Week 9 Notes on Anatomy and Physiology

ANATOMY AND PHYSIOLOGY – ANAT 1010 NICOLA ROBERTSON WEEK 9 HOUSEKEEPING AND QUESTIONS If you are behind on comps please talk to me asap Mini presentations, 1-2 slides to present to the class, this will be a comp Topics 1. Tissue inflammation 2. Tissue proliferation...

ANATOMY AND PHYSIOLOGY – ANAT 1010 NICOLA ROBERTSON WEEK 9 HOUSEKEEPING AND QUESTIONS If you are behind on comps please talk to me asap Mini presentations, 1-2 slides to present to the class, this will be a comp Topics 1. Tissue inflammation 2. Tissue proliferation 3. Tissue remodelling 4. Aging in muscles 5. Aging in bones 6. Exercise effects on muscles Mistake Not having a plan, not s investing enough time, believing in myths, not adapting your learning, not https://www.kenhub.com/ asking for help, not en/library/education/hum an-anatomy-study-guide visualizing the information, https://www.kenhub.com/ not seeing the big picture, en/get/human-anatomy-a not putting what you learn tlas in context, passive learning Coloring book – Solution Avoiding the above s mistakes, active learning and recall, quizzes, visual learning (videos), using learning strategies  SCHEDULE Week Monday Friday comp 8 Muscle Lower limb Lower limb If you are behind on Physiology surface anatomy surface and group work comps please talk to 9 Muscles and Muscles and Upper limb joints; UE joints; UE muscles me asap 10 Muscled and Muscles and Lower limb joints: LE joints: LE muscles 11 Muscles and Muscles and Spinal muscles joints; Spine joints; Spine 12 Neuro Group work – Mini presentation intro- muscles in action ONLINE 13 Exam prep Exam prep class N/A 14 MCQ exam In person exam N/A KAHOOT JOINTS Synarthroses Amphiarthroses (slightly (immovable). These are fixed movable). Also known as or fibrous joints. They’re defined The human body has three main cartilaginous joints, these joints as two or more bones in close types of joints. They’re are defined as two or more contact that have no movement. categorized by the movement bones held so tightly together The bones of the skull are an they allow: that only limited movement can example. The immovable joints take place. The vertebrae of the between the plates of the skull spine are good examples. are known as sutures. Diarthroses (freely movable). Also known as synovial joints, these joints have synovial fluid enabling all parts of the joint to smoothly move against each other. These are the most prevalent joints in your body. Examples include joints like the knee and shoulder. JOINTS ANATOMY Bones. The framework of your body, bones are the primary structures that support the connecting tissue. For example, the knee joint consists of three bones ? the femur (thighbone), tibia (shin bone) and patella (kneecap). Tendons. Tendons (a type of tough connective tissue) on each side of a joint that attach to the muscles that control movement of the joint. Ligaments. Strong ligaments (tough, elastic bands of connective tissue) surround the joint to give support and limit the joint's movement. Cartilage. A type of tissue that covers the surface of a bone at a joint. Cartilage helps reduce the friction of movement within a joint. Meniscus. This is a curved part of cartilage in the knees and other joints. Synovial membrane. A tissue called the synovial membrane lines the joint and seals it into a joint capsule. The synovial membrane secretes synovial fluid (a clear, sticky fluid) around the joint to lubricate it. Bursas. Fluid-filled sacs, called bursas, between bones, ligaments, or other adjacent structures help cushion the friction in a joint. Synovial fluid. A clear, sticky fluid secreted by the synovial membrane.  