Lesson No 3
Theme 1: Bones of upper limb.
Theme 2: Articulations of upper limb.
Theme 3: Bones of lower limb.
Aim: To study the structure scapula and clavicle. To receive general data about skeleton of upper limb. To study the structure of humerus. To find, term and show carpal bones and hand in preparations, discribe their structure. The normal structure of shoulder girdle joints provide the possibility to recognise the different kinds of this joints malformations and to treat them correctly.
Study the structure of the hipbone, femur and patella. To find, term and show structural elements in preparations, to orient them in space, to distinguish right bone from left one. To acquaint with sexual and age differences hipbone and femur. To find, term and show structural elements of the leg and foot bones in preparations, to orient them in space, to distinguish right bone from left one.
Professional motivation: Knowledge structure of the shoulder joint, elbow joints, forearm and hand bone’s joints are very important for medical practice. Congenital joints disease and pathology of shoulder joint, elbow joint, forearm and hand bone’s joints are the most common in adults and children. The good knowledge structure of these joints provides the possibility to recognise the different kinds of joint malformation and to treat it correctly. Knowledge the structure of leg and foot bones allow to understand morphological peculiarities of locomotory apparatus of lower limb. The correct structure and position of the bones are very important for normal functioning of nerves, vessels and muscles. Understanding the structure is a fundamental base for the neurosurgical, and therapeutical practice, also traumatology and sport medicine.
Basic Level. Roman (Latin) terminology.
Special attention should be paid to the following questions:
1. What department of the upper limb does humerus belong to?
2. What bones do humerus epiphysises join with?
3. How distinguish right humerus from left one?
4. What formations are there in proximal and distal humerus epiphysises?
5. Which groove is situated in humerus diaphysis?
6. How many bones are there in forearm region? Term them.
7. In what position of upper limb forearm bones are arranged parallel?
8. What position do radius and ulna occupy (medial / lateral)?
9. What parts do they distinguish in each forearm bones?
10. How distinguish right bone from left one?
11. What formations are there in proximal and distal radius epiphysises?
12. What formations are there in proximal and distal ulna epiphysises?
13. In what position of the forearm can they grope for olecranon?
14. What surfaces and margins do they distinguish in hand?
15. How many bones are there in hand?
16. What departments does hand have and how many bones form them?
17. How are disposed carpal bones?
18. In what surfaces can they feel the pisiform?
19. In what surfaces can they feel the capitate and hamate?
20. What structure of the metacarpals?
21. What and how many phalanges are there?
22. Acromio-clavicular articulation:
a) the superior acromio-clavicular ligament;
b) the interior acromio-clavicular ligament;
c) the interarticular fibro-cartilage;
d) the synovial membrans;
e) the coraco-clavicular ligament;
l)actions.
15. Proper ligaments of the scapula:
a) the coraco-acromiol ligament;
b) the transverse or caracoid (suprascapular) ligament;
c) movements of scapula.
16. Shoulder-joint:
a) Joint surfaces;
b) Capsular ligament;
c) Coracohumeral ligament;
d) Supplemental bonds of the capsular ligament;
e) Transverse humeral ligament;
l) Glenoid ligament;
g) Synovial membrane;
q) Actions
17. Elbow-joint:
a) Formation of a elbow-joint;
b) Anterior ligament;
c) Posterior ligament;
d) Internal lateral ligament;
e) External lateral ligament;
l) Synovial membranes;
g) Actions.
18. Radio-ulnar articulations:
a) Superior radio-ulnar articulation;
b) Middle radio-ulnar union;
c) Inferior radio-ulnar articulation.
19. Radio-carpal or wrist-joint:
a) External lateral ligament;
b) Internal lateral ligament;
c) Anterior ligament;
d) Posterior ligament;
c) Synovial membranes;
e) Relations;
g) Actions.
20. Articulations of the carpus:
a) Articulations of the first
Row of carpal Bones;
b) Articulations of the second
Row of carpal Bones
c) Articulations of the two
Rows with each other.
21. Carpo-metacarpal articulations.
22.
a) Anterior ligaments;
b) Lateral ligaments;
c) Actions.
23. Articulations of the phalanges:
a) Anterior ligaments;
b) Lateral ligaments;
c) Actions.
1. What part of the lower limb does hip bone belong to?
2. What bones form hip bone?
3. How distinguish they left hip bone from right one?
4. What parts of the bones form acetabulum?
5. What is obturator foramen bordered by?
6. What surfaces do they distinguish in iliac wing?
7. What structures do they distinguish in iliac wing?
8. What spines do they distinguish in iliac?
9. Where is ischial tuberosity disposed?
10. What formations are disposed in superior branch of the pubis?
11. What department of the lower limb does femur belong to?
12. How distinguish they left femur from right one?
13. What formations are disposed in proximal and distal epiphysises of the femur?
14. What is aspera line? Where is it disposed?
15. What bones does patella belong to?
16. What structure of the patella?
17. What bones form leg skeleton?
18. What position do each bone occupy in leg region?
19. What parts, margins, surfaces do they distinguish in each bone?
20. How distinguish they left bones from right one?
21. What formations are disposed in proximal and distal epiphysises of the tibia and fibula?
22. What margin of the tibia can they feel in human?
23. What bones do form foot skeleton?
24. What departments does foot have? How many bones go into each of them?
25. What margins and surfaces do they distinguish in foot?
26. What tarsal bones do you know?
27. Describe the structure of each tarsal bone?
28. How many metatarsal bones are there?
29. What and how many phalanges are there in foot?
30. What difference between upper and lower limb skeleton? Why?
Demonstrate on preparations:
1. Sholder joint: fenoid labrum, coracohumeral ligament.
2. Elbow joint: humeroulnar joint, humeroradial joint, the proximal radioulnar joint, the ulnar collateral ligament, the radial collateral ligament, the anular ligament of radius.The radiocarpal(wrist) joint: articular disc, the radial collateral ligament, the ulnar collateral ligament, the palmar radiocarpal ligament, the dorsal radiocarpal ligament, carpal canal.
3. Hipbone: parts, ala of the ilium, iliac crest, outer and inner lips, intermediate zone, anterior superior iliac spine, posterior inferior iliac spine, anterior, posterior and inferior gluteal lines. Acetabulum. Iliac fossa, auricular surface, iliopubic eminence, iliac tuberosity. Pubic bone: body, superior and inferior ramus, pubic tubercle, symphysial surface. Ischial bone: body, ischial tuberosity, ischial spine, greater and lesser sciatic notches, obturator foramen, obturator groove.
4. Femur bone: head of the femur, neck of the femur, greater and lesser trochanter, intertrochanteric line, intertrochanteric crest, body, medial and lateral lips, pectineal line, gluteal tuberosity, popliteal surface, medial and lateral condyles, medial and lateral epicondyle.
5. Patella: base and apex, articular surface.
6. Tibia bone: medial and lateral condyles, intercondylar eminence and tubercles, fibular articular facet, body, surfaces, borders, fibular notch, medial malleolus.
