This document provides an overview of human anatomy, bones, and joints. It begins by defining anatomical position and anatomical planes used to describe the body. It then discusses the skeletal system, including bone composition, classification of bones, bone cells, and growth. The document also covers joints, describing their classification and functions. Key anatomical structures like body cavities and regions are defined.
This document provides information about congenital talipes equinovarus, or clubfoot. It begins with definitions and descriptions of the deformities associated with clubfoot. It then discusses the epidemiology, causes, bony abnormalities, pathological anatomy, clinical features, classifications systems including Pirani and Dimeglio, treatment including serial casting and the Ponseti method as well as surgical options. Radiographic images are included to illustrate the deformities. The goal of treatment is to produce a plantigrade, supple foot that functions well, and the Ponseti method is now the standard non-operative treatment approach.
The document summarizes the biomechanics of the lower extremity, including the hip, knee, ankle, and foot. It describes the bony structures, ligaments, muscles, and movements of each joint. It also discusses common injuries to these areas such as fractures, strains, ligament tears, and tendonitis. Loads and forces on the joints during various activities are explained.
This document provides an overview of congenital bone and cartilage diseases. It discusses osteogenesis imperfecta, which is caused by defective type 1 collagen synthesis resulting in brittle bones. It describes the different types of OI from mildest to most severe. It also covers fibrous dysplasia, which is a benign bone tumor, and its different forms. Achondroplasia is discussed as being caused by a mutation affecting cartilage growth plate maturation. Osteopetrosis, or marble bone disease, is characterized by increased bone density due to defective osteoclast activity.
Kinesiology is the study of human movement. It involves the analysis of motion from anatomical, mechanical, and physiological perspectives. Key topics covered in the chapter include osteokinematics, which describes bone motion; arthrokinematics, which describes joint motion; and kinetics, which describes the forces that produce movement. Proper understanding of these biomechanical principles is important for analyzing and evaluating human movement.
MRI is a noninvasive imaging technique that is useful for evaluating many orthopedic conditions. It provides excellent soft tissue contrast without radiation exposure. Key applications in orthopedics include evaluation of the spine, knee, shoulder, hip and other joints. MRI uses different pulse sequences like T1- and T2-weighted images to characterize tissues. T1 images provide good anatomical detail while T2 images are useful for detecting pathologies like edema. MRI is especially helpful for identifying injuries to ligaments, tendons, menisci and labral structures.
Diabetes can cause many complications affecting the feet including neuropathy, vasculopathy, and immunopathy which increase risks for foot ulcers and infections. Neuropathy damages nerves through multiple pathways like reactive oxygen species, impairing sensation and motor function. Vasculopathy damages blood vessels increasing risks of ischemia. Immunopathy impairs immune response to infection. Charcot arthropathy is a condition where loss of autonomic control and sensation leads to repetitive micro-trauma and bone destruction in the foot. Treatment involves wound care, offloading pressure through casting, surgery to correct deformities or remove infected tissue, and managing underlying complications of diabetes.
The knee joint is the largest and most complicated joint in the body. It consists of three joints within a single synovial cavity: the medial and lateral condylar joints between the femur and tibia, and the patellofemoral joint between the patella and femur. The knee joint is supported by ligaments such as the ACL and PCL, as well as menisci. Osteoarthritis is a common condition affecting the knee joint, characterized by the progressive destruction of articular cartilage and new bone growth, leading to pain and stiffness. It results from an imbalance between mechanical stress on the cartilage and its ability to withstand that stress.
This document discusses the management of hip dislocations. It covers the anatomy of the hip joint, mechanisms of injury, classification systems, clinical evaluation including imaging, closed and open reduction techniques, postoperative management, and complications. The key points are that early reduction within 6 hours can decrease the risk of avascular necrosis, multiple imaging views may be needed, and surgical treatment is often required for irreducible, unstable, or incongruent dislocations. Complications include avascular necrosis, osteoarthritis, recurrent dislocation, and nerve injury.
This document provides information about congenital talipes equinovarus, or clubfoot. It begins with definitions and descriptions of the deformities associated with clubfoot. It then discusses the epidemiology, causes, bony abnormalities, pathological anatomy, clinical features, classifications systems including Pirani and Dimeglio, treatment including serial casting and the Ponseti method as well as surgical options. Radiographic images are included to illustrate the deformities. The goal of treatment is to produce a plantigrade, supple foot that functions well, and the Ponseti method is now the standard non-operative treatment approach.
The document summarizes the biomechanics of the lower extremity, including the hip, knee, ankle, and foot. It describes the bony structures, ligaments, muscles, and movements of each joint. It also discusses common injuries to these areas such as fractures, strains, ligament tears, and tendonitis. Loads and forces on the joints during various activities are explained.
This document provides an overview of congenital bone and cartilage diseases. It discusses osteogenesis imperfecta, which is caused by defective type 1 collagen synthesis resulting in brittle bones. It describes the different types of OI from mildest to most severe. It also covers fibrous dysplasia, which is a benign bone tumor, and its different forms. Achondroplasia is discussed as being caused by a mutation affecting cartilage growth plate maturation. Osteopetrosis, or marble bone disease, is characterized by increased bone density due to defective osteoclast activity.
Kinesiology is the study of human movement. It involves the analysis of motion from anatomical, mechanical, and physiological perspectives. Key topics covered in the chapter include osteokinematics, which describes bone motion; arthrokinematics, which describes joint motion; and kinetics, which describes the forces that produce movement. Proper understanding of these biomechanical principles is important for analyzing and evaluating human movement.
MRI is a noninvasive imaging technique that is useful for evaluating many orthopedic conditions. It provides excellent soft tissue contrast without radiation exposure. Key applications in orthopedics include evaluation of the spine, knee, shoulder, hip and other joints. MRI uses different pulse sequences like T1- and T2-weighted images to characterize tissues. T1 images provide good anatomical detail while T2 images are useful for detecting pathologies like edema. MRI is especially helpful for identifying injuries to ligaments, tendons, menisci and labral structures.
Diabetes can cause many complications affecting the feet including neuropathy, vasculopathy, and immunopathy which increase risks for foot ulcers and infections. Neuropathy damages nerves through multiple pathways like reactive oxygen species, impairing sensation and motor function. Vasculopathy damages blood vessels increasing risks of ischemia. Immunopathy impairs immune response to infection. Charcot arthropathy is a condition where loss of autonomic control and sensation leads to repetitive micro-trauma and bone destruction in the foot. Treatment involves wound care, offloading pressure through casting, surgery to correct deformities or remove infected tissue, and managing underlying complications of diabetes.
The knee joint is the largest and most complicated joint in the body. It consists of three joints within a single synovial cavity: the medial and lateral condylar joints between the femur and tibia, and the patellofemoral joint between the patella and femur. The knee joint is supported by ligaments such as the ACL and PCL, as well as menisci. Osteoarthritis is a common condition affecting the knee joint, characterized by the progressive destruction of articular cartilage and new bone growth, leading to pain and stiffness. It results from an imbalance between mechanical stress on the cartilage and its ability to withstand that stress.
This document discusses the management of hip dislocations. It covers the anatomy of the hip joint, mechanisms of injury, classification systems, clinical evaluation including imaging, closed and open reduction techniques, postoperative management, and complications. The key points are that early reduction within 6 hours can decrease the risk of avascular necrosis, multiple imaging views may be needed, and surgical treatment is often required for irreducible, unstable, or incongruent dislocations. Complications include avascular necrosis, osteoarthritis, recurrent dislocation, and nerve injury.
