Bony Landmarks of the Lower Extremity
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Lab #23 Anal Triangle
THE BONY PELVIS AND ANAL TRIANGLE (Grant's Dissector [16th Ed.] pp. 141-145) TODAY’S GOALS: 1. Identify relevant bony features/landmarks on skeletal materials or pelvic models. 2. Identify the sacrotuberous and sacrospinous ligaments. 3. Describe the organization and divisions of the perineum into two triangles: anal triangle and urogenital triangle 4. Dissect the ischiorectal (ischioanal) fossa and define its boundaries. 5. Identify the inferior rectal nerve and artery, the pudendal (Alcock’s) canal and the external anal sphincter. DISSECTION NOTES: The perineum is the diamond-shaped area between the upper thighs and below the inferior pelvic aperture and pelvic diaphragm. It is divided anatomically into 2 triangles: the anal triangle and the urogenital (UG) triangle (Dissector p. 142, Fig. 5.2). The anal triangle is bounded by the tip of the coccyx, sacrotuberous ligaments, and a line connecting the right and left ischial tuberosities. It contains the anal canal, which pierced the levator ani muscle portion of the pelvic diaphragm. The urogenital triangle is bounded by the ischiopubic rami to the inferior surface of the pubic symphysis and a line connecting the right and left ischial tuberosities. This triangular space contains the urogenital (UG) diaphragm that transmits the urethra (in male) and urethra and vagina (in female). A. Anal Triangle Turn the cadaver into the prone position. Make skin incisions as on page 144, Fig. 5.4 of the Dissector. Reflect skin and superficial fascia of the gluteal region in one flap to expose the large gluteus maximus muscle. This muscle has proximal attachments to the posteromedial surface of the ilium, posterior surfaces of the sacrum and coccyx, and the sacrotuberous ligament. -
The Axial Skeleton – Hyoid Bone
Marieb’s Human Anatomy and Physiology Ninth Edition Marieb Hoehn Chapter 7 The Axial and Appendicular Skeleton Lecture 14 1 Lecture Overview • Axial Skeleton – Hyoid bone – Bones of the orbit – Paranasal sinuses – Infantile skull – Vertebral column • Curves • Intervertebral disks –Ribs 2 The Axial Skeleton – Hyoid Bone Figure from: Saladin, Anatomy & Physiology, McGraw Hill, 2007 Suspended from the styloid processes of the temporal bones by ligaments and muscles The hyoid bone supports the larynx and is the site of attachment for the muscles of the larynx, pharynx, and tongue 3 1 Axial Skeleton – the Orbit See Fig. 7.6.1 in Martini and Fig. 7.20 in Figure: Martini, Right Hole’s Textbook Anatomy & Physiology, Optic canal – Optic nerve; Prentice Hall, 2001 opthalmic artery Superior orbital fissure – Oculomotor nerve, trochlear nerve, opthalmic branch of trigeminal nerve, abducens nerve; opthalmic vein F Inferior orbital fissure – Maxillary branch of trigeminal nerve E Z S L Infraorbital groove – M N Infraorbital nerve, maxillary branch of trigeminal nerve, M infraorbital artery Lacrimal sulcus – Lacrimal sac and tearduct *Be able to label a diagram of the orbit for lecture exam 4 Nasal Cavities and Sinuses Paranasal sinuses are air-filled, Figure: Martini, mucous membrane-lined Anatomy & Physiology, chambers connected to the nasal Prentice Hall, 2001 cavity. Superior wall of nasal cavities is formed by frontal, ethmoid, and sphenoid bones Lateral wall of nasal cavities formed by maxillary and lacrimal bones and the conchae Functions of conchae are to create swirls, turbulence, and eddies that: - direct particles against mucus - slow air movement so it can be warmed and humidified - direct air to superior nasal cavity to olfactory receptors 5 Axial Skeleton - Sinuses Sinuses are lined with mucus membranes. -
Medial Acetabular Wall Breach in Total Hip Arthroplasty – Is Full-Weight Bearing Possible?
Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2018 Medial Acetabular Wall Breach in Total Hip Arthroplasty - Is Full-Weight Bearing Possible? Mandelli, Filippo ; Tiziani, Simon ; Schmitt, Jürgen ; Werner, Clément M L ; Simmen, Hans-Peter ; Osterhoff, Georg Abstract: BACKGROUND A breach of the medial acetabular wall is a phenomenon seen frequently due to over-reaming during total hip arthroplasty (THA). The consequences of this issue are not fully understood particularly in cementless THA. A retrospective study was performed to answer whether: 1) immediate postoperative full-weight bearing in the presence of a medial acetabular wall breach after THA results in more short-term revisions of the acetabular component, 2) increases the risk for migration of the acetabular component? HYPOTHESIS Immediate full-weight bearing in the presence of a medial breach is not associated with an increased likelihood for acetabular-related revision surgery or migration of the cup. PATIENTS AND METHODS In this retrospective cohort study, consecutive patients (n=95; mean age 68±13 years; 67 female) who underwent THA with an uncemented acetabular component were identified and a retrospective chart review was performed (follow up 23±17 months, range6to79 months). The presence of a postoperative radiographic medial acetabular breach was documented and the need for revision surgery and the rate of acetabular component migration were assessed during follow-up. RESULTS Some extent of radiographic medial acetabular wall breach was seen in 26/95 patients (27%). With regard to the primary outcome, 2/95 patients (2%) required revision surgery during follow up. -
1 Anatomy – Lower Limb – Bones
Anatomy – Lower limb – Bones Hip (innominate) bone Acetabulum lat, pubic symph ant Ilium, pubis and ischium which fuse in Y-shaped epiphysis involving acetabulum Acetabulum - Articulates with head femur Ilium Iliac crest from ASIS to PSIS Gluteal surface - Three gluteal lines Glut max above superior Glut med between superior-middle Glut min between middle-inferior Pubis Obturator groove lodges obturator nerve/vessels Ischium L-shaped Ischial spine projects medially, divide greater/lesser sciatic notch Lesser sciatic notch forms lesser sciatic foramen due to bridging of sacrotuberous ligament Medial surface Pectineal line, arcuate line Lesser Sciatic Foramen Between lesser sciatic notch ilium and sacrotuberbous/sacrospinous ligaments Contents Tendon obturator internus, Int pudendal artery/vein, pudendal nerve Greater Sciatic Foramen Between greater sciatic notch ilium and sacrotuberbous/sacrospinous ligaments Contents Above Piriformis: sup gluteal vessels/nerve Below Piriformis: inf gluteal/int pudendal vessels; inf gluteal, pudendal, sciatic, post fem cutaneous nerves Femur Linea aspera and intercondylar fossa post Head hyaline cartilage Neck Upwards and medially G trochanter - Glut min ant, med post, Piri sup Obturator externus/internus in troch fossa Quadratus femoris L trochanter - Psoas major/iliacus Shaft Linea aspera middle 1/3 shaft posteriorly Vastus med/lat/int, Add magnus/longus/brevis, Quadratus femoris, Short head biceps, Pectineus Medial and lateral condyles Intercondylar fossa between, Patella surf ant Medial epicondyle - TCL, medial head gastroc Lateral epicondyle - FCL, plantaris, popliteus Articulations: talus, fibula, femur at patellofemoral joint Tibia Med mall lat, sharp ant border 1 Articulations - Femoral condyles, Talus, Fibula – prox/distal Tibial plateau Tubercles of intercondylar eminence Many ant horn med meniscus Amorous ant cruciate Ladies ant horn lat meniscus Like post horn lat meniscus My post horn med meniscus P…. -
Class Outline: Anterior Anatomy
Class Outline: Anterior Anatomy 5 minutes Attendance and Breath of Arrival 40 minutes Anterior muscles 10 minutes Quadriceps femoris OIA’s Classroom Rules Punctuality- everybody's time is precious: ◦ Be ready to learn by the start of class, we'll have you out of here on time ◦ Tardiness: arriving late, late return after breaks, leaving early The following are not allowed: ◦ Bare feet ◦ Side talking ◦ Lying down ◦ Inappropriate clothing ◦ Food or drink except water ◦ Phones in classrooms, clinic or bathrooms You will receive one verbal warning, then you'll have to leave the room. Anterior Anatomy Anterior Muscles Names, locations, and shapes The Big