State establishment "DnEpropetrovsk Medical Academy of health Ministry of Ukraine"



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STATE ESTABLISHMENT

"DnEpropetrovsk Medical Academy
OF Health Ministry of Ukraine"


G.V. Dovgal, E.O. Nefedova, N. J. Zarikov,

Y.V. Suponko

hUMAN ANATOMY

Guide for the practice and self-taught classes
MODULE 1
The anatomy of apparatus of motion (bones, joints, muscles). Nerves and vessels of extremities”.



DnEpropetrovsk - 2014

UDS: 611.7:611.98:612.13 (075.8)

LBC: 54.18+28.91+я7

О 61.
Human anatomy. Guide for the practice and self-taught classes. Module 1. The anatomy of apparatus of motion (bones, joints, muscles). Nerves and vessels of extremities / G.V. Dovgal, E.O. Nefedova, N.J. Zarikov, Y.V. Suponko. - Dnepropetrovsk, 2013. – 259 p.


Reviewed by:

N. A. Voloshin - MD, Professor. Head of Department of Human Anatomy, Operative Surgery and Topographic Anatomy Zaporizhzhia State Medical University. Honored Worker of Science and Technology of Ukraine, academician of the International Academy of the Integrative Anthropology.
V.S. Pikaluk - MD, Professor. Head of Department of Human Anatomy, State Establishment "Crimea State Medical University named after S.I. Georgievsky".
Approved and recommended by the CMC (Protocol № _ of __.__.201_ year) State Establishment "Dnepropetrovsk Medical Academy of Health Ministry of Ukrain."

The educational-methodical manual contains materials for practical training and final control of Human anatomy for Module 1.

Drawn up in accordance with the working programs on pharmacology chair, approved SSC SE "Dnepropetrovsk Medical Academy Health Ministry of Ukraine" on the basis of a model program in human anatomy for medical students of III - IV levels of accreditation in the specialties 7.110101 - Medicine, 7.110104 – pediatrics.

In the Instructor's Manual, which contains 259 pages, contains a list of topics of practical lessons and topics of the first module to be submitted to an independent study. The manual section reveals the anatomy of the musculoskeletal system, and innervations and blood supply to the extremities. Each theme is built practical lesson plan and outline its implementation.

     The manual includes block diagrams. At the end of each topic contains the base tests for self-control. Meets all the requirements that relate to the teaching activities of this type is relevant and appropriate to the learning process as one of alternative textbooks in today's diversity of views and approaches to the process of studying anatomy.

A team of members of the Department of Human Anatomy State Establishment «Dnepropetrovsk Medical Academy of Health Ministry of Ukraine», developed manual.

© G.V. Dovgal, E.O. Nefedova, N.J. Zarikov, Y.V. Suponko
Dnepropetrovsk state medical academy

Human anatomy department


Module 1. The anatomy of apparatus of motion (bones, joints, muscles). Nerves and vessels of extremities.

Plan for the human anatomy practice classes for first-year students



1st term


Class

Topic

1

The introduction to the anatomy. The axes and planes of the body, terminology. The structure of vertebra.

2

The cervical, thoracic, lumbar, sacral vertebrae, the coccyx. The bends of the vertebral column, its functions.

3

The humerus. The bones of forearm and hand (the carpal and metacarpal bones, the skeleton of fingers).

4

The bones of the girdle of lower extremity: iliac, pubic and sciatic.

5

The femur. The patella. Bones of the leg.

6

Bones of the leg and food (tarsal, metatarsal, skeleton of fingers). X-ray-anatomy of bones.

7

Written tests and examination of practice skills of skeleton of the trunk and limbs. Examination of self-taught tasks. Review of the skull. The frontal, parietal, occipital bones.

8

The ethmoid bone. The sphenoid bone.

9

The temporal bone, its cavities and channels.

10

Anatomy of upper and lower jaws. The skull as a whole. The structures of the external and internal surface bases of skull.

11

The cavities of skull (orbit, nasal cavity). The hard palate.

12

The fossae of the skull (temporal, infratemporal, pterygopalate). The age features of skull, its X-rays anatomy.

13

Written tests and examination of practice skills of skull. Examination of self-taught tasks. Review of joints. The joints of the bones of skull. The temporo-mandibular joint.

14

The joints of the vertebral column. The joints of the vertebral column and skull.

15

The joints of shoulder girdle. The shoulder joint.

16

The elbow joint. The connections of the bones of forearm and hand.

17

The hip joint. The knee-joint.

18

The connections of the bones of leg and foot.

19

Written tests and examination of practice skills of joints. Examination of self-taught tasks. Review of myology. The muscles and fasciae of the head.

20

The muscles of the cervical region. The fasciae and spaces of the neck.

21

The muscles and fasciae of the abdomen. The inguinal canal.

22

The muscles and fasciae of the thorax. The diaphragm.

23

The muscles and fasciae of the shoulder girdle and arm.

24

The muscles of forearm.

25

The muscles of hand. The synovial vaginas of the hand. The topography of the upper extremity.

