Full transcript
0:00We're covering classifications or types
0:02of bones just based on their shape. And
0:05we did this with other types of tissue.
0:07Remember, there's four types of tissue
0:08in the body. Epithelial, connective,
0:11muscle, and nervous. And we look at
0:13connective tissue. There's three types.
0:15Connective tissue proper. We learn
0:18connective tissue fluid and now
0:19supporting. And supporting includes our
0:22cartilage and bone. So, we're on to bone
0:24now. But we start by just naming how do
0:26we describe them and compare them to
0:28others based on their shape or or type.
0:31We start to do this with epithelial
0:33tissue because we name based on cell
0:35layer and the shape of the cells.
0:37Remember we talked about cuboidal
0:38columnar. So we do the same thing with
0:41bones because we try to compare them and
0:44especially when we start to learn how
0:45they grow and how they develop through
0:48osteogenesis and bone development which
0:50is oification. So, our classification of
0:52types of bone, simply put, one is long
0:55relative to another one is short. So,
0:58we're comparing them relative to other
1:00bones. So, our our long bones include
1:02things like the femur, the humorris, the
1:05tibia, the fibula, relative to bones
1:09like the toarscils. And here are the
1:11carpals. So, there's eight carpals here
1:13that we'll come back to naming them in a
1:15future video, but these are short bones
1:18relative to the long one. So, you have
1:19short bones. And then we get into things
1:21like flat bones. So flat bones, I showed
1:24two examples here. First, the sternum is
1:27a flat bone. This bone takes about 20 25
1:30years for it to completely all fuse
1:31together. And then we have our ribs. We
1:34have different types of ribs. We have
1:36true and false and floating. And they
1:38curve, but relative to other bones,
1:41they're still flat. So they may curve,
1:43but relative to a long and a short,
1:46they're flatter bones. Okay? And then
1:49irregular. They're all over the place.
1:50Some of my facial bones. So my face is
1:53irregular. And my vertebrae. So this is
1:56stacking three vertebrae here. But they
1:58they're not long, they're not short,
2:00they're not flat. They're kind of all
2:01over the place. So we call them
2:02irregular.
2:04And then sesimoid bone. The primary
2:07example any text will give for a
2:08sesimoid bone is the patella. And
2:10sesimoid bone means sesame like it looks
2:14like a sesame seed. And this is looking
2:16at the kneecap or patella. And it's
2:18going to be surrounded by other types of
2:20tissue. So I'll have other connective
2:23tissues in our connective tissue proper
2:25that will cover over the top of this. So
2:27it's actually embedded in other types of
2:30tissue. This makes it a sesimoid bone.
2:32We see this also in our hands and our
2:35feet, but the primary example is going
2:37to be your patella. And then sutral
2:40bone. So I have dense fibrous tissue
2:43that helps connect all of my cranial
2:46bones. And when I look at facial, we'll
2:48come back to sutures as well, but
2:50they're sutral and it's the boundaries
2:52of each of these bones as they come
2:54together and fuse. And so later videos,
2:57we'll talk about fontels and how we see
2:59those early on in development. And then
3:01sutures and suture bones are just these
3:04tiny little fragments that help create
3:07the actual skull or cranium. And these
3:10connections we'll learn as we describe
3:12how the bone develops and comes
3:14together. So sutral bones. And then
3:16lastly, pneumatized bone. Some texts
3:19don't talk about pneumatized bone, but
3:22this is an example of the ethmoid bone.
3:24So the ethmoid bone comes right in top
3:26of my nose and it'll show up on the
3:28inside the cranial floor when I open up
3:30the cranium. But a pneumatized is
3:33essentially it's an irregular bone, but
3:36the difference is it has a lot of air
3:38sacks to it. And this helps with like
3:40our sinuses and draining when we think
3:43about just getting into our nasal
3:45cavity. But we also use it to breathe.
3:48So as air goes through the different
3:50holes that we'll describe with the
3:51ethmoid bone, it helps us stimulate the
3:53olfactory nerve, cranial nerve number
3:56one for olfaction or smell. So
3:58pneumatized by definition meaning it has
4:01more air sacks to it. We'll see in other
4:03types of bones the temporal bone has a
4:05landmark called the mastoid process that
4:08has air sacks to it. So it's unique in
4:10the sense and how it's developed. So I
4:13have long short flat irregular sesimoid
4:17sutral and pumatized. These are shapes
4:21and we describe them as classifications
4:23of bones or types of bones. And now
4:25later in next video we'll talk about the
4:28makeup of bone. How do we get to this
4:30point to where we see these types? We're
4:32covering the makeup of bone. How do we
4:34actually create a bone? Later we'll talk
4:37about growth and development. But we
4:39start out which what are the actual
4:41cells that give me the tissue that we
4:43see. Remember there's four types of
4:45tissue and we look at connective tissue.
4:47We said it's specialized cells that make
4:49a matrix. When we learned epithelial
4:52tissue, we describe one of their
4:53characteristics as cellularity with
4:56tightly bunched cells, not much material
4:58in between relative to the other
5:01tissues. When we cover connective tissue
5:04and look at bones, now we have cells
5:06that become specialized because they're
5:08making a matrix. Remember, a matrix
5:10includes two things, protein fibers and
5:13ground substance. So, we're describing
5:15this. When we look at the cells of bone,
5:18it only accounts sometimes up to 2 to 3%
5:21of all of the tissue. The rest is what
5:24it makes, which is the matrix. And then
5:26we have a balance of some cells that
5:28help to create a homeostatic balance
5:31during repair and building the bone as
5:34we grow up to 25 years old. So let's
5:37cover these cells. Starting with
5:39mezenyim or mezenymal tissue. Mezenymal
5:43cells are the basic embryionic stem
5:45cells for which all connective tissue
5:48will arise. So anything from our dense
5:51regular connective tissue to our
5:52cartilage. We start out with mezenymal
5:55tissue. We have a basic starting point.
