Lecture #1

Introduction to Anatomy
Prof. Mihly, Andrs, MD, PhD, DSc

2nd September 2014

The Anatomy Department

(Kossuth L. sgt. 40.; http://anatomy.szote.uszeged.hu/Anatomy/)

Professor Dr. Mihly, Andrs MD, PhD, DSc, director of the Department
Professor Dr. Ngrdi, Antal MD, PhD, DSc deputy director
Associate professor: Dr. Kovcs, Annamria, MD, PhD
Assistant professors: Dr. Blint Erika MD, PhD, Dr. Czigner Andrea MD, PhD,
Dr. Dob Endre MSc, PhD, Dr. Gyegyjfalvi-Lzrn, Dr. Hegeds Hajnalka
DMD, Dr. Molnr Gergely MSc, PhD, Dr. Pr Istvn, DPh, Dr. Szabados Andrea
MD, PhD, Dr. Szigeti Csaba, MSc, PhD
Senior research assistant: Dr. Sle Zoltn, PhD
Senior teaching assistant: Krisztinn Pva Beta MSc, Fejesn Bakos Mnika
MSc, Dr. Juhsz Zoltn, MD
Teaching assistants (MSc): Kruppa Eszter, Mtys Adrienne, Kroly Norbert,
Harkai Anik
Physician: Dr. Pr Erzsbet
Senior medical students (demonstrators): 13 medical student Colleagues,
helping in teaching, dissection and research (listed on the webpage of the
Department).

Main topics in Anatomy

Gross anatomy: descriptive anatomy of organs
and organ systems. The chapters of this are
named after the topic: osteology-syndesmology,
myology, angiology, neuranatomy, anatomy of the
viscera (respiratory, digestive, urogenital, etc
apparatuses).
Cytomorphology and histology: microscopic
anatomy of cells and tissues. Important in
pathology and cytodiagnostics (e.g.: hematology).
Embryology: development of the organs and
organ systems, anatomy of the pregnancy.

Teaching program of Anatomy

1st semester: anatomy of the limbs (bones, joints,
muscles, blood vessels and nerves). Anatomy of
the trunk and the skull. Basic tissues.
2nd semester: cardiovascular anatomy,
respiratory and alimentary tract anatomy.
Anatomy of the urogenital organs. Histology of the
cardiovascular, respiratory, alimentary and
urogenital organs. The endocrine organs, the
immune system and the blood.
3rd semester: anatomy and histology of the brain
and spinal cord. Head and neck anatomy.
Anatomy and histology of the eye and the ear.
Embryology: fertilisation, segmentation and
embryogenesis.

Exams in Anatomy
Practical Exams: practical viva voce exams in the
dissecting room and histology room, two times in a
semester. The marks (1-5) are written in the index book at
the end of the semester. Successful practical exams are
necessary for the entry to the semester exams and for the
credit of the practices.
Semester exams (2): comprehensive viva voce exams in
the examination period with different question types,
cadavers, atlas pictures and radiological images which
are presented on the lectures, seminars and practices.
Final exam: comprehensive examination after the 3rd
semester. The exam has written and oral parts, where the
students have to prove their knowledge of the anatomy,
histology and embryology. The oral parts consist of
theoretical and practical sections: in the practical section
the student demonstrates a dissected cadaver.

How to learn: the students have to use their textbooks

(gross antomy, histology and embryology), the handouts
of the Department, the electronic aids supplied by the
Department (found on the webpage), and their own notes.
It is highly recommended to make lecture notes and use them
in study. The participation on practices and seminars is
compulsory (see Regulations of the Faculty).

Textbooks are absolutely necessary for

study: recommended books
Grays Anatomy for Students (Drake-VoglMitchell)
Concise Histology (Gartner-Hiatt)
Snell, RS: Clinical Anatomy by Regions
(Wolters Kluwer)
Donth: Lexicon Anatomiae (published by
Semmelweis University Publishing House)

Morphology: science describing shape (morph = shape)

Anatomy: science of dissection
(anatemnein = to cut apart)
Systematic anatomy: description of organ systems.
Regional anatomy: description of body regions, and the
topography of structures within. Surface anatomy.
Applied anatomy: surgical anatomy, radiological anatomy.
Microscopic anatomy: cell morphology and histology.
Embryology: growth and morphogenesis
of the human body and organs from the conception to
the birth (and after).

Levels of biological organization

Cells and extracellular space.
Tissues (epithelia, connective tissue,).
Organs (brain, liver).
Organ systems (cardiovascular system,
urinary tract,).
Body parts (thorax, limbs,).
The human body.

