St.

Paul University Philippines

Anatomy 1.0 School of Medicine June 28, 2012
Anatomic Structures
Dr. Lasam

Group | Keith Daliuag, Roselyn baculi, Jamie Acierto
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Outline
I. Definition of Anatomy and its Branches
II. Anatomical Position
III. Medical Terminologies related to position
IV. Terms related to movement
V. The Skin
A. Parts
B. Appendages of the Skin
C. Clinical Notes
VI. Fasciae
VII. Muscle
VIII. Joints
IX. Ligaments
X. Bone
XI. Bone Marking and Formations


I. DEFINITION OF ANATOMY AND ITS BRANCHES

ANATOMY is the science of the structure and function of the body.

Clinical anatomy (Applied) is the study of the macroscopic structure
and function of the body as it relates to the practice of medicine and
other health sciences.

Basic anatomy is the study of the minimal amount of anatomy
consistent with the understanding of the overall structure and
function of the body.



-the person is standing erect, with the upper limbs by the sides of
the trunk and the face and palms of the hands directed forward.
-gives a sense of UNIFORMITY in assessing


IMAGINARY PLANES

1. MEDIAN SAGITTAL PLANE
- Vertical plane passing through the center of the body, dividing into
2 equal R&L halves.

2. CORONAL PLANE
Imaginary vertical plane @ R angles to the median plane

3. HORIZONTAL or TRANSVERSE PLANES
- Right angles to both the median and the coronal planes


III. TERMS RELATED TO POSITION

Anterior and Posterior
-are used to indicate the front and back of the body
Palmar and Dorsal
-used in place of anterior and posterior in describing the
hand
Plantar and Dorsal
-Used in place of anterior and posterior in describing the
foot
Proximal and Distal
-Describes the relative distances from the root of the limbs
Superficial and Deep
-Describes the relative distances of structures from the
surface of the body.
Superior and Inferior
-Denotes levels relatively high or low with reference to the
upper and lower ends of the body
Internal and External
-Used to describe the relative distance of a structure from
the center of an organ or cavity
Ipsilateral
- refers to the same side of the body
example: left hand and left foot
Contralateral
-refers to the opposite sides of the body
example: right ostiomeatal complex and the left middle
turbinate
Supine
-lying on the back
Prone
-lying facing downward
II. ANATOMICAL POSITION
Group | Keith Daliuag, Roselyn baculi, Jamie Acierto
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IV. TERMS RELATED TO MOVEMENT

Flexion
movement that takes place in a sagittal plane
Extension
straightening the joint and usually takes place in a
posterior direction
Lateral Flexion
is a movement of the trunk in the coronal plane
Abduction
-Movement of a limb away from the midline of the body
in a coronal plane.
Adduction
-Movement of a limb towards the body in a coronal plane
Rotation
movement of a part of the body around its long axis.
a. Medial rotation
- movement that result in the anterior surface of the part
facing medially.
b. Lateral Rotation
- anterior surface facing laterally.
Pronation Of The Forearm
- medial rotation of the forearm in such a manner that
the palm faces posteriorly
Supination Of The Forearm
-Lateral rotation of the forearm from the pronated
position so that the palm comes to face anteriorly.
Circumduction
-combination of sequence of the movements of flexion,
extension, abduction, and adduction.
Protraction
-to move forward
Retraction
-to move backward
Inversion
movement of the foot so that the sole faces in a medial
direction.
Eversion
opposite movement of the foot so that the sole faces in
a lateral direction.

V. SKIN















A. PARTS

1. Epidermis
-superficial( more mature flat cells )
-Stratified Squamous Epithelium (Keratinized)

2. Dermis
-Deeper layer
-Composed of dense connective tissue
-Contains Blood vessels, lymphaticvessels and nerves

SKIN CREASES- where the skin of the joint always folds


B. APPENDAGES OF THE SKIN:

I. NAILS
-keratinized plates on the dorsal surfaces of the tip s of
the fingers and toes



Nail Root-The proximal edge of the plate
Nail Folds- the nail is surrounded and overlapped by folds of
skin
Nail Bed- The surface of skin covered by the nail

II. Hairs
- grow out of follicles, which are invaginations of the
epidermis into the dermis

Hair Bulbs- The follicles lie obliquely to the skin surface, and
their expanded extremities
Hair Papilla- Each hair bulb is concave at its end, and the
concavity is occupied by vascular connective tissue
Arrector Pili- A band of smooth muscle that connects the
undersurface of the follicle to the superficial part of the dermis.
The muscle is innervated by sympathetic nerve fibers, and its
contraction causes the hair to move into a more vertical
position; it also compresses the sebaceous gland and causes it
to extrude some of its secretion

Gooseflesh- The pull of the muscle also causes dimpling of
the skin surface

III. Sebaceous Glands
- pour their secretion, the sebum, onto the shafts of the
hairs as they pass up through the necks of the follicles

Sebum- . an oily material that helps preserve the flexibility
of the emerging hair. It also oils the surface epidermis
around the mouth of the follicle.


