The tibiofibular joints are a set of articulations that unite the tibia and fibula. These two bones of the leg are connected via three junctions; The superior (proximal) tibiofibular joint - between the superior ends of tibia and fibula. The inferior (distal) tibiofibular joint - between their inferior ends.
The tibiofibular joints are a set of articulations that unite the tibia and fibula. These two bones of the leg are connected via three junctions; The superior (proximal) tibiofibular joint - between the superior ends of tibia and fibula. The inferior (distal) tibiofibular joint - between their inferior ends.
The Popliteal Fossa is a diamond-shaped space behind the knee joint. It is formed between the muscles in the posterior compartments of the thigh and leg. This anatomical landmark is the major route by which structures pass between the thigh and leg.
The Popliteal Fossa is a diamond-shaped space behind the knee joint. It is formed between the muscles in the posterior compartments of the thigh and leg. This anatomical landmark is the major route by which structures pass between the thigh and leg.
The Ankle Joint.pptx Dr Haki Selaj Residency in Orthopedic and Traumatology i...HakiSelaj1
it is one of the joints most often attacked by injury, in this case it is distorted. for this reason, accurate evaluation and diagnosis is required. for this reason, this presentation will help young doctors for access, exam tests and radiology around the TC joint
Tibia,fibula, patella print By M Thiru murugan.pptxthiru murugan
Tibia, Fibula & Patella
By, M. Thiru murugan
Tibia (Shinbone): The tibia is the main bone of the lower leg.
It expands at its proximal and distal ends; articulating at the knee and ankle joints respectively.
The tibia is the second largest bone in the body and it is a key weight-bearing structure.
Proximal: The proximal tibia is widened by the medial and lateral condyles, which aid in weight-bearing. The condyles form a flat surface, known as the tibial plateau.
This structure articulates with the femoral condyles to form the key articulation of the knee joint.
Located between the condyles is a region called the intercondylar eminence - this projects upwards on either side as the medial and lateral intercondylar tubercles. This area is the main site of attachment for the ligaments of the knee joint.
Shaft
The shaft of the tibia is prism-shaped, with 3 borders and 3 surfaces; anterior, posterior and lateral.
Anterior border: palpable subcutaneously down the anterior surface of the leg as the shin. The proximal aspect of the anterior border is marked by the tibial tuberosity; the attachment site for the patella ligament.
Posterior surface: marked by a ridge of bone known as soleal line. This line is the site of origin for part of the soleus muscle
Lateral border: also known as the interosseous border. It gives attachment to the interosseous membrane that binds the tibia and the fibula together.
Distal: The distal end of the tibia widens to assist with weight-bearing.
The medial malleolus is a bony projection continuing inferiorly on the medial aspect of the tibia.
It articulates with the tarsal bones to form part of the ankle joint.
On the posterior surface of the tibia, there is a groove for passage of tendon of tibialis posterior.
Laterally is the fibular notch, where the fibula is bound to the tibia - forming the distal tibiofibular joint.
Fibula (Calf Bone) The fibula is the second bone in the lower leg,
The fibula is a bone located within the lateral aspect of the leg. Its main function is to act as an attachment for muscles, and not as a weight-bearer.
Articulations:
Proximal tibiofibular joint: articulates with the lateral condyle of the tibia.
Distal tibiofibular joint: articulates with the fibular notch of the tibia.
Ankle joint: articulates with the talus bone of the foot
Proximal:
At the proximal end, the fibula has an enlarged head, which contains a facet for articulation with the tibia.
On the posterior and lateral surface of the fibular neck (fibular nerve located)
Shaft
The fibular shaft has 3 surfaces - anterior, lateral and posterior. The leg is split into 3 compartments, and each surface faces its respective compartment
Distal
Distally, the lateral surface is called the lateral malleolus.
The lateral malleolus is more prominent than the medial malleolus, and can be palpated at the ankle on the lateral side of the leg.
