The document discusses the anatomy and functions of the human foot. It describes how the foot is made up of bones, muscles, ligaments and arches that work together to support body weight and enable walking, running and balance. The medial and lateral longitudinal arches and transverse arch are described. Their roles in weight distribution, acting as levers and protecting structures are summarized. Common foot deformities such as flat feet, high arches, club foot and bunions are also outlined.
Atlanto occipital and atlanto axial jointShubham Singh
Anatomy:
>Atlas is the topmost vertebra and chief peculiarity of atlas is that it has no body, it is ring like and consist of anterior and posterior arch and two lateral masses.
>Axis, the 2nd cervical vertebra has a concave under side and convex from side to side. The most distinctive characteristic of this bone is strong odontoid process, the dens.
TheJoint:
>Atlanto-occipital joint (articulation between the atlas and the occipital bone) consists of a pair of condyloid joints.
>The atlanto-occipital joints are synovial socket-type joints
Ligaments:
> Posterior atlanto-occipital membrane: extend from anterior arch of atlas to posterior margin of foramen magnum.
>Anterior atlanto-occipital membrane: extend from anterior arch of atlas to anterior margin of foramen magnum.
>The ligamentam flavam join laminae of adjacent vertebral arches.
>The interspinous ligaments expand to form the ligamentum nuchae which inserts along the posterior foramen magnum and external occipital condyle.
> The following four ligaments stabilize these joints:
1.Apical ligament: Connects the dens to the foramen magnum of the occipital bone.
2.Alar ligaments: Connect the dens to the lateral margins of the foramen magnum.
3.Cruciate ligament: Attaches the dens to the anterior arch of the atlas and the body of the axis to the foramen magnum of the occipital bone.
4.Tectorial membrane: Starts at the skull and becomes the posterior longitudinal ligament.
>Atlanto-axial articular capsules are thick and loose, and connect the margins of the lateral masses of the atlas with those of the posterior articular surfaces of the axis.
Muscles:
>Flexion is produced mainly by the action of longis capitis, rectus capitis anterior and sternocleidomastoid (anterior fibres)
>Extension by the rectus capitis posterior major and minor, the obliquus capitis superior, the semispinalis capitis, splenius capitis, longissimus capitis, sternocleidomastoid and upper fibres of the trapezius
>The recti lateralis are concerned in the lateral movement, assisted by the trapezius, splenius capitis, semispinalis capitis, and the sternocleidomastoid of the same side, all acting together.
Movements:
>Flexion and extension in the Sagittal axis, which give rise to the ordinary forward and backward nodding of the head.
>Lateral flexion to one or other side in the Frontal axis(titling of head
>Lateral AAJ Movement: It is a synovial joint which allows only gliding
>Medial AAJ Movement: This joint allows the rotation of the atlas the axis i.e round the dens.
Clinical anatomy:
> Headaches can arise from many different sources including dysfunctional muscles, tears in the ligaments, misalignment of the vertebral bodies, injury to cervical facets and degenerative discs.
>Excessive flexion could rupture the supraspinous ligament.
>Posterior atlanto-occipital membrane ossification cause migraine headaches due to compression of artery.
Atlanto occipital and atlanto axial jointShubham Singh
Anatomy:
>Atlas is the topmost vertebra and chief peculiarity of atlas is that it has no body, it is ring like and consist of anterior and posterior arch and two lateral masses.
>Axis, the 2nd cervical vertebra has a concave under side and convex from side to side. The most distinctive characteristic of this bone is strong odontoid process, the dens.
TheJoint:
>Atlanto-occipital joint (articulation between the atlas and the occipital bone) consists of a pair of condyloid joints.
>The atlanto-occipital joints are synovial socket-type joints
Ligaments:
> Posterior atlanto-occipital membrane: extend from anterior arch of atlas to posterior margin of foramen magnum.
>Anterior atlanto-occipital membrane: extend from anterior arch of atlas to anterior margin of foramen magnum.
>The ligamentam flavam join laminae of adjacent vertebral arches.
>The interspinous ligaments expand to form the ligamentum nuchae which inserts along the posterior foramen magnum and external occipital condyle.
