Adv Anatomy Exam 1 Material

Surface Anatomy for back of head and neck

Site of external occipital protuberance, nuchal groove, C7 spinous process, T1 spinous process, T2 spinous process, supraspinous ligament, T4 spinous process

Surface Anatomy for back

Location of base of sacrum, spinous processes of lumbar vertebrae, posterior median furrow, supracristal plane, dimples overlying posterior superior iliac spines, superior part of intergluteal cleft

Normal Curvatures of the Spine

Kyphoses and Lordoses

Kyphoses

Concave anteriorly. Includes thoracic and sacral curves

Lordoses

Concave posteriorly. Include cervical and lumbar curves

Abnormal Curvatures of the Spine

Excessive kyphosis, excessive lordosis, and scoliosis

Differences between the male and female pelvis

The female ilia are more laterally flared to provide a wider pelvis. The female pelvis inlets are wider and oval while the male inlets are somewhat heart shaped. The subpubic angle in the female is wider (greater than 90 degrees while males are less than 90 degrees)

Angle of Inclination of the Femur

Angle of the head/neck to the shaft. This angle is greatest at birth and decreases with age. This angle is less in females. Is normally between 120-130 degrees.

Q Angle of Femur

Angle between the vertical line through the midpoint of the patella and the oblique line connecting the midpoint of the patella to the ASIS. Is normally between 8-10 degrees for males and up to 15 degrees for females

Excessive Q angles (>15 degrees)

Likely to increase risks of patellofemoral pathology. Can cause pain, chondromalacia, extensor dysfunction, recurrent dislocation/subluxation

Angle of Torsion of the Femur

The twist of the femur. The head/neck are not perfectly aligned with the condyles, they are at an angle to each other. Normal angle is between 7-15 degrees.

To much torsion of the femur

Greater than 15 degrees. Called excessive anteversion and results in toe in gait

Not enough torsion of the femur

Less than 7 degrees. Called retroversion and results in toe out gait

Angle of Inclination of the Humerus

The angle between the axis of the head/neck of the humerus and the anatomical axis of the humeral shaft. Usually around 135 degrees.

Repetitive overhead motion in youth

can reduce the normal humeral torsion during development. The same can be said for elite baseball players.

Angle of Torsion of the Humerus

The twist of the humerus. The angle between the axis of the head/neck of the humerus and the inter-epicondylar axis. Is usually around 20 degrees. It’s highest at birth but decreases in childhood.

6 Types of synovial joints

Gliding, pivot, hinge, condylar, saddle, ball-and-socket

Gliding Joint

Uniaxial. Two flat or slightly curved bone surfaces slide past each other. Includes intercarpals, intertarsals, and acromioclavicular

Pivot Joint

Uniaxial. Rotation around longitudinal axis. Atlanto-axial joint and radiohumeral.

Hinge Joint

Uniaxial. Flexion and extension only. Humeroulaner, interphalangeal

Condylar Joint

Biaxial. Eggshaped head fit in oval shaped cavity of another bone. Either flexion/extension and abduction/adduction or flexion/extension and rotation. Metarsophalangeal, metacarpophalangeal.

Saddle Joint

Biaxial. Includes flexion/extension and abduction/adduction. Trapezium and 1st metacarpal

Ball and Socket Joint

Multiaxial. Flexion, extension, abduction, adduction, horizontal abduction, horizontal adduction, internal rotation, external rotation, circumduction, Glenohumeral and acetabulofemoral

Open Chained movement

The most distal part of the joint segment moves. Hands and feet typically move the resistance. Includes knee extensions, bench press, lat pulldown, bicep curls

Closed Chain movement

The most distal joint segment contacts the earth or another immovable object. Proximal segments move. Typically involves more joints and muscle groups. Includes squats, deadlifts, pushups, pullups

Close-Packed position

where the joint is most stable

Open-packed position

features surfaces that are less closely matched and can move in a combination of small imperceptible movements called roll, spin, and glide

Close packed position of the glenohumeral joint (shoulder)

Abduction + external rotation

Open packed position of the glenohumeral (shoulder) joint

Semi-abduction

Close packed position of the ulnohumeral (elbow) joint

extension

Open packed position of the ulnohumeral (elbow) joint

Semi-flexion

Close packed position of the radiocarpal (wrist) joint

extension

Open packed position of the radiocarpal (wrist) joint

Semi-flexion

Close packed position of the acetabulofemoral (hip) join

Extension+internal rotation

Open packed position of the acetabulofemoral (hip) joint

Semi-flexion

Close packed position of the tibiofemoral (knee) joint

Extension

Open Packed position of the tibiofemoral (knee) joint

Semi-flexion

Close packed position of the talocrural (ankle) joint

Dorsiflexion

open packed position of the talocrural (ankle) joing

Neutral

Screw Home Mechanism

The knee joint automatically rotates during the final degrees of straightening and “locks” the leg into a stable standing position. Allows the person to stand without constantly using leg muscles.