Parts of the human body

Head (caput)
Neck (collum, cervix)
Trunk (truncus): chest (thorax), belly
(abdomen), pelvis
Limbs (extremities): upper limb
(extremitas superior), lower limb
(extremitas inferior)

Trunk parts
Chest (pectus, thorax)
Belly (abdomen, venter)
Groin (inguen, inguinal region)
Back (dorsum)
Loin (waist; lumbus, lumbar
region)
Buttocks (regio glutea)

Parts of the limbs

Pectoral girdle (scapula and clavicle)

Arm (brachium)
Forearm (antebrachium)
Wrist and hand (manus, carpus, metacarpus,
digiti)
Pelvic girdle (hip or coxa)
Thigh (femur)
Leg (crus)
Foot (pes)

Collum, cervix

Pectus
(thorax)

Abdomen, venter

waist

umbilicus
Inguen

Caput

Brain, eyes

Collum, cervix
Thorax
(cavitas thoracis)

Abdomen
(cavitas abdominis)
Pelvis
(cavitas pelvis)

Lungs, heart

Liver, stomach, spleen,

pancreas, intestines

Prostate, urinary
bladder, rectum

Dorsum (back)

Lumbus
(waist)

Regio glutea
(buttocks)

Introduction to osteology
os, ossis: bone

ANATOMY OF LONG LIMB BONES

EPIPHYSIS
Epiphysis-cartilage remnant

DIAPHYSIS

METAPHYSIS

Cavum medullare

Substantia spongiosa

Substantia compacta

SPONGY BONE IN THE

PROXIMAL EPIPHYSIS
OF THE FEMUR

Substantia
compacta
(compact bone)
Substantia spongiosa
(spongy or cancellous bone)

Spongy bone
Cavum medullare

Spongy bone under

scanning EM. The
minute cavities
contain bone marrow,
lined by endosteum.

Spongy bone is also called trabecular bone, and

the trabecules of the epiphysis and metaphysis
are arranged according to trajectories of the
forces generated by the body weight (B).
Spongiosa

Compacta

Marrow cavity

Distal epiphysis

Proximal epiphysis
Diaphysis

The surface of the bone is uneven:

tuberosities, eminences, cristae, pecten.
Blood vessels enter through foramina.

Compact bone is built of osteons. In the center of the osteon

the Haversian (H) canal is visible, containing the blood vessel. The Haversian
canal is surrounded by bone lamellae (1-6) arranged concentrically. The cells
of the bone (osteocytes) reside in minute cavities (lacuna arrows).
The osteocytes possess thin, long processes travelling in canaliculi.

5
1
4

Blood supply of the bone is rich. Epiphyses and diaphyses are supplied by
separate vessels. Diaphyseal arteries enter the medullary cavity. They supply
the medullary cavity, bone cortex and the bone marrow;
from the cavity they step back into the compact bone and form a rich vessel
system in the canals of Volkmann and Havers.
The compacta is also supplied from the periosteal arteries.
The vessels of the compacta run in the Volkmann- s Haversian canals
(see the osteon).

Endosteum and periosteum

Endosteum: continuous layer, covering every inner
cavity of the bone. Endosteum consists of a fine
layer of collagen fibrils plus one cell layer with
different cells (osteoprogenitor cells, osteoblasts
and osteoclasts).
Periosteum: connective tissue layer covering the
entire outer surface of the living bone (except
articular surfaces). Periosteum contains two layers:
1. stratum fibrosum (outer fibrous connective
tissue); 2. stratum osteogenicum (osteoblasts,
osteoclasts, osteoprogenitor cells). Periosteum has
a rich blood vessel supply and thin nerve fibers (pain
fibers).

The cells of bone

Osteocyte: mature, functioning bone cell. The cells
reside in the lacunae of bone. The cells possess thin
cytoplasmic processes which are in the bone
canaliculi, and communicate with each other through
gap junctions.
Osteoblast: cuboidal cell with strong basophilia. Cell
actively synthesizes bone matrix molecules
osteoblast builds the bone.
Osteoclast: multinucleated large phagocyte of the
bone. Destroys bone matrix.
Osteoprogenitor cell: young, undifferentiated cell in
the bone, from which osteoblasts differentiate under
the effect of mitogenic signals.

