Anatomy Study Guide - Week 1 & 2 PDF

Skeletal Joints Arthrology: “The study of joints, including their anatomy, function, and treatment” What’s a joint? A place where bones meet. More mobility = less stability + vice versa Types of Joints: ✔️ Structural Classification (based on binding): 1.​ Fibrous (false) a.​...

Skeletal Joints Arthrology: “The study of joints, including their anatomy, function, and treatment” What’s a joint? A place where bones meet. More mobility = less stability + vice versa Types of Joints: ✔️ Structural Classification (based on binding): 1.​ Fibrous (false) a.​ Immovable and connect bones with dense fibrous connective tissue; bones connected by ligaments b.​ Ex: sutures of skull and gomphoses of teeth 2.​ Cartilaginous a.​ Connect bones with fibrocartilage or hyaline cartilage which can stretch b.​ Two types: primary (synchondrosis) = hyaline cartilage ​ Secondary (symphysis) = between bones, fibrocartilage pad c.​ Excellent for shock absorption d.​ Ex: pubic symphysis (secondary) 3.​ Synovial (true) a.​ Freely moveable and enclosed in a capsule; the most common joint b.​ Surrounded by a capsule filled with synovial fluid which lubricates the joint and allows for smooth movement c.​ Ex: shoulder, hip, elbow Functional Classification (based on movement): 1.​ Synarthrosis a.​ Not moveable; fibrous; b.​ Ex: sutures of skull, gomphoses of teeth; syndesmosis between lone bones 2.​ Amphiarthrosis a.​ Semi movable; provides stability with some flexibility; cartilaginous b.​ Ex: pubic symphysis and intervertebral discs 3.​ Diarthrosis a.​ Freely moveable; ALL synovial joints are considered diarthrosis  b.​ Ex: shoulder, hip, elbow Based on # of axes (Synovial): 1.​ Uniaxial - allows simple, controlled movements in only one plane; provide stability a.​ Pivot, Hinge, Plane b.​ Ex: elbow, knee 2.​ Biaxial - allows movement in two perpendicular planes; allow for flexion/extension and abduction/adduction a.​ Condylar, saddle b.​ Ex: thumb, wrist 3.​ Multiaxial (polyaxial) a.​ Ball and Socket b.​ Ex: shoulder, hip Based on Joint Surface Shapes (synovial): 1.​ Plane (uniaxial): gliding/sliding 2.​ Hinge (uniaxial): flexion/extension 3.​ Pivot (uniaxial): rotation around single axis 4.​ Saddle (biaxial): flexion/extension + abduction/adduction a.​ Shaped like a saddle with one bone resting on the other b.​ Note: Allows for more mobility than a hinge joint; the 1st carpometacarpal joint (thumb) is susceptible to wear and tear leading to pain and dysfunction 5.​ Condyloid (condylar) (biaxial): flexion/extension + abduction/adduction a.​ Shaped like a condyle that fits into a cavity 6.​ Ball and Socket (spheroidal) (multiaxial): Cartilaginous Joint Tissues: ✔️ “type of joint where the bones are entirely joined by cartilage” 1.​ Hyaline (articular) Cartilage: a.​ found in articulating surfaces of long bones and structures such as the trachea 2.​ Fibrocartilage: a.​ Combination of hyaline cartilage and dense connective tissue  b.​ found in structures like the intervertebral discs, pubic symphysis, and meniscus Joint Cavity: 1.​ Synovial Membrane: a.​ Thin layer of tissue that lines insides of joints, bursae, and tendon sheaths b.​ produces synovial fluid which lubricates joints and helps them move smoothly c.​ Has blood vessels which supply joint with nutrients and oxygen 2.​ Fibrous Articular Capsule: a.​ Made up of dense irregular C.T b.​ responsible for for maintaining joint stability; prevents excess movement; holds bones together Intra Articular Tissues- tissues found within a joint; include ligaments, fibrocartilages, fat pads, and synovium ex: meniscus Meniscus: fibrocartilaginous structure that cushions the knee joint; two in each knee (medial>lateral); attached to tibia and femur 1.