7. Fibula bone: head, borders, lateral malleolus.
8. Bones of the foot: departments. Talus, calcaneus, navicular bone, cuboid bone, cuneiform bones. Metatarsal bones, phalanges of the foot.
Illustrative materials:
1. Skeleton.
2. Humerus: formations are disposed in proximal and distal epiphysis and body.
3. Formations are disposed in proximal epiphysis of the radius and ulna.
4. Formations are disposed in distal epiphysis distal epiphysis
5. Departments of the hand.
6. Rows of the carpal bones.
7. Humid preparations of upper limb joint.
Methods of practical work
Work 1. Study anatomy of forearm and hand bones
Independently, after the active teacher consultation, using textbooks and atlases, to learn a humerus, forearm and hand bones anatomy on separate preparations and on skeleton.
Work 2. Studying shoulder girdle and upper limb joints
Using separate bones and humid preparations, necessary to show the joint of the bones of upper limb belt. To show a sternoclavicular joint (it’s ball and socket by shape). It’s necessary to account the sense of intraarticular disc.
While consideration of acromioclavicular joint flat in form, observing insignificant movements amplitude in it and role in this limitation of coracoclavicular ligament.
Work 3. After the teacher’s consultation, using textbooks and atlases, preparations, to learn the theme for such plan:
1. Humeri joint: articulate surfaces, shape, function, capsule of humeri joint, its attachment and peculiarities of joint.
2. To show on the human axes and movements volume in humeri joint.
3. Elbow joint: articulate surfaces, shape, function and ligaments, which fix this joint.
4. Types of forearm bones’ joints: proximal and distal radioulnar joints.
5. Radiocarpal joint: articulate surfaces, articulate disc, capsule and ligaments.
6. Joint: intermetacarpea, mediocarpea, pisiform bone, carpometacarpea, carpometacarpea pollicis, metacarpophalangea and interphalangea.
Work 4. Studying anatomy of hip bone, femur patella
After the teacher’s consultation, using textbooks and atlases, to learn anatomy of hip bone, femur, patella on separate preparations and on skeleton.
References:
1. H. Gray. Anatomy, Descriptive and Surgical. –
2. W. Kahle, H. Leonhardt, W. Platzer. Color atlas and Textbook of Human Anatomy. –
3. R.D. Lockhart, G.F. Hamilton, F.W. Fyfe. Anatomy of the human body. –
5. Lecture.
6. Colin H. Wheatley, B.Kolz. Human anatomy and physiology. 1995.
7. Borys Y. Reminetskyy, Yaroslav I. Fedonyuk, Human Anatomy.- Locomotory apparatus – Notes, 2002.
Lesson No 4
Theme: Articulations of lower limb. Skull.
Frontal, parietal, occipital bones. Sphenoid and ethmoid bones
Aim. To study pelvic bone’s joints. Hip and knee joints. Sazes of the female pelvic.
To study leg and foot bone’s joints.
Can to find, to name and to show on preparations anatomic bone structures and their joints. To term, find and show in cranium and separate preparations occipital, parietal and frontal bones, their parts, tell about their structure.
To study location, part, structural features of the sphenoid and ethmoid. Understand their participation in different scull structures.
Professional motivation: Good knowledge the structure hip bone’s joints, pelvis, hip and knee joints allow to recognize the different kinds of this joints alterations and to treat them correctly.
Knowledge the structure of leg and foot bone’s joints allow to recognize the different kinds of this joints alterations and to treat them correctly.
Studying of bones gives conception about external structure of bones, and sections- about their internal structure. These practical knowledge, if they base on good theoretical student’s knowledge, will allow to determine localization of pathology processes in the body, participating in osseous reference-points, to choose correct damages cure methods of supporting-impellent vehicle, will lend a hand to master the methods of manual therapy. Knowledge of bone structure will help to understand such widespread phenomenon as osteoporosis.
Knowledge the structure of occipital, parietal and frontal bones allow to understand morphological peculiarities of cavity for brain and cranial nerves, also important vessels. The correct structure and position of the bones are very important for normal functioning of visual organs, frontal air sinuses, also dural venous sinuses and internal jugular veins. Understanding the structure is a fundamental base for the neurosurgical, and therapeutical practice also traumatology. knowledge the structure of Sphenoid and Ethmoid bones allow to understand morphological peculiarities of cavity for brain and cranial nerves, also important vessels and hypophysis. The correct structure and position of the bones are very important for normal functioning of ethmoid and sphenoid air sinuses, also dural venous sinuses and portion of nasal cavity. Understanding the structure is a fundamental base for the neurosurgical, and therapeutical practice also traumatology and ENT specialiats.
Basic Level: Roman (Latin) terminology.
Special attention should be paid to the following questions:
1. Articulations of the lower extremity.
2. The structure of hip-joint:
a) capsular ligament;
b) ilio-femoral ligament;
e) transverse ligament;
j) synovial membrane;
g) actions.
3. The structure of knee-joint:
f) anterior ligament or ligamentum patellae;
b) posterior ligament;
c) internal lateral ligament;
d) long external lateral ligament;
e) short external lateral ligament;
j) capsular ligament;
g) anterior and posterior crucial ligaments;
k) semilunar fibro-cartilages;
e) transverse ligament;
m) coronary ligaments
n) synovial membrane;
o) structures around the joint;
p) actions.
4. Articulations between the tibia and fibula:
a) superior tibio-tibular articulation;
b) the middle tibio-fibular ligament or interosseus membrane;
c) the inferior tibio-tibular articulation.
5. The ankle-joint.
6. The articulations of the tarsus.
7. The articulations of the talus with naviculare bone.
8. The articulation of the navicular with cuneiform bones.
9. The articulation of the navicular with the cuboid.
10. The tarso-metatarsal articulations.
11. Articulations of the metatarsal bones with each other.
12. The metatarso-phalangeal articulations.
13. Articulations of the phalanges.
Demonstrate on preparations:
1. Pelvis as a whole: syndesmosis, synchondrosis, synostosis, major and minor pelvic, transverse size of major pelvic, size of minor pelvic, greater sciatic foramen, lesser sciatic foramen, obturator canal.
2. Coxal joint: articular surfaces, ligaments.
3. Knee joint: articular surfaces, menisci, ligaments, synovial bursae.
4. Articulations of the bones of the leg: interosseous membrane, tibiofibular syndesmosis.
5. Ankle joint: articular surfaces, ligaments, shape, type, movement.
6. Articulations of the bones of the foot: the transverse tarsal joint(Chopart’s joint), bifurcate ligament-the key of the Chopart’s joint. Tarsometatarsal joint(Lisfranc’s joint), medial interosseous cuneometatarsal ligament-the key of the Lisfranc’s joint.
5. Transversal ligaments of foot, fixing them passive vehicle (plantar aponeurosis, long plantar ligament) and their functional significance in case of supporting and locomotor foot functions.
