Appendicular Skeleton Appendicular Skeleton

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Appendicular Skeleton Appendicular Skeleton

Humerus Appendicular Head Skeleton Greater Tubercle Intertubercular Groove Lesser Tubercle Humerus Patella Deltoid Tuberosity Radius Tibia Lateral Epicondyle D L M V Ulna Fibula Medial Epicondyle D L M V Capitulum Hands Talus Trochlea Femur Calcaneus Olecrenon Fossa Intertubercular Groove Greater Tubercle Lesser Tubercle Capitulum Trochlea Head Lateral Epicondyle Medial Shoulder Epicondyle Girdle Olecrenon Fossa Muscle Attachments Proximal End Distal End Biceps & Triceps Deltoid 1 Radius Ulna Head Neck Radial Tuberosity Interosseous Crest Styloid Process Olecrenon Process Ulnar Notch Radial Notch Tuberosity L M D V Styloid Process D L M V Interosseous Crest Trochlea Radial Tuberosity Olecrenon Process Capitulum Head Medial Epicondyle Phalanges 1st 3rd Proximal Phalange 3rd Metacarpals 1st Proximal Phalange 2 Femur Head, medial Larger epicondyle, lateral Femur head Olecrenon fossa, distal Fovea capitus Olecrenon process, proximal Greater trochanter Radial notch, lateral Lesser trochanter Styloid process, towards ‘pinky’ Linea aspera Head, proximal Medial condyle Tuberosity, medial Lateral condyle Styloid towards thumb Intercondylar fossa V D L M Patellar articular surface Proximal Femur Fovea capitus Trochanteric Fossa Greater Trochanter Lesser femur humerus Trochanter Proximal Femur Medial condyle Lateral condyle Patella Patellar articular surface Intercondylar notch V D Apex Base Facet for lateral femoral condyle Distal Femur Facet for medial femoral condyle 3 Tibia Tibia Lateral condyle Lateral condyle Lateral condyle Medial condyle Medial condyle Fibular articular facet Intercondylar eminence Tibial tuberosity Intercondylar eminence Soleal line Anterior crest Nutrient foramen Medial malleolus V D L M Fibular notch Fibula Styloid process Malleolus Malleolar fossa Muscle Attachments D L M V of the Knee Knee Knee Joint Knee Joint Anterior View Medial View 4 Medial S View D M Bipedal Head Talus Foot Trochlear surface Superior View Calcanean articular surface L Bipedal Ankle Joint I S Calcaneus Talar articular surface Sustentaculum tali Attachment for Achilles tendon D Tubercle Metatarsals & Phalanges Distal Phalange Phalanx Phalange 1. Fibula 2. Tibia 3. Distal Tibia 4. Calcaneus 1st Metarasal 5 Appendicular Foot Tendons/Ligaments Joint Movements 6.

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Skeletal Foot Structure
Foot Skeletal Structure The disarticulated bones of the left foot, from above (The talus and calcaneus remain articulated) 1 Calcaneus 2 Talus 3 Navicular 4 Medial cuneiform 5 Intermediate cuneiform 6 Lateral cuneiform 7 Cuboid 8 First metatarsal 9 Second metatarsal 10 Third metatarsal 11 Fourth metatarsal 12 Fifth metatarsal 13 Proximal phalanx of great toe 14 Distal phalanx of great toe 15 Proximal phalanx of second toe 16 Middle phalanx of second toe 17 Distal phalanx of second toe Bones of the tarsus, the back part of the foot Talus Calcaneus Navicular bone Cuboid bone Medial, intermediate and lateral cuneiform bones Bones of the metatarsus, the forepart of the foot First to fifth metatarsal bones (numbered from the medial side) Bones of the toes or digits Phalanges -- a proximal and a distal phalanx for the great toe; proximal, middle and distal phalanges for the second to fifth toes Sesamoid bones Two always present in the tendons of flexor hallucis brevis Origin and meaning of some terms associated with the foot Tibia: Latin for a flute or pipe; the shin bone has a fanciful resemblance to this wind instrument. Fibula: Latin for a pin or skewer; the long thin bone of the leg. Adjective fibular or peroneal, which is from the Greek for pin. Tarsus: Greek for a wicker frame; the basic framework for the back of the foot. Metatarsus: Greek for beyond the tarsus; the forepart of the foot. Talus (astragalus): Latin (Greek) for one of a set of dice; viewed from above the main part of the talus has a rather square appearance.
