Anatomy Drawings LE

Femoral Triangle with floor and roof

*PROFUNDA FEMORIS* -have nerve, artery vein empty space/canal lymph nodes -roof: fascia lata -floor: iliopsaos and pectineus

Femoral Blood Supply

*profunda femoris* not just profunda

Dense Fibrous Connective Tissue Fiber Org (Regular and Irregular)

- tendon most organized (loading in 1 direction) then ligament then aponeurosis then irregular (joint cap) -most irregular bc pull in many directions

Draw Cutaneous Innervation of Ant/Post Upper Leg

-*Ant*: iliohypo is sup inguinal so up there and sup lat thigh, then go medial to genitofem adn then ilioinguinal sup med thigh (scrotum, labia Majora) -lat fem is lat thigh, femoral is front, obturator medial bc innervate distal med thigh and by adductors! -saphenbous medial calf Bc that's where run in dissection (from femoral in fem triangle) -*Post*: sup middle and inf cluneals innervate butt (upper, middle and lower) -ikiohypo is sup lat thigh, then lat fem -obturator is distal med thighs -saphenous medial calf

Draw Cutaneous Innervation of Ant/Post Lower Leg and Foot

-*Ant*:saphenous medial calf be that's where run in dissection (branch from femoral in femoral triangle) -lat sural top lat leg (branch from common fib) -superficial perineal by perineal SKMS/fibula and top of foot by that's what innervates (extensors) -deep by toe -sural lat toes -*Post*: medial sural (branch from tibial) innervate back of calf -sural is lower back of calf and lat toes -medial calcaneal (branch of tibial nerve) is heel -medial and lateral plantar (from tibial) are bottom of foot

Synovial Joint

-3 types Ligament: intrinsic (in joint cap), extrinsic (outside), capsular (thickening of capsule or extend to bone with some blend to capsule) -fibrocart pads increase bony fit and distribute force over larger area to decrease stress -synovial Membrane produce synovial fluid (*only fucntion*) which decreases friction (lube) nourish reticular cart and fibrocart pads) -articular cartilage: covers bones to reduce stress, reduce friction and cushion subchondral bone (lower amount of force to subchondral bone to crease loading on subchondral bone)

Artery and Nerves of Posterior Calf/Ankle

-Artery: femoral to popliteal, branch to ant tibial (go to anterior leg) and posterior tibial -post tib has branch for fibular/peroneal artery (lat side of leg so run thru tarsal sinus under FHL and run with tibial nerve) and after foot branches into medial and lateral plantar artery -Nerves: sciatic nerve (COME FROM PLEXUS not from femoral, saphenous branch from femoral) branch to tibial and common fib which have med and lat sural that form sural proper -once tibial pass foot turns into medial and lateral plantar nerve

Draw Graph of CNS, PNS, Branches

-CNS (brain and Spinal Cord) send and receive info from PNS (cranial and Spinal nerves, communication between CNS and body) -PNS send and receive info from Somatic (info to and from external environ/SKM) and Visceral (info to and from internal environ/organs) systems -in *somatic* receive info from somatosensory (afferent) division (info from skin, proprio from joints and muslce spindles) and send info to somatomotor (efferent) division (info to skelteal Muscle voluntary) -in *visceral* recieve info from viscerosensory division (from viscera) and send info to visceromotor division (smooth SKM, glands, mainly involuntary) -*visceromotor* division send info to sympathetic NS (fight or flight) and parasympathetic (rest and digest)

Types of Tissues

-Epithelial (primarily cells, cells tightly packed, very little matrix), Muscle (generate force, striated), Nervous (carry and trans info bet cells via neurons), Connective (ECM give it f(x) cap not cells) -*Connective Tissue*: *ECM (fibrilar (collagen) and interfib (proteo)) IMPORTANT* 1. Bone (osteoblasts/cytes) = compression load lead to these -compact or Spongey -*unique* bc have organic (cells collagen fibers, proteo) and inorganic (mineral salts, hydroxyapatite crystals) component 2. Fibrous (fibroblast/cyte) = tensile load A) loose: adipose (fat), areolar (wraps and cushions organs), reticular (around kidney, spleen, lymphoid organs) B) Dense: Regular (tendons, ligaments, aponeuroses/IT band), Irregular (joint capsules, digestive tract), Elastic (artery walls) 3. Cartilage: (chondroblast/cyte) = comp and tensile -Elastic (outer ears), Hyaline (articular, high ECM bc high proteo so high water), Fibrocartilage (fibrocartilage pads in joints, sympheses, lower ECM but higher fibrillar comp/collagen) 4. Blood: does not connect or support other tissues but has cells, ECM (plasma) and fibers (albumin)