6. Skull: neurocranium and viscerocranium, border between calvria and base.
7. Frontal bone: sguama: external, internal, temporal surfaces. Frontal tuber, superciliary arch, supraorbital margin, zygomatic process, frontal crest, groove for the superior sagittal sinus, foramen caecum. Nasal part: nasal spine. Orbital part: ethmoidal notch, trochlear fovea, trochlear spine, fossa for the lacrimal gland.
8. Parietal bone: external and internal surfaces, frontal, occipital, sagittal and sguamous borders, fronta, occipita, sphenoid and mastoid angles. Groove for the superior sagittal sinus, groove for the sigmoid sinus, superior and inferior temporal lines.
9. Occipital bone: foramen magnum, sguama, basilar part. Grooves for the transverse and sigmoid sinuses. Hypoglossal and condylar canals. Pharyngeal tubercle.
10. Sphenoid bone: body, sella turcica, hypophysial fossa, tuberculum sellae, carotid sulcus, sphenoidal crest, sphenoidal conchae, opening of the sphenoid sinus. Small wing: optic canal, supirior orbital fissure. Great wing: cerebral, orbital, temporal and maxillary surfaces: foramen rotundum, foramen ovale and foramen spinosum. Pterygoid processes: medial and lateral plates, pteryoid fossa, pteryoid canal.
11. Ethmoid bone: cribriform plate, crista galli, perpendicular plate. Ethmoidal labyrinth: ethmoidal cells, orbital plate, superior and middle nasal conchae.
12. Ligaments, which support sacrum with hip bone and form greater and lesser sciatic fossae. Obturator membrane, obturator channel.
13. Pelvis as whole: pelvic walls, major pelvis, minor pelvis, walls of minor pelvis.
14. Pelvis sizes: external sizes of pelvis, anatomic and gynaecological conjugates, transversal and straight sizes of the entrance and exit from the minor pelvis.
15. Hip joint: articulate surfaces, capsule attachment places, intracapsular and capsular ligaments.
16. Knee-joint: articulate surfaces, shape, function. Peculiarities of knee-joint: presence of meniscuses, intraarticular ligaments, synovial plicae, sesamoid bone and ligaments, which fix a joint.
Special attention should be paid to the following questions:
1. Name and show departments of cranium.
2. Demonstrate border between calvaria and basicranium.
3. Name and show departments of frontal bone.
4. Describe topography of the frontal sinus, tell about its importance.
5. Orient in space frontal bone.
6. Where is dislocated parietal bone?
7. Name and show formations of the parietal bone.
8. How distinguish they left parietal bone from right one?
9. Where is dislocated occipital bone?
10. What parts do they distinguish in occipital bone?
11. What is foramen magnum bordered by?
12. Describe the squamous part of the occipital bone?
13. What formations are dislocated in lateral parts of the occipital bone?
14. What formations are dislocated in basilar parts of the occipital bone?
15. What part of skull does sphenoid belong to?
16. What bones and cavities does sphenoid border up?
17. How is sphenoid body built and what formations does it have?
18. Describe the structure of the lesser wing?
19. What anatomical formations located in greater wing? Their practical importance.
20. What structures do greater wings take part in?
21. What is structure of the pterygoid process and what does it border up?
22. How is ethmoid structured and what part of scull does it belong to?
23. How is ethmoidal labyrinth structured? Where are ethmoidal cells opened?
24. What structures does ethmoid take part in?
Illustrative materialss:
1. Skeleton.
2. Pelvic bones.
3. Humid preparations: pelvis fossa, hip and knee joint.
4. Humid leg and foot bones joints’ preparations.
Methods of practical work
Work 1. Studying of pelvic bones’, knee and hip articulations.
After the active teacher’s consultation, to learn the lesson material for the plan.
1. Types of joints between pelvic bones: syndesmosis, synchondrosis, synostosis, hemiarthrosis, diarthrosis.
2. To characterize a sacroiliac joint: articulate surfaces, shape, function, peculiarities and ligaments, which fix this joint.
3. Pubic symphisis: peculiarities, articular disc, ligaments, function.
Work 2. . Studying anatomy of frontal, parietal and occipital bones
After the active teacher’s consultation, using textbooks and atlases, to learn an anatomy of the frontal, parietal and occipital bones on separate preparations and on a skull.
Work 3. Studying anatomy of sphenoid and ethmoid
After the active teacher’s consultation, using textbooks and atlases, to learn anatomy of sphenoid and ethmoid bones on separate preparations and on skull.
Work 4. . Studying leg and foot bones’ joints
After the teacher’s consultation, to learn the lesson material for plan:
1. Types of joints between leg bones.
2. General structure description of articulate surfaces of distal leg bones’ ends and talus, which form talocrulalis joint, to characterize its capsule and ligaments.
3. Shopara’s and Lisfrank’s joint, their “keys”.
References:
1. H. Gray. Anatomy, Descriptive and Surgical. –
2. W. Kahle, H. Leonhardt, W. Platzer. Color atlas and Textbook of Human Anatomy. –
3. R.D. Lockhart, G.F. Hamilton, F.W. Fyfe. Anatomy of the human body. –
4. Borys Y. Reminetskyy, Yaroslav I. Fedonyuk, Human Anatomy- Locomotory apparatus – Notes, 2002.
5. F.H. Netter. Atlas of Human Anatomy. – Ciba Pharmaceuticals Division, 1994. – 514 p.
6. Lecture.
Lesson No 5
Theme: Temporal bone. Canals of the temporal bone.
Maxilla and mandible. Maxillary sinus (shape, structure). Small bones of the viscerocranium (palatine, nasal, lacrimal, zygomatic bones, hyoid,
inferior nasal concha, vomer).
Aim. To study structure of the temporal bone and its parts, to elucidate way of the canals.
To study structure, location and correlation viscerocranium elements with adjacent bones of face.
Professional motivation:: knowledge the structure of temporal bone and its parts allows to understand morphological peculiarities of cavities for external, middle and internal ear, passage the cranial nerves also important vessels. The correct structure and position of temporal bone are very important for normal functioning of hearing and balansing sensority, innervating different organs. knowledge the structure of facial portion of the skull allows to understand morphological peculiarities of cavities for eyes, nose, mouth, pharynx and cranial nerves also important vessels, action of the mastication and neck muscles. The correct structure and position of viscerocranium elements are very important for normal functioning of oral digestive and respiratory organs. Understanding the structure is a fundamental base for the neurosurgical, and therapeutical practice also traumatology and ENT specialist.
Basic Level. Structure of thoracic vertebrae, roman (Latin) terminology.
