Comparing the Upper & Lower Limbs Docs/SH19_lower_limb.pdf · Upper & Lower Limbs Lower Limb ......
Transcript of Comparing the Upper & Lower Limbs Docs/SH19_lower_limb.pdf · Upper & Lower Limbs Lower Limb ......
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Comparing the Upper & Lower Limbs
Lower Limb • Femoral Triangle • Gluteal Region • The Thigh • The Leg • Foot • Pre-axial - medial
Upper Limb • Axilla • Deltoid Region • The Arm • The Forearm • Hand • Pre-axial - lateral
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The Thigh • Named Regions
– Femoral Triangle (cf the axilla) – Subsartorial Canal – Popliteal Fossa (cf the Cubital fossa)
• Muscle groups & their Nerves – Adductors (of the hip) - Obturator Nerve – Abductors - Gluteal Nerves – Extensors (of the knee, some also flex
the hip) - Femoral Nerve – Flexors (of the knee, most also extend
the hip) / Hamstrings - Sciatic Nerve
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Arteries, Veins & Lymphatics
Like Bathroom Plumbing • Arteries - Deliver - High pressure - Thick wall - Narrow pipe • Veins - Retrieve - Low pressure - Thin wall - Wide pipe • Lymphatics - Scavenge
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Anterior Superior Iliac Spine Pubic
Tubercle
Inguinal Ligament
The Femoral Triangle
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Inguinal Ligament
The Femoral Triangle
Adductor Longus
Sartorius
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The Floor
Pectineus
Ilio-Psoas
Adductor Longus
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N
L
A V
The Contents
Long saphenous vein
Saphenous opening
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Bones & Joints
•Bone as a Tissue •Ossification
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Composition of Bone
• Bone cells • Extracellular Components
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Types of Bone
• Cortical/dense/compact Bone – Shafts of long bones – Contains yellow (fatty marrow) in
adults • Cancellous/spongy/trabecular
– Flat bones – Ends of long bones – Contains red (haemopoietic) marrow
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Extracellular Components of Bone
• Fibres – Type 1 collagen
• Matrix – Minerals
• Nerves & vessels
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Organisation of Bone
• Woven (Immature bone) – random
• Mature (Lamellar bone) – Concentric cylindrical plates
(Lamellae) – Haversian Canals - nerves and vessels
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Ossification of a Typical Long Bone
Cartilagenous Outline
Primary centre of ossification embryo Week 9
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Ossification of a Typical Long Bone
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Ossification of a Typical Long Bone
Secondary Centre of Ossification - After birth
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Ossification of a Typical Long Bone
Epithyseal Growth Plate - new bone on shaft side
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Ossification of a Typical Long Bone
Another secondary centre of ossification
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Union! The 2ndary centre that appears last, unites 1st
Main Growth centre remains
Ossification of a Typical Long Bone
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Ossification of a Typical Long Bone
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Joints Either
A discontinuity in bones or
A place where bones meet
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Types of Joints •Fibrous
–No Movement –Located
•Distal tibiofibular joint •Between bone of the skull
•Cartilagenous –Primary - where cartilage meets bone- Strong but no movement
•Ribs & their costal cartilages •Epiphyses in growing bones
–Secondary
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Types of Joints •Cartilagenous
–Secondary - bones joined by fibrocartilage. Limited movement –Midline
•Symphysis pubis •Intervertebral discs
•Synovial “Egg white joints” May allow free movement
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Synovial Joints 6 essential features
•Bone ends covered by hyaline cartilage •A joint cavity filled with synovial fluid •Joint surrounded by a fibrous capsule •Capsule lined by synovial membrane •Capsule reinforced by ligaments •Potentially free movement
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Synovial Joints 6 essential features
Bone ends covered by hyaline cartilage •Hyaline cartilage
–Gristle –More flexible than bone –Avascular –Chondrocytes in ground substance of mucopolysaccharides & collagen
•Fibrocartilage –more like tendon etc, with some chondrocytes
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Synovial Joints 6 essential features
A joint cavity filled with synovial fluid •Sticky lubricating fluid
–Normally sparse 0.5 ml per knee joint –More produced with damage to joints
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Synovial Joints 6 essential features
•Joint surrounded by a fibrous capsule –Originally attached to epiphyses, but it does migrate –Varies in thickness
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Synovial Joints 6 essential features
Capsule lined by synovial membrane •Membrane regarded as connective tissue, not epithelium •Cells produce extracellular substance - synovial fluid •Not joined by junctional complexes etc
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Synovial Joints 6 essential features
Capsule reinforced by ligaments •Ligaments - bone to bone •Tendons - muscle to bone •Aponeuroses - flat tendon •Fascia - wrapping •Retinaculum - holds tendons in place
All basically the same stuff
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Synovial Joints 6 essential features
Potentially free movement •Depends on shape of bone ends •Competing
–Mobility –Stability –Congruous bone shapes –Tight strong ligaments –Adjustable (“live”) ligaments
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Plane X-ray