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Ligaments of the Costovertebral Joints Including Biomechanics, Innervations, and Clinical Applications: a Comprehensive Review W
Open Access Review Article DOI: 10.7759/cureus.874 Ligaments of the Costovertebral Joints including Biomechanics, Innervations, and Clinical Applications: A Comprehensive Review with Application to Approaches to the Thoracic Spine Erfanul Saker 1 , Rachel A. Graham 2 , Renee Nicholas 3 , Anthony V. D’Antoni 2 , Marios Loukas 1 , Rod J. Oskouian 4 , R. Shane Tubbs 5 1. Department of Anatomical Sciences, St. George's University School of Medicine, Grenada, West Indies 2. Department of Anatomy, The Sophie Davis School of Biomedical Education 3. Department of Physical Therapy, Samford University 4. Neurosurgery, Complex Spine, Swedish Neuroscience Institute 5. Neurosurgery, Seattle Science Foundation Corresponding author: Erfanul Saker, [email protected] Abstract Few studies have examined the costovertebral joint and its ligaments in detail. Therefore, the following review was performed to better elucidate their anatomy, function and involvement in pathology. Standard search engines were used to find studies concerning the costovertebral joints and ligaments. These often- overlooked ligaments of the body serve important functions in maintaining appropriate alignment between the ribs and spine. With an increasing interest in minimally invasive approaches to the thoracic spine and an improved understanding of the function and innervation of these ligaments, surgeons and clinicians should have a good working knowledge of these structures. Categories: Neurosurgery, Orthopedics, Rheumatology Keywords: costovertebral joint, spine, anatomy, thoracic Introduction And Background The costovertebral joint ligaments are relatively unknown and frequently overlooked anatomical structures [1]. Although small and short in size, they are abundant, comprising 108 costovertebral ligaments in the normal human thoracic spine, and they are essential to its stability and function [2-3]. -
The Morphometric Study of Occurrence and Variations of Foramen Ovale S
Research Article The morphometric study of occurrence and variations of foramen ovale S. Ajrish George*, M. S. Thenmozhi ABSTRACT Background: Foramen vale is one of the important foramina present in the sphenoid bone. Anatomically it is located in the greater wing of the sphenoid bone. The foramen ovale is situated posterolateral to the foramen rotundum and anteromedial to the foramen spinosum. The foramen spinosum is present posterior to the foramen ovale. The carotid canal is present posterior and medial to the foramen spinosum and the foramen rotundum is present anterior to the foramen ovale. The structures which pass through the foramen ovale are the mandibular nerve, emissary vein, accessory middle meningeal artery, and lesser petrosal nerve. The sphenoid bone has a body, a pair of greater wing, pair of lesser wing, pair of lateral pterygoid plate, and a pair of medial pterygoid plate. Aim: The study involves the assessment of any additional features in foramen ovale in dry South Indian skulls. Materials and Methods: This study involves examination of dry adult skulls. First, the foramen ovale is located, and then it is carefully examined for presence of alterations and additional features, and is recorded following computing the data and analyzing it. Results: The maximum length of foramen ovale on the right and left was 10.1 mm, 4.3 mm, respectively. The minimum length of the foramen in right and left was 9.1 mm, 3.2 mm, respectively. The maximum width of foramen ovale on the right and left was 4.8 mm and 2.3 mm, respectively. The minimum width of the foramen in the right and the left side was 5.7 mm and 2.9 mm, respectively. -
