Lecture 1: Osteology of Lower Limb PDF

Lecture 1: Osteology of Lower Limb Course Code: ANA 211 Course Title: Anatomy of Lower Limb Course Lecturer: Edem E. Edem Objectives At the end of the class, students should be able to: Mention segments and general functions of the lower limb Appreciate anatomical positions/movements and...

Lecture 1: Osteology of Lower Limb Course Code: ANA 211 Course Title: Anatomy of Lower Limb Course Lecturer: Edem E. Edem Objectives At the end of the class, students should be able to: Mention segments and general functions of the lower limb Appreciate anatomical positions/movements and use anatomical terminologies appropriately. Classify lower limb bones with examples. Describe the parts of a long bone. Describe different types of epiphysis. Define ossification, describe its types and identify different ossification centres. Describe the blood supply of the typical long bone and appraise its significance in bone pathologies like osteomyelitis. Summarize the steps of ossification and explain the significance of the law of ossification. Differentiate among the different types of joints and list the examples. Describe the features of a typical synovial joint. 2 Edem, E. E. Segments of the Lower Limb Limb Girdle pelvic girdle (gluteal) Free limb - thigh - leg - foot 3 Edem, E. E. General Functions of Lower Limbs Support the body weight The ligaments at the hip and knee joints facilitate locking of these joints therefore reducing the amount of muscular energy required to maintain a standing position. Locomotion To move the body through space. This involves integration of movements at all joints of the lower limb to place the foot on the ground and move the body over it. 4 Edem, E. E. Anatomical Positions Provides a reference point for describing the structures of the body. In this position, the body is erect and the face forward. The feet are together, flat on the floor and the toes pointing forward. The arms are down at the sides with the palms turned forward with the thumb side of the hand away from the body. 5 Edem, E. E. Anatomical Positions (Cont’d) SUPINE POSITION: A patient lying on lying on his/her back PRONE POSITION: A patient lying face down 6 Edem, E. E. Anatomical Positions (Cont’d) RECUMBENT POSITION: A patient lying on lying on his/her right/left side 7 Edem, E. E. Anatomical Positions (Cont’d) FOWLER’S POSITION: A patient sitting straight up or leaning slightly backwards. Their legs may either be straight or bent TRENDELENBURG POSITION: A patient lying supine with their head slightly lower than their feet 8 Edem, E. E. Anatomical Positions (Cont’d) FOWLER’S POSITION: A patient sitting straight up or leaning slightly backwards. Their legs may either be straight or bent TRENDELENBURG POSITION: A patient lying supine with their head slightly lower than their feet 9 Edem, E. E. Anatomical Positions (Cont’d) LITHOTOMY POSITION: A supine position where the patient’s legs are separated, flexed and supported. - Used for lower abdomen and pelvic examinations - Used during childbirth 10 Edem, E. E. Anatomical Relations 11 Edem, E. E. About Lithotomy Position, Choose the ODD option Used during childbirth It is a pronated position The patient’s legs are separated, flexed and supported with a stirrup. The patient lies horizontally with his/her back down 12 Edem, E. E. Anatomical Planes Hypothetical planes used to transect the human/animal body, which aid in studying body structures or direction of movements. Three major planes are used in anatomy: - Sagittal plane (longitudinal, anteroposterior): plane parallel to the sagittal suture; divides the body into two left and right - Coronal or frontal plane: divides the body into back and front (anterior and posterior) portions - Transverse or axial plane: divides the body into head and tail (cranial and caudal) portions 13 Edem, E. E. Fundamental Movements of LL 14 Edem, E. E. Bones of the Lower Limb Functions: Acetabulum Locomotion Thigh Femur Carry weight of entire erect Knee Patella body Support Leg Tibia (medial) Points for Fibula (lateral) muscular Foot attachments Tarsals (7) Components: Metatarsals (5) Hip (Pectoral Phalanges (14) girdle) Ilium Ischium Pubis 