REHAB 544 FUNCTIONAL ANATOMY OF THE UPPER EXTREMITY & LOWER EXTREMITY



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REHAB 544 FUNCTIONAL ANATOMY OF THE UPPER EXTREMITY & LOWER EXTREMITY Mark Guthrie, PhD Rehabilitation Medicine University of Washington

REHAB 544: Musculoskeletal Anatomy of the Upper & Lower Extremities, 2013 Monday 9:30-11:20, Room T-733; & Tuesday 9:30-11:20, Room T-747 Mark Guthrie, PT, PhD anatomy@u.washington.edu 206-598-5440 Rehab 544: SCHEDULE 2013 INTRODUCTION! WEEK (BEGINNING) TOPIC PAGES (Jenkins 9 th ed) 1 Since Autumn Quarter begins on Wed Sept 25 th, Rehab 544 will not meet that first week 2 (Sept 30) Introduction, Basic Concepts 1-50, (Planes, Axes, Movements, Location, etc.) (recommend 50-55) Connective Tissue; Begin Shoulder 57-72 3 (Oct 7) Joints; continue Shoulder 57-72, 79-104 Axilla, Brachial Plexus 73-78, 229-235 4 (Oct 14) Continue Axilla; Brachial Plexus ************* OCTOBER 14 th or 15 th -- EXAM I ************* 5 (Oct 21) Arm 107-124 Elbow, Forearm 109-112, 126-165 6 (Oct 28) Continue Forearm; Wrist, Hand 159-202 7 (Nov 4) ************* NOVEMBER 4th -- EXAM II ************ Pelvis 238-249 8 (Nov 11) NOV 11 VETERANS DAY HOLIDAY L-S Plexus, Hip 249-53, 261-63, 279-80 Buttocks 281-90 9 (Nov 18) Thigh 263-277, 286-289 Knee 256-260 10 (Nov 25) *********** NOVEMBER 25 th or 26th EXAM III ********** Continue Knee; Begin Leg 307-330 11 (Dec 2) Continue Leg; Ankle and Foot 333-355 ***** FINAL EXAM -- MONDAY, DECEMBER 9th, 8:00-11:00AM *****

Transverse! Sagittal! Coronal! Position! Medial/Lateral! Anterior/Posterior! Superior/Inferior! Superficial/Deep! Internal/External! Ipsilateral/Contralateral! Proximal/Distal! Supine/Prone!? Movement / Axis of Flexion/Extension! Ab/Adduction! Rotation! Pronation/Supination! Circumduction! Pro/Retraction! Inversion/Eversion! Axes/Planes of motion!

INTRODUCTION!

Position! Medial/Lateral! Anterior/Posterior! Superior/Inferior! Superficial/Deep! Internal/External! Ipsilateral/Contralat.! Proximal/Distal! Supine/Prone!? Movement / Axis of Flexion/Extension! Ab/Adduction! Rotation! Pronation/Supination! Circumduction! Pro/Retraction! Inversion/Eversion! Axes/Planes of motion!

INTRODUCTION! TISSUE = Primarily Cells a few Fibers and some Stuff = epithelium, muscle, & nerve

INTRODUCTION! CT = Few Cells lots of Fibers and lots of Stuff = tendons, ligaments fascia cartilage, etc. Connective tissue is any type of biological tissue with an extensive extracellular matrix and generally serves to support, bind together, and protect structures throughout the body.!

INTRODUCTION! Extracullular Matrix!

INTRODUCTION! DENSE REGULAR CONNECTIVE TISSUE Extracullular Matrix! DENSE IRREGULAR CONNECTIVE TISSUE WHAT ABOUT LOOSE CONNECTIVE TISSUE?

INTRODUCTION! Extracullular Matrix!

INTRODUCTION! Extracullular Matrix! TENDON

INTRODUCTION! ARTICULAR/HYALINE CARTILAGE (Type II Cartilage) Extracullular Matrix!

