Bones, Part 1: the Axial Skeleton
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Diapositiva 1
Thoracic Cage and Thoracic Inlet Professor Dr. Mario Edgar Fernández. Parts of the body The Thorax Is the part of the trunk betwen the neck and abdomen. Commonly the term chest is used as a synonym for thorax, but it is incorrect. Consisting of the thoracic cavity, its contents, and the wall that surrounds it. The thoracic cavity is divided into 3 compartments: The central mediastinus. And the right and left pulmonary cavities. Thoracic Cage The thoracic skeleton forms the osteocartilaginous thoracic cage. Anterior view. Thoracic Cage Posterior view. Summary: 1. Bones of thoracic cage: (thoracic vertebrae, ribs, and sternum). 2. Joints of thoracic cage: (intervertebral joints, costovertebral joints, and sternocostal joints) 3. Movements of thoracic wall. 4. Thoracic cage. Thoracic apertures: (superior thoracic aperture or thoracic inlet, and inferior thoracic aperture). Goals of the classes Identify and describe the bones of the thoracic cage. Identify and describe the joints of thoracic cage. Describe de thoracic cage. Describe the thoracic inlet and identify the structures passing through. Vertebral Column or Spine 7 cervical. 12 thoracic. 5 lumbar. 5 sacral 3-4 coccygeal Vertebrae That bones are irregular, 33 in number, and received the names acording to the position which they occupy. The vertebrae in the upper 3 regions of spine are separate throughout the whole of life, but in sacral anda coccygeal regions are in the adult firmly united in 2 differents bones: sacrum and coccyx. Thoracic vertebrae Each vertebrae consist of 2 essential parts: An anterior solid segment: vertebral body. The arch is posterior an formed of 2 pedicles, 2 laminae supporting 7 processes, and surrounding a vertebral foramen. -
Synovial Joints Permit Movements of the Skeleton
8 Joints Lecture Presentation by Lori Garrett © 2018 Pearson Education, Inc. Section 1: Joint Structure and Movement Learning Outcomes 8.1 Contrast the major categories of joints, and explain the relationship between structure and function for each category. 8.2 Describe the basic structure of a synovial joint, and describe common accessory structures and their functions. 8.3 Describe how the anatomical and functional properties of synovial joints permit movements of the skeleton. © 2018 Pearson Education, Inc. Section 1: Joint Structure and Movement Learning Outcomes (continued) 8.4 Describe flexion/extension, abduction/ adduction, and circumduction movements of the skeleton. 8.5 Describe rotational and special movements of the skeleton. © 2018 Pearson Education, Inc. Module 8.1: Joints are classified according to structure and movement Joints, or articulations . Locations where two or more bones meet . Only points at which movements of bones can occur • Joints allow mobility while preserving bone strength • Amount of movement allowed is determined by anatomical structure . Categorized • Functionally by amount of motion allowed, or range of motion (ROM) • Structurally by anatomical organization © 2018 Pearson Education, Inc. Module 8.1: Joint classification Functional classification of joints . Synarthrosis (syn-, together + arthrosis, joint) • No movement allowed • Extremely strong . Amphiarthrosis (amphi-, on both sides) • Little movement allowed (more than synarthrosis) • Much stronger than diarthrosis • Articulating bones connected by collagen fibers or cartilage . Diarthrosis (dia-, through) • Freely movable © 2018 Pearson Education, Inc. Module 8.1: Joint classification Structural classification of joints . Fibrous • Suture (sutura, a sewing together) – Synarthrotic joint connected by dense fibrous connective tissue – Located between bones of the skull • Gomphosis (gomphos, bolt) – Synarthrotic joint binding teeth to bony sockets in maxillae and mandible © 2018 Pearson Education, Inc. -
Part 1 the Thorax ECA1 7/18/06 6:30 PM Page 2 ECA1 7/18/06 6:30 PM Page 3