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List: Bones & Bone Markings of Appendicular Skeleton and Knee
List: Bones & Bone markings of Appendicular skeleton and Knee joint Lab: Handout 4 Superior Appendicular Skeleton I. Clavicle (Left or Right?) A. Acromial End B. Conoid Tubercle C. Shaft D. Sternal End II. Scapula (Left or Right?) A. Superior border (superior margin) B. Medial border (vertebral margin) C. Lateral border (axillary margin) D. Scapular notch (suprascapular notch) E. Acromion Process F. Coracoid Process G. Glenoid Fossa (cavity) H. Infraglenoid tubercle I. Subscapular fossa J. Superior & Inferior Angle K. Scapular Spine L. Supraspinous Fossa M. Infraspinous Fossa III. Humerus (Left or Right?) A. Head of Humerus B. Anatomical Neck C. Surgical Neck D. Greater Tubercle E. Lesser Tubercle F. Intertubercular fossa (bicipital groove) G. Deltoid Tuberosity H. Radial Groove (groove for radial nerve) I. Lateral Epicondyle J. Medial Epicondyle K. Radial Fossa L. Coronoid Fossa M. Capitulum N. Trochlea O. Olecranon Fossa IV. Radius (Left or Right?) A. Head of Radius B. Neck C. Radial Tuberosity D. Styloid Process of radius E. Ulnar Notch of radius V. Ulna (Left or Right?) A. Olecranon Process B. Coronoid Process of ulna C. Trochlear Notch of ulna Human Anatomy List: Bones & Bone markings of Appendicular skeleton and Knee joint Lab: Handout 4 D. Radial Notch of ulna E. Head of Ulna F. Styloid Process VI. Carpals (8) A. Proximal row (4): Scaphoid, Lunate, Triquetrum, Pisiform B. Distal row (4): Trapezium, Trapezoid, Capitate, Hamate VII. Metacarpals: Numbered 1-5 A. Base B. Shaft C. Head VIII. Phalanges A. Proximal Phalanx B. Middle Phalanx C. Distal Phalanx ============================================================================= Inferior Appendicular Skeleton IX. Os Coxae (Innominate bone) (Left or Right?) A.
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Ideal Medial Malleolar Screw Length Based on the Tibial Epiphyseal Scar Location in Weight Bearing CT’S Collin G
Ideal Medial Malleolar Screw Length Based on the Tibial Epiphyseal Scar Location in Weight Bearing CT’s Collin G. Messerly DPM, Keegan A. Duelfer DPM, Troy J. Boffeli DPM, FACFAS, Tyler K. Sorensen, DPM Regions Hospital / HealthPartners Institute for Education and Research - Saint Paul, MN Figure 1. Zone of Dense Bone in Medial Malleolar ORIF Figure 4. Measuring Distal – Most 5% to Medial Malleolus Table 2. Distance Between Epiphyseal Scar & Distal – Most 5% of RESULTS STATEMENT OF PURPOSE The epiphyseal scar is located in the distal The medial malleolus to distal – most 5% mark Tibia 97 WB ankle CT scans evaluated in uninjured ankles Medial malleolar fractures are one of the most common fracture types metaphysis of the tibia, and can oftentimes be was measured on the coronal WB CT slice with Measurement of interest Male: Mean ± SD Female: Mean ± SD (mm) In males < 60 years old there was a 12.75 mm zone of increased bone the widest medial malleolus. Screw threads observed in the ankle joint and have been long fixated with two screws; easily visualized on X-ray and CT scan (red line). (mm) density, as compared to 13.66 mm in those ≥ 60 which was not statistically The distal – most 5% of the tibia (distal to the beyond this point will purchase less dense bone however, the bone density of the distal tibia has potential for poor screw significant. purchase due to compromised bone density. This is especially true in elderly black line) contains dense bone with marked in the medullary canal with potential to not have Epiphyseal Scar to Medial Malleolus 12.75 ± 2.91 9.39 ± 2.38 In females < 60 years old there was 9.39 mm zone of increased bone populations with osteoporotic bone.