Picture Head and Neck (detailed later) Pectoralis Major (chest muscle) Rectus Abdominis (abs) External Obliques Serratus Anterior Deltoids Biceps Brachii (biceps) Forearm Flexors TFL (tensor fascia latae) Sartorius Quadriceps Femoris (quads) Adductors (inner leg muscles) Tibialis Anterior Peroneus Longus Review of Muscle Names Pectoralis major Rectus abdominis External obliques Serratus anterior Deltoid Biceps brachii Forearm flexors TFL Sartorius Quadriceps Tibialis anterior Peroneus longus Trapezius Rhomboids Levator scapula Erector spinae Lats Deltoid Triceps Forearm extensors Gluteus maximus Gluteus medius Biceps femoris Semitendinosus Semimembranosus Gastrocnemius Soleus Anterior Bones Giving names to the bones on the front of the body. The Big Picture Let’s Name the Bones! Skull Cervical Vertebrae (neck) Thoracic Vertebrae (upper back) and Ribs Thoracic Vertebrae (upper back) and Ribs -
Thigh Muscles
Lecture 14 THIGH MUSCLES ANTERIOR and Medial COMPARTMENT BY Dr Farooq Khan Aurakzai PMC Dated: 03.08.2021 INTRODUCTION What are the muscle compartments? The limbs can be divided into segments. If these segments are cut transversely, it is apparent that they are divided into multiple sections. These are called fascial compartments, and are formed by tough connective tissue septa. Compartments are groupings of muscles, nerves, and blood vessels in your arms and legs. INTRODUCTION to the thigh Muscles The musculature of the thigh can be split into three sections by intermuscular septas in to; Anterior compartment Medial compartment and Posterior compartment. Each compartment has a distinct innervation and function. • The Anterior compartment muscle are the flexors of hip and extensors of knee. • The Medial compartment muscle are adductors of thigh. • The Posterior compartment muscle are extensor of hip and flexors of knee. Anterior Muscles of thigh The muscles in the anterior compartment of the thigh are innervated by the femoral nerve (L2-L4), and as a general rule, act to extend the leg at the knee joint. There are three major muscles in the anterior thigh –: • The pectineus, • Sartorius and • Quadriceps femoris. In addition to these, the end of the iliopsoas muscle passes into the anterior compartment. ANTERIOR COMPARTMENT MUSCLE 1. SARTORIUS Is a long strap like and the most superficial muscle of the thigh descends obliquely Is making one of the tendon of Pes anserinus . In the upper 1/3 of the thigh the med margin of it makes the lat margin of Femoral triangle. Origin: Anterior superior iliac spine. -
Lateral Hip & Buttock Pain
Lateral Hip & Buttock Pain Contemporary Diagnostic & Management Strategies Potential sources of nociception in the lateral hip & buttock Lateral Hip & Buttock Pain Contemporary Diagnostic & Management Strategies Introduction Dr Alison Grimaldi BPhty, MPhty(Sports), PhD Australian Sports Physiotherapist Practice Principal Physiotec Adjunct Senior Research Fellow University of Queensland, Australia 12 Myofascial Structures Superficial Nerves Latissimus Dorsi Thoracodorsal IHGN Fascia EO SubCN TFL SCN’s: Superior Cluneal Nerves IO SCN’s MCN’s: Middle Cluneal Nerves GMed MCN’s ICN’s: Inferior Cluneal Nerves GMax Gluteal ITB Fascia PFCN: Posterior Femoral PFCN Cutaneous Nerve VL ICN’s IHGN: Iliohypogastric Nerve AM SubCN: Subcostal nerve ST SM BFLH EO:External Oblique; IO:Internal Oblique; GMed:Gluteus Medius; GMax:Gluteus Maximus; AM:Adductor Magnus; SM:Semimembranosis; ST:Semitendinosis; BFLH:Biceps Femoris Long Head; TFL: Tensor Fascia Lata; ITB:Iliotibial Band 34 Deeper posterolateral musculotendinous structures Major Bursae of the Lateral Hip & Buttock Axial MRI: Level of HOF Coronal MRI: Level of HOF Axial MRI: Level of IT GMed GMin Quadratus Lumborum Gluteus Medius SGMi HOF Gluteus Minimus Piriformis OI SGMe SGMa IS HO Superior Gemellus SGMa SGMi F Gluteus Medius & SGMe IT Minimus Tendons Obturator Internus Inferior Gemellus GMax OIB IG Quadratus femoris Obturator Internus Proximal hamstring tendons SGMa: Subgluteus Maximus (Trochanteric) Bursa; SGMe: Subgluteus Medius Bursa; SGMi: Subgluteus Minimus Bursa; OIB: Obturator Internus Bursa; -
Hip Joint: Embryology, Anatomy and Biomechanics
