Normal human anatomy. The structure of the muscular skeleton

Title: Normal human anatomy. Lecture notes.

This book contains a course of lectures on normal human anatomy, where concepts are clearly formulated, which is the main advantage in preparing for the exam and successfully passing it. The material is extremely specific and systematized. The manual is also an alternative for teachers when planning lessons.

GENERAL INFORMATION ABOUT OSTEOLOGY .
Skeleton- the totality of all the bones of the human body. The skeleton makes up up to 10% of the mass of the human body. The human skeleton performs many different functions. There are more than 200 bones in the human body. The spinal column consists of 26, the skull - of 29 bones. The skeleton of the lower extremities is formed by 62 bones, and the upper extremities - 64.

Human skeleton:
1) performs a supporting function, supporting a variety of soft tissues;
2) protects internal organs by creating containers for them;
3) is a depot organ for many important macroelements (calcium, phosphorus, magnesium). These substances are necessary for normal metabolism.

The bone (os) is externally covered with periosteum (periosteum), inside the bone there is a bone marrow cavity (cavitas medullares), in which red and yellow bone marrow (medulla ossium rubra et flava) is located.
The strength of bone is determined by the content of organic and inorganic compounds in it. Bone is composed of 29% organic, 21% inorganic, and 50% water.

Classification of bones:
1) tubular bones (os longum) most often have a triangular or cylindrical shape. The length of the bone can be divided into approximately three parts. The central part, which occupies a large proportion of the length of the bone, is the diaphysis, or the body of the bone, and the epiphyses (epiphysis) - the marginal parts that have a thickened shape. The epiphyses have an articular surface (facies articularis), which is covered with articular cartilage. The junction of the diaphysis and the epiphysis is called the metaphysis.

There are long tubular bones (for example, the shoulder, thigh, forearm, tibia) and short ones (for example, the phalanges of the fingers, metacarpals and metatarsals);
2) flat bones (ossa plana). These include the pelvic bones, ribs, sternum, bones of the roof of the skull;
3) mixed bones (ossa irregularia) have a complex structure and varied shape (an example is a vertebra);
4) spongy bones (os breve) often have the shape of an irregular cube (tarsal and carpal bones);
5) air-bearing bones (ossa pneumatica) have a cavity in their thickness lined with epithelium and filled with air (for example, the upper, sphenoid, ethmoid, frontal jaws).

The elevations on the surface of the bone to which ligaments and muscles are attached are called apophyses. The apophyses include the crest (crista), tubercle (tuber), tubercle (tuberculum) and process (processus). In addition to the elevations, there are depressions - a fossa (fossula) and a pit (fovea).

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Normal human anatomy. Lecture notes

Published with the permission of the copyright holder - Literary Agency "Scientific Book"

LECTURE 1. OSTEOLOGY

GENERAL INFORMATION ABOUT OSTEOLOGY

Skeleton(skeleton) – the totality of all the bones of the human body. The skeleton makes up up to 10% of the mass of the human body. The human skeleton performs many different functions. There are more than 200 bones in the human body. The spinal column consists of 26, the skull - of 29 bones. The skeleton of the lower extremities is formed by 62 bones, and the upper extremities - 64.

Human skeleton :

1) performs a supporting function, supporting a variety of soft tissues;

2) protects internal organs by creating containers for them;

3) is a depot organ for many important macroelements (calcium, phosphorus, magnesium). These substances are necessary for normal metabolism.

Bone(os) is covered on the outside with periosteum, inside the bone there is a bone marrow cavity (cavitas medullares), in which red and yellow bone marrow (medulla ossium rubra et flava) is located.

The strength of bone is determined by the content of organic and inorganic compounds in it. Bone is composed of 29% organic, 21% inorganic, and 50% water.

Classification of bones :

1) tubular bones(os longum) most often have a triangular or cylindrical shape. The length of the bone can be divided into approximately three parts. The central part, which occupies a large proportion of the length of the bone, is the diaphysis, or the body of the bone, and the epiphysis, the marginal parts that have a thickened shape. The epiphyses have an articular surface (facies articularis), which is covered with articular cartilage. The junction of the diaphysis and the epiphysis is called the metaphysis.

There are long tubular bones (for example, the shoulder, thigh, forearm, tibia) and short ones (for example, the phalanges of the fingers, metacarpals and metatarsals);

2) flat bones(ossa plana). These include the pelvic bones, ribs, sternum, bones of the roof of the skull;

3) mixed dice(ossa irregularia) have a complex structure and varied shape (an example is a vertebra);

4) spongy bones(os breve) often have the shape of an irregular cube (tarsal and carpal bones);

5) air bones(ossa pneumatica) have a cavity in their thickness lined with epithelium and filled with air (for example, the upper, sphenoid, ethmoid, frontal jaws).

The elevations on the surface of the bone to which ligaments and muscles are attached are called apophyses. The apophyses include the crest (crista), tubercle (tuber), tubercle (tuberculum) and process (processus). In addition to the elevations, there are depressions - a fossa (fossula) and a hole (fovea).

The edges (margo) delimit the surfaces of the bone.

If a nerve or vessel is adjacent to the bone, a groove (sulcus) is formed as a result of pressure.

When a nerve or vessel passes through a bone, an incision (incisura), a canal (canalis), a canaliculus (canaliculus) and a fissure (fissure) are formed.

On the surface of the bone there are nutrient openings (foramina nutricia).

STRUCTURE OF THE CERVICAL, THORACIC AND LUMBAR VERTEBRES

Cervical vertebrae(vertebrae cervicales) have a feature - the opening of the transverse process (foramen processus transverses). On the upper surface of the transverse process there is a groove of the spinal nerve (sulcus nervi spinalis). The process ends in two tubercles: anterior and posterior.

The first cervical vertebra (atlas) does not have a body, but has anterior and posterior arches (arcus anterior et posterior) and a lateral mass (massa lateralis). There is an anterior tubercle on the anterior surface of the anterior arch, and a posterior tubercle on the posterior surface of the posterior arch. On the lateral masses there are upper (connected to the condyles of the occipital bone) and lower (connected to the second vertebra) articular surfaces.