1) The document discusses acetabular fractures, including the anatomy and biomechanics of the acetabulum, classification systems, imaging, and management considerations.
2) Key anatomical structures include the anterior and posterior columns that support the acetabulum. The Judet-Letournel classification system categorizes fractures as elementary or associated types based on involvement of the anterior column, posterior column, transverse fracture pattern, and combinations.
3) Evaluation involves clinical exam along with radiographs including pelvis AP, iliac and obturator oblique views, and CT scan to fully characterize the fracture pattern and guide treatment planning. Accurate classification is important for determining the proper surgical approach and management.
The Achilles tendon is the largest tendon in the body, originating from the gastrocnemius and soleus muscles and inserting on the calcaneal tuberosity. It lacks a true synovial sheath and is surrounded by a paratenon with visceral and parietal layers that allows 1.5cm of tendon glide. The tendon has a blood supply from the musculotendinous junction, osseous insertion, and multiple vessels on the anterior surface of the paratenon. Ruptures most commonly occur in the watershed area 4cm proximal to the insertion in those aged 30-40 years old during eccentric loading. Treatment involves diagnosis, primary care, and either operative
This document discusses intertrochanteric fractures, including definition, epidemiology, classification systems, treatment options, and complications. It provides an overview of fracture anatomy, mechanisms of injury, evaluation with x-rays, and classifications including Boyd & Griffin, Evans, and AO. Treatment options discussed include non-operative management, internal fixation with devices like the dynamic hip screw and intramedullary nails, and prosthetic replacement. Post-operative rehabilitation and complications of treatment are also summarized.
The sciatic nerve is the longest and largest nerve in the human body. It runs from the lower back through the back of the leg, and down to the toes. Any type of pain and/or neurological symptoms that are felt along the sciatic nerve is referred to as sciatica.
Fractures & dislocations general principlesDr KAMBLE
This document provides an overview of fractures and dislocations, including:
- A fracture is a break in the continuity of a bone, while a dislocation is the complete displacement of articular surfaces from one another.
- Fractures can be classified based on etiology (traumatic, pathological, stress), displacement, relationship to external environment (closed, open), complexity of treatment (simple, complex), and pattern (transverse, oblique, etc.).
- Pathological fractures occur through weakened bone from underlying disease. Treatment involves addressing the underlying cause and stabilizing the fracture.
- Dislocations can cause immediate complications like neurovascular injury or long-term issues like recurrence, stiffness and arthritis.
Post traumatic myositis ossificans dr. k. prashanthPrashanth Kumar
This document discusses myositis ossificans, a condition where heterotopic bone forms in soft tissue, most often muscle, following trauma. Key points include:
- It is characterized by the development of mature bone in non-osseous tissues like muscle. Adolescents and young men are most commonly affected.
- Trauma is the most common precipitating factor. The pathogenesis involves cellular injury, necrosis, and proliferation of fibroblasts and mesenchymal cells that form bone.
- Radiographs show calcifications and ossification developing over weeks. Histopathology shows zones of ossification.
- Treatment involves rest, splinting, NSAIDs, and physical therapy to prevent loss of range
This document discusses zonal CME conducted at GSLMC on the superior shoulder suspensory complex (SSSC). It defines the SSSC as a bony and soft tissue ring structure that maintains the stable relationship between the scapula and axial skeleton. Injuries to two structures in the SSSC can cause instability known as the "floating shoulder". Treatment depends on the amount of displacement, with conservative management used for displacements under 5mm and no caudal displacement of the glenoid. Surgical stabilization is recommended for larger displacements or malalignment.
The document discusses Lisfranc injuries to the midfoot. It describes the anatomy of the tarso-metatarsal joint and ligaments. Lisfranc injuries typically result from direct trauma or twisting forces that cause plantar flexion and axial loading. Clinical presentation can vary from pain with weight bearing to deformity and instability. Diagnosis involves physical exam, x-rays showing misalignment or "fleck sign", and possibly CT/MRI. Injuries are classified as homolateral or divergent. Treatment depends on severity and may include immobilization, closed reduction, or surgery. Complications can include chronic pain or repeated injuries.
The hip joint is a ball and socket synovial joint that connects the femur to the pelvis. It allows flexion, extension, abduction, adduction, and rotation. Stability is provided by the depth of the acetabulum, ligaments like the iliofemoral and ischiofemoral, and surrounding muscles. Diseases that can affect the hip joint include congenital hip dislocation, Legg-Calve-Perthes disease, osteoarthritis, and tuberculosis.
Vertebral Column is a complex structure of the Human body. It does not only provides protection for spinal cord but also provide mobility and stability of the trunk and the extremities. To learn structure of Vertebral Column and more Online Medical Resource, Visit at http://gisurgery.info
Coxa vara is a deformity of the hip where the angle between the femoral head and shaft is reduced to less than 120 degrees. This causes shortening of the leg and a limp. It is commonly caused by injury like a fracture or a softer bone structure in the femoral neck. Symptoms include a short leg limp or restricted abduction. It is diagnosed radiologically by signs like a widened bitrochanteric measurement. Treatment may involve a valgus osteotomy of the femur if needed to correct the deformity.
Perthes disease is a childhood condition that affects the blood supply to the femoral head, causing bone death (avascular necrosis). It most commonly affects boys between ages 4-8. While the disease process is self-limiting, it can have permanent effects on the femoral head shape and hip function. Treatment aims to contain the femoral head within the acetabulum during healing to promote proper reshaping, through nonsurgical means like bracing or surgical options like osteotomies if needed. The long-term outcomes are evaluated using classifications like Stulberg or Mose, with the goal of achieving a spherical femoral head congruent with the acetabulum. Management approaches vary between centers based on each child's severity and prognosis
The document provides guidance on how to effectively work up and summarize a surgical patient case during a residency interview. It emphasizes knowing the preferred procedures of the interviewing program and being able to describe radiographic findings of flat feet in a systematic way. For a flat foot work up, the assistant should identify deformities in the sagittal, frontal, and transverse planes, then suggest procedures to address each, such as a gastrocnemius recession for sagittal plane correction or a medial calcaneal slide for frontal plane correction. Reading flat foot radiographs involves assessing specific angles on both AP and lateral views that indicate planovalgus deformity severity and type.
Jean-Martin Charcot first described neuropathic arthropathy in 1868. It is a progressive joint condition characterized by dislocations, fractures, and deformities that results from sensory or autonomic neuropathy from various conditions like diabetes, MS, alcoholism, etc. The pathophysiology involves both repetitive microtrauma from loss of sensation and an inflammatory process induced by neurovascular changes. It commonly affects the foot, knee, and hip. Diagnosis is made clinically and radiographically, showing features like joint destruction and deformity. Treatment involves casting, bracing, and surgery like fusion for advanced cases.
This document discusses meniscus injuries of the knee. It describes the anatomy and functions of the medial and lateral meniscus. Common types of meniscal tears are described based on location and pattern. Physical exam maneuvers for diagnosing meniscal tears include Thessaly test, McMurray's test, and Apley's grinding test. MRI is the most sensitive imaging method. Treatment involves initial rest, ice, and NSAIDs for minor tears. Surgery options include partial meniscectomy, meniscal repair, or meniscal transplantation for more severe tears. The goal of treatment is to relieve symptoms and prevent further joint damage.