Special attention should be paid to the following questions
1. What cavities does temporal form and what organs does it contain?
2. Describe the topography of the temporal bone.
3. What parts does temporal bone consist of?
4. What formations separate parts of the temporal bone each other?
5. What part of the temporal bone has a difficult structure?
6. What margins and surfaces does pyramid have?
7. What anatomical formations are located in pyramid?
8. Demonstrate tympanic cavity.
9. Describe the structure of squamous part.
10. Describe the structure of the mastoid process.
11. What skull bones is maxilla border up?
12. What cavities does maxilla form?
13. What parts does maxilla have?
14. What surfaces does maxilla have? What anatomical formations are located in them?
15. What surface of the maxilla is maxillary sinus dislocated? What its practical importance?
16. Infra-orbital canal, its topography, foramina, practical importance.
17. What parts do they distinguish in mandible?
18. Describe the structure of mandible body and demonstrate anatomical formations.
19. What formations do mandible branches have?
20. What formations are dislocated in alveolar arch?
21. Where is mandible angle found?
22. Where are entrance and exit orifices of the mandible dislocated?
23. What formations does palatine border?
24. What parts do they distinguish in palatine? What formations are dislocated in it?
25. How are greater and lesser palatine canals?
26. What do belong to small bones of scull?
27. Where are dislocated zygomatics and what do they border with?
28. What surface and formations does zygomatic have? What fossa and cavities does
Demonstrate on preparations:
1. Skull: topografy of the temporal fossa.
2. Temporal bone: petrous, tympanic and sguamous parts. Petrosguamous, petrotympanic, tympanomastoid, tympanosguamous fissure. Petrous part: surfaces, grooves, foramens, fossas, processes. Tympanic part: external acoustic opening. Sguamous part: margins, surfaces, grooves, processes. Canals: carotid, musculotubal, facial; canaliculus: for chorda tympani, tympanic, mastoid.
3. Temporal bone: facial canal, walls of the tympanic cavity, osseous labyrinth.
4. Skull: base.
5. Maxilla: body, orbital, infratemporal, nasal and anterior surfaces. Frontal process, alveolar process, palatine and zygomatic process.
6. Palatine bone: horizontal and perpendicular plate; ethmoid and conchal crests; orbital, sphenoidal and pyramidal processes; palatine canal.
7. Mandible: body, base, mental protuberance, mental spine; digastric, sublingual and submandibular fossaes; mylohyoid line, alveolar arch, dental alveoli, interalveolar septa, alveolar yokes. Ramus of the mandible: angle, masseteric and pterygoid tuberosity, coronoid process, mandibular notch, mandibular foramen, condylar process, head and neck of the mandible.
8. Zygomatic bone: lateral, temporal and orbital surfaces; temporal and frontal process; zygomaticofacial, zygomaticoorbital and zygomaticotemporal foramens.
9. Nasal bone: ethmoid groove.
10. Lacrimal bone: posterior lacrimal crest, lacrimal groove.
11. Inferior nasal concha: lacrimal, maxillar and ethmoidal processes.
12. Vomer: wing of the vomer.
13. Hyoid bone: body, greater and lesser horns.
Illustrative materialss:
1. Skeleton.
2. Skull.
3. Temporal bone.
4. Maxilla.
5.
6. Mandible.
7. Zygomatic, nasal , lacrimal, inferior nasal concha, vomer, hyoid bones.
Methods of practical work
Work 1.. Studying anatomy of temporal bone
After the consultation, using textbooks and atlases, to learn an anatomy of temporal bones on separate preparations, sections and on skull.
Work 2: . Studying anatomy of facial skull
After the active teacher’s consultation, using textbooks and atlases, to learn an anatomy of facial skull bones on separate preparations and on skull.
References:
1. H. Gray. Anatomy, Descriptive and Surgical. –
2. W. Kahle, H. Leonhardt, W. Platzer. Color atlas and Textbook of Human Anatomy. –
3. R.D. Lockhart, G.F. Hamilton, F.W. Fyfe. Anatomy of the human body. –
4. Borys Y. Reminetskyy, Yaroslav I. Fedonyuk, Human Anatomy- Locomotory apparatus – Notes, 2002.
5. F.H. Netter. Atlas of Human Anatomy. – Ciba Pharmaceuticals Division, 1994. – 514 p.
6. Lecture.
Lesson No 6
Theme: Skull as a whole. Base of the skull.
Temporal, infratemporal, pterygopalatine fossae.
Orbit. Nasal cavity.
Aim. To study the skull, topography and structure of the cranial fossae, temporal, infratemporal, pterygopalatine fossae.
To study age features of the skull, topography and structure of the orbit and nasal cavity.
Professional motivation: knowledge the structure of the skull allows to understand morphological peculiarities of cavities for brain and most importanr nerves and vessels. Understanding the structure is a fundamental base for the neurosurgical and therapeutical practice also traumatology and ENT specialist.
Knowledge the structure of orbit and nasal cavity allows to understand morphological peculiarities of cavities for eyes and nose, passage the cranial nerves also important vessels. The age features of the scull are very important for normal birth process and necessary in obstetric practice.
Special attention should be paid to the following questions:
1. Name and show departments of cranium.
2. Demonstrate border between calvaria and basicranium.
3. What suture do you know?
4. What bones belong to viscerocranium?
5. What bones belong to neurocranium?
6. What formations build anterior cranial fossa? Borders and connections of the anterior cranial fossa?
7. What bones form middle cranial fossa, its borders and connections?
8. What bones form posterior cranial fossa, its borders and connections?
9. What formations border temporal fossa?
10. Where is infratemporal fossa situated and what formations border it?
11. What formations build pterygopalatine fossa and its connections.
12. What walls and connections does orbit have?
13. What formations build orbit walls, roof and floor?
14. What walls does nasal cavity have and what formations build them?
15. What nasal meatus do you know, what formations border them?
16. What cavities open into each nasal meatus?
17. What formations build bony palate?
18. What fontanelles are there in foetal scull?
19. Where do fontanelles heal?
Demonstrate on preparations:
1. Skull: border between skullcap and base, cranial suture.
2. Base of the skull: temporal and infratemporal fossa. Anterior, middle and posterior cranial fossa. Greater palatine and incisive canals, hard palate. Lacerum and jugular foramen, clivus. Pterygopalatine fossa: walls and its connections.
3. Skall of a newborn: anterior, posterior, sphenoidal and mastoid fontanels.
4. Orbit: walls and connections. Paranasal sinuses.
5. Nasal cavity: walls, superior, midle and infirior nasal meatus, connections.
Illustrative materialss:
1. Skeleton.
2. Skull.
3. Base of the skull.
4.
Methods of practical work
Work 1. Studying of topography
After the active teacher’s consultation, using textbooks and atlases, to learn a skull’s topography.
Work 2. Studying of skull’s topography
After the active teacher’s consultation, using textbooks and atlases, to learn skull’s topography, structure of foetal skull.
References:
1. H. Gray. Anatomy, Descriptive and Surgical. – Philadelphia, USA. – 1974.
2. W. Kahle, H. Leonhardt, W. Platzer. Color atlas and Textbook of Human Anatomy. – Stuttgart, New York, 1986.
3. R.D. Lockhart, G.F. Hamilton, F.W. Fyfe. Anatomy of the human body. – Philadelphia, – 1965.
5. Lecture.
6. Borys Y. Reminetskyy, Yaroslav I. Fedonyuk, Human Anatomy.- Locomotory apparatus – Notes, 2002.
Lesson No 7
Theme: Articulations of the skull. Preparation of bones and joints. Muscles of the back (superficial and deep). Topography and fasciae.
