Anatomical Terminology: Planes Axes Direction (Text Pg 2 3)

Transcription

1 Anatomical Terminology: Planes Axes Direction (Text Pg 2 3) Anatomy: The structure and organization of the body and its organs. From Greek Origin: Anatome dissection Physiology: The function of the body and its organs Exercise physiology: How the body responds and adapts to the stress caused by exercise Anatomical Terminology Anatomical Position: human body when standing erect, with arms by the sides, palms facing forward, legs straight, feet turned out slightly and feet flat on the floor Anatomical Planes Planes: An imaginary, flat surface passing through the body or organ (divides the structure) 3 Anatomical Planes: Frontal (coronal) divides body into front and back sections Medial (sagittal) divides body into right and left sections (Parallel to median plane) a. Median/midline = perfect left and right halves Transverse (horizontal) divides body into upper and lower sections

2 Axes of Rotation Axis: An imaginary line (point of rotation) that passes through a joint or the body to describe movement. 3 Primary Axes of Rotation Medio-lateral Axis: (Horizontal) o Runs from side to side o Perpendicular to sagittal plane o Typically flexion/extension movements Antero-posterior (sagittal) o Runs from front to back o Perpendicular to the coronal plane o Typically abduction/adduction movements Vertical (longitudinal) o Runs straight through the top of the head down between feet o Perpendicular to transverse plane o Typically rotation type movements Summary of 3 planes and axes of rotation Plane Medial (Sagittal) Coronal (Frontal) Transverse (Horizontal) Perpendicular Axis Medio-lateral (Horizontal) Antero-posterior (Sagittal) Longitudinal (Vertical)

3 Terms of Relative Position and Direction (6 pairs Text Pg 6) Lateral: is away from or further from the midline 1 { Medial: is towards or closer to the midline Proximal: Closer to the trunk or point of attachment; top of limb segment. 2 { Distal: Away from the trunk or point of attachment; bottom of limb segment Anterior: (ventral) Towards the front of the body 3 { Posterior: (dorsal) Towards the back of the body Superior: Towards the top of the body 4 { Inferior: Towards the bottom of the body Deep: Farther away from the surface of the body 5 { Superficial: Closer to the surface of the body Plantar: Towards the sole of the foot 6 { Dorsum: Uppermost surface of the foot

4 Introduction to the Skeletal System (Text Pg 9 11) The Human Skeleton Skeletal is Greek for dried up Has living and non-living components Consists of 206 bones Accounts for ~14% of our body mass Five Functions of the skeletal system: o o o o o Supports tissues and provides a framework for our body. Protects organs e.g. rib cage, skull Reservoir of minerals such as phosphorus and calcium which may be used in time of need (repair and function). Produces Red & white blood cells & platelets. Provides the levers on which muscles pull to produce movement. Two Primary Differences Between Male And Females 1. Pelvis Structure a. Shape 2. Size And Weight a. Males longer and thicker bones. b. Females Shorter and thinner ( risk of fractures) Two Primary Divisions of the Skeleton: 1. Axial Skeleton (80 bones): a. Consists of the: i. Skull ii. Vertebral column iii. Thoracic Cage (Sternum, ribs & spine) b. supports and protects the organs. c. Most musculature originates or attaches to it.

5 2. Appendicular Skeleton (126 bones): a. Upper and lower extremities b. The shoulder and pelvic girdles which anchor the bony appendages to the axial skeleton. c. Major role in movement Two Anatomical Girdles 1. The Shoulder Girdle 2. The Pelvic Girdle 5 Classifications of bone 1. Long Bones a. Tubular shell with cavity in the middle. b. Found in: Arms, legs, hands, etc. E.g. humerus & femur 2. Short Bones a. No marrow cavity b. Found in: Wrist & ankle E.g. carpals and tarsals 3. Flat Bones a. Flat and thin, (protection, broad surface for muscle attachment)

6 b. Found in: Cranium, pectoral and pelvic girdles E.g. parietal, scapula, ilium 4. Irregular Bones a. Specialized shape and function (support weight, dissipate loads, protect spinal cord) b. Found in:spinal column E.g. vertebral bodies 5. Sesamoid Bones a. Small bones embeded within a tendon or joint capsule (alters angle of insertion, reduces friction) b. Found in: Knee, hand, thumb & big toe E.g. patella & Pisiform

7 Anatomy of The Long Bone (Text Pg 12) Bone consists of non-living materials Component Function Calcium carbonate (CaCO 3 ) - adds stiffness & resists compression Calcium phosphate (Ca 3 PO 4 ) - adds stiffness & resists compression Collagen - adds flexibility & resists tension And living Cells There are 3 Types of Bone Cells 2. Osteoblasts: a. Bone forming/reconstructing cells b. Deposits osteoid (un-calcified bone matrix) into the bone matrix to build up cortical bone 3. Osteocytes: a. Mature bone cells 4. Osteoclasts: a. Cells that break down and reabsorb bone b. Secrete acids and enzymes to dissolve calcium and organic matrix of the bone. Homeostasis of Bone Cell Activity: The activity of osteoblasts and osteoclasts are interconnected (i.e. the activity of one is influenced by the other) These cells must be is a state of HOMEOSTASIS in order to maintain proper bone formation and remodeling!!!