​ Provides stability and shock absorption 2.​ Distributes weight evenly across knee **Tearing of this fibrocartilaginous structure can lead to joint impairments and symptoms Basic Joint Mechanics ✔️ Osteokinematics - gross movements of bones at joints such as flexion and extension -​ Described typically in terms of planes of motion and axes of rotation Degrees of Freedom - number of independent ways a joint or system of joints can move Arthrokinematics: 1.​ Roll - one joint surface rolls on to the other joint surface 2.​ Spin - one joint surface rotates around a fixed axis on the other joint surface 3.​ Glide - one joint surface glides or slides across another joint surface Joint axis passes through/across from the convex member of the joint The joint surface motions of spin, roll, and glide are different components associated with joint motion/mobility. Passive joint mobilization techniques often use "gliding" of one joint surface relative to another to restore a joint's range of motion/mobility Convex and Concave Bony Joint Surfaces: **Convex think more round end while concave think more of an opening/space** Use your skeleton to observe and study the shapes and sizes of the joint surfaces of the joints listed here. You will need to have a basic knowledge of the shapes of joint surfaces when you learn techniques that specifically aim to restore the arthrokinematics of a dysfunctional joint 1.​ Glenohumeral Joint - Humeral Head Glenoid Fossa a.​ The humeral head is considered convex because it fits into the concave glenoid fossa (picture to the right) 2.​ Humeroulnar Joint - Trochlea of Humerus Trochlear Notch a.​ Trochlea of h. fits into the notch of the ulna 3.​ Humeroradial Joint - Capitulum of Humerus Radial Head a.​ Capitulum of h. fits into the radial head 4.​ Metacarpal-phalangeal Joint - Head of metacarpal Base of Prox Phalange 5.​ Interphalangeal Joint - Head of the phalange Base of the phalange 6.​ Femoroacetabular Joint - Femoral head Acetabulum a.​ Femoral head fits into the acetabulum 7.​ Tibiofemoral Joint - Femoral Condyles (2) Tibial Condyles (2) 8.​ Talotibial Joint - Dome of the talus Distal Tibia Peripheral and Spinal Nerves ✔️ hint: peripheral nerves have multi segmental innervation from multiple spinal nerves For example: Your quadriceps receive contribution from spinal nerves L2,3,4 and your biceps brachii receive innervation from spinal nerves C5,6. Damage to a single spinal nerve can affect a muscle's ability to generate force. Structural Organization of a Peripheral Nerve 1.​ Neuron a.​ Functional units of the nervous system composed of axons, dendrites, and soma 2.​ Motor Fibers a.​ Efferent nerve that conducts impulses from spinal cord/brain to motor end plates in endomysium of muscle 3.​ Sensory Fibers a.​ Afferent nerve composed of cell bodies, axons, and their surrounding myelin sheath b.​ Transmit sensory information from sensory organs to the CNS i.​ Senses such as: touch, pain, pressure, vibration, temperature, and proprioception 4.​ Autonomic Fibers a.​ Peripheral nerve fibers that innervate smooth muscle, cardiac muscle, and glandular epithelium b.​ Either stimulate and activate the muscle or tissue OR receive sensory impulses from them c.​ Release neurotransmitters that bind to the sarcolemma of smooth muscle cells, triggering muscle contraction 5.​ Cranial Nerves a.​ 12 paired nerves of the PNS that emerge directly from the brain b.​ Carry motor information, sensory information, or both i.​ Motor: oculomotor, trochlear, abducens, accessory, hypoglossal ii.​ Sensory: olfactory, optic, vestibulocochlear iii.​ Both: trigeminal, facial, glossopharyngeal, vagus 6.​ Axons a.