Anatomy - oct 10th - jamie melling - this is on the ligaments PDF

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jamie melling
- this is on the ligaments ...

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Anatomy Oct 10th, 2019 View of the Plateau - This is a superior view from a transverse plane on the knee joint - The lateral and medial menisci is diff in size -> medial one is quite large - Medial collateral ligament is attached to the capsule and the medial menisci in the square -> they’re all together so when there’s an injury it will destroy three structures - LCL -> off of the capsule there’s a space - cruciate ligament -> anterior and posterior -> anterior moves anterior on the tibia and vice versa - posterior ligament -> restrict or stop excessive movements on the femur on top of the tibia conversely the PCP is going to stop posterior excessive movement of the tibia with respect to the femur -> anterior does the exact opposite just flip the arrows - structures in the middle they’re all tied together - this is a grey’s anatomy view - where you have one tear on a ligament it takes a lot of structures with it Unhappy Triad - blow to the lateral part of the knee -> forces excessive opening on the medial side -> tibia and femur forces an opening -> have a capsule and a MCL to prevent this but if the force is excessive you can tear these structures -> if you tear either one the capsule will go as well and the medial menisci because they’re sandwiched together and as they blow the knee is in a susceptible position and it will open up and then the next ligament there is the ACL (anterior cruciate ligament) it has the potential to be torn when those two ligaments are separated -> called blown out their knee -> multiple structures are torn - Anterior cruciate ligament has the potential to be torn when the tibial collateral ligament and medical meniscus are torn because it’s the next structure visable -> also the capsule will be destroyed because all of these ligaments are attaching to one another Hip Anterior View - very mobile joint - most movable synovial joint it’s a ball-and-socket - has three strong ligaments -> need stability of the hip -> in addition to movement we need stability to bear the weight of the body - three ligaments -> enhance their stabilizing effect called the corkscrew effect -> ligaments twist and forces the head of the femur into the acetabulum while you’re standing and bearing weight - look at the image on the right it’s twisted the ligament -> all originate off the greater trochanter on the femur and they go to the three regions of the hip - iliofemoral -> greater trochanter to illum - pubofemoral -> greater trochanter to the pubis

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ischial femoral -> greater trochanter of the femur to the ischium -> the one on the posterior picture highlighted in green - all coming off the femur form an anterior position and spreading out - in the sitting position they’re chill -> important when we become mobile -> they fan out across the hip they twist and shorten the ligament and by doing this they drive the head of the femur into the acetabulum creating a stronger and more stabilizing joint - extracapsular ligaments of the hip: Iliofemoral, Pubofemoral and Ischium femoral - intracapsular ligament of the hip: ligament to the head of the femur (doesn’t serve a stabilizing purpose but it does protect the artery going to the head of the femur which is its main blood supply) It’s synovial - inside the joint -> typical synovial joint - it doesn’t have a disc !! -> surprise - synovial cavity that has the fluid have a capsule, extracapsular ligament the three ligaments above, synovial membrane also have an intracapsular ligament -> this attaches to the fovea capitis the impression on top of the femur and moves downwards and attaches to the capsule not even going to boney tissue its function doesn’t make sense that it’s a stabilizing agent -> name of this ligament is the ligament of the head of the femur -> there’s an artery inside of this -> artery to the head of the femur -> this joint has an intracapsular ligament it’s not like the ones in the knee this one protects the artery to the head of the femur within this joint because there’s a lot of pressure in this joint Hip Dislocations - most hip dislocations (90% are posterior) -> hard because the ligaments hold this tight -> happens when the person is in the sitting position bc the ligaments are relaxed -> number one way is in a car accident -> the force is transmitted down the leg - importance of the ligament it protects the artery to the head of the femur and that supplies blood to the head of the femur important otherwise it doesn’t get enough blood -> when you dislocate your hip you often tear that ligament and the artery Glenohumeral Joint - complete opposite of the hip joint is the shoulder joint that is the most separated joint - Glenoid Labrum -> cartilage that surrounds the glenoid process -> it’s going to deepen the area -> it’s not as solid as bone and easy to tear in comparison to bone - looking at the shoulder joint -> a lot of ligaments -> coracohumeral, coracoclavicular, acromioclavicular, coracoacromial -> these are holding the scapula into position -> they’re associated ligament but don’t attach the two bones in the joint aka the scapula and humerus -> only one ligament that attaches the scapula to the humerus and that is the - glenohumeral ligament -> corachumeral ligament one attaches them the only dedicated ligament *check up on this* - have one ligament to support the joint have cartilage that doesn’t really help -> major stabilizing for the joint are muscles they’re rotator cuff muscle -> bc of their position they do help to stabilize the joint