Aim. To study the joints of the skull bone’s joints and temporomandibular joint. To study the joints between ribs, sternum and vertebrae, sternoclavicular joint. Shoulder girdle bone’s and shoulder joints. To study shoulder and elbow joints, forearm and bone’s joints.
The aim: to learn the basic questions of general myology. To be able to find, name and show separate muscles of the back and their groups on a corpse. To know the shape, origin, insertion (attachment), functions and fasciae of these muscles. To gain the basic skills of preparation.
Professional motivation:
Pathology of skull are most common in adult patients. The knowledge of the origin and the insertion (attachment) of the muscles of the back is necessary for manual therapy, medical (therapeutic) massage and it is also important for the practice of vertebrologists, traumatologists, specialists of non-traditional medicine, neuropathologists. The topical diagnostics of the injuries of muscles, tendons on the basis of muscle function investigation.
Basic Level: Roman (Latin) terminology.
Special attention should be paid to the following questions:
1. To which group belongs a atlantooccipitalis joint?
2. Peculiarities of joints between 1-st and 2-nd cervical vertebrae and their movements.
3. How do bodies of vertebrae articulate eacha other, their arcs, vertebrae processes?
4. Which structure of intervertebral discs and their function?
5. Which types of joints can we distinguish in vertebral column (examples)?
6. Which movements of vertebral column are possible and around which axes?
7. Articulations of the ribs with the vertebrae:
a) articulations between the head of the ribs and the bodies of the vertebrae;
b) articulations of the heads and tubercles of the ribs with the transverse processes.
8. Articulation of the cartilages
a) the ribs with the sternum
a) the anterior chondro-sternol ligament;
b) the posterior chondro-sternal ligament;
c) the capsular ligament;
d) the interarticular chondro-sternal ligaments;
e) the anterior chondro-xiphoid;
f) the posterior chondro-xiphoid;
d) synovial membranes.
9. Articulations of the cartilages of the ribs with each other (interchondral).
10. Articulations of the ribs with their cartilages (costo-chondral).
11. Articulations of the sternum:
a) anterior intersternal ligament;
b) posterior intersternal ligament;
12. Articulations of the upper extremity.
13. Sterno-clavicular articulations:
a) the capsular ligament;
b) the anterior sterno-clavicular ligament;
c) the posterior sterno-clavicular ligament;
d) the interclavicular ligament;
e) the costo-clavicular ligament (rhomboid);
t) the interarticular fibro-cartilage;
g) the synovial membranes of this articulation;
k) action.
The list of questions
1. The division of the muscles of the back into layers and groups.
2. Name the superficial muscles attached to the bones of the shoulder girdle and the humerus: their origin, insertion, function.
3. Name the superficial muscles attached to the ribs: their origin, insertion, function.
4. Name the deep autochthonous muscles of the back: their origin, insertion, function.
5. Name the deep muscles of the back of the ventral origin: their origin, insertion, function.
6. What is the function of the latissimus dorsi muscle?
7. Which muscle causes the lowering of a raised arm, its adduction to the body and pronation?
8. Which muscle lifts the scapula bringing it closer to the spine?
9. Which muscle elevates (raises) the scapula?
10. Which muscles contract when lowering and raising the ribs?
11. Which muscle contracts during the extension of the cervical part of the vertebral column?
12. Which parts does the erector spinae muscle have?
13. What is the function of the erector spinae muscle?
14. Which muscles bend the body to the sides?
15. Which muscles contract during the rotation of the body around the vertical axis?
16. Name the muscles that extend the vertebral column.
17. Name the suboccipital muscles of the back.
18. Characterize the function of the suboccipital muscles of the back.
19. Which muscle turns the head to its sides?
20. Name the muscles that move the head to its sides.
III. Show the indicated anatomic formations on the preparations.
1. The corpse with the prepared muscles and fasciae of the back: the muscles of the superficial and deep layers, the fasciae that cover them.
2. The skeleton: the place of origin and attachment (insertion) of the muscles of the back.
3. The corpse with the prepared muscles of the abdomen, back and with the prepared anterior abdominal wall: Pti’s triangle, Lesgaft’s quadrangle, the muscles of the abdomen, tendinous intersections of the rectus abdominis muscle. The regions of the abdomen, the umbilical ring. The skeleton: the origin and insertion of the muscles of the abdomen.
The methods of practical work performance.
Work 1. The performance of the skin section.
Cut the skin of the back along the medial line (above the spinous processes) from the external occipital protuberance to the coccyx. The transversal section: between the bases of the papilliform processes of the temporal bones, the inferior section – from the top of the sacrum to the crests of the iliac bones; the additional section – next to the scapular spines.
Work 2. The preparation of the superficial muscles of the back.
Prepare the skin pieces with the superficial (subcutaneous) fascia of the back to the posterior axillary line and the lateral regions of the neck. During this procedure the superficial muscles of the back and the occipital region covered with their own fascia are exposed. Their own (proper) fasciae are prepared and separated.
Work 3. The preparation of the deep muscles of the back.
The erector spinae muscle covered with the transversal pectoral fascia is opened. Having separated the superficial lamina of this fascia in an obtuse way, three parts of the muscle are prepared.
The osteal (musculus spinosus) and semi-osteal muscles of the head and neck are separated in the occipital region under the trapezius muscle on the right side of the body. Then these muscles are cut transversally and the muscles situated below are prepared. All the muscles are separated from their own fasciae.
References:
1. H. Gray. Anatomy, Descriptive and Surgical. –
2. W. Kahle, H. Leonhardt, W. Platzer. Color atlas and Textbook of Human Anatomy. –
3. R.D. Lockhart, G.F. Hamilton, F.W. Fyfe. Anatomy of the human body. –
4. F.H. Netter. Atlas of Human Anatomy. – Ciba Pharmaceuticals Division, 1994. – 514 p.
5. Lecture.
6. Colin H. Wheatley, B.Kolz. Human anatomy and physiology. 1995.
7. Borys Y. Reminetskyy,
Lesson No 8
Theme: Muscles and fasciae of thorax and abdomen. Topography and fasciae. Diaphragm. Inguinal canal. Muscles of head (classification, origin, insertion, action). Fasciae of the head. Muscles, topography and fasciae of the neck.
The aim: to be able to find, name and show separate muscles and fasciae of the abdomen on a corpse. To know their shape, origin, insertion (attachment), functions. To learn the peculiarities of the topographic formations of the anterior abdominal wall (the white line (linea alba), the rectus sheath of the abdomen (vagina musculi recti abdominis), the inguinal canal). To be able to find, name and show the borders, walls, foramina and the content of these formations on a corpse. To know their practical significance for medicine. To gain the practical skills of preparation of these formations.