Group | Keith Daliuag, Roselyn baculi, Jamie Acierto
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IV. Sweat Glands
- are long, spiral, tubular glands distributed over the surface
of the body, except on the red margins of the lips, the nail
beds, and the glans penis and clitoris
-most deeply penetrating structures of all the epidermal
appendages.

C. CLINICAL NOTES

Skin Infections
-The nail folds, hair follicles, and sebaceous glands are common
sites for entrance into the underlying tissues of pathogenic
organisms such as Staphylococcus aureus.


Paronychia
- Infection occurring between the nail and the nail fold

Common Boil(Furuncle)
-Infection of the hair follicle and sebaceous

Carbuncle
-a staphylococcal infection of the superficial fascia. It
frequently occurs in the nape of the neck and usually starts as
an infection of a hair follicle or a group of hair follicles

Sebaceous Cyst
- caused by obstruction of the mouth of a sebaceous duct and may
be caused by damage from a comb or by infection. It occurs most
frequently on the scalp

Shock
-A patient who is in a state of shock is pale and exhibits
gooseflesh as a result of overactivity of the sympathetic
system, which causes vasoconstriction of the dermal
arterioles and contraction of the arrector pili muscles.

Skin Burns
Types:
a. Partial-Skin-Thickness Burn
-superficial, very painful
-heals from the cells of the hair follicles, sebaceous glands,
and sweat glands as well as from the cells at the edge of the
burn

b. Full Thickness Burn
-extends deeper and heals
-to speed up healing and reduce the incidence of
contracture, a deep burn should be grafted.

Two Main Types of Skin Grafting:

a. Split-Thickness Graft- the greater part of the epidermis,
including the tips of the dermal papillae, is removed from
the donor site and placed on the recipient site. This leaves
at the donor site for repair purposes the epidermal cells on
the sides of the dermal papillae and the cells of the hair
follicles and sweat glands.
b. Full-Thickness Skin Graft- includes both the epidermis and
the dermis and, to survive, requires rapid establishment of
a new circulation within it at the recipient site. The donor
site is usually covered with a split-thickness graft.
full-thickness graft is made in the form of a pedicle
graft, in which a flap of full-thickness skin is turned
and stitched in position at the recipient site, leaving
the base of the flap with its blood supply intact at the
donor site. Later, when the new blood supply to the
graft has been established, the base of the graft is cut
across.

VI.FASCIAE

Two types:
a. Superficial Fascia or Subcutaneous Tissue
-a mixture of loose areolar and adipose tissue that unites
the dermis of the skin to the underlying deep fascia

b. Deep Fascia
-a membranous layer of connective tissue that invests the
muscles and other deep structures

retinacula- In the region of joints, the deep fascia may be
considerably thickened to form restraining bands

VII.MUSCLE




Three Types Of Muscle:
1. Skeletal Muscle (Voluntary Muscles)
-produce the movements of the skeleton
-has two or more attachments:
origin -The attachment that moves the least
insertion- the one that moves the most
belly- The fleshy part of the muscle
tendons- The ends of a muscle are attached to bones,
cartilage, or ligaments by cords of fibrous tissue
Aponeurosis -flattened muscles are attached by a thin but
strong sheet of fibrous tissue
Raphe - an interdigitation of the tendinous ends of fibers
of flat muscles

Internal Structure of Skeletal Muscle
Epimysium -The muscle fibers are bound together with
delicate areolar tissue, which is condensed on the surface to
form a fibrous envelope