5:58So these are the embryionic stem cells.
6:01Once we learn that we're turning into
6:03bone, meaning there's there's markers in
6:05the DNA that will be activated to say
6:07we're going to be at this place. We're
6:08creating bone. Meenymal tissues will
6:11then turn into the specialized cells
6:13that make bone. So we start with the
6:15stem cells called osteoprogenitor
6:18cells. So messenymal cells turn into
6:22osteoprogenitor cells. Remember the key
6:24term of differentiation that cells
6:27change over time. No different than you
6:29change over time. You go from a baby to
6:31a child to a teenager to adult and you
6:34change as you get older but it's still
6:36you. So mezenymal will change into
6:39osteoprogentor cells. These are now the
6:41stem cells of bone. So we now mature to
6:44where we get to the point to where we're
6:45going to start going through mitosis.
6:48Osteoprogentor cells keep dividing and
6:51eventually will then turn into the cells
6:53that actually do the work. So
6:55osteoprogentor cells are still stem
6:58cells, but they're specific to bone.
7:00They will turn into osteoblast.
7:03Osteoblasts are the young cells, the
7:06baby cells for B and blast, B for baby.
7:09Osteoblasts are the ones that are going
7:11to secrete the matrix. So, they're
7:13actively doing something and creating
7:15the foundation. To me, it's like
7:17creating the house. It's the people that
7:18live in the house that are building it.
7:21There's only a couple people living in
7:22the big house that they're building.
7:24Remember, we said bone cells account for
7:26only sometimes 2 to 3% of all the bone
7:28depending on the bone. Osteoblasts get
7:31older and become osteocytes and they
7:34help maintain the matrix. Remember
7:36osteoblasts as they get older and they
7:38become sightes they now form that bubble
7:41around it called the lacun. So
7:44osteocytes and lacuna. So now you have
7:46two cells. The younger cells secrete the
7:49matrix. Osteocytes are the ones that
7:51help maintain it. Now we finally get to
7:54the point to where all that
7:56differentiation occurred and you have
7:58actual bone material. Now I put this in
8:02red for osteoclass.
8:04Osteoclass come from what we call
8:06macrofasages. Remember luccoytes are
8:09white blood cells. These are
8:11macrofasages. Macrofasages engulf and
8:14eat things. And so osteoclass with the C
8:17what they do is they break down bone
8:20which is helpful when I break a bone and
8:22help to repair and remodel it. So in
8:24theory it goes back to the same shape.
8:26Remember in a previous video we talked
8:28about long short irregular flat the
8:30types of bone. So based on the DNA it
8:33knows how to regrow it to the same
8:35shape. And when we look at osteoclass
8:37they help for as the bone develops over
8:40time. When my bone grows, it's getting
8:43bigger and bigger. So, if I think about
8:45my femur, the biggest bone in the body,
8:47when I go from 10 years old to 20 years
8:49old, it's increasing dramatically in
8:51size. To help support the bone, I got to
8:54make sure there's enough inside material
8:57to make it function. So, the diameter
9:00will increase, but then I have to allow
9:02room for it to develop. So, osteoclass
9:05will help create that room. And
9:07specifically, they're breaking down the
9:09inside to allow more structural support.
9:12So, intuitively, that seems off. But if
9:14I'm going to build the house and I keep
9:17adding the walls to it, I'm going to
9:19need to do more inside the house and
9:21specifically give me more more room for
9:23it to function. If the body needs
9:26calcium, osteioclass will break down
9:29some of the bone to demineralize it and
9:31take some of that calcium and put it in
9:33the bloodstream. So osteoclass is a
9:35homeostatic balance and it helps us to
9:38create the bones, remodel it, provide
9:40that calcium in the body when need it.
9:43And so we're finally at that point to
9:44create that balance and let's get into
9:46the matrix. So the matrix remember is
9:49made by osteoblast. So osteoblast
9:52secrete the matrix. Our matrix includes
9:55two things protein fibers and ground
9:58substance. protein fibers. Three types,
10:01collagen, elastic, and reticular.
10:05Up to a third of all the matrix is
10:07including our collagen fibers. Remember,
10:10collagen fibers are the most abundant
10:12and they're the strongest to give us
10:14tensile strength. So, these protein
10:16fibers help with that supportive
10:19flexibility.
10:21And then the ground substance is the
10:23material. Remember, it could be a fluid,
10:24it could be gelatinous, it can be hard.
10:26In this case, it's hard like bone.
10:28Calcium is our primary mineral that we
10:31use. Calcium phosphate, calcium
10:33carbonate are the primary compounds that
10:35we see in bone. Phosphate is a strong
10:39material that helps with compression. We
10:41see phosphate in the enamel of our
10:43teeth. Calcium phosphate is one of the
10:45hardest materials in our body because
10:47it's got to support that compression.