ISSN: 2574-1241 Volume 5- Issue 4: 2018 DOI: 10.26717/BJSTR.2018.12.002267 Ahmed Zaghloul. Biomed J Sci & Tech Res Review Article Open Access Hip Joint: Embryology, Anatomy and Biomechanics Ahmed Zaghloul1* and Elalfy M Mohamed2 1Assistant Lecturer, Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Mansoura University, Egypt 2Domenstrator, Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Mansoura University, Egypt Received: : December 11, 2018; Published: : December 20, 2018 *Corresponding author: Ahmed Zaghloul, Assistant Lecturer, Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Mansoura University, Egypt Abstract Introduction: Hip joint is matchless developmentally, anatomically and physiologically. It avails both mobility and stability. As the structural linkage between the axial skeleton and lower limbs, it plays a pivotal role in transmitting forces from the ground up and carrying forces from the trunk, head, neck and upper limbs down. This Article reviews the embryology, anatomy and biomechanics of the hip to give a hand in diagnosis, evaluation and treatment of hip disorders. Discussion: Exact knowledge about development, anatomy and biomechanics of hip joint has been a topic of interest and debate in literature dating back to at least middle of 18th century, as Hip joint is liable for several number of pediatric and adult disorders. The proper acting of the hip counts on the normal development and congruence of the articular surfaces of the femoral head (ball) and the acetabulum (socket). It withstands enormous loads from muscular, gravitational and joint reaction forces inherent in weight bearing. Conclusion: The clinician must be familiar with the normal embryological, anatomical and biomechanical features of the hip joint. -
A Variant Accessory Muscle of the Gluteus Maximus*
eISSN 1308-4038 International Journal of Anatomical Variations (2015) 8: 10–11 Case Report A variant accessory muscle of the gluteus maximus* Published online February 10th, 2015 © http://www.ijav.org Victor TAYLOR Abstract Geoffrey D. GUTTMANN Routine dissection of the gluteal region revealed an accessory muscle originating from the deep, inferior fibers of the gluteus maximus muscle. The described muscle was surrounded by a Rustin E. REEVES separate facial sheath and contained fibers that converged into a tendon with origins from both the gluteus maximus muscle and the iliotibial tract (band). This tendon inserted on the proximal Department of Integrative Physiology and Anatomy, femur lateral to the intertrochanteric crest, slightly superior to the upper border of the gluteal University of North Texas Health Science Center, Fort tuberosity. Typically, the inferior fibers of the gluteus maximus muscle will insert into the gluteal Worth, Texas, USA. tuberosity. This variant accessory muscle of the gluteus maximus seen with a separate muscle belly and tendinous insertion has not been previously described in the literature regarding the Rustin E. Reeves, PhD anatomy of the gluteal region. Professor and Vice Chair for © Int J Anat Var (IJAV). 2015; 8: 10–11. Anatomy Education Department of Integrative Physiology and Anatomy UNT Health Science Center 3500 Camp Bowie Blvd. Fort Worth, TX 76107, USA. +1 (817) 735-2050 [email protected] Received February 20th, 2014; accepted May 20th, 2014 Key words [gluteus] [maximus] [variant] [tuberosity] [iliotibial] Introduction Syndrome (GTPS), a variant accessory muscle originating The gluteus maximus muscle is the largest and most powerful from the gluteus maximus muscle was observed in the right muscle in the gluteal region of the body. -
Color Enhancement Strategies for 3D Printing of X-Ray Computed Tomography Bone Data for Advanced Anatomy Teaching Models
applied sciences Technical Note Color Enhancement Strategies for 3D Printing of X-ray Computed Tomography Bone Data for Advanced Anatomy Teaching Models Megumi Inoue 1,2, Tristan Freel 2, Anthony Van Avermaete 2 and W. Matthew Leevy 1,2,3,* 1 Department of Biological Sciences, 100 Galvin Life Science Center, University of Notre Dame, Notre Dame, IN 46556, USA; [email protected] 2 IDEA Center Innovation Lab, 1400 E Angela Blvd, South Bend, IN 46617, USA; [email protected] (T.F.); [email protected] (A.V.A.) 3 Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN 46556, USA * Correspondence: [email protected]; Tel.: +57-4631-1683 Received: 22 January 2020; Accepted: 17 February 2020; Published: 25 February 2020 Abstract: Three-dimensional (3D) printed anatomical models are valuable visual