​ Impulses travel away from cell body; transmits to other nerve cells or to effector organs b.​ Larger axons surrounded by a myelin sheath 7.​ Fascicle a.​ Tract, bundle or groups of nerve fibers that are more or less associated with functionally b.​ Two types: primary and secondary i.​ Primary: group of nerve fibers bundled together separated by perineurial septa ii.​ Secondary: formed of several primary fascicles bundled together into groups and sheathed by perineurium  8.​ Myelin Sheath a.​ Covering around the axon to accelerate the speed of the impulse 9.​ Vaso Nervorum a.​ The small arteries supplying the peripheral nerves Associated CT Layers: 1.​ Endoneurium - wraps individual nerve fibers (neurons)​ a.​ These connective tissue layers protect and support the delicate axons of a nerve as well as its internal blood & lymphatic vessels. b.​ Stains slightly darker pink 2.​ Perineurium - wraps fascicles (group of neurons) a.​ groups multiple axons into fascicles b.​ Smooth and transparent; thick extracellular matrix of collagen and fibronectin 3.​ Epineurium - wraps groups of fascicles (entire nerve) a.​ outer loose CT layer encasing and protecting fascicles from damage e.g compression b.​ Fills space between the fascicles to hold the fascicles along with blood vessels and loose CT within the nerve Spinal Nerve Anatomy ✔️ 1.​ Spinal Nerves (31 Pairs) **scroll down for image** a.​ 8 paired cervical (C1-C8) b.​ 12 paired thoracic (T1-T12) c.​ 5 paired lumbar (L1-L5) d.​ 5 paired sacral (S1-S5) e.​ 1 paired coccygeal 2.​ Mixed Nerves: NOTE** easy way to remember = SAME a.​ Sensory/Afferent b.​ Motor/Efferent 3.​ Ant and Post Nerve roots combine = spinal nerves (mixed) a.​ Ant (ventral) rootlets i.​ Small, fingerlike projection bundle of nerve fibers directly emerging from anterior horn of the spinal cord ii.​ Carry motor (efferent) signals from spinal cord to muscles and glands b.​ Post (dorsal) rootlets i.​ Small, fingerlike projection bundle of nerve fibers directly emerging from posterior root of the spinal cord ii.​ Carry sensory (afferent) signals from body to spinal cord c.​ Ant (ventral) nerve root i.​ Multiple rootlets from a single spinal cord segment ii.​ Efferent nerve fibers which carry stimuli away from the CNS towards target structures iii.​ Cell bodies located in central grey matter of spinal cord d.​ Post (dorsal) nerve root  i.​ Multiple rootlets from a single spinal cord segment ii.​ Afferent nerve fibers which return sensory information from the trunk and limbs to the CNS iii.​ Cell bodies not located in central grey matter; found in spinal root ganglion …After the anterior and posterior nerve roots merge to form a spinal nerve, it divides into two branches: Dorsal (post) Ramus -​ Innervates post-vertebral muscles and skin of the back -​ Smaller branch of spinal nerve Ventral (ant) Ramus -​ Innervates skin, muscle on ant aspect of trunk, limbs -​ Larger branch of spinal nerve Which both carry afferent and efferent Feature Anterior (Ventral) Posterior (Dorsal) Rootlets Motor (efferent) Sensory (afferent) Nerve Root Formed by merging ant Formed by merging post rootlets rootlets Connected to Ant horn of spinal cord Dorsal root ganglion and post horn Function Motor commands to Sensory information to the muscles/glands spinal cord Spinal Nerve Functional Organization ✔️ 1.​ Somites a.​ Appear in vertebrate embryos and develop into tissues such as vertebral bone, rib bone, skeletal muscle, and skin b.​ Biscuit like formations flanking our primitive spinal cord (neural tube) 2.​ Sclerotomes a.​ Medial side of somite; cells of which exit the somite and migrate medially b.​ Regions of mesenchymal tissue that forms bone during embryonic development 3.​ Dermatomyotomes a.