INTRODUCTION PLANES AND DIRECTION OF THE BODY GENERAL OSTEOLOGY SKELETON OF THE SPINE AND THORAX 1. lecture and seminar, DENTISTRY AUTUMN 2017 Lecturer: RNDr. MICHAELA RAČANSKÁ, Ph.D. Lending of bones (first five weeks of tuition) monday 10.00 – 16. 00* tuesday 8.00 – 16.00* wednesday 8.00 – 17.00* thursday 10.00 – 17.00* friday 8.00 – 14.00* *in each whole hour, lending bones against to ISIC, it is not allowed to take them away from the department, you can study in the red floor Syllabus Lectures: We 13,20-15,00 Seminars: We 15,40- 17,20 Change! App.13,30-17,10 lecture and seminar together Week and date Lectures Seminars 1. 2. 9. 2017 Planes and direction of the body. General osteology. Skeleton of the spine and thorax. Introduction to the study, X-rays anatomy.skeleton of the spine and the thorax Anatomical museum. 2. 27. 9. 2017 Skeleton of the upper limb. Skeleton of the upper limb 3. 4. 10. 2017 Skeleton of the lower limb Skeleton of the lower limb 4. 11. 10. 2017 Neurocranium Neurocranium 5. 18. 10. 2017 Splanchnocranium Splanchnocranium 6. 25. 10. 2017 Cavities of the skull Cavities of the skull 7. 1. 11. 2017 General arthrology Joints of the spine and thorax and skull General arthrology Joints of the spine and thorax and skull 8. 8. 11. 2017 Joints of the upper extremity and lower extremity, pelvis Joints of the upper extremity and lower extremity. The pelvis. 9. 15. 11. 2017 General myology. Introduction to the study of the muscles Muscles and fasciae of the head and neck Repetition of the whole skeleton and joints 10. 22. 11. 2017 Control examination (osteology, arthrology) 11. 29. 11. 2017 The muscles of the thorax, abdomen and back Muscles and fasciae of the head and neck 12. 6. 12. 2017 Muscles of the upper extremity Muscles of the thorax, abdomen and back S 4, 5 - P2 blue floor Where you can study from? Liebgott, Bernard. The anatomical basis of dentistry. 3rd ed. Mosby, ISBN 0-323-06807-3 PÁČ, Libor, Ladislava HORÁČKOVÁ a Hana NECHUTOVÁ. Anatomy of human locomotor system. 1. vyd. Brno: Masarykova univerzita Brno, 2010. 119 s. ISBN 978-80-210-5258-1. Atlas of human anatomy. Edited by Johannes Sobotta - Reinhard Putz - Reinhard Pabst - Renate Putz. 13th English ed., 21st Germa. Philadelphia: Lippincott Williams & Wilkins, 2001. 404 s. ISBN 0-7817-3174-7. NETTER, Frank H. Atlas of human anatomy. 4th ed. Philadelphia: Saunders Elsevier, 2006. 548 color. ISBN 1-4160-3385-8. Frame – studying materials on the IS PROTOCOLS – IS, ONE BOOK + ONE ATLAS – up to you Test on the beginning of each lecture!!! WHAT YOU WILL NEED? and SAFETY AT WORK OR Long hair pin together, painted nails, earings, rings and bracelets x Probe (skewer, pin …) Later Cases Lock and the key Safety at work • Every accident (even small injuries) that happens during your education immediately report, write to the accident book, and will be treaten • If a student becomes pregnant – please report, not allowed to ateend the dissection rooms Anatomical nomenclature Anatomy is the basis of the language of medicine. Students learn a new language consisting of at least 4500 words. International. Many anatomical terms are derived from Latin and Greek. To describe the relationship of one structure to another, the anatomical nomenclature should be used. To be understood you must express yourself clearly, using the official terms in the correct way. • 1. Andreas Vesálius, founder of the modern anatomy, 16. century. • 2. Basiliensia Nomina Anatomica, B. N. A., 1895 • 3. Ienaiensia Nomina Anatomica, I. N. A., 1935 • 4. Parisiensia Nomina Anatomica, P. N. A., 1955 accepted 1960, last corrections - 1985 (5640 terms) • 5. TERMINOLOGIA ANATOMICA 1998 Terminologia Anatomica – International Anatomical terminology (FCAT) 1998 Source: https://upload.wikimedia.org/wikipedia/commons/thumb/7/71/Vesalius_Portrait_pg_xii_-_c.png/220px-Vesalius_Portrait_pg_xii_-_c.png The first word is name of described formation, next adjectives specificate it and in the end there is a name of formation where the described formation is located. Examples: Collum (neck) radii (of radius) Collum (a neck) anatomicum (anatomical) humeri (of humerus) Collum (a neck) chirurgicum (surgical) humeri (of humerus) Tuberculum (a tubercle, a bulge) majus (big) humeri (of humerus) Spina (a thorn) iliaca (iliac) anterior (fore) superior (upper) ossis coxae (of