The second cervical vertebra (axis) has a distinctive feature - a tooth (dens), located on the upper surface of the body. The tooth has an apex, anterior and posterior articular surfaces.

In the VI cervical vertebra, the posterior tubercle is better developed than on other vertebrae and is called the carotid tubercle (tuberculum caroticum).

The VII cervical vertebra is called protruding (vertebra prominens) due to the long spinous process.

Thoracic vertebrae(vertebrae thoracicae) have smaller vertebral foramina compared to the cervical ones. The thoracic vertebrae from II to IX have upper and lower costal fossae (fovea costales superior et inferior) on the posterolateral surfaces on the right and left. On the anterior surface of the transverse processes from the I to X vertebrae there is a costal fossa of the transverse process (fovea costalis processus transverse).

Lumbar vertebrae(vertebrae lumbales) have a massive body and additional processes (processus accessories). All superior articular processes have a mastoid process (processus mamillares).

STRUCTURE OF THE SACRUM AND COCCYX

Sacrum(os sacrum) consists of five lumbar vertebrae fused into a single bone. It is divided into a base (basis ossis sacri), an apex (apex ossis sacri), a concave pelvic surface (facies pelvia) and a convex posterior surface (facies dorsalis).

There are four transverse lines on the pelvic surface, at the ends of which the anterior sacral openings (foramina sacralia anteriora) open.

On the posterior surface there are five longitudinal ridges: median (crista sacralis mediana), paired intermediate (crista sacralis intermedia) and paired lateral ridges (crista sacralis lateralis). The posterior sacral foramina open near the intermediate ridges. Outward from the lateral ridges is the lateral part, on which the articular surface is located. Next to it is the sacral tuberosity (tuberositas sacralis). The sacrum has a canal ending in the sacral fissure (hiatus sacralis), on the sides of which are the sacral horns (cornu sacrale).

Coccyx(os coccyges) consists of 4–5 coccygeal vertebrae. The coccyx is connected to the sacrum through the body and coccygeal horns.

STRUCTURE OF RIBS AND STERNUM

Ribs(costae) consist of bone (os costale) and cartilaginous parts (cartilago costales). The seven pairs of upper ribs are called true and are connected by a cartilaginous part to the sternum. The remaining ribs are called false, or fluctuating (costae fluctuantes).

The ribs have a head (caput costae) and a neck (collum costae), between which there is a tubercle. On the ten upper pairs of ribs the tubercle is forked. Behind the neck is the body (corpus costae), which has an angle of the rib (angulus costae). Throughout the entire body of the rib, there is a rib groove in the lower part.

The first rib differs in structure from other ribs. It has medial and lateral edges delimiting the superior and inferior surfaces. On the upper surface there is a tubercle of the anterior scalene muscle (tuberculum musculi scaleni anterioris), in front of which there is a groove of the subclavian vein, and behind it there is a groove of the subclavian artery.

Sternum(sternum) consists of three parts: the manubrium (manubrium sterni), the body (corpus sterni) and the xiphoid process (processus xiphoideus).

The manubrium has jugular and clavicular notches. The manubrium and body form the angle of the sternum (angulus sterni). At the edges of the body of the sternum there are costal notches (incisurae costales).

UPPER LIMB BELT

Spatula(scapula) refers to flat bones. The scapula has three angles: upper (angulus superior), lower (angulus inferior) and lateral (angulus lateralis) - and three edges: upper (margo superior), which has a notch (incisura scapulae), lateral (margo lateralis) and medial (margo medialis) ).

There are concave - anterior costal (facies costalis) - and posterior - convex - surfaces (facies posterior). The costal surface forms the subscapular fossa. The posterior surface has the spine of the scapula (spina scapulae), which divides it into the supraspinatus and infraspinatus fossa. These pits contain the muscles of the same name. The spine of the scapula ends in the acromion, at the apex of which there is an articular surface.

The lateral angle of the scapula forms the glenoid cavity (cavitas glenoidalis), into which the head of the humerus enters. The articular surface, tapering, forms supra- and subarticular tubercles. Behind the glenoid cavity is the neck of the scapula (collum scapulae). The coracoid process (processus coracoideus) extends upward and anteriorly from the upper edge of the scapula.

Collarbone(clavicula) has an S-shape. The clavicle has a body (corpus claviculae), thoracic (extremitas sternalis) and acromial (extremitas acromialis) ends. At the thoracic end there is a sternal articular surface. The acromial end of the clavicle is connected to the acromion of the scapula. The upper surface of the clavicle is smooth, and on the lower there is a cone-shaped tubercle (tuberculum conoideum) and a trapezoidal line (linea trapezoidea).

LOWER LIMB BELT

Hip bone(os coxae) consists of three bones fused together: the ilium, the pubis and the ischium, the bodies of which form the acetabulum (acetabulum). In the center of the depression there is a hole of the same name. The acetabulum is limited by a high edge, which, interrupted on the medial side, forms the notch of the acetabulum (incisura acetabuli). Along the periphery of the cavity (in its lower part) there is a semilunar surface (facies lunata).

Ischium(ischium) has the body and branches of the ischium. An angle is formed between the body and the branch, in the area of which the ischial tuberosity (tuber ischiadicum) is located.

Ilium(os ilium) has a body (corpus ossis illi) and a wing (ala ossis illi). The wing ends with a convex edge - the iliac crest (crista iliaca), on which three lines are distinguished: the outer lip (labium externum), the intermediate line (linea intermedia) and the inner lip (labium internum).

On the crest in front and behind there are symmetrically located protrusions: upper anterior (spina iliaca anterior superior), lower anterior (spina iliaca anterior inferior), upper posterior (spina iliaca posterior superior) and lower posterior iliac spines (spina iliaca posterior inferior).