Ball and socket joint. Permitting Hinge joint. The hinge movement in all Condyloid joint. The joint is like a door, directions, the ball and condyloid joint allows opening and closing in socket joint features the movement, but no one direction, along one rounded head of one bone rotation. plane. sitting in the cup of another bone. Gliding joint. The gliding Pivot joint. The pivot joint is also called the joint, also called the Saddle joint. Although plane join. Although it rotary joint or trochoid the saddle joint does not only permits limited joint, is characterized by allow rotation, it does movement, it’s one bone that can swivel enable movement back characterized by smooth in a ring formed from a and forth and side to side. surfaces that can slip over second bone. one another. TYPES OF JOINTS SHOULDER; PARTS OF THE JOINT Articulating Surfaces Joint Capsule Ligaments Bursae Movements Muscles Nerves SHOULDER; ARTICULATING SURFACES The shoulder joint is also known as the glenohumeral joint (GH jt) It is created by glenoid (part of the scapula) and the humerus It is a ball and socket joint MORE ON THE JOINT The socket, or the glenoid, is shallow and flat. It is rimmed with soft tissue called the labrum that makes a deeper socket that moulds to fit the humeral head. SHOULDER JOINT CAPSULE It is attached above to the circumference of the glenoid cavity beyond the glenoid labrum, and below to the anatomical neck of the humerus, It is thicker above and below loose and lax it has no action in keeping the bones in contact. Still, it allows them to be separated from each other more than 2.5 cm LIGAMENTS Glenohumeral ligaments (superior, middle and inferior) – extend from the humerus to the glenoid fossa, reinforcing the joint capsule. They act to stabilise the anterior aspect of the joint. Coracohumeral ligament – extends from the base of the coracoid process to the greater tubercle of the humerus. It supports the superior part of the joint capsule. Coracoacromial ligament – extends between the acromion and coracoid process of the scapula, forming an arch-like structure over the shoulder joint (coracoacromial arch). This resists superior displacement of the humeral head. Transverse humeral ligament – extends between the two tubercles of the humerus. It holds the tendon of the long head of the biceps in the intertubercular groove. SHOULDER JOINT - BURSA The subacromial bursa serves its function by protecting the underlying supraspinatus muscle from attrition wear between the humeral head and the acromion SHOULDER MOVEMENTS – WHAT'S NORMAL FLEXION - 180º EXTENSION – 45º-60º INTERNAL ROTATION – 70º-90º EXTERNAL ROTATION – 90º ADDUCTION – TO MIDLINE ABDUCTION - 150º MUSCLES OF THE SHOULDER Rotator cuff SITS on the shoulder Supraspinatus Infraspinatus Teres minor Subscapularis Supraspinatus Origin: supraspinous fossa of scapula muscle Insertion: greater tubercle of the humerus Innervation: suprascapular nerve (C5, C6) Function: initiation of abduction of arm to 15° at glenohumeral/shoulder joint, stabilizes humeral head in glenoid cavity Infraspinatus Origin: infraspinatous fossa muscle Insertion: greater tubercle of humerus Innervation: suprascapular nerve (C5, C6) Function: external rotation of the arm at glenohumeral/shoulder joint, stabilizes humeral head in glenoid cavity Teres minor Origin: lateral border of scapula muscle Insertion: greater tubercle of humerus Innervation: axillary nerve (C5, C6) Function: external rotation of the arm at the glenohumeral/shoulder joint, stabilizes humeral head in glenoid cavity Subscapularis Origin: subscapular fossa muscle Insertion: lesser tubercle of humerus Innervation: upper and lower subscapular nerves (C5-C6) Function: internal rotation of the arm at glenohumeral/shoulder joint, stabilizes humeral head in glenoid cavity OTHER MUSCLES 1. Teres major 7. Pectoralis minor 2. Serratus anterior 8. Coracobrachialis 3. Levator scapulae 9. Latissimus dorsi 4. Rhomboid major 10. Brachialis 5. Rhomboid minor 11. Biceps brachii 6. Pectoralis major 12. Triceps brachii SHOULDER NERVES The nerves in this area originate from the brachial plexus. In the shoulder and arm, the brachial plexus gives rise to two nerves: the suprascapular nerve the axillary nerve  ARTERY; axillary artery BLOOD VEIN; brachial veins, and the basilic and SUPPLY cephalic veins SHOULDER Mobility: Type of joint – ball and socket joint. JOINT FACTS Bony surfaces – shallow glenoid cavity and large humeral head – there is a 1:4 disproportion in surfaces. A commonly used analogy is the golf ball and