17.09.2019 1 Introduction to the anatomy Axial skeleton Marek Joukal, M.D., Ph.D. Head of Department mjoukal@med.muni.cz Department of Anatomy, Faculty of Medicine Masaryk University Doctors without anatomy are like moles. They work in the dark and the work of their hands are mounds. prof. Tiedemann: Heidelberg, 1781–1861 Rooms Seminary rooms S 1-5 (red floor) Dissection rooms P 1-3 (blue floor) Study room – red floor Bone room – lending of bones Mo 10.00 – 17.00 Tue 10.00 – 16.00 Wed 8.00 – 15.00 Th 8.30 – 16.00 Fri 8.30 – 14.00 Every single hour Textbooks https://ezdroje.muni.cz/prehled/zdroj.php?lang=cs&id=333 Atlases Other sources Applications - 3D atlases, quizes 17.09.2019 2 Labcoat Shoecovers Probes (tweezer) Lock for the locker Seminars Anatomical nomenclature Vesalius (1542), Basilian (1895) BNA, Jenna (1935) INA, Parisian (1955) PNA, NA, TA • approximately 5640 words derived from latin, greek or arabian • Each structure has valid international name • Description of position and relations used in medical records, articles etc. Anatomical structure (latine) – substantive in nominative, adjectives genitive – structure of location antonyms (major-minor, superior-inferior) Example: Collum anatomicum humeri - Anatomical head of humerus Arteria carotis externa – External carotid artery Anatomical orientation Surface planesAnatomicalposition Longitudinal axis: • Cranial (superior) • Caudal (inferior) Transverse axis: • Medial • Lateral • Medius • Medianus • Dexter • Sinister Sagittal axis: • Ventral (anterior) • Dorsal (posterior) • Internus (profundus) • Externus (superficial) Directions: http://www.emsjunkie.com/anatomy-physiology/anatomical-position-directions-planes/ Upper limb: Radial (lateral) Ulnar (medial) Palmar Dorsal Lower limb: Tibial (medial) Fibular (lateral) Plantar Dorsal Extremities Proximal Distal Čihák, 2001 Čihák, 2001 17.09.2019 3 Parts of body head – caput neck – collum (cervix) trunk – truncus thorax abdomen back – dorsum pelvis Upper extremity – membrum superius arm – brachium forearm – antebrachium hand – manus Lower extremity – membrum inferius thigh – femur crus Foot - pes Periost : nutrition innervation fractures healing Spongy bone Proximal epiphysis Hyaline cartilage Compact bone Nutrient artery Diaphysis Distal epiphysis STH – pituitary gland – nanism – gigantism thyroid gland, parathyroid gland, calcium, sexual hormons etc. Ossification and bone growth Chondral ossification – long bones perichondral ossification enchondral ossification ossification centre Desmogenous ossification – bone of skull Growth plate – longitudinal growth Periosteum–width growth Čihák, 2001 X-ray picture of 4 year old children Ossification centres Adenohypophysis dysfunction (higher or lower hormon production or cell receptors miss) STH a) gigantism b) Nanism Axial skeleton Columna vertebralis Costae Sternum 17.09.2019 4 33-34 vertebrae, 24 free 7 vertebrae cervicales 12 vertebrae thoracicae 5 vertebrae lumbales 5 vertebrae sacrales – os sacrum 4–5 vertebrae coccygeae – os coccygis 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 Vertebral morphology 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 Foramen processus transversi !!!!!! Sulcus nervi spinalis Tuberculum anterius et posterius processus transversi Uncus corporis vertebrae Position of processus articulares Bifurcated spinous process (C2 – C6) C6 - tuberculum caroticum C3 – the smalest 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 postavení processus articulares Vertebrae thoracicae Th1 – Th12 17.09.2019 5 processus costarii processus mammillares processus accessorii pozice kloubních výběžků tvar processus spinosi lumbální punkce Vertebrae lumbales L1 – L5 Vertebrae sacrales, os sacrum 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 (Co1 – Co 4-5) Costa, rib (12) Costae verae (true) (1.-7.) Costae spuriae (false) (8.-10.) Costae fluctuantes (improper) (11., 12.) Cervical rib Lumbar rib 17.09.2019 6 Os costae Cartilago costae Caput facies articularis (2. -10. - 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 11th and 12th – tuberculum and sulcus are missing !!! Manubrium sterni incisura clavicularis incisura jugularis incisurae costales 1.,2. Angulus sterni Corpus sterni incisurae costales (3.-7. žebro) Processus xiphoideus Sternal puncture Sternum X-Ray anatomy X-Ray beams - 1895 Different absorption Types: Native vs. contrast – brightness, shadow Iodine contrast medium Contrast X-Ray pictures Barium meal Negative Positive (gas) Projection – A-P, lateral Ultrasound, CT, MRI 17.09.2019 7 Putz, R. (2008): Atlas of Human Anatomy Sobotta. Elsevier Books. Keith L. Moore, Arthur F. Dalley (2005): Clinically Oriented Anatomy. Williams and Wilkins. Platzer, W., Kahle, W., Leonhardt H. (1992): Locomotor system. Georg Thieme Verlag, Stuttgart, New York, 4th edition. Čihák, R. (1987): Anatomie 1. Avicenum, Zdravotnické nakladatelství. References