26

The muscles and fasciae of the pelviс region and thigh. The femoral canal.

27

The muscles and fasciae on the leg and foot. The topography of lower extremity.

28

Written tests and examination of practice skills of myology. Examination of self-taught tasks. Review of neurology. The reflex arch.

29

Structural and functional characteristic spinal cord and its meninges

30

The cervical plexus, branches. The short branches of brachial plexus.

31

The long branches of brachial plexus.

32

The lumbar plexus, branches. The sacral plexus, branches.

33

Written tests and examination of practice skills of spinal nerves. Examination of self-taught tasks. Review of angiology. Aorta: topography, parts.

34

The subclavian, axillary and brachial arteries: relations, branches, supplement. The arteries of forearm and hand.

35

The arteries of the pelvic region and lower extremity: relations, branches, supplement, anastomoses.

36

The veins of the extremities. The superior and inferior venae cavae.

37

The nerves and vessels of the upper and lower extremity.

38

Written tests and examination of practice skills of nerves and vessels of extremities. Tutorial of module 1.

39

Examination of module 1. (3 hours)

Plan for the human anatomy self-taught classes for first-year students



1st term


Class

Topic




Skeleton of the trunk and limbs

1

The structure of bone. The types of osteogenesis. Classification of bones.

2

The bones of the shoulder girdle: the scapula and clavicle. The ribs, the sternum. Thorax as a whole.

3

Bones of the foot. X-rays anatomy of the bones.




Skull

4

Review of the skull. The frontal, parietal, occipital bones.

5

The bones of the facial skull. The hyoid bone.

6

Communications of cavities and fossae of the skull.

7

The age features of skull, its X-rays anatomy.




Arthrology

8

The types of the connection of bones. The biomechanics of joints.

9

The connections of the ribs with vertebrae and sternum. Thorax as a whole.

10

The connections of the pelvic bones. The diameters, distances and sexual features of the pelvis. X-rays anatomy of the joints.




Myology

11

The general myology. The muscles and fasciae of the head.

12

The muscles and fasciae of the back.

13

The topography of the upper and lower extremity.

14

The auxiliary apparatus of the muscles. The synovial vaginas of the extremities.




Spinal nerves

15

The anatomic characteristic of the spinal nerves. The forming of the spinal nerve and its branches. The posterior branches of spinal nerves.

16

The thoracic spinal nerves.

17

The nerves for muscles of the extremities.




Nerves and vessels of extremities.

18

The anatomy of the heart: structure of chambers and walls. The greater and lesser circles of blood circulation.

19

Anastomoses of the vessels of upper extremity.

20

Anastomoses of the vessels of lower extremity.

21

Cava-cava anastomoses


UNIT 1. THE SKELETON OF THE TRUNK END EXTREMITIES

Practice class 1. The introduction to the anatomy. The axes and planes of the body, terminology. The structure of vertebra.
The aim: to understand meaning of basic anatomical terms of relationship and comparison; to know the axes and planes of the human body; to define the anatomical position of the human body; to know the general characteristics of vertebra.

Professional orientation: knowledge of this topic is essential for medical students of all the specialities because of its necessity for further study.

The plan of the practice class:

  1. Checking of the basic level of knowledge: oral quiz or written test control – 10 minutes.

  2. Summary lecture on the topic by teacher – 30 minutes.

    1. Anatomical terms

    2. Planes and axes

    3. General characteristics of vertebrae. Structure of vertebrae

  3. Students’ self-taught time – 35 minutes

  4. Home-task – 5 minutes

TERMS OF RELATIONSHIP

Various adjectives are used to describe the relationship of parts of the body in the anatomical position.

1. Anterior or frontal means – nearer to the front of the body. For example: the nose and umbilicus are on the anterior surface of the body. Rostral is also used instead of anterior.

2. Posterior or dorsal means – nearer to the back of the body. For example: the gluteal region (buttock) is on the posterior or dorsal surface.

3. Superior or cranial means – nearer to the head. For example: the head is superior to the diaphragm.

4. Inferior or caudal means «toward the feet» or lower part of the body. For example: the heart is inferior to the head.

5. Medial means – toward the median plane of the body. For example: the sternum is medial to the ribs.

6. Lateral means – farther away from the median plane of the body. For example: the nipple is lateral to the sternum.

7. Intermediate means – between two structures, one of which is medial and the other is lateral. For example: the third digit is intermediate between the fourth and second digit.
TERMS OF COMPARISON

These terms compare the relative position of two structures with each other.



1. Proximal means – nearest to the trunk or to the point of origin (of a vessel, nerve, or organ). In the limbs, proximal is used to indicate positions nearer to the attached end of a limb. For example: the arm is at the proximal end of the upper limb.

2. Distal means – farthest from the trunk or point of origin (of a vessel, nerve, or organ). In the limbs, distal is used to indicate positions farther from the attached end of a limb. For example: the forearm is at the distal end of the upper limb.