ECA1 7/18/06 6:30 PM Page 1 Part 1 The Thorax ECA1 7/18/06 6:30 PM Page 2 ECA1 7/18/06 6:30 PM Page 3 Surface anatomy and surface markings The experienced clinician spends much of his working life relating the surface anatomy of his patients to their deep structures (Fig. 1; see also Figs. 11 and 22). The following bony prominences can usually be palpated in the living subject (corresponding vertebral levels are given in brackets): •◊◊superior angle of the scapula (T2); •◊◊upper border of the manubrium sterni, the suprasternal notch (T2/3); •◊◊spine of the scapula (T3); •◊◊sternal angle (of Louis) — the transverse ridge at the manubrio-sternal junction (T4/5); •◊◊inferior angle of scapula (T8); •◊◊xiphisternal joint (T9); •◊◊lowest part of costal margin—10th rib (the subcostal line passes through L3). Note from Fig. 1 that the manubrium corresponds to the 3rd and 4th thoracic vertebrae and overlies the aortic arch, and that the sternum corre- sponds to the 5th to 8th vertebrae and neatly overlies the heart. Since the 1st and 12th ribs are difficult to feel, the ribs should be enu- merated from the 2nd costal cartilage, which articulates with the sternum at the angle of Louis. The spinous processes of all the thoracic vertebrae can be palpated in the midline posteriorly, but it should be remembered that the first spinous process that can be felt is that of C7 (the vertebra prominens). The position of the nipple varies considerably in the female, but in the male it usually lies in the 4th intercostal space about 4in (10cm) from the midline. -
Unit 2 Lab 2
Unit 2, Lab 1 PTA/OTA 106 Regional A & P G. Blevins Updated: Fall 2011 SURFACE ANATOMY: VERTEBRAL COLUMN BONES [26] Jugular or suprasternal notch Vertebra (general features) Sternal angle Body Manubrium Neural arch Body of the sternum Pedicles Xiphisternal joint Laminae Costal margin Spinal (or vertebral) foramen Costal arch Transverse processes Anterior median line Spinous process Midclavicular lines Superior articulating processes Intermammary cleft Inferior articulating processes Axillary fossa Intervertebral foramen Anterior axillary line Intervertebral disc Anterior axillary fold Midaxillary line Thoracic vertebrae [12] Posterior axillary line Rib facets or demifacets Posterior median line Scapular lines Lumbar vertebrae [5] Epigastric fossa Lack rib facets and transverse Iliac crest foramina Umbilicus Linea alba Sacrum [1] Rectus abdominis Fused bone consisting of 5 Serratus anterior vertebrae Semilunar line Sacral promontory Sacral foramina (pelvic & dorsal) VERTEBRAL COLUMN- Auricular surface Special Features Coccyx [1] Normal Curves Fused bone consisting of 3-5 Primary: vertebrae Thoracic Sacral THORACIC BONES [25] Secondary: Sternum [1] Cervical Manubrium Lumbar Body (or gladiolus) Abnormal Curves Jugular (or suprasternal) notch Kyphosis Xiphoid process Lordosis Ribs [12 pair] Scoliosis Head Neck Tubercle Body (or shaft) Costal groove Costal cartilages Types of ribs True ribs False ribs Floating ribs PECTORAL (OR SHOULDER) GIRDLE Clavicles [2] Sternal extremity Acromial extremity Conoid tubercle Scapula [2] Borders: Superior -
Slipping Rib Syndrome
Slipping Rib Syndrome Jackie Dozier, BS Edited by Lisa E McMahon, MD FACS FAAP David M Notrica, MD FACS FAAP Case Presentation AA is a 12 year old female who presented with a 7 month history of right-sided chest/rib pain. She states that the pain was not preceded by trauma and she had never experienced pain like this before. She has been seen in the past by her pediatrician, chiropractor, and sports medicine physician for her pain. In May 2012, she was seen in the ER after having manipulations done on her ribs by a sports medicine physician. Pain at that time was constant throughout the day and kept her from sleeping. However, it was relieved with hydrocodone/acetaminophen in the ER. Case Presentation Over the following months, the pain became progressively worse and then constant. She also developed shortness of breath. She is a swimmer and says she has had difficulty practicing due to the pain and SOB. AA was seen by a pediatric surgeon and scheduled for an interventional pain management service consult for a test injection. Following good temporary relief by local injection, she was scheduled costal cartilage removal to treat her pain. What is Slipping Rib Syndrome? •Slipping Rib Syndrome (SRS) is caused by hypermobility of the anterior ends of the false rib costal cartilages, which leads to slipping of the affected rib under the superior adjacent rib. •SRS an lead to irritation of the intercostal nerve or strain of the muscles surrounding the rib. •SRS is often misdiagnosed and can lead to months or years of unresolved abdominal and/or thoracic pain. -