The skeletal system has several functions including protection of organs, providing levers for movement, and storing minerals. It is divided into the axial skeleton which includes the skull, vertebrae, and ribs, and the appendicular skeleton comprising the upper and lower limbs. Bones are classified as long, short, flat, or irregular. Bone formation occurs through ossification by osteoblasts and osteoclasts. Osteoporosis is the thinning of bones which can be prevented by sufficient calcium, vitamin D, weight bearing exercise, and good nutrition. Synovial joints like the ball-and-socket hip joint allow a wide range of movement. Connective tissues like cartilage, tendons, and ligaments support the skeletal system.
Principle of tension band wiring n its applicationRohit Kansal
1. The tension band technique converts tensile forces into compressive forces through the application of a tension band on the tension side of a bone.
2. Examples of where tension band fixation is commonly used include patella and olecranon fractures, as well as fractures of the greater tuberosity and greater trochanter.
3. Tension band wiring, plating, and external fixation can all function as tension bands by applying a compressive force across a fracture to promote healing.
A 41-year-old male presented with right hip, knee, and groin pain that began six months ago after a fall. He was previously treated with high-dose corticosteroids for skin lesions, which likely caused his current avascular necrosis (bone cell death due to interrupted blood flow). Imaging showed abnormalities in his right femoral head consistent with avascular necrosis. He was diagnosed with avascular necrosis likely caused by his past prolonged corticosteroid use.
Biomechanics of Ankle joint- intended to share the powerpoint with first year undergraduate students at Kathmandu University School of Medical Sciences, Nepal.
This is a short presentation on avascular necrosis of femoral head. This presentation gives brief description of causes of AVN, investigations and modes of treatment options available.
AVN TREATMENT IN HYDERABAD
Core decompression for AVN
Stem cell treatment for AVN
Surgery for AVN
Avascular necrosis treatment options
Hip replacement in hyderabad
Hip specialist in hyderabad
Hip surgery in hyderabad
Total hip replacement in hyderabad
cemented hip replacement
uncemented hip replacement in hyderabad
ceramic hip replacement
delta motion hip
ceramic on ceramic hip replacement
metal on poly hip replacement
affordable hip replacement in hyderabad
1) The document discusses acetabular fractures, including the anatomy and biomechanics of the acetabulum, classification systems, imaging, and management considerations.
2) Key anatomical structures include the anterior and posterior columns that support the acetabulum. The Judet-Letournel classification system categorizes fractures as elementary or associated types based on involvement of the anterior column, posterior column, transverse fracture pattern, and combinations.
3) Evaluation involves clinical exam along with radiographs including pelvis AP, iliac and obturator oblique views, and CT scan to fully characterize the fracture pattern and guide treatment planning. Accurate classification is important for determining the proper surgical approach and management.
The Achilles tendon is the largest tendon in the body, originating from the gastrocnemius and soleus muscles and inserting on the calcaneal tuberosity. It lacks a true synovial sheath and is surrounded by a paratenon with visceral and parietal layers that allows 1.5cm of tendon glide. The tendon has a blood supply from the musculotendinous junction, osseous insertion, and multiple vessels on the anterior surface of the paratenon. Ruptures most commonly occur in the watershed area 4cm proximal to the insertion in those aged 30-40 years old during eccentric loading. Treatment involves diagnosis, primary care, and either operative
This document discusses intertrochanteric fractures, including definition, epidemiology, classification systems, treatment options, and complications. It provides an overview of fracture anatomy, mechanisms of injury, evaluation with x-rays, and classifications including Boyd & Griffin, Evans, and AO. Treatment options discussed include non-operative management, internal fixation with devices like the dynamic hip screw and intramedullary nails, and prosthetic replacement. Post-operative rehabilitation and complications of treatment are also summarized.
The sciatic nerve is the longest and largest nerve in the human body. It runs from the lower back through the back of the leg, and down to the toes. Any type of pain and/or neurological symptoms that are felt along the sciatic nerve is referred to as sciatica.
Fractures & dislocations general principlesDr KAMBLE
This document provides an overview of fractures and dislocations, including:
- A fracture is a break in the continuity of a bone, while a dislocation is the complete displacement of articular surfaces from one another.
- Fractures can be classified based on etiology (traumatic, pathological, stress), displacement, relationship to external environment (closed, open), complexity of treatment (simple, complex), and pattern (transverse, oblique, etc.).
- Pathological fractures occur through weakened bone from underlying disease. Treatment involves addressing the underlying cause and stabilizing the fracture.
- Dislocations can cause immediate complications like neurovascular injury or long-term issues like recurrence, stiffness and arthritis.
Post traumatic myositis ossificans dr. k. prashanthPrashanth Kumar
This document discusses myositis ossificans, a condition where heterotopic bone forms in soft tissue, most often muscle, following trauma. Key points include:
- It is characterized by the development of mature bone in non-osseous tissues like muscle. Adolescents and young men are most commonly affected.
- Trauma is the most common precipitating factor. The pathogenesis involves cellular injury, necrosis, and proliferation of fibroblasts and mesenchymal cells that form bone.
- Radiographs show calcifications and ossification developing over weeks. Histopathology shows zones of ossification.
- Treatment involves rest, splinting, NSAIDs, and physical therapy to prevent loss of range
This document discusses zonal CME conducted at GSLMC on the superior shoulder suspensory complex (SSSC). It defines the SSSC as a bony and soft tissue ring structure that maintains the stable relationship between the scapula and axial skeleton. Injuries to two structures in the SSSC can cause instability known as the "floating shoulder". Treatment depends on the amount of displacement, with conservative management used for displacements under 5mm and no caudal displacement of the glenoid. Surgical stabilization is recommended for larger displacements or malalignment.
The document discusses Lisfranc injuries to the midfoot. It describes the anatomy of the tarso-metatarsal joint and ligaments. Lisfranc injuries typically result from direct trauma or twisting forces that cause plantar flexion and axial loading. Clinical presentation can vary from pain with weight bearing to deformity and instability. Diagnosis involves physical exam, x-rays showing misalignment or "fleck sign", and possibly CT/MRI. Injuries are classified as homolateral or divergent. Treatment depends on severity and may include immobilization, closed reduction, or surgery. Complications can include chronic pain or repeated injuries.
The hip joint is a ball and socket synovial joint that connects the femur to the pelvis. It allows flexion, extension, abduction, adduction, and rotation. Stability is provided by the depth of the acetabulum, ligaments like the iliofemoral and ischiofemoral, and surrounding muscles. Diseases that can affect the hip joint include congenital hip dislocation, Legg-Calve-Perthes disease, osteoarthritis, and tuberculosis.
Vertebral Column is a complex structure of the Human body. It does not only provides protection for spinal cord but also provide mobility and stability of the trunk and the extremities. To learn structure of Vertebral Column and more Online Medical Resource, Visit at http://gisurgery.info
Coxa vara is a deformity of the hip where the angle between the femoral head and shaft is reduced to less than 120 degrees. This causes shortening of the leg and a limp. It is commonly caused by injury like a fracture or a softer bone structure in the femoral neck. Symptoms include a short leg limp or restricted abduction. It is diagnosed radiologically by signs like a widened bitrochanteric measurement. Treatment may involve a valgus osteotomy of the femur if needed to correct the deformity.
