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  1. 1. Intro To Basic AnatomyKinesiotherapy Clinical Training
  2. 2. BASIC ANATOMY Organization of the Body – Direction & Planes•  Anatomical position - body stands erect with the arms at the sides, palms facing forward•  All body movements and location of anatomical structures are referenced from this position Basic Anatomy 2
  3. 3. Basic Anatomical Positions and Directions•  Inferior – toward the bottom•  Superior – toward the top•  Anterior – toward the front•  Posterior – toward the back•  Medial – toward the midline•  Lateral – away from the midline•  Proximal – closest to the trunk•  Distal – positioned away from the trunk•  Prone – lying face downward•  Supine – lying face upward Basic Anatomy 3
  4. 4. •  The body is divided into 3 imaginary planes of reference •  Sagittal plane – divides the body into right and left sides •  Coronal (frontal plane) – divides the body into front and back sections •  Transverse (horizontal) plane – divides the body into top and bottom sections•  To determine the plane in which a movement occurs, follow the bisecting line. •  Movements of flexion and extension generally occur in the sagittal plane •  Movements of abduction and adduction generally occur in the coronal plane •  Movement of rotation generally occur in the transverse plane Basic Anatomy 4
  5. 5. Skeletal System•  Composed of bones (206), ligaments, and joints•  Main supportive structure of the body•  Axial Skeleton - skull, vertebral column, ribs, sternum, and hyoid bone•  Appendicular Skeleton – upper extremity (scapula, shoulder, arm and hand); lower extremity (hip, femur, tibia, fibula, foot) Articular System•  Articulation – a place of union between two or more bones, regardless of the degree of movement permitted•  Ligaments – attach one bone to another•  Hyaline Cartilage – flexible connective tissue made up of collagen fibers that line the bones of most joints, aids in smooth articulation of the joint•  Joints – articulating structures within the skeletal system; most serve the purpose of bearing weight and providing motion Basic Anatomy 5
  6. 6. Basic Body Joints•  Shoulder girdle – scapula, clavicle•  Shoulder joint – scapula (glenoid fossa), humerus•  Elbow joint – humerus, radius, ulna•  Wrist joint – radius, ulna, carpal bones•  Vertebral column – facet joints of the vertebrae, body-to-body via discs•  Hip joint – pelvis (acetabulum), femur•  Knee joint – femur, tibia, fibula•  Ankle joint – tibia, fibula, talus Basic Anatomy 6
  7. 7. Basic Joint Movements•  Abduction – movement away from the body midline•  Adduction – movement toward the body midline•  Flexion – decreased angle between 2 structures•  Extension – increased angle between 2 structures•  Medial (internal) rotation – rotation of the vertical axis of a bone toward the body midline•  Lateral (external) rotation – rotation of the vertical axis of a bone away from the midline•  Circumduction - complete circular movement at the joint•  Pronation – medial rotation of the forearm (palms down position)•  Supination – lateral rotation of the forearm (palms up position)•  Plantar flexion – moving the foot downward , away from the shin•  Dorsiflexion – moving the foot upward, toward the shin Basic Anatomy 7
  8. 8. Basic Joint Movements•  Shoulder horizontal abduction – moving the humerus across the body away from the midline•  Shoulder horizontal adduction – moving the humerus across the body toward the midline•  Scapular elevation – upward scapula movement (shrugging)•  Scapular depression – downward scapula movement•  Scapular abduction – scapular movement away from the spine•  Scapular adduction – scapular movement toward the spine•  Trunk flexion – anterior movement of the torso toward the pelvis•  Trunk extension – posterior movement of the torso toward the pelvis•  Foot eversion (pronation)– moving the sole of the foot outward at the ankle•  Foot inversion (supination)– moving the sole of the foot inward at the ankle Basic Anatomy 8
  9. 9. Muscular System•  Muscles: •  compose 40-60% of body weight •  provide an important mechanism for maintaining joint stability•  Body movements occur as a result of muscle contractions pulling one bony structure toward another •  Skeletal movement occurs at the joint structures within the body•  Three types of muscle tissue: •  Cardiac – involuntary (cannot be influenced at will) •  Smooth – involuntary •  Skeletal/Striated – voluntary §  made up of long slender cells (fibers), with length greater than width §  control body movements and maintain posture. Basic Anatomy 9
  10. 10. Muscular System•  Musculoskeletal System – the skeletal and muscular systems working in concert to provide body stabilization and movement •  Skeletal movement occurs at the joint structures within the body•  Tendon•  Indirect attachment of muscle to bone•  Distal structures of a muscle that transmits the force of the muscle contraction to bone•  Tendon attachments•  Origin – attachment closest to the body midline or axial skeleton •  Generally the fixed portion that provides a stable base during muscle contraction•  Insertion – attachment farthest from the body midline or axial skeleton •  Is drawn toward the origin during muscle contraction Basic Anatomy 10
