GENERAL CONCEPTS: - The person / patient = anatomical position - Stand straight up with feet flat on the ground - Toes pointing forward - Eyes facing forward - Palms facing anteriorly - Thumbs pointed AWAY from the body REGIONAL TERMS: (terms for the names of specific areas) - Axial-head, neck, trunk - Appendicular -upper, lower limbs - Anterior- facing forwards - Posterior- facing backwards RELATIVE POSITION: - Superior - head, top of body - Proximal- towards midline - Lateral- away from the midline - Distal - towards bottom “distant” - Medial- midline,” middle of body” - Inferior- feet, “bottom of body” - The foot is distal to the knee - The thigh is proximal to the knee - The patellar region is anterior to the popliteal region - The sacral region is posterior to the umbilical region Superficial-near the surface Deep-more internal/under surface. Coxal-Hip Plantar- Sole of the foot Crural- Leg (the portion of the lower limb between the knee and the ankle) Popliteal- Area posterior to the knee Pubic -Anterior region of the pelvis Digital-Fingers or toes (also called phalangeal) Femoral -Thigh Fibular-Lateral aspect of the leg Sural Calf -(posterior part of the leg) Gluteal-Buttock Tarsal-Proximal part of foot and ankle Hallux -Great toe Tibial- Medial aspect of the leg - Coronal plane- also called a frontal plane, is a vertical plane that divides the body into anterior (front) and posterior (back) parts. - Transverse plane- also called a cross-sectional plane or horizontal plane, cuts perpendicularly along the long axis of the body or organ. The body or organ is separated into both superior (upper) and inferior (lower) parts, and the relationship of neighboring organs at a particular level is revealed. - Midsagittal plane- or median plane, extends through the body or organ vertically and divides the structure into right and left halves. A plane that is parallel to the midsagittal plane, but either to the left or right of it, is termed a sagittal plane. RELATIVE TO FRONT (BELLY SIDE) OR BACK (BACK SIDE) OF THE BODY: Anterior- In front of; toward the front surface Posterior-In back of; toward the back surface Dorsal-Toward the back side of the human body Ventral-Toward the belly side of the human body RELATIVE TO THE HEAD OR TAIL OF THE BODY: Superior -Closer to the head Inferior-Closer to the feet Caudal-At the rear or tail end Rostral-Toward the nose or mouth RELATIVE TO THE MIDLINE OR CENTER OF THE BODY: Medial-Toward the midline of the body Lateral-Away from the midline of the body Deep-On the inside, internal to another structure Superficial-On the outside, external to another structure RELATIVE TO POINT OF ATTACHMENT OF THE APPENDAGE: Proximal- Closest to point of attachment to trunk Distal- Furthest from point of attachment to trunk PELVIC GIRDLE - Sacrum + right and left ossa coxae - Supports visceral. Organs of pelvis - Pelvic brim= illium&pubis - The bones of the lower limb include the pelvic girdle, femur, patella, tibia, fibula, and bones of the foot. - The pelvic girdle contains the hip bone and the sacrum. the hip bone contains the ilium, ischium, and pubis. the iliac crest contains the anterior superior iliac spine (ASIS) and the posterior superior iliac spine (PSIS). - The iliac spine contains the entire iliac crest and extends inferiorly in the front and back to include the anterior inferior iliac spine (AIIS) and posterior inferior iliac spine (PIIS). - The ischium has a significant bone marking in the ischial tuberosity. The hamstring muscles connect to the ischial tuberosity. In addition, the ischium contains a spine, which separates the greater sciatic notch from the lesser sciatic notch. - The thigh adductors originate on the pubis. - The acetabulum is the name of the socket that articulates with the head of the femur to form the hip joint. - The acetabulum is where the ilium, ischium, and pubis join together. FEMUR - The femur, or thigh bone, is the longest and strongest bone in the body. - Its rounded head, located on the proximal, medial aspect of the femur, fits beautifully in the acetabulum to form the hip joint - The greater trochanter is a sizable bone marking on the lateral aspect of the proximal femur. - The lesser trochanter is smaller and is located distal and slightly posterior to the head of the femur on the medial aspect of the bone. - Rounded medial and lateral condyles are located on the distal end of the femur and articulate with the tibia. - A rough line called the linea aspera runs almost the full length of the posterior femur. - The gluteal tuberosity is located on the proximal, posterior femur, very close to the proximal linea aspera. - The pectineal line is located proximal and medial on the posterior femur, just inferior to the lesser trochanter. PATELLA - The patella or kneecap is a sesamoid bone that lies anterior to the junction of the femur and tibia. - The patella is embedded in the quadriceps tendon and causes the tendon to be positioned more anteriorly, thus enhancing the leverage of the quadriceps tendon as it pulls on the tibial tuberosity to extend the knee. - The patella slides up and down as we flex and extend the leg. Cartilage on the poste- rior