There are three lines on the outer surface of the wing: the anterior, posterior and lower gluteal lines (lineae gluteales anterioris, posterioris et inferioris). On the inner surface of the wing there is an iliac fossa (fossa iliaca), the lower border of which is an arcuate line (linea arcuata), starting from the auricular surface (facies auricularis). Above this surface is the iliac tuberosity (tuberositas iliaca).

pubic bone(os pubis) has a body from which the upper branches (ramus superior ossis pubis) extend, having an iliopubic eminence (eminencia iliopubica). On the upper branches there is a pubic tubercle (tuberculum pubicum), from which the crest of the same name begins. The anterior parts of the upper branches bend downwards and are considered as lower branches (ramus inferior ossis pubis). The transition point of the upper branches to the lower ones is called the symphyseal surface.

TEMPORAL BONE

Temporal bone(os temporale) is a container for the organs of balance and hearing. The temporal bone, connecting with the zygomatic bone, forms the zygomatic arch (arcus zygomaticus). The temporal bone consists of three parts: squamosal, tympanic and petrous.

Scaly part(pars squamosa) of the temporal bone has an outer smooth temporal surface (facies temporalis), on which runs the groove of the middle temporal artery (sulcus arteriae temporalis mediae). From this part (just above the external auditory canal) the zygomatic process (processus zygomaticus) begins, at the base of which there is the mandibular fossa (fossa mandibularis). In front, this fossa is limited by the articular tubercle (tuberculum articulare). On the inner cerebral surface (facies cerebralis) there are finger-like impressions and arterial grooves.

Drum part(pars tympanica) of the temporal bone is fused at its edges with the mastoid process and the scaly part, limiting the external auditory opening (porus acusticus externus) on three sides, the continuation of which is the external auditory canal (meatus acusticus externus). At the back, at the site of fusion of the tympanic part with the mastoid process, a tympanomastoid fissure (fissura tympanomastoidea) is formed. In front of the auditory opening there is a tympanic-squamous fissure (fissura tympanosquamosa), which is divided by the edge of the roof of the tympanic cavity into a stony-squamous fissure (fissura petrosquamosa) and a stony-tympanic fissure (fissura petrotympanica).

Rocky part, or pyramid(pars petrosa), the temporal bone has the shape of a triangular pyramid. The pyramid is distinguished by the apex (apex partis petrosae), anterior, posterior and lower surfaces, upper and posterior edges and the mastoid process.

Canals of the temporal bone.

The anterior surface of the temporal bone on the lateral side passes into the medullary surface of the squamosal bone, from which it is separated by a petrosquamous fissure (fissura petrosquamosa). Next to the stony-scaly fissure lies the opening of the muscular-tubal canal (canalis musculotubaris), which is divided by a septum into two semi-canals. One of them is the hemicanal of the auditory tube, and the other is the tensor tympani muscle.

In the middle of the anterior surface of the temporal bone there is an arched eminence (eminencia arcuata), between it and the stony-squamosal fissure there is the roof of the tympanic cavity (tegmen tympani). Near the apex of the anterior surface there is a trigeminal depression, lateral to which is the opening of the canal of the greater petrosal nerve (hiatus canalis nervi petrosi majoris), from which the groove of the same name begins. Lateral to this canal is the opening of the canal of the lesser petrosal nerve, from which the groove of the same name extends.

In the middle of the posterior surface of the pyramid of the temporal bone is the internal auditory opening (porus acusticus internus), which passes into the internal auditory canal. Lateral to this opening lies the subarcuate fossa (fossa subarcuata), below and lateral to which there is an external opening of the vestibular aqueduct (apertura externa aqueductus vestibuli).

The lower surface of the pyramid of the temporal bone has at its base a jugular fossa (fossa jugularis), on the anterior wall of which there is a groove ending in a mastoid foramen (foramen mastoideus). The posterior wall of the jugular fossa is represented by the notch of the same name. This notch and the notch of the occipital bone form the jugular foramen (foramen jugulare). In front of the jugular fossa, the carotid canal (canalis caroticus) begins, in the wall of which there are small pits that continue into the carotid-tympanic canaliculi. On the ridge separating the jugular fossa and the external opening of the carotid canal, there is a stony dimple (fossula petrosa), at the bottom of which the lower opening of the tympanic tubule opens. Lateral to the jugular fossa begins the styloid process (processus styloideus), posterior to which there is a stylomastoid foramen (foramen stylomastoideum).

The upper edge of the pyramid of the temporal bone separates the anterior surface from the posterior, and a groove of the superior petrosal sinus (sulcus sinus petrosi superioris) runs along its surface.

The posterior edge of the pyramid of the temporal bone separates the posterior and inferior surfaces; along it runs the groove of the inferior petrosal sinus (sulcus sinus petrosi inferioris).

The mastoid process (processus mastoideus) of the temporal bone is separated from the top from the scaly part by the parietal notch (incisura parietalis), and from below the process is limited by the mastoid notch (incisura mastoidea). Medial to the latter is the groove of the occipital artery (sulcus arteriae occipitalis). On the inner surface of the process there is a wide groove of the sigmoid sinus (sulcus sinus sigmoidei). The internal structure of the process is represented by cells, the largest of which is called the mastoid cave (antrum mastoideum).

Numerous canals and tubules pass through the temporal bone:

1) mastoid tubule (canaliculus mastoideus);

2) tympanic tubule (canaliculus tympanicus);

3) canaliculus chordae tympani;

4) carotid-tympanic tubules (canaliculus caroticotympanici);

5) carotid canal (canalis caroticus);

6) facial canal (canalis facialis);

7) muscular-tubal canal (canalis musculotubarius).

ETHMOID BONE

Ethmoid bone(os ethmoidae) consists of the ethmoidal labyrinth, ethmoidal and perpendicular plates.

Lattice Maze(labyrinthus ethmoidalis) of the ethmoid bone consists of communicating ethmoid cells (cellulae ethmoidales). On the medial side are the superior and middle nasal conchae (conchae nasales superior et media). There is a highest nasal concha (concha nasalis suprema). Under the middle turbinate there is a nasal passage of the same name; the middle turbinate at the posterior end has a hook-shaped process (processus uncinatus), behind which is located a ethmoidal vesicle (bulla ethmoidalis). Between the last formations there is a funnel of the same name. The lateral side of the ethmoid labyrinth is covered with a plate, which is part of the orbital plastic (lamina orbitalis).

cribriform plate(lamina cribrosa) is the upper part of the ethmoid bone. Above the plate there is an elevation - the cockscomb (crista galli), which anteriorly continues into the wing of the cockscomb (ala cristae galli).