> The following four ligaments stabilize these joints:
1.Apical ligament: Connects the dens to the foramen magnum of the occipital bone.
2.Alar ligaments: Connect the dens to the lateral margins of the foramen magnum.
3.Cruciate ligament: Attaches the dens to the anterior arch of the atlas and the body of the axis to the foramen magnum of the occipital bone.
4.Tectorial membrane: Starts at the skull and becomes the posterior longitudinal ligament.
>Atlanto-axial articular capsules are thick and loose, and connect the margins of the lateral masses of the atlas with those of the posterior articular surfaces of the axis.
Muscles:
>Flexion is produced mainly by the action of longis capitis, rectus capitis anterior and sternocleidomastoid (anterior fibres)
>Extension by the rectus capitis posterior major and minor, the obliquus capitis superior, the semispinalis capitis, splenius capitis, longissimus capitis, sternocleidomastoid and upper fibres of the trapezius
>The recti lateralis are concerned in the lateral movement, assisted by the trapezius, splenius capitis, semispinalis capitis, and the sternocleidomastoid of the same side, all acting together.
Movements:
>Flexion and extension in the Sagittal axis, which give rise to the ordinary forward and backward nodding of the head.
>Lateral flexion to one or other side in the Frontal axis(titling of head
>Lateral AAJ Movement: It is a synovial joint which allows only gliding
>Medial AAJ Movement: This joint allows the rotation of the atlas the axis i.e round the dens.
Clinical anatomy:
> Headaches can arise from many different sources including dysfunctional muscles, tears in the ligaments, misalignment of the vertebral bodies, injury to cervical facets and degenerative discs.
>Excessive flexion could rupture the supraspinous ligament.
>Posterior atlanto-occipital membrane ossification cause migraine headaches due to compression of artery.
this PPT contain detailed kinetics & kinematics of ankle joint & all joints of foot complex, muscles of ankle & foot complex, plantar arches & weight distribution during standing.
Musculoskeletal system – movements of the lower limb technologiesKareem Magar
A teaching resource I created for an assessment for university. It lists all the main movements of the lower limb (hip joint, leg/knee and leg/foot), the muscles associated with each movement and any other relevant information. At the end is a table summarizing all the information in depth, including origin and insertion. Included within the presentation are pictures of every movement and muscle involved, as well as links to useful resources such as a 3D anatomy model.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
5. Human Foot performs
- supports weight of body
- serves as lever to propel
body in walking & running
Child starts walking without support at 18 months age
Myelination of pyramidal tracts begin
Arches begin to get shape
6. These functions are carried out by
1. Foot skeleton made of series of small bones
- Foot acts as a segmented lever with multiple joints
thus becomes pliable and adapts to uneven surfaces
2. Long Flexors and Intrinsic muscles of foot act on
forepart of foot and assist propulsive action of
gastrocnemius and soleus
7. These functions are carried out by
2. Long Flexors and Intrinsic muscles of foot act on
forepart of foot and assist propulsive action of
gastrocnemius and soleus
8. Arches of foot
1. Longitudinal
2. Transverse
Concavity of both arches directed
to the plantar surface
Functions of arches
1. Proportional distribution
of weight
9. Body weight
120 pounds
Rt. Foot - Talus
60 pounds
Lt. Foot - Talus
60 pounds
Rt. Calcaneus
30 pounds
Heads of
5 Meta tarsals
30 pounds
6 Bearing points
4 metatarsals + 2
sesmaoids under hallux
Each 5 founds
1
2
3
4
5
6
10. Functions of arches
2. Arched foot acts as a segmented lever
Fore part of foot short muscles and long flexors
assist gastrocnemius and soleus
helps in take off of fore part from ground
Lumbricals prevent buckling from contraction of
Flex. Dig. Longus
11. Functions of arches
3. Plantar concavity protects plantar vessels and nerves
from compression
Flat foot – compression leads to Metatarsalgia
12. Functions of arches
4. Arched foot is dynamic and pliable
- When foot is on the ground arch flattens
- Off the ground restores original contour
Acts like a spring board
13. Functions of arches
5. Invertors lift foot on medial side shifts weight to lat.border
Tibialis anterior, Tibialis posterior
Evertors lift foot on lateral side shift weight to med. Border
Peroneus longus, brevis assisted by Per. Tertius
LATERALMEDIAL
Tib.Posterior
Tib.Anterior
Per.Longus
Per.Brevis
Per.Tertius
16. Medial Longitudinal arch
Summit of arch
Art. Surf.Talus
Post.pillar
Med.Tub.Calcaneus
Ant.pillar
Heads of 1st
to 3rd
Met.Tar
Vulnerable part
Head of Talus
“Key stone”
17. The medial longitudinal arch
This arch is very tall
(which is why the medial side of the foot is missing
from a footprint )
and is extremely resilient due to its large number
of component bones.