What is the anatomy behind the Screw Home Mechanism

The larger shape of the medial femoral condyle, tension in the anterior cruciate ligament, and lateral pull of quadriceps all contribute to external rotation of the tibia relative to the femur

Medial Meniscus

Broader posteriorly than anteriorly, C shaped, less mobile on the tibial plateau than the lateral meniscus, attached to TCL/MCL, more prone to damage

Lateral Meniscus

lies on the lateral tibial plateau, nearly circular, smaller than medial, more moveable than medial, no attachment to FCL/LCL

The shoulder girdle

considered the articulation of the scapular, clavicle, and humerus

The glenohumeral joint

is simply the articulation of the humerus and glenoid fossa of the scapula

Scapulohumeral rythymn

the scapula and humerus move in 1:2 ratio. When the arm is abducted 180 degrees, 60 degrees occurs by rotation of the scapula and 120 degrees by rotation of the humerus at the shoulder joint

3 Arthrokinematics Rules

Roll always goes in the same direction with the moving bone. When the concave surface moves glide occurs in the same direction. When the convex surface moves glide occurs in the opposite direction.

Talocalcaneal or Subtalar Joint

The articulation between the talus and calcaneus. Is a multiaxial gliding joint. Open chain is when calcaneus moves freely while the talus is fixed in place and closed chain is when the calcaneus is fixed on the ground while the talus moves on top of it.

Attachment of the Acromioclavicular Ligament

Acromion process of scapular to the acrmoal end of clavicle

Function of Acromioclavicular Ligament

Resists anteroposterior displacement of the clavicle

Attachment of the Coracohumeral ligament

Coracoid process of the scapular as two bands to the greater and lesser tubercles

Function of the Coracohumeral ligament

Resists inferior humeral head translation and external rotation. Also supports weight of arm

Attchament of Glenohumeral superior ligament

superior anatomic neck of humerus to supraglenoid tubercle of the scapula

Function of the Glenohumeral superior ligament

Resists inferior and anterior translation and external rotation of humerus

Attachment of the Glenohumeral middle ligament

Middle anatomical neck of humerus to middle glenoid margin of scapula

Function of Glenohumeral middle ligament

Resists anterior translation and external rotation of humerus

Attachment of Glenohumeral inferior ligament

ingerior anotimcal neck of the humerus to anterior to posterior aspects of inferior glenoid margin of scapula

Function of Glenohumeral inferior ligament

Resists abduction of humerus

Attachment of the Annular ligament

Anterior margin of radial notch of ulna to posterior margin of radial notch of ulna

Function of Annular ligament

stabilizes the radial head within the radial notch of the ulna during rotation

Attachment of the Radial collateral ligament

lateral epicondyle of the humerus to annular ligament

Function of the radial collateral ligament

stabilizes against lateral forces to the elbow and resists excessive movement of the elbow laterally

Attachment of the ulnar collateral ligament

medial epicondyle of the humerus to olecranon of the ulna and coronoid process of ulna. also coronoid process of ulna to olecranon of ulna

Function of Ulnar collateral

stabilizes during actions such as throwing and resists excessive movement of the elbow medially

Attachment of the Pubofemoral ligament

iliopubic ramus, superior pubic ramus to intertrochanteric crest of femur

Function of Pubofemoral ligament

resists excessive abduction, extension, and external rotation of the hip

Attachment of the iliofemoral

Anterior inferior iliac spine of ilium to intertrochanteric crest of femur

Function of iliofemoral ligament

resists excessive extension and external rotation of the hip

Attachment of the ischiofemoral ligament

acetabular rim to greater trochanter of femur

Function of ischiofemoral ligament

resists excessive internal rotation and extension of the hip

Attachment of the anterior cruciate ligament

anterior interconylar eminence of tibia to posteromedial surface of intercondylar notch on the lateral femoral condyle

Function of the anterior cruciate ligament

resists excessive posterior translation of the femur and excessive anterior translation of the tibia

Attachment of the posterior cruciate ligament

posterior intercondylar eminence of tibia to anterolateral surface of intercondylar notch on the medial femoral

Function of the posterior cruciate ligament

resists excessive anterior translation of the femur and excessive posterior translation of the tibia

Attachment of the Tibial collateral

Medial femoral epicondyle to medial meniscus and posteromedial crest of the tibia

Function of the Tibial collateral ligament

resists lateral forces at the knee, knee extension and rotation

Attachment of fibular collateral ligament

lateral femoral epicondyle to lateral surface of fibular heaf

Function of Fibular collateral ligament

resists medial forces at the knee, knee extension and rotation

Attachment of the Deltoid ligament

medial malleolus of tibia to medial aspects of the navicular, calcaneous, and talus

Function of the deltoid ligament

resists excessive ankle eversion

Attachment of the anterior talofibular ligament

lateral malleolus of fibula to lateral talus

Function of Anterior talofibular ligament

resists inversion and anterior foot translation

Attachment of posterior talofibular ligament

lateral malleolar fossa of fibular to posterolateral talus

Function of Posterior talofibular ligament

resists inversion and posterior translation of foot

Attachment of Calcaneofibular ligament

anterior lateral malleolus of fibula to lateral calcaneous

Function of Calcaneofibular ligament

resists inversion and posteior translation of the foot