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MASARYK UNIVERSITY FACULTY OF MEDICINE ANATOMY 1 LOCOMOTOR SYSTEM LIBOR PÁČ LADISLAVA HORÁČKOVÁ HANA NECHUTOVÁ BRNO 2011 Anatomy is one of elementary fields of study of medicine that the future physicians comes in contact with. It is a science of form, organisation, structure, and posture of human body and its parts. It includes not only forms and structures, which are accessible to a human eye (macroscopic), but also structures, which we can only observe after microscopic maximalisation (microscopic). Thus, we can differentiate between macroscopic anatomy and microscopic anatomy. Anatomy is often incorrectly called morphology. Morphology is more general term than anatomy; it represents the summary of all knowledge about organ form and structure, with respect to its development. The following fields can be classified as morphology fields: anatomy, histology, microscopic anatomy, embryology, cytology, physical anthropology and in clinical sense also pathology (pathological anatomy). Anatomy can be studied from various aspects, directions and for various purposes. The elementary anatomical body position For establishing directions is upright position, upper extremities hanging alongside the body with palms inverted forward. In this position, thumb is the external finger; little finger is the internal finger. Basic planes of the body For purposes of spatial orientation. All three types of planes are mutually perpendicular. o sagittal planes – they pass through the body or organ front to back (like arrow) and divide them into two unequal parts. Median plane a special case of sagittal surfaces, which passes through the body or organ also front to back, but it divides them (theoretically) into two equal parts (halves) o frontal planes – are vertical, parallel with front (front – frons in Latin) and divides a body or an organ into frontal part and rear part o transversal planes passe through the body or organ diagonally and divide them into upper part and lower part Axes Axis originate in the point of intersection of the above planes (longitudinal, sagittal, and transversal). Establishing the directions in the body In the trunk, on the longitudinal axis, we use this indication: cranialis (superior) – direction towards the head, upper (Latin cranium – skull) caudalis (inferior) – direction towards the lower part of body, lower (Latin cauda – tail) On the sagittal axis: ventralis (anterior) – frontal (Latin venter – abdomen) dorsalis (posterior) – backward, rear (Latin dorsum – back) On the transversal axis: lateralis – external, lying further from the median surface (Latin latus – side) medialis – internal, lying closer to median surface middle – intermedius, if we are to determine the middle formation from the formations, where two are in lateral positions, and the third is in-between From other directions: internus – internal externus – external dexter – right sinister – left superficialis – superficial profundus – deep On both extremities, instead of cranialis and caudalis we use the following terms: proximalis – closer from joining extremity to trunk distalis – more distant from joining extremity to trunk In upper extremity: ulnaris – internal, on the ulnar side of bone – ulna radialis – external, on radial side of bone – radius palmaris – palmar, direction in palm (Latin palma – palm) dorsalis – dorsal, direction to the back, dorsum of palm In lower extremity: tibialis – internal, on the inner side of shin bone – tibia fibularis – external, on the side of calf bone – fibula plantaris – solar, direction to the sole of feet (Latin planta – sole, plant sole) dorsalis – dorsal, direction to the dorsum of feet Main parts of human body The body trunk consists of head – caput, neck – collum (its dorsal part name is isthmus – nucha) and trunk – truncus. On the trunk we differentiate chest – thorax (its frontal part is thorax – pectus and dorsal back – dorsum), next belly – abdomen (its dorsal part is indicated as shoulder – lumbus), pelvis – pelvis (with rear part buttocks – nates or clunes). Extremities include right and left upper extremity – membrum superius dextrum et sinistrum and lower right and left extremity – membrum inferius dextrum et sinistrum. Extremities consist of plexus (cingulum membri superioris et inferioris) and free extremity. Free upper extremity consists of arm – brachium, forearm – antebrachium and hand – manus with palm – palma manus, dorsum hand – dorsum manus and fingers – digiti manus. Free lower extremity include thigh – femur, shin – crus (its dorsal side is called a calf – sura) and foot – pes (where the sole is called as planta pedis and dorsal side of foot – dorsum pedis) and toes – digiti pedis. BONE SYSTEM (SYSTEMA SKELETALE, OSTEOLOGY) I. GENERAL OSTEOLOGY The