metatarsia Clinical Information:
1.II. due to the shape of the tarsometatarsal joint II. The metatarsal bone can move very little. If the distal end of the foot is unusually and suddenly overworked, this bone can break. For example, if an unaccustomed individual tries to do exercises such as forced walking exercises, very long walks, ballet exercises, he may suffer a bone walking fracture.
In amputations of the 2nd foot, if the event has not progressed too far, Lisfranc amputation is preferred. As the starting point of this amputation, the tarsometatarsal joint is entered behind the tuberositas ossis metatarsi V and the foot is cut by leaving the inner end of the joint.
If the event progressed a little further, amputation art. It is performed along the transversa tarsalis. Art talonvicularis et al. Although calcaneocuboidea are separate joints, they are located in the same transverse plane. Increase both together. It is called trasversa tarsalis.
3. The first metatarsopalangeal joint may be deformed and enlarged. In this case, the proximal tip of the big toe may turn outward and overflow. This phenomenon is called hallux valgus. It is very common in those who wear narrow-toed shoes. These individuals are the first and second parts of the sesamoid bones. Since the metatarsal heads are correctly displaced, they cannot move their thumbs away from the second finger. If the event started in youth, it progresses gradually. The treatment is surgery as the prognosis is poor.
4. Gout; It is a metabolic disease that develops with the deposition of urate crystals in connective tissue bones and cartilages. It is mostly located in the first metatorsophalangeal joint. There is swelling and pain in the joint.
5. The first joint involved in osteoarthritis is mostly the first metatarsophalangeal joint. The big toe in such a condition that goes with pain without deformity is called hallux rigidus.
6. Permanent dorsiflexion of the proximal phalanx is called hammer toe. Mostly the second part of the foot. It appears on the finger. heart in distal phalangeal flexion or extension. This phenomenon occurs with weakening of the lumbrical and interosseal muscles that flex the metatarsophalangeal joints.
7. In infants, the footpad appears flat due to the abundance of the subcutaneous fat pad. Although arches of the feet are present at birth, they are not evident until the child has walked for several months. This situation is considered normal.
8. The collapse of the arch and dome of the foot for any reason and the flat foot of the foot is called flat feet (pes planus).
In standing posture, the plantar ligaments and plantar aponeurosis have important roles in maintaining the condition of the foot dome under the pressure of body weight. If these ligaments become excessively stretched in individuals who have to stand for long periods of time, lig. calcaneonaviculare plantere cannot adequately support the talus head from below. The arcus longitudinalis collapses medially and the tip of the foot deviates outward. The sole sticks to the ground as it is.
In a common type of flat feet, when the weight falling on them is removed, the arches return to their normal shape.
Transverse arches may also collapse on flat feet. Since the heads of the outer 4 metatarsal bones will rest on the ground, callus may occur in them. In these areas, the skin also thickens as a protective mechanism against pressure. Flat feet get tired very quickly.
C. Head-Neck and Trunk Joints
Head-neck joints
1. Art. temporomandibularis: It is a bicondylar joint formed between the arch in the condylar process of the arm of the mandible and the fossa mandibularis in the os temporale. It has a thin and loose capsule. Within the joint cavity is the discus articularis. Joint ligaments. laterally, lig. medial, lig. sphenomandibilare and lig. stylomandibulare.
2. Art. atlantooccipitaiis: It is a condylar type joint formed between the concave articular surfaces of the lateral masses of the atlas and the condyles of the occipital bone. Articular ligaments consist of two membranes (membrana atlantooccipitalis anterior et posterior) and two right and left lateral ligaments (lig. atlantooccipitale laterale). Allows joint flexion-extension, slight right and left bending movements.
3. Art. atlantoaxiale: Dens axis ile atlas’ın ön kemeri ve lig. transversum atlantis arasında trokoid tipte, median bir eklem (art. atlantoaxialis mediana-ligg. alaria başın rotasyonunu sınırlar.
Diğer bağları lig. apicis dentis. Lig. cruciforme atlantis ve membrana tectoria’dır) atlasın lateral kitleleri ile axis’in üst eklem yüzleri arasında plana tipte iki lateral eklem (artt. atlantoaxiales laterales) oluşur.
4. Boyundaki diğer eklemler: Boyun omurları arasındaki eklemler olup vertebral eklemler başlığı altında aşağıda anlatılmıştır.
Juncturae columnae vertebralis (Omurga eklemleri)
Omurgayı oluşturan omurlar arasında iki grup eklem vardır. Omur cisimleri arasındaki eklemler (omur kemerlerindeki eklem çıkıntıları arasındaki eklemler).
l. Omur cisimleri arasındaki eklemler: Omur cisimleri birbirleriyle simfizis tarzında eklemleşmişlerdir. Omur cisimlerinin eklem yapacak alt ve üst yüzleri, ince bir hiyalin kıkırdak tabakası ile kaplanmıştır. C 2’den S l’e kadar corpus vertebralar arasında fibro-cartilaginöz bir oluşum olan discus intervertebralis’ler bulunur. Diskuslar, sert omur cisimleri arasında sınırlı ve kontrollü hareket olanakları sağlama yanında darbe emici olarakta görev yaparlar. Bu eklemlerin omurganın ön yüzü ile vertebral kanalın ön yüzü boyunca uzanan iki uzunlamasına bağı (lig. longitudinale anterius, lig. longitudinale posterius) vardır.
2. Omur kemerlerindeki eklem çıkıntıları arasındaki eklemler: Omur kemerlerindeki eklem çıkıntıları (proc. articularis) arasındaki eklemler. Grekçe eklem çıkıntısı anlamına gelen zygapophysis teriminden türetilerek art. zygapophysialis olarak adlandırılır. Klinikte bu eklemler için “faset eklemleri “terimi kullanılır. Bütün faset eklemleri sinoviyal-plana tipindedir. İnce ve gevşek bir kapsülle sarılı olan eklemler ligamenta flava, ligg. interspinalia, ligg. supraspinalia, lig. nuchae ve ligg. intertransversaria’larla desteklenmiştir. Bu eklemler, üstteki omurun bir alttaki omur üzerinde öne doğru kaymasını engellerler.
Juncturae thoracis (Göğüs eklemleri):
İki grup göğüs eklemi vardır. Bunlardan birinci grup omurlarla kaburgalar arasındaki costovertebral eklemler, ikinci grup ise kaburgalar ile sternum arasındaki stenocostal eklemlerdir.
Sağlıklı günler dileği ile…
Uzman Dr.Ali AYYILDIZ – Veteriner Hekim – İnsan Anatomisi Uzmanı Dr.(Ph.D.)