tee. Joint capsule – lax Stability: Rotator cuff muscles surround the shoulder joint, attaching to the tuberosities of the humerus while also fusing with the joint capsule. The resting tone of these muscles act to compress the humeral head into the glenoid cavity. Glenoid labrum – a fibrocartilaginous ridge surrounding the glenoid cavity. It deepens the cavity and creates a seal with the head of the humerus, reducing the risk of dislocation. Ligaments – act to reinforce the joint capsule and form the coracoacromial arch. Biceps tendon – it acts as a minor humeral head depressor, thereby contributing to stability. OTHER MUSCLES 1. Teres major 7. Pectoralis minor 2. Serratus anterior 8. Coracobrachialis 3. Levator scapulae 9. Latissimus dorsi 4. Rhomboid major 10. Brachialis 5. Rhomboid minor 11. Biceps brachii 6. Pectoralis major 12. Triceps brachii SHARED EXCEL SHEET F24 ANAT1010 Muscles STERNOCLAVICULA R (SC) JOINT Articulating Surfaces Joint Capsule Ligaments Bursae Movements Muscles Nerves SC JOINT The sternoclavicular joint is a synovial saddle joint that connects the sternum with the clavicles. It is the only direct connection between the appendicular skeleton of the upper limb and the axial skeleton of the trunk. SC JOINT Type Synovial saddle joint; multiaxial Articular surfaces Sternal end of clavicle, clavicular notch of sternum, superior surface of first costal cartilage; intra-articular fibrocartilaginous disc Ligaments Intrinsic ligaments: anterior and posterior sternoclavicular ligaments Extrinsic ligaments: interclavicular and costoclavicular ligaments Innervation Medial supraclavicular nerve, nerve to subclavius Blood supply Suprascapular artery, internal thoracic artery Movements Elevation - depression Protraction - retraction SC JOINT MUSCLES 13. Subclavius 14. Deltoid 15. Pectoralis 16. Trapezius 17. Sternocleidomastoid muscles. the subclavius muscle, whose actions involve pulling the clavicle towards the sternoclavicular intra-articular disc and sternum. This functions to depress the lateral end of the clavicle and stabilize the clavicle during movements of the pectoral girdle. THE ACROMIOCLAVICULA R JOINT There are no muscles that act directly on this joint; the movements within it are entirely passive. The function of this joint is to enable the pectoral girdle to follow the movements of the shoulder joint, particularly after the sternoclavicular joint has reached its maximal range of motion. In addition, the AC joint also allows for the transmission of forces from the upper limb to the clavicle. AC JOINT Type Synovial plane joint; multiaxial Articular surfaces Acromion of scapula, acromial end of clavicle Ligaments Intrinsic: Superior acromioclavicular ligament, inferior acromioclavicular ligament Extrinsic: Coracoclavicular ligament (with conoid and trapezoid parts) Innervation Lateral pectoral nerve, suprascapular nerve Blood supply Thoracoacromial artery, suprascapular artery Movements Protraction - retraction Elevation - depression Axial rotation SCAPULA The scapula is an important bone as each scapula provides a point of attachment for a number of muscles that make up the arm and shoulder. It also articulates with the humerus and clavicle, forming the glenohumeral (shoulder) joint and acromioclavicular joint respectively. The medial aspect of the scapula is not directly attached to the axial skeleton, but is rather held in place and connected to the thorax and vertebral column by muscles, the scapula can move freely across the posterior thoracic This allows the arm to move with the scapula, providing a wide range of movement and mobility for the upper limb compared to the lower limb. SCAPULA Borders Superior, lateral and medial Angles Lateral, superior and inferior Surfaces Anterior: subscapular fossa Posterior: supraspinous fossa, spine, infraspinous fossa Processes Coracoid, acromion Muscles that originate from Deltoid, supraspinatus, infraspinatus, triceps brachii (long head), teres scapula minor, teres major, latissimus dorsi, coracobrachialis, biceps brachii, subscapularis, omohyoid muscles Muscles that insert on the Trapezius, levator