Anatomy 1.0 School of Medicine June 28, 2012 Anatomic Structures Dr. Lasam
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Outline I. Definition of Anatomy and its Branches II. Anatomical Position III. Medical Terminologies related to position IV. Terms related to movement V. The Skin A. Parts B. Appendages of the Skin C. Clinical Notes VI. Fasciae VII. Muscle VIII. Joints IX. Ligaments X. Bone XI. Bone Marking and Formations
I. DEFINITION OF ANATOMY AND ITS BRANCHES
ANATOMY is the science of the structure and function of the body.
Clinical anatomy (Applied) is the study of the macroscopic structure and function of the body as it relates to the practice of medicine and other health sciences.
Basic anatomy is the study of the minimal amount of anatomy consistent with the understanding of the overall structure and function of the body.
-the person is standing erect, with the upper limbs by the sides of the trunk and the face and palms of the hands directed forward. -gives a sense of UNIFORMITY in assessing
IMAGINARY PLANES
1. MEDIAN SAGITTAL PLANE - Vertical plane passing through the center of the body, dividing into 2 equal R&L halves.
2. CORONAL PLANE Imaginary vertical plane @ R angles to the median plane
3. HORIZONTAL or TRANSVERSE PLANES - Right angles to both the median and the coronal planes
III. TERMS RELATED TO POSITION
Anterior and Posterior -are used to indicate the front and back of the body Palmar and Dorsal -used in place of anterior and posterior in describing the hand Plantar and Dorsal -Used in place of anterior and posterior in describing the foot Proximal and Distal -Describes the relative distances from the root of the limbs Superficial and Deep -Describes the relative distances of structures from the surface of the body. Superior and Inferior -Denotes levels relatively high or low with reference to the upper and lower ends of the body Internal and External -Used to describe the relative distance of a structure from the center of an organ or cavity Ipsilateral - refers to the same side of the body example: left hand and left foot Contralateral -refers to the opposite sides of the body example: right ostiomeatal complex and the left middle turbinate Supine -lying on the back Prone -lying facing downward II. ANATOMICAL POSITION Group | Keith Daliuag, Roselyn baculi, Jamie Acierto Page 2 of 6
IV. TERMS RELATED TO MOVEMENT
Flexion movement that takes place in a sagittal plane Extension straightening the joint and usually takes place in a posterior direction Lateral Flexion is a movement of the trunk in the coronal plane Abduction -Movement of a limb away from the midline of the body in a coronal plane. Adduction -Movement of a limb towards the body in a coronal plane Rotation movement of a part of the body around its long axis. a. Medial rotation - movement that result in the anterior surface of the part facing medially. b. Lateral Rotation - anterior surface facing laterally. Pronation Of The Forearm - medial rotation of the forearm in such a manner that the palm faces posteriorly Supination Of The Forearm -Lateral rotation of the forearm from the pronated position so that the palm comes to face anteriorly. Circumduction -combination of sequence of the movements of flexion, extension, abduction, and adduction. Protraction -to move forward Retraction -to move backward Inversion movement of the foot so that the sole faces in a medial direction. Eversion opposite movement of the foot so that the sole faces in a lateral direction.
2. Dermis -Deeper layer -Composed of dense connective tissue -Contains Blood vessels, lymphaticvessels and nerves
SKIN CREASES- where the skin of the joint always folds
B. APPENDAGES OF THE SKIN:
I. NAILS -keratinized plates on the dorsal surfaces of the tip s of the fingers and toes
Nail Root-The proximal edge of the plate Nail Folds- the nail is surrounded and overlapped by folds of skin Nail Bed- The surface of skin covered by the nail
II. Hairs - grow out of follicles, which are invaginations of the epidermis into the dermis
Hair Bulbs- The follicles lie obliquely to the skin surface, and their expanded extremities Hair Papilla- Each hair bulb is concave at its end, and the concavity is occupied by vascular connective tissue Arrector Pili- A band of smooth muscle that connects the undersurface of the follicle to the superficial part of the dermis. The muscle is innervated by sympathetic nerve fibers, and its contraction causes the hair to move into a more vertical position; it also compresses the sebaceous gland and causes it to extrude some of its secretion
Gooseflesh- The pull of the muscle also causes dimpling of the skin surface
III. Sebaceous Glands - pour their secretion, the sebum, onto the shafts of the hairs as they pass up through the necks of the follicles
Sebum- . an oily material that helps preserve the flexibility of the emerging hair. It also oils the surface epidermis around the mouth of the follicle.