Perthes disease is a childhood condition that affects the blood supply to the femoral head, causing bone death (avascular necrosis). It most commonly affects boys between ages 4-8. While the disease process is self-limiting, it can have permanent effects on the femoral head shape and hip function. Treatment aims to contain the femoral head within the acetabulum during healing to promote proper reshaping, through nonsurgical means like bracing or surgical options like osteotomies if needed. The long-term outcomes are evaluated using classifications like Stulberg or Mose, with the goal of achieving a spherical femoral head congruent with the acetabulum. Management approaches vary between centers based on each child's severity and prognosis
The document provides guidance on how to effectively work up and summarize a surgical patient case during a residency interview. It emphasizes knowing the preferred procedures of the interviewing program and being able to describe radiographic findings of flat feet in a systematic way. For a flat foot work up, the assistant should identify deformities in the sagittal, frontal, and transverse planes, then suggest procedures to address each, such as a gastrocnemius recession for sagittal plane correction or a medial calcaneal slide for frontal plane correction. Reading flat foot radiographs involves assessing specific angles on both AP and lateral views that indicate planovalgus deformity severity and type.
Jean-Martin Charcot first described neuropathic arthropathy in 1868. It is a progressive joint condition characterized by dislocations, fractures, and deformities that results from sensory or autonomic neuropathy from various conditions like diabetes, MS, alcoholism, etc. The pathophysiology involves both repetitive microtrauma from loss of sensation and an inflammatory process induced by neurovascular changes. It commonly affects the foot, knee, and hip. Diagnosis is made clinically and radiographically, showing features like joint destruction and deformity. Treatment involves casting, bracing, and surgery like fusion for advanced cases.
This document discusses meniscus injuries of the knee. It describes the anatomy and functions of the medial and lateral meniscus. Common types of meniscal tears are described based on location and pattern. Physical exam maneuvers for diagnosing meniscal tears include Thessaly test, McMurray's test, and Apley's grinding test. MRI is the most sensitive imaging method. Treatment involves initial rest, ice, and NSAIDs for minor tears. Surgery options include partial meniscectomy, meniscal repair, or meniscal transplantation for more severe tears. The goal of treatment is to relieve symptoms and prevent further joint damage.
The skeletal system has several functions including protection of organs, providing levers for movement, and storing minerals. It is divided into the axial skeleton which includes the skull, vertebrae, and ribs, and the appendicular skeleton comprising the upper and lower limbs. Bones are classified as long, short, flat, or irregular. Bone formation occurs through ossification by osteoblasts and osteoclasts. Osteoporosis is the thinning of bones which can be prevented by sufficient calcium, vitamin D, weight bearing exercise, and good nutrition. Synovial joints like the ball-and-socket hip joint allow a wide range of movement. Connective tissues like cartilage, tendons, and ligaments support the skeletal system.
Principle of tension band wiring n its applicationRohit Kansal
1. The tension band technique converts tensile forces into compressive forces through the application of a tension band on the tension side of a bone.
2. Examples of where tension band fixation is commonly used include patella and olecranon fractures, as well as fractures of the greater tuberosity and greater trochanter.
3. Tension band wiring, plating, and external fixation can all function as tension bands by applying a compressive force across a fracture to promote healing.
A 41-year-old male presented with right hip, knee, and groin pain that began six months ago after a fall. He was previously treated with high-dose corticosteroids for skin lesions, which likely caused his current avascular necrosis (bone cell death due to interrupted blood flow). Imaging showed abnormalities in his right femoral head consistent with avascular necrosis. He was diagnosed with avascular necrosis likely caused by his past prolonged corticosteroid use.
Biomechanics of Ankle joint- intended to share the powerpoint with first year undergraduate students at Kathmandu University School of Medical Sciences, Nepal.
This is a short presentation on avascular necrosis of femoral head. This presentation gives brief description of causes of AVN, investigations and modes of treatment options available.
AVN TREATMENT IN HYDERABAD
Core decompression for AVN
Stem cell treatment for AVN
Surgery for AVN
Avascular necrosis treatment options
Hip replacement in hyderabad
Hip specialist in hyderabad
Hip surgery in hyderabad
Total hip replacement in hyderabad
cemented hip replacement
uncemented hip replacement in hyderabad
ceramic hip replacement
delta motion hip
ceramic on ceramic hip replacement
metal on poly hip replacement
affordable hip replacement in hyderabad
The human skeleton is the internal framework of the human body. It is composed of around 270 bones at birth – this total decreases to around 206 bones by adulthood after some bones get fused together. The bone mass in the skeleton makes up about 14% of the total body weight and reaches maximum density around age 21
The skeletal system is composed of bones, cartilage, joints and ligaments. It provides structure and support to the body, protects internal organs, allows for movement via muscle attachment, and stores minerals. The bones are classified as long, short, flat, or irregular. Key bones include the skull, vertebral column, ribs, shoulder girdle, pelvis and bones of the upper and lower limbs. The skeletal system enables vital body functions and works with muscles for movement.
The skeletal system has two main divisions: the axial skeleton and appendicular skeleton. The axial skeleton includes the skull, vertebral column, ribs, and sternum, while the appendicular skeleton attaches to the axial skeleton and includes the pectoral girdle, upper and lower extremities. There are four main bone shapes - long bones, short bones, flat bones, and irregular bones. Bone tissue consists of organic and inorganic components that give bone its structure and strength. Bones are made of compact bone on the outside and spongy bone on the inside, and contain bone cells that allow for growth and remodeling.
Skeletal cartilage contains no blood vessels or nerves and is surrounded by perichondrium. There are three main types of cartilage - hyaline, elastic, and fibrocartilage. Hyaline cartilage provides support and flexibility and is the most abundant type found in areas like joints. Cartilage grows through appositional growth on the outside and interstitial growth on the inside. During aging or injury, cartilage can calcify and turn to bone through endochondral ossification.
The document summarizes key aspects of the skeletal system including:
- Functions of the skeletal system such as support, protection, leverage, storage of minerals, and blood cell production
- Different bone shapes including long bones, short bones, flat bones, and irregular bones
- Structure of long bones including diaphysis, epiphysis, periosteum, endosteum, and bone cells
- Growth and remodeling processes like intramembranous ossification and endochondral ossification
- Factors that influence bone growth like nutrition, hormones, and diseases like osteoporosis and osteomalacia
- Bone repair following fractures and aging effects on the skeletal system.
The document summarizes key topics related to the skeletal system and bone structure and function:
- Bones provide structural support, protection of organs, leverage for muscle attachment, storage of minerals, and production of blood cells.
- Long bones have a diaphysis, epiphyses, periosteum, endosteum, and contain compact or cancellous bone.
- Bones are remodeled throughout life by osteoblasts which build bone and osteoclasts which resorb bone.
- Bones grow in length via the epiphyseal plate until closure in early adulthood. Nutrition, hormones, and mechanical stresses influence bone growth and remodeling.
The skeletal system consists of bones, joints, cartilages, and ligaments. There are two types of bones - compact bone and spongy bone. Bones can be classified into four categories - long bones, short bones, flat bones, and irregular bones. Bones provide structure and support to the body, protect organs, allow movement, store minerals, and enable blood cell formation. The skeletal system is remodeled throughout life by bone cells including osteoblasts, osteoclasts, and osteocytes.
The skeletal system consists of bones and other connective tissues that provide structure and protect internal organs. Bones are composed of both organic and inorganic materials, including collagen proteins and hydroxyapatite salts. The skeletal system includes long bones in the limbs, short and flat bones, and irregular bones like those in the spine. Bones are living tissues that contain osteoblasts, osteocytes, and osteoclasts, which form, maintain, and break down bone respectively. The skeletal system provides structure, movement, protection, mineral storage, and blood cell formation.