Structure of the Human Body
STRUCTURE OF THE HUMAN BODY Vertebral Levels 2011 - 2012 Landmarks and internal structures found at various vertebral levels. Vertebral Landmark Internal Significance Level • Bifurcation of common carotid artery. C3 Hyoid bone Superior border of thyroid C4 cartilage • Larynx ends; trachea begins • Pharynx ends; esophagus begins • Inferior thyroid A crosses posterior to carotid sheath. • Middle cervical sympathetic ganglion C6 Cricoid cartilage behind inf. thyroid a. • Inferior laryngeal nerve enters the larynx. • Vertebral a. enters the transverse. Foramen of C 6. • Thoracic duct reaches its greatest height C7 Vertebra prominens • Isthmus of thyroid gland Sternoclavicular joint (it is a • Highest point of apex of lung. T1 finger's breadth below the bismuth of the thyroid gland T1-2 Superior angle of the scapula T2 Jugular notch T3 Base of spine of scapula • Division between superior and inferior mediastinum • Ascending aorta ends T4 Sternal angle (of Louis) • Arch of aorta begins & ends. • Trachea ends; primary bronchi begin • Heart T5-9 Body of sternum T7 Inferior angle of scapula • Inferior vena cava passes through T8 diaphragm T9 Xiphisternal junction • Costal slips of diaphragm T9-L3 Costal margin • Esophagus through diaphragm T10 • Aorta through diaphragm • Thoracic duct through diaphragm T12 • Azygos V. through diaphragm • Pyloris of stomach immediately above and to the right of the midline. • Duodenojejunal flexure to the left of midline and immediately below it Tran pyloric plane: Found at the • Pancreas on a line with it L1 midpoint between the jugular • Origin of Superior Mesenteric artery notch and the pubic symphysis • Hilum of kidneys: left is above and right is below. • Celiac a. -
Epithelia Joitns
NAME LOCATION STRUCTURE FUNCTION MOVEMENT Temporomandibular joint Condylar head of ramus of Synovial Diarthrosis Modified hinge joint mandible and glenoid fossa of Rotation and gliding temporal bone Biaxial Zygapophyseal joint Between articular processes of Synovial Diarthrosis Gliding 2 adjacent vertebrae Non axial Atlanto-Occipital joints Atlas and occipital condyle of Synovial Diarthrosis Ellipsoid occipital bone Biaxial Atlantoaxial joints Atlas and axis Synovial Diarthrosis Pivot Uniaxial Joints of vertebral arches Ligaments Fibrous Amphiarthrosis Syndesmoses Intervertebral symphyseal Intervertebral disk between 2 Cartilaginous Amphiarthrosis joints vertebrae Symphysis Costovertebral Head of ribs and body of Synovial Diarthrosis Gliding thoracic vertebra Non axial Costotrasnverse joints Tubercle of rib and transverse Synovial Diarthrosis Gliding process of thoracic vertebra Non axial Lumbosacral Joint Left and right zygopophyseal Laterally Synovial joint Intervertebral symphyseal joint Symphysis SternoclavicularJoint Clavicular notch articulates Synovial Diarthrosis Gliding with medial ends of clavicle Non Axial Manubriosternal Joint Hyaline cartilage junction Cartilaginous Synarthrosis Sternal Angle between manubrium and body Symphysis Xiphisternal Joint Cartilage between xiphoid Synchondrosis Synarthrosis process and body Synostoses Sternocostal Joint (1st) Costocartilage 1 with sternum Cartilaginous Synchondrosis Synarthrosis NAME Location Section Anterior longitudinal runs down anterior surface of vertebral body Vertebral column ligament Posterior longitudinal in canal, runs down posterior surface of vertebral body ligament Interspinous ligament Connects spinous processes Ligamentum flavum Connects laminae ! Intra-articular Disc Between articulating surface of sternum and clavicle Sternoclavicular Joint Costoclavicular ligament 1st rib to clavicle !. -
Posterior Longitudinal Ligament Status in Cervical Spine Bilateral Facet Dislocations