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muscles move they’re meant for movement, so we have muscles here to move the joint and they try to be stabilizing agents but they’re there for movements and that’s why we have a lot of shoulder injuries Associated Ligaments: coracohumeral, coracoclavicular, acromioclavicular and coracoacromial -> these are there to help keep the scapula into position not join two bones together Ligament: Glenohumeral Ligament -> this is the only ligament dedicated to holding the humerus in place into the scapula that is why you get a lot of shoulder dislocations For support we also have -> rotator cuff muscles -> muscles are designed for movement not support and in case they’re used for support which is another reason why shoulder injuries are common The Elbow Joint on the lateral side -> LCL and we have a radial collateral ligament -> connecting the lateral distal humerus to the head of the radius -> LCL/ radial collateral ligament of the elbow joint!! -> have to be specific to the joint because the wrist has the same RCL on the medial side -> MCL better known as the ulnar CL of the elbow -> attach the medial distal humerus to the ulna third ligament here -> the annular ligament -> wraps around the head of the radius -> starts on the ulna and ends there it creates a ring so the head of the radius can pivot within this ring -> why do we want it to pivot allows us to pronate and supinate ulna is medial to the radius when we pronate we bring the radius over top the ulna -> happens at the level of the elbow not on the wrist the ulna will be a hinge joint and the radius will be a pivot joint because of the annular ligament allowing it to turn -> the ulna doesn’t turn because of the trochlear notch it has where it tightly joins the humerus’ trochlea

The Wrist - ulnar collateral ligament and a radial collateral ligament of the wrist -> want to be specific to the joint - in the wrist the 8 carpal bones have an assortment of ligaments -> very mobile area allows us to move our fingers -> flex and extend our wrists - only talking about 2 these are the most commonly injured ones - on the medial side -> ulnar collateral ligament -> smaller ulna to the fifth metacarpal -> the length of it - the lateral CL (radial collateral ligament)-> runs from the distal radius to the first metacarpal - these are stabilizing agents for either side of the wrist - ulna -> styloid processes on the distal radius and ulna -> that’s where these ligaments are attaching for on the wrist - both the radial and ulnar collateral ligament attach on the styloid process on both the radius and the ulna

Medial Ankle Joint and Arch Supports - assortment of ligaments that will attach all the tarsals together -> tarsal create these arches - commonly injure the large ligaments -> attaching the distal tibia and fibula to the tarsal bones - medial side -> deltoid ligament it’s a triangular three-sided ligament that’s what it stands for in order to tear it -> eversion sprain the three green ones makes up the tibial navicular, tibiocalcanial, tibotalar -> all based on where they’re located -> deltoid is medial and the tibia is medial so the names of the ligaments will start with tibio - also have muscle tendons -> stabilizing agents of these joints that are only dedicated to stabilizing -> ligaments aren’t there for movement just stabilizing - long plantar ligament and the calcaneonavicualar (runs from calcaneus to navicular bone) the long plantar one the tuberosity and spans out underneath the foot it’s very supportive -> if you have fallen arches this is the ligament that gets torn can lead to bone spurs the bone grows out of the heel Lateral Ligaments - just have three they’re attaching from the lower leg to tarsals - calcaneofibular ligament -> fibula to calcaneus it’s in green -> there are two tendons that split this ligament - talofibular it has an anterior portion and a posterior -> moves anterior from the talus to the fibula the posterior one is from the fibular to the posterior talus both of these are in red in the slide - the lateral ligaments involve the fibula so will have fibula in their name instead

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TMJ joint between the mandible and the temporal bone -> injury to the jaw from the blow the brain is just above the articulating point of where the mandible articulates in the temporal lobe -> easy to become concussed there’s a lot of wear and tear here because we talk and eat bare -> a lot of movement across the jaw a lot of friction and that’s the reason we have a disc inside this joint the one to the right is where the capsule is intact we can’t see inside therefore it’s a synovial joint the extracapsular ligaments are named on their attachments sphenomandibular ligament -> the sphenoid bone and it’s meant to be transparent it’s attaching on the mandible on the inner side of the jaw lateral temporomandibular ligament -> temporal bone to the mandible stylomandibular ligament -> styloid process on temporal bone to mandible these three ligaments support the TMJ inside the joint see on the right side -> have an articular disc to reduce the frictional forces across this joint this joint is well structed for lifespan of opening and closing the jaw for chewing and speaking movement is set up nicely with an impression on the temporal bone -> mandibular fossa is where the mandible goes to the temporal bone

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looks like your typical hinge joint important movements of the jaw is protraction and retraction -> jaw slides forwards -> when your jaw is wide open you’re in a susceptible position all the force would go up to the head off the mandible and go to the temporal fossa which is hella thin you can break through this and right above are your temporal lobes -> have a protective response when we open our mouth articular tubercle will save us -> it’s a thicken bone and difficult to break through jaw is in the best position when it’s close -> all about the transmission of the forces when you get hit in the jaw idea of the mouth guard -> it keeps your mouth closed to be in the best position to get a blow to your face

*review the movements across the body *...