10:49Think about my teeth. As I'm constantly
10:51chewing, it supports that compression as
10:53I squeeze onto my carrot that I'm
10:55eating. Calcium carbonate similar to
10:58what's in an egg. So when you think
10:59about an egg, it's got a lot of calcium
11:01carbonate to it. So we see other species
11:03were similar in structure and function,
11:05how we do things. So I have the fibers
11:08that provide that flexibility, ground
11:10substance to help support that
11:11compression. So this all of this
11:14contains majority of what you see in
11:17bone and the body can keep rebuilding
11:19it. Remember we said that in epithelial
11:22tissue we said it does the most
11:24regeneration that I keep rebuilding this
11:26over and over again. All of my epidermis
11:29can regrow in a month. Bones still grow
11:32and repair itself and we know that when
11:33we break our bone but a lot of our
11:35skeleton is completely remodeled and
11:38replaced every 7 to 10 years depending
11:40on your health status, genetics. But as
11:42I get older that'll slow down. But we
11:44keep rebuilding it to create that
11:46strength because it's the structural
11:48support of our body. This is the makeup
11:50of bone. We're covering bone regions and
11:53structures and specifically doing this
11:55from a long bone. This long bone they
11:57have in this picture is a humorris. And
12:00we'll start with just the basic regions.
12:02And so a lot of it just understanding
12:03the terminology as we describe some
12:07different areas in structures of the
12:08bone. We have regions at the ends called
12:12the epiphosis.
12:14Plural is aes so e s. So epiphosis is
12:18the regions where we have the ends of
12:20the bones. And then I notice I put
12:23proximal and distal because we use our
12:25directional terms to understand where
12:28it's connecting. Remember proximal is
12:29closest to that attachment point. Distal
12:32is furthest away. In the middle I have
12:35the shaft or the diaphosis which is the
12:38majority of the long bone. What I don't
12:40have listed here and some texts don't
12:42talk about too much is the metaphysis.
12:44So if you notice here I put a little gap
12:47here but this is the metaphysis and
12:50metaphysis is where we have this
12:52epiphysial plate. Epiphysal plate is
12:56where I have that growth. When we talk
12:58about oifications there's two types of
13:00bone development intramebranus and
13:02endocchondrial. Endocchondrial means
13:04within cartilage and we'll come back to
13:06that in a later video. But
13:08endocchondrial is where I have this
13:10strip of highin cartilage. As the bone
13:13is developing, we're stacking high and
13:15cartilage plates together. That's called
13:17the epiphysial plate. When it's done
13:20growing, it forms bone and then it's
13:22called epiphysial line. So, it's the
13:24same thing, a line and plate. It just
13:26depends on the point of development. So,
13:28that's where the metaphysis is. You may
13:31also see the term surgical neck that the
13:34neck here is called the surgical neck
13:36referring to from the medical side of
13:38breaking a bone. So we have our regions
13:41our plates and then when we look at the
13:44type of tissue type of tissue for bone
13:47oius tissue is spongy and compact in the
13:50epiphyses I tend to see more spongy bone
13:54so the type of tissue in this region of
13:58the epiphosis is spongy bone and it's
14:00spongy because it's porous and I may not
14:03be able to see through it but it's got
14:05holes to it just like the sponge on the
14:07kitchen sink that you have I can't see
14:09through the sponge, but I know water is
14:11going to go through it. Same thing with
14:13bone. One of our primary functions is
14:15blood formation. So, we'll see blood
14:17fill within these spaces or pores of the
14:20spongy bone versus as I come down
14:23towards the diaphosis, I see more
14:26compact bone. So, compact bone gives us
14:29that compression strength as we use the
14:32bone for our movement and leverage. So,
14:35two types of tissue. And then when we
14:38look at the outside of the bone, the
14:40outside layer of this fibrous connective
14:42tissue is called the perryostium.
14:45Perry towards a periphery oium referring
14:47to bone. So it's the outside layer of
14:50the bone. As it's developing, we call it
14:52perchondrium because we'll see cartilage
14:54turn into bone. So perryioium is the
14:57outside lining. What I don't have listed
15:00here is indostium. Indoium is the tissue
15:03that'll line everything inside the bone.
15:06And we'll come back to that when we do
15:07atologology of spongy bone. So I have
15:10three regions epiphosis, diaphosis
15:13and metaphysis. And then we talk about
15:15two layers that help create it.
15:17Perryostium on the outside, indo
15:20indostium on the inside. And then I have
15:23spongy bone and compact bone. Two types
15:26of tissue. We see blood inside the
15:28spongy bone. Within this space of the
15:31diaphosis, it's called the medularary
15:34cavity or the marrow cavity. And that
15:37marrow cavity is our yellow bone marrow.
15:40So it's yellow for a reason because it's
15:41made up of atapose tissue or lipids. So
15:44it's energy supply as we need it. So
15:47within the shaft I see fat, atapost
15:51tissue. Within the epiphosis I see
15:54blood. So I use this a way not only to
15:57support the bone but also support the
16:00body if it's needed. And then lastly
16:02when I look on the outside here it's
16:04showing nutrient arteries. So I have
16:06arteries that help to attach to the
16:08perryostium and this is helping to feed
16:11the bone. We're taking blood out of it
16:13but also during growth and development
16:15we bring in these supplies because
16:17remember bones can reproduce themselves
16:19and regenerate not as fast as other
16:21tissues but roughly every 7 to 10 years.
16:24This whole bone will be redone over and
16:27over again throughout your lifetime if
16:28you live long enough. On the top here, I
16:32have what's called articular cartilage.
16:34So, we'll see articular cartilage.
16:36Remember, three types of cartilage.
16:37Highland elastic and fibroartilage. This
16:41is hyelin cartilage. Highland cartilage
16:44is one of our weaker cartilage for
16:46strength, but it provides a lot of good
16:49support during movement. So, I can move
16:51my shoulder over and over again. And
16:53remember cartilage doesn't have a blood
16:54supply. It doesn't have a nerve supply.
16:56So it makes it easy as I'm using it when
16:59I have a bone that's constantly in
17:01motion over the period of my lifetime.
