Articulated skeleton of hand : viva questions

 

Articulated skeleton of hand

Anatomical points

Carpal bones lies above

Concavity of articulated skeleton of hand directed forward

1^st metacarpal bone short and shout lies laterally

Identification of carpal bone : proximal, scaphoid, lunate, triquetral and pisiform and distal row: trapezoid , trapezium capitates hamete

Which carpal bone is largest : capitates

Scaphoid : boat shape

Lunate : half moon shape  

Morphological types of carpal bone : all bones are short bone except pisiform  

Why carpal bones are  known as short bone?

they have six surfaces, Carpal bones ossify from one primary ossification centre

but no secondary ossification centre

Usually primary ossification center develops before birth

 but primary ossification center of carpal bone develops after birth.

Each year of life one carpal bone develops Ex: 1 years age children has one carpal bone ,

 three years old contain three carpal bones and 7 years old contain 7 carpal bones

Pisiform is a sesamoid bone:  form within the tendon of flexor carpi ulnaris,

Mention some features of sesamoid bone 

Morphological type of metacarpal and phalanges bones: miniature long bone

Why do you mean by  miniature long bone : because they have one epiphysis (only one secondary ossification center)  and one primary ossification center for shaft

 1^st metacarpal bone has one primary ossification center for shaft and one 2^nd ossification centre (epiphyses) for base

2^nd to 5^th metacarpal bones, each  has one primary ossification center for shaft and one epiphysis ( 2^nd ossification centre ) for head  (metacarpal)

Attachment of flexor retinaculum : (which form carpal tunnel)

·         Laterally : tubercle of scaphoid, crest of trapezius

·         Medially: pisiform, tip of hook of hamate

q. What are the structures passage through  the carpal tunnel :

Ten structures pass through the carpal tunnel, most of them flexor tendons (not the muscles themselves):

·         flexor digitorum profundus (four tendons)

·         flexor digitorum superficialis (four tendons)

·         flexor pollicis longus (one tendon)

1.      What are the structures passage above the carpal tunnel or flexor retinaculum

The ulnar artery and ulnar nerve, and the cutaneous branches of the median and ulnar nerves, pass on top of the flexor retinaculum.

2.      What is carpal tunnel syndrome?

3.                                    Attachment of FD superficialis :four tendon of FDS inserted  two side of base of middle phalages (medial four digit)

4.      Attachment of FD Profundus : 1^st four tendon of FDP passage through the tendon of FDS and then it inserted to base of the distal phalages for medial four digit

Identify the joints of articulated skeleton of hand and their types:

 

Joint	Type
1st carpometacarpal joint	Saddle variety of synovial joint
2nd to 5th carpometacarpal joint	Ellipsoid variety of synovial joint
Intercarpal joint	Plane variety of synovial joint
Interphalangeal joint	Hinge variety of synovial joint
Metacarpophalangeal joint	Condylar variety of synovial joint
Inter metacarpal joint	Plane variety of synovial joint

 Movement of 2^nd to 5^th metacarpophalangeal joint :

Adduction of fingers : palmar interossei

Abduction of fingers : dorsal interossei

Flexion : interossei and lumbricals

Extension : extensor digitorum, extension indicis, extensor digiti minimi 

Articulated skeleton of foot : viva examination

 

Articulated skeleton of foot

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1.       Ana points:

·         1^st metatarsal is shortest and thickest and lies medially

·         Tarsal bones are lies posteriorly

·         Phalanges lie anteriorly

·         Superior surface of talus is directed upwards

 

2.       Morphological type : tarsal: short bone metatarsal and phalanges : miniature short bone (why call miniature short bone : because it has one epiphysis)

3.       Parts of metatarsal and phalanges bone : base,  shaft and head

4.       1^st metatarsal and all phalanges : epiphysis present at the base

5.       2^nd to 5^th metatarsal : epiphysis present at the head

6.       Ossification  of Articulated skeleton of foot: intra cartilaginous ossification

7.         Identify tarsal bone

8.       Show attachment of following muscles with origin, action and nerve supply :

 tibialis ant and pos , peroneus longus and brevis, FHL,FDL,tendoachilis- how it is formed