coxal bone) Epicondylus medialis humeri Epicondylus medialis femoris Anatomical nomenclature General osteology Before we´ll start, take a piece of paper and write down what you already know regarding: •What is the composition of the bone? •What types of bones do you know? General osteology  The skeleton is composed of a living, dynamic, rigid, connective tissue that forms bones and cartilages  In total 214 (incl. sessamoid bones), it varies  Cartilage at the places where flexibility is important, or covers articulation surfaces FUNCTION OF SKELETAL SYSTEM  Support  Protection of vital organs  Together with muscles a mechanism for movement  Storage of calcium (99% of body´s calcium is stored in bone) and other salts  A source of blood cells (Bone marrow in the central cavity, hemopoetic (blood- forming) cells Basic structure of bones • Bone as a conective tissue consists of :  bone cells (osteocytes)  Ground substance+ collagenous fibrils form - osteoid (ossein) – organic material  Different sallts – hardness and strenght – anorganic material A salt free or decalcified bone is pliable • in young 52% of organic component • In elderly 40 % 2) spongy (trabecular or cancellous) bone A less dense trabeculated network of bone spicules making up the substance of most bones, surrounding an inner marrow cavity, TYPES OF BONE ACCORDING TO THE STRUCTURE 1) compact bone A relatively solid mass of bone Commonly seen as a superficial layer of bone, that provides strenght BONE STRUCTURE Periosteum External fibrous (periost) Internal cambious layer (osteoblasts, Sharpey´s fibers, remodelation the site of osteoblasts – built up bone and help of healing – fractures) Substantia compacta Substantia spongiosa Bone architecture, trajectories Endosteum Bone reconstruction, it is not possible to peel it off Cavitas medullaris - (bone marrow) medulla ossium rubra medulla ossium flava medulla ossium gelatinosa 1 – Haversian lamellae 2 – intersticial lamellae 3 – superficial lamellae 4 – lamellae of spongy bone H – Haversian system of lamellae, osteon 1 – osteocyte 2 – lacuna 3 – canaliculus osseus 4 – Haversian canal of osteon 5 – concentric lamellae of osteon 6 – superficial lamellae Lamellar bone tissue BONE MARROW Medulla ossium rubra – red bone marrow (active hematopoetic tissue) Medulla ossium flava – yellow bone marrow (source of energy for organism) Medulla ossium gelatinosa – grey bone marrow BLOOD SUPPLY • Nutrient arteries (one or more, through the diaphyssis) • Periosteal arteries (supply the compact bone) • Metaphysial arteries • Epiphyseal arteries • Apophyseal arteries BONE DEVELOPMENT (ossification) a. nutricia aa. epiphysariae aa. epiphysariae 1) Intramembranous formation Flat bones Direct calcium deposition into mesenchymal model of the bone 2) Endochondral formation Long bones, irregular bones Calcium deposition into a cartilagineous model of the bone a) perichondral originates in diaphysis b) enchondral in cartilage near epiphyses Growing of the epifyseal cartilage followed ba the osification of both epiphysis and diaphysis as the background of growing into the lenght To the thickness growth the bone thanks to the periostal cells of the cambial (inner) layer! Bone growthGrowth plate = epiphyseal disk is necessary for growth in length, forms a layer between the epiphysis and the diaphysis. The part of diaphysis adjacent to the epiphysial disk is called metaphysis. Classification of bones accoring to the shape Ossa longa (long bones) Ossa brevia (short bones) Ossa plana (flat bones) Proximal end Distal end Body (corpus) Compact bone =corticalis Spongy bone bone architecture Lamina externa Lamina interna diploe Ossa sesamoidea (sesamoid bones) – in tendons of some muscles Ossa pneumatica (pneumatised) – paranasal sinuses Ossa irregularia (irregular) Control questions? The bones are classified by their shape. Which of the following shapes is used to define the kneecap (patella)? a. Long b. Flat c. Irregular d. Short e. Sesamoidal Which of the following portions of the long bone is most important in lengthening the bone? a. Diaphysis b. Epiphysis c. Epiphyseal plate d. Apophysis e. metaphysis Orientation on the body Anatomical position standarderectposition Not a military position! x PLANES – 3 anatomical planes or sections Sagittal plane (median), Midsagittal vertical plane - Right and left