SECTION OF SPONGY BONE

(hematoxylin-eosin staining)

osteoclast

osteocytes

trabecule

Osteoblasts
in endosteum

The extracellular matrix of bone

(organic: 30%; inorganic: 70%)
Collagen fibers (90% of the organic)
Matrix-proteins (10% of the organic):
osteocalcin, osteonectin, osteopontin,
proteoglycans, fibronectin.
Hidroxylapatite (calcium-phosphate) crystals
Fluoride, citrate ions
Magnesium, iron, zinc, copper, strontium,
lead ions
Water (10-20%)

Metabolic regulation of bone cells

Parathyroid hormone: stimulates osteoblasts (synthesis of
the matrix osteoid). The osteoblast secretes cytokines,
which stimulate the formation of osteoclast cells. The
osteoclast releases calcium and phosphorus from bone,
and elevates blood calcium and phosphorus levels.
Calcitriol (vitamin D): increases the absorption of Ca and P
from the gut, and stimulates osteoblasts (synthesis of
matrix protein osteocalcin). Rickets, osteomalacia: lack of
vitamin D.
Calcitonin: inhibits activity of osteoclasts (thus inhibiting
the release of Ca from the bone).
Estrogens and androgens: increase osteoblast activity and
inhibit osteoclasts. Lack of estrogen: osteoporosis.
Vitamin C: essential for normal collagen synthesis.

Anatomy of the bones is well

visible on X-ray pictures

Introduction to syndesmology
articulatio = joint
arthron = joint
syndesmos = ligament

CLASSIFICATION OF JOINTS
Solid joints (synarthroses): fibrous
joints, cartilaginous joints. Fibrous:
suture, gomphosis, syndesmosis.
Cartilaginous: synchondrosis,
symphysis.
Cavitated joints (diarthroses): synovial
joints are classified according to the
shape of the articular head and the
number of the axis of the movements.

TWO TYPES OF SOLID, CARTILAGINOUS JOINTS (SYNARTHROSES)

synchondrosis

symphysis

Histological differences
between bone and
cartilage: in cartilage,
the matrix contains
only a small amount
of inorganic material.
Cartilage contains
mainly collagen,
proteoglycans, proteins
and
glycosaminoglycans,
and water.
There are no blood
vessels in cartilage,
therefore regeneration
is difficult and slow.
Cells of cartilage:
chondroblast,
chondrocyte,
chondroclast.

Cartilage is compressible, therefore the articular surfaces contact

each other broadly in cavitated joints. This helps stability and
movements, too.

GENERAL COMPONENTS OF SYNOVIAL (CAVITATED) JOINTS

1. Facies articularis articular surface (hyaline cartilage)
2. Articular capsule (membrana fibrosa, membrana synovialis)
3. Articular cavity (synovial fluid)
4. Articular ligaments
5. Discus articularis (special component found in some joints)
6. Meniscus articularis (special component found in some
joints)

HUMERUS
Capsule

Cartilage

ulna

Articular capsule

Section of the elbow joint:

the humero-ulnar ginglymus

RADIUS
Membrana interossea

JOINTS OF THE WRIST AND HAND:

Radiocarpal- (wrist) joint
Intercarpal joints
Carpometacarpal joints
Articulatio carpometacarpea pollicis
Metacarpophalangeal joints
Interphalangeael joints

This is a dry specimen:

the joints, the articular capsules
and some ligaments are visible.

Hyaline cartilage
(cartilago articularis)
Joint capsule (capsula articularis)

Meniscus-like structure

Cavity (cavitas articularis)

Membrana synovialis
Interphalangeal joint on histological section

1
2

Histology of articular hyaline cartilage.

There are a few joints which contain
fibrocartilage instead hyaline cartilage:
sternoclavicular joint is one of them.

Hyaline cartilage

Cartilage-bone transition
5

Mineralisation of cartilage

Bone tissue

Fibrous
capsule (C)

SM: synovial membrane (blood vessels)

cartilage

cartilage

SYNOVIAL MEMBRANE: LIGHT- and ELECTRON MICROSCOPY

Synovial membrane
A-type synoviocyte: macrophage.
B-type synoviocyte: fibroblast hialuronic
acid, matrix-proteins, connectice tissue
fibers: synthesis and secretion.
Lymph capillaries, blood capillaries, nerve
endings.
Composition of the synovial fluid: hialuronic
acid, proteins (serum proteins,
glycoproteins, proteoglycans), electrolytes,
glucose, water, few white blood cells.

Ligaments inside
joint (cruciate lig.)

Ligament outside
joint (collateral lig.)

Meniscus

Syndesmosis tibiofibularis

Menisci of the knee from

above (arrows)
Articular lip
(labrum articulare)

Lig. inside
the joint

Different morphological types of cavitated joints: types according to the

shape of the articular surfaces (arrows indicate movements)

Radiology is widely used in the investigation of joints. Anatomical

details are also visible on traditional X-ray photographs (knee).

Shoulder arthroscopy
Arthroscope is from dorsal direction, surgery device is from ventral:
both of them are introduced through small skin incisions.

Surgical device

Arthroscopy video of the shoulder

during surgery through arthroscopy
Fixation of the biceps tendon

Shaving the glenoid labrum

Pictures: Benninghoff-Drenckhahn: Anatomie, Urban & Fischer

Grays Anatomy, 40th edition, Elsevier
Szegedi Anatmiai Mzeum

Thank you for your attention.