Patella: The patella (kneecap) is located at the front of the knee joint, within the patellofemora
knee joint
Functionally, the knee joint is a condylar & modified hinge joint.
Transverse axis of movement is not fixed, & moves forward during extension & translates backward in flexion;
Along with extension & flexion, there is a conjunct rotation of femur on tibia(or vice versa) around a more or less vertical axis.
1. Capsular ligament
2. Synovial membrane
3. Ligamentum patellae
4. Tibial collateral ligament
5. Fibular collateral ligament
6. Oblique popliteal ligament
Arcuate popliteal ligament
Medial & lateral menisci
TIBIAL COLLATERAL LIGAMENT
The ligament consist of superficial & deep part . Both part are attached above to the medial epicondyle of femur. The superficial part extends downward & forward as a flattened band & is attached to the medial condyle & upper part of medial border of shaft of tibia along a rough strip of bone.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
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is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
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(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
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comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
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Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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2. Tibiofibular Joints
• The proximal and distal tibiofibular
joints refer to two articulations between
the tibia and fibula of the leg.
• These joints have minimal function in
terms of movement but play a greater
role in stability and weight-bearing.
4. Proximal Tibiofibular Joint
• Articulating Surfaces:
• The proximal tibiofibular joint is formed
by an articulation between the head of
the fibula and the lateral condyle of the
tibia.
• It is a plane type synovial joint; where
the bones to glide over one another to
create movement.
5. Proximal Tibiofibular Joint
• Supporting Structures:
• The articular surfaces of the
proximal tibiofibular joint are
lined with hyaline cartilage and
contained within a joint capsule.
6. Proximal Tibiofibular Joint
• The joint capsule receives additional support
from:
–Anterior and posterior superior tibiofibular
ligaments – span between the fibular head
and lateral tibial condyle
–Lateral collateral ligament of the knee joint
–Biceps femoris – provides reinforcement
as it inserts onto the fibular head.
7. Proximal Tibiofibular Joint
• Neurovascular Supply:
• The arterial supply to the proximal tibiofibular
joint is via the inferior genicular arteries and
the anterior tibial recurrent arteries.
• The joint is innervated by branches of
the common fibular nerve and the nerve to
the popliteus (a branch of the tibial nerve).
9. Distal Tibiofibular joint
• Articulating Surfaces:
• The distal (inferior) tibiofibular
joint consists of an articulation between
the fibular notch of the distal tibia and
the fibula.
• It is an example of a fibrous joint, where
the joint surfaces are by bound by tough,
fibrous tissue.
10. Distal Tibiofibular joint
• Supporting Structures:
–The distal tibiofibular joint is supported by:
• Interosseous membrane – a fibrous structure
spanning the length of the tibia and fibula.
• Anterior and posterior inferior tibiofibular ligaments
• Inferior transverse tibiofibular ligament – a
continuation of the posterior inferior tibiofibular
ligament.
– As it is a fibrous joint, the distal tibiofibular joint does not
have a joint capsule (only synovial joints have a joint
capsule).
11. Distal Tibiofibular joint
• A syndesmosis is a fibrous joint between two bones
and linked by ligaments and a strong membrane. [
• The distal tibiofibular syndesmosis is a syndesmotic
joint.
• It is formed between the distal tibia and fibula and
it is attached by
– The interosseous ligament (IOL),
– The anterior-inferior tibiofibular ligament (AITFL),
– The posterior-inferior tibiofibular ligament
– The (PITFL)the transverse tibiofibular ligament (TTFL).
12. Distal Tibiofibular joint
The left distal tibiofibular joint, supported by
the interosseous membrane and the anterior
inferior tibiofibular ligament. The posterior
ligaments are not visible in this illustration.
13. Distal Tibiofibular joint
• Neurovascular Supply:
• Arterial supply to the distal
tibiofibular joint is via branches of
the fibular artery and the anterior
and posterior tibial arteries.
• The nerve supply is derived from
the deep peroneal and tibial nerves.