Chondral Apophyseal Tendon Insertion

-Fibrocartilage Junction (direct insertion not thru peri) from tendon to tubercle or tuberosity -relaxed SKM collagen fibers crimped and during tensile loading it is removed then move SKM (increase loading time so less likely fail at that site) -chondrocytes (cartilage Cells) found in collagen fiber bundles so when apply tensile load (SKM contract) Cartilage cells go under comp and sense how much load so lay down additional fibrocartilage to strengthen junction -also resist compression to help distribute load across junction adn protect junction

Draw Plantar Foot Blood Supply

-Have posterior tibial artery which branches to lat and med plantar artery -deep plantar arch come off of lateral plantar Artery which gives branches to plantar MT arteries and those turn into plantar digital arteries once pass MTP Joints

Transverse Plane Hip Adductors = IR

-IR bc head of femur is axis and attach to medial linea aspera so when contract pull and move axis not move at shaft = IR

Draw Transverse Cross Section Lower Leg

-Right leg: IO mem between tib and fib, anterior and post intermusc septum between ant and lat compartments, transverse intermust septum separate post compartment to post superficial and post deep 1. Anterior Compartment: DF: Tib ant, EHL, EDL and peroneus tert -deep fib nerve -ant tib artery 2. Lateral Compartment: PF: peron brev, long (more superficial than brevis) -superficial fib nerve would be here but not on diagram 3. Post: PF : gastroc, soleus and plantaris more superficial, the transverse intermusc septum separate them with more deep post compartment PF FDL, Tob Post (closest to IO mem), FHL -tibial nerve -post tibial artery with tibial nerve, peroneal artery by itself near FHL

Draw Tom Dick and Harry on Medial Mal

-Tom Dick Harry with TOm closest and Harry closest to HEEL -Tom dick nervous Harry bc dick and Harry have artery and nerve -go tib post, flexor digitorum longus, post tib artery, tib nerve then flexor hallicus longus -all covered by *flexor retinaculum* (hold Tendons close to bone and prevent bowstring)

Muscle Conn Tissue Coverings

-conn tissue coverings provide strength, come together to form tendon (contribute to tendon) -nervous system det how many activated so conn tissue coverings allow one fiber to slide past another -help wall off infections/injuries -within covering have small nerves and blood vessels that supply muscle cells

Draw Spinal Nerve Formation

-dorsal rootless (afferent/sensory info) and ventral spinal rootlets (efferent/motor info) stem from ant (ventral)/post (dorsal) horns of spinal cord --> ventral and dorsal root (dorsal has ganglion = collection cell bodies) and come together --> exit *intervert foramena* and become *spinal nerve* (have both efferent and afferent info) -spilt to dorsal (post) and ventral (anterior) ramus (afferent and efferent info) -*ventral rami* join and make a plexus -SO motor info from ventral root/rootlets, sensory from dorsal and spinal nerve carry both -plexus good bc if damage to single spinal nerve or ventral ramus will not lose complete f(x) (protective mech)