aspect of the patella provides cushioning between the patella and the femur TIBIA AND FIBULA - The tibia and fibula are the bones of the leg. The tibia is much the larger and is located medial - to the fibula. - The tibia is the weight-bearing bone and is part of the knee joint. - Several important bone markings exist on the tibia and fibula. The proximal end of the tibia contains two condyles, a medial condyle and a lateral condyle. - The tibial tuberosity is located on the proximal anterior aspect of the tibia, just inferior to the patella - It serves as the insertion site for the quadriceps tendon. - On the distal medial side of the tibia is the me- dial malleolus, which is commonly referred to the “inner ankle bone” in lay terms. - The fibula contains some important bone markings, as well. The head of the fibula is the bone’s most proximal aspect. Two important muscles connect to this bone marking. Distally, the fibula has a lateral, rounded projection called the medial malleolus in anatomical language and called the “outer ankle bone” BONES OF THE FOOT - We have seven tarsals in each foot, a group of three and then a row of four distal to the group of three. - The calcaneus is the heel bone and is the largest tarsal bone. - The sizable Achilles tendon connects to the posterior aspect of the calcaneus. The calcaneus has a roughened - tuberosity on its plantar aspect, where three muscles originate. The talus is superior to the calcaneus and joins with the distal tibia and distal fibula to form the ankle joint. Our metatarsals are located distal to the tarsal bones, one metatarsal per digit, thus matching the hand’s metacarpals. The proximal aspect of each metatarsal is called the base, and the rounded, distal end of each metatarsal is called a head. Distal to the metatarsals are our phalanges, arranged in rows. Each of the four lateral toes has a proximal, middle, and distal phalanx. Digit 1, or the big toe, has only two phalanges, a proximal and a distal. JOINTS, LIGAMENTS OF THE REGION - Joints of the lower limb include the sacroiliac joint, hip joint, knee joint, tibiofibular joints, ankle joints, joints that permit inversion and eversion, and other joints within the foot. - synarthrosis-is an immobile joint. Two types of fibrous joints and one type of cartilaginous joint are synarthroses. - Amphiarthrosis- is a slightly mobile joint. One type of fibrous joint and one type of cartilaginous joint are amphiarthroses. - A diarthrosis- is a freely mobile joint. All synovial joints are diarthroses. - A plane joint- also called a planar or gliding joint, is the simplest synovial articulation and the least mobile type of diarthrosis. This type of synovial joint is considered a uniaxial joint because only side-to-side movements are possible. - A hinge joint- is a uniaxial joint in which the convex surface of one articulating bone fits into a concave depression on the other bone in the joint. Movement is confined to a single axis, like the hinge of a door. An example is the elbow joint. - A pivot joint- is a uniaxial joint in which one articulating bone with a rounded surface fits into a ring formed by a ligament and another bone. The first bone rotates on its longitudinal axis relative to the second bone. - A saddle joint is so named because the articular surfaces of the bones have convex and concave regions that - - - - resemble the shape of a saddle. It allows a greater range of movement than either a condylar or hinge joint. Ball-and-socket joints are multiaxial joints in which the spherical articulating head of one bone fits into the rounded, cuplike socket of a second bone. Examples of these joints are the hip joint and the glenohumeral joint. Hyperextension-is the extension of a joint beyond 180 degrees. Flexion- is movement in an anterior-posterior (AP) plane of the body that decreases the angle between the articulating bones. Extension- which is movement in an anterior-posterior plane Lateral flexion-occurs when the trunk of the body moves in a coronal plane laterally away from the body. Abduction- which means to “move away,” is a lateral movement of a body part away from the body midline. Abduction occurs when either the arm or the thigh is moved laterally away from the body midline. Adduction- which means to “move toward,” and is the medial movement of a body part toward the body midline. Adduction occurs when you bring your raised arm or thigh back toward the body midline, or in the case of the digits, toward the midline of the hand. SACROILIAC JOINT - The sacrum articulates with the ilium at two sacroiliac (SI) joints. The articulating surfaces of the sacrum and ilium nestle against each other, so that the joints allow very little movement. - The anterior SI ligament joins the iliac fossa to the anterior sacrum. The posterior SI ligament joins the PSIS to the sacrum. - The sacrotuberous ligament joins the ischial tuberosity to the sacrum. HIP JOINT - The hip joint is a ball-and-socket joint designed to have the stability needed for a weight-bearing join - A strong ring of fibro- cartilage, called the acetabular labrum, connects to the edge of the acetabulum, giving the socket greater