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C01 10/31/2017 11:23:53 Page 1 1 1 The Normal Anatomy of the Neck David Bainbridge Introduction component’ of the neck is a common site of pathology, and the diverse forms of neck The neck is a common derived characteristic disease reflect the sometimes complex and of land vertebrates, not shared by their aquatic conflicting regional variations and functional ancestors. In fish, the thoracic fin girdle, the constraints so evident in this region [2]. precursor of the scapula, coracoid and clavi- Unlike the abdomen and thorax, there is no cle, is frequently fused to the caudal aspect of coelomic cavity in the neck, yet its ventral part the skull. In contrast, as vertebrates emerged is taken up by a relatively small ‘visceral on to the dry land, the forelimb separated from compartment’, containing the larynx, trachea, the head and the intervening vertebrae speci- oesophagus and many important vessels, alised to form a relatively mobile region – the nerves and endocrine glands. However, I neck – to allow the head to be freely steered in will not review these structures, as they do many directions. not represent an extension of the equine ‘back’ With the exception of the tail, the neck in the same way that the more dorsal locomo- remains the most mobile region of the spinal tor region does. column in modern-day horses. It permits a wide range of sagittal plane flexion and exten- sion to allow alternating periods of grazing Cervical Vertebrae 3–7 and predator surveillance, as well as frontal plane flexion to allow the horizon to be scan- Almost all mammals, including the horse, ned, and rotational movement to allow possess seven cervical vertebrae, C1 to C7 nuisance insects to be flicked off. -
Gross Anatomy Assignment Name: Olorunfemi Peace Toluwalase Matric No: 17/Mhs01/257 Dept: Mbbs Course: Gross Anatomy of Head and Neck
GROSS ANATOMY ASSIGNMENT NAME: OLORUNFEMI PEACE TOLUWALASE MATRIC NO: 17/MHS01/257 DEPT: MBBS COURSE: GROSS ANATOMY OF HEAD AND NECK QUESTION 1 Write an essay on the carvernous sinus. The cavernous sinuses are one of several drainage pathways for the brain that sits in the middle. In addition to receiving venous drainage from the brain, it also receives tributaries from parts of the face. STRUCTURE ➢ The cavernous sinuses are 1 cm wide cavities that extend a distance of 2 cm from the most posterior aspect of the orbit to the petrous part of the temporal bone. ➢ They are bilaterally paired collections of venous plexuses that sit on either side of the sphenoid bone. ➢ Although they are not truly trabeculated cavities like the corpora cavernosa of the penis, the numerous plexuses, however, give the cavities their characteristic sponge-like appearance. ➢ The cavernous sinus is roofed by an inner layer of dura matter that continues with the diaphragma sellae that covers the superior part of the pituitary gland. The roof of the sinus also has several other attachments. ➢ Anteriorly, it attaches to the anterior and middle clinoid processes, posteriorly it attaches to the tentorium (at its attachment to the posterior clinoid process). Part of the periosteum of the greater wing of the sphenoid bone forms the floor of the sinus. ➢ The body of the sphenoid acts as the medial wall of the sinus while the lateral wall is formed from the visceral part of the dura mater. CONTENTS The cavernous sinus contains the internal carotid artery and several cranial nerves. Abducens nerve (CN VI) traverses the sinus lateral to the internal carotid artery. -
Questions on Human Anatomy
Standard Medical Text-books. ROBERTS’ PRACTICE OF MEDICINE. The Theory and Practice of Medicine. By Frederick T. Roberts, m.d. Third edi- tion. Octavo. Price, cloth, $6.00; leather, $7.00 Recommended at University of Pennsylvania. Long Island College Hospital, Yale and Harvard Colleges, Bishop’s College, Montreal; Uni- versity of Michigan, and over twenty other medical schools. MEIGS & PEPPER ON CHILDREN. A Practical Treatise on Diseases of Children. By J. Forsyth Meigs, m.d., and William Pepper, m.d. 7th edition. 8vo. Price, cloth, $6.00; leather, $7.00 Recommended at thirty-five of the principal medical colleges in the United States, including Bellevue Hospital, New York, University of Pennsylvania, and Long Island College Hospital. BIDDLE’S MATERIA MEDICA. Materia Medica, for the Use of Students and Physicians. By the late Prof. John B Biddle, m.d., Professor of Materia Medica in Jefferson Medical College, Phila- delphia. The Eighth edition. Octavo. Price, cloth, $4.00 Recommended in colleges in all parts of the UnitedStates. BYFORD ON WOMEN. The Diseases and Accidents Incident to Women. By Wm. H. Byford, m.d., Professor of Obstetrics and Diseases of Women and Children in the Chicago Medical College. Third edition, revised. 164 illus. Price, cloth, $5.00; leather, $6.00 “ Being particularly of use where questions of etiology and general treatment are concerned.”—American Journal of Obstetrics. CAZEAUX’S GREAT WORK ON OBSTETRICS. A practical Text-book on Midwifery. The most complete book now before the profession. Sixth edition, illus. Price, cloth, $6.00 ; leather, $7.00 Recommended at nearly fifty medical schools in the United States. -