14. Clinical Relevance
• Dislocation of the Proximal Tibiofibular Joint
• A proximal tibiofibular joint dislocation is a rare and often
missed diagnosis. It accounts for <1% of all knee injuries.
• The typical mechanism of injury is a fall onto an adducted
and flexed knee. They can also occur as a result of high-
energy trauma.
• Common clinical features include inability to weight-bear,
lateral knee pain and tenderness/prominence of the fibular
head.
• This type of injury is typically treated with a closed
reduction (a reduction is a procedure to restore the joint to
its natural alignment).
• Complications of proximal tibiofibular joint dislocation
include common fibular nerve injury (the nerve winds around
the neck of the fibula), and recurrent dislocation.
15. INTEROSSEUS MEMBRANE OF LEG
(middle tibiofibular ligament)
• This ligament extends through the fibula and
tibia's interosseous borders and separates the
muscles in the back of the leg from the
muscles located in the front of the leg.
• It is made of an aponeurotic lamina, which is a
thin layer of oblique, tendon-like fibers.
• Most of the fibers run laterally and
downwards while the others run in an
opposite direction.
16. INTEROSSEUS MEMBRANE of leg
(middle tibiofibular ligament)
• The ligament thins out at the lower portion, but is
broader in the upper half.
• The upper portion of the interosseous membrane of leg
does not reach the tibiofibular joint, but does create a
large concave border that allows the anterior tibial
vessels to pass through to the front of the leg.
• The lower part of the interosseous membrane of leg
there is an opening so that the anterior peroneal
vessels can pass through.
• In addition to the two main openings for the passage of
vessels, there are also numerous openings so that small
vessels can pass through.
17. INTEROSSEUS MEMBRANE of leg
(middle tibiofibular ligament)
• Function:
• The inferior segment assists in
stabilising the tibiofibular
syndesmosis.
18. LIGAMENTS DESCRIPTION PROXIMAL
ATTACHMENT
DISTAL ATTACHMENT ROLE / FUNCTION
Anterior-inferior
tibiofibular ligament
(AITFL)
Trapezoid shape (the
tibial insertion is
wider)
The ligament runs
obliquely
Weaker than the
PITFL
20% intra-articular
Anterior tubercle of the
distal tibia
Anterior surface of the
distal fibula at the
lateral malleolus
One of the primary
stabilisers
Limits excessive:
external rotation of
the foot on the leg
distal fibular motion
on the tibia
Posterior or posterior-
inferior tibiofibular
ligament
(PITFL)
Strong compact
ligament
Known as the
Superficial
component of the
PITFL
Posterior edge of the
lateral malleolus
Posterior tibial
tubercle
One of the primary
stabilisers Limits
excessive:
external rotation of
the foot on the leg
distal fibular motion
on the tibia
Transverse ligament
or the Transverse
tibiofibular ligament
(TTFL)
Cone shaped
Also known as the
Deep component of
the PTIFL
Proximal area of the
malleolar fossa
Posterior edge of the
tibia -- directly posterior
to the cartilaginous
covering of the inferior
tibial articular surface
and may extent up to
the medial malleolus
Forms a true labrum
Provides talocrural joint
stability.
Prevents Posterior
translation
Interosseus ligament
or the interosseous
tibiofibular ligament
(IOL)
Thickened portion of
the distal
interosseous
membrane
Dense mass of short
fibers with adipose
tissue and small
branching vessels
from the peroneal
artery
Span between the tibia
and fibula
The most proximal
fibres attach to the
apex of the incisura
tibialis on the tibia
Most distal fibres attach
to the anterior tubercle
of the tibia and
descends straight to the
talocrural joint of the
fibula
The length of the fibres
increase from proximal
to distal
One of the primary
stabilisers
Buffer to neutralise forces
during weight bearing as it
transfers some of the axial
compressive load to the
fibula
'Spring' action - allowing
for minor separation
between the distal tibia
and fibula during
dorsiflexion. Allowing
slight wedging of the talus
in the mortise