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Body Mechanics As the Rotator Cuff Gether in a Cuff-Shape Across the Greater and Lesser Tubercles the on Head of the Humerus
EXPerT CONTENT Body Mechanics by Joseph E. Muscolino | Artwork Giovanni Rimasti | Photography Yanik Chauvin Rotator Cuff Injury www.amtamassage.org/mtj WORKING WITH CLieNTS AFFecTED BY THIS COmmON CONDITION ROTATOR CUFF GROUP as the rotator cuff group because their distal tendons blend and attach to- The four rotator cuff muscles are gether in a cuff-shape across the greater and lesser tubercles on the head of the supraspinatus, infraspinatus, the humerus. Although all four rotator cuff muscles have specific concen- teres minor, and subscapularis (Fig- tric mover actions at the glenohumeral (GH) joint, their primary functional ure 1). These muscles are described importance is to contract isometrically for GH joint stabilization. Because 17 Before practicing any new modality or technique, check with your state’s or province’s massage therapy regulatory authority to ensure that it is within the defined scope of practice for massage therapy. the rotator cuff group has both mover and stabilization roles, it is extremely functionally active and therefore often physically stressed and injured. In fact, after neck and low back conditions, the shoulder is the most com- Supraspinatus monly injured joint of the human body. ROTATOR CUFF PATHOLOGY The three most common types of rotator cuff pathology are tendinitis, tendinosus, and tearing. Excessive physi- cal stress placed on the rotator cuff tendon can cause ir- ritation and inflammation of the tendon, in other words, tendinitis. If the physical stress is chronic, the inflam- matory process often subsides and degeneration of the fascial tendinous tissue occurs; this is referred to as tendinosus. The degeneration of tendinosus results in weakness of the tendon’s structure, and with continued Teres minor physical stress, whether it is overuse microtrauma or a macrotrauma, a rotator cuff tendon tear might occur.
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Should Joint Presentation File
6/5/2017 The Shoulder Joint Bones of the shoulder joint • Scapula – Glenoid Fossa Infraspinatus fossa – Supraspinatus fossa Subscapular fossa – Spine Coracoid process – Acromion process • Clavicle • Humerus – Greater tubercle Lesser tubercle – Intertubercular goove Deltoid tuberosity – Head of Humerus Shoulder Joint • Bones: – humerus – scapula Shoulder Girdle – clavicle • Articulation – glenohumeral joint • Glenoid fossa of the scapula (less curved) • head of the humerus • enarthrodial (ball and socket) 1 6/5/2017 Shoulder Joint • Connective tissue – glenoid labrum: cartilaginous ring, surrounds glenoid fossa • increases contact area between head of humerus and glenoid fossa. • increases joint stability – Glenohumeral ligaments: reinforce the glenohumeral joint capsule • superior, middle, inferior (anterior side of joint) – coracohumeral ligament (superior) • Muscles play a crucial role in maintaining glenohumeral joint stability. Movements of the Shoulder Joint • Arm abduction, adduction about the shoulder • Arm flexion, extension • Arm hyperflexion, hyperextension • Arm horizontal adduction (flexion) • Arm horizontal abduction (extension) • Arm external and internal rotation – medial and lateral rotation • Arm circumduction – flexion, abduction, extension, hyperextension, adduction Scapulohumeral rhythm • Shoulder Joint • Shoulder Girdle – abduction – upward rotation – adduction – downward rotation – flexion – elevation/upward rot. – extension – Depression/downward rot. – internal rotation – Abduction (protraction) – external rotation
