Wk 1 Axial Skeleton, Ribs PDF

STRUCTURAL ANATOMY FTHP 213 WEEK 1 RUPAL PANCHAL BSC., RMT HOW TO SUCCEED IN THIS COURSE!!! SELF-DIRECTED LEARNING!! Be accountable to yourself Buy the book Look at the course outline Read the required readings Be able to ‘DO’ the weekly learning outcomes in the course outline HOW TO SUCCEED IN...

STRUCTURAL ANATOMY FTHP 213 WEEK 1 RUPAL PANCHAL BSC., RMT HOW TO SUCCEED IN THIS COURSE!!! SELF-DIRECTED LEARNING!! Be accountable to yourself Buy the book Look at the course outline Read the required readings Be able to ‘DO’ the weekly learning outcomes in the course outline HOW TO SUCCEED IN THIS COURSE: TAKE RESPONSILIBITY Dedicate 4 hours (minimum) a week to this course Come to class, and participate! Take notes - ALL information in lecture is TESTABLE Ask Questions!  HOW TO SUCCEED IN THIS COURSE!!! TAKE NOTES… EVERYTHING I SAY IS TESTABLE Draw pictures in your notes Use different coloured pens! BONE FORMATIONS PROTUBERANCE: A LUMP, BUMP, PROJECTION OR EMINENCE ON A BONE FOSSA: A SHALLOW DEPRESSION IN A BONE FORAMEN: AN OPENING OR HOLE IN A BONE BORDER: AN EDGE PROCESS: A POINT ON THE END OF A BONE BONE FORMATIONS CONDYLE: A ROUNDED ARTICULAR PROTUBERANCE AT THE END OF A BONE EPICONDYLE: A PROTUBERANCE ABOVE A CONDYLE ON A LONG BONE ANGLE: A CORNER, POINT OR APEX OF A BONE LINE: A RIDGE OR STRAIGHT RAISED SURFACE ON A BONE SYMPHYSIS: A FIBROCARTILAGINOUS FUSION BETWEEN TWO BONES RAMUS: AN ARM OR BRANCH OF A BONE BONE FORMATIONS PLATE: A FLAT SURFACE OF A BONE TUBEROSITY: A LARGE ROUNDED PROMINENCE OF A BONE WHERE MUSCLES ATTACH TUBERCLE: A SMALL ROUNDED PROJECTION ON A BONE WHERE MUSCLES ATTACH TROCHANTER: A LARGE PROTUBERANCE THAT MUSCLES ATTACH TO GROOVE: A LONG NARROW DEPRESSION IN A BONE CREST: A RIDGE ALONG THE SURFACE OF A BONE  STRUCTURE AND COMPONENTS OF THE SPINE Normal Curves of the Spine Primary or Kyphotic Curves (formed in utero): oThoracic oSacral Secondary or Lordotic Curves oCervical – as the infant begins to hold their head up oLumbar – as the toddler begins to walk and is upright Companion Notes: Pg 2 GENERAL STRUCTURE OF VERTEBRAE Anterior Vertebral Body oWeight-bearing cylindrical shaped portion of the vertebra oOuter collar of compact bone oIncreases in size from T4 down (increased weight bearing responsibilities) Companion Notes: Pg 2 GENERAL STRUCTURE OF VERTEBRAE Posterior Vertebral/Neural Arch oWhen the vertebrae are stacked, the aligned foramina of the vertebral arches form a long tunnel called the vertebral canal o“pedicles” (l. feet) are the part of the arch that extends posteriorly from the vertebral body Companion Notes: Pg 2  SPECIAL VERTEBRAE C1 – Atlas (named because it supports the skull) A ring-shaped bone No SP or vertebral body Instead it has anterior and posterior arches Each arch has a tubercle (ant and post) There is a lateral mass on each side which consists of a:  TVP  Superior and inferior articular facets  A notch for the odontoid process of C2  Tubercles for the transverse ligament Companion Notes: Pg 4  SPECIAL VERTEBRAE C2 – Axis It is the strongest of the cervical vertebrae A blunt tooth-like process called the dens or odontoid process extends superiorly from the vertebral body The dens acts as a pivot point around which C1 with the skull firmly attached rotates – this provides most of the rotation of the entire spine Companion Notes: Pg 4 STRUCTURE OF INDIVIDUAL VERTEBRA Cervical Thoracic Lumbar Body Smallish, Heart-shaped Kidney-shaped rectangular and T1 – T10 have Large wide from side to costal demifacets side on the lateral *note Superior aspects vertebral bodies Vertebral bodies of body project for rib articulations increase in size as upward to form (costovertebral you go down the “uncinate joints) spine processes” that T11 & T12 have a connect with the single costal facet vertebra above for ribs 11 &12 creating an “uncovertebral joint” Companion Notes: Pg 3 SACRUM Sacrum pl. sacra Large triangular bone located at the base of the spine Curved with a convex posterior surface Formed by the fusing of sacral vertebrae S1-S5 which fuse between 18 and 30 years of age Situated between the two wings of the ilia INTERVERTEBRAL DISCS (IVDS) Characteristics: IVDs are plates of fibrocartilage that join adjacent vertebrae The shape of the IVDs will match the shape of the vertebral bodies IVDs act as shock absorbers and alter slightly in shape to accommodate movement between vertebrae. IVDs are present between all adjacent vertebrae of the spine except between the occiput & C1 and C1 & C2 (these are synovial joints). They strongly bind the vertebrae together. …CONTINUED - INTERVERTEBRAL DISCS (IVDS) Discs make up approximately 1/3 rd the length of spine They are thinnest in the thoracic region and thickest in the lumbar region. They are thicker anteriorly in regions of the spine that are lordotic (cervical & lumbar) and posteriorly in parts of the spine that are kyphotic (thoracic). Discs are very strong and are essential weight- bearing components of the spine. Their strength is such that a compressive force is more likely to fracture vertebral bodies than to rupture a disc. Unfortunately, discs are susceptible to shearing or rotational forces (hence the risk of the ‘lift and twist’ injury. STRUCTURE OF INTERVERTEBRAL DISCS Structure: outer annulus fibrosis & inner nucleus pulposus Anulus fibrosus An outer collar formed by concentric lamellae (layers) of fibrocartilage (collagen). Fiber direction of the collagen of adjacent layers is at right angles thus providing a structure of flexibility and strength. Superficial fibres are attached to the peripheral collar of compact bone of the vertebral body and the deep fibres are attached to the margins of the central disc of hyaline cartilage that covers the superior and inferior surfaces of the vertebral bodies. STRUCTURE OF INTERVERTEBRAL DISCS Structure: outer annulus fibrosis & inner nucleus pulposus Anulus fibrosus An outer collar formed by concentric lamellae (layers) of fibrocartilage (collagen). Fiber direction of the collagen of adjacent layers is at right angles thus providing a structure of flexibility and strength. Superficial fibres are attached to the peripheral collar of compact bone of the vertebral body and the deep fibres are attached to the margins of the central disc of hyaline cartilage that covers the superior and inferior surfaces of the vertebral bodies. FACET JOINTS Paired joints between the vertebral arches of adjacent vertebrae Type: Plane/gliding, synovial FACET JOINTS Articular surfaces Superior articular facets of the inferior vertebrae and inferior articular facets of the superior vertebrae FACET JOINTS Supportive ligaments No intrinsic ligaments which are specific to the facet joints These joints get their support from the joint capsule and accessory ligaments of the spine  Movements FACET JOINTS C-spine Facets are horizontally oriented and on an angle facilitating flex/ext but rotation must occur with lateral bending and vice versa T-spine Facets are vertical in the frontal plane, facilitating slight rotation, flexion & extension L-Spine Facets are vertical in the sagittal plane restricting rotation but allowing for flex/ext and lateral bending ACCESSORY LIGAMENTS OF THE SPINE Anterior longitudinal ligament (one long lig.) Runs along the anterior aspect of all vertebral bodies from the occiput to the sacrum Posterior longitudinal ligament (one long lig.) Runs along the posterior aspect of vertebral bodies (within the vertebral canal) from C2 to the sacrum Has a scalloped look as it must narrow when travelling between the pedicles of vertebrae but widens as it attaches to the posterior aspect of the intervertebral discs (IVDs) Ligamentum flavum (a series of short repeating fibres between adjacent vertebrae) Constructed primarily of elastin – is yellow in appearance (flavum – lemon) and connects adjacent laminae ACCESSORY LIGAMENTS CONT’D Interspinous ligament Short fibres between spinous processes throughout entire spine but usually not very noticeable in the thoracic spine (d/t the overlapping nature of T-spine SPs) Intertransverse ligament Short fibres between transverse processes throughout entire spine Supraspinous ligament (S1 – C7) One long strip attaching to tips of spinous processes Nuchal ligament (C7 – occiput) Attaches to tips of spinous processes in the cervical spine. Acts as a