To learn to prepare, find, name and show the diaphragm, its parts, crura and foramina, separate muscles, fasciae, the topographic formations of the thorax on a corpse. To know their shape, the places of origin and attachment (insertion), their function and significance during respiration.
To be able to prepare, find, name and show the groups and separate muscles of the neck and head on a corpse. To know their shape, the places of origin and attachment (insertion) and function. To know the functional peculiarities of the muscles of facial expression and the masticatory muscles. To be able to prepare the muscles and fasciae of the head.
To know the peculiarities of the location of the fasciae of the neck and its topographic formations – triangles, their practical significance for medicine. To be able to prepare, find, name and show these formations and their borders on a corpse.
The professional orientation.
The significance of the topography of the anterolateral abdominal wall for pain, wound, tumour localization. The abdominal wall is often the place of operational access and the object of operational interventions. The white line of the abdomen (linea alba) is widely used during operational access to the organs of the abdominal cavity. Sex, constitutional, age peculiarities of the structure and topography of the muscles of the abdominal wall and the inguinal canal that is the usual site of the hernia formation.
The data about the topographic and anatomic peculiarities of the muscles of the thorax are necessary for manual therapy, medical (therapeutical) massage, during operations on a mammary gland, thoracic wall and the organs of the thoracic cavity. Knowing the functions of separate muscles will help in accurate topical diagnostics of the injured tendons. The weak places of the diaphragm often become the site of diaphragmatic hernias.
The muscles of the face and neck due to their special structure can express emotions and they also take part in the processes of eating, respiration, speaking, that’s why knowing these muscles is necessary in cosmetology, plastic surgery, neurology and neurosurgery, otolaryngology, stomatology. The violations of the functions of the muscles of this region cause different monstrosities that influence the emotional state of a persoegatively, that’s why the doctors of different specialties must preserve maximally or restore the anatomic and functional integrity of the muscles of the neck and face which is impossible without the deep knowledge of their anatomy. According to the practical aim we distinguish the regions of the neck with external borders that help to determine the projections of neurovascular fascicles and inner organs on external integuments. The important anatomic formations of the neck are the fascial fissures (rimae) that are connected causing the hematoma and inflammatory process spreading.
The basic level of knowledge and skills
1. Skeleton of thorax, abdomen, bones of the head and neck, latin terminology.
The list of questions
1. Name the groups of the abdominal muscles.
2. Name and show the lateral muscles of the abdomen: their origin, insertion, function.
3. Name and show the anterior muscles of the abdomen: their origin, insertion, the peculiarities of their structure, function.
4. Name and show the posterior muscles of the abdomen: their origin, insertion, function.
5. Name the fasciae of the abdomen, show the places of their attachment (insertion).
6. The peculiarities of the aponeuroses of the abdominal muscles.
7. Name and show the regions of the anterior abdominal wall, their borders.
8. What is the white line of the abdomen? Its significance in laparotomy.
9. Name the weak places of the anterior abdominal wall.
10. What forms the walls of the rectus sheath above the umbilicus?
11. What forms the walls of the rectus sheath below the umbilicus?
12. What are the arcuate and semilunar lines?
13. Explain the formations of the inguinal canal, its content.
14. Name and show the walls of the inguinal canal.
15. Name and show the deep and superficial rings, their borders.
16. Name and show the fossae and folds on the posterior surface of the anterior abdominal wall.
17. Explain when the strait and oblique inguinal hernias are formed. What is the scrotal hernia?
18. Name the groups of the muscles of the thorax.
19. Name the thoracic muscles of the upper extremity: their origin, insertion (attachment), shape and function.
20. Name the autochthonous muscles of the thorax: their origin, insertion (attachment), shape and function.
21. Which muscle causes the lowering of a raised arm, its adduction to the body and pronation?
22. Which muscle pulls (bends) the scapula forward?
23. Which muscle strengthens the sternoclavicular joint?
24. Which muscle turns the inferior angle of the scapula forward and laterally?
25. Name the muscles, which lower the ribs?
26. What muscles raise the ribs?
27. Which parts does the diaphragm have?
28. Name the organs, nerves and vessels that pass through the diaphragm.
29. Describe the structure of the lumbar part of the diaphragm.
30. Describe the “weak” places of the diaphragm.
31. What is the central tendon of the diaphragm (centrum tendineum)?
32. What is the function of the diaphragm?
33. Describe the fascia of the thorax, its laminae.
34. Name the triangles of the thorax, their walls.
35. The classification of the muscles according to the origin and topography.
36. The superficial muscles of the neck, their origin, attachment (insertion), function.
37. The medial muscles of the neck – the suprahyoid group, their origin, attachment (insertion), function.
38. The medial muscles of the neck – the infrahyoid group, their origin, attachment (insertion), function.
39. The deep muscles of the neck – the scalene muscles, their origin, attachment (insertion), function.
40. The deep muscles of the neck – the prevertebral muscles, their origin, attachment (insertion), function.
41. The masticatory muscles, their origin, attachment (insertion), function.
42. The peculiarities of the muscles of facial expression.
43. The muscles of facial expression of the roof of the skull, their function.
44. The muscles of facial expression of the eyelid and orbit, their function.
45. The muscles of facial expression of the mouth, their function.
46. The muscles of facial expression of the nose, their function.
47. The regions of the neck, their borders.
48. The triangles of the anterior wall of the neck, their sides and the organs that pass through them.
49. The intermuscular spaces of the neck and the organs that pass through them.
50. The triangles of the lateral wall of the neck, their sides.
51. The classification of the fasciae of the neck according to Shevkunenko.
52. The classification of the fasciae of the neck according to international anatomic nomenclature.
53. The first fascia of the neck, its location, insertion (attachment), peculiarities.
54. The second fascia of the neck, its location, insertion (attachment), peculiarities.
55. The third fascia of the neck, its location, insertion (attachment), peculiarities.
56. The fourth fascia of the neck, its location, insertion (attachment), peculiarities.
57. The fifth fascia of the neck, its location, insertion (attachment), peculiarities.
58. The interfascial spaces of the neck, their borders and significance for practical medicine.
59. The fasciae of the head, their location, insertion (attachment) and significance for practical medicine.
III. Show the indicated anatomic formations on the preparations.
1. The regions of the abdomen, the white line, the umbilical ring, the layers of the rectus sheath (vagina musculi recti abdominis), the arcuate and semilunar lines, the inguinal canal, its walls, content, the superficial inguinal ring, the medial and lateral crura of the aponeurosis of the external oblique muscle of the abdomen, intercrural fibers, the retroflexed ligament. The inguinal ligament. The deep inguinal ring: the inguinal sickle (falx). The fossae and folds of on the posterior surface of the anterior abdominal wall.
2. The skeleton: the origin and insertion of the muscles of the abdomen.
3. The corpse with the prepared muscles of the thorax and with the cut thoracic and abdominal cavities: the muscles of the thorax, the diaphragm, its parts.
4. The skeleton: the places of the origin and insertion (attachment) of the muscles of the thorax and the parts of the diaphragm.