​ Lateral side of somite; gives rise to the skeletal muscles and dermis of skin b.​ Key role in development of muscles in embryo 4.​ Dermatome a.​ Unilateral area of skin supplied by a single spinal nerve segment b.​ PTs assess cutaneous sensation with a dermatome map as a way to localize lesions within central nervous tissue, injury to specific spinal nerves, and to determine the extent of the injury. 5.​ Myotome a.​ Unilateral mass of muscle supplied by a single spinal nerve b.​ They are useful for clinical evaluation of patients in understanding the pattern of neurological deficit after a complex nerve injury. c.​ Therapists use myotomes to test the strength of individual muscles or groups of muscles that are innervated by specific nerve roots. Somatic Nerve Plexus formed from Ant. Ventral Rami 1.​ Cervical (C1-C5) Plexus a.​ Connects to the: head, neck, shoulders, and diaphragm 2.​ Brachial (C5-T1) Plexus a.​ Connects to the: shoulders, chest, upper arms, forearms, and hands 3.​ Lumbar (L1-L4 +T12) Lumbar Plexus a.​ Connects to the: back, abdomen, groin, thighs, knees, and calves 4.​ Lumbosacral Trunk (L4-L5) a.​ A collection of neural fibers originating from L4 and L5 ventral rami b.​ Interconnects the lumbar plexus and sacral nerve plexus 5.​ Sacral Plexus (L4-S4) a.​ Connects to the: pelvis: buttocks, genitals, thighs, calves, and feet Basic Spinal Cord Anatomy Spinal Cord 1.​ Protective Membrane Coverings (Meninges) a.​ Spinal Dura Mater i.​ Tough outermost fibrous membrane that protects and encloses the spinal cord ii.​ Arises at foramen magnum, to which it attaches iii.​ Dural sac = tubal sheath along the vertebral column, terminates at S2 vertebra b.​ Arachnoid Mater i.​ Thin opaque layer that sends wispy fibers inwards to the pia mater ii.​ Middle of the meninges layers, adjacent to the dura mater; separated from spinal cord and pia mater by cerebrospinal fluid; NOT directly attached to the dura mater c.​ Pia Mater i.​ Similar to cranial pia mater; wrapped directly on the spinal cord and invests within the ventral median fissure and dorsal sulci ii.​ Extends laterally to form denticulate ligaments and inferiorly to form filum terminale below inferior terminus of the spinal cord iii.​ Generally not visible due to being so thin and transparent 2.​ Meningeal Spaces a.​ Subdural i.​ Thin space between dura mater and arachnoid mater b.​ Epidural i.​ Outside of the dura mater, deep to the vertebral column ii.​ Space that separates the dural sac from bony walls of vertebral column iii.​ Terminate at the S2 vertebra iv.​ Note: Injections of steroids into this space in the lumbar spine is sometimes used in the treatment of chronic low back pain c.​ Subarachnoid i.​ Area/space containing cerebrospinal fluid (which acts as protection and cushioning of the spinal cord and has nutritional functions for the spinal cord) ii.​ Extends beyond the conus medullarus 3.​ Denticulate Ligaments a.​ Toothlike ligaments, extensions of the pia mater b.​ Comes off spinal cord and acts as support function c.​ Holds spinal cord in place laterally at each vertebral level 4.​ Conus Medullaris a.​ Terminal end of the spinal cord at L1/L2 5.​ Cauda equina a.​ “The horses tail” b.​ Big group of axons at the bottom below L1/L2  6.​ Filum terminale a.​ extending from the conus medullaris b.​ Anchors the spinal cord to the coccyx Basic Organization of the Spinal Cord 1.​ Gray Matter (houses cell bodies) a.​ Found more deeply within the spinal cord, H like pattern b.​ Processing power 2.​ Anterior Horn (motor cell bodies) a.​ IMPORTANT: associate the anterior horn with motor functions b.​ Motor component and exits anterior through rootlets 3.​ Posterior Horn (sensory) a.