depth and helping to hold the head of the femur in the socket. - the ischiofemoral ligament, the iliofemoral ligament, and the pubofemoral ligament join each of the hip bones to the femur. In addition, the ligament of the head of the femur joins the head of the femur to the acetabulum. KNEE JOINT - The knee joint is the articulation between the proximal tibia and distal femur. - The rounded condyles of the distal femur fit into concave condyles of the proximal tibia - The knee joint is classified as a hinge joint and permits a wide range of flexion and extension. - The knee joint also allows a small amount of medial and lateral rotation, due to the difference in sizes between the medial and lateral condyles of the femur. - The medial condyle of the femur is longer (from front to back) than the lateral condyle of the femur. - Many important muscles and ligaments stabilize the knee. The large quadriceps group and the large hamstring muscles provide stability to the joint - We have two ligaments that run vertically along the sides of the knee joint. - The lateral or fibular collateral ligament joins the lateral epicondyle of the femur to the head of the fibula. - The patellar ligament completes the knee ligaments. This ligament runs from the patella to the tibial tuberosity and is a portion of the quadriceps tendon of insertion. TIBIOFIBULAR JOINTS - The distal tibiofibular joint is an amphiarthrotic joint and permits almost no movement at all. - An interosseus mem- brane adds further stability between the two bones of the leg ANKLE JOINTS - The ankle joint is composed of the distal end of the tibia, the distal end of the fibula, and the talus. - The distal ends of the tibia and fibula form a shape that is similar to three sides of a box. This structure fits perfectly with the talus, especially when the ankle is in a dorsiflexed position. - The posterior talofibular ligament joins the lateral malleolus to the talus. The calcaneofibular ligament joins the lateral malleolus to the calcaneus. Inversion- is the foot movement that results in turning the plantar surface of the foot inward toward the midline. Eversion- is the foot movement that causes the plantar surface of the foot to turn outward MUSCLES - 3 types o Skeletal=muscular system- voluntary o Cardiac=heart-involuntary o Smooth=vessels, tubes-involuntary - Skeletal muscle is- muscle fibers bundled together (fascicles)- wrapped in connective tissue. o Functions: movement, maintain posture, support, regulate orifices (external sphincter), maintain body temp 37c - Muscle cell= muscle fiber= fascicle - Connective tissue surrounds each muscle, tendon and bone - Muscle fibersendomysium-covers individual muscle cells - Fasciclesperimysium-covers groups of. muscle cells - Muscleepimysium- covers a large. Muscle body - Tendons- muscle to bone - Ligaments- bone to bone - Contraction- shortens-one bone moves, other isn’t Fascicles- a group of muscle cells Connective tissue: connects tissues of the body; includes bones, muscles, tendons, ligaments, blood, fascia Agonist: primary mover (flexor) Antagonist: opposite action of agonist (extensor) Synergist: works with agonist Fixator: synergist that stabilizes joint LUMBAR PLEXUS 1. Femoral nerve- anterior/superior compartment of leg A. Innervates the rectus femoris, vastus lateralis,vastus medius, vastus intermedius, sartorius, psoas major, iliacus and iliopsoas B. Artery/vein: femoral 2. Obturator nerve: medial/superior compartment of leg A. Innervates the Gracilis, adductor longus and adductor brevis ( adductor group) B. Artery/vein: obturator SACRAL PLEXUS 1. Sciatic nerve A. Tibial nerve: posterior compartment of lower leg a. Innervates gastrocnemius, soleus, popliteus, tibialis posterior, flexor digitorum longus. Flexor hallucis longus, and semimembrenousus and semitendinousus b. Artery/vein- anterior tibial B. Superficial fibular nerve: lateral lower leg a. Innervates fibularis group ( fibularis longus, fibularis breves) b. Artery/vein: peroneal (fibular); peroneal artery is a branch of the posterior tibial artery C. Deep fibular nerve: anterior compartment of inferior leg a. Innervates tibialis anterior, extensor digitorum longus, extensor hallucis longus b. Artery/vein: anterior tibial 1. Superior glueteal nerve a. Innervates glueteus medius and minimus, tensor fascia latae b. Artery/vein: anterior tibial 2. Inferior glueteal nerve a. Innervates gluteus maximus b. Artery/vein:inferior glueteal **GLUETEAL ARTERIES DERIVE FROM COMMON ILIAC ARTERY** 1. Saphenous a. Nerve- cutaneous branch of the femoral nerve, runs on the medial side of the leg, arising in the thigh and running inferiorly to the medial side of the ankle joint and foot b. Artery: femoral artery ( which runs alongside femoral vein and femoral nerve) c. Vein: large superficial vein that runs alongside the saphenous nerve) 2. Lateral cutaneous nerve of thigh: sensory nerve for the lateral thigh 3. Posterior cutaneous nerve of thigh : travels the inferior glueteal artery; sensory nerve for posterior thigh BONES Function- hematopoiesis ( production of RBCs and WBCs) stability, structure Osteoblast- build bones Osteoclast-cleave/ breakdown bone