The skeletal system is divided into the axial skeleton and appendicular skeleton. The axial skeleton forms the body's central axis and includes the skull, vertebral column, and bony thorax. The skull is composed of two sets of bones - the cranium and facial bones. The cranium is made up of eight flat bones: the frontal, parietal, temporal, occipital, sphenoid, and ethmoid bones.
This document provides an overview of the skeletal system and bones. It defines what bones are, their functions, and structural elements. It describes the different bone cells including osteoprogenitor cells, osteoblasts, osteoclasts and osteocytes. It explains the two types of bones - compact and spongy bone. Factors that affect bone growth such as minerals, vitamins, hormones and exercise are discussed. Terms related to bone fractures and the process of bone fracture repair are also summarized.
The skeletal system has 6 main functions including providing support and protecting internal organs. Bone is made up of water, organic proteins, and mineral salts. It is constantly remodeling and made of two main tissues, bone and cartilage. The skeletal system contains long bones, flat bones, and irregular bones that each have specific structures like compact and spongy bone. Bone growth and repair are complex processes involving cells like osteoblasts and osteoclasts. Calcium levels, hormones, and mechanical forces all influence bone metabolism and aging affects bone density and strength.
1. There are two main types of ossification that form bone: intramembranous and endochondral. Endochondral ossification uses hyaline cartilage as a model and requires its breakdown before bone formation.
2. During postnatal growth of long bones, the epiphyseal plate contains zones of growth, transformation, and osteogenesis that allow elongation. Growth hormone and sex hormones regulate epiphyseal plate activity and closure during development.
3. Bone is constantly remodeled through the balanced actions of bone-forming osteoblasts and bone-resorbing osteoclasts. Hormonal and mechanical factors help control this remodeling process.
This document provides an overview of the skeletal, muscular, and respiratory systems. It begins by outlining the topics that will be covered, including bones, joints, muscles, parts of the respiratory system, types of respiration, breathing mechanisms, and respiration regulation. It then discusses the types of bones and their functions, physiology of bone formation, and division of the skeleton into the axial and appendicular parts. Specific bone types such as long, short, flat, and irregular bones are described along with their structures. The document also covers bone remodeling, pathologies like rickets and fractures, and the components of the axial skeleton including the skull, vertebral column, and thoracic cage.
Bone is a living tissue composed of collagen, proteins, and hydroxyapatite crystals. Bone remodeling is carried out by osteoblasts, osteoclasts, and osteocytes through a basic multicellular unit process where bone is resorbed and formed at equal rates. During remodeling, osteoclasts resorb bone through the secretion of acids and proteases, while osteoblasts form new bone matrix through the deposition of collagen and minerals. The remodeling cycle maintains bone strength and mineral homeostasis.
Bones provide structure, protect organs, allow movement, and store minerals. There are several bone types classified by shape. Long bones have a shaft and two ends, while short, flat, and irregular bones vary in shape. Bone tissue contains cells, water, collagen fibers, and minerals. Growth and remodeling is regulated by hormones and nutrients. Bones develop from cartilage templates in a multi-step process beginning before birth and continuing into early adulthood.
The document discusses the structure and function of long bones. It describes the key parts of long bones including the diaphysis, epiphyses, articular cartilage, periosteum, medullary cavity, compact and spongy bone. It also discusses bone formation through intramembranous and endochondral ossification as well as homeostasis and functions of bone such as support, protection, movement, blood cell formation, and storage of inorganic salts.
This document provides information on musculoskeletal disorders including physiology, anatomy, articulations, injuries, and fractures. It discusses the functions of bones and muscles in protection, support, movement, mineral storage, and heat production. Anatomy sections cover the types and classifications of bones, basic cell types, histological structures of compact and cancellous bone, and muscle types. Traumatic injuries like strains, sprains, and contusions are also summarized along with fracture grading and general nursing management.
This document provides information on musculoskeletal disorders including physiology, anatomy, articulations, injuries, and fractures. It discusses the functions of bones and muscles in protection, support, movement, mineral storage, and heat production. Anatomy sections cover the types and classifications of bones, basic cell types, bone features, and muscle types. Traumatic injuries like strains, sprains, and contusions are also summarized along with fracture grading and general nursing management.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
Reimagining Your Library Space: How to Increase the Vibes in Your Library No ...Diana Rendina
Librarians are leading the way in creating future-ready citizens – now we need to update our spaces to match. In this session, attendees will get inspiration for transforming their library spaces. You’ll learn how to survey students and patrons, create a focus group, and use design thinking to brainstorm ideas for your space. We’ll discuss budget friendly ways to change your space as well as how to find funding. No matter where you’re at, you’ll find ideas for reimagining your space in this session.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
3. Anatomical position
most widely used &
accurate for all aspects
of the body
standing in an upright
posture, facing straight
ahead, feet parallel and
close, & palms facing
forward
5. Body Planes and
Sections
Coronal (frontal) plane - Lies vertically and divides
body into anterior (front) and posterior (back) parts
Sagittal plane – lies vertically and divides the body into
left and right sides.
Median (midsagittal) plane - Specific sagittal plane that
lies vertically in the midline
Transverse plane - runs horizontally and divides body
into superior (up) and inferior (down) parts
7. Anatomical directional terms
• Anterior
in front or in the front part
Anteroinferior
in front & below
Anterosuperior
in front & above
Posterior
behind, in back, or in the rear
Posteroinferior
behind & below; in back &
below
Posterolateral
behind & to one side,
specifically to the outside
12. Body Cavities and Membranes
Dorsal body cavity
Cranial cavity
Cranial cavity
houses the brain
Vertebral cavity
Vertebral cavity
runs through the
vertebral column
and encloses the
spinal cord
13. Body Cavities and Membranes
Ventral body cavity
Thoracic cavity
Two lateral parts each
containing a lung
surrounded by a
pleural cavity
Mediastinum –
contains the heart
surrounded by the
pericardial sac
14. Body Cavities and Membranes
Ventral body cavity
Abdominopelvic
cavity
Abdominal cavity –
contains the liver,
stomach, kidneys, and
other organs
Pelvic cavity –
contains the bladder,
some reproductive
organs, and rectum
15. Body Cavities and Membranes
Serous cavities – a slit-like space lined by a
serous membrane
Pleura, pericardium, and peritoneum
Parietal serosa – outer wall of the cavity
Visceral serosa covers the visceral organs
17. Other Body Cavities
Oral cavity
Nasal cavity
Orbital cavities
Middle ear cavities
Synovial cavities
18. Abdominal Regions and Quadrants
Abdominal regions divide the abdomen into nine
regions
19. Abdominal Quadrants
Abdominal quadrants divide the abdomen into four
quadrants
Right upper and left upper quadrants
Right lower and left lower quadrants
22. Bone growth
Prenatal, after wk 8, starts mineralization
Postnatal, longitudinal and diameter
23. Classification of Bones
Long bones
Typically longer than wide
Have a shaft with heads at both ends
Contain mostly compact bone
Examples: Femur, humerus
Short bones
Generally cube-shape
Contain mostly spongy bone
Examples: Carpals, tarsals
24. Classification of Bones, cont.
Flat bones
Thin and flattened, usually curved
Thin layers of compact bone around a layer of
spongy bone
Examples: Skull, ribs, sternum
Irregular bones
Irregular in shape
Do not fit into other bone classification categories
Example: Vertebrae
25.