Pennate Muscles (they resemble a feather)- Muscles whose
fibers run obliquely to the line of pull
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a. Unipennate Muscle -one in which the tendon lies along one
side of the muscle and the muscle fibers pass obliquely to it
(e.g., extensor digitorum longus)


b. Bipennate Muscle- one in which the tendon lies in the center
of the muscle and the muscle fibers pass to it from two sides
(e.g., rectus femoris)

c. Multipennate Muscle- arranged as a series of bipennate
muscles lying alongside one another (e.g., acromial fibers of
the deltoid) or may have the tendon lying within its center
and the muscle fibers passing to it from all sides, converging
as they go (e.g., tibialis anterior)

SKELETAL MUSCLE ACTION
-All movements are the result of the coordinated action of many
muscles. However, to understand a muscles action, it is
necessary to study it individually

A muscle may work in the following FOUR WAYS:
a. Prime Mover -the chief muscle or member of a chief group
of muscles responsible for a particular movement.

Example: the quadriceps femoris is a prime mover in the movement
of extending the knee joint

b. Antagonist -opposes the action of the prime mover

Example: the biceps femoris opposes the action of the quadriceps
femoris when the knee joint is extended

c. Fixator- contracts isometrically to stabilize the origin of the
prime mover so that it can act efficientl

Example: the muscles attaching the shoulder girdle to the trunk
contract as fixators to allow the deltoid to act on the shoulder joint

d. Synergist-contract and stabilize the intermediate joints

Example: the flexor and extensor muscles of the carpus contract to
fix the wrist joint, and this allows the long flexor and the extensor
muscles of the fingers to work efficiently

2. Smooth Muscle
-consists of long, spindle-shaped cells closely arranged in bundles or
sheets

-In the tubes of the body, it provides the motive power for
propelling the contents through the lumen

- In the digestive system, it also causes the ingested food to be
thoroughly mixed with the digestive
juices
Peristalsis- A wave of contraction of the circularly arranged
fibers passes along the tube, milking the contents onward. The
longitudinal fibers pull the wall of the tube proximally over the
contents.
3. Cardiac Muscle
-consists of striated muscle fibers that branch and unite with each
other. It forms the myocardium of the heart

-Its fibers tend to be arranged in whorls and spirals, and they have
the property of spontaneous and rhythmic contraction

-supplied by autonomic nerve fibers that terminate in the nodes of
the conducting system and in the myocardium.

VIII.JOINTS
-A site where two or more bones come together, whether or not
movement occurs between them.

Joints are classified according to the tissues that lie between the
bones:

1. Fibrous Joints
-The articulating surfaces of the bones are joined by fibrous
tissue and thus very little movement is possible
Example: inferior tibiofibular joints

2. Cartilaginous Joints
Cartilaginous joints can be divided into two types:
a. Primary Cartilaginous Joint- one in which the bones are
united by a plate or a bar of hyaline cartilage

Example: union between the epiphysis and the diaphysis of
a growing bone and that between the 1st rib and the
manubrium

b. Secondary Cartilaginous Joint- one in which the bones are
united by a plate of fibrocartilage and the articular surfaces
of the bones are covered by a thin layer of hyaline cartilage

Example: joints between the vertebral and the symphysis
pubis

3. Synovial Joints
-The articular surfaces of the bones are covered by a thin layer
of hyaline cartilage separated by a joint cavity
Group | Keith Daliuag, Roselyn baculi, Jamie Acierto
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-This arrangement permits a great degree of freedom of
movement

Synovial membrane
-lines the cavity of the joint which extends from the
margins of one articular surface to those of the other

Capsule of the joint
a tough fibrous membrane protects the outside of the
synovial cavity.

Synovial Fluid
-produced by the synovial membrane
- a viscous fluid that lubricates the articular surface

Articular Discs
-discs or wedges of fibrocartilage that are interposed
between the articular surfaces of the bones

Synovial joints classified according to the ARRANGEMENT OF THE
ARTICULAR SURFACES and TYPES OF MOVEMENT that are possible:

a. Plane joints
-the apposed articular surfaces are flat or almost flat, and this
permits the bones to slide on one another
Examples: sternoclavicular and acromioclavicular joints

b. Hinge joints
-resemble the hinge on a door so that flexion and extension
movements are possible
Examples: elbow, knee, and ankle joints

c. Pivot joints
-a central bony pivot is surrounded
by a bonyligamentous ring and rotation is the only movement
possible
Examples: atlantoaxial and superior radioulnar joints

d. Condyloid joints
-have two distinct convex surfaces that articulate with two
concave surfaces.
-the movements of flexion, extension, abduction,
and adduction are possible together with a small
amount of rotation
Example: etacarpophalangeal joints or knuckle joints