Thomas Jefferson University Jefferson Digital Commons Department of Orthopaedic Surgery Faculty Papers Department of Orthopaedic Surgery November 2005 Posterior longitudinal ligament status in cervical spine bilateral facet dislocations John A. Carrino Harvard Medical School & Brigham and Women's Hospital Geoffrey L. Manton Thomas Jefferson University Hospital William B. Morrison Thomas Jefferson University Hospital Alex R. Vaccaro Thomas Jefferson University Hospital and The Rothman Institute Mark E. Schweitzer New York University & Hospital for Joint Diseases Follow this and additional works at: https://jdc.jefferson.edu/orthofp Part of the Orthopedics Commons LetSee next us page know for additional how authors access to this document benefits ouy Recommended Citation Carrino, John A.; Manton, Geoffrey L.; Morrison, William B.; Vaccaro, Alex R.; Schweitzer, Mark E.; and Flanders, Adam E., "Posterior longitudinal ligament status in cervical spine bilateral facet dislocations" (2005). Department of Orthopaedic Surgery Faculty Papers. Paper 3. https://jdc.jefferson.edu/orthofp/3 This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in Department of Orthopaedic Surgery Faculty Papers by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected]. -
Chapter 02: Netter's Clinical Anatomy, 2Nd Edition
Hansen: Netter's Clinical Anatomy, 2nd Edition - with Online Access 2 BACK 1. INTRODUCTION 4. MUSCLES OF THE BACK REVIEW QUESTIONS 2. SURFACE ANATOMY 5. SPINAL CORD 3. VERTEBRAL COLUMN 6. EMBRYOLOGY FINAL 1. INTRODUCTION ELSEVIERl VertebraeNOT prominens: the spinous process of the C7- vertebra, usually the most prominent The back forms the axis (central line) of the human process in the midline at the posterior base of body and consists of the vertebral column, spinal cord, the neck supporting muscles, and associated tissues (skin, OFcon- l Scapula: part of the pectoral girdle that sup- nective tissues, vasculature, and nerves). A hallmark of ports the upper limb; note its spine, inferior human anatomy is the concept of “segmentation,” and angle, and medial border the back is a prime example. Segmentation and bilat l Iliac crests: felt best when you place your eral symmetry of the back will be obvious as you hands “on your hips”; an imaginary horizontal study the vertebral column, the distribution of the line connecting the crests passes through the spinal nerves, the muscles of th back, and its vascular spinous process of the L4 vertebra and the supply. intervertebral disc of L4-L5, a useful landmark Functionally, the back is involved in three primary for a lumbar puncture or epidural block tasks: l Posterior superior iliac spines: an imaginary CONTENThorizontal line connecting these two points l Support: the vertebral column forms the axis of passes through the spinous process of S2 (second the body and is critical for our upright posture sacral segment) (standing or si ting), as a support for our head, as an PROPERTYattachment point and brace for move- 3. -
1 the Thoracic Wall I
AAA_C01 12/13/05 10:29 Page 8 1 The thoracic wall I Thoracic outlet (inlet) First rib Clavicle Suprasternal notch Manubrium 5 Third rib 1 2 Body of sternum Intercostal 4 space Xiphisternum Scalenus anterior Brachial Cervical Costal cartilage plexus rib Costal margin 3 Subclavian 1 Costochondral joint Floating ribs artery 2 Sternocostal joint Fig.1.3 3 Interchondral joint Bilateral cervical ribs. 4 Xiphisternal joint 5 Manubriosternal joint On the right side the brachial plexus (angle of Louis) is shown arching over the rib and stretching its lowest trunk Fig.1.1 The thoracic cage. The outlet (inlet) of the thorax is outlined Transverse process with facet for rib tubercle Demifacet for head of rib Head Neck Costovertebral T5 joint T6 Facet for Tubercle vertebral body Costotransverse joint Sternocostal joint Shaft 6th Angle rib Costochondral Subcostal groove joint Fig.1.2 Fig.1.4 A typical rib Joints of the thoracic cage 8 The thorax The thoracic wall I AAA_C01 12/13/05 10:29 Page 9 The thoracic cage Costal cartilages The thoracic cage is formed by the sternum and costal cartilages These are bars of hyaline cartilage which connect the upper in front, the vertebral column behind and the ribs and intercostal seven ribs directly to the sternum and the 8th, 9th and 10th ribs spaces laterally. to the cartilage immediately above. It is separated from the abdominal cavity by the diaphragm and communicates superiorly with the root of the neck through Joints of the thoracic cage (Figs 1.1 and 1.4) the thoracic inlet (Fig. -