scapulae, rhomboid major, rhomboid minor, serratus scapula anterior, pectoralis minor muscles Vascularization Suprascapular, posterior circumlex humeral, circumflex scapular, transverse cervical arteries MUSCLES OF THE SCAPULA Due to the large surface area of the scapula there are a large number of muscles attached (17 in total) which fix the scapula to the thoracic wall and allow it to move PRotraction - Pectoralis minor & seRRatus anterior ReTraction - Rhomboid & horizontal and lower fibres of Trapezius 18. Omohyoid 19. Rhomboid minor 20. Rhomboid minor 21. Serratus Anterior ELBOW The elbow joint is made up of 2 separate articulations Trochlear notch of the ulna and the trochlea of the humerus Head of the radius and the capitulum of the humerus They share a joint capsule  Key points about the elbow joint Bones Humerus, radius, ulna Joints Humeroulnar joint, ELBOW humeroradial joint, proximal radioulnar joint Ligaments Ulnar collateral ligament, radial collateral ligament, anular ligament of radius Movement Flexion, extension, s supination, pronation LIGAMENTS The joint capsule of the elbow is strengthened by ligaments medially and laterally. The radial collateral ligament is found on the lateral side of the joint, extending from the lateral epicondyle, and blending with the annular ligament of the radius (a ligament from the proximal radioulnar joint). The ulnar collateral ligament originates from the medial epicondyle, and attaches to the coronoid process and olecranon of the ulna. MUSCLES OF THE LOWER ARM The muscles of the lower arm become quite complex. The anterior compartment lies on the front of the arm, in an anatomical position. These muscles cross the wrist joint; some insert into the phalanges. These muscles, in large, are responsible for the flexion of the wrist and fingers. The posterior compartment muscles also cross the wrist joint, and some insert onto the phalanges. The muscles in this compartment are, in large, responsible for the extension of the wrist and fingers. ANTERIOR COMPARTMENT The superficial group includes the pronator teres, flexor carpi radialis, flexor carpi ulnaris, palmaris longus and flexor digitorum superficialis muscles The deep group includes Flexor digitorum profundus muscle, Flexor pollicis longus muscle, Pronator quadratus muscle Key facts about the anterior compartment muscles of the forearm Superficial Pronator teres muscle part Flexor carpi radialis muscle Flexor carpi ulnaris muscle Palmaris longus muscle Flexor digitorum superficialis muscle Deep part Flexor digitorum profundus muscle Flexor pollicis longus muscle Pronator quadratus muscle Innervation Median nerve (except for flexor carpi ulnaris and the ulnar half of flexor digitorum profundus which are supplied by the ulnar nerve) Function Movements (flexion, abduction, adduction, pronation) of the forearm, hand and fingers POSTERIOR COMPARTMENT The superficial part is a group of 6 muscles, containing the brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor carpi ulnaris and extensor digiti minimi. The deep group includes Supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus and extensor indicis Key points about the extensors of the forearm Superficial part Brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor carpi ulnaris and extensor digiti minimi Deep part Supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus and extensor indicis Innervation Superficial part: Radial nerve (C5-C8) Deep part: Posterior interosseous nerve (C7, C8) Functions Mainly extension of hand and digits RADIOULNAR JOINTS Proximal – near the elbow Distal – near the wrist This is where supination and pronation happen They are joined by an interosseous membrane that hold them together (stability) attachment point for muscles and transfer force from the radius to the ulna PROXIMAL RADIOULNAR JOINT the proximal radioulnar joint is located immediately distal to the elbow joint and is enclosed within the same articular capsule. Articulation between the head of the radius and the radial notch of the ulna forms it. The radial head is held in place by the annular radial