Articulation of the thoracic limb

Objectives:
1. Define Synsarcosis
2. List the joints of the forelimb
3. Describe the joints of the fore limb regarding
structure, type of movement and ligaments
4. Clinical applications of the forelimb
 Syndesmology (Articulations ) of the forelimb
- The thoracic limb does not form an articulation with the trunk.
- It is attached by muscles to the trunk (synsarcosis)
- Synsarcosis: Group of muscles which connect the thoracic limb with the head ,
Neck and Trunk.
- These muscles are classified into two groups (LTR PBS):
a. Dorsal group: Latissimus dorsi, Trapezius and Rhombideus muscles &
Omotransversarius (in dog)
b. Ventral group: Pectoral, Brachiocephalic and serratus ventralis muscles
 I- Shoulder joint
(Glenohumeral joint or Scapulohumeral articulation)
A- Motion: Ball and socket – Extension, flexion, adduction, abduction and
circumduction but (mainly extension and flexion due to muscle limitation)
B- Structure:
I- Bone: Glenoid cavity of the scapula and head of the humerus
II- Joint capsule: loose, allow the bone to draw a part for about 2-3cm
III- Ligaments: a- two elastic medial and lateral glenohumeral ligaments (cranial
thickening in the fibrous capsule). It attaches the supraglenoid tubercle to the
tuberosities of the humerus.
- There is a transverse humeral retinaculum ligament attaches between the
greater and lesser tubercles and holds the biceps tendon in the bicipital groove.
b- Muscles which are attached around the joint act as ligaments which confer
stability to the joint are:
laterally, supraspinatus, infraspinatus and teres minor
medially: subscapularis
Cranially, Biceps brachii Due to these muscles and the head
of the humerus is twice larger, so the
Caudally, Triceps brachii
clinical luxation or dislocation is rare
Bursa:

Def: A sac-like dilatation between two different tissues

Function: Reduce friction
Structure: Consists of fibrous capsule lined by a synovial membrane
Location: May be between the following:
A- skin and bone B- tendon and bone C- muscle and bone D- ligament and bone

Bicipital Bursa: it presents in the shoulder joint between the bicipital tendon and
bicipital groove in the horse and ruminants but the bursa communicates with the joint
capsule in the pig and carnivores.
It may be inflamed causing lameness

Injection of shoulder joint:

In carnivores: direct the needle medially just caudal to the end of the acromion
In large animals: in similar manner just cranial to the tendon of the infraspinatus
muscle.

- To take mediolateral radiograph of the humeral joint: pull the limb cranially and
ventrally to a marked degree to avoid superimposing the joint
 II- Brachioantebrachial articulation
(Cubital articulation or elbow joint)
A- Motion: Hing or ginglymus joint ------ extension and flexion but limited by
collateral ligaments and biceps brachii muscle
B- Structure:
I- Bones: 3 bones (distal end of the humerus as well as the proximal ends of
radius & ulna ( head of radius and trochlear notch of ulna)
II- Joint capsule: single cavity includes the 3 parts
III- Ligaments: collateral ligaments
A- Medial (ulnar) collateral ligament: between medial humeral epicondyle
and medial tuberosity of the radius & ulna (1- long superficial part 2-
short deep part)

B- Lateral (radial) collateral ligament: between lateral humeral epicondyle

and lateral tuberosity of the radius. This ligament is divided in carnivores
into a cranial and caudal (ulnar) part.

- In carnivores: radial annular ligament (around the humerus head) and

olecranon ligament extends from medial epicondyle to ulna.

- In dog: a small sesamoid bone is seen radiographically embedded in ulnar

collateral ligament
• Clinical: Capped elbow (olecranon bursitis):

False subcutaneous bursa between the skin and the olecranon tuberosity due
to repeated trauma (acquired bursitis) by the shoe of the affected limb either
during locomotion or when laying down (shoe boil)
- Luxation is rarely occurs medially because the enlarged medial epicondyle of
the humerus prevents the radius and ulna from dislocating in the medial side.
- Injection of the cubital joint in carnivores, ox and horse by directing the needle
between the olecranon tuberosity and lateral epicondyle of the humerus.
 III- Radioulnar articulation
(Proximal and Distal)

A- Motion: No movement

B- Structure:
I- Bones: 2 convex facets on ulna and 2 corresponding facets on radius
II- Joint capsule: enclosed in the elbow joint capsule

III- Ligaments (3 for proximal one and 1 for distal one).