26. Bones
The adult skeleton has 206 bones
Two basic types of bone tissue
Compact bone
Homogeneous
Spongy bone
Small needle-like
pieces of bone
Many open spaces
27. Long Bone
Diaphysis
Shaft
Composed of compact bone
Epiphysis
Ends of the bone
Composed mostly of spongy
bone
Hematopoiesis
28.
29. Structures of a Long Bone
Periosteum
Outside covering of the
diaphysis
Fibrous connective tissue
membrane
Sharpey’s fibers
Secure periosteum to
underlying bone
Arteries
Supply bone cells with
nutrients
30.
31. Structures of a Long Bone
Articular cartilage
Covers the external
surface of the epiphyses
Made of hyaline cartilage
Decreases friction at joint
surfaces
Figure 5.2a
32. Structures of a Long Bone
Medullary cavity
Cavity of the shaft
Contains yellow marrow
(mostly fat) in adults
Contains red marrow (for
blood cell formation) in
infants
Figure 5.2a
33. Microscopic Anatomy of Bone
Osteon (Haversian System)
A unit of bone
Central (Haversian) canal
Carries blood vessels
and nerves
Perforating (Volkman’s)
canal
Canal perpendicular to
the central canal
Carries blood vessels
and nerves
34. Bone Markings
Surface features of bones
Projections and processes – grow out from the bone surface
Depressions or cavities – indentations
Sites of attachments for
muscles, tendons, and
ligaments
Passages for nerves and
blood vessels
35. Changes in the Human
Skeleton
In embryos, the skeleton is primarily hyaline cartilage
During development, much of this cartilage is
replaced by bone
Cartilage remains in isolated areas
Bridge of the nose
Parts of ribs
Joints
36. Bone Growth
Epiphyseal plates allow for growth of long bone
during childhood
New cartilage is continuously formed
Older cartilage becomes ossified
Cartilage is broken down
Bone replaces cartilage
37. Bone Growth
Bones are remodeled and lengthened until
growth stops
Bones change shape somewhat
Bones grow in width
39. Types of Bone Cells
Osteocytes
Mature bone cells
Osteoblasts
Bone-forming cells
Osteoclasts
Bone-destroying cells
Break down bone matrix for remodeling and release of
calcium
Bone remodeling is a process by both osteoblasts
and osteoclasts
41. Composition of Bone…
Inorganic component:
Hydroxyapatite crystals with carbonate content
Organic component:
- Osteoid
Type I collagen (95%)
type V collagen (<5%)
Non collagenous proteins
Osteocalcin,
Osteopontin,
Bone sialoprotein,
Osteonectin.(SPARC)- Cell adhesion ,proliferation,
modulation of cytokine activity.
42. OSTEOCYTES:
Nerve cells
Sense the change in environment and send signals that affect
response of other cells involved in bone remodelling
Maintains balance between
resorption and remodelling
Bone that forms more rapidly
shows more osteocytes
43. Osteocytic lacunae
Canaliculi- narrow extension of lacunae, permits
diffusion of gases and nutrients
Maintains bone integrity and vitality
Failure of inter connecting system between osteocytes
and osteoblasts leads to sclerosis and death of bone
44. Osteoblasts :
Derived from osteoprogenitor cells
Periosteum serves as important reservoir .
Morphology :
basophilic
cuboidal or slightly elongated cells
contain prominent bundles of actin, myosin
BONE CELLS:
45.
46. Osteoblast, Functions
New bone formation
Controls bone mineralization at 3 levels
1. In its initial phase, by production of matrix vesicle
2. At a later stage, by controlling the ongoing process of
mineralization
3. By regulating the number of ions available
Regulation of bone remodeling and mineral metabolism
47. Osteoblasts Functions
Secrete type I collagen, small amount of type V collagen,
osteonectin, osteopontin, RANKL, osteoprotegerin,
Proteoglycans, latent proteases and growth factors
including bone morphogenic proteins
Exhibit high levels of alkaline phosphatase -cytochemical
marker
48. BONE LINING CELLS:
Osteoblasts flatten, when bone is not forming and extend
along the bone surface and hence the name
They are present on periosteal as well as endosteal surfaces
49. BONE RESORPTION: Osteoclasts
Sequence of events of bone resorption: Involves 3 phases
First phase -
formation of osteoclast
Second phase-
activation of osteoclast
Third phase -
resorption of bone
50. Alterations in the osteoclast
Removal of hydroxyapatite
acidic environment by proton pump
Degradation of organic matrix
acid phosphatase, cathepsin B
Removal of degradation products from lacunae
endocytosis
Translocation of degraded products and extracellular release
51.
52. Removal of hydroxyapatite:
The initial phase involves the dissolution of the mineral phase –
HCl
The protons for the acid arise from the activity of cytoplasmic
carbonic anhydrase II, which is synthesized in osteoclast.
The protons are then released across the ruffled border into the
resorption zone by an ATP consuming proton pump.
This leads to a fall in pH to 2.5 to 3.0 in the osteoclast resorption
space.
53. As age increases resorption exceeds
Cortical bone turnover -5% per year
Trabecular and endosteal surface – 15% per year
Coupling
The processes of bone synthesis and bone breakdown go on
simultaneously and the status of the bone represents the net result
of a balance between the two processes
54. Hormones and coupling
With the exception of calcitonin, all the hormones, cytokines, and
growth factors that act on bone, as an organ, mediate their activity
through osteoblasts
Resorbing hormones act directly on osteoblasts, which then
produce other factors that regulate osteoclast activity
This results in both bone formation and bone resorption being
coupled
55. To prevent accumulation of damaged bone by regenerating
new bone
Allowing to respond to the changes in mechanical forces
Mineral homeostasis
Functions of remodeling
60. Hormonal Control of Blood Ca
PTH;
calcitonin
secreted
Calcitonin
stimulates
calcium salt
deposit
in bone
Parathyroid
glands release
parathyroid
hormone (PTH)
Thyroid
gland
Thyroid
gland
Parathyroid
glands
Osteoclasts
degrade bone
matrix and release
Ca2+ into blood
Falling blood
Ca2+ levels
Rising blood
Ca2+ levels
Calcium homeostasis of blood: 9–11 mg/100 ml
PTH
62. Pathologies caused due to improper control of remodelling are:
•Osteoporosis
•Osteopetrosis*
•Malignant bone tumors
•Inflammatory joint diseases
*Osteopetrosis is a bone disease that makes bones abnormally
dense and prone to fracture
Autosomal Dominant Osteopetrosis(ADO)
63. Response to Mechanical Stress
Trabeculae form along lines of stress
Large, bony projections occur where heavy, active
muscles attach
64. Response to Mechanical Stress
Wolff’s law: a bone grows or remodels in response to the
forces or demands placed upon it
Observations supporting Wolff’s law include
Long bones are thickest midway along the shaft
(where bending stress is greatest)
Curved bones are thickest where they are most
likely to buckle
68. •Cranial and Facial Bones (22):
•frontal bone
•parietal bone (2)
•temporal bone (2)
•occipital bone
•sphenoid bone
•ethmoid bone
•mandible
•maxilla (2)
•palatine bone (2)
•zygomatic bone (2)
•nasal bone (2)
•lacrimal bone (2)
•vomer
•inferior nasal conchae (2)
70. Joint definition
Joints connect the components of the skeletal
system together
They give the skeletal system flexibility, and allow
muscles to direct movements by moving bones in
different directions
74. Functional classification,
187 joints in body
Synarthrosis are almost immovable joints; these joints
are common where protection of delicate internal
structures
Skull, mandible
Amphiarthrosis are slightly movable joints; connected
by broad flattened disks of fibrocartilage, of a more or
less complex structure, which adhere to the ends of
each bone
Vertebrae, pubic symphysis, sternocostal joint
Diarthrosis are freely movable joints; these joints
dominate in the limbs and areas of the body where
movement is important
77. Structural classification
Fibrous joints allow very little movement, and are composed of fibrous (dense)
connective tissue
skull sutures, tibia and fibula
Cartilaginous joints allow very little or no movement, and are characterized by
a connection between adjoining bones made of cartilage, no joint cavity
1. Fibrocarlilage: epiphyseal plate of growing bones is an immovable cartilaginous
joint
2. Hyaline cartilage: pubic symphysis, intervertebral joints and connection between
the first rib and sternum are slightly movable cartilaginous joints
Synovial joints are the most complex of the joint types
Characterized by articular (hyaline) cartilage covering the ends of bones, a fibrous
articular capsule (composed of fibrous connective tissue) lined with synovial
membrane, a joint cavity containing synovial fluid and reinforcing ligaments to hold the
bones together
Between the bones of the limbs
Bursae: flattened fibrous sacs lined with synovial membrane that develop in areas of
friction
Tendon sheaths are special bursae that wrap around tendons in areas of friction
78.