ligament, which forms a ‘collar’ around the joint. The annular radial ligament is lined with a synovial membrane, reducing friction during movement. Movement is produced by the head of the radius rotating within the annular ligament. Pronation: Produced by the pronator quadratus and pronator teres. Supination: Produced by the supinator and biceps brachii. DISTAL RADIOULNAR JOINT This distal radioulnar joint is located just proximally to the wrist joint. It is an articulation between the ulnar notch of the radius, and the ulnar head. In addition to anterior and posterior ligaments strengthening the joint, there is also a fibrocartilaginous ligament present, called the articular disk. It serves two functions: Binds the radius and ulna together, and holds them together during movement at the joint. Separates the distal radioulnar joint from the wrist joint. Like the proximal radioulnar joint, this is a pivot joint, allowing for pronation and supination. The ulnar notch of the radius slides anteriorly over the head of the ulnar during such movements. Pronation: Produced by the pronator quadratus and pronator teres Supination: Produced by the supinator and biceps brachii Key points about the bones of the wrist and hand Carpal bones 8 irregular bones that comprise the root of the hand. Proximal row: Scaphoid, lunate, triquetrum, pisiform Distal row: Trapezium, trapezoid, capitate, hamate Joints: Radiocarpal, intercarpal, midcarpal, carpometacarpal Metacarpal bones 5 long bones that comprise the roots of digits. Parts: Metacarpal base, body, head Joints: Carpometacarpal, intermetacarpal, metacarpophalangeal Phalanges 14 long bones that comprise the skeleton of the digits. 5 proximal phalanges; 4 middle phalanges (absent in thumb); 5 distal phalanges. Each phalanx consists of: base, body, head. Joints: Metacarpophalangeal, interphalangeal THE WRIST ellipsoidal (condyloid) type synovial joint The wrist joint is formed by an articulation between: Distal end of the radius and the articular disk. Proximal row of the carpal bones (except the pisiform). Together, the carpal bones form a convex surface, which fits into the concave shape of the radius and articular disk. The ulna is prevented from articulating with the carpal bones by the presence of a fibrocartilaginous ligament, the articular disk. Instead, the ulna articulates with the radius just proximal to the wrist – at the distal radio ulnar joint. WRIST The wrist joint is a highly mobile joint to allow the hand Blood Supply to move in several directions. Because of this, the The wrist joint receives blood from branches wrist joint is prone to injury. of the dorsal and palmar carpal arches, which The wrist joint does maintain some stability due to are derived from intrinsic and extrinsic ligaments. Intrinsic carpal the ulnar and radial arteries ligaments, the tiny ligaments between the carpal bones, are short ligaments that provide stability but are easily damaged with excessive force or twisting Innervation due to their small size. Median nerve – Anterior interosseous The extrinsic ligaments, which include the branch. palmar/dorsal radiocarpal ligaments and the radial and Radial nerve – Posterior interosseous ulnar collateral ligaments are stronger and stabilise from the radius and ulna to the carpal bones of the branch. wrist Ulnar nerve – deep and dorsal branches Distal radioulnar joint Palmar radioulnar ligament Dorsal radioulnar ligament Radiocarpal (wrist) joint Palmar radiocarpal ligament (radioscaphocapitate ligament, short and long radiolunate ligaments, radioscapholunate ligament) Palmar ulnocarpal ligament (ulnocapitate, ulnolunate, ulnotriquetral, ulnopisiform ligaments) Dorsal radiocarpal ligament Triangular fibrocartilage complex (palmar ulnocarpal ligaments, palmar radioulnar ligament, articular disc, ulnomeniscal homologue, tendon sheath of extensor carpi ulnaris muscle) Collateral ligaments of wrist (radial/ulnar collateral ligaments of wrist joint) Intercarpal joints Fascial bands: Flexor retinaculum of wrist Extensor retinaculum of wrist Palmar ligaments: Palmar intercarpal ligaments: Radiate