Tissues in Body

-epithelial (protect, mostly cells), muscle (smooth, skeletal, cardiac, generate force), nervous (carries into and transfers info between cells via neurons), Connective (supports, anchors, connects tissues) CONNECTIVE TISSUE 1. Bone (osteoblasts/cytes) = compression load lead to these -compact or Spongey -mineral storehouse, blood cell prod, protection, structure, movement 2. Fibrous (fibroblast/cyte) = tensile load A) loose: adipose (fat), areolar (wraps and cushions organs), reticular (around kidney, spleen, lymphoid organs) B) Dense: Regular (tendons, ligaments, aponeuroses/IT band), Irregular (joint capsules, digestive tract), Elastic (artery walls) 3. Cartilage: (chondroblast/cyte) = comp and tensile -Elastic (outer ears), Hyaline (articular), Fibrocartilage (fibrocartilage pads in joints, sympheses) 4. Blood: have cells, extracell fluid matrix (plasma) and fibers (albumin so conn tissue

Torque and Elbow Flexion

-external load creating moment/torque that would extend elbow -prevent elbow from move needs SKM activation for elbow flexors -moment in other direction must be equal to moment of external load to stabilize -moment arm = perp distance from axis to line of pull/force vector -torque = moment arm x force

Osseotendinous/Ligamentous Junction

-fibrocartilage junction (not through peri/direct insertion) -design allow gradual increase stiffness and transfer of stress from SKM to tendon to bone so less likely fail

Draw the Functional Continuum of Joints

-function = how they move -Mobility on one end Stability on other, joints fall on continuum/line 1. Mobility: loose bony tissues, poor bony congruency (bad fit but hip is the exception), multipplanar movement, high ROM -Diarthroses on this end bc a lot of movemetn (i.e. Shoulder) 2. Stability: tight binding tissues, good bony congruency, no or uni planar movement -synathroses on this end (no movement i.e skull sutures that hold cranial bones) -Diarthroses, Amphiarthroses (some movement) and Synarthroses just terms to relate structure to function -so ankle more in middle, knee farther left and elbow between. 2 -SO factors that contribute to joint mobile or stable are binding tissue (tight/loose) and bony fit/congruency (round head into convave joint)

Ant and Post Leg Cutaneous Innervation

-genitofemoral: genital branch (medial) and femoral branch (more lateral) with ilioinguinal inbetween

Neutralization Chart Ankle: 1. DF and 2. Inversion

-have SKM, action at ankle (talocrulral) and action at intertarsal (subtalar joint) -talocrural = DF/PF, intertarsal = in/eversion

Tendon Sheath

-high blood supply -fibrous membrane that hold tendon close to bone to prevent bowstring and reduce friction -have synovial mem under sheath with synovial fluid to reduce friction of movement of tendon

Superior Tibial Plateau (Ligaments)

-menisci bound to tibia via coronary ligaments -transverse binds 2 menisci (anterior horns) -intercondylar ligaments bound meniscal horns to intercondylar eminence (all horns) -post meniscofemoral ligament = post horn lateral meniscus to medial fem condyle

Draw Compact Bone Cell/Structure

-no spaces for capillaries so need haversion systems for nutrient diffusion -have medullary cavity through center/shaft of bone and osteons around outside of cavity -osteons allow for adequate blood supply to bone cells 1. OSTEON: each osteon is a layered cylinder of bone tissues (with osteocytes) that has central capillary at core embedded in a haversian canal -in one layer of osteon, osteocytes are arranged in circular pattern around central cap of osteon and are connected to each other and to HAVERSIAN CANAL via CANALICULI -circular pattern continues with intercellular matrix between the canaliculi and osteocytes -osteons has own central cap parallel to shaft of the bone and are arranged around medullary cavity 2. BLOOD SUPPLY: central cap of osteon get blood from medullary cavity via nutrient artery or from periosteum -nutrients get delivered via blood from 2 sources via VOLKMAN CANALS -ARTERIES (02 rich) bring blood to osteons -VEINS (02 poor) bring waste from osteons to blood

Draw Interrossei, Lumbricals and Lumbrical Insertion

-plantar = adduct (3-5) dorsal abduct (2-4 but are 4 skm) -lumbricals on medial border FDL tendons to dorsal apron 2-5 -1st lumbrical abduct second toe, others adduct toes 3,4,5 -enter on prom phal plantar side and go into dorsal aponeuorisis on dorsal side so extend IP 2-5 and flex MTP 2-5