17:03So articular cartilage is high
17:06cartilage. So we have our regions, we
17:08have our type of tissues compact and
17:10spongy. We have layers perryostium and
17:14osteium. So a lot of it's understanding
17:16our terminology as we learn these
17:18structures and regions of a long bone.
17:20There's two types of bone or oius
17:23tissue, spongy bone, and compact bone.
17:27How do we get to this point? There's
17:28four types of tissue in the body.
17:30Epithelial, connective, muscle, and
17:33nervous. When we look at connective
17:35tissue, there's three types of
17:36connective tissue. Connective tissue
17:38proper. We have three types of dense and
17:40three types of loose. Connective tissue
17:43fluid, which is my blood and my lymph.
17:45And then connective tissue that's
17:47supporting. So supporting connective
17:49tissue is cartilage and bone. Three
17:51types of cartilage, elastic, hyelin, and
17:54fibroartilage. Now we're looking at
17:56bone. Two specific types. Spongy and
17:59compact. They tell you what they are by
18:02their appearance. Spongy is spongy like
18:05the sponge on your sink when you're
18:07washing dishes. That it's porous. That
18:09allows something to go through it. I
18:11can't see through it, but I know the the
18:13water and the soap will go through it.
18:15And that's similar to we see blood and
18:17bones that we fill this area with blood
18:19versus compact is now solid more like
18:22the wall to give me the structural
18:24support. So it's more densely packed
18:26cells. When we look at the model here,
18:29this is referring to an osteon model and
18:31then it's got spongy bone to it. So as
18:35we look at the outer cover, remember
18:37that dense fibrous connective tissue is
18:39the perryostium. So this is the outside
18:42of the bone, the perryostium. And as I
18:44move inward, then we're looking at
18:47compact bone. So this is all compact.
18:50And then once it gets to where it's more
18:52like appearance of a sponge, this is
18:54spongy bone. So let's first look at the
18:56compact bone. When I look at compact
18:59bone, it's organized into a bunch of
19:02functional units that we call an oion.
19:04So each of these circles in circles
19:07within circles are called oons. And you
19:10can see when I pull one up and it's
19:12going the length of a long bone that the
19:15way the fibers move is it crosses this
19:18way and then it twists this way and this
19:20twists this way. So that complimentary
19:22structure how it changes every circle
19:25within it the direction it's going gives
19:27me that shock compression strength for
19:30the bone. So when I look at one osteon,
19:34what we're showing here is it's got a
19:36middle section here to where I have
19:38blood supply, lymph, nerve supply. This
19:41is called the central canal or
19:42herversion canal. So it's bringing in
19:44all the supplies. So on the side here,
19:46they're showing one that's opened up
19:48because we're constantly using this for
19:50blood formation and moving materials
19:53throughout our body. Bones are very
19:55useful for structure support, but
19:56there's a lot of things that are moving
19:58in and out. So when I look at the
20:00central canal then it expands out and
20:02you can see it's a circle within a
20:04circle within a circle within a circle.
20:07Those are called concentric lama and
20:10it's basically how they've been building
20:12and they'll circle around each other
20:13with the blood supply to keep forming
20:15those circles. This gives me an osteon.
20:18And the cells around it, what I try to
20:20indicate with those dark dots are the
20:22osteocytes or osteocytes that would be
20:25in a bubble called the lacun. And the
20:27way they interconnect are these little
20:29lines here. And these little lines are
20:31called canaliculi. Little canals
20:34canaliculi
20:36that help connect cell to cell. So it's
20:38that communication point to where we can
20:41expand and use this as way to move
20:42materials.
20:44And when I look on the sides, you can
20:46see the strength what's left over from
20:48building my osteons. These lines are
20:52called interstitial lamlet. Interstitial
20:55lamlet. So it's the way it's been formed
20:58to give me the structural support for
21:00compact bone. When I pull over and look
21:03at the slide, when I look at this, this
21:05is one nice central canal. That dark dot
21:08in the center. Central canal. Central
21:11canal. So those are indicating my
21:13oonons. So if I look at one oion, it's
21:17got a circle within a circle within a
21:19circle within a circle. Hard to see it
21:21on the histology, but some are better if
21:24we go on a higher magnification, but I
21:25can see almost it looks like a tree
21:27trunk or a dart board to where it's just
21:29a circle within a circle. These dark
21:31dots that circle around, these are all
21:34my osteocytes and the lacun and they're
21:37connected with all these faint lines and
21:39they look like eyelashes or sun rays but
21:42they're real faint through here and
21:43these are all the canaliculi and as I
21:45create these circles these are
21:47concentric lamite. I put all these oons
21:50together and I'm getting compact bone
21:53versus when we pull over to spongy bone.
21:57Spongy bone we tend to see more in the
21:59epiphosis and compact bone we see more
22:02in the diaphosis for that strength. So
22:05spongy bone is porous. So if I show on
22:08this slide here, it's these pinkish
22:11rivers here and it's a lower
22:13magnification, but I'm looking at the
22:15spongy nature of it. The darker purple
22:18inside is some of our blood or blood
22:20marrow or red bone marrow that fills in
22:23those spaces. Just like I talked about
22:25the sponge at your sink that we're
22:27filling those spaces for a reason. So
22:29when I look at the lighter pink rivers,
22:31this is all spongy bone that's been
22:34formed. So if we went on a higher
22:36magnification in the middle, I would see
22:39osteocytes and they would be in the
22:41lacun, the bubble that houses them.