8 Anatomy of the Long Bone: o Periosteum A fibrous, cellular, vascular and highly sensitive life support sheath covering the length of the bone (not ends). Allows for ligaments and tendons to attach to the bone. o Diaphysis The shaft or central part of a long bone. o Medullary Cavity The cavity of the diaphysis that contains red and yellow marrow. o Epiphysis The ends of the long bone. Outer surface made up of cancellous bone. Articulates (i.e. makes contact) with adjacent bones. o Articular Cartilage Covers the end (Epiphysis) of the long bone. Smooth, slippery, porous, malleable, insensitive, and bloodless surface that makes contact with adjacent bones. o Nutrient Artery The principal artery and major supplier of oxygen and nutrients to the shaft of a bone. 2 Types of Bone 1. Cancellous (Spongy) Bone Consists of interwoven beams (trabeculae) of bone The spaces are filled with marrow. 2. Compact (Cortical) Bone Dense bone that forms in the walls of the diaphysis. Provides structural integrity

9 2 Types of Bone Marrow 1. Red Marrow a. A gelatinous substance where blood cell formation occurs (red and white). 2. Yellow Marrow a. Fatty connective tissue that no longer produces blood cells (with age red marrow becomes yellow). Bone Formation & Remodeling (Text Pg 29) The Process of Bone Formation 1. Bones begin as cartilaginous models (8 wks after conception) 2. The periosteum forms around the models. 3. Osteoblasts synthesize the compact bone of the diaphysis. 4. Cartilage in diaphysis is transformed into cancelous bone as growth continues outward from the centre. 5. Osteoclasts breakdown cancelous bone to form the medullary cavity. Bone Growth Bone growth is governed by the combined effect of growth hormone, thyroid hormone, sex hormones, proper nutrition and physical activity. The Epiphyseal plate (growth region) allows for bone growth to continue. The Epiphyseal line Appears when longitudinal bone growth stops. The Epiphyseal plate becomes an epiphyseal line as we reach the end of maturity.

10 Bone Remodeling The process by which our body continually destroys and rebuilds bone tissue throughout our lives. The process of bone remodeling is governed by: o Wolf s law Bones will grow or remodel in response to the forces or demands placed on them Therefore: When bones are subjected to regular loads they tend to become more dense and mineralized. e.g. a tennis player s arms. Inactivity works in the opposite way leading to a decrease in bone weight and strength, e.g. bed rest

11 Anatomy of The Long Bone

12 A Transverse Cross-Section of a Long Bone

13 BONE CELLS

14 Bone Fractures and Healing (Text Pg 30 31) Fractures Defined: When a bone cracks or breaks when subjected to extreme loads, impacts or stresses. The Stress Strain Curve! Two Basic Types of Fractures 1. Simple/Incomplete Fractures: a. No separation of the bone into parts. b. A crack or break is usually detectable. Two Types of Simple Fractures: i. Hairline/Fissure Fracture: The fracture only extends into the outer layer of the bone. ii. Greenstick Fracture: The fracture occurs only on one side of the bone (outside of bend). Mostly seen in children.

15 2. Compound/Complete Fractures: a. The bone has been completely fractured through it's own width. b. Usually also results in damage to the surrounding soft tissue (Complex Fracture). c. They are either OPEN (Bone breaks through the skin) or CLOSED (Bone does not break through the skin) Four Types of Compound Fractures: i. Comminuted Fracture: The bone is broken into more than two fragments (highly unstable). ii. Spiral Fracture: The bone has been broken due to a twisting type motion and looks like a corkscrew. iii. Avulsion Fracture: A fragment of bone is detached from it s point of insertion by a tendon or ligament. iv. Impacted Fracture: One bone fragment is driven into the medullary space or spongy bone of itself or another bone. The ends of the broken bones are wedged together. The Process of Bone Healing o Step 1: Fracture Hematoma a. Bleeding occurs at the fracture site and a blood clot, or fracture hematoma, develops. b. Bone cells at the site become deprived of nutrients and die. The site becomes swollen, painful, and inflamed o Step 2: Fibrocartilagenous Callus formation a. Collagen fibres, a cartilage matrix, and trabeculae span the break to splint the bone.

16 o o Step 3: Bony Callus formation a. Bone trabeculae increase in number and convert the fibrocartilaginous callus into a bony callus. b. The bony callus seals the broken ends of the bone and forms a band of thickened material, like a cuff, around the break site. (~ 6-8 weeks). Step 4: Bone Remodeling a. During the next several months, the bony callus is continually remodeled. b. Osteoclasts work to remove the temporary supportive structures c. Osteoblasts rebuild the compact bone and reconstruct the bone so it returns to its original shape/structure. Immobilization: In order to avoid disturbing the actions of bone healing, the bone must be immobilized.