septum between muscles on either side SUPPORTIVE LIGAMENTS OF AO & AA Transverse ligament Cruciate ligament Alar ligament Apical ligament Tectorial membrane TRANSVERSE LIGAMENT Within atlas Between the tubercles of the lateral masses Holds the dens of C2 in place CRUCIATE Formed by bands LIGAMENT Extends superiorly from the transverse ligament to the occiput Extends inferiorly from the transverse ligament to the body of C2 “cruciate” is used for both the transverse ligament plus the vertical fibres  ALAR LIGAMENT Extends from the sides of the odontoid process to the margins of the foramen magnum They are short, strong, round cords almost the size of a pencil that attach to the skull to C2 Limit rotation and side-side movement of the head APICAL LIGAMENT A small ligament going from the apex of the odontoid process to the occiput TECTORIAL MEMBRANE Superior continuation of the PLL from C2 Extends from the body of C2 to the internal surface of the foramen magnum/occiput Covers the alar, cruciform and transverse ligaments APERATURES Definition is simply “a hole or a gap” We have 2 Thoracic aperatures THORACIC INLET Kidney shaped Superior thoracic aperature About 5cm from front to back (depth) and 11cm across (width) THORACIC INLET Boundaries: Posterior = T1 vertebral body Anterior = manubrium Anterolaterlally = 1st rib and their costal cartilages Structures: Trachea, esophagus, brachiocephalic trunk, left subclavian artery, and veins (that supply the upper limb) pleura of the apex of lungs as they project superiorly through the opening THORACIC OUTLET Large, inferior thoracic aperture bridged by the respiratory diaphragm Separating the thoracic and abdominal cavities THORACIC OUTLET Boundaries: Posterior = T12 vertebral body Anterior = xiphisternal joint Anterolaterlally = rib 12 and inferior costal borders Structures: Esophagus, vagus nerve, abdominal aorta, inferior vena cava CONTENTS OF THORAX Includes structures of the cardiovascular , respiratory, digestive, endocrine, nervous and lymphatic systems Heart, aorta, vena cava, lymphatic trunks, lungs, bronchi, trachea, esophagus, pleura, past of liver and spleen STERNUM CLAVICLE  CLAVICLE - JOINTS SC joint saddle, synovial Along with AC joint, enables humerus in the glenoid to move through a full 180º of abduction A disc lies between the 2 bony joint surfaces, provides significant strength preventing medial displacement of clavicle Is surrounded by a strong capsule  CLAVICLE - JOINTS SC Joint Depends on 3 intrinsic ligaments for strength Ant and post sternoclavicular ligaments provide stability for joint capsule and ant/post movement of clavicle Interclavicular ligament Limits excessive depression/inferior glide of clavicle (helps support weight of upper limb when clavicle depressed  CLAVICLE - JOINTS SC Joint There is 1 extrinsic ligament to limit elevation and superior glide on the clavicle costoclavicular ligament Runs from clavicle to 1st rib It is the site of the axis movement of elevation-depression and protraction- retraction  CLAVICLE - JOINTS AC Joint Plane, synovial Articular surfaces are clavicle and scapula, clavicle sits on acromion Like SC joint, an articular disc is found within the joint, it’s surrounded by a strong capsule and is supported by ligaments  CLAVICLE - JOINTS AC Joint (commonly first ligaments injured when joint is stressed) Intrinsic Superior and inferior AC ligaments reinforce the joint Extrinsic Coracoclavicular ligaments (conoid and trapezoid) Primary support for the AC jt Conoid lig is medially located, conical in shape Trapezoid lig is more lateral, flat twisted trapezoid shape Clavicle - Joints  SPINAL CORD Gross Anatomy of the Spinal Cord About 18 inches (45 cm) long 1/2 inch (14 mm) wide Ends between vertebrae L1 and L2 Symmetrical bilaterally NEUROCRANIUM In adults it is formed by a series of 8 bones: 1 frontal 2 parietals 2 temporals 1 occipital 1 sphenoid 1 ethmoid* VISCEROCRANIUM There are 15 irregular bones 2 lacrimal 2 nasal 2 maxillae 2 zygomatic 2 palatine 2 inferior nasal conchae 1 mandible 1 ethmoid* 1 vomer FOR NEXT WEEK - Make a study plan - Review spinal meninges - Start to review the muscles of the back (refer to next slide)