79. Fibrous Joints
Bones united by fibrous
tissue
Examples
Sutures
Syndesmoses
Allows more
movement than
sutures
Example: distal
end of tibia and
fibula
83. Synovial joints
Some synovial joints such as knee and hip have
fatty pads between the fibrous capsule and the
bone
Some have discs or wedges of fibrocartilage
separating the articular surface of bones (menisci of
knee)
Some synovial joints have bursa which is a fluid
filled sac containing the synovial fluid to decrease
the friction
84. Features of Synovial Joints
Articular cartilage (hyaline cartilage) covers the ends
of bones
Joint surfaces are enclosed by a fibrous articular
capsule
Have a joint cavity filled with synovial fluid
Ligaments reinforce the joint
85. Structures Associated with the Synovial
Joint
Bursae – flattened fibrous sacs
Lined with synovial membranes
Filled with synovial fluid
Not actually part of the joint
Tendon sheath
Elongated bursa that wraps around a tendon
91. • Plane joints connect two flat surfaces of bone to one another, and only allow
side-to-side movement with no rotation, so called nonaxial joints. Flat wrist
bones, Acromioclavicular joint(ACJ)
• Hinge joints connect a cylindrical bone end to a concave portion of another
bone. Rotation can occur in only one plane (like a door hinge), so called uniaxial
joints. Elbow and ankle, PIP, DIP
• Pivot joints connect the rounded end of one bone to a ring or sheath formed by
another bone, so are uniaxial joints. Radius & ulna, atlas & axis
• Condyloid joints fit the rounded convex articular surface of one bone into the
rounded concave surface of another bone. Allow side to side and forwards-
backwards movements, similarly to saddle joints, so are biaxial joints.
Knuckles(MCP)
• Saddle joints are characterized by concave and convex surfaces on both
articular surfaces. Allow side to side and forwards-backwards movements, but no
rotation, so are biaxial joints. Carpal & metacarpal of the
thumb **SternoClavicular**(with rotational mvmnt)
• Ball-and-socket joints join the spherical end of one bone to the concave,
rounded socket of another bone. Allow movement in all axes and rotation, and
92.
93.
94.
95. Motion depends on:
Joints
Muscle and tendon
Ligaments
Capsule
Skin
Other soft tissues such as vessels, adipose tissue,
nerves & etc.
99. Sometimes these paired
bones will show the same
motions, sometimes
opposite, depending on the
pair Clinically, this means
that problems in one bone
can often be driven by its
paired bone
For instance, if a person
chronically has problems
with their C1 in the upper
neck, one should also
address problems in its pair;
the L5 in the low back
Lovett Reactor System
Postural Homeostasis
100. Spinal Coupling:
C1 should move in a similar direction as L5
C2 should move in a similar direction as L4
C3 should move in a similar direction as L3
C4 should move in the opposite direction as L2
C5 should move in the opposite direction as L1
This continues downward to T5 which moves in the opposite direction
as T6
101.
102. Pelvic-Cranial Coupling:
Sacrum should move in the opposite direction as the occiput
The ilium should move in the opposite direction to the
ipsilateral temporal bone (e.g., an anteriorly rotated left ilium
should automatically rotate the left temporal bone posteriorly)
The coccyx should move in the same direction as the
sphenoid bone
In essence, the Lovett Reactor is a description of what
occurs in the pelvis, vertebrae and cranial bones when the
Righting Reflex is working correctly
103.
104.
105. The Vertebral
Column
Vertebrae separated by
intervertebral discs
The spine has a normal
curvature
Each vertebrae is given a
name according to its location
4 Curves
Primary: Thoracic &
Sacrococcygeal
Secondary: Cervical & Lumbar
109. Cervical vertebrae
Unlike the other parts of the spine, the cervical
spine has TRANSVERSE FORAMINA in each vertebra
for the vertebral arteries
Classify to upper and lower parts
Y-shape spinous process(C3-C6)
U-shape transverse processes for cervical spinal
nerves
Transverse foramen for paravertebral artery
Larger spinous process at C7
110.
111.
112. Cervical, Upper part
The upper cervical spine consists of the atlas (C1) and
the axis (C2)
These first 2 vertebrae are quite different from the rest of
the cervical spine
The atlas articulates superiorly with the occiput (the
atlanto-occipital joint) and inferiorly with the axis (the
atlantoaxial joint), synovial joints
The atlantoaxial joint is responsible for 50% of all
cervical rotation; the atlanto-occipital joint is responsible
for 50% of flexion and extension
The unique features of C2 anatomy and its articulations
complicate assessment of its pathology
115. Steel’s Rule of Thirds
At the level of the atlas, the odontoid process, the
subarachnoid space, and spinal cord each occupy
one third of the area of the spinal canal
116. Axis
The axis is composed of a vertebral body, heavy
pedicles, laminae, and transverse processes, which
serve as attachment points for muscles
The axis articulates with the atlas via its superior
articular facets, which are convex and face upward and
outward
117.