carpal ligament (scaphocapitate, triquetrocapitate, palmar capitohamate, palmar trapezoideocapitate, trapezocapitate ligaments), palmar scaphotriquetral, palmar lunotriquetral, palmar triquetrohamate, pisotriquetral and pisohamate ligaments Dorsal ligaments: Dorsal intercarpal ligaments Interosseous ligaments: Intercarpal interosseous ligaments: Scapholunate interosseous ligament, lunotriquetral interosseous ligament, trapeziotrapezoidal interosseous ligament, trapezoideocapitate interosseous ligament, capitohamate interosseous ligament Carpometacarpal joints Dorsal carpometacarpal ligaments Palmar carpometacarpal ligaments Intermetacarpal joints Palmar metacarpal ligaments Dorsal metacarpal ligaments Interosseous metacarpal ligaments Metacarpophalangeal Proper collateral metacarpophalangeal joints ligaments Accessory collateral metacarpophalangeal ligaments Phalangoglenoid ligaments Palmar metacarpophalangeal ligaments Deep transverse ligament Interphalangeal joints Palmar interphalangeal ligaments Proper collateral interphalangeal ligaments Accessory collateral interphalangeal ligaments Annular ligaments Cruciform ligaments MOVEMENTS HAND The base of the hand and wrist is comprised of eight small bones known as carpals that are responsible for movement of the wrist joint (radiocarpal joint) and hand at the midcarpal joint. These bones are arranged into two rows of 4 bones and are responsible for movement of the wrist. The proximal row includes (named from lateral to medial) Scaphoid Lunate Triquetrum Pisiform: This small round bone projects anteriorly, because it articulates on the anterior surface of the triquetrum. It can be felt at the base of your palm The distal row includes (named from lateral to medial) Trapezium Trapezoid Capitate Hamate: The hamate has an anterior bony extension called the hook of the hamate MUSCLES OF THE HAND The intrinsic muscles of the hand are very intricate. We will not be learning every muscle of the hand.. They are responsible for the fine movements of the fingers that allow for the delicate and intricate functions our fingers provide us. CARPAL BONES – HOW TO REMEMBER Some – Scaphoid. Lovers – Lunate. Try – Triquetrum. Positions – Pisiform. That – Trapezium. They – Trapezoid. Can't – Capitate. Handle – Hamate. Key facts about the upper limb muscles and movements Scapula Supraspinatus, Infraspinatus, Teres minor, Subscapularis, Teres major, Serratus anterior, Levator scapulae, Rhomboid major, Rhomboid minor, Trapezius Mnemonic for rotator cuff muscles: Rotator cuff SITS on the shoulder Shoulder Arm Pectoralis major, Pectoralis minor, Deltoid, Latissimus dorsi Brachialis, Biceps brachii, CoracoBrachialis, Triceps brachii UPPER LIMB Mnemonic: 'Busy Bees CollaBorate well' Forearm flexors Pronator teres, Flexor carpi radialis, Palmaris longus, Flexor carpi MUSCLES ulnaris, Flexor digitorum superficialis, Pronator quadratus, Flexor pollicis longus, Flexor digitorum profundus Mnemonic: 'Pass/Fail, Pass/Fail, Faill' Forearm Supinator, Extensor digitorum, Extensor carpi ulnaris, Extensor extensors carpi radialis longus and brevis, Extensor indicis proprius, Extensor digiti minimi, Brachioradialis Hand Thenar eminence, Hypothenar eminence, Interossei, Lumbricals Mnemonics: 'APB is A Friend Of Police' (thenar muscles include Abductor Pollicis Brevis, Adductor pollicis, Flexor pollicis brevis, Opponens Pollicis)  BICEP Origin Short head - Apex of the Coracoid process of the scapula Long head - Supraglenoid tubercle of the scapula Mnemonic: 'You walk Shorter to a street Corner. You ride Longer on a Superhighway' Insertion Radial tuberosity of the radius Deep fascia of forearm (insertion of the bicipital aponeurosis) Innervation Musculocutaneous nerve (C5- C6) Blood supply Branches of brachial artery Function Flexion and supination of the forearm at the elbow joint, weak flexor of the arm at the glenohumeral joint GROUP LEARNING 1. In groups; 40mins Work on muscle list 2. Be able to identify 4 muscles of the upper limb, their origin, insertion, and action for comp – complete today 3. See worksheet for additional practice 4. Complete quiz