Perpendicular plate(lamina perpendicularis) of the ethmoid bone is a continuation of the cock's crest downwards.

UPPER JAW

Upper jaw(maxilla) has a body and four processes: zygomatic, alveolar, palatine and frontal.

Zygomatic process(processus zygomaticus) of the upper jaw connects to the zygomatic bone.

Frontal process(processus frontalis) of the upper jaw on its medial surface has a ethmoidal ridge (crista ethmoidalis), on the lateral surface - an anterior lacrimal ridge (crista lacrimalis anterior).

Palatine process(processus palatinus) extends from the upper jaw on the medial edge has a nasal ridge (crista nasalis), takes part in the formation of the hard palate when connected to the process of the same name with opposite side. When they are connected, a median suture is formed, at the anterior end of which there is an opening for the incisive canal. In the posterior part of the lower surface of the palatine process there are palatine grooves (sulci palatini).

Bottom edge alveolar ridge(processus alveolaris) on the upper jaw has dental alveoli (alveoli dentales), separated by interalveolar septa (septa interalveolaria). On the outer surface of the process there are elevations of the same name.

Body of the maxilla(corpus maxillae) has a maxillary sinus (sinus maxillaries), communicating with the nasal cavity through the maxillary cleft. The anterior surface is separated from the orbital surface by the infraorbital margin, under which the foramen of the same name is located (foramen infraorbitale). Under this hole is the canine fossa (fossa canina).

On the medial edge of the upper jaw there is a nasal notch, the lower edge of which forms the anterior nasal spine (spina nasalis anterior).

The nasal surface has a lacrimal groove (sulcus lacrimalis), in front of which there is a conchal ridge (crista conchalis).

The orbital surface forms the inferior wall of the orbit. On its posterior part the infraorbital groove (sulcus infraorbitalis) begins, which anteriorly passes into the canal of the same name.

The infratemporal surface has a tubercle of the upper jaw (tuber maxillae), on which the alveolar openings (foramina alveolaria) open, leading into the canals of the same name. The greater palatine groove (sulcus palatinus major) runs medial to the tubercle.

Inferior turbinate(concha nasalis inferior) has three processes: ethmoidal (processus ethmoidalis), lacrimal (processus lacrimalis) and maxillary (processus maxillaris).

Cheekbone(os zygomaticum) has three surfaces: temporal, orbital and lateral - and two processes: temporal and frontal. On the orbital surface there is a zygomatic orbital foramen (foramen zygomaticoorbitale).

SMALL BONES OF THE NOSE

Lacrimal bone(os lacrimale) has on the lateral surface a posterior lacrimal crest (crista lacrimalis posterior), which ends in a lacrimal hook (hamulus lacrimalis). In front of the crest there is a lacrimal groove (sulcus lacrimalis), which participates in the formation of the fossa of the lacrimal sac (fossa sacci lacrimalis).

Opener(vomer) participates in the formation of the bony septum of the nose and has two wings (alae vomeris) on the superior posterior edge.

Nasal bone(os nasale) forms the bony dorsum of the nose; has three edges: superior, inferior and lateral. On its anterior surface there is a ethmoidal groove (sulcus ethmoidalis).

Hyoid bone(os hyoideum) has a body (corpus ossis hyoidei), large (cornu majora) and small horns (cornu minora).

Palatine bone(os palatum) consists of perpendicular and horizontal plates connected at right angles; has three processes: wedge-shaped (processus sphenoidalis), orbital (processus orbitalis) and pyramidal (processus pyramidalis).

Perpendicular plate(lamina perpendicularis) of the palatine bone has on the lateral surface a large palatine groove (sulcus palatinus major), which, with the same grooves of the sphenoid bone and upper jaw, forms a large palatine canal, which ends with a large palatine foramen (foramen palatinum majus). On the medial surface of the perpendicular plate there are conchal (crista conchalis) and ethmoidal ridges (crista ethmoidalis).

Horizontal plate(lamina horisontalis) of the palatine bone participates in the formation of the bony palate (palatum osseum). It has two surfaces: the superior nasal, on which the nasal ridge (crista nasalis) is located, which passes into the posterior nasal spine (crista nasalis posterior) and the palatine.

LECTURE 2. ARTHROLOGY

FOOT JOINTS

The foot consists of 12 bones that have little mobility. The foot has one transverse and five longitudinal arches.

Talon-calcaneonavicular joint(articulatio talocalcaneonavicularis) is formed by two joints: the subtalar (articulatio subtalaris) and the talonavicularis (articulatio talonavicularis). The talocalcaneal-navicular joint is a ball-and-socket joint, but it allows movement only around the sagittal axis. The plantar calcaneonavicular ligament (lig calcaneonaviculare plantare) complements the anterior talus articular surface of the calcaneus. The talocaleonavicular joint is strengthened by the talonavicular ligament (lig talonaviculare) and a strong interosseous talocalcaneal ligament (lig talocalcaneum).

The calcaneocuboid joint (articulatio calcaneocuboidea) belongs to the saddle joints. The articular cavity of this joint communicates with the cavity of the talocalcaneal-navicular joint. On the plantar side, the joint capsule is strengthened by the long plantar ligament (lig plantare longum) and the plantar calcaneo-cuboid ligament (lig calcaneocuboideum plantare). The calcaneocuboid joint and the talonavicular joint are considered as a single transverse joint of the tarsus - the chopard joint (articulatio tarsi transversa). Common to these joints is the bifurcated ligament (lig bifurcatum), which is divided into the calcaneocuboideum (lig calcaneocuboideum) and calcaneonavicular (lig calcaneonaviculare) ligaments.