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IV. Sweat Glands - are long, spiral, tubular glands distributed over the surface of the body, except on the red margins of the lips, the nail beds, and the glans penis and clitoris -most deeply penetrating structures of all the epidermal appendages.
C. CLINICAL NOTES
Skin Infections -The nail folds, hair follicles, and sebaceous glands are common sites for entrance into the underlying tissues of pathogenic organisms such as Staphylococcus aureus.
Paronychia - Infection occurring between the nail and the nail fold
Common Boil(Furuncle) -Infection of the hair follicle and sebaceous
Carbuncle -a staphylococcal infection of the superficial fascia. It frequently occurs in the nape of the neck and usually starts as an infection of a hair follicle or a group of hair follicles
Sebaceous Cyst - caused by obstruction of the mouth of a sebaceous duct and may be caused by damage from a comb or by infection. It occurs most frequently on the scalp
Shock -A patient who is in a state of shock is pale and exhibits gooseflesh as a result of overactivity of the sympathetic system, which causes vasoconstriction of the dermal arterioles and contraction of the arrector pili muscles.
Skin Burns Types: a. Partial-Skin-Thickness Burn -superficial, very painful -heals from the cells of the hair follicles, sebaceous glands, and sweat glands as well as from the cells at the edge of the burn
b. Full Thickness Burn -extends deeper and heals -to speed up healing and reduce the incidence of contracture, a deep burn should be grafted.
Two Main Types of Skin Grafting:
a. Split-Thickness Graft- the greater part of the epidermis, including the tips of the dermal papillae, is removed from the donor site and placed on the recipient site. This leaves at the donor site for repair purposes the epidermal cells on the sides of the dermal papillae and the cells of the hair follicles and sweat glands. b. Full-Thickness Skin Graft- includes both the epidermis and the dermis and, to survive, requires rapid establishment of a new circulation within it at the recipient site. The donor site is usually covered with a split-thickness graft. full-thickness graft is made in the form of a pedicle graft, in which a flap of full-thickness skin is turned and stitched in position at the recipient site, leaving the base of the flap with its blood supply intact at the donor site. Later, when the new blood supply to the graft has been established, the base of the graft is cut across.
VI.FASCIAE
Two types: a. Superficial Fascia or Subcutaneous Tissue -a mixture of loose areolar and adipose tissue that unites the dermis of the skin to the underlying deep fascia
b. Deep Fascia -a membranous layer of connective tissue that invests the muscles and other deep structures
retinacula- In the region of joints, the deep fascia may be considerably thickened to form restraining bands
VII.MUSCLE
Three Types Of Muscle: 1. Skeletal Muscle (Voluntary Muscles) -produce the movements of the skeleton -has two or more attachments: origin -The attachment that moves the least insertion- the one that moves the most belly- The fleshy part of the muscle tendons- The ends of a muscle are attached to bones, cartilage, or ligaments by cords of fibrous tissue Aponeurosis -flattened muscles are attached by a thin but strong sheet of fibrous tissue Raphe - an interdigitation of the tendinous ends of fibers of flat muscles
Internal Structure of Skeletal Muscle Epimysium -The muscle fibers are bound together with delicate areolar tissue, which is condensed on the surface to form a fibrous envelope
Pennate Muscles (they resemble a feather)- Muscles whose fibers run obliquely to the line of pull Group | Keith Daliuag, Roselyn baculi, Jamie Acierto Page 4 of 6
a. Unipennate Muscle -one in which the tendon lies along one side of the muscle and the muscle fibers pass obliquely to it (e.g., extensor digitorum longus)
b. Bipennate Muscle- one in which the tendon lies in the center of the muscle and the muscle fibers pass to it from two sides (e.g., rectus femoris)
c. Multipennate Muscle- arranged as a series of bipennate muscles lying alongside one another (e.g., acromial fibers of the deltoid) or may have the tendon lying within its center and the muscle fibers passing to it from all sides, converging as they go (e.g., tibialis anterior)
SKELETAL MUSCLE ACTION -All movements are the result of the coordinated action of many muscles. However, to understand a muscles action, it is necessary to study it individually
A muscle may work in the following FOUR WAYS: a. Prime Mover -the chief muscle or member of a chief group of muscles responsible for a particular movement.
