Unit 2 NotesSeptember 12, 2012Bones & Joints (Part II)Bone Structure- Compact Bone: outside layer of bone, really dense tissue made up of tiny ‘cylinders’ or lamellae- Spongy Bone: inside layer of bone (looks like honeycomb), loosely organized bone, provides strength without a lot of surface area, lightens the skeleton- Epiphysis: ends- Diaphysis: middle- Metaphysis: where epiphysis and diaphysis meets, growth plates occur here- Medullary (marrow) cavityo Red bone marrow: most common, hemopoetic – responsible for producing blood cells, white blood cells, and platelets, occur in epiphysis of boneso Yellow bone marrow: also hemopoetic, yellow because its got a lot of fat in it, occur in diaphysis of bones, in severe cases of sickness like anemia or leukemia, yellow can be converted to red bone marrow- Periosteum: outer case of the bone, surface where tendons attach- Endosteum: Bone Growth- Intramembraneous ossification: when bone forms from embryonic tissue, mesencheim (embryonic tissue)  bone, top of skull forms this way- Endochondral ossification: embryonic tissuecartilaginous modelbone, bones in hand form this way, bones in hand may not ossify until 10-14 years of age, have a handle on how it progresses: look at picture on ppt- Bone elongation: adding new cells and pushing the epiphysis further away from each other, girls stop growing earlier than guys, we physiologically stop growing because the cartilage has fully ossifiedOld Bones- Osteoporosis: deterioration of bones – compaction of bones and bones are more susceptible to break, maximum bone density for women - late teens, early 20’s, menstrual cycles after that time take away from bones (calcium deposits), worst time for women is post menopausal stage, working out & ingesting things that will help slow down osteoporosis, men aren’t effected until later in life (70’s), female athletes get amenorrhea – stop having period and this has same effects on bonesas post menopauseBroken Bones- Pathological fractures: breaks that occur because there is a disease involved- Stress fractures: done something that causes a breako Open reduction: surgery is involved (rods, pins, plates, screws)o Closed reduction: no surgery is involvedOut of Joint- Arthritis: damage that occurs at a joint, cartilage damageo Osteoarthritis: damage of articular cartilage due toinjury, impact, or wear n tearo Rheumatoid: autoimmune disorder- Dislocations: one thing has moved completely away from where its supposed to be connected, two things come out of socket from one another- Sprains: damaged the ligaments at a joint- Strains: damage to the musclesSeptember 14, 2012 (missed class)Overview of Upper LimbJoints- Ball-and-socket- Ellipsoid (condylar)- Hinge- Saddle- Pivot- PlaneBones & Regions- Sternum- Pectoral Girdleo Scapulao Clavicle Coracoid process, acromion process, lateral border, medial border, superior border, superior angle, inferior angle, subscapular fossa, glenoid fossa, supraglenoid fossa, scapular notch- Brachiumo Humerus- Antebrachiumo Radiuso Ulna- Hando Carpalso Metacarpalso PhalangesCompartments & Nerves- Anterior (Ventral) Nerves: flexors, pronation, & oppositiono Musculocutaneouso Mediano Ulnar- Posterior (Dorsal) Nerves: extensors, adduction, supination, stabilize shouldero Suprascapularo Axillaryo Radial**All of these make up the brachial plexus. (Spinal nerves C5-T1) The brachial plexus breaks into RootsTrunksDorsal or Ventral divisionsExact NervesArteries- Subclavian & branches- Axillary & branches- Brachial & branches- Radial & branches- Ulnar & branchesVeins- Deep veins- Superfical veins- Median veins- Cephalic veins- Basilic veins- Median Cubital veins- Dorsal Venous ArchLymphatic System- Fluid balance- Immunity- Metastasis of cancerAxillary Nodes- Lymph from: upper limb, abdomen, & chest- Breast Lymph: 75% axilla & 25% parasternalBreast Cancer- Uncontrolled cell growth/replication in lactiferous ducts- Lymphatic blockage- Metastasis to axillary nodes- Mastectomy: removal of breast tissueSeptember 19, 2012Glenohumeral Joint (humerus & scapula make it up, clavicle stabilizes)Joint- Multiaxial ball-and-socket- Multiaxial: wide range of motion on many planes- Ligaments: Coracoacromial (protection: stabilizes humeral head), Coracohumeral (dorsal), Glenohumeral (ventral), Transverse Humeral (covers intertubercular sulcus/biceps groove where tendon of long head of biceps brachii is)Bursae – outpocketing of joint (clinical: Bursitis - inflammation)- Function: cushion, lubricates, and protects joints so bones don’t rub against each other and wear each other down.- Subscapular – beneath scapula- Subacromial – beneath acromion- Tendon SheathMuscles- Muscles acting on the humerus: Deltoid, SITS, & Teres Major- Muscles acting on the scapula: Trapezius, Levator Scapulae, Rhomboideous Major, & Rhomboideous MinorCompartments- On humeruso Dorsal: Axillary nerve, Subscapular nerve, Suprascapular nerveo Ventral: Pectoral nerve (lateral & medial)- On the scapulao Hypaxial (superficial mm) innervated by ventral rami of spinal nervesInjuries of the Shoulder- Rotator cuff injuries- Dislocation: effected by GH joint- Separation: effected by AC jointSeptember 21, 2012Elbow Joint & BrachiumArticulations- Humeroulnar: Hinge joint- Radioulnar: Pivot joint- Humeroradial: Ball-and-socket jointLigaments (Syndesmoses)- Annular: wraps around head of radius to bind it to the ulna- Ulnar & Radial Collateral: provide lateral stability for theelbow- Interosseous Membrane: between ulna & radius, load sharing between radiusulnahumerusClinical Applications- Brachial A & pulse & blood pressure- “Pulled Elbow” and childrenTommy John Surgery- Ulnar collateral ligament reconstruction (common for baseball players)Muscles- Dorsal Compartmento Triceps: Long, lateral, and medial heado AconeusSeptember 23, 2012 (missed class)Wrist & AntebrachiumJoints- Distal Radioulnar (pivot)- Radiocarpal (ellipsoid)- Ulnar Articulation (Triangular Disc)Ligaments- Radial/Ulnar Collateral- Palmar/Dorsal Radiocarpal- Palmar/Dorsal RadioulnarConnective Tissues- Extensor/Flexor Retinacula- Palmar AponeurosisCarpal Tunnel Syndrome- Compression of median nerve- Idopathic- ParesthesiaMuscles- Dorsal Compartment (Extensors): Radial Nerve- Longus & brevis: based on length of tendono Brachioradialiso Extensor Carpi Radialis Longuso Extensor Carpi Radialis Breviso Extensor Digitorumo Extensor Digiti Minimio Extensor Carpi Ulnariso Abductor Pollicis