Wedge-navicular joint (articulatio cuneonavicularis) refers to flat joints. This joint is strengthened by interosseous intercuneiform ligaments (ligg intercuneiformia interossea), dorsal and plantar cuneonavicular ligaments (ligg cuneonavicularia dorsalia et plantaria), dorsal and plantar intercuneiformia dorsalia et plantaria.

Lisfranc joint , or tarsometatarsal joints (articulationes tarsometatarsales), refers to flat joints; formed by the cuboid and sphenoid bones and the bases of the metatarsal bones. The joint capsules are strengthened by the dorsal and plantar tarsal-tarsal ligaments (ligg tarsometatarsalia dorsalia et plantaria), between the metatarsal and wedge-shaped bones there are interosseous and cuneiform tarsal ligaments (ligg cuneometatarsalia interossea).

Intermetatarsal joints (articulationes intermetatarsales) are formed by the surfaces of the bases of the metatarsal bones facing each other. The joint capsules are strengthened by the dorsal and plantar metatarsal joints (ligg metatarsalia dorsalia et plantaria) and interosseous metatarsal ligaments (ligg metatarsalia interossea).

Metatarsophalangeal joints (articulationes metatarsophalangeales) are formed by the heads of the metatarsal bones and the bases of the proximal phalanges of the fingers; belong to ball-and-socket joints. The joint capsule is strengthened on the sides by collateral ligaments (ligg collateralia), from below by plantar ligaments (ligg plantaria) and the deep transverse metatarsal ligament (lig metatarsale transversum profundum).

Interphalangeal joints of the foot (articulationes interphalanges pedis) belong to the block joints. The articular capsule of these joints is strengthened from below by plantar ligaments (ligg plantaria), and from the lateral and medial sides by collateral ligaments (ligg collateralia).

CONNECTIONS OF THE SKULL BONES

All bones of the skull, with the exception of the connection of the temporal bone with the lower jaw, which forms the joint, are connected using continuous connections, represented by sutures in adults, and syndesmoses in children.

Continuous connections are formed by the edges of the frontal and parietal bones, forming the serrated coronal suture (sutura coronalis); the edges of the belt bones form a serrated sagittal suture; the edges of the parietal and occipital bones are the serrated lambdoid suture (sutura lambdoidea).

The bones that form the facial skull are connected using flat sutures. Some sutures are named after the bones that form the sutures, for example the temporomygomatic suture (sutura temporozigomatica). The scales of the temporal bone are connected to the greater wing of the sphenoid bone and the parietal bone using a scaly suture (sutura squamosa). In addition to sutures, some bones are connected using synchondrosis: the body of the sphenoid bone and the basilar part of the occipital bone - sphenooccipital synchondrosis (synchondrosis sphenooccipitalis), the pyramid of the temporal bone with the basilar part of the occipital bone - petrooccipital synchondrosis (synchondrosis petrooccipitalis). By the age of 20, synchondroses are replaced by bone tissue.

Joints of the skull .

Temporomandibular joint (articulatio temporomandibularis) is a complex paired elliptical joint. This joint is formed by the mandibular fossa of the temporal bone (fossa mandibularis) and the head of the mandible (caput mandibulae). Between these articular surfaces there is an articular disc, dividing the articular cavity into two floors.

Movement in the right and left joints occurs symmetrically, the following movements are possible: lateral movements, lowering and raising the lower jaw and shifting the lower jaw forward and backward (to its original position).

The upper synovial membrane (membrana synovialis superior) covers the entire joint capsule, attaching along the edge of the articular cartilage, and the lower membrane (membrane synovialis inferior), in addition to the capsule, also covers the posterior surface of the articular disc. In the upper floor, the articular surface of the temporal bone articulates with the upper surface of the articular disc, and in the lower floor, the head of the lower jaw articulates with the lower surface of the articular disc.

The joint capsule is strengthened on the lateral side by the lateral ligament (lig laterale), on the medial side there are auxiliary ligaments: the stylomandibular ligament (lig stylomandibulare) and the sphenomandibular ligament (lig sphenomandibulare).

CONNECTION OF VERTEBRES

Vertebral connection(articulationes vertebrales) is carried out at the connection of the bodies, arches and processes of the vertebrae.

The vertebral bodies are connected by intervertebral discs (discus intervertebrales) and symphyses (symphysis intervertebrales). The intervertebral discs are located: the first is between the bodies of the II and III cervical vertebrae, and the last is between the bodies of the V lumbar and I sacral vertebrae.

In the center of the intervertebral disc is the nucleus pulposus (nucleus pulposus), along the periphery there is a fibrous ring (annulus fibrosus), formed by fibrous cartilage. There is a gap inside the nucleus pulposus, which turns this connection into a semi-joint - the intervertebral symphysis (symphysis intervertebralis). The thickness of the intervertebral discs depends on the level of location and mobility in a given section of the spinal column and ranges from 3 to 12 mm. The connections of the vertebral bodies through intervertebral discs are strengthened by the anterior (lig longitudinale anterius) and posterior (lig longitudinale posterius) longitudinal ligaments.

The vertebral arches are connected by the yellow ligaments (lig flava).

The articular processes form intervertebral joints (articulationes intervertebrales), related to flat joints. The most prominent articular processes are the lumbosacral joints (articulationes lumbosacrales).

The spinous processes are connected by the supraspinous ligament (lig supraspinale), which is especially pronounced in the cervical spine and is called the nuchal ligament (lig nuchae), and interspinous ligaments (lig interspinalia).

The transverse processes are connected by intertransverse ligaments (lig intertransversalia).

Atlanto-occipital joint (articulatio atlantooccipitalis) consists of two symmetrically located condylar joints, being a combined joint. This joint allows movement around the sagittal and frontal axes. The joint capsule is strengthened by the anterior (membrana atlantooccipitalis anterior) and posterior (membrana atlantooccipitalis posterior) atlantooccipital membranes.