22:43Towards the edge of the tissue, I'm
22:45going to see more osteoblasts because
22:48they're contributing to the formation of
22:50all of these structures that we call
22:52tvicula. So I have osteoblast the cells
22:55towards the edge in the middle. I know
22:58it's we have to go on a hard
22:59magification to see that but the cells
23:01the tiny little dots through here these
23:03are osteocytes in the middle. They're
23:05helping to form the spicules which are
23:07the little struts that form the spicules
23:09which are the little struts that give me
23:11tbvic which is the functional piece of
23:14spongy bone. So all of these little
23:17pieces are these pink pieces here. So
23:19the difference between spongy and
23:21compact is not a location. Same chemical
23:23composition. It's just how they're
23:25created and developed. So when I see my
23:27tree trunks, I know I'm looking at
23:29compact bone. When I see these pink
23:31rivers with the blood in between, I know
23:33I'm looking at spongy bone. Two types of
23:36oius tissue. We're covering bone
23:38development or oifications.
23:41As we learn how we get to understand our
23:43matrix of bone and we develop bone
23:46there's two types of ocification which
23:48is a bone development intramebranous and
23:51endocchondrial. We're just going to
23:53describe the difference between the two
23:55and then we'll have more videos talking
23:57about them independently. But when bone
24:00forms that's called osteogenesis
24:03which is bone formation. And then once
24:06it forms it can start to grow. We grow
24:08bones in two ways. in width which is a
24:11posositional growth and then in length
24:14which is interstitial growth. But we
24:16can't grow until we have the materials
24:18to develop it so it can grow. To me bone
24:21development is this process of
24:23ocification. We bring in the right
24:25materials which means the right cells to
24:28then create the right matrix to give us
24:30what we need to develop bone. Because
24:31remember bone is only sometimes 2 to 3%
24:35of cells. It's what they develop and
24:37make to form the bone that creates the
24:39actual product that you see as a bone.
24:42So two types of oification intramebranus
24:45and endocchondrial. Intramebranus is
24:48referring to within a membrane and we
24:50refer to this for dermal bone. So we say
24:52dermal like closer to the skin. So it's
24:54bones that I can when I think about
24:56intramebrous it's what I can feel. So I
24:58can feel my mandible. I can feel my
25:01frontal bone, my praa bone. Those are
25:03bones that I can actually touch and feel
25:05my clavicle. They're right at the skin
25:07dermal bones. And we call intrammebrous
25:10ocification within membranes. And we'll
25:13talk about those membranes, but it's
25:15referring to these types of dermal
25:16bones. More of a simpler process of bone
25:19development versus endocchondrial is
25:21within cartilage and specifically it's
25:24hyelin cartilage that we use it as a
25:27model. And what happens is when we talk
25:29about oification the actual definition
25:32is taking one tissue and replacing it
25:34with another. In intramebrous we take
25:37mezenyal tissue and turn it into bone
25:40and we use the cells to make bone
25:43osteoblast and then our osteoccytes to
25:45maintain it. When we look at
25:46endocchondrial we're taking first
25:49mezenymal tissue and then turning into
25:52highin cartilage to create a building
25:54block to then turn that into bone. And
25:57this can take years in many cases
25:59depending on the bone somewhere up to 25
26:02years for endocchondrial usually
26:04referring to long bones. So as we look
26:07at this let's just talk about when we
26:09talk about intramebrous
26:11this the picture here is matching the
26:13microscope slide down here but we're
26:14basically saying is I have a top sheet
26:17of mezenymal tissue and then a bottom
26:20sheet. So it's in between two sheets of
26:22tissue. Remember meenchymal tissue is
26:26our stem cells or embryionic tissue for
26:29which all connected tissue arises. So
26:31mezenymal tissue is that basic tissue
26:34that then it differentiates and turns to
26:36other types of cells to give me the
26:39final product. In this case we're
26:40talking about bone. So we'll see two
26:43sheets, one here and one here of
26:46mezenymal tissue that'll gradually
26:49migrate and change with the blood supply
26:51to give me the actual structure of bone.
26:55How do we do that? Well, the mezenymal
26:57cells turn into osteoblasts. Some books
27:00will say, well you also see
27:01osteoprogenitor cells, which we'll talk
27:03about that in the next video, but it
27:05turns it into bone because the cells
27:08change. And because the cells change,
27:10their function changes. And what are
27:12they doing? They're secretreting the
27:13matrix, which is that osteoid to where
27:16you're getting the calcification.
27:18Calcification is creating the
27:20mineralization of the bone specifically
27:22using calcium, calcium phosphate,
27:24calcium carbonate. So I look down below
27:27here. This dark purple is trying to show
27:29you the formation of bone. And you could
27:31start to see that it's looking more like
27:33spongy bone. So we're turning this into
27:36spongy bone. And then on the top I have
27:38a membrane sheet of tissue that mechmal
27:41tissue and then also here on the bottom.
27:44So in between two membrane sheets I'm
27:46creating this type of bone and it occurs
27:49in dermal bones versus when we look at
27:52endocchondrial this is showing you a
27:54long bone. So a lot of our long bones go
27:56through this process to where they're
27:58using now hyelin cartilage to where we
28:01occur at the epiphysial plate. So this
28:04section here at the epiphosis and then
28:08the diaphosis there's a section in
28:10between there a region called the
28:11metaphysis
28:13and this is where I have highland
28:15cartilage this is matching on this side
28:18to where there's different zones on how
28:20it develops but basically you're going
28:22to have hypertrophy or dying off of
28:24cartilage cells and where do those cells
28:26come from we start with mezenymal then
28:28it turns into hyelin cartilage so we're
28:31using condro blast and condondroytes
28:34to use this as stacking cells. So they
28:36call it a pipal plate because it's
28:39literally like we're stacking plates of
28:41cartilage that will then be replaced by
28:43bone. We're taking one tissue and
28:44turning into another. That's an
28:46oification.