aids that are widely used in clinical and academic settings to teach complex anatomy. Procedures for converting human biomedical image datasets, like X-ray computed tomography (CT), to prinTable 3D files were explored, allowing easy reproduction of highly accurate models; however, these largely remain monochrome. While multi-color 3D printing is available in two accessible modalities (binder-jetting and poly-jet/multi-jet systems), studies embracing the viability of these technologies in the production of anatomical teaching models are relatively sparse, especially for sub-structures within a segmentation of homogeneous tissue density. Here, we outline a strategy to manually highlight anatomical subregions of a given structure and multi-color 3D print the resultant models in a cost-effective manner. Readily available high-resolution 3D reconstructed models are accessible to the public in online libraries. -
Pelvis & Thigh
Pelvis & Thigh 6 After meeting a stranger, you soon begin to palpate their piriformis Topographical Views 276 muscle (located deep in the posterior buttock). You certainly wouldn’t try Exploring the Skin and Fascia 277 this in “everyday life,” but in patient care settings this level of familiarity is Bones of the Pelvis and Thigh 278 commonplace—and welcomed by a client with a hypercontracted piriformis. Bony Landmarks of the Pelvis Touch is a unique privilege afforded to health care providers. As such, we and Thigh 279 need to be mindful of the trust our clients have in us. One way to insure this Overview: Bony Landmark Trails 284 is through good communication skills. For instance, working the adductors Overview: Muscles of the and gluteal region requires a practitioner to provide ample explanation as to Pelvis and Thigh 296 the rationale, need, and goals of working these intimate areas of the body. Synergists—Muscles Working This chapter might pose new challenges for you, as we will be palpating Together 302 structures close to intimate areas. Muscles of the Pelvis and Thigh 306 Ligaments and Other Before proceeding, consider the following questions: Structures of the Pelvis and Thigh 336 E Have you ever been anxious to undergo a physical exam? Was there anything the practitioner did or could have done to alleviate this anxiety? Consider multiple elements, including both verbal and nonverbal communication, draping, physical pressure, and pace. E Tissues and landmarks found in the pelvis and thigh tend to be significantly larger than those discussed in previous chapters. How might your palpation techniques need to change? E Also, how might you properly and comfortably position your patient to access structures needing to be palpated. -
Ilium, Pubis, and Ischium. What Kind of Joint Is This?? There Are 2 Pelvic Bones to Make up the Pelvic Girdle
The pelvis is also called the innominate bone—comprised of 3 bones fused together: ilium, pubis, and ischium. What kind of joint is this?? There are 2 pelvic bones to make up the pelvic girdle. Each pelvic bone is also called an os coxae (right and left). The sacrum forms the back of the pelvis. The pubic bones from the 2 innominate bones articulate with each other at the pubic symphysis (which will be addressed in a few slides). 1 *Remember the Ilium is the top part of the pelvic bone and articulates the pelvis with the spinal column through the sacrum.* Iliac crest—rounded top edge Anterior superior iliac spine—rounded anterior point Anterior inferior iliac spine—rounded pt below ASIS Posterior superior iliac spine—rounded posterior point Posterior inferior iliac spine—rounded pt below PSIS Greater sciatic notch—large groove below PIIS Gluteal lines—slash markings that are attachments for the gluteal muscles 2 The ilium is where you put your hands on your hips. 3 *Remember the Ischium is the posterior part of the pelvis bone. The ischial tuberosity is what you sit on. For those of you that have been told that you have a “bony butt” it is because the people you have sat on can feel your ischial tuberosities very well.* Ischial spine—pointy process below greater sciatic notch Lesser sciatic notch—below ischial spine Ischial tuberosity—rounded edge Ramus—before the fissure to the pubis; helps form the bridge 4 Notice the ramus helping form the bridge to the pubic bone. 5 *The pubic bone is the most anterior part of the innominate bone.