Median atlantoaxial joint (articulatio atlantoaxialis mediana) is a cylindrical joint. It is formed by the anterior and posterior articular surfaces of the tooth of the axial vertebra, the articular surface of the transverse ligament of the atlas and the fossa of the atlas tooth. The transverse atlas ligament (lig transversum atlantis) is stretched between the inner surfaces of the lateral masses of the atlas.

Lateral atlantoaxial joint (articulatio atlantoaxialis lateralis) belongs to the combined joints, as it is formed by the articular fossa (fovea articularis inferior) on the right and left lateral masses of the atlas and the upper articular surface of the body of the axial vertebra. The paired lateral and median atlantoaxial joints are strengthened by paired pterygoid ligaments (lig alaria) and a ligament of the apex of the tooth (lig apices dentis). Behind the pterygoid ligaments there is a cruciate ligament of the atlas (lig cruciforme atlantis), which is formed by fibrous longitudinal bundles and the transverse ligament of the atlas. At the back, these joints are covered with a wide integumentary membrane (membrana tectoria).

Sacrococcygeal joint (articulatio sacrococcigea) is formed by the apex of the sacrum and the first coccygeal vertebra. The joint capsule is strengthened by the ventral (lig sacrococcigeum ventrale), superficial dorsal (lig sacrococcigeum dorsale superficiale), deep dorsal (lig sacrococcigeum dorsale profundum), paired lateral sacrococcygeum ligaments (lig sacrococcygeum laterale).

Spinal column (columna vertebralis) is represented by the totality of all vertebrae connected to each other. The spinal column is the container for the spinal cord, which is located in the spinal canal (canalis vertebralis).

The spine has five sections: cervical, thoracic, lumbar, sacral and coccygeal.

The spine has an S-shape due to the presence of physiological curves in the frontal and sagittal planes: thoracic and sacral kyphosis, cervical and lumbar lordosis, as well as pathological ones: thoracic scoliosis.

LECTURE 3. MYOLOGY

MUSCLES OF THE SHOULDER GIRDLE

Deltoid (m. deltoideus) starts from the outer edge of the acromion, the anterior edge of the lateral third of the clavicle, the spine of the scapula, attaching to the deltoid tuberosity.

Function: the scapular part extends the shoulder, lowers the raised arm down; the clavicular part bends the shoulder, lowers the raised arm down; the acromion abducts the arm.

Innervation: n. axillaris.

Teres minor muscle (m. teres minor) originates from the lateral edge of the scapula and infraspinatus fascia, attaching to the lower platform of the greater tubercle of the humerus.

Function: shoulder supination.

Innervation: n. axillaris.

Teres major muscle (m. teres major) originates from the lower angle of the scapula, infraspinatus fascia, the lower part of the lateral edge of the scapula, attaching to the crest of the lesser tubercle of the humerus.

Function: with a fixed scapula: brings the raised arm to the body, extends and pronates the shoulder in the shoulder joint; with a strengthened arm: pulls the lower angle of the scapula outward with a forward shift.

Supraspinatus muscle (m. supraspinatus) originates from the posterior surface of the scapula above the scapular spine and from the supraspinatus fascia, attaching to the upper platform of the greater tubercle of the humerus.

Function: abducts the shoulder, retracting the joint capsule.

Innervation: n. subscapularis.

Infraspinatus muscle (m. infraspinatus) originates from the posterior surface of the scapula under the scapular spine and from the infraspinatus fascia, attaching to the middle platform of the greater tubercle of the humerus.

Function: supination of the shoulder while retracting the joint capsule.

Innervation: n. suprascapularis.

Subscapularis muscle (m. subscapularis) originates from the lateral edge of the scapula and from the surface of the subscapularis fossa, attaching to the lesser tubercle and the crest of the lesser tubercle of the humerus.

Function: pronation and adduction of the shoulder to the body.

Innervation: n. subscapularis.

SHOULDER MUSCLES

Anterior shoulder muscle group .

Biceps brachii (m. biceps brachii) consists of two heads. The short head (caput breve) starts from the apex of the coracoid process of the scapula, and the long head (caput longum) starts from the supraspinatus tubercle of the scapula. Both heads in the middle of the humerus form a single belly, the tendon of which is attached to the tuberosity of the radius.

Function: flexes the shoulder at the shoulder joint, supinates the forearm turned inward, flexes the forearm at the elbow joint.

Coracobrachialis muscle (m. coracobrachialis) originates from the apex of the coracoid process, attaching below the crest of the lesser tubercle to the humerus.

Function: bends the shoulder at the shoulder joint and brings it to the body. When the shoulder is pronated, it participates in the outward rotation of the shoulder.

Innervation: n. musculocutaneus.

Brachialis muscle (m. brachialis) originates from the lower two-thirds of the body of the humerus between the deltoid tuberosity and the articular capsule of the elbow joint, attaching to the tuberosity of the ulna.

Function: flexes the forearm at the elbow joint.

Innervation: n. musculocutaneus.

Posterior shoulder muscle group .

Elbow muscle (m. anconeus) originates from the posterior surface of the lateral epicondyle of the shoulder, attaching to the lateral surface of the olecranon process, the fascia of the forearm and the posterior surface of the proximal part of the ulna.

Function: extends the forearm.

Innervation: n. radialis.

Triceps brachii (m. triceps brachii) has three heads. The medial head originates on the posterior surface of the shoulder between the olecranon fossa and the insertion of the teres major muscle. The lateral head originates from the outer surface of the humerus between the groove of the radial nerve and the insertion of the teres minor muscle. The long head starts from the subarticular tubercle of the scapula. The heads unite and form the belly of the muscle, the tendon of which is attached to the olecranon process of the ulna.

Function: extends the forearm at the elbow joint, the long head is involved in straightening and adducting the shoulder to the body.

Innervation: n. radialis.

MUSCLES OF THE FOREARM

Anterior muscle group of the forearm .

The anterior muscles of the forearm are located in four layers.

First or superficial , layer of muscles of the forearm.

Pronator teres (m. pronator teres) originates from the medial epicondyle of the shoulder, fascia of the forearm, medial intermuscular septum (this is its largest part) and from the coronoid process of the ulna (this is its small part), ending in the middle of the lateral surface of the radius.