1.       Show groove for FHL, peroneus longus

 

2.       Ligament :  deltoid and spring lig : show attachment on bones

 1.       Which tarsal bone devoid of muscular attachment: talus  

2.       Joints  of articulated sk of foot–( articular surfaces, type, movement and muscle producing the movement)

Ankle joint	Type: hinge variety of synovial joint Innervation: sural, tibial, saphenous, deep peroneal  nerves Muscles: tibialis anterior (dorsiflexion), gastrocnemius (plantar flexion)
Inferior (distal) tibial joint	Type : syndesmosis variety of fibrous joint  Muscles: no muscles act on this joint
Talocalcaneal joint or subtalar joint	Type : plane type of synovial joint Muscles: tibialis anterior, tibialis posterior, gastrocnemius, soleus (inversion); peroneus  longus, peroneus  tertius, peroneus  brevis (eversion)
Talocalcaneonavicular joint	Type: ball and socket type of synovial joint Muscles:  tibialis anterior, tibialis posterior, gastrocnemius, soleus (inversion); peroneus  longus, peroneus  tertius, peroneus  brevis (eversion)
Naviculocuneiform joint	Type : compound joint Muscles: peroneus  longus,  peroneus  brevis (eversion) , tibialis anterior and posterior (gliding, rotation)
Calcaneocuboid joint	Type : saddle type of synovial joint Muscles: tibialis anterior, tibialis posterior, gastrocnemius, soleus (inversion); peroneus  longus, peroneus  tertius, peroneus  brevis (eversion)
Cuboideonavicular joint	Type : syndesmosis variety of fibrous joint Muscles: fibularis longus and brevis, tibialis anterior and posterior (gliding, rotation)
Intercuneiform and cuneocuboid joints	Muscles: Muscles: fibularis longus and brevis, tibialis anterior and posterior (gliding, rotation)
Tarsometatarsal joint	Type : plane variety of synovial joint Muscles: short and long extensors of the toe (flexion, extension);  tibialis anterior, fibularis longus (abduction, rotation)
Intermetatarsal	Plane variety of synovial joint
Metatarsophalangeal	Type : ellipsoid variety of synovial joint Muscles:  flexor digitorum brevis, lumbricales, interossei (flexion);  flexor hallucis longus and brevis (extension);  abductor hallucis, plantar interossei (abduction); adductor hallucis, dorsal interossei, abductor digiti minimi (adduction)
Interphalangeal joints	Type : hinge variety of synovial joint Muscles: flexor digitorum longus and brevis (flexion);  extensor digitorum longus and brevis (extension)

 

1.       Subtalar jt , very important ( muscles producing movement )

2.       Related questions :

3.       What is arch?

4.       How medial and lateral  longitudinal arches are formed ?

5.       How anterior and posterior  transverse arches are formed ?

6.       Factors maintaining the arches of foot

                                             

 

Bony pelvis : lecture notes for viva examination

 

Bony pelvis

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Anatomical points

1.      Anterior superior iliac spine and upper part of pubic symphysis lie in the same coronal  plane

2.      Pubis symphysis lies horizontally

3.      The tip of the coccyx and upper part of pubic symphysis lie in same horizontal plane

|Formation of pelvis : two hip bones, sacrum and coccyx

Joint of pelvis :

Pubic symphysis : secondary cartilaginous joint

Sacroiliac joint : plane variety of synovial joint

Divisions of pelvis : greater(false pelvis )  and lesser pelvis (true )

Why greater pelvis is known as false pelvis: it has no body boundary in front

Why lesser pelvis is known as true pelvis: it has complete body boundary

Q. Trace the pelvic inlet and outlet

Q. Content of pelvis in male and female

Q: How pelvic outlet is covered  in living body ?