15 Edem, E. E. Hip Bone 16 Edem, E. E. Bone of the Thigh 17 Edem, E. E. Bones of the Leg 18 Edem, E. E. Bones of the Foot 19 Edem, E. E. About anatomical movements, Choose the ODD option Flexion involved straightening your legs Eversion involves all the bones of the foot Abduction is moving your leg towards the midline. Rotation involves all the lower bones 20 Edem, E. E. Types of Bones in the Skeleton The skeletal system is adapted for protection and supporting weight Bones come in shapes as related to their functions 5 bone types make up the skeletal system, viz: Flat Long Irregular Short Sesamoid 21 Edem, E. E. Types of Bones in the Skeleton They shield and protect internal organs They can provide large areas of attachment for muscles 22 Edem, E. E. Types of Bones in the Skeleton Supports weight Facilitates movements 23 Edem, E. E. Types of Bones in the Skeleton Look cube-like Provide stability and allow some forms of movement 24 Edem, E. E. Types of Bones in the Skeleton Complex shape (neither any of the shapes) Provide protection for internal structures 25 Edem, E. E. Types of Bones in the Skeleton Embedded in tendons Provide protection for tendons against stress and tear 26 Edem, E. E. About bone types, choose the ODD option Patella is a sesamoid bone The metatarsals are irregular bones Flat bones serve as shield for internal organs Fibula is a long bone 27 Edem, E. E. Parts of a Developing Long Bone Epiphysis End of long bones that ossify from the secondary centre of ossification Made up of spongy bone covered by a thin layer of compact bone Contains red bone marrow where haematopoiesis happens 28 Edem, E. E. Parts of a Developing Long Bone Diaphysis The elongated, cylindrical shaft of long bone that ossifies from the primary ossification centre Made up of compact bone and encloses a tubular cavity called marrow cavity 29 Edem, E. E. Parts of a Developing Long Bone metaphysis Part of the diaphysis adjacent to the epiphyseal plate Most active site of bone formation in the developing bone Highly vascularised 30 Edem, E. E. Parts of a Developing Long Bone Epiphyseal plate Thin plate of hyaline cartilage between the diaphysis and epiphysis. Proliferation of the cartilage cells responsible for the length of developing bone Disappears when growth in length stops 31 Edem, E. E. Types of Epiphyses Pressure Epiphysis Found at the ends of long bones Articular in nature Takes part in transmission of weight Examples: head of femur, humerus, lower end of radius 32 Edem, E. E. Types of Epiphyses Traction Epiphysis Produced due to the pull of the muscle and therefore provides attachment to the muscle(s) Non-articular in nature Does not take part in transmission of weight Examples: greater and lesser tubercles of humerus, greater and lesser trochanters of femur and mastoid process of temporal bone. 33 Edem, E. E. Types of Epiphyses Atavistic Epiphysis An independent bone in lower animals, but part of a another bone in humans Examples: Coracoid process of scapula, posterior tubercle of talus 34 Edem, E. E. Types of Epiphyses Aberrant Epiphysis Not present in everybody Examples: epiphysis at the head of first metacarpal and base of other metacarpals. (Normally, metacarpals have only one epiphysis, i.e. base of 1st metacarpal and heads of other metacarpals ) 35 Edem, E. E. Ossification 36 Edem, E. E. Ossification 37 Edem, E. E. Ossification A process of bone formation by deposition of calcium in the foetal hyaline cartilage Can also be referred to as bone remodelling or osteogenesis Bone formation happens in 2 ways: i. Intramembranous ii. Intracartilagenous or endochondral 38 Edem, E. E. Ossification 39 Edem, E. E. Intramembranous Ossification 40 Edem, E. E. Intracartilagenous/endochondral Ossification 41 Edem, E. E. 42 Edem, E. E. Ossification Centres A point where ossification starts There are 2 types of ossification centres 43 Edem, E. E. Ossification Centres 44 Edem, E. E. Ossification Centres in the LL 45 Edem, E. E. Ossification Centres in the LL 46 Edem, E. E. Laws of Ossification 47 Edem, E. E. Blood and Nerve Supply of Bones of the Lower Limbs 48 Edem, E. E. Blood and Nerve Supply of Bones of the Lower Limbs 49 Edem, E. E. Choose the CORRECT option… Which of the following bones develop by endochondral ossification? The ribs The ribs and sternum The ribs, sternum and clavicle The ribs, sternum, clavicle and vertebrae 50 Edem, E. E. Types of JOINTS 51 Edem, E. E. Types of Joints Joints hold the skeleton together and support movement. There are two ways to categorize joints: Joint function (range of motion). Organization by structure. 