e. Ellipsoid joints
-an elliptical convex articular surface fits into an elliptical
concave articular surface
-the movements of flexion, extension, abduction, and
adduction can take place, but rotation is impossible
Example: wrist joint

f. Saddle joints
-the articular surfaces are reciprocally concavoconvex and
resemble a saddle on a horses back
-these joints permit flexion, extension, abduction, adduction,
and rotation
Example: carpometacarpal joint of the thumb



g. Ball-and-socket joints
-a ballshaped head of one bone fits into a socketlike
concavity of another. This arrangement permits free
movements, including flexion, extension, abduction,
adduction, medial rotation, lateral rotation, and
circumduction
Examples: shoulder and hip joints

Nerve Supply of Joints
The capsule and ligaments receive an abundant sensory nerve
supply
Hiltons law -a sensory nerve supplying a joint also
supplies the muscles moving the joint and the skin
overlying the insertions of these muscles


IX.LIGAMENTS

LIGAMENTS
-a cord or band of connective tissue uniting two structures
-Commonly found in association with joints, ligaments are of
two types:

a. Fibrous Ligaments
-prevent excessive movement in a joint

b. Elastic Ligaments
-elastic tissues and can therefore regain its original length
after stretching

BURSAE
-a lubricating device consisting of a closed fibrous sac lined
with a delicate smooth membrane
-Its walls are separated by a film of viscous fluid

SYNOVIAL SHEATH
-a tubular bursa that surrounds a tendon. Synovial sheaths
occur where tendons pass under ligaments and retinacula and
through osseofibrous tunnels

Mesotendon
-tendon invaginates the bursa from one side so that the
tendon becomes suspended within the bursa
-In certain situations, when the range of movement is
extensive, the mesotendon disappears or remains in the
form of narrow threads, the Vincula.


X.BONE
- a living tissue capable of changing its structure as the result
of the stresses to which it is subjected
-It is hard because of the calcification of its extracellular matrix
and possesses a degree of elasticity because of the presence
of organic fibers

Functions:
protective function
serves as a lever
important storage area for calcium salts
houses and protects within its cavities the
delicate blood-forming bone marrow
Group | Keith Daliuag, Roselyn baculi, Jamie Acierto
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Two Forms:
1. Compact Bone- appears as a solid mass
2. Cancelous Bone- consists of a branching network of
trabeculae

Bones are grouped as follows based on their
general SHAPE:

1. Long Bones
-are found in the limbs
- ends of long bones are composed of cancellous bone
surrounded by a thin layer of compact bone

They have a tubular shaft, the diaphysis, and usually an
epiphysis at each end
The part of the diaphysis that lies adjacent to the
epiphyseal cartilage is called the metaphysis

Examples: humerus, femur, metacarpals, metatarsals, and
phalanges

2. Short Bones
- found in the hand and foot
- They are roughly cuboidal in shape
Examples: scaphoid, lunate, talus, and calcaneum

3. Flat Bones
- found in the vault of the skull
- they are composed of thin inner and outer layers of
compact bone, the tables, separated by a layer of
cancellous bone, the Diploe
Examples: frontal and parietal bones, scapula

4. Irregular Bones
Examples: bones of the skull, the vertebrae, and the
pelvic bones

5. Sesamoid Bones
- small nodules of bone that are found in certain tendons
where they rub over bony surfaces
Example: Patella

Development of Bone:
1. Membranous
-directly from connective tissue membrane

2. Endochondral
-cartilagenous model is first laid down and is later replaced
by bone












XI.BONE MARKINGS AND FORMATIONS

Capitulum: small, round, articular head
Condyle: rounded, knuckle-like articular area, usually
occurring in pairs
Crest: ridge of bone
Epicondyle: eminence superior to a condyle
Facet: smooth flat area, usually covered with cartilage,
where a bone articulates with another bone
Foramen: passage through a bone
Fossa: hollow or depressed area
Groove: elongated depression or furrow
Head: large, round articular end
Line: linear elevation
Malleolus: rounded process
Notch: indentation at the edge of a bone
Protuberance: projection of bone
Spine: thorn-like process
Spinous process: projecting spine-like part
Trochanter: large blunt elevation
Trochlea: spool-like articular process or process that acts
as a pulley
Tubercle: small raised eminence
Tuberosity: large rounded elevation