​ IMPORTANT: associate the posterior horn with receiving, processing, and relaying SENSORY information. 4.​ White Matter (houses tracts made of axons) a.​ Found more superficial; where we send the information b.​ Periphery of the spinal cord c.​ Tracts or bundles of nerve fibers. i.​ Sensory information INTO the brain (ascending) ii.​ Motor information FROM the brain (descending) d.​ Divided into funiculi i.​ 3 funiculus 1.​ Anterior Funiculi: contains various ascending/descending pathways (vibration, touch, sense of position) 2.​ Lateral Funiculi: carries pain sensations to the brain and descending motor pathways from the brain 3.​ Posterior Funiculi: fibers to the brain are involved with touch and sense of position Two Enlargements: Cervical and Lumbosacral Spinal Cord Vasculature: Arterial: 1.​ Anterior Spinal Artery (ASA) a.​ Originates within cranium from branches of the vertebral arteries, extends inferiorly along anterior median fissure b.​ spinal cord artery most commonly affected by blockage. c.​ Can only supply the superior part of the spinal cord d.​ a blockage in this artery can lead to anterior spinal artery syndrome (also known as anterior cord syndrome), which is a serious condition that results in the loss of motor function and certain types of sensation below the level of injury 2.​ Posterior Spinal Artery (paired) (PSAs) a.​ Can only supply the superior part of the spinal cord b.​ Originated in the cranium either as branches of the vertebral arteries or the post inf cerebellar arteries c.​ Commonly form anastomosing channels in the pia mater 3.​ Sulcal Artery a.​ Branches of the ASA, enter spinal cord through anterior median fissure b.​ Supply approx. 2/3 of the cross-sectional area of the spinal cord & superior part {Feeders to the ASA and PSAs} 1.​ Anterior/Posterior Segmental Medullary Artery a.​ Derived from spinal branches of the: ascending cervical, deep cervical, vertebral, post intercostal, and lumbar arteries i.​ Supply blood mainly to the cervical and lumbosacral enlargements b.​ Communicates with the epidural venous plexus 2.​ Great Anterior Segmental Medullary Artery a.​ Reinforces the blood supply to the lower 2/3 of the spinal cord b.​ A branch of an inferior posterior intercostal or upper lumbar artery 3.​ Spinal Artery 4.​ Anterior and Posterior Radicular Arteries a.​ These are the primary vessels supplying the spinal roots and spinal nerves. b.​ DO NOT anastomose with the ant and post spinal arteries Venous: usually follow the arteries; veins of the spinal cord join the internal vertebral (epidural) venous plexuses in the epidural space. 1.​ Anterior Spinal Vein (3)/Posterior Spinal Vein (3) 2.​ Anterior Medullary Vein (12) 3.​ Posterior Medullary Vein (12) 4.​ Radicular Veins (12) a.​ Communicates with the epidural venous plexus b.​ From the plexus, blood, flows to the dural sinuses of the cranium, vertebral veins, external vertebral venous plexuses Bony Anatomy: Vertebral Column General Orientation/Posture of the Vertebral Column Sagittal Plane 1.​ Cervical Lordosis a.​ Inward curvature of the cervical neck 2.​ Thoracic Kyphosis a.​ Outward Curvature of the Thoracic 3.​ Lumbar Lordosis a.​ Inward curvature of the lumbar Intervertebral Disc: 1.​ Intervertebral Discs (IV disc) a.​ Fibrocartilaginous discs between the vertebrae. Consist of binding connective tissue that joins the vertebrae together 2.​ Annulus Fibrosus a.​ A bulging fibrous ring consisting of concentric lamellae (layers) of fibrocartilage forming the circumference of the Intervertebral disc (IV disc) and surrounding the Nucleus Propulsus 3.​ Nucleus Propulsus a.​ Lies posterior to the center of the vertebral body (surrounded by the annulus.) b.​ Acts as a shock absorber and permits a very limited range of movement betweens the vertebrae 4.