1. Annular ligament of the radius: around the radial head and attaches distally
to radial notch of ulna.
2. Interosseous ligament of antebrachium--- in proximal half of interosseous
space
3. Interosseous membrane of the antebrachium: joints the ulna with radius in dog

4. Radioulnar ligament: between the radial trochlea and styloid process of ulna.

- The proximal and distal radioulnar joints ossify in case of the horse and
ruminants
Articulations of the manus
 1V-Articulations of the manus
1- Knee (carpal) joints
- It consists of 4 joints (composite joint)
- A- Motion: act together as ginglymus joint
( extension and flexion & limited amount of gliding).
- Most movement occurs at joint (1), considerable movement at joint (2) and no
movement at joint (3).

- B- Structure:
- I- Bones:
- 1- Antebrachiocarpal (ulnocarpal & radiocarpal) joint: between the distal end
of the radius & ulna (carpal articular surface of the radius and first row of
carpal bone (radial, intermediate, ulnar and accessory carpal bones)
(Hinge in horse, cochlear in ox and ellipsoidal in dog).
- 2- Middle carpal joint: between the proximal and distal rows of the carpal
bones. It also includes the accessory carpal (intercarpal) joints
Complex hinge joint
- 3- Carpometacarpal joint: between the distal row of the carpal bone (1st , 2nd,
3rd and 4th carpal bones) and the proximal surface of the metacarpal bones
Plane joint
- 4- Intercarpal joints: between the carpal bones in the same row
- II- Joint capsule:
-
A- Fibrous joint capsule:
- Is common to the 4 joints and forms the extensor retinaculum (dorsal carpal
ligament) dorsally and the carpal palmar ligament palmarly
- The carpal palmar ligament is the dorsal boundary of the carpal canal (for
SDFT and DDFT) and it then continues distally as the inferior check ligament
of DDFT (carpal head of the DDFT)

• B- The synovial joint capsule: The synovial membrane forms three sacs
corresponding to the joints:
• 1- Antebrachicarpal: doesn’t communicate with the two distal
compartments
• 2- Midcarpal 3- carpometacarpal --- communicate with each other in
horse and dog.
III- Ligaments:
1- Collateral ligaments:
A- Medial collateral ligament: from medial styloid process of the radius to the 2nd
and 3rd metacarpal bones (also to radial and 2nd carpal bone). The palmar part of
this ligament fused with the flexor retinaculum (transverse ligament of the
carpus).
B- Lateral collateral ligament:
1- Long superficial part: from lateral styloid process of the radius to the 4th MC
and some to 3rd one. Absent in dog.
2- Short deep part (2): from lateral styloid process to the ulnar carpal bone--- to
4th carpal ---- 4th metacapal.

2- Special ligaments:
a- accessory ulnar b- accessoricarpoulnar c- accessory metacarpal
d- palmar intercarpal e- palmocarpometacarapl f- plmar radiocarpal
g- dorsal intercarpal h- dorsocarpometacrapal i- Accessoriquartal liagmant
• Various configuration of the equine carpus:
• Congenital or Acquired Varus/Valgus deviations of the carpus, tarsus, and
fetlock
Carpal valgus: lateral deviation of the carpus
Carpal Varus : medial deviation of the carpus

Angular Limb Dynasplint System

Intercarpal joints

- The metacarpal bones articulate with each other at their proximal ends in dog and
pig.
- In ox: the 3rd and 4th metacarpal bones are fused and no movement is possible.

- Small joints between the proximal ends of the splint bones and the cannon bone in
the horse, movement is very limited, due to the interosseous ligament between the
shaft of the metacarpal bones, which undergoes ossification (syndesmosis).
 2-Metacarpophalangeal articulation
Fetlock joint
A- Motion: Ginglymus joint ---- Extension and flexion
B- Structure:
I- Bones: Distal articular surface (trochlea) of 3rd metacarpus (metatarsal),
Proximal articular surface of the first phalanx and proximal sesamoid bones (2)
II- Joint capsule: attached around the margin of the articular surfaces
- Thick dorsally separated from extensor tendon by bursa and forms a pouch
between the suspensory ligament and metacarpus (palmarly) & or metatarsus
(plantarly) and a pouch dorsally between extensor tendon and cannon bone.
III- Ligaments:
1- Collateral ligaments: Medial and lateral and each one has (a superficial and
deep part)
a- the superficial part extends between the distal end of 3rd metacarpal
(metatarsal) bone and first phalanx
b- The deep part extends between the 3rd metacarpal bone and abaxial surface of
sesamoid bones and the first phalanx
2- Sesamoid ligaments: group of ligaments attach to the proximal sesamoid
bones to form the part of the stay apparatus or brace

a- Proximal ----- Suspensory ligament (interosseous m) : arises from the

proximal part of the 3rd metacarpal (metatarsal) bone, distal row of carpal
(tarsal) and planter tarsal ligament and inserts into the abaxial surface of the
proximal sesamoid bones. A branch passes to the dorsal surface of the
proximal phalanx where it joins the common digital extensor tendon. In the
young the tendon has some striated muscle but becomes completely
tendinous in adult life. The tendon supports the fetlock and prevents excessive
dorsal flexion of the joint when the foot in the ground. The dorsal branch limits
flexion of the joint. It Prevents deep flexor tendon from flexing the joint as a
result of tension on it (deep flexor), when limb is on the ground and joint is
extended.