20. The lateral longitudinal arch
The arch is flat and contains relatively less no. of bones
Hence more rigid
Bears the body weight before the medial arch comes into play
Note the foot print
22. Transverse arch
When med. Borders of both feet are approximated a
complete transverse arch is formed
Each foot represents a half dome
Made of prox. By 3 cuneiforms
and cuboid
Distally bases of 5 metatarsals
24. Factors maintaining arches of foot
Med. Long. Arch:
1 Shape of bones
wedge shape with thin edge downwards
Talus “key stone” rests on concave art.surface of
navicular and on sustentaculum tali of calcaneus
2 Intersegmental tiers - like staples
Plantar ligs. Spring Lig. (supported from below by Tib.Post.)
permanent stretch of spr.lig. Produces flat foot.
3. Factors acting as tie beams
Plantar aponeurosis, Abd.Hallucis,
Med.part of Flex.dig.brevis, Tendon of Flex.Hal.Longus,
Med.part of tendon of Flex.dig.longus, Flex.hal.brevis
4. Suspending arch from above
Tendon of Tib.anterior, Sup.fibres of Delt.Lig.
Tend. Of Tib.Post.
25. Factors maintaining arches of foot
Lat. Long. Arch:
1 Calcaneal angle of cuboid
supports ant lower art.surf. of calcaneus
– upward tilt of long axis of calcaneus
2 Intersegmental tiers - like staples
Long and short plantar ligs.
3. Factors acting as tie beams
Plantar aponeurosis, Abd.dig.minimi,
Lat.part of Flex.dig.brevis,
Lat.part of tendon of Flex.dig.longus, Flex.dig.min.brevis
4. Suspending arch from above
Tendon of Per.brevis and tertius exert sling action
Peroneus longus – long course below foot
- sustentacular action
26. Factors maintaining arches of foot
Transverse Arch:
1 Shape of bones
Wedge shaped 3 cuneiforms
Bases of middle 3 metatarsals accentuate arch
2 Intersegmental tiers - like staples
Deep transverse ligs, other intrinsic plantar ligs.
Dorsal interossei,
Oblique and transverse heads of add. hallucis
3. Factors acting as tie beams
Tendons of per. Longus and Tib. Posterior
4. Acting from above
Per. Longus and tertius on lat. Side
Tib.anterior on med. Side
Factors which maintain long. Arches also maintain Trans.arch.
27. Deformities of the foot
1 Pes planus – Flat foot
2 Pes Cavus – High arched foot
Exaggeration of long. Arch
Toes dorsiflexed at metatarso-phalang. Joints
plantarflexed at inter-phalang. Joints - Claw foot
3. Club Foot – Talipes – congenital or acquired
a. Talipes equinus – Toes dorsiflexed and directed to ground
similar to horse
b. Talipes calcaneus – Heel remains on ground toes are
upturned
c. Talipes varus – Foot fixed in inversion and adduction
d. Foot fixed in eversion and abduction
28. Deformities of the foot
Foot print
(Normal)
Flat foott
(Pes planus)
Highly arched foot
(Pes cavus)
29. Deformities of the foot
March Foot
Neck of intermediate metatarsals undergo
decalcification
Minor injury may lead to pathological fracture
Commonly observed in soldiers prolonged walk after
prolonged sedentary rest
30. Deformities of the foot
Hallux vulgus
Great toe adducted towards midline
1st
Metatarsal abducted
wearing of narrow pointed shoes results in undue
prominence of medial part of metatarsal head and
a bunion may develop