  11. 11.   Muscular System•  Muscles that control joint movements are aligned as agonists and antagonists •  Agonist – the muscle that causes a movement to occur (ex. biceps brachii muscle flexes the elbow joint) •  Antagonist – the muscle that directly opposes an agonist muscle action (ex. triceps brachii extends the elbow joint; must relax for elbow flexion to occur)•  Reciprocal Inhibition – when an agonist contracts, the antagonist muscle must relax •  Reciprocal inhibition allows joint movement to occur •  If this does not occur, then tetanus (a state of sustained contraction during which the muscle does not relax to its initial length or tension) results in no movement Basic Anatomy 11
  12. 12. Muscular System•  Stabilizers – muscles that contract statically in one joint, so that movement in an adjacent joint can occur •  Example – During walking or running, the hip abductor muscles of the weight bearing limb contract to stabilize the pelvis so that it does not drop to the non-weight bearing side •  Synergists – muscles that contract to eliminate an undesired joint action in another muscle; can also be called "neutralizers" because they help cancel out, or neutralize, extra motion from the prime mover •  Example – when the gluteus maximus contracts during hip extension, it also attempts to externally rotate the hip; gluteus minimus and the tensor fasciae lata contract to neutralize this movement Basic Anatomy 12
  13. 13. Muscular System•  Strain –an over stretch or tear of a muscle or tendon •  Acute (instant or recent) strain of the musculo-tendinous structure occurs at the junction where the muscle transitions into a tendon •  Occur when a muscle over-stretches or over-contracts, as with running or jumping •  Symptoms may include pain, muscle spasm, loss of strength, and limited range of motion •  Chronic (long-lasting) strains occur over time, from overuse or repetitive stress, resulting in tendinitis (inflammation of a tendon) •  Example: tendinitis in the shoulder as the result of constant stress from repeated tennis serves Basic Anatomy 13
  14. 14. Muscular System•  Sprain –the over stretch or tear of a ligament or a joint capsule •  Sprains occur when a joint is forced beyond its normal range of motion, such as turning or rolling the ankle •  Symptoms may include pain, inflammation, bruising and in some cases, the inability to move a limb•  Sprains (ligament) and strains (muscle or tendon) are categorized according to severity •  Grade I (mild) - involves a minor over stretch or minor tear •  Grade II (moderate) - partially torn but still intact •  Grade III (severe) – a complete tear; can result in joint instability Basic Anatomy 14
  15. 15. Muscular System•  Hypertrophy – an increase in the cross-sectional size of a muscle fiber (cell)•  Atrophy – the wasting or reduction of size of muscle, tissues, organs, etc•  Myalgia – muscle pain•  Myositis – inflammation of a muscle•  Fibrositis – inflammation of connective tissue within a muscle•  Tendonitis –inflammation of the tendon•  Fasciculation(muscle twitch) - small, local, involuntary muscle contraction and relaxation visible under the skin•  Myoclonus - brief, involuntary twitching of a muscle or a group of muscles•  Spasm - a sudden involuntary contraction of a muscle, or a group of muscles Basic Anatomy 15
  16. 16. Muscle Contraction•  Muscle contraction – strength of contraction depends on the number of motor units activated, stimulation frequency of the motor units, muscle fiber length, and speed of contraction•  Types of Contraction •  Isometric (static)- muscle tension develops with no change in muscle length and no joint movement; ex. carrying a heavy object •  Isotonic (dynamic) – muscle tension remains constant, muscle length changes and movement occurs; contraction can be concentric or eccentric •  Concentric - force generated is sufficient to overcome the resistance, and the muscle shortens as it contracts; this is what most people think of as a muscle contraction •  Eccentric – the muscle lengthens as it develops tension, and contracts to control motion against an external resistance; ex. lowering a load gently rather than letting it drop Basic Anatomy 16
  17. 17. Muscle Fibers•  Skeletal muscle contains a combination of fiber types that are classified as: •  Slow Twitch or Type 1 •  Fast Twitch or Type IIa •  Fast Twitch or Type IIx•  Type I (slow twitch) fibers use oxidative metabolism •  Appear red due to the high concentration of myoglobin •  Generate a low level of muscle tension •  Have slow contraction times, are well suited for prolonged, low intensity work •  Endurance athletes generally have a high quantity of slow-twitch fibers Basic Anatomy 17
  18. 18. Muscle Fibers•  Type IIa (fast twitch) use oxidative and glycolytic metabolism •  Type IIa are also red •  An intermediate fast twitch fiber •  Tend to contract with a burst of force, then fatigue •  Can sustain activity for moderate lengths of time at higher intensities •  Examples - Type IIa fibers would be advantageous in gymnastics and rowing•  Type IIx (fast twitch) use oxidative and glycolytic metabolism •  Type IIx appear white (absence of myoglobin) •  Provide rapid force production, but then fatigue quickly •  Provides greatest potential for power movements that rely on maximal efforts •  Examples - sprinters, jumpers, shot putters, and Olympic weight lifters benefit from Type IIx fibers Basic Anatomy 18