118. Axis
At birth, a vestigial cartilaginous disc space called the
neurocentral synchondrosis separates the odontoid process
from the body of C2
The synchondrosis is seen in virtually all children aged 3 years
and is absent in those aged 6 years
The apical portion of the dens ossifies by age 3-5 years and
fuses with the rest of the structure around age 12 years
This synchondrosis should not be confused with a fracture
121. Joint of Luschka
Between C3-C7
The joint believed to be
the result of degenerative
changes in the annulus,
which lead to fissuring in
the annulus and the
creation of the joint
Can develop osteophytic
spurs, which can narrow
the intervertebral foramina
122. Facet Joints
The facet joints in the cervical spine are Diarthrodial
synovial joints with fibrous capsules
The joint capsules are more lax in the lower cervical
spine than in other areas of the spine to allow
gliding movements of the facets
The joints are inclined at an angle of 45° from the
horizontal plane and 85° from the sagittal plane
This alignment helps prevent
excessive anterior translation and is
important in weight-bearing
123. Intervertebral Discs
These disks are composed of 4 parts: the nucleus
pulposus in the middle, the annulus fibrosis surrounding
the nucleus, and 2 end plates that are attached to the
adjacent vertebral bodies
They serve as force dissipators, transmitting compressive
loads throughout a range of motion
The disks are thicker anteriorly and therefore contribute to
normal cervical lordosis
133. Facet Joints*
To guide and limit mvmts in vertebral segments
Cartilage
Synovial fluid
Nerve & blood vessels
Ligaments
*Zygapophyseal(Z-joint)
134. Facet Joint Orientation, Cervical
Cervical Region: 45 degrees; all movements are
possible such as flexion, extension, lateral flexion, and
rotation
The articulating facets in the cervical vertebrae face
45o to the transverse plane and lie parallel to the
frontal plane, with the superior articulating process
facing posterior and up and the inferior articulating
processes facing anteriorly and down
135. Facet Joint Orientation, Thoracic
Thoracic Region; lateral flexion
and rotation; least
flexion/extension
The facet joints between
adjacent thoracic vertebrae are
angled at 60° to the
transverse(Hor) plane and 20°
to the frontal plane, with the
superior facets facing posterior
and a little up and laterally and
the inferior facets facing
anteriorly, down, and medially
144. Atypical Ribs
Rib1
One facet on its head
Subclavian groove for art & vein
Scalene tubercle
Rib2
Two articular facet on head
Tuberosity for serratus ant
148. Facet Joint Orientation, Lumbar
Lumbar Region: 90 degrees; sagittal plane;
only flexion and extension, limited rotation,
least lat flexion
The facet joints in the lumbar region lie in
the sagittal plane; the articulating facets are
at right angles to the transverse plane and
45° to the frontal plane
The superior facets face medially, and the
inferior facets face laterally, this changes at
the lumbosacral junction, where the
apophyseal joint moves into the frontal
plane and the inferior facet on L5 faces front
This change in orientation keeps the
vertebral column from sliding forward on the
sacrum
159. Herniation Stages
1) Disc Degeneration: chemical changes
associated with aging causes discs to
weaken, but without a herniation
2) Prolapse: the form or position of the
disc changes with some slight
impingement into the spinal canal. Also
called a bulge or protrusion
3) Extrusion: the gel-like nucleus pulposes
breaks through the annulus fibrosus but
remains within the disc
4) Sequestration: nucleus pulposus
breaks through the annulus fibrosus and
lies outside the disc in the spinal canal
162. Posterior Longitudinal Ligament
From C2 to sacrum
Long and
important ligament located
immediately posterior to the
vertebral bodies (to which it
attaches loosely) and
intervertebral discs
Extends from the back of the
sacrum inferiorly and
gradually broadens as it
ascends
164. Facet Joint Syndrome
Narrowing the joint space
Friction and destroying articular cartilage and the
fluid
Wear away cartilage
Bone spurs
Compress nerve
More bone spurs extend to the spinal canal
Spinal stenosis
165. Facet Joint Symptoms
Difficulty in head rotation
Difficulty in straightening back and get up of a chair
Pain, numbness, muscle weakness,..
166. FJS Treat
Ice, to reduce inflammation
Ultrasound, Electrostimulation to reduce muscle
spasm
Massage, traction, mobilization to increase ROM
and reduce pain
Exercise for more stability
167. Spondylolisthesis
Birth defect
Rapid growth during adolescence
Football
Weightlifting
Wrestling
Gymnastics
Track and field…
175. The Pectoral (Shoulder) Girdle
Composed of two bones
Clavicle – collarbone
Scapula – shoulder blade
These bones allow the upper limb to have
exceptionally free movement
177. Acromioclavicular Joint
To allow the scapula additional range of rotation on
the thorax
Allow for adjustments of the scapula (tipping and
internal/external rotation) outside the initial plane of
the scapula in order to follow the changing shape of
the thorax as arm movement occurs
The joint allows transmission of forces from the
upper extremity to the clavicle
188. Bones of the Upper Limb
The hand
Carpals – wrist
Metacarpals – palm
Phalanges – fingers
So Long To Pinky, Here Comes The Thumb
189. Bones of the Pelvic Girdle
Hip bones
Composed of three pair of fused bones
Ilium
Ischium
Pubic bone
The total weight of the upper body rests on the pelvis
Protects several organs
Reproductive organs
Urinary bladder
Part of the large intestine
200. ROM benefits
To determine presence of impairment
Establishing a diagnosis
Evaluation of progress
Modify the treatment
Motivate the patient
Research
201. Definitions
Power: work produced /time
For more power: more repetition
Strength: contract against external load
Endurance: perform activities over prolonged
period
Flexibility: ability to move a single joint or series of
joints smoothly & easily through an unrestricted
pain-free ROM
Plasticity: property of skeletal muscle that allow for
a new & greater length after a stretch that has been
applied
202. Manual Muscle Testing(MMT)
Grade Result
0 No contraction, no movement
1 Visible contraction, a little
2 Visible contraction, full ROM in elimination of gravity
3 Visible contraction, full ROM against gravity
4 Full ROM with moderate resistance
5 Full ROM with max resistance
203. Joint improvement
Passive range of motion
Active range of motion
Active assistive range of motion
Strengthening
Isometric
Isotonic
Concentric
Eccentric
Stretching
204. Benefits of exercises
Increase & maintain muscle strength
Increase endurance
Improve & maintain ROM
Increase circulation
Increase flexibility
Improve balance & coordination
Increase CV fitness
Improve sense of wellbeing
205. Stretching, indications
Adhesion, contracture, scar tissue
Decreased ROM(may lead deformity)
Part of a fitness program to prevent injury
Warm-up & cool-down exercise
206. Stretching, contra-indications
Recent fracture, incomplete bony union
Muscle ossification
Acute inflammation, infection
Sharp pain
Hematoma in muscle or area
Hypermobility
208. Inflammatory Conditions Associated with
Joints
Bursitis – inflammation of a bursa usually caused by a
blow or friction
Tendonitis – inflammation of tendon sheaths
Arthritis – inflammatory or degenerative diseases of joints
Over 100 different types
The most widespread crippling disease in the United
States
209. Clinical Forms of Arthritis
Osteoarthritis
Most common chronic arthritis
Probably related to normal aging processes
Rheumatoid arthritis
An autoimmune disease – the immune system attacks
the joints
Symptoms begin with bilateral inflammation of certain
joints
Often leads to deformities
210. Clinical Forms of Arthritis
Gouty Arthritis
Inflammation of joints is caused by a deposition of
urate crystals from the blood
Can usually be controlled with diet
211. Developmental Aspects of the Skeletal
System
At birth, the skull bones are incomplete
Bones are joined by fibrous membranes – fontanelles
Fontanelles are completely replaced with bone within two
years after birth
212. The Skull
Two sets of bones
Cranium
Facial bones
Bones are joined by sutures
Only the mandible is attached by a freely movable
joint
219. The Hyoid Bone
The only bone that does
not articulate with another
bone
Serves as a moveable base
for the tongue
220. The Fetal Skull
The fetal skull is large
compared to the infants
total body length
221. The Fetal Skull
Fontanelles – fibrous
membranes connecting the
cranial bones
Allow the brain
to grow
Convert to bone within 24
months after birth
223. Bone Fractures
A break in a bone
Types of bone fractures
Closed (simple) fracture – break that does not
penetrate the skin
Open (compound) fracture – broken bone penetrates
through the skin
Bone fractures are treated by reduction and
immobilization
Realignment of the bone
225. Repair of Bone Fractures
Hematoma (blood-filled swelling) is formed
Break is splinted by fibrocartilage to form a callus
Fibrocartilage callus is replaced by a bony callus
Bony callus is remodeled to form a permanent patch