acc. to sagittal axis Transverse plane (horizontal, axial, cross sections) Vertical plane - Superior and inferior (acc. to transversal axis) Frontal plane (coronal) Anterior and posterior (acc. to longitudinal axis) cranialis caudalis superior inferior ventralis dorsalis anterior posterior medialis lateralis medianus medius (intermedius) dexter sinister superficilais profundus internus externus Directions on the body Directions at the limbs PROXIMALIS DISTALIS RADIALIS (lateralis) ULNARIS (medialis) PALMARIS DORSALIS PLANTARIS FIBULARIS (lateralis) TIBIALIS (medialis) Are you ok with the directions? Which of the following terms is synonymous with the frontal plane? a. Axial b. Coronal c. Sagittal d. Transverse e. Cross section 1) 2) 3) The green arrow faces ……………. The green part of body is ……….. How to describe bones - knowledges of the general osteology, basic orientation on the body withplanes are obvious In describing bones we proceed according to the following outline:: 1. Name of the bone (english, latin) 2. Type of the bone (long, short ….) 3. Dividing into separate parts (ends, body, surfaces, borders….) 4. Description of the positive and negative relief of the isolated parts 5. In paired bones estimate the laterality IMPORTANT!!! STUDY WITH THE BORROWED MATERIAL IN THE BONY ROOM OR IN THE MUSEUM AT THE DEPARTMENT!!! Marking of bones -positive and negative relief • Sulcus – a groove • Incisura – a notch • Canalis – a canal • Fossa – a pit, hollow • Fovea – a pit, hollow • Foramen – an opening, orifice, gap • Groove – a furrow • Processus – a projection, prominence • Spina – a thorn • Tuberculum – a tubercle • Tuber – a torus • Tuberositas – a tuberosity, large rounded eminence Internus – internal Externus – external Superficialis – superficial Profundus – deep Caput – a head Capitulum – a small head Collum, cervix – a neck Os, ossis, ossa – a bone, bones Articulus – a joint Facies – a facet, surface NEGATIVE POSITIVE Fossa x fovea Fovea capitis femoris Fossa iliaca Fossa trochanterica Fossa olecrani Source of the pictures: Atlas der Anatomie des Menschen/Sobotta. Putz,R., und Pabst,R. 20. Auflage. München:Urban & Schwarzenberg, 1993 Caput x condylus Caput humeri Condylus medialis et lateralis et epicondylus med. et lat. femoris Epicondylus med. et lat. humeri Caput tali Caput femoris Source of the pictures: Atlas der Anatomie des Menschen/Sobotta. Putz,R., und Pabst,R. 20. Auflage. München:Urban & Schwarzenberg, 1993 Incisura x foramen Incisura scapulae Foramen obturatum Source of the pictures: Atlas der Anatomie des Menschen/Sobotta. Putz,R., und Pabst,R. 20. Auflage. München:Urban & Schwarzenberg, 1993 AXIAL SKELETON Bones of the skull Vertebral column (spine) Ribs Sternum APPENDICULAR SKELETON Bones of the limbs Pectoral girdle Pelvic girdle Central line of the body (80) Attach the limbs to the body´s axis (134) Thorax Columna vertebralis (vertebral column, spine 26) Costae (ribs, 24) Sternum (breast bone) COLUMNA VERTEBRALIS (vertebral column) 33-34, usually 24 free vertebras 7 vertebrae cervicales (C) cervical vertebra 12 vertebrae thoracicae (Th) thoracic vertebra 5 vertebrae lumbales (L) lumbar vertebra 5 vertebrae sacrales – os sacrum (sacral bone) 4–5 vertebrae coccygeae – os coccygis (coccyx) Costa Processus transversus Corpus vertebrae Processus articulares Processus spinosus Arcus vertebrae DEVELOPMENT OF VERTEBRAS Corpus vertebrae (facies terminalis superior et inferior) Pediculus arcus vertebrae Arcus vertebrae Foramen vertebrale (canalis vertebralis) Incisura vertebralis superior et inferior Foramen intervertebrale Processus vertebrales 4x processus articulares (processus articularis superior et inferior - dexter et sinister) 2x processus transversus (dexter et sinister) 1x processus spinosus General features of all vertebras Processus vertebrales Processus articulares (4) processus articularis superior - dexter et sinister processus articularis inferior - dexter et sinister Processus transversus dexter et sinister (2) Processus spinosus (1) Vertebrae cervicales C1 – C7 (Cervical vertebras) Foramen processus transversi !!!!!! Sulcus nervi spinalis Tuberculum anterius et posterius processus transversi Uncus corporis vertebrae Procesus articulares Bifurcations of the spinous processes (C2 – C6) C6 - tuberculum caroticum C3 – the smallest body C7 – vertebra