Anatomic Variations of the Nose and Paranasal Sinuses in Saudi Population
234 Original article Anatomic variations of the nose and paranasal sinuses in saudi population: computed tomography scan analysis Nada Alshaikha, Amirah Aldhuraisb aDepartment of Otolaryngology Head & Neck Background Surgery, Rhinology Unit, Dammam Medical Knowledge of the anatomy constitutes an integral part in the total management of Complex (DMC), bDepartment of ENT, King Fahad Specialist Hospital (KFSH), Dammam, patients with sinonasal diseases. The aim of this study was to obtain the prevalence Saudi Arabia of sinonasal anatomic variations in Saudi population and to understand their importance and impact on the disease process, as well as their influence on Correspondence to Nada Alshaikh, MD, Department of Otorhinolaryngology Head and surgical management and outcome. Neck Surgery, Dammam Medical Complex, Materials and methods Dammam - 31414, Saudi Arabia This study is prospective review of retrospectively performed normal computed e-mail: [email protected] tomography (CT) scans of the nose and paranasal sinuses in adult Saudi Received 13 November 2016 population at Dammam Medical Complex. The scans were reviewed by two Accepted 23 December 2016 independent observers. The Egyptian Journal of Otolaryngology Results 2018, 34:234–241 Of all CT scans that were reviewed, 48.4% were of female patients and 51.6% were of male patients. The mean age of the study sample was 38.5±26.5 years. The most common anatomic variation after excluding agger nasi cell was pneumatized crista galli, which was seen in 73% of the scans. However, the least common variation seen in this series was hypoplasia of the maxillary sinus, which was encountered in 5% of the cases. We did not detect a single pneumatized inferior turbinate among the studied scans. -
Para Nasal Sinusitis : a Problem for the General Practitioner
University of Nebraska Medical Center DigitalCommons@UNMC MD Theses Special Collections 5-1-1933 Para nasal sinusitis : a problem for the general practitioner Robert James Ralston University of Nebraska Medical Center This manuscript is historical in nature and may not reflect current medical research and practice. Search PubMed for current research. Follow this and additional works at: https://digitalcommons.unmc.edu/mdtheses Recommended Citation Ralston, Robert James, "Para nasal sinusitis : a problem for the general practitioner" (1933). MD Theses. 283. https://digitalcommons.unmc.edu/mdtheses/283 This Thesis is brought to you for free and open access by the Special Collections at DigitalCommons@UNMC. It has been accepted for inclusion in MD Theses by an authorized administrator of DigitalCommons@UNMC. For more information, please contact [email protected]. PARA-NASAL SINUSITIS A PROBLEM FOR THE GENERAL PRACTITIONER by Rooert James Ralston, B. Sc. Presented to the Faculty of The College of Medicine in the University of Nebraska in Partial Fulfillment of the Requirements - for the Degree of Doctor of Medicine 1933 Omaha, Nebraska TABLE O.F' CONTENTS Pages I Introductory and Historioal 1 - 2 II Anatomioal Discussion of Nose and Accessory Nasal Sinuses 3 - 16 III Etiology and Inoidence of Paranasal Sinus Infection 17 - 20 IV Pathology of Paranasal Sinusitis 21 - 23 V Sinus Infection in Relation to Systemic Disease 24 - 28 VI Symptoms and Diagnosis of Paranasal Sinusitis 29 - 38 VII Treatment of Paranasal Sinusitis 39 - 45 VIII Case Histories 46 - 55 IX Conclusion 56 X Bibliography 1 INTRODUOTORY AND HISTORICAL The paranasal, or accessory sinuses of the nose, are as sociated with the general health of the individual just as closely as are the tonsils, the teeth, the gall bladder, or any other of the commonly accepted foci of infection in the human body. -
Septation of the Sphenoid Sinus and Its Clinical Significance