5. The moulage of the body (trunk): the parts of the diaphragm, the crura, fissures (rimae)
6. The skeleton: the origin and insertion (attachment) of the muscles of the head and neck.
7. The corpse with the prepared muscles of the head and neck: the superficial and deep groups of the muscles of the neck, the muscles of facial expression, the masticatory muscles.
8. The corpse with the prepared muscles and fasciae of the neck: the regions of the neck, the triangles, the interscalene and prescalene spaces, the fasciae of the neck, the interfascial spaces.
9. The skeleton: the attachment of the separate muscles.
The illustrative material
1. The skeleton.
2. The demonstration corpse with the prepared muscles.
3. The educational corpse for muscle and fascia preparation.
4. The mulage of the body (trunk).
Work 1. The preparation of the anterior abdominal wall.
According to the skin sections performed at the previous lesson, the skin in the abdominal region is prepared and separated up to the axillary line. The fascia that covers the external oblique abdominal muscle is prepared and removed. Then the internal oblique and transverse abdominal muscles situated below are opened.
Work 2. The preparation of the wall of the inguinal canal.
The forceps is introduced through the right external inguinal ring (along the seminal canal (spermatic cord) or round uterine ligament). The aponeurosis of the external oblique muscle of the abdomen is dissected along the forceps (9-
Work 3. The performance of the skin section.
The middle section – from the jugular excision to pubic, the transversal cuts are performed along the inferior border of the thorax up to the middle axillary lines next to the axillary ligaments – from the pubic tubercle up to the anterior superior iliac spine.
Work 4. The preparation of the muscles of the thorax.
The skin and subcutaneous fatty tissue are separated up to the middle axillary line. The superficial layer of the thoracic fascia is separated along the whole anterior surface of the thorax, the pectoralis major muscle is prepared. Having performed the semicircular cut of this muscle at the distance of 2 –2,5 cm from its beginning, it is dissected transversally along the orientation of the muscular fascicles and it is heaved aside. Having separated and heaved aside the muscle, the deep layer of the pectoral fascia is prepared and separated, afterwards the pectoralis minor muscle and the serratus anterior muscle are opened and separated. The superficial and internal intercostal muscles muscles are prepared deeply, in the intercostal spaces.
Work 5. The preparation of the muscles of facial expression.
The skin is separated aside carefully in order not to damage the muscles of facial expression at the auricular conchae (the skin of the eyelids and contours of the lips are not separated). Then the muscles of the facial expression are prepared.
Work 6. The preparation of the masticatory muscles.
The masticatory fascia and the fascia of the auricular gland are prepared. Alongside with the auricular gland, the fascia is separated from the masseter and it is heaved aside to the auricular concha. To reach the temporal muscle on the left side above the zygomatic arch, the temporal fascia is dissected, the zygomatic arch is sawed next to the zygomatic bone and together with the masseter it is turned downwards. The coronoid process is sawed off and turned upwards together with the temporal muscle. Then with the help of the chisel (gouge) and cutting forceps the anterior part of the ramus of the mandible is removed and the lateral and medial pterygoid muscles are opened.
Work 7. The performance of the skin section on the head.
The middle section is supplemented with the transversal one – on the same level as the clavicle up to the scapular acromion. The skin is separated without subcutaneous fatty tissue not to damage the subcutaneous muscle of the neck.
Work 8. The preparation of the muscles of and fasciae of the neck.
At first the subcutaneous muscle of the neck is prepared, it is carefully separated from the situated below structures and it is turned upwards (being attached to the mandible). The sternocleidomastoid muscle is prepared more deeply opening its sheath alongside with the suprahyoid and infrahyoid muscles that are separated from the pretracheal lamina of the cervical fascia.
References:
1. Human anatomy/ edited by M.R.Sapin. – 2005. – volume 1, – p. 175-184, p. 209-217.
2. Synelnikov R.D. The atlas of human anatomy. In 4 volumes. – Moscow.: Medicina, 1991.
3. Lectures.
Lesson No 9
Theme: Muscles of the shoulder girdle, arm and forearm. Muscles of hand. Topography and fasciae of the upper limb. Muscles of hip, thigh and leg
The aim: to know the places of origin and insertion (attachment), functional peculiarities of the muscles of the shoulder girdle and humerus. To be able to find, name and show the separate muscles on a corpse. To gain the practical skills of their preparation.
To be able to find, name and show the separate muscles of the forearm and hand and lower limb on a corpse. To know their classification, shape, origin, insertion and peculiarities of the function of the upper extremity. To gain the practical skills of the preparation of these muscles.
To know the peculiarities of the structure of the fasciae and topographic formations of the upper extremity and their significance for practical medicine. To be able to find, name and show these formations on a corpse. To gain the practical skills of their preparation.
The professional orientation. The peculiarities of the structure of the muscles of the shoulder and pelvic girdles cause the significant mobility of the joints of the upper extremity, that’s why this region is often traumatized.
The complex structure of the muscles of the forearm and hand and lower limb is caused by their participation in the complex movements of the arm. Special difficulties and responsibility of the operations in this region have distinguished the surgery of the hand as a separate field of medicine. There is the department of the surgery of the hand in big hospitals.
Within the upper extremity there are grooves, fossae, openings, canals highly supplied with vessels and nerves that can become the ways of the pathologic process spreading. Knowing them is important for practical medicine.
The basic level of knowledge and skills
1. Latin terminology.
The program of student self-preparation
I. Read and learn the information on p. 214-220, 220-230, 231-
II. Answer the questions in the list.
The list of questions
1. The ventral group of the muscles of the shoulder girdle, their origin, insertion (attachment), shape, function.
2. The dorsal of the muscles of the shoulder girdle, their origin, insertion (attachment), shape, function.
3. The anterior group of the muscles of the humerus, their origin, insertion (attachment), shape, function.
4. The posterior the muscles of the humerus, their origin, insertion (attachment), shape, function.
5. The classification of the muscles of the forearm.
6. The superficial muscles of the anterior group of muscles of the forearm, their origin, insertion (attachment), function.
7. The deep muscles of the anterior group of muscles of the forearm, their origin, insertion (attachment), function.
8. The radial group of the muscles of the forearm: their layers, origin, insertion (attachment), function.
9. The ulnar group of the muscles of the forearm: their layers, origin, insertion (attachment), function.
10. The classification of the muscles of the hand and the role of their functioning in their specialization and differentiation.
11. The muscles of the thenar of the finger I: the location, name, function.
12. The muscles of the hypothenar of the finger V: their location, name, function.
13. The muscles of the palmar impression: their location, name, function.
14. The fasciae of the shoulder girdle and humerus: their location, intermuscular septa.
15. The fasciae of the forearm and hand: their location, intermuscular septa, muscle sheaths, the palmar aponeurosis.
16. The topography of the muscles of the humerus (the canal of the radial nerve, medial and lateral grooves of the biceps brachii muscle).
