DEPARTMENT OF ANATOMY

Introduction to Clinically Oriented Anatomy

Dr Raj

Introduction to Clinically Oriented Anatomy • • • Anatomy is the study of the structure of the body.

Anatomy includes those structures that can be seen grossly (without the aid of magnification) and microscopically (with the aid of magnification).

Microscopic anatomy, also called 'histology ', is the study of cells and tissues using a microscope.

How can gross anatomy be studied? • • • • Anatomy can be studied following either a regional or a systemic approach.

Regional approach: each region of the body is studied separately and all aspects of that region are studied at the same time.

Systemic approach: each system of the body is studied and followed throughout the entire body.

Each of these approaches has benefits and deficiencies. The regional approach works very well if the anatomy course involves cadaver dissection.

Anatomical Position • • • The anatomical position is the standard reference position of the body used to describe the location of structures.

The body is in the anatomical position when standing upright with feet together, hands by the side and face looking forward.

The mouth is closed and the facial expression is neutral.

Anatomical Planes • • • • Three major groups of planes pass through the body in the anatomical position.

1.

Coronal planes

:oriented vertically and divide the body into anterior and posterior parts.

2.

Sagittal planes

:oriented vertically, but are at right angles to the coronal planes and divide the body into right and left parts. 3. Transverse, horizontal, or axial planes divide the body into superior and inferior parts.

Brain and different planes

CT Scan

Supine position and Prone position • • The supine position is a position of the the body face : lying down with up.

Prone position is a position of the body lying face down.

Ipsilateral/Contralateral

• • • • Ipsilateral parts on the same side of the body. refers to a part or The illustration shows the ipsilateral shoulder and hip. Contralateral describes a part or parts on the opposite sides of the body from each other.

The illustration shows, the contralateral hip and knee.

Terms of Relationship and Comparison 1.Anterior (ventral) and posterior (dorsal), medial and lateral, superior and inferior.

2. Proximal and distal, cranial and caudal, rostral.

3.Superficial and deep.

Terms of movement

• These terms describe movements of the limbs and other parts of the body; the movements take place at joints , where two or more bones or cartilages articulate with one another.

Flexion and Extension

Abduction and Adduction

Pronation and Supination

Dorsiflexion and plantarflexion Eversion and Inversion

Elevation and Depression

Protrusion and Retrusion

Basic Structures • • • • • • 1. Skin 7. Lymphatic System 2. Fascia 8. Nervous System a. superficial fascia b. Deep fascia 3. Muscle 4.Bone

5. Joints 6. Blood Vessels

• The skin is divided into two parts: the superficial part, the epidermis , and the deep part, the dermis.

Skin

Fasciae

• Superficial fascia, or subcutaneous tissue: Mixture of loose areolar and adipose tissue that unites the dermis of the skin to the underlying deep fascia

Deep fascia

• Membranous layer of connective tissue that invests the muscles and other deep structures.

Muscle • • • • Three types of muscle 1. Skeletal Muscle 2. Smooth 3. Cardiac.

Structure of Skeletal Muscle

• The attachment that moves the least is referred to as the origin , and the one that moves the most, the insertion.

Joints • • • • A site where two or more bones come together, whether or not movement occurs between them, is called a joint. 1. Fibrous Joints: bones are joined by fibrous tissue. 2. Cartilaginous Joints: bones are united by a plate or bar of hyaline cartilage. 3. Synovial Joints: Most common type of joint, provide free movement between the bones they join; they are joints of locomotion.

Fibrous Joint and Cartilaginous Joint

Synovial joints

• • • • The six major types of synovial joints are classified according to the shape of the articulating surfaces and/or the type of movement they permit.

1. Plane joints 4. Condyloid joints 2. Hinge joints 5. Ball and socket joints 3. Pivot joints 6. Saddle joints

Lymphatic System • • • • Lymph is the name given to tissue fluid once it has entered a lymphatic vessel.

1. Lymphatic vessels 2. Lymph node 3. Lymphatic ducts

Lymphatic System

The thoracic duct and right lymphatic duct and their main tributaries.

Metastasis • • Metastasis, is the spread of a cancer from one organ or part to another non adjacent organ or part.

When tumor cells metastasize, the new tumor is called a secondary or metastatic tu mor , and its cells are similar to those in the original tumor.

Routes of metastasis

• •

Lymphatic spread:

This is the most common route of metastasis for carcinomas .

Haematogenous

spread: This is typical route of metastasis for sarcomas.

Nervous System

• Nervous tissue consists of two main cell types: neurons (nerve cells) and neuroglia (glial cells) , which support the neurons.

The nervous system is divided

•

Structurally into the

central nervous system (CNS)

and

peripheral nervous system (PNS)

.

•

Functionally into the

somatic nervous system (SNS)

and

autonomic nervous system (ANS).

Cranial Nerves • • There are 12 pairs of cranial nerves that leave the brain and pass through foramina in the skull. All the nerves are distributed in the head and neck except the Xth (vagus), which also supplies structures in the thorax and abdomen.

Spinal Nerves • • A total of 31 pairs of spinal nerves leave the spinal cord and pass through intervertebral foramina in the vertebral column. 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal.

Spinal nerve(anterior and posterior rami) • • • On emerging from the foramen, the spinal nerve divides into a large anterior ramus and a smaller posterior ramus.

Posterior ramus vertebral column to supply the muscles and skin of the back.

passes posteriorly around the Anterior ramus limbs.

continues anteriorly to supply the muscles and skin over the anterolateral body wall and all the muscles and skin of the

Spinal nerve

Plexuses • • • • A nerve plexus is a network intersecting nerves .

of Except for the ventral rami of Th2-Th12 nerves.

At the root of the limbs, the anterior rami join one another to form complicated nerve plexuses.

The cervical and brachial plexuses are found at the root of the upper limbs, and the lumbar and sacral plexuses limbs.

are found at the root of the lower

Autonomic Nervous System

• 2 divisions: – Sympathetic • • “Fight or flight” “E” division – Exercise, excitement, emergency, and embarrassment – Parasympathetic • • “Rest and digest” “D” division – Digestion, defecation, and diuresis