skeleton (skeleton) forms firm, solid and mobile support of body. Together with the system of joints it also forms passive locomotive apparatus (muscles represent the active locomotive apparatus). The skeletal system also forms protective capsules for important organs, such as brain, sensual organs, heart, lungs and others. Skeleton system also has other important function, such as being a deposit of mineral substances; its red bone marrow is organ of haematopoiesis, fat cells of yellow bone marrow are an important source of energy. The bone skeleton of each human consists of 202 bones. Skeleton of each adult human weighs about 12 to 14 kg, i.e. about 16 % of body weight. Knowledge of skeleton bones, their parts, surfaces, formations, channels and holes is an essential pre-requisite for understanding chapters of much greater anatomical importance – skeleton as a whole, its spaces and parts, holes, channels, and slits for vessels and nerves, attachments of muscles and ligaments. Classification of bones A bone – os is an elementary construction element of a skeleton. Based on their form, we classify bones into five basic categories: o long bones – ossa longa (e.g. forearm bones) o short bones – ossa brevia (e.g. wrist bones) o flat bones – ossa plana (e.g. shoulder blade) o pneumatized bones – ossa pneumatica (e.g. frontal bone) o irregular formed bones – ossa irregularia (e.g. maxilla) o sezamoidal bones – ossa sesamoidea (e.g. kneecap) Long bones are characterized by its tubous middle sections, to which terminal parts are connected, usually forming joint heads or joint pits covered with joint cartilage. The middle section of long bone (diaphysis) is hollow, often cylindrical. Its jacket forms compact bone (substantia compacta). Hollow part of the diafysis is called the medullar cavity (cavitas medullaris) and it is filled with bone marrow (medulla ossium). Epiphyses (epiphysis) are at both ends filled by spongious bone tissue (substantia spongiosa), which is surrounded by thin layer of compact bone (corticalis). Epiphyses and diaphysis are separated by growth cartilage, epiphyseal (growth) cartilage (cartilago epiphysialis) in course of bone growth. Short bones usually have various shapes; they have thin corticallis on the surface, and spongious bone on the inside. Joint areas form a big part of their surface. Flat bones are formed by external and internal layer of compacta (lamina externa and lamina interna), the spongiosis in-between is called as diploe. They are typical for skull bones. Pneumatized bones have a hollow cavity inside, covered with mucous membrane. They are created by exvagination of the surrounding mucous membrane into the bone (e.g. from nasal cavity into frontal cavity). Saesamoidal bones originate in muscle ligaments, which help in their function or they protect the joint, which has a ligament passing through. Bone structure The bone is formed by two elementary forms of bone tissue (compact and spongiose). Compact – compact bone (substantia compacta) in humans is formed by lamellar bone, which is characteristically organised into concentric lamellas. Havers lamells create concentric cylinders (in the cross-section these are visible as circles) around the bone vessels. The lamellas system around one vessel forms elementary construction bone unit – osteon. On the bone grinding we find in the middle the Havers channel – the remainder of the original vessel can be found inside on the bone grinding. Intersected lamells – are the remnants of the previous ostheons, which were disrupted by bone reconstruction, and replaced with new Havers systems. Superficial lamells – were created by periostal ossification and bone apposition from cambial layers of periost, these don’t form ostheons. Spongiose – spongious bone (substantia spongiosa) forms frames, which are organised either quite irregularly (diploe of flat skull bones) or they are oriented into certain directions (due to pressure on the bone, they are organised into geometrical shapes – trajectories, which in spatial net optimally transmit pressures into the entire bone matter). This organisation of bone trabecules of spongious bone is called bone architectonics. The spongious trabecules are located in short bones, in diploe of flat bones and in epiphyses and metaphases of long bones of extremities. Due to the changes of functional use of the respective bone, the architectonics of bone tissue also changes. Bone marrow (medulla ossium) – fills all hollows cavities in a bone. It is a haematopoietic tissue, which in a living human is of red, yellow or grey color. Red bone marrow (medulla ossium rubra) is active haematopoietic tissue. It is formed by network of reticular connecting tissue, in which red blood cells and blood platelets are created. In adults red marrow is present