These are sheets of fibrous tissue which may be present instead of tendons (microscopically very similar)
May attach directly into bone or soft tissue
Collagen fibres often arranged at angle to each other
Note: Muscles attachments to bone via condensation of tissues will often lead to the development of a prominence (less likely where muscles attach directly into bone)
Synovial Tendon Sheaths
Some tendons which pass over or under bony or fibrous structures may be subject to friction:
To prevent excessive friction some tendons are covered in invaginated synovial sheaths
2 layers of Synovial Sheaths:
Innermost - Visceral
Outermost - Parietal
Separated by a thin film of synovial fluid (lubrication)
In other cases the tendon may be separated from underlying structures by a Synovial Bursa
Muscle Attachments
To be known in detail for all relevant muscles….
Proximal Attachment (Origin) - usually closest point to axial skeleton (Tends to be point of least movement)
Distal Attachment (Insertion) - usually furthest from axial skeleton (Tends to be point of freest movement)
A muscle will normally produce movement at each joint it crosses (if it contracts in isolation)
Anatomical Classification of Muscles
Muscles are classified according to shape and orientation of fibres
Muscles with fibres parallel to (or almost) line of pull
Provide a contraction over a large range but limited strength
Pennated Muscles
Role of pennation is to increase force generation
Achieved by increasing number of fibres contributing to force (see sarcomeres in parallel)
Action of Muscles
Each Muscle fibre is under neurogenic control (i.eStimulation & contraction of individual fibres)
Force may be sufficient to produce movement
If force generated by muscle exceeds external force (weight of limb, resistance etc.)
Approximation of attachments - Concentric contraction
If external force exceeds that generated by the muscle contraction that occurs is Eccentric (e.g. lowering weight)
Fascia
The limbs, trunk and head are invested in a double ‘stocking’ of connective tissue - Fascia
Divided into:
Superficial - subcutaneous, dense ,irregular connectivetissue allows skin mobility and may contain muscles e.g. platysma
Deep - tough, collagenous (resembles aponeuroses) inelastic
Provides attachment for some muscles
May form Intermuscular Septa
Compartmentalises limbs
May attach to superficial bony points
Learning of Muscles (e.g. Gluteus Maximus)
Functional group(Hip extensor)
General form / classification (Quadrilateral)
General position (Posterior aspect of hip. Gives buttock contour)
Proximal and distal attachments
Direction of fibres (downwards forwards and laterally)
Actions muscle can produce (Hip extension - primary role, lateral rotation and upper fibres may assist with abduction)
Nerve Supply(Inferior Gluteal Nerve L5, S1 and S2)
Function of the muscle - do not simply state action (Extension phase of gait, stepping up, standing up etc. Provides lateral stability of knee via ITB. When working with reverse attachments will raise trunk from flexed position by pulling pelvis back over femurs)
Palpation(Spread hand down from PSIS)
Introduction to Neurology
In order for any living organism to adapt to and survive environmental changes it must:
Identify the changes – sensory feedback
Integrate and analyse the information
Effect a response
This is the role of the nervous system
Nervous system made up of a group of highly specialised cells for the transfer of information between the periphery and brain / spinal cord
The Nerve Cells
These are nerve cells or neurones - excitable cells that do not reproduce and typically demonstrate extreme longevity (100 billion in brain)
Each neurone has a:
Cell Body
Neuronal processes:
Dendrites - many short processes to receive information from other neurone - pass information towards the cell body
One axon - long process the passage of information away from the cell body
Supporting cells - support neurones (up to 900 billion through CNS)
Divisions of the Nervous System
Broadly divided up into:
Central Nervous System (CNS) - brain and spinal cord housed in the skull and vertebral column
Formed by collection of cells bodies and bundles of axons
Divided into grey matter - mostly cells
White matter - mostly projections
Divisions of the Nervous System
Peripheral Nervous System:
Connects CNS with target organs
Sensory (afferent) division - information relayed from periphery to CNS (from sensory organs in tissues)
Motor (efferent) division - information / commands relayed from CNS to effector organs (muscles and glands)
Somatic - controls voluntary actions of skeletal muscles
Autonomic nervous system - involuntary control of target organs (controls blood vessels, gut, heart etc) via the sympathetic and parasympathetic divisions
The Nerve Root
The vertebral column is subdivided into 4 sections and each section is made up of a number of vertebrae, each identified by a letter (denoting which section it belongs to) and a number (denoting where it lies within the section)
The spinal cord is also divided in segments - each segment gives rise to a pair of ‘mixed spinal nerves’
Each spinal nerve root is identified in a similar way to the vertebra - (the only exception being in the cervical region):
31 pairs of spinal nerves
C1 to C8
C1 Nerves exit between the occiput & C1
C2 Nerves exit between C1 & C2 etc
C8 Nerves exit between C7 & T1
From T1 Nerve onwards the nerve will exit between its corresponding vertebra and the one below
The Mixed Spinal Nerve
Each mixed spinal nerve is formed by the ventral / anterior (motor) and dorsal / posterior (sensory) roots fusing to form the mixed spinal nerve.
The mixed spinal nerve then divides into anterior and posterior primary rami (mixed) - each containing sensory, motor and autonomic nerves.
The Plexi
Posterior (dorsal) primary rami pass backward to provide the sensory and motor innervation of the back
In the thoracic region the anterior primary rami pass forwards between adjacent ribs to supply the skin and muscles of this region as the intercostal nerves
The anterior (ventral) primary rami in the cervical, lumbar and sacral regions pass forwards, divide and fuse with each other to form peripheral nerves of the limbs and trunk
These ramifications and anastamoses are known as the plexi.
There are 3 main somatic plexi:
The Brachial – supplying the upper limb
The Lumbar – supplying the anterior and medial thigh
The Sacral – supplying the rest of the lower limb
From here the peripheral nerves form (e.g. sciatic, median etc)
Introduction to Angiology
This involves the study of the circulatory systems of the body
The Cardiovascular System
The Lymphatic System
All living tissues will require appropriate nutrients for survival and an efficient system for removal of metabolic waste products
The Cardiovascular System
Includes the heart (the pump of the CV system) – 4 chambers
The Arterial systems – take oxygenated blood to tissues and deoxgenated blood to the lungs
The Venous systems – take deoxygenated blood from the tissues back to the heart and oxygenated blood from the pulmonary system back to the heart
The Lymphatic System
In addition to the venous systems the role of the lymphatic system is to assist with drainage of interstitial fluid from the tissues
This systems is made up of vessels & organs
Lymphatic vessels transport fluid that has escaped from the vascular system into the tissues back into the blood
Lymph organs house phagocytes and lymphocytes essential for defence mechanisms of the body