1793 International Journal of Collaborative Research on Internal Medicine & Public Health Septation of the Sphenoid Sinus and its Clinical Significance Eldan Kapur 1* , Adnan Kapidžić 2, Amela Kulenović 1, Lana Sarajlić 2, Adis Šahinović 2, Maida Šahinović 3 1 Department of anatomy, Medical faculty, University of Sarajevo, Čekaluša 90, 71000 Sarajevo, Bosnia and Herzegovina 2 Clinic for otorhinolaryngology, Clinical centre University of Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina 3 Department of histology and embriology, Medical faculty, University of Sarajevo, Čekaluša 90, 71000 Sarajevo, Bosnia and Herzegovina * Corresponding Author: Eldan Kapur, MD, PhD Department of anatomy, Medical faculty, University of Sarajevo, Bosnia and Herzegovina Email: [email protected] Phone: 033 66 55 49; 033 22 64 78 (ext. 136) Abstract Introduction: Sphenoid sinus is located in the body of sphenoid, closed with a thin plate of bone tissue that separates it from the important structures such as the optic nerve, optic chiasm, cavernous sinus, pituitary gland, and internal carotid artery. It is divided by one or more vertical septa that are often asymmetric. Because of its location and the relationships with important neurovascular and glandular structures, sphenoid sinus represents a great diagnostic and therapeutic challenge. Aim: The aim of this study was to assess the septation of the sphenoid sinus and relationship between the number and position of septa and internal carotid artery in the adult BH population. Participants and Methods: A retrospective study of the CT analysis of the paranasal sinuses in 200 patients (104 male, 96 female) were performed using Siemens Somatom Art with the following parameters: 130 mAs: 120 kV, Slice: 3 mm. -
Evaluation and Treatment of Selected Sacral Somatic Dysfunctions
Evaluation and Treatment of Selected Sacral Somatic Dysfunctions Using Direct and HVLA Techniques including Counterstrain and Muscle Energy AND Counterstrain Treatment of the Pelvis and Sacrum F. P. Wedel, D.O. Associate Adjunct Professor in Osteopathic Principles and Practice A.T. Still University School of Osteopathic Medicine in Arizona, and private practice in Family Medicine in Tucson, Arizona Learning Objectives HOURS 1 AND 2 Review the following diagnostic and treatment techniques related to sacral torsion Lumbosacral spring test Sacral palpation Seated flexion test HOURS 3 AND 4 Counterstrain treatments of various low back pathologies Sacral Techniques Covered : 1. Prone, direct, muscle energy, for sacral rotation on both same and opposite axes 2. HVLA treatment for sacral rotation on both same and opposite axes 3. Counterstain treatment of sacral tender points and of sacral torsion Counterstrain Multifidi and Rotatores : UP5L Gluteii – maximus: HFO-SI, HI, P 3L- P 4L ,medius, minimus Piriformis Background and Basis The 4 Osteopathic Tenets (Principles) 1. The body is a unit; the person is a unit of body, mind, and spirit. 2. Structure and function are reciprocally inter-related. 3. The body is capable of self- regulation, self-healing, and health maintenance. 4. Rational treatment is based upon an understanding of these basic principles. Somatic Dysfunction - Defined • “Impaired or altered function of related components of the somatic (body framework) system: • Skeletal, arthrodial, and myofascial structures, • And… • Related vascular, lymphatic, and neural elements” Treatment Options for Somatic Dysfunctions All somatic dysfunctions have a restrictive barrier which are considered “pathologic” This restriction inhibits movement in one direction which causes asymmetry within the joint: The goal of osteopathic treament is to eliminate the restrictive barrier thus restoring symmetry…. -
Skeletal System? Skeletal System Chapters 6 & 7 Skeletal System = Bones, Joints, Cartilages, Ligaments
Warm-Up Activity • Fill in the names of the bones in the skeleton diagram. Warm-Up 1. What are the 4 types of bones? Give an example of each. 2. Give 3 ways you can tell a female skeleton from a male skeleton. 