Load Frequency Graph Bone

-train appropriately shift graph to the right -with adequate rest after event, microtears can be recovered to shift curve bc new bone is stronger (but must give time to mineralized before tear again) -ploys (purple horizontal line) cant do as frequently before go to injury zone -running (lower) yes

Transverse Cross Section Adductor Canal

-vastus med lateral, start medial, add longus and Magnus posterior -have femoral artery and vein, spahenous Nerve no muscular branch to vastus med (carry motor info to SKM) -when view cut from top (*superior view), use adductor long and Magnus, from bottom (*inferior view*) use add Magnus can see so that is only post border (bc add Magnus large and span all the way down, longus insert at medial linea) -superior apex of femoral triangle, inferior adductor hiatus (opening posterior IMS) -roof sartorius, floor

Load Deformation Curve: Healthy

-yield point (bone crack), max/peak load (where fracture occur) -first part is linear region (increase increase in load and Deformation similar -slope = stiffness of bone -area under = energy to failure/toughness -*highest area under curve = max energy to failure = best bone!*

Hip and Pelvis Ligaments

1. Hip Joint: -*extrinsic* : iliofemoral (AIIS & acetab rim to intertroch line, limit add, hyper), pubofemoral (sup pubic ramus to inferior neck femur, limit hyper abd), ischiofemoral (post, ishcial acetab rim to intertroch line (ant), limit hyper and IR) -*intrinsic*: teres (acetab rim to fem head), transverse (span acetab notch, create foramen) *protect foveolar artery* 2. Sacroiliac Joint: sacrum to ilium -*intrinsic* : all *reinforce joint capsule* and attach to auricular margins of sacrum to auricular ilium -Anterior sacroiliac (auricular margin sacrum to ilium, reinforce capsule ant), posterior sacroiliac (PSIS and auricular margin ilium to auricualr sacrum), iliolumbar (L4-L5 transverse process to iliac crest adn anterior sacroiliac lig) -*extrinsic*: limits anterior *rotation* of sacrum -sacrotuberous (ant sacrum to ischial tub), Sacrospinous (ant sacrum to ischial spine)

Tibiofib, Medial Ankle Ligaments, Lateral Ligaments

1. Superior tibiofibular: lateral tibial condyle and ant/post head of fib (*synovial plane joint* so ant and post fibers of fibular head are capsular) -middle: between shafts of tibia and fib, *syndesmosis* joint -interrosseous mem (fibrous conn tissue) is binding Tissue -inferior: fibrous union between concave facet tibia and convex facet of fibula -*syndesmosis joint* also so have ant and post ligaments -associated with high ankle sprains 2. Medial Ankle Ligaments: of talocrural joint (synovial hinge), Deltiod Ligament, all originate on med mal of tibia -anterior tibiotalar (tibia to talus) -tibionavicular (tibia to navicular) -tibiocalcanean (calcaneus) -posterior tibiotalar (post talus) 3. Lateral Ligaments: talocrural also, all attached to lat mal of fibula -Anterior talofibular (talus to fib front foot), calcaneofibular (calcan to fib), post talofibular

Draw Dorsal Foot Blood Supply

Anterior tibial artery become dorsal pedal artery (med) and lateral tarsal artery -dorsal pedal give rise to accurate artery which then becomes *dorsal arch* -Dorsal MT arteries come off arch adn go down each MT and once pass MTP joints become dorsal digital arteries

Lumbo Sacral Plexus

Branches 2 1 2 2 3 3 3 3 3 5 3 3 1 2 Start at : 1 1 1 2 2 2 4 5 4 4 1 2 Pudendal is Pereneum cut -GENITOFEMORAL: genital branch and femoral so ilioinguinal between 2 cutaneous patches (femoral branch lateral and the most medial patch is genital branch)

Pelvic Blood Supply

INTERNAL PUDENDAL NOT JUST PUDENDAL ARTERY (it is pudendal nerve)

Lateral View Acetabulum

Teres lig: acetabulum rim to head of femur (support foveolar) Transverse: span acetabulum notch (creates foramen and protect foveolar from comp) -*acetabular notch* not in drawing but put it in = little indent bottom bony acetabulum where foveolar come thru)