Function: rotates the forearm along with the hand to the ulnar side, participates in flexion of the forearm at the elbow joint.

Innervation: n. medianus.

Palmaris longus muscle (m. palmaris longus) originates from the medial epicondyle of the shoulder, adjacent muscular septa and fascia of the forearm, attaching in the middle of the forearm.

Function: participates in flexion of the hand and stretches the palmar aponeurosis.

Innervation: n. medianus.

Brachioradialis muscle (m. brachioradialis) originates from the lateral supracondylar crest of the humerus and the lateral intermuscular septum, attaching to the lateral surface of the distal end of the radius.

Function: bends the forearm at the elbow joint, sets the hand in a mid-position between pronation and supination, rotates the radius.

Innervation: n. radialis.

Flexor carpi radialis (m. flexor carpi radialis) originates from the medial epicondyle of the shoulder, medial intermuscular septum and fascia of the shoulder, attaching to the base of the second metacarpal bone.

Function: flexes the wrist, participates in abduction of the hand to the lateral side.

Innervation: n. medianus.

Flexor carpi ulnaris (m. flexor carpi ulnaris)

Ticket number 1.

1. Skeleton of the lower limb: sections. The structure of the femur. Hip joint: structure, biomechanics.

The skeleton of the free lower limb (skeleton membri inferioris liberi) consists of the femur, two bones of the lower leg and bones of the foot. In addition, there is another small (sesamoid) bone adjacent to the femur - the patella.

The femur, femur, is the largest and thickest of all the long tubular bones. It has a diaphysis, metaphyses, epiphyses and apophyses. The upper (proximal) end of the femoral head, caput femoris (epiphysis), slightly down from the middle on the head there is a small rough pit, fovea captits femoris, - the place of attachment of the ligament of the femoral head. The head is connected to the rest of the bone through the neck, collum femoris. At the junction of the neck and the body of the femur, two bony tubercles, called trochanters (apophyses), protrude. Greater trochanter, trochanter major, upper end of the body of the femur.

The lesser trochanter, trochanter minor, is located at the lower edge of the neck on the medial side and somewhat posteriorly. Both trochanters are connected to each other on the posterior side of the femur by an obliquely running ridge, crista intertrochanterica, and on the anterior surface - linea intertrochanterica.

The body has a triangular-rounded shape; on its back side there is a trace of the attachment of the thigh muscles, linea aspera, consisting of two lips - the lateral one, labium laterale, and the medial one, labium mediale. At the bottom, the lips, diverging from each other, limit a smooth triangular area, facies poplitea, on the back of the thigh.

The distal end of the femur forms two condyles, condylus medialis and lateralis (epiphysis). On the posterior and inferior sides, the condyles are separated by a deep intercondylar fossa, fossa intercondylaris. On the side of each condyle above its articular surface there is a rough tubercle called epicbndylus medialis lateralis.

Hip joint, art. coxae, is formed on the side of the pelvic bone by a hemispherical acetabulum, acetabulum, more precisely its facies lunata, which includes the head of the femur. A fibrocartilaginous rim, labium acetabulars, runs along the entire edge of the acetabulum. The acetabulum is covered with hyaline articular cartilage only along the facies lunata, and the fossa acetabuli is occupied by loose adipose tissue and the base of the ligament of the femoral head. The hip joint has two more intra-articular ligaments: the mentioned lig. transversum acetabuli and ligament of the head, lig. capitis femoris, which with its base begins from the edges of the acetabulum notch and from the lig. transversum acetabuli; with its apex it is attached to the fovea capitis femoris. The head ligament is covered with a synovial membrane, which rises onto it from the bottom of the acetabulum. It is an elastic lining that softens shocks. Therefore, if this shell is preserved during fractures of the femoral neck, the head does not become dead.

The hip joint is a ball-and-socket joint, and therefore allows movement, as in a free ball-and-socket joint, around three main axes: frontal, sagittal and vertical. Circular movement, circumductio, is also possible.

Around the frontal axis there is flexion and extension, around the sagittal axis abduction and adduction of the leg occurs, around the vertical axis there is rotation of the lower limb in and out.

2. Inferior vena cava.

Inferior vena cava, v. cava inferior, collects blood from the lower extremities, walls and organs of the pelvis and abdominal cavity. The inferior vena cava begins on the right anterolateral surface of the IV-V lumbar vertebrae. It is formed from the confluence of two common iliac veins, left and right.

The inferior vena cava receives two groups of branches: parietal and splanchnic.

The parietal branches include:

A) Lumbar veins vv. lumbales, two on the left and right, go between the muscles of the abdominal wall. The lumbar veins receive the posterior branch, which runs between the transverse processes from the skin and muscles of the back, and in the area of the intervertebral foramina - blood from the venous plexuses of the spinal column. The lumbar veins contain a small number of valves;

B) Inferior phrenic vein, v. phrenica inferior, steam room, accompanies the branches of the artery of the same name on the lower surface of the diaphragm and flows under the diaphragm into the inferior vena cava.

Internal branches:

A) Testicular vein, v. testicularis, (in women ovarian, v.ovaria) originates in the scrotum with the own veins of the testicle. The latter emerge in the area of the posterior surface of the testicle, connect with the veins of the epididymis and form several small stems, which, anastomosing among themselves, form the pampiniform venous plexus, plexus pampiniformis.

B) Renal vein, v. renalis, is formed in the area of the renal hilum from the fusion of 3-4, and sometimes more, veins emerging from the renal hilum. The renal veins are directed from the hilum of the kidney to the medial side and flow at a right angle into the inferior vena cava at the level of the intervertebral cartilage between the I and II lumbar vertebrae (the left one is slightly higher than the right). The renal veins receive veins from the fatty capsule of the kidney and the ureter. Left renal vein, v. renalis sinistra, longer than right; she takes v. suprarenalis sinistra et v. testicularis and crosses the aorta in front.

The renal veins anastomose with the lumbar veins, vv. lumbales, azygos and semi-gypsy veins, v. azygos et v. hemiazygos.