Example: the quadriceps femoris is a prime mover in the movement of extending the knee joint
b. Antagonist -opposes the action of the prime mover
Example: the biceps femoris opposes the action of the quadriceps femoris when the knee joint is extended
c. Fixator- contracts isometrically to stabilize the origin of the prime mover so that it can act efficientl
Example: the muscles attaching the shoulder girdle to the trunk contract as fixators to allow the deltoid to act on the shoulder joint
d. Synergist-contract and stabilize the intermediate joints
Example: the flexor and extensor muscles of the carpus contract to fix the wrist joint, and this allows the long flexor and the extensor muscles of the fingers to work efficiently
2. Smooth Muscle -consists of long, spindle-shaped cells closely arranged in bundles or sheets
-In the tubes of the body, it provides the motive power for propelling the contents through the lumen
- In the digestive system, it also causes the ingested food to be thoroughly mixed with the digestive juices Peristalsis- A wave of contraction of the circularly arranged fibers passes along the tube, milking the contents onward. The longitudinal fibers pull the wall of the tube proximally over the contents. 3. Cardiac Muscle -consists of striated muscle fibers that branch and unite with each other. It forms the myocardium of the heart
-Its fibers tend to be arranged in whorls and spirals, and they have the property of spontaneous and rhythmic contraction
-supplied by autonomic nerve fibers that terminate in the nodes of the conducting system and in the myocardium.
VIII.JOINTS -A site where two or more bones come together, whether or not movement occurs between them.
Joints are classified according to the tissues that lie between the bones:
1. Fibrous Joints -The articulating surfaces of the bones are joined by fibrous tissue and thus very little movement is possible Example: inferior tibiofibular joints
2. Cartilaginous Joints Cartilaginous joints can be divided into two types: a. Primary Cartilaginous Joint- one in which the bones are united by a plate or a bar of hyaline cartilage
Example: union between the epiphysis and the diaphysis of a growing bone and that between the 1st rib and the manubrium
b. Secondary Cartilaginous Joint- one in which the bones are united by a plate of fibrocartilage and the articular surfaces of the bones are covered by a thin layer of hyaline cartilage
Example: joints between the vertebral and the symphysis pubis
3. Synovial Joints -The articular surfaces of the bones are covered by a thin layer of hyaline cartilage separated by a joint cavity Group | Keith Daliuag, Roselyn baculi, Jamie Acierto Page 5 of 6
-This arrangement permits a great degree of freedom of movement
Synovial membrane -lines the cavity of the joint which extends from the margins of one articular surface to those of the other
Capsule of the joint a tough fibrous membrane protects the outside of the synovial cavity.