28:48So once we're done growing depending on
28:50the bone like I said this could take
28:52years it turns into epiphysal line. So
28:55epiphysal plate and line is at the point
28:58in development. A plate is when it's
28:59growing. A line is when it's f finally
29:02done. So for example, some bones take a
29:04couple decades for them to actually
29:06finish their product. So we see is a
29:08difference here is that highland
29:11cartilage model that we're using and
29:13then it starts to turn into bone. So
29:15when I look at the dark purple over here
29:17for spongy bone that's forming these
29:19dark little purple sections here. So
29:21it's very baby spongy bone that we're
29:23looking at. So intramebrance and
29:25endocchondrial oifications
29:27is understanding how do we get to the
29:29final product of bone. We use our cells
29:31to create the matrix. But we can't do
29:33that without a foundation. We both start
29:36with mezenymal tissue. And then it just
29:38depends on where we're at which bone.
29:40Are we just using mezzenyal turn into
29:42osteoblast osteoccytes or we using
29:44hyelin cartilage as a model? This is
29:47intramebrous and endocchondrial
29:49oification. In the next couple videos,
29:51we'll break down the two and just go the
29:53order of the steps of the cells and how
29:55they differentiate. This is
29:57intramebranous oification which is bone
29:59development. So we're discussing just
30:01this type. In a previous video we
30:04briefly compared the difference between
30:06intramebranus
30:07and endocchondrial oification. Remember
30:11this is bone development and we're
30:12taking one tissue and turning into
30:14another. We see that throughout the
30:16course of our body in different parts
30:18that things change and specialize.
30:20That's differentiation. Our body has the
30:22ability to change from one cell to the
30:24next for the purpose of creating some
30:27type of product. In this case, it's
30:29both. When we talk about intramembranous
30:32oification, it's in between membrane
30:35bones, dermal bones. We discussed that
30:37it's part of like the mandible, some of
30:39my bones of my cranium, my clavicle.
30:42These are dermal bones that I can feel
30:44right through my skin. How they develop
30:48is starting with meenymal tissue. So in
30:50the previous video we looked at the same
30:52pictures but it's good to highlight
30:53what's happening here that this picture
30:56is describing this picture and it's a
30:58point in time of the development but
31:00essentially we have mezenymal tissue
31:03which is our basic stem cells. So what
31:05is mezenymal tissue? It's our stem cells
31:09or basic embryionic tissue for which all
31:11connective tissue arises. In other
31:13words, mezenyal tissue can turn into
31:15other types of tissue just besides bone
31:17or cartilage. it could turn into things
31:19like connective tissue proper dense and
31:22loose. So as we describe this we're
31:24specifically looking how do we form our
31:26two types of oius tissue remember that's
31:29spongy and compact bone. So what are our
31:31two types of oius tissue spongy and
31:34compact bone but we got to get to that
31:36point we got to be able to develop it
31:38and then they got to grow. So how they
31:41develop is through intramebrous
31:43oification when we talk about our dermal
31:45bones. So we start here with a sheet of
31:48mezenymal tissue and a sheet of
31:50mezenymal tissue and we're bringing in
31:52blood supply. Remember one of our
31:54functions of bone is blood formation but
31:56it's also heavily used for the
31:57development of bone to bring in the
31:59supplies we need for it to develop. And
32:01that's why I think of bone development
32:03is bring in the supplies and then it can
32:05grow. So we start with mezenymal tissue
32:08and usually two sheets of it to where
32:10the mesenymal cells are migrating but
32:13they start to change or differentiate
32:15into osteoblasts.
32:17Remember you also have osteoprogenitor
32:21cells which are then the stem cells of
32:23bone. So depending on the text sometimes
32:25messenymal will turn into
32:27osteoprogenitor
32:28and then osteoblast. You'll see some
32:31text that'll say it'll go straight for
32:32meal and skip osteoprogentor straight to
32:35osteoblast. But you still have the
32:37presence of osteoporoggenitor
32:39cells. Those are the stem cells for bone
32:42itself. So we go from mezenymal to
32:45blast. Remember baby cells for the bead
32:48blasts are the ones secretreting the
32:50matrix because we know that majority of
32:52the bone is actually what the cells are
32:54secretreting which is the matrix. That
32:56includes our protein fibers primarily
32:59collagen fibers because we have three
33:01types. You remember those three types
33:03collagen, elastic and reticular.
33:06Collagen is for our strength. So we use
33:08it for bone and it's the most abundant
33:10fibers. So osteoblast is secretreting
33:13the matrix of collagen fibers but then
33:16also includes that osteoid that compound
33:19that creates the ground substance. and
33:21we start to mineralize the bone and we
33:23do that through calcium. So
33:26calcification occurs as well to give us
33:29the mass that hardened material which is
33:31calcium phosphate calcium carbonate
33:34primarily. So that was a lot to say just
33:36what's going on with osteoblast but
33:38meenymal cells differentiate and turn
33:41into osteoblast to actually secrete the
33:43matrix. Remember this is occurring
33:46within now this purple area because this
33:49is the start development of bone
33:50specifically spongy bone. So those
33:54osteoblasts will continue to secrete the
33:56matrix. Remember as they get older they
33:58turn into osteocytes and they tend to
34:00form a little bubble around them called
34:02a lacun. So osteoblasts turn into
34:06osteoccytes to help maintain the tissue.