B) Adrenal veins. vv. suprarenales, are formed from small veins emerging from the adrenal gland. Left adrenal veins, vv. suprarenales sinistrae, join v. renalis sinistra; right adrenal veins, vv. suprarenales dextrae, most often flow into v. cava inferior, and sometimes in v. renalis dextra; in addition, some of the adrenal veins flow into the inferior phrenic veins.

D) Hepatic veins, vv. hepaticae, are the last branches that the inferior vena cava receives in the abdominal cavity and generally before entering the right atrium. The hepatic veins collect blood from the capillary system of the hepatic artery and portal vein in the thickness of the liver.

3. Prostate gland, seminal vesicles, bulbourethal glands: innervation, blood supply, lymph nodes.

The prostate gland, prostata, is located in the anterior lower part of the pelvis under the bladder, on the urogenital diaphragm. The initial section of the urethra and the right and left ejaculatory ducts pass through the prostate gland.

In the prostate gland, there is a base, basis prostatae, which is adjacent to the bottom of the bladder, seminal vesicles and ampoules of the vas deferens, as well as the anterior, posterior, inferolateral surfaces and apex of the gland. The anterior surface, faces anterior, faces the pubic symphysis, to which the lateral and median puboprostatic ligaments, ligg, go from the prostate gland. puboprostaticae, and puboprostatic muscle, m. puboprostaticus.

The posterior surface, faces posterior, is directed towards the ampulla of the rectum and is separated from it by a connective tissue plate - the rectovesical septum, septum rectovesicdle.

The inferolateral surface, faces inferolateralis, faces the levator ani muscle. The apex of the prostate gland, apex prostatae, faces down and is adjacent to the urogenital diaphragm.

The prostate gland has two lobes: the right, lobus dexter, and the left, lobus sinister. The area of the gland protruding on the posterior surface of the base and bounded by the urethra in front and the ejaculatory ducts in the back is called the isthmus of the prostate gland, isthmus prostatae, or the middle lobe of the gland, lobus medius.

The structure of the prostate gland. Externally, the prostate gland is covered with a capsule, cdpsula prostatica. The capsule consists of glandular tissue, forming the glandular parenchyma, parenchyma, as well as smooth muscle tissue, constituting the muscular substance, substdntia musculdris.

Vessels and nerves of the prostate gland. The prostate gland is supplied with blood by numerous small arterial branches arising from the inferior vesical and middle rectal arteries (from the system of internal iliac arteries). Venous blood from the prostate gland flows into the venous plexus of the prostate, from it into the inferior vesical veins, which flow into the right and left internal iliac veins. The lymphatic vessels of the prostate gland drain into the internal iliac lymph nodes.

The nerves of the prostate gland originate from the prostatic plexus, into which sympathetic (from the sympathetic trunks) and parasympathetic (from the pelvic splanchnic nerves) fibers arrive from the lower hypogastric plexus.

The seminal vesicle, vesicula (glandula) seminalis, is a paired organ located in the pelvic cavity lateral to the ampulla of the vas deferens, above the prostate gland, behind and to the side of the bottom of the bladder. The seminal vesicle is a secretory organ. The seminal vesicle has an anterior and posterior surface.

The bulbourethral gland, glandula bulbourethralis, is a paired organ that secretes a viscous fluid that protects the mucous membrane of the wall of the male urethra from irritation with urine. The bulbourethral glands are located behind the membranous part of the male urethra, in the thickness of the deep transverse perineal muscle. The bulbourethral glands are supplied with blood by branches from the internal genital arteries. Venous blood flows into the veins of the penile bulb. The bulbourethral glands are innervated by branches of the pudendal nerve and from the plexuses surrounding the arteries and veins (from the venous plexus of the prostate).

4. Classification and significance of the nervous system.

The function of the nervous system is to control the activities of various systems and apparatuses that make up the whole organism, to coordinate the processes occurring in it, to establish the relationship of the organism with the external environment.

The nervous system consists of:

1) central nervous system: brain, spinal cord,

2) peripheral nervous system: somatic (voluntary) nervous system and autonomic (involuntary) nervous system. In the composition of vegetative n.s. includes the sympathetic system (stimulates the body and mobilizes its energy) and the parasympathetic system (relaxes the body and conserves its energy). Unity of somatic and vegetative n.s. in that they develop from the neural tube, have a general principle of structure (nerve cells, nuclei, nodes, fibers) and conduct nerve impulses under the control of the cerebral cortex. The structural and functional units of the nervous system are neurons that contact each other through processes - dendrites and axons. This forms a branched complex that transmits commands from the brain (central nervous system) to the skeletal muscles (peripheral nervous system) and automatically regulates the work of involuntary muscles (vegetative autonomic nervous system).

The brain is part of the central system located inside the skull. Consists of a number of organs: the cerebrum, cerebellum, brainstem and medulla oblongata. The spinal cord forms the distribution network of the central nervous system. It lies inside the spinal column, and all the nerves that form the peripheral nervous system depart from it. The autonomic nervous system regulates the internal activities of the body; its work does not depend on our will. Performs its functions through two systems that coordinate the work of different organs - sympathetic and parasympathetic. Peripheral nerves are bundles or groups of fibers that transmit nerve impulses.

Maxim Vasilievich Kabkov

Normal human anatomy

1. General information about osteology

Skeleton is the totality of all the bones of the human body. There are more than 200 bones in the human body.

Human skeleton:

1) performs a supporting function, supporting a variety of soft tissues;

2) protects internal organs by creating containers for them;

3) is a depot organ for many important microelements (calcium, phosphorus, magnesium).

Bone is composed of 29% organic, 21% inorganic, and 50% water.

Classification of bones:

1) tubular bones (os longum). Most often they have a triangular or cylindrical shape. The length of the bone can be divided into approximately three parts. The central part, which makes up most of the length of the bone, is the diaphysis, or the body of the bone, and the epiphysis, the marginal parts that have a thickened shape. The epiphyses have an articular surface)