​ Cartilaginous Endplates Motion Segment: 1.​ Two adjoining vertebrae, its intervertebral disc and its associated ligaments Bony Structures Vertebral Column Structures Guide: 1.​ Vertebral Body a.​ The more massive, roughly cylindrical, anterior part of the bone that gives strength to the column and supports body weight 2.​ (Median) Spinous Process (one on each) a.​ Bony projection on the back of a vertebra i.​ Projects posteriorly (and usually inferiorly, typically overlapping the vertebra below) front the vertebral arch and the junction of the laminae. 3.​ Transverse Process (two on each) a.​ Project posterolaterally form the junctions of the pedicles and laminae 4.​ Articular Processes (four on each) a.​ Two superior and two inferior i.​ Also arise from the junctions of the pedicles and laminae, each bearing an articular surface (facet) 5.​ Pedicle  a.​ Short, stout cylindrical processes that project posteriorly from the vertebral body to meet two broad flat plates of the bone called the laminae 6.​ Lamina a.​ Broad flat plates of bane 7.​ Articular Facets a.​ Are oriented on the articular processes of the vertebrae in a characteristic direction that determines the type of movement permitted between the adjacent vertebrae and, in aggregate, for the region. i.​ Example, the articular facets of the thoracic vertebrae are nearly vertical and together define an arch centered in the IV disc. This arrangement permits rotation and lateral flexion of the vertebral column in this region b.​ Cervical -> Thoracic -> Lumbar Facet Angles: oblique to frontal to sagittal NOTE*** Facet orientations help to guide the movements between two adjacent vertebrae Atlas (C1): unique in that it has neither a body nor a spinous process Articulations: 1.​ Atlanto-occipital joints (2) 2.​ Lateral atlanto-axial joints (2) 3.​ Median atlanto-axial joint (1) Structures: 1.​ Ant Arch 2.​ Ant Tubercle 3.​ Post Arch 4.​ Post Tubercle 5.​ Facet for dens of C2 (axis) 6.​ Lateral mass 7.​ Transverse foramen 8.​ Transverse process 9.​ Superior articular facet surfaces 10.​Inferior articular facet surfaces (bottom side, opposite to the Superior articular facet surfaces) if there was a inferior view, we could see it on the image provided Axis (C2): Articulations 1.​ Lateral atlanto-axial joints (2) 2.​ Median atlanto-axial joint (1) Structures: 1.​ Dens (odontoid process) 2.​ Ant articular facet 3.​ Transverse foramen (2) 4.​ Transverse processes 5.​ Sup articular facets (2) 6.​ Inf articular facets (2) 7.​ Spinous process C3-C6: 1.​ Bifid spinous process a.​ Small and wider from side to side than anteroposteriorly; superior surface concave with uncus of body (uncinate process); inferior surface convex 2.​ Paired apophyseal (facet) 3.​ Facet angles (~ 450 oblique-sagittal plane) 4.​ Uncinate process (uncus) a.​ The elevated superolateral margin 5.​ Transverse foramen 6.​ transverse process a.​ Foramina transversarii and anterior and posterior tubercles; vertebral arteries and accompanying venous and sympathetic plexuses pass through foramina transversarii of all cervical vertebrae except C7, which transmits only small accessory vertebral veins 7.​ superior articular facet & articular process 8.​ Inferior articular facet and articular process 9.​ Pedicles 10.​Lamina C7: 1.​ Vertebra prominence aka prominens 2.​ Paired apophyseal (facet) 3.​ Facet angle (~ 45 degree oblique-sagittal plane) 4.​ Uncinate process (uncus) 5.​ Transverse process 6.​ Superior articular facet 7.​ Inferior articular facet 8.​ Spinous process 9.​ Pedicles 10.​Lamina T1-T12: 1.​ Costovertebral facet (articulates with the ribs, located in a V shape, closer to frontal plane) 2.​ Costotransverse facet (aka transverse costal facet) 3.