B- Middle sesamoidean ligaments:

1- Intersesamoidean ligament: is a mass of fibrocartilage in which the
sesamoid bones are partially embedded, it forms transverse connection
between the two proximal sesamoid bones
2- Collateral sesamoidean ligaments (lateral and medial): each arises from the
abaxial surface of the corresponding sesamoid bone and insert into the 3rd
metacarpal (metatarsal) bone and first phalanx
C- Distal sesamoidean ligaments:
1- Superficial (straight) sesamoidean ligament: Y- shape, arises from the
sesamoid bone and insert distally on the complementary fibrocartilage of the 2nd
phalanx

2- Middle (oblique) ligament: V-shape, arises from the sesamoid bones to the
rough triangular area on the proximal phalanx.

3- Deep (Cruciate) sesamoidean ligament: X –shape, arises from the base of the
sesamoid bone, crossing each other to be inserted on the proximal part of the
first phalanx

4- Short sesamoidean ligament: attach to the sesamoid bones and to the

proximal end of the proximal phalanx

N.B: Suspensory apparatus: suspensory ligament and distal sesamoidean

ligaments.
 Wind Puffs, Wind Galls, Wind Galls Soft and
Road Puffs

They are distentions of a tendon sheath, bursa,

or joint capsule on a horse's legs; usually on
the fetlock

If interosseus ligament rupture ---- Fetlock sinks

if the SDF tendon ruptures: Fetlock sinks slightly, not grounded

if both the SDF and interosseous mm. rupture: Complete grounding (collapse) of the fetlock
 3-Proximal interphalngeal articulation
Pastern joint
A- Motion: saddle joint --- extension and flexion

B- Structure
I- Bones: the articular surface of the distal end of the 1st phalanx, the articular
surface of the 2nd phalanx and plate of fibrocartilage.
II- Joint capsule: attached around the margin of the articular surface, blends
dorsally with extensor tendon and on the sides by the collateral ligaments.

III- Ligaments:
1- Collateral ligaments: Lateral and medial: short bands attach between the distal
end of the 1st phalanx and proximal end of the 2nd phalanx. Dog has this ligament
only.

2- Palmar ligaments:
A- Central pair: arise from the rough triangular area of 1st phalanx
B- Lateral and Medial bands: arises from the middle of the borders of the 1st
phalanx
A and B are inserted on the palmar (plantar) aspect of the 2nd phalanx
 4-Distal interphalngeal articulation
Coffin joint
A- Motion: ginglymus joint --- extension and flexion
B- Structure
I- Bones: the articular surface of the distal end of the 2nd phalanx, proximal surface of the
3rd phalanx and navicular bone
II- Joint capsule: attached around the margin of the articular surface, blends dorsally with
extensor tendon and on the sides by the collateral ligaments.
- The capsule forms a pouch palmarly (plantarly) which extends proximally up to the
middle of the middle phalanx.
- Extends proximally on dorsal and palmar surfaces, forming pouches in mid 2nd
phalangeal region and another below the navicular bone

III- Ligaments:
1- Collateral ligaments: Lateral and medial: short bands attach between the distal end of
the 2nd phalanx and extensor process of the end of the 3rd phalanx

2- Collateral sesamoidean (suspensory navicular )ligaments: attach between the distal end
of the 1st phalanx and distal sesamoid bone and angle of the 3rd phalanx

3- Distal sesamoidean impar (navicular impar) ligament: from distal sesamoid bone to
flexor surface of 3rd phalanx
 Stay apparatus of the forelimb
(Suspensory apparatus and ckeck appratus)
- It is a system of muscles, tendons and ligaments in equine limbs. It allows
horse to lock joints in his limb with no muscular effort. This mechanism
explains how equine species can sleep while standing:
- The structure are:
- 1- Tendons of biceps brachii muscle
- 2- lacertus fibrosus tendon
- 3- Extensor carpi radialis tendon
- 4- Thoracic part of serratus ventralis muscle
- 5- Long head of triceps brachii muscle
- 6- SDFT& superior check ligament
- 7- DDFT& inferior check ligament
- 8-Suspensor ligament and its extensor
branches Indication of joint blocks
1- Localize areas of lameness
- 9- Common digital extensor tendon
within a limb
- 10- Distal sesamoidean ligaments
2- Desensitize areas of a limb for
surgical procedures