prominens Arcus anterior et posterior atlantis fovea dentis tuberculum anterius et posterius atlantis foramen vertebrale Massae laterales facies/fovea articularis superior et inferior sulcus arteriae vertebralis processus transversi Corpus vertebrae Dens axis facies articularis ant. et post. dentis apex dentis C1 - Atlas C2 - Axis fovea costalis (dextra et sinistra) fovea costalis processus transversi processus articulares Vertebrae thoracicae Th1 – Th12 (hrudní obratle) processus costarii processus mammillares processus accessorii Processus articulares Shape and direction of spinous process Vertebrae lumbales L1 – L5 (lumbar vertebras) Lumbar punction - between L3 – L4 Cerebral liquor Vertebrae sacrales, os sacrum (sacral bone) basis – facies terminalis superior apex – facies terminalis inferior facies pelvina lineae transversales foramina sacralia pelvina promontorium canalis sacralis – hiatus canalis sacralis cornua sacralia Os sacrum Facies dorsalis crista sacralis mediana cristae sacrales intermediae cristae sacrales laterales foramina sacralia dorsalia tuberositas sacralis Partes laterales facies auriculares Canalis sacralis hiatus canalis sacralis cornua sacralia basis – facies terminalis superior cornua ossis coccygis apex Vertebrae coccygeae, os coccygis (coccyx) (Co1 – Co 4-5) Costa, rib (12) Costae verae (1.-7.) Costae spuriae (8.-10.) Costae fluctuantes (11., 12.) Cervical rib Lumbar rib (near to the kidneys) Os costae Cartilago costae Caput facies articularis (2. - 10. rib - crista capitis costae) Collum tuberculum costae facies articularis tuberculi costae Corpus angulus costae crista costae sulcus costae tuberculum musculi scaleni anterioris sulcus arteriae subclaviae tuberculum musculi scaleni medii tuberositas musculi scaleni posterioris tuberositas musculi serrati anterioris Costa prima Costa secunda 11. and 12. ribs – tuberculum costae and sulcus costae are missing!!! Cervical rib Manubrium sterni incisura clavicularis incisura jugularis incisurae costales 1.,2. Angulus sterni Corpus sterni incisurae costales (3.-7. žebro) Processus xiphoideus Sternum (breast bone) Sternebrae Hollow in the body of the breast bone 2nd intercostal space Sternal punction heart diaphragma Breast bone column Thank you for your attention X-rays anatomy Anatomy is essential for understanding radiology. Wilhelm Conrad Röntgen 1845-1923 1895 – discovery of x-ray 1901- awarded by Nobel price in physics) X-rays principle • A highly penetrating beam of x-rays „transluminates“ the patient, showing tissues of differing densities on x-ray film. • A tissue or organ that is relatively dense absorbs (stops) more x-rays than a less dense tissue. • Like a negative • Light structures –shadows • Dark structures -brightening NATIVE x-ray without using of contrast agent X-rays with contrast material (Contrast examination) Negative Gass, air Positive Barium sulfate Iodine-based molecules SPINE CERVICAL PART axial projection spinous process transverse process mandible vertebral body disc space 1th rib clavicle thoracic vertebra cervical vertebra SPINE CERVICAL PART lateral projection posterior arch of C1 spinous processes C3 C4 C5 C6 C7 mandible intervertebral disc spaces C1 C2 dens (C2) occiput hyoid intervertebral joint inf. articular process sup.articular process intervertebral foramen Tuberculum posterius atlantis SPINE THORACIC PART axial projection thoracic vertebral body spinous process costovertebral joint pedicles disc space ribs diaphragm SPINE THORACIC PART lateral projection thoracic vertebral body intervertebral disc space ribs SPINE LUMBAR PART axial projection pedicle spinous process sacrum intervertebral space costal process vertebral body superior articular process inferior articular process intervertebral joint last rib 1th thoracic vertebraL1 L2 L3 L4 L5 SPINE LUMBAR PART lateral projection spinous processes sacrum L5 L4 L3 L2 L1 disc space vertebral body pedicle intervertebral foramen Any questions? The pictures used in this lectures were taken from following sources: • Atlas der Anatomie des Menschen/Sobotta. Putz,R., und Pabst,R. 20. Auflage. München:Urban & Schwarzenberg, 1993 • Netter: Interactive Atlas of Human Anatomy. • Naňka, Elišková: Přehled anatomie. Galén, Praha 2009. • Čihák: Anatomie I, II, III. • Drake et al: Gray´s Anatomy for Students. 2010 • Own archiv of the lecturer