  19. 19. Muscle Fibers•  Each muscle contains a combination of all three fiber types•  Percentage of fiber distribution varies considerably from muscle to muscle, and person to person•  Distribution/proportion of fiber types in a given muscle determines that muscle’s performance capabilities•  Fiber distribution influences how the muscle responds to training, and ultimately how it develops•  The mode of training application will not alter a person’s fiber distribution; however specific fibers within the distribution are enhanced by the type of stimulus applied to the muscle Basic Anatomy 19
  20. 20. Muscle Fibers•  When performing a series of repetitions during a resistance exercise movement (such as a barbell curl) the slow twitch fibers are recruited first•  As the repetitions progress, and the effort becomes more intensive, more fast twitch fibers are recruited Basic Anatomy 20
  21. 21. Nervous System•  Group of tissue composed of highly specialized cells possessing the characteristics of excitability and conductivity•  Regulates all functions related to human movement, as well as other bodily functions•  Two types of cells •  Neuroglia – function in supportive, reparative, and metabolic capacities •  Neurons – basic unit of the nervous system which conducts an electrical impulse from one part of the body to another •  Two types of processes on each neuron: •  Axon - carries impulse away from the cell body •  Dendrites - carry impulse toward the cell body Basic Anatomy 21
  22. 22.   Nervous System •  Neurons (cont.) •  Two types of functions: •  Afferent (sensory) – convey impulses from receptor cells in the skin , tissues, or other organs to the spinal cord and brain •  Efferent (motor) - carry impulses from the spinal cord and brain to effector cells (muscle fibers)•  Major Branches of the Nervous System •  Central Nervous System (CNS) – brain and spinal cord •  Peripheral Nervous System (PNS) – cranial and spinal nerves •  Autonomic Nervous System (ANS) – portions of the CNS and peripheral nervous system, regulates organ function, blood flow, and other involuntary functions Basic Anatomy 22
  23. 23.  Nervous System Basic Anatomy 23
  24. 24.   Central Nervous System•  Brain – largest mass of nervous tissue in the body, located in skull •  Cerebrum - largest portion of the brain which contains nerve centers governing all sensory and motor activities •  Partially divided by median longitudinal fissure into two hemispheres •  Each hemisphere divided by fissures into four major lobes: frontal, parietal, occipital, temporal •  Cerebellum – occupies the posterior cranial fossa and consists of three lobes •  Anterior: controls posture •  Posterior: controls coordination and movement •  Flocculonodular: controls equilibrium Basic Anatomy 24
  25. 25.   Central Nervous System•  Spinal Cord – contains all ascending (afferent) and descending (efferent) fiber tracts connecting PNS and ANS, and brain •  Anterior gray matter contains cell bodies from which efferent (motor) fibers of the spinal nerves arise •  Posterior gray contains cell bodies from which afferent (sensory) fibers pass toward brain Basic Anatomy 25
  26. 26. Peripheral Nervous System•  Cranial Nerves – 12 pairs of symmetrically arranged nerves attached to the brain Basic Anatomy 26
  27. 27.   Peripheral Nervous System•  Spinal Nerves – 31 pairs: •  8 cervical •  12 thoracic •  5 lumbar •  5 sacral •  1 coccygeal •  Four plexuses: •  cervical (C-1,2,3,4) •  brachial (C5,6,7,8,&T1) •  lumbar (L1,2,3,4) •  sacral (L4,5,S1,2,3) Basic Anatomy 27
  28. 28. Dermatomes•  An area of skin supplied by one pair of spinal nerves Basic Anatomy 28
  29. 29. Reflexes•  Reflex – an involuntary and nearly instantaneous movement in response to a sensory stimulus •  Can be superficial (cutaneous stimulation), deep (tendon or vascular tissue stimulation), visceral (organs), or pathologic (abnormal) •  Generally serve to protect the body •  Indirect reflex arc – sensory impulse that is processed by a mediating or internuncial neuron before being passed on to an anterior motor neuron •  Most reflexes are this type •  Example: receptors detect tension applied to a tendon by muscle contraction; reflex arc results in inhibition of further contraction Basic Anatomy 29
  30. 30. Reflexes•  Direct Reflex Arc – sensory impulse that passes directly to the anterior motor neuron •  Monosynaptic (i.e. only one sensory and one motor neuron is involved) •  Example: stretch or myotatic reflex •  Most important and prominent •  Leads to contraction of the muscle •  Prevents overstretching of the muscle •  Ex. knee jerk (stimulation of patellar tendon) Basic Anatomy 30
  31. 31. Autonomic Nervous System•  Controls the visceral functions of the body•  Generally considered to be involuntary•  Links the control centers of the brain with the effector organs•  Overall function is to maintain homeostasis of the internal environment and provide the “fight or flight” response•  Divided into the sympathetic and parasympathetic nervous divisions •  Sympathetic – more primitive, constricts blood vessels, involved in “fight or flight”, stimulates activity •  Parasympathetic – more advanced, acts principally on smooth muscles and glands in the gut, concerned with restorative processes, inhibits activity Basic Anatomy 31
  32. 32. BASIC ANATOMY•  Suggested Readings :•  1. Jacob, SW and Francone, CA, Structure and Function in Man. W.B Saunders, 5th Ed. 1982 Basic Anatomy 32