3. What hormones are involved in the skeletal system? Skeletal System Chapters 6 & 7 Skeletal System = bones, joints, cartilages, ligaments • Axial skeleton: long axis (skull, vertebral column, rib cage) • Appendicular skeleton: limbs and girdles Appendicular Axial Skeleton Skeleton • Cranium (skull) • Clavicle (collarbone) • Mandible (jaw) • Scapula (shoulder blade) • Vertebral column (spine) • Coxal (pelvic girdle) ▫ Cervical vertebrae • Humerus (arm) ▫ Thoracic vertebrae • Radius, ulna (forearm) ▫ Lumbar vertebrae • Carpals (wrist) • Metacarpals (hand) ▫ Sacrum • Phalanges (fingers, toes) ▫ Coccyx • Femur (thigh) • Sternum (breastbone) • Tibia, fibula (leg) • Ribs • Tarsal, metatarsals (foot) • Calcaneus (heel) • Patella (knee) Functions of the Bones • Support body and cradle soft organs • Protect vital organs • Movement: muscles move bones • Storage of minerals (calcium, phosphorus) & growth factors • Blood cell formation in bone marrow • Triglyceride (fat) storage Classification of Bones 1. Long bones ▫ Longer than they are wide (eg. femur, metacarpels) 2. Short bones ▫ Cube-shaped bones (eg. wrist and ankle) ▫ Sesamoid bones (within tendons – eg. patella) 3. Flat bones ▫ Thin, flat, slightly curved (eg. sternum, skull) 4. Irregular bones ▫ Complicated shapes (eg. vertebrae, hips) Figure 6.2 • Adult = 206 bones • Types of bone -
The Influence of the Rib Cage on the Static and Dynamic Stability
www.nature.com/scientificreports OPEN The infuence of the rib cage on the static and dynamic stability responses of the scoliotic spine Shaowei Jia1,2, Liying Lin3, Hufei Yang2, Jie Fan2, Shunxin Zhang2 & Li Han3* The thoracic cage plays an important role in maintaining the stability of the thoracolumbar spine. In this study, the infuence of a rib cage on static and dynamic responses in normal and scoliotic spines was investigated. Four spinal fnite element (FE) models (T1–S), representing a normal spine with rib cage (N1), normal spine without rib cage (N2), a scoliotic spine with rib cage (S1) and a scoliotic spine without rib cage (S2), were established based on computed tomography (CT) images, and static, modal, and steady-state analyses were conducted. In S2, the Von Mises stress (VMS) was clearly decreased compared to S1 for four bending loadings. N2 and N1 showed a similar VMS to each other, and there was a signifcant increase in axial compression in N2 and S2 compared to N1 and S1, respectively. The U magnitude values of N2 and S2 were higher than in N1 and S1 for fve loadings, respectively. The resonant frequencies of N2 and S2 were lower than those in N1 and S1, respectively. In steady-state analysis, maximum amplitudes of vibration for N2 and S2 were signifcantly larger than N1 and S1, respectively. This study has revealed that the rib cage improves spinal stability in vibrating environments and contributes to stability in scoliotic spines under static and dynamic loadings. Scoliosis, a three-dimensional deformity, prevents healthy development. -
Morfofunctional Structure of the Skull
N.L. Svintsytska V.H. Hryn Morfofunctional structure of the skull Study guide Poltava 2016 Ministry of Public Health of Ukraine Public Institution «Central Methodological Office for Higher Medical Education of MPH of Ukraine» Higher State Educational Establishment of Ukraine «Ukranian Medical Stomatological Academy» N.L. Svintsytska, V.H. Hryn Morfofunctional structure of the skull Study guide Poltava 2016 2 LBC 28.706 UDC 611.714/716 S 24 «Recommended by the Ministry of Health of Ukraine as textbook for English- speaking students of higher educational institutions of the MPH of Ukraine» (minutes of the meeting of the Commission for the organization of training and methodical literature for the persons enrolled in higher medical (pharmaceutical) educational establishments of postgraduate education MPH of Ukraine, from 02.06.2016 №2). Letter of the MPH of Ukraine of 11.07.2016 № 08.01-30/17321 Composed by: N.L. Svintsytska, Associate Professor at the Department of Human Anatomy of Higher State Educational Establishment of Ukraine «Ukrainian Medical Stomatological Academy», PhD in Medicine, Associate Professor V.H. Hryn, Associate Professor at the Department of Human Anatomy of Higher State Educational Establishment of Ukraine «Ukrainian Medical Stomatological Academy», PhD in Medicine, Associate Professor This textbook is intended for undergraduate, postgraduate students and continuing education of health care professionals in a variety of clinical disciplines (medicine, pediatrics, dentistry) as it includes the basic concepts of human anatomy of the skull in adults and newborns. Rewiewed by: O.M. Slobodian, Head of the Department of Anatomy, Topographic Anatomy and Operative Surgery of Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Doctor of Medical Sciences, Professor M.V.