​ Paired apophyseal (facet) 4.​ Facet angle (~ 60 degree oblique-sagittal plane) 5.​ Transverse process 6.​ Superior articu​lar facet 7.​ Inferior articular facet 8.​ Spinous process (longer and pointier) 9.​ Pedicles 10.​Lamina L1-L4: 1.​ Facet angle (~ vertical sagittal plane) 2.​ Paired apophyseal (facet) 3.​ Transverse process 4.​ Superior articu​lar facet 5.​ Inferior articular facet 6.​ Spinous process (big broad flat) 7.​ Pedicles 8.​ Lamina 9.​ Mamillary process L5-S1: 1.​ Facet angle (~ between vertical & coronal planes) a.​ Note the changing orientations of the facet surfaces moving down from T12 down to L5/S1.. b.​ Osteoarthritis is not uncommon in the lumbar facet joints with age which is some cases can lead to pain and dysfunction 2.​ Lumbar lordosis 3.​ Paired apophyseal (facet) 4.​ Lumbosacral angle 5.​ Transverse process 6.​ Superior articu​lar facet 7.​ Inferior articular facet 8.​ Spinous process 9.​ Pedicles 10.​Lamina 11.​Mamillary process Sacrum: 1.​ Body 2.​ Base 3.​ Ala 4.​ Ant. (sacral) foramen 5.​ Post. (sacral) foramen 6.​ Sacral promontory of S1 7.​ Median sacral crest 8.​ Sacral hiatus 9.​ Sacral cornua 10.​Auricular surface of ilium 11.​Auricular surface of sacrum Coccyx: 1.​ Sacral-coccyxgeal joints Bony Structure: Pelvis Ilium (2): 1.​ Iliac crest 2.​ Iliac fossa 3.​ Gluteal fossa 4.​ Post. gluteal line 5.​ Ant. gluteal line 6.​ Inf. gluteal line 7.​ Iliac tubercle 8.​ Post. sup. Iliac spine 9.​ Ant. sup. Iliac spine 10.​Ant. inf. Iliac spine 11.​Auricular surface of ilium 12.​Greater sciatic notch Ischium (2): 1.​ Ischial tuberosity 2.​ Spine 3.​ Lesser sciatic notch 4.​ Body 5.​ Ramus Pubis: 1.​ Sup ramus 2.​ Inf ramus 3.​ Pubic tubercle 4.​ Pubic crest 5.​ Pecten pubis **Pubic symphysis: Fibrocartilage Hip Joint + motions: 1.​ Acetabulum: parts of the ilium, ischium, and pubis 2.​ Articular lunate surface a.​ Degenerative conditions of the articular cartilage is quite common with aging. Note that the whole surface of the acetabulum is not covered with hyaline cartilage--just the lunate surface 3.​ Articular fossa 4.​ Acetabular notch 5.​ Fovea centralis Motions: 1.​ flexion/extension, abduction/adduction, internal/external rotation Sacroiliac joints: ​ Guiding Questions Async 1: 1.​ What are the key surface anatomy landmarks in the spine and pelvis? a.​ Iliac crest, ASIS (anterior superior iliac spine), PSIS, Ischial tuberosity b.​ Spinous processes, transverse processes, Async 2: 1.​ What are the basic anatomical structures of joints and what are the various ways joints can be classified? a.​ 2.​ How are the movements of joints described and characterized? a.​ Movement as: synarthrosis, amphiarthrosis, diarthrosis b.​ Synarthrosis: no movement c.​ Amphiarthrosis: some movement d.​ Diarthrosis: freely moveable joints 3.​ When describing motions what is meant by osteokinematics and arthrokinematics? a.​ Osteo: movement of bone b.​ Arthro: movement of joints 4.​ What is the basic anatomy of synovial joints associated with the axial and appendicular skeleton? a.​ Innermost: synovial fluid b.​ Hyaline cartilage: lines the ends of bones c.​ Synovial membrane d.​ Fibrous (articulate) capsule e.​ Outermost: supporting ligaments Async 3: 1.​ What is the anatomy of peripheral nerves and what are the main functions of the various types of peripheral nerves within the peripheral nervous system? a.​ Anatomy: b.​ Main function: 2.​ Differentiate between somatic peripheral nerves, cranial nerves, and autonomic nerves which are all part of the peripheral nervous system. a.​ Cranial nerves: 12 cranial nerves, found mostly in the skull b.​ Somatic nerves: provide innervation to musculature and voluntary movements c.