34:08Once I have these cells, I'm creating
34:11that product. And we call this spicules
34:13or tbicula. Spicules is a basic little
34:16branch that starts and as it all
34:18branches together like a tree, it
34:21becomes tbvicula. So if I just took
34:23little pieces of this in segments like
34:25this is a spicule that combines with a
34:27spicule. Here's another little strut
34:29here, a spicule, and it just starts
34:31forming all together, which is called
34:33turbicula. So you might use those terms
34:35interchangeably in some text. spicules
34:38turn into tbvicula. Once I have that
34:41final branching, now I can start to form
34:43my two tops types of oius tissue,
34:46spongy, and then it could continue to
34:48develop and turn into compact bone
34:50depending on where we're at in the bone
34:52and what type of bone it is. So it's
34:54just the basic steps but it's the key is
34:56understanding that it's the the change
34:59that we are replacing one type of tissue
35:01mezenymal tissue and with our blood
35:04supply to bring in the actual cells
35:06that'll turn into the bone making
35:09process of intramebrous ocification. So
35:12as soon as I see the difference between
35:14the two from intramebranus I just see
35:17two sheets of tissue versus when we look
35:20at endocchondrial endocchondrial
35:22oification is our next video and that's
35:24seeing highin cartilage. So we compare
35:26the two slides I'm really just looking
35:28for the bubbling of cartilage cells that
35:31we'll look at in the next video. This is
35:33intramebranus oification. This is
35:36endocchondrial oification.
35:39Endocchondrial is referring within
35:41cartilage. We looked at intramebranous
35:44ocification in a previous video to where
35:46it's within membranes of mezenymal
35:48tissue. And in endocchondrial we still
35:51use mezenymal tissue. We just add an
35:53extra step of using highland cartilage.
35:56This is often confusing for students
35:58because it's like what the heck are we
36:00talking about here? This is about how we
36:02develop bone because remember we said
36:05once we get into connective tissue we
36:06see a lot more in the spaces the
36:09interstitial spaces of cells of what the
36:12cells are making and this is the matrix.
36:14So as we develop bone we're taking one
36:18tissue and turning it into another.
36:20That's an ocification. In this case
36:22we're using cartilage high and
36:24cartilage. So what this slide is trying
36:26to show you is that when we look at long
36:28bones we tend to see more highland
36:32cartilage and the point here where this
36:34arrow is and I magnified it on this side
36:37this is our epiphysial plate and there's
36:39different zones on how we categorize the
36:42development of it I'm just going to
36:43focus on where we have this hypertrophy
36:46or the building in in larger cells of
36:49highland cartilage cells specifically
36:52condroytes that start to bubble up And
36:54then we're going to replace them with
36:56osteoblasts and osteoccytes because
36:58they're the ones that make the matrix.
37:00So remember as refer to a long bone,
37:03we're going in this development here to
37:05where we we build or develop first in
37:08the diaphosis which is the shaft and
37:11we'll call that the primary oification
37:13center. And as we gradually build out,
37:16we're building into the epiphosis or
37:18epiphyses which is the secondary
37:20oification center. And where we stack
37:23then that cartilage is in the epiphysial
37:26plate. So epiphysial plate is that point
37:29of development. As it fully develops
37:32sometimes up to 20 25 years then it
37:34becomes an epiphysial line and forms
37:36bone. So as we describe this and we just
37:40started with the basics of cartilage in
37:43the embryionic development of bones
37:45within our first six weeks inside the
37:47womb as a fetus. We're all cartilage and
37:50we're gradually changing into bone where
37:52it's needed because the cells become
37:55specialized. They differentiate. In this
37:57case, when we look at a long bone, we
37:59see a lot of cartilage and we're
38:01starting in this developmental process
38:04in the middle, which is the primary
38:06oification center. And what we're doing
38:08is mineralizing the bone at the same
38:10time. And how do we do that? We do it
38:12with calcium. Calcium phosphate, calcium
38:14carbonate. That's the mineralization or
38:17calcification of bone. So what this is
38:20saying is we're going to bring in the
38:22materials to help the bone grow. So it
38:26mentions perchondrium up here. This is
38:29referring to the outside layer of the
38:31bone which is cartilage to start. Later
38:34it becomes the perryostium
38:36which is referring to now that it's bone
38:38towards the outside.
38:40So now we go from paricondum to
38:42perryioium. We're building in this
38:45primary oification center and it
38:47gradually then going to bring in blood
38:49supply to start to build in our
38:51secondary oification center which is
38:54then the epiphosis. So what's happening
38:56here is we start with our basic
38:58embryionic cells are stem cells which
39:00are mezenymal cells. They will turn into
39:03the cells that help to make bone. You'll
39:06see osteoprogenitor cells which are stem
39:09cells for bone specifically. they turn
39:11into osteoblasts and osteoblasts are the
39:15ones that are starting to secrete the
39:17matrix and when we see that that's
39:19coming through the blood supply to take
39:21over that cartilage that we built. So
39:24this is where we start to see that
39:26epiphysial plate that's building as a
39:30long bone. And when that epiphysial
39:33plate continues to grow, we just stack
39:36cartilage cells. And the specific
39:38cartilage cells are my condo sites. And
39:41those condo sites, we go through what's
39:43called aertrophy or hypertrophy. They
39:45get larger and larger and die off. And
39:47we replace them with the bone cell. So
39:49what you're seeing here is from this
39:51growth plate, all this dark purple here
39:54is starting the formation of basically
39:56baby bone. And you can see it looks
39:58somewhat porous. It's forming spongy
40:01bone and then it'll gradually turn into
40:04compact bone where needed. So we go
40:06through messenymal cells. They turn into
40:09cartilage. So condond condro blasts
40:11condondroytes because those are the
40:13cells that make my highland cartilage.