52 Edem, E. E. Types of Joints 53 Edem, E. E. Types of Joints Type of Joint Function Examples Skull Sutures, articulations Synarthrosis (range of joint of bony sockets and teeth motion: no movement) in facial skeleton Amphiarthrosis (range of distal joint between the joint motion: little tibia and the fibula and the Movement) pubic symphysis Diarthrosis (range of joint Elbow, shoulder, ankle motion full movement) Joints Can Be Grouped By Their Structure into Fibrous, Cartilaginous, and Synovial Joints 54 Edem, E. E. Types of Joints Between the articulations of fibrous joints is thick connective tissue, which is why most fibrous joints are immovable (synarthroses). There are three types of fibrous joints: 1. Sutures are nonmoving joints that connect bones of the skull. These joints have serrated edges that lock together with fibers of connective tissue. 2. The fibrous articulations between the teeth and the mandible or maxilla are called gomphoses and are also immovable. 3. A syndesmosis is a joint in which a ligament connects two bones, allowing for a little movement (amphiarthroses). The distal joint between the tibia and fibula is an example of a syndesmosis. 55 Edem, E. E. Types of Joints Unite bones with cartilage. There are two types of cartilaginous joints: (1) A synchrondosis is an immovable cartilaginous joint. One example is the joint between the first pair of ribs and the sternum. (2) A symphysis consists of a compressible fibrocartilaginous pad that connects two bones. This type of joint allows for some movement. The hip bones, connected by the pubic symphysis, and the vertebrae, connected by intervertebral discs, are two examples of symphyses. 56 Edem, E. E. Types of Joints Characterised by the presence of an articular (cartilage) capsule between the two joined bones. Supported and reinforced by surrounding ligaments, which limit movement to prevent injury. There are 6 types of synovial joints: (1) Gliding joints move against each other on a single plane. E.gs. intervertebral joints and the bones of the wrists and ankles. (2) Hinge joints move on just one axis. These joints allow for flexion and extension. E.gs. the elbow and finger joints. (3) A pivot joint provides rotation. At the top of the spine, the atlas and axis form a pivot joint that allows for rotation of the head. 57 Edem, E. E. Types of Joints (4) A condyloid joint allows for circular motion, flexion, and extension. The wrist joint between the radius and the carpal bones is an example of a condyloid joint. (5) A saddle joint allows for flexion, extension, and other movements, but no rotation. In the hand, the thumb’s saddle joint (between the first metacarpal and the trapezium) lets the thumb cross over the palm, making it opposable. (6) The ball-and-socket joint is a freely moving joint that can rotate on any axis. The hip and shoulder joints are examples of ball and socket joints. 58 Edem, E. E. Choose the CORRECT option… Joints that move like a hinge on door or back and fourth are called Slightly Moveable Joints Hinge Joints Ball-and-socket Joints Fixed Joints 59 Edem, E. E. Choose the CORRECT option… Example of ball-and-socket joint is Vertebral disc joint Shoulder and hip joints Knee and elbow joints Spinal cord joints 60 Edem, E. E. Applied Anatomy: Fractures 61 Edem, E. E. Ricket 62 Edem, E. E. 63 Edem, E. E. 64 Edem, E. E. 65 Edem, E. E. Sciatica Can Result from Disc Herniation 66 Edem, E. E. Cartilage Degenerating Over Time May Lead to Cervical Spondylosis (osteoarthritis) 67 Edem, E. E. Plantar Fasciitis Can Result from Repeated Foot Strain 68 Edem, E. E. 69 Edem, E. E. A Sharp Knee Movement Can Lead to an ACL (anterior cruciate ligament)Tear 70 Edem, E. E. 71 Edem, E. E. Comprehensively review the different types of fractures possible in the lower limb. 72