3. Superficial means – nearer to or on the surface. For example: the subskin fat is closer to the skin or surface of the body than the muscles.

4. Deep means – farther from the surface. For example: in the arm, the humerus is deep to skin.

5. Internal means – toward or in the interior of an organ or cavity. For example: the internal surface of the stomach is the interior of the organ. The term is also used to describe structures that pass from the anterior to the posterior surface of the body or that enclose other structures. For example: Hence, the internal surface of a sternum is the surface toward the interior, and the internal iliac artery passes to the interior of the pelvis cavity.

6. External means – toward or on the exterior of an organ or cavity. For example: the external surface of the stomach is the exterior of the organ.

7. Parietal means-located on the wall of cavity.

8. Visceral means – located inside or near the organs.
ANATOMICAL PLANES

Anatomical descriptions are based on three planes – sagittal, frontal and horizontal.



1. Sagittal planethe vertical plane passing longitudinally through the body– dividing it into right and left halves. Only one such plane can be provided in human body.

2. Coronal planes or frontal planes are vertical planes passing through the body at right angles to the sagittal. The number of coronal or frontal planes is unlimited.

3. Horizontal (transverse) planes are planes passing through the body at right angles to the median (or sagittal) and coronal (or frontal) planes. A horizontal plane divides the body into superior (upper) and inferior (lower) parts. It is helpful to give a reference point to identify the level of the plane, such as a "horizontal plane through the xyphoid process". Commonly, sections in coronal and horizontal planes are symmetrical, passing through both the right and left members of paired structures, allowing some comparison. The number of horizontal planes is unlimited.

AXES: sagittal, frontal and vertical (longitudinal).


ANATOMICAL POSITION is the standard position assumed when describing the human body. It is the position of human standing facing forward and palms facing outward.
GENERAL CHARACTERISTICS OF A VERTEBRA

A typical vertebra consists of two essential parts–viz., an anterior segment, the body, and a posterior part, the vertebral or neural arch; these enclose a foramen, the vertebral foramen. The vertebral arch consists of a pair of pedicles and a pair of laminae, and supports seven processes–viz., four articular, two transverse, and one spinous.


When the vertebrae are articulated with each other the bodies form a strong pillar for the support of the head and trunk, and the vertebral foramina constitute a canal for the protection of the medulla spinalis (spinal cord), while between every pair of vertebrae are two apertures, the intervertebral foramina, one on either side, for the transmission of the spinal nerves and vessels.
Body (corpus vertebrae).–The body is the largest part of a vertebra, and is more or less cylindrical in shape. Its upper and lower surfaces are flattened and rough, and give attachment to the intervertebral fibrocartilages, and each presents a rim around its circumference. In front, the body is convex from side to side and concave from above downward. Behind, it is flat from above downward and slightly concave from side to side. Its anterior surface presents a few small apertures, for the passage of nutrient vessels; on the posterior surface is a single large, irregular aperture, or occasionally more than one, for the exit of the basi-vertebral veins from the body of the vertebra.
Pedicles (radices arci vertebrae).–The pedicles are two short, thick processes, which project backward, one on either side, from the upper part of the body, at the junction of its posterior and lateral surfaces. The concavities above and below the pedicles are named the vertebral notches; and when the vertebrae are articulated, the notches of each contiguous pair of bones form the intervertebral foramina, already referred to.
Laminae – The laminae are two broad plates directed backward and medialward from the pedicles. They fuse in the middle line posteriorly, and so complete the posterior boundary of the vertebral foramen. Their upper borders and the lower parts of their anterior surfaces are rough for the attachment of the ligamenta flava.
Processes – Spinous Process (processus spinosus).–The spinous process is directed backward and downward from the junction of the laminae, and serves for the attachment of muscles and ligaments.
Articular Processes – The articular processes, two superior and two inferior, spring from the junctions of the pedicles and laminae. The superior project upward, and their articular surfaces are directed more or less backward; the inferior project downward, and their surfaces look more or less forward. The articular surfaces are coated with hyaline cartilage.
Transverse Processes (processus transversi).–The transverse processes, two in number, project one at either side from the point where the lamina joins the pedicle, between the superior and inferior articular processes. They serve for the attachment of muscles and ligaments.
STRUCTURE OF A VERTEBRA

The body is composed of cancellous tissue, covered by a thin coating of compact bone; the latter is perforated by numerous orifices, some of large size for the passage of vessels; the interior of the bone is traversed by one or two large canals, for the reception of veins, which converge toward a single large, irregular aperture, or several small apertures, at the posterior part of the body. The thin bony lamellae of the cancellous tissue are more pronounced in lines perpendicular to the upper and lower surfaces and are developed in response to greater pressure in this direction. The arch and processes projecting from it have thick coverings of compact tissue.


Practice skills

Students are supposed to put each vertebra to right position and identify the anatomical structures on the samples of vertebrae:



  • body

  • arch

  • spinous process

  • transverse process

  • superior and inferior articular processes

  • superior and inferior vertebral notches

  • vertebral foramen





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