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Wednesday, February 28, 2024

Summary of ossification of whole skeleton of body

 

Summary of ossification of whole skeleton of body

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 Membranous ossification:

Ex: head and neck: parietal bone, frontal bone, maxilla, zygomatic,

Sup extre: clavicle

Cartilaginous ossification: all vertebrae, all ribs, sternum, scapula, all bones of upper limb except clavicle, all bones of lower limb

Membrano-cartilaginous ossification:

Occipital: membranous ossification area above the highest nuchal line, rest of the parts arises from cartilaginous ossification 

Sphenoid: membranous ossification above the lateral part of greater wing and pterygoid process except the hamulus, rest of the part arises from cartilage,

Temporal: membranous ossification – squamous part and tympanic part, rest of the parts arises from cartilage,

 Mandible: cartilaginous ossification anterior part of body and part of ramus above mandibular foramen, rest of the body arises from membranous ossification

Name of bone

Primary ossification center

Secondary ossification center

Clavicle

Two

One for sternal end

Humerus

One for shaft

Three for upper end – head , greater & lesser tubercle

Four for lower end – lateral & medial epicondyle, capitulum, trochlear

Radius

One primary ossification center for shaft

One for upper end

One for lower end

Ulna

One primary ossification center for shaft

One for upper end

One for lower end

Carpal bone

One primary ossification center which appear after birth

No secondary ossification centre

Metacarpal bone

One primary ossification center for shaft

One 2nd ossification centre :

 base of  1st metacarpal bones is ossified from 2nd ossification center

Heads of  2-5 metacarpal bone are ossified from 2nd ossification center

Phalanges

One primary ossification center for shaft and head

One 2nd ossification center for base  of each phalanx

 


Lower limb

Name of bone

Primary ossification center

Secondary ossification center

Hip bone

Three – ilium, ischium, pubis

5 secondary ossification center 

Femur

One for shaft

Three for upper end – head , greater & lesser trochanter

One for lower end

Tibia

One primary ossification center for shaft

One for upper end

One for lower end

Fibula

One primary ossification center for shaft

One for upper end

One for lower end

Tarsal bone (except calcaneus)

One primary ossification center

No secondary ossification centre

Calcaneus

One primary ossification center

One secondary ossification centre

Metatarsal bone

One primary ossification center for shaft

One 2nd ossification centre :

 base of  1st metatarsal bones is ossified from 2nd ossification center

Heads of  2-5 metatarsal bone are ossified from 2nd ossification center

Phalanges

One primary ossification center for shaft and head

One 2nd ossification center for base  of each phalanx

 

Articulated skeleton of hand : viva questions

 

Articulated skeleton of hand

Anatomical points

Carpal bones lies above

Concavity of articulated skeleton of hand directed forward

1st 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

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

2nd to 5th metacarpal bones, each  has one primary ossification center for shaft and one epiphysis ( 2nd 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 : 1st 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 2nd to 5th 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:

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

5.       2nd to 5th 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