Successful Treatment of Supraspinous and Interspinous Ligament Injury with Ultrasound-Guided Platelet-Rich Plasma Injection
HSSXXX10.1177/1556331621992312HSS Journal®: The Musculoskeletal Journal of Hospital for Special SurgeryCreighton et al 992312case-report2021 Case Report HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery Successful Treatment of Supraspinous 1 –4 © The Author(s) 2021 Article reuse guidelines: and Interspinous Ligament Injury sagepub.com/journals-permissions DOI:https://doi.org/10.1177/1556331621992312 10.1177/1556331621992312 With Ultrasound-Guided Platelet-Rich journals.sagepub.com/home/hss Plasma Injection: Case Series Andrew Creighton, DO1, Roger A. Sanguino, MS1, Jennifer Cheng, PhD1, and James F. Wyss, MD, PT1 Keywords supraspinous ligament, interspinous ligament, platelet-rich plasma, ultrasound, nonoperative treatments, lumbar spine Received October 18, 2020. Accepted October 21, 2020. Introduction running volume. The LBP intensity ranged from 3 to 9/10 and was worse with prolonged standing, sitting, or running. Low back pain (LBP) is a very common complaint and is He reported no improvement with 3 prior courses of PT, now the number one cause of disability across the globe NSAIDs, and use of a seat cushion. Physical examination [5,13]. Both the supraspinous ligament (SSL) and interspi- revealed mild right thoracolumbar curvature. Tenderness nous ligament (ISL) form part of the posterior ligamentous was appreciated over the L5 spinous process and interspi- complex, which is believed to play an integral role in the nous region above and below L5. Strength, sensation, and stability of the thoracolumbar spine [8]. The SSL begins at reflexes were normal. the C7 spinous process and extends to L3 and L4 in 22% Radiographs were unremarkable. Magnetic resonance and 74% of adults, respectively [11]. -
Pictorial Essay
EDUCATIONAL REVIEW ER_024 Pictorial essay. ZATTAR-RAMOS, L.C.1* LEÃO, R.V. 1 CAVALCANTI, C.F.A.1 BORDALO-RODRIGUES, M.1 1 LEITE, C.C. HOSPITAL SÍRIO-LIBANÊS, 1 São Paulo – SP, Brazil. CERRI, G.G. *[email protected] 1Department of Radiology ▶ DISCLOSURE PARAGRAPHS: - The authors of this educational review declare no relationships with any companies, whose products or services may be related to the subject matter of the article. - The authors state that this work has not received any funding. ▶ INTRODUCTION: - Sternal abnormalities are commonly seen in clinical practice. - In addition to the numerous anatomical variations and congenital anomalies, the sternum and sternoclavicular joints can be affected by various pathological conditions such as trauma, infection, tumors, degenerative and inflammatory changes. - This study aims to demonstrate and illustrate such conditions, as the knowledge of its characteristics and imaging findings are essential for correct diagnosis and patient management. ▶ DISCUSSION: - Sternum injuries are common and should be properly recognized and characterized; using different imaging methods we will illustrate the variations of normality, congenital abnormalities and characteristic radiographic findings of sternal lesions highlighting: psoriatic arthritis, inflammatory osteitis, SAPHO syndrome, neoplastic, traumatic and degenerative lesions. ▶ ANATOMY: STERNUM: Flat bone, with 3 parts: *MANUBRIUM: superior central (jugular) notch and 2 lateral fossae that articulate with the MANUBRIUM clavicles. Also articulates with the 1o and 2o ribs and the body of the sternum. - Atachments: sternohyoideus, sternothyroideus, subclavius, pectoralis major, transversus thoracis and sternocleidomastoideus muscles. BODY OF *BODY OF THE STERNUM: articulates with the THE manubrium, xiphoid process and with the 2o STERNUM through 7o ribs.