​ Autonomic nerves: innervation to automatic systems (breathing, blood supply etc) 3.​ What is the role and organization of the connective tissues that support peripheral nerves?  a.​ Async 4: 1.​ What are spinal rootlets, spinal roots, spinal nerves, and spinal rami? How are they interconnected? a.​ Spindle rootlets: (dorsal & ventral) small individual finger-like projections from the spinal cord b.​ Spinal roots: the convergence of the spinal rootlets c.​ Spinal nerves: combination of the ventral and dorsal roots d.​ Spinal rami: branching of the spinal nerve into ventral and dorsal 2.​ What are somatic plexi, what are they made from, and where are they found? a.​ Somatic plexi: collection or grouping of nerves; made from the ventral rami b.​ Cervical Plexus (C1-C5), Brachial (C5-T1), Lumbar (L1-L4), Sacral (L4-S3), Coccygeal (S4 & S5) Async 5: 1.​ What are the basic anatomical features of the spinal cord in terms of its protective coverings, anatomical spaces, terminal structures and ligaments that support the spinal cord? a.​ Epidural space - area outside the dura mater but deep to the ventral column b.​ Dura mater - tough outer covering c.​ Arachnoid mater - below the dura mater i.​ Subarachnoid space - below the arachnoid mater and houses CSF d.​ Pia mater - innermost layer. i.​ Denticulate ligament: extensions from the spinal cord that travel laterally and hold the spinal cord in place by attaching to the dura mater 2.​ While the vasculature of the spinal cord is complex, what are the main arteries and veins that are involved with maintaining the health and functions of the spinal cord and spinal nerves? a.​ 3 longitudinal arteries of the spinal cord: i.​ 1 anterior spinal artery ii.​ 2 posterior spinal arteries b.​ Provide circulation to majority of the spinal cord and run along the spinal roots: i.​ Posterior segmental medullary artery ii.​ Anterior segmental medullary artery iii.​ Radicular arteries 3.​ What regions of the spinal cord are supplied by the main arteries supplying the spinal cord, (i.e. which arteries supply the anterior or posterior regions of the spinal cord)? a.​ Anterior spinal artery originates from branches of the vertebral arteries. b.​ Posterior spinal arteries originate from either the vertebral artery or the posterior inferior cerebellar arteries 4.​ What are the primary arteries supplying the spinal nerves?  a.​ Posterior segmental medullary artery, anterior segmental medullary artery, radicular arteries i.​ Posterior and anterior segmental medullary arteries arise at various vertebral levels from the spinal branches of 1.​ Ascending cervical artery, deep cervical artery, vertebral artery, posterior intercostal artery, lumbar artery Async 6: 1.​ What are myotomes and what is their clinical significance in physical therapy? a.​ Myotomes reflect the segmental and developmental origin of muscle innervation 2.​ What are dermatomes and what is their clinical significance in physical therapy? a.​ Dermatomes play a crucial role in diagnosing and understanding neurological conditions Async 7: 1.​ What are the major arterial and venous vessels supplying the spinal cord? a.​ Anterior Spinal Artery (1), Posterior Spinal Arteries (2), Radicular Arteries, Great Ant Segmental Medullary Artery b.​ Anterior/Posterior Spinal Veins (3 ea), Ant/Post medullary (12), Radicular veins (12) 2.​ What are the major vessels supplying the spinal nerve and spinal roots? a.​ Async 8: 1.​ What are the important bony structures of the cervical, thoracic, and lumbar vertebrae? 2.​ What are the main functions of the vertebral column? 3.​ What are the common features and what are the unique features in each region of the spine? 4.​ What are the major sagittal plane curvatures of the spine?