In front by urogenital diaphragm and behind pelvic diaphragm

Q: What is urogenital diaphragm :

 It is formed by deep transverse perinea muscle and sphincter urethrae muscle

Q: What is pelvic diaphragm

It is formed by levator ani and coccygeus muscle

Show the Diameters of pelvis :

Pelvic inlet

	Antero-posterior diameter	Transverse diameter:	Oblique diameter:
Pelvic inlet	Measured between sacral promontory and symphysis pubis Upper border of pubic symphysis:  True or Anatomical conjugate Middle of pubic symphysis:  Obstetric conjugate (most important) Lower border of pubic symphysis: Diagonal conjugate	Maximum transverse diameter	Measured between the sacro-iliac (SI) joint and opposite ilio-pubic eminence
Pelvic cavity	Middle of S3 vertebra to the middle of the back of pubic symphysis	Widest distance across the lateral bony wall of the pelvic cavity	From the lower end of sacroiliac joint to the center of the opposite obturator membrane
Pelvic outlet	Antero-posterior diameters: From the lower border of symphysis pubis to – Anatomical: tip of coccyx Obstetric: tip of sacrum	Transverse diameters: diameter: between 2 ischial tuberosities	From the junction of the ischiopubic ramus to the middle of the opposite sacrotuberous ligament

 

Diameter of female pelvis

	Antero-posterior diameter	Transverse diameter:	Oblique diameter:
Pelvic inlet	11 cm	13	12
Pelvic cavity	12	12	12
Pelvic outlet	13	11	12

Diameter of different conjugate of  female   :

·         True or Anatomical conjugate: 11 cm

·         Obstetric conjugate (most important): 0.5 cm shorter than the true conjugate

·         Diagonal conjugate: 11.5 cm

Classification of pelvis

1.      Gynecoid (50%) – normal female pelvis

2.      Anthropoid (25%) – direct occipito-posterior position is most common in anthropoid pelvis

3.      Android (20%) – male type (face to pubes delivery, persistent occipito-posterior position, deep transverse arrest/non-rotation, dystocia-dystrophica syndrome are most common in android pelvis)

4.      Platypelloid (5%)

Difference between male and female pelvis

 

Topic	Male	Female
Shape of pelvic inlet	Heart shape	Oval
shape of pelvic caviy	conical and long ( long section of a cone)	short and cylindrical ( short section of a cylinder)
sub pubic angle	less , 55-60 degree	More, about  90 degree
ischial spine	inverted	everted
sacrum	longer and narrower	shorter and wider
Obturator foramen	Larger and oval and abruptly curve	Smaller and triangular, gradually curved

 

 

Base of the skull anatomical points, parts

 Base of the skull:

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Define skull:  cranium with mandible is known as skull

Parts of the skull :

Base of the skull and

Cranial vault

Ossification :

base of the skull (intracartilaginous ossification) &

cranial vault : intramembranous ossification

Anatomical points:

1.       infraorbital margin and and upper border of external auditory meatus lies in same horizontal line , this line is known as  Frankfort  line

2.       orbital cavity directed anteriorly

3.       foramen magnum lies horizontally and directed  inferiorly

Show different view of skull :

·         norma verticalis : viewed from above

·         norma frontalis  from front

·         norma basalis from below

·         norma occipitalis from behind

·         norma lateralis from sides

Identification and definition of: bregma, lambda , asterion, pterior  

** pterion: it is the meeting point of 4 bones frontal , squamous part of temporal bone, parietal bone and greater wings of sphenoid clinical important : deep to this point branches of middle meningeal vessels are present . this vessel torn in accident , barr hole operation done here

Cranial fossa : three in number anterior, middle and posterior

Learn Boundary and content of each cranial fossa :

Development of skeletal system : summary

 

Development of skeletal system 

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The skeletal system develops from paraxial, somatic layer of lateral plate mesoderm and neural crest

 Neural crest: develops facial skeleton, and most of the vault of cranium and prechordal part of  base of the skull (area of base of the skull just rostral to the rostral half of the sella turcica)

Paraxial mesoderm: parietal bone, occipital bone, petrous part of temporal bone, vertebrae, ribs

Somatic layer of lateral plate mesoderm: develops all  bones of upper and lower limb