17. The olecranon fossa, the intermuscular grooves at the elbow joint.
18. The intermuscular grooves of the forearm.
19. The osteofibrous canals and synovial sheaths of the palmar surface of the hand.
20. The osteofibrous canals and synovial sheaths of the dorsal surface of the hand.
1. How are the muscles of the lower extremity divided according to their topography?
2. Which groups are the muscles of the pelvis divided into?
3. What are the muscles of the internal group: their origin, insertion (attachment) and function?
4. What are the muscles of the external group: their origin, insertion (attachment) and function?
5. Which groups are the muscles of the thigh divided into?
6. What are the muscles of the anterior group: their origin, insertion (attachment) and function?
7. What are the muscles of the medial group: their origin, insertion (attachment) and function?
8. What are the muscles of the posterior group: their origin, insertion (attachment) and function?
9. Which groups are the muscles of the leg divided into according to their function?
10. Which groups of muscles (topographically) are there in the region of the leg?
11. What are the muscles of the anterior group: their origin, insertion (attachment) and function?
12. What are the muscles of the lateral group: their origin, insertion (attachment) and function?
13. What are the muscles of the posterior group of the leg: their location?
14. What are the superficial muscles of this group? Their origin, insertion (attachment) and function.
15. What are the deep muscles of the leg? Their origin, insertion (attachment) and function.
III. Show the indicated anatomic formations on the preparations.
1. The corpse with the prepared muscles of the shoulder girdle and humerus: the muscles of the dorsal and ventral groups of the shoulder girdle, the anterior and posterior groups of the humerus.
2. The skeleton: the origin and insertion (attachment) of the muscles of the shoulder girdle and humerus.
3. The axillary cavity, its borders, foramina, triangles.
4. The corpse with the prepared muscles of the forearm and hand: the superficial and deep muscles of the anterior group of the forearm, the superficial and deep muscles of the radial and ulnar groups of the forearm. The muscles of the hypothenar of the fingers I, V and of the palmar impression of the hand.
5. The skeleton: the origin and insertion (attachment) of the muscles.
6. The corpse with the prepared muscles and fasciae of the upper extremity: the fasciae of the extremity, intermuscular septa, the circular ligaments of the radiocarpal joint, the palmar aponeurosis. The olecranon fossa, its borders, intermuscular grooves, content. The intermuscular grooves of the forearm. The osteofibrous canals and synovial sheaths of the palmar and dorsal surfaces of the hand.
7. The skeleton: the places of the insertion (attachment) of the intermuscular septa and ligaments.
8. The corpse with the prepared muscles of the pelvis and thigh, the division of the muscles of the pelvis into external and internal, the origin and location of the iliopsoas major and minor muscles, pay attention to the formation of the iliopsoas muscle, the place of its outlet from the pelvis. The piriform muscle, its origin, the exit from the pelvic cavity and insertion, pay attention to the formation of the piriform foramina. The internal obturator muscle: its origin, location, the exit from the pelvic cavity, the annexation of the gemellus muscles and their insertion. The external muscles of the pelvis: pay attention to their location. The division of the muscles of the thigh into three groups: anterior, posterior and medial, pay attention to their topography and function.
9. The muscles of the anterior group of the leg. The muscles of the posterior group of the leg. The muscles of the lateral group of the leg.
The illustrative material
1. The skeleton.
2. The demonstration corpse with the prepared muscles.
3. The educational corpse for muscle and fascia preparation.
The methods of practical work performance.
Work 1. The performance of the skin section on the upper extremity.
The lengthwise section – from the acromion of the scapula distally in the middle of the anterior surface of the humerus, forearm, hand (to the basis of the finger III); the semicircular sections – on the same level as the elbow, radiocarpal joints (with the preservation of the cutaneous ponticuli on the dorsal surface). The transversal section of the skin of the palm is performed at the carpophalangeal joints and the lengthwise section are performed in the middle of the palmar surface of the fingers II, V. The lengthwise section of the palmar surface of the finger I is performed from the region of the carpophalangeal joint to the tip of the finger I.
Work 2. The preparation of the axillary cavity.
In the axillary region the fascia with its fatty tissue, lymphatic nodes, vessels and nerves is prepared and removed. Successively the muscles that form te wall of the axillary cavity are prepared. Trilateral and tetralateral foramina in the region of the posterior wall and the muscles that form the borders of the clavipectoral, pectoral and subpectoral triangles in the region of the anterior wall are opened.
Work 3. The preparation of the muscles of the forearm.
At the proximal part of the forearm the tendons of the biceps brachii muscle are prepared, separating and preserving its aponeurosis as a narrow, 1-
Having removed the fascia, the muscles of the posterior surface of the forearm are prepared. At the radiocarpal joint the thickened region of the fascia of the forearm – the retinaculum of the extensors is removed and preserved as a transversal 2-
Work 4. The preparation of the muscles of the hand.
On the hand the palmar aponeurosis is separated from the situated below structures and it is left connected with the tendon of the palmaris longus muscle. Afterwards the muscles of the hypothenar of the thumb and little finger, the muscles of the middle group and the tendons of the superficial and deep flexors digitorum are prepared.
On the dorsal surface of the hand the dorsal interosseous muscles are opened, during the preparation of the tendons of the extensors digitorum, the intertendoneous septa between them are preserved.
Work 5. The preparation of the muscles of the shoulder girdle and humerus.
At the region of the forearm and hand the fasciae are prepared, separated and removed, opening the superficial group of the muscles. The medial and lateral intermuscular septa are removed between the anterior and posterior groups of the muscles of the forearm. The retinacula of extensors and flexors are left at the distal region of the forearm.
Work 6. The preparation of the muscles of the posterior group of the thigh.
The biceps femoris, semimembranosus and semitendinosus muscles are prepared on the posterior surface of the thigh. The ischiatic nerve and vessels of the posterior surface of the thigh are removed and the posterior surface of the adductor magnus muscle is prepared. The nerves, vessels and fat are removed from the popliteal fossa. The muscles that make up the walls of the popliteal fossa are removed and demonstrated.
Work 7. The preparation of the muscles of the leg.
Having separated the fascia of the leg, the muscles of the anterior and lateral group of the leg are prepared. The superior and inferior retinacula of the tendons of the extensor-retinacula in the crural region and on the dorsal surface of the foot should be preserved.
The triceps muscle is prepared on the dorsal surface of the leg. Both heads of the surae muscle (in its upper third) are dissected transversally and the soleus, popliteus and plantar muscles are removed. The soleus muscle is cut at its origin place and it is turned laterally from the tibia, exposing the deep layer of the muscles of the leg. Vessels and nerves are removed. The superior and inferior retinacula of the fibular muscles at the region of the lateral bone and the retinaculum of the tendons of the extensors at the region of the medial bone should be preserved.
References:
1. Human anatomy/ edited by M.R.Sapin. – 2005. – volume 1, – p. 241-268. .2. Synelnikov R.D. The atlas of human anatomy. In 4 volumes. – Moscow.: Medicina, 1991.
3. Lectures.