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Assessment, Management and Decision Making in the Treatment Of
Pediatric Ankle Fractures Anthony I. Riccio, MD Texas Scottish Rite Hospital for Children Update 07/2016 Pediatric Ankle Fractures The Ankle is the 2nd most Common Site of Physeal Injury in Children 10-25% of all Physeal Injuries Occur About the Ankle Pediatric Ankle Fractures Primary Concerns Are: • Anatomic Restoration of Articular Surface • Restoration of Symmetric Ankle Mortise • Preservation of Physeal Growth • Minimize Iatrogenic Physeal Injury • Avoid Fixation Across Physis in Younger Children Salter Harris Classification Prognosis and Treatment of Pediatric Ankle Fractures is Often Dictated by the Salter Harris Classification of Physeal Fractures Type I and II Fractures: Often Amenable to Closed Tx / Lower Risk of Physeal Arrest Type III and IV: More Likely to Require Operative Tx / Higher Risk of Physeal Arrest Herring JA, ed. Tachdjian’s Pediatric Orthopaedics, 5th Ed. 2014. Elsevier. Philadelphia, PA. ISOLATED DISTAL FIBULA FRACTURES Distal Fibula Fractures • The Physis is Weaker than the Lateral Ankle Ligaments – Children Often Fracture the Distal Fibula but…. – …ligamentous Injuries are Not Uncommon • Mechanism of Injury = Inversion of a Supinated Foot • SH I and II Fractures are Most Common – SH I Fractures: Average Age = 10 Years – SH II Fractures: Average Age = 12 Years Distal Fibula Fractures Lateral Ankle Tenderness SH I Distal Fibula Fracture vs. Lateral Ligamentous Injury (Sprain) Distal Fibula Fractures • Sankar et al (JPO 2008) – 37 Children – All with Open Physes, Lateral Ankle Tenderness + Normal Films – 18%: Periosteal
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Isolated Lesser Trochanter Fracture Associated with Leukemia
A Case Report & Literature Review Isolated Lesser Trochanter Fracture Associated With Leukemia Jake P. Heiney, MD, MS, and Mark C. Leeson, MD, FACS solated lesser trochanteric fractures are rare1; few cases Erythrocyte sedimentation rate was slightly elevated (23 have been reported in the literature. When an isolated mm/h). Radiographs of the right hip and pelvis showed an lesser trochanteric fracture occurs in a patient with isolated lesser trochanteric avulsion fracture and no signs closed growth plates, it is thought to be pathognomonic of a pathologic process (Figure 1). Given the patient’s Ifor neoplasm.2-4 inability to ambulate and need for pain control and further To our knowledge, this is the first report of a case of iso- workup, she was admitted. As MRI could not be performed lated lesser trochanteric fracture associated with leukemia. that night without her case being declared an emergency, The other 18 reported cases of this fracture were associated with metastatic carcinoma (breast, pancreatic, thyroid, colon, prostate, lung, squamous cell), synovial cell sarcoma, non- Hodgkin lymphoma, or primary plasmacytoma.2-8 CASE REPORT A woman in her late 40s presented to the emergency department with right hip pain after twisting with a slight slip in her kitchen. The patient stated that she had not fallen but was having terrible groin pain that inhibited her from ambulating. She said there had been no groin pain before the incident. She had been seeing an orthopedic surgeon for knee pain on the ipsilateral side for some time. The knee pain was global but had increased tenderness in the medial joint line.
