GROSS ANATOMY 2017/2018 2018 BACK and UPPER LIMB 20 Lutego Vertebral column and skeleton of thoracic cage repetition (small review. (Wtorek) quiz) I Back: 1. Regions of the back: vertebral region, scapular region, infrascapular region, loin or lumbar region, sacral region (coccygeal foveola) 2. Muscles and bursa: Suboccipital muscles. origin and insertion, function of the muscles Superficial muscles of the back, origin and insertion, function of the muscles: trapezius (descending or superior part, transverse or middle part, ascending or inferior part), latissimus dorsi, rhomboid major et minor, levator scapulae, serratus posterior superior and serratus posterior inferior, subtendinous bursa of trapezius, subtendinous bursa of latissimus dorsi Deep muscles of the back, origin and insertion, function (unilaterally and bilaterally) of the muscles: erector spinae: sacrospinalis (iliocostalis, longissimus), spinotransversalis, transversospinalis (semispinalis, multifidus, rotator), interspinales, intertransversarii muscles Fascia: nuchal fascia, thoracolumbar fascia (anterior, middle and posterior layer) Nerves and vessels of the back: spinal accessory nerve, spinal nerve (cervical, thoracic, lumbar, sacral and coccygeal nerves), dorsal scapular nerve, deep cervical artery, arteries and veins of vertebral column (revision), cutaneous innervation of the back. 3. Topographical elements of the back (borders): triangle of auscultation, superior lumbar space, lumbar triangle or inferior lumbar space II. Regions of upper limb: deltoid region, brachial region or arm (anterior and posterior region of arm with lateral and medial bicipital groove), elbow or cubital region (anterior surface of elbow with cubital fossa, posterior surface of elbow), forearm (anterior and posterior region of forearm, lateral or radial border, medial or ulnar border), hand (wrist - anterior and posterior region of wrist, dorsum of hand, palm of hand, thenar and hypothenar eminence, metacarpus, digits of the hand). Shoulder girdle: o Bones (scapula, clavicle), o Synovial joints (acromioclavicular joint, sternoclavicular joint), articular facet, accessory elements, movements and classification of joint, syndesmoses of shoulder girdle. o Muscles (origin and insertion, and function of the muscles), deltoid (clavicular, acromial, spinal part), supraspinatus, infraspinatus, teres minor, teres major, subscapularis.
o Principal muscles acting on the shoulder joint o Bursae: (subcutaneous acromial bursa), subdeltoid bursa, subacromial bursa, subtendinous bursa of infraspinatus, subtendinous bursa of teres major, subtendinous bursa of subscapularis Fasciae (deltoid fascia, supraspinous fascia, infraspinous fascia, axillary fascia and suspensory ligament of axilla). Nerves: brachial plexus: Supraclavicular part: dorsal scapular nerve, long thoracic nerve, subclavian nerve, suprascapular nerve Infraclavicular part: subscapular nerves, thoracodorsal nerve, medial pectoral nerve, lateral pectoral nerve,- muscular branches Cutaneous innervations of the back and shoulder region the course and distribution and neuromers of the nerves of back, shoulder girdle. Vessels: subclavian artery and axillary artery (parts and branches), axillary vein and subclavian vein, axillary lymphatic nodes and vessels (apical, central, brachial, lateral, subscapular, pectoral, interpectoral, deltopectoral, infraclavicular) III Arm: Bones and joints: humerus, shoulder joint, articular facets, accessory elements, movements and classification of the joint. Muscles of the arm: o anterior compartiment of the arm: biceps brachii: long and short head, intertubercular tendon sheath, bicipital aponeurosis, bicipitoradial bursa, coracobrachialis, (coracobrachial bursa), brachialis o posterior compartiment of the arm triceps brachii: long, lateral and medial head, (intratendinous olecranon bursa), subtendinous bursa of triceps brachii, anconeus, articularis cubitis origin and insertion, and function of the muscles. Fasciae axillary fascia, deltoid fascia, brachial fascia, medial and lateral intermuscular septum of arm. Nerves and vessels of arm brachial artery, profunda brachii artery; deep artery of arm o deltoid branch o middle collateral artery o radial collateral artery superior ulnar collateral artery inferior ulnar collateral artery brachial veins, cephalic vein, basilic vein, lymphatic nodes and vessels
Spinal nerve: cervical nerves and thoracic nerves. Brachial plexus: roots, trunks, divisions, cords, supraclavicular and infraclavicular part, musculocutaneous nerve,axillary nerve, superior lateral cutaneous nerve of arm, medial cutaneous nerve of arm, radial nerve, posterior cutaneous nerve of arm, inferior lateral cutaneous nerve of arm, muscular branches Cutaneous innervations of the shoulder region and arm the course and distribution and neuromers of the nerves of the arm. Surface anatomy and surface markings with bony landmarks and palpation. Functional joints of the upper limb. Topographical elements and glossary: sensory / afferent, motor / efferent, somatic / parietal, visceral / splanchnic, ganglion and nucleus somatic afferent, visceral afferent, somatic efferent, and visceral efferent rootlets, dorsal/ventral roots, dorsal/ventral rami of spinal nerve, dorsal (sensory) root ganglion (spinal