Synovial Fluid -produced by the synovial membrane - a viscous fluid that lubricates the articular surface
Articular Discs -discs or wedges of fibrocartilage that are interposed between the articular surfaces of the bones
Synovial joints classified according to the ARRANGEMENT OF THE ARTICULAR SURFACES and TYPES OF MOVEMENT that are possible:
a. Plane joints -the apposed articular surfaces are flat or almost flat, and this permits the bones to slide on one another Examples: sternoclavicular and acromioclavicular joints
b. Hinge joints -resemble the hinge on a door so that flexion and extension movements are possible Examples: elbow, knee, and ankle joints
c. Pivot joints -a central bony pivot is surrounded by a bonyligamentous ring and rotation is the only movement possible Examples: atlantoaxial and superior radioulnar joints
d. Condyloid joints -have two distinct convex surfaces that articulate with two concave surfaces. -the movements of flexion, extension, abduction, and adduction are possible together with a small amount of rotation Example: etacarpophalangeal joints or knuckle joints
e. Ellipsoid joints -an elliptical convex articular surface fits into an elliptical concave articular surface -the movements of flexion, extension, abduction, and adduction can take place, but rotation is impossible Example: wrist joint
f. Saddle joints -the articular surfaces are reciprocally concavoconvex and resemble a saddle on a horses back -these joints permit flexion, extension, abduction, adduction, and rotation Example: carpometacarpal joint of the thumb
g. Ball-and-socket joints -a ballshaped head of one bone fits into a socketlike concavity of another. This arrangement permits free movements, including flexion, extension, abduction, adduction, medial rotation, lateral rotation, and circumduction Examples: shoulder and hip joints
Nerve Supply of Joints The capsule and ligaments receive an abundant sensory nerve supply Hiltons law -a sensory nerve supplying a joint also supplies the muscles moving the joint and the skin overlying the insertions of these muscles
IX.LIGAMENTS
LIGAMENTS -a cord or band of connective tissue uniting two structures -Commonly found in association with joints, ligaments are of two types:
a. Fibrous Ligaments -prevent excessive movement in a joint
b. Elastic Ligaments -elastic tissues and can therefore regain its original length after stretching
BURSAE -a lubricating device consisting of a closed fibrous sac lined with a delicate smooth membrane -Its walls are separated by a film of viscous fluid
SYNOVIAL SHEATH -a tubular bursa that surrounds a tendon. Synovial sheaths occur where tendons pass under ligaments and retinacula and through osseofibrous tunnels
Mesotendon -tendon invaginates the bursa from one side so that the tendon becomes suspended within the bursa -In certain situations, when the range of movement is extensive, the mesotendon disappears or remains in the form of narrow threads, the Vincula.
X.BONE - a living tissue capable of changing its structure as the result of the stresses to which it is subjected -It is hard because of the calcification of its extracellular matrix and possesses a degree of elasticity because of the presence of organic fibers
Functions: protective function serves as a lever important storage area for calcium salts houses and protects within its cavities the delicate blood-forming bone marrow Group | Keith Daliuag, Roselyn baculi, Jamie Acierto Page 6 of 6
Two Forms: 1. Compact Bone- appears as a solid mass 2. Cancelous Bone- consists of a branching network of trabeculae
Bones are grouped as follows based on their general SHAPE:
1. Long Bones -are found in the limbs - ends of long bones are composed of cancellous bone surrounded by a thin layer of compact bone
They have a tubular shaft, the diaphysis, and usually an epiphysis at each end The part of the diaphysis that lies adjacent to the epiphyseal cartilage is called the metaphysis
Examples: humerus, femur, metacarpals, metatarsals, and phalanges
2. Short Bones - found in the hand and foot - They are roughly cuboidal in shape Examples: scaphoid, lunate, talus, and calcaneum
3. Flat Bones - found in the vault of the skull - they are composed of thin inner and outer layers of compact bone, the tables, separated by a layer of cancellous bone, the Diploe Examples: frontal and parietal bones, scapula
4. Irregular Bones Examples: bones of the skull, the vertebrae, and the pelvic bones
5. Sesamoid Bones - small nodules of bone that are found in certain tendons where they rub over bony surfaces Example: Patella
Development of Bone: 1. Membranous -directly from connective tissue membrane
2. Endochondral -cartilagenous model is first laid down and is later replaced by bone
XI.BONE MARKINGS AND FORMATIONS
Capitulum: small, round, articular head Condyle: rounded, knuckle-like articular area, usually occurring in pairs Crest: ridge of bone Epicondyle: eminence superior to a condyle Facet: smooth flat area, usually covered with cartilage, where a bone articulates with another bone Foramen: passage through a bone Fossa: hollow or depressed area Groove: elongated depression or furrow Head: large, round articular end Line: linear elevation Malleolus: rounded process Notch: indentation at the edge of a bone Protuberance: projection of bone Spine: thorn-like process Spinous process: projecting spine-like part Trochanter: large blunt elevation Trochlea: spool-like articular process or process that acts as a pulley Tubercle: small raised eminence Tuberosity: large rounded elevation