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Posterior Compartment Of
POSTERIOR COMPARTMENT OF LEG Cross Section of Leg Cutaneous Innervation Superficial vessels of leg Deep Fascia of Posterior Compartment Boundaries and Sub-divisions Flexor Retinaculum Muscles of Posterior Compartment I. Superficial Muscles a) Gastrocnemius b) Soleus c) Plantaris a) Gastrocnemius Origin:- by 2 heads i. Lateral head- lateral aspect of lateral condyle of femur ii. Medial head- popliteal surface of femur above medial condyle Insertion:- Posterior surface of calcaneum as Tendo-calcaneus b) Soleus Origin:- i. Inverted ‘V’ shaped from soleal line on tibia ii. Upper 1/4th of upper surface of shaft of fibula iii. Fibrous arch between these 2 bones Insertion:- Posterior surface of calcaneum as Tendo-calcaneus c) Plantaris- fusiform belly Origin:- Lateral supracondylar ridge of femur Insertion:- Posterior surface of calcaneum medial to Tendo- calcaneus Superficial Strata Deep Strata I. Deep Muscles a) Popliteus b) Flexor Digitorum Longus c) Flexor Hallucis Longus d) Tibialis Posterior a) Popliteus Origin:- Groove on lateral surface of lat. femoral condyle Insertion:- Triangular area on posterior surface of tibia b) Flexor Digitorum Longus Origin:- i. Upper 2/3rds of medial part of post. surface of tibia ii. Fascia covering tibialis posterior Insertion:- Plantar surface of base of distal phalanx of lateral 4 toes a) Flexor Hallucis Longus Origin:- i. Lower 3/4th of post. surface of fibula ii. Interosseous membrane Insertion:- Plantar surface of base of distal phalanx of great toe a) Tibialis Posterior Origin:- i. Upper 2/3rds of lat. Part of posterior surface of tibia ii. Post. Surface of fibula and interosseous membrane Insertion:- Tuberosity of navicular bone Posterior Tibial Artery • Larger terminal branch of Popliteal artery • Branches:- a.
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Rethinking the Evolution of the Human Foot: Insights from Experimental Research Nicholas B
© 2018. Published by The Company of Biologists Ltd | Journal of Experimental Biology (2018) 221, jeb174425. doi:10.1242/jeb.174425 REVIEW Rethinking the evolution of the human foot: insights from experimental research Nicholas B. Holowka* and Daniel E. Lieberman* ABSTRACT presumably owing to their lack of arches and mobile midfoot joints Adaptive explanations for modern human foot anatomy have long for enhanced prehensility in arboreal locomotion (see Glossary; fascinated evolutionary biologists because of the dramatic differences Fig. 1B) (DeSilva, 2010; Elftman and Manter, 1935a). Other studies between our feet and those of our closest living relatives, the great have documented how great apes use their long toes, opposable apes. Morphological features, including hallucal opposability, toe halluces and mobile ankles for grasping arboreal supports (DeSilva, length and the longitudinal arch, have traditionally been used to 2009; Holowka et al., 2017a; Morton, 1924). These observations dichotomize human and great ape feet as being adapted for bipedal underlie what has become a consensus model of human foot walking and arboreal locomotion, respectively. However, recent evolution: that selection for bipedal walking came at the expense of biomechanical models of human foot function and experimental arboreal locomotor capabilities, resulting in a dichotomy between investigations of great ape locomotion have undermined this simple human and great ape foot anatomy and function. According to this dichotomy. Here, we review this research, focusing on the way of thinking, anatomical features of the foot characteristic of biomechanics of foot strike, push-off and elastic energy storage in great apes are assumed to represent adaptations for arboreal the foot, and show that humans and great apes share some behavior, and those unique to humans are assumed to be related underappreciated, surprising similarities in foot function, such as to bipedal walking.
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5Th Metatarsal Fracture
FIFTH METATARSAL FRACTURES Todd Gothelf MD (USA), FRACS, FAAOS, Dip. ABOS Foot, Ankle, Shoulder Surgeon Orthopaedic You have been diagnosed with a fracture of the fifth metatarsal bone. Surgeons This tyPe of fracture usually occurs when the ankle suddenly rolls inward. When the ankle rolls, a tendon that is attached to the fifth metatarsal bone is J. Goldberg stretched. Because the bone is weaker than the tendon, the bone cracks first. A. Turnbull R. Pattinson A. Loefler All bones heal in a different way when they break. This is esPecially true J. Negrine of the fifth metatarsal bone. In addition, the blood suPPly varies to different I. PoPoff areas, making it a lot harder for some fractures to heal without helP. Below are D. Sher descriPtions of the main Patterns of fractures of the fifth metatarsal fractures T. Gothelf and treatments for each. Sports Physicians FIFTH METATARSAL AVULSION FRACTURE J. Best This fracture Pattern occurs at the tiP of the bone (figure 1). These M. Cusi fractures have a very high rate of healing and require little Protection. Weight P. Annett on the foot is allowed as soon as the Patient is comfortable. While crutches may helP initially, walking without them is allowed. I Prefer to Place Patients in a walking boot, as it allows for more comfortable walking and Protects the foot from further injury. RICE treatment is initiated. Pain should be exPected to diminish over the first four weeks, but may not comPletely go away for several months. Follow-uP radiographs are not necessary if the Pain resolves as exPected.