sensory ganglion) dermatome and myotome rotator cuff, subacromial and subdeltoid bursa, auscultatory triangle, axilla, axillary cavity (borders, contens) lateral and medial axillary space (foramen), or quadrangular and triangular space borders and contens tricipital hiatus, intertubercular groove, epicondylar line, epicondylo-olecranon triangle arterial anastomoses around the scapula bones fracture and dislocation, dislocation of shoulder injury of nerves and related structures (e.g. describe the signs and symptoms of a lesion to the: spinal accessory, dorsal scapular, long thoracic, thoracodorsal, axillary, radial and ulnar nerves) upper and lower brachial plexus nerve lesion supraspinatus tendinitis functional loss of the deep muscles of the back resulting from nerve lesions to these muscles triangle of Petit ligamentous injuries insertion of a catheter for central venous access (infraclavicular subclavian venipuncture) 21 Lutego Wet lab classes with PBL and SGD (Środa) Review of lab 1 - radius and ulna
23 Lutego Forearm: (Piątek) 1. Bones and joints: bones review (radius, ulna), synovial joints (elbow joint, distal radioulnar joint), articular facets, accessory elements, movements and classification of the joints. Radioulnar syndesmosis 2. Muscles: muscles of forearm anterior (flexor) compartment of the forearm o superficial part pronator teres (humeral and ulnar head), flexor carpi radialis, palmaris longus, flexor carpi ulnaris (humeral and ulnar head), flexor digitorum superficialis (humero- ulnar head, radial head) o deep part flexor digitorum profundus, flexor pollicis longus, pronator quadratus posterior compartment of the forearm extensor digitorum (Intertendinous connection), extensor digiti minimi, extensor carpi ulnaris (Humeral and ulnar head), abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis lateral part brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, supinator Origin and insertion, and function of the muscles. 3. Fasciae of forearm: antebrachial fascia, subcutaneous olecranon bursa 4. Nerves: nerves of forearm - the course and distribution of the nerves of forearm. 5. Vessels: vessels of forearm radial artery o radial recurrent artery ulnar artery, o ulnar recurrent artery o common interosseous artery o superficial veins cephalic vein median cubital vein median antebrachial vein; Median vein of forearm cephalic vein of forearm basilic vein of forearm o deep veins ulnar veins radial veins anterior interosseous veins posterior interosseous veins
27 Lutego Hand: (Wtorek) o lymphatic nodes cubital lymph nodes Radiological anatomy: X-ray, CT, MR, Angiography. Clinical Anatomy: - muscles acting on the elbow, and muscles acting on the wrist and hand - pulled elbow, posterior dislocation of elbow - bones fractures and injury of the nerves and others related structures - risk during intravenous access of the basilic or cephalic veins in the cubital fossa 1. Bones and joints (review): carpal bones, metacarpal bones, phalanges, radiocarpal joint, carpal joints, carpometacarpal joints, intermetacarpal joints, metacarpophalangeal joints, interphalangeal joints of the hand, articular facets, accessory elements, movements and classification of joints 2. Muscles and fascia: muscles o thenar eminence muscles abductor pollicis brevis, flexor pollicis brevis (superficial and deep head), opponens pollicis, adductor pollicis (oblique and transverse head) o hypothenar eminence muscles abductor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi, palmaris brevis o palmar and dorsal interossei, o lumbricals Origin, insertion and function of muscles of the hand. Dorsal fascia of hand: o extensor retinaculum and flexor retinaculum, o palmar aponeurosis, o transvers fasciculi, o tendinous chiasm. o carpal tendinous sheaths, o fibrous sheaths of digits of hand, o synovial sheaths of digits of hand 3. Nerves of hand: the course and distribution of the nerves of hand, and its topographical anatomy. Cutaneous innervations of the hand 4.Vessels of the hand superficial palmar arch deep palmar arch, superficial veins deep veins, lymphatic nodes,
topographical anatomy of the vessels 5.Topographical elements: carpal canal, ulnar canal, tendinous chiasma, radial fovea, spaces of the hand: superficial pulp space of fingers, intermetacarpal spaces, the ulnar and radial bursae and the synovial tendon sheaths of the fingers (fibrous flexor sheath, midpalmar space, thenar space) 6.Radiological anatomy: X-ray, CT, MR, Angiography. 7.Clinical Anatomy -segmental and regional cutaneous supply of upper limb -cervical rib syndrome -costo-clavicular syndrome -anatomy of upper limb deformities (e.g. brachial plexus injury: Erb- Duchenne paralysis, Klumpke s paralysis, crutch palsy, Saturday night palsy, wist drop, clow hand or main en griffe, monkey s hand, Volkmann s contracture (contractura ischemica), Dupuytren s contracture, trigger finger (stenosing tenosynovitis) -Colle s fracture and Smith fracture -boxer s fracture -mallet finger, swan neck -carpal tunel syndrome -surface anatomy of upper limb -surface landmarks and location of the pulse, -dermatoms. -useful surface markings of nerves and vessels (e.g. Henry s method) 28 Luty Wet lab classes with PBL and SGD (Środa) Review of lab 1 to 4 02 Marzec CREDIT: Back and Upper Limb (UL) (Piątek)