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18 Connective Tissues, Terms & Common Sports Injuries (Text Pg 72 73) Definitions: Fascia The fibrous connective tissue that supports, covers and separates all the muscle groups. It also unites the underlying tissue with the skin. Ligaments A band of fibrous, collagenous tissue connecting bone or cartilage to each other (bone-to-bone) Tendons Tough fibrous and inelastic bands that anchor muscles to bone. Allows action of muscle to be transferred across joints. Tendonitis Inflammation of a tendon caused by irritation due to prolonged or abnormal use (e.g. Carpal tunnel Syndrome) Treatment (RX): o First 48 Hrs: Rest and cold, severe cases = cast or splint o After 48hrs: Heat and contrast bathing o Also: Corticosteroids or Non Steroidal Anti-Inflammatory Drugs (NSAID) Vascularity Amount of blood supplied to a tissue. o Vascular = with blood.g. Bone and Muscle o Avascular = without blood e.g. Ligaments and cartilage. o Generally, increased vascularity means faster recovery from injury.

19 3 Types of Cartilage: Hyaline: Tough, flexible cartilage found at ends of long bones, nose, trachea and bronchi Fibrous: Tough, shock-absorbing cartilage e.g. intervertebral discs, meniscus, lines edges of glenoid cavity & acetabulum Elastic: Most flexible cartilage that provides structure and support for tissues. Bends and recovers shape e.g. larynx, ear. Injury Terminology: Sprains & Tears Injury to ligaments and tendons Pulls & Strains injury to muscle Dislocation: Bone is displaced from its normal location. May also include damage to joint capsule, ligaments, muscle & tendon. E.g. finger, shoulder, etc. Separation: Ligaments holding a joint together tear and separate from one another. E.g. Strenoclavicular or Acromiocalvicular Generic Injury Mechanics Model

20 Two Different Types of Injuries 1. Acute Injuries a. High Force, awkward posture low repetition. b. E.g. moving a piano! 2. Repetitive Strain or Chronic Injuries (RSI) a. Lower forces, awkward posture, high repetition. b. E.g. assembly line work! Acute Injury Chronic Injury Severity of Injury First degree: Least severe o A few days to heal Second degree: Moderate o Longer to heal and require special treatment Third degree: Most severe o Longest to heal (6-12 mo) may require surgery The Signs and Symptoms (S&S) of Soft Tissue Injuries Swelling Heat Altered function Red Painful

21 Treatment of Soft Tissue Injuries (PIER Principle) Pressure Ice Elevation Restriction When to Apply Heat: After 48 hours of initial injury Heat may initially increase swelling

22 Shoulder, Knee, Ankle and Spine (Text Pg 74 79) Inverse Relationship Between Joint Mobility and Stability The Shoulder Joint Sternoclavicular Joint Acromioclavicular Joint Glenohumeral Joint The Shoulder joint is readily injured due to its high degree of mobility (Moves about all three axes) The Rotator Cuff Consists of 4 muscles (S.I.T.S.): Supraspinatus, subscapularis infraspinatus, and teres minor Primarily allow for internal & external rotation of the shoulder. These muscles wrap around the shoulder joint to stabilize it. These muscles help decelerate the arm in throwing actions.

23 The Knee Joint Tibiofemoral joint (Condyloid or modified ellipsoid joint) Relatively stable due to additional structural supports around and within the joint: o Menisci: shock-absorbing fibrocartilaginous discs o Cruciate ligaments: anterior and posterior in the centre of the joint o Collateral ligaments: lateral and medial extending from the sides of the femur to the tibia and fibula o The musculature that surrounds it Knee ligament Tears/Sprain Blow to: Medial side of knee = LCL tear/sprain Blow to: lateral side of knee = MCL tear/sprain Blow to: anterior side of tibia = PCL tear/sprain Blow to: posterior side of tibia = ACL tear/sprain Combination of injuries can occur depending on the severity & direction of the blow. Arthroscopy Surgical procedure involving small incisions to allow a fiber optic camera and/or instruments into a joint (knee, shoulder, wrist, etc) to assess and treat injuries. ACL Repair: Patellar tendon-bone autograft or a strand from one or both of semitendinosus and/or gracilis tendons. The Ankle A modified hinge joint Gains stability from the numerous ligaments that surround the joint yet has little musculature to protect it. Very susceptible to injury while plantar flexed.

24 The Spine 7 Cervical vertebrae (of the neck) o Atlas = Axis = 12 Thoracic vertebrae (of the chest) 5 Lumbar vertebrae (of the lower back) Sacrum (5 fused sacral vertebrae mid-line region of buttocks) Coccyx (4 fused vertebrae of the tail bone) The shape of the vertebrae change from top to bottom based upon their function (Load bearing, flexibility, muscle attachment, etc.) Vertebrae are arranged in a cylindrical column interspersed with fibro-cartilaginous (intervertebral) discs which absorb impact. The vertebrae provide a strong and flexible support structure that keeps the body erect yet allows great mobility. Vertebrae provide a point of attachment for the back musculature (i.e. Erector Spinae Group - Text Pg 46). Protects the spinal cord in the vertebral foramen.