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A New Caenagnathid Dinosaur from the Upper Cretaceous Wangshi
www.nature.com/scientificreports OPEN A new caenagnathid dinosaur from the Upper Cretaceous Wangshi Group of Shandong, China, with Received: 12 October 2017 Accepted: 7 March 2018 comments on size variation among Published: xx xx xxxx oviraptorosaurs Yilun Yu1, Kebai Wang2, Shuqing Chen2, Corwin Sullivan3,4, Shuo Wang 5,6, Peiye Wang2 & Xing Xu7 The bone-beds of the Upper Cretaceous Wangshi Group in Zhucheng, Shandong, China are rich in fossil remains of the gigantic hadrosaurid Shantungosaurus. Here we report a new oviraptorosaur, Anomalipes zhaoi gen. et sp. nov., based on a recently collected specimen comprising a partial left hindlimb from the Kugou Locality in Zhucheng. This specimen’s systematic position was assessed by three numerical cladistic analyses based on recently published theropod phylogenetic datasets, with the inclusion of several new characters. Anomalipes zhaoi difers from other known caenagnathids in having a unique combination of features: femoral head anteroposteriorly narrow and with signifcant posterior orientation; accessory trochanter low and confuent with lesser trochanter; lateral ridge present on femoral lateral surface; weak fourth trochanter present; metatarsal III with triangular proximal articular surface, prominent anterior fange near proximal end, highly asymmetrical hemicondyles, and longitudinal groove on distal articular surface; and ungual of pedal digit II with lateral collateral groove deeper and more dorsally located than medial groove. The holotype of Anomalipes zhaoi is smaller than is typical for Caenagnathidae but larger than is typical for the other major oviraptorosaurian subclade, Oviraptoridae. Size comparisons among oviraptorisaurians show that the Caenagnathidae vary much more widely in size than the Oviraptoridae. Oviraptorosauria is a clade of maniraptoran theropod dinosaurs characterized by a short, high skull, long neck and short tail.
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Percutaneous Reduction Techniques
AAOS 2016 Specialty Day Orthopaedic Trauma Associacion (OTA) Percutaneous Reduction Techniques Christian Krettek Trauma Department, Hannover Medical School, Germany [email protected] www.mhh-unfallchirurgie.de Short segment tibial fractures can be stabilized using different implants like plates, screws, external fixators and nails. This syllabus deals mainly with reduction techniques in the context of the use of intramedullary nails. 1.1 PREOPERATIVE PLANNING AND MANAGEMENT 1.1.1 Primary shortening and secondary overdistraction eases definitive nailing In the acute setting primary shortening of a shaft fracture is a helpful strategy to de- crease soft tissue tension and intra-compartmental pressure. However, reduction gets more difficult and more time consuming, the longer the fracture is kept in a shortened position. The concept of primary shortening (acute phase) and secondary (after 3 or 4 days) overdistraction eases definitive nailing. Using a electro-mechanical load cell, our group has compared the reduction forces in patients undergoing femoral nailing after Damage Control in shortend vs overdistracted fracture configuration. In the overdistrac- tion group, the reduction forces were lower (200 N +/-43.1 N vs. 336 N +/- 51.9 N, p = 0.007) and the reduction time was shorter (5.8 min +/-4.0 min vs. 28.3 min +/-21.8 min, p = 0.056). It was concluded, that DCO with the fracture shortened leads to higher restrai- ning forces & prolonged reduction time. Overdistraction should be performed as soon as possible under careful soft-tissue monitoring [1a, 2a]. Primary shortening and secondary overdistraction eases definitive nailing Example of a femoral shaft fracture stabilized in shortening first with an external fixator.
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