SHOULDER Bones Sternum Clavicle Scapula angles borders fossae processes, etc Humerus THE SHOULDER SHOULDER JOINTS Sternoclavicular Acromioclavicular Scapulo-thoracic Glenohumeral SHOULDER MOVEMENT Clavicle Elevation / Depression Horiz. Flex / Ext Rotation Scapular/Shoulder Elevation / Depression Protraction / Retraction Superior / Inferior Rot. Tilting Winging Arm Flexion / Extension Abduction / Adduction Internal / External Rot. Scaption SHOULDER MUSCLES

INTRODUCTION! MUSCULOSKELETAL ARTICULATIONS NONSYNOVIAL Fibrous Cartilaginous Extracullular Matrix! SYNOVIAL

INTRODUCTION! GENERIC SYNOVIAL JOINT Extracullular Matrix!

INTRODUCTION! On to some real anatomy.finally Extracullular Matrix!

Ann Emerg Med. 2003 May;41(5):738-40. Helmets for preventing head and facial injuries in bicyclists. Thompson DC, Rivara FP, Thompson R. Pediatrics; Harborview Injury Prevention & Research Center, University of Washington, Box 359960, 325 Ninth Avenue, Seattle, WA 98104, USA. dct@u.washington.edu BACKGROUND: Each year, in the United states, approximately 900 persons die from injuries due to bicycle crashes and over 500,000 persons are treated in emergency departments. Head injury is by far the greatest risk posed to bicyclists, comprising one-third of emergency department visits, two-thirds of hospital admissions, and three-fourths of deaths. Facial injuries to cyclists occur at a rate nearly identical to that of head injuries. Although it makes inherent sense that helmets would be protective against head injury, establishing the real-world effectiveness of helmets is important. A number of case-control studies have been conducted demonstrating the effectiveness of bicycle helmets. Because of the magnitude of the problem and the potential effectiveness of bicycle helmets, the objective of this review is to determine whether bicycle helmets reduce head, brain and facial injury for bicyclists of all ages involved in a bicycle crash or fall. OBJECTIVES: To determine whether bicycle helmets reduce head, brain and facial injury for bicyclists of all ages involved in a bicycle crash or fall. SEARCH STRATEGY: We searched The Cochrane Controlled Trials Register, MEDLINE, EMBASE, Sport, ERIC, NTIS, Expanded Academic Index, CINAHL, PsycINFO, Occupational Safety and Health, and Dissertations Abstracts. We checked reference lists of past reviews and review articles, studies from government agencies in the United States, Europe and Australia, and contacted colleagues from the International Society for Child and Adolescent Injury Prevention, World Injury Network, CDC funded Injury Control and Research Centers, and staff in injury research agencies around the world. SELECTION CRITERIA: Controlled studies that evaluated the effect of helmet use in a population of bicyclists who had experienced a crash. We required that studies have complete outcome ascertainment, accurate exposure measurement, appropriate selection of the comparison group and elimination or control of factors such as selection bias, observation bias and confounding. DATA COLLECTION AND ANALYSIS: Five published studies met the selection criteria. Two abstractors using a standard abstraction form independently abstracted data. Odds ratios with 95% CI were calculated for the protective effect of helmet for head and facial injuries. Study results are presented individually. Head and brain injury results were also summarized using meta-analysis techniques. MAIN RESULTS: No randomized controlled trials were found. This review identified five well conducted case control studies which met our selection criteria. Helmets provide a 63%-88% reduction in the risk of head, brain and severe brain injury for all ages of bicyclists. Helmets provide equal levels of protection for crashes involving motor vehicles (69%) and crashes from all other causes (68%). Injuries to the upper and mid facial areas are reduced 65%. REVIEWER'S CONCLUSIONS: Helmets reduce bicycle-related head and facial injuries for bicyclists of all ages involved in all types of crashes including those involving motor vehicles.