40:15We take over that highland cartilage
40:17model. So we built the framework for the
40:20bone but would then we replace it with
40:21osteoblast and osteoccytes to secrete
40:24the bony matrix. There's two types of
40:26tissue that we're trying to develop
40:28spongy bone and compact bone. So that's
40:32the big difference with endocchondrial.
40:34We see it in long bones and we're using
40:36a highland cartilage model. When I look
40:38at intramembranous
40:40slide I don't see this stacking in the
40:43bulgy condondroytes. So when you're
40:45looking at histologology just process
40:48elimination I'm trying to find that
40:50cartilage model first if I don't see it
40:53then I know I'm looking at intramebranus
40:55this is endocchondrial oification the
40:57development of bone specifically for
40:59long bones we're going to cover some of
41:01our cranial bones and then we'll look at
41:03the sutures associated with cranial
41:05bones and then move on to facial bones.
41:07So when we look at our cranial bones,
41:09there's eight bones total, but only six
41:11terms because two of the bones have two
41:15of them. So as we cover the frontal
41:17bone, we start with just the frontal
41:19side. So our forehead is our frontal
41:21bone. That's number one. Over the top,
41:24we have two parietal bones. Parietal
41:28bones. As they go posterior, oipital
41:32bone. I tried to outline it here for
41:34you. This is occipital bone. And then on
41:37the sides I have a temporal bone where
41:40my ear is temporal bone. And then same
41:43thing on the other side. Temporal bone.
41:46When I look inside the skull, we're
41:48going to look at ethmoid and spinoid.
41:52And I'm going to turn it this way. This
41:53is anterior. Tried to highlight this
41:56best I could. But the green here, this
41:58is the part of the ethmoid bone, one of
42:01our pneumatized bones. And then where I
42:04drew the purple that's creating the
42:07boundary there, this is the spinoid
42:09bone. Spinoid bone. So eight bones total
42:12when we look at our cranial bone. One
42:15frontal parietal two and three occipital
42:19on the back four. My temporal five and
42:23six. And when I open it up and look
42:26inside our cranial fossas at the floor
42:29here, ethmoid 7, sphenoid 8. So our
42:33eight cranial bones. Let's look at some
42:36of the sutural bones. This is dense
42:38fibrous connective tissue to connect our
42:40bones together. So these sutures that
42:43come across. First we'll start with as
42:46it creates this boundary to connect my
42:49frontal my pietals. This is the coronal
42:52suture. So coronal suture just like we
42:56cover sections or planes a sagittal cut
42:59this is the sagittal suture. So we did
43:02coronal sagittal. As I come to the
43:05posterior side with the oipital bone
43:08this outline here this is all lambdoid
43:12lambdoid or lamoidal suture. And then on
43:16the sides where I see my temporal bone
43:19this is squamus or squamosal suture. So,
43:22squamus suture. So, as we cover the
43:25sutures, they're combining to the bones.
43:28Now that we've talked about the cranial
43:29bones, let's look at some of the bony
43:31landmarks or bony markings of those
43:34bones. So, when we look at our frontal
43:37bone, inside is the frontal sinus. So, I
43:40need a sagittal cut to see that. As I
43:42come across and look at the posterior
43:45side and we go back to our occipital
43:47bone, some of our bony markings, if I
43:49look at this bulge here, this little
43:52projection is called the external
43:54occipital protuberance. External
43:56occipital protuberance. And we'll attach
43:58a ligament there that's called the nucal
44:00ligament associated with lip lash. So
44:02this is the external occupants.
44:05Coming off of it on either side is this
44:08line superior nucal line. Superior nucal
44:13line external occipital protuberance
44:16superior nucal line. Then below there's
44:20an inferior nucal line that's underneath
44:23or inferior to my superior. And then as
44:26I run down this is my
44:30oipital crest. Oipital median crest.
44:34occipital median crest. This will lead
44:37down to this big hole that we call the
44:40fam and magnets. Fammens are holes. It's
44:43a larger hole magnus. So framin magnum.
44:46So the hole there for our brain stem is
44:48famin magnum. On either side I have a
44:52smooth projection here on either side of
44:55fram and magnum. This is called oipital
44:58condiles. Oipital condiles is the
45:01attachment for the C1 vertebrae which is
45:03called my atlas. We say yes I love
45:06learning this stuff. So oipital
45:09condiles
45:11when we look at our temporal bone
45:13temporal bone when we look at right or
45:15left I'm using this projection here
45:17which is a process and this is called
45:19the zygomatic process and to me it's
45:22almost like you're using as a like a
45:24Bluetooth microphone. That's how I can
45:27tell right or left with this. But this
45:29is all temporal bone. That projection
45:32coming off is zygomatic process because
45:35it leads to my zygomatic bone. When I
45:38look at other projections, I have two
45:41more processes that we'll learn. This
45:43big one is a mass. This is called the
45:45mastoid process. Mastoid process.
45:50And then just like a stylus you have for
45:52an iPad or some of our phones, this
45:54projection that comes underneath,
45:57if you can see it there, that looks like
46:00a a stylus or a pen. Styloid process. So
46:05styloid process, mastoid process where I
46:10can pick my ear and I put my hole in the
46:12ear where the sound travels in. So when
46:14I hear things this is external acoustic
46:18miatus also called external auditory
46:21canal. External acoustic miatus or
46:24external auditory canal. When I open it
46:27up and I look inside I have these big
46:31bulges here. And so all of this
46:35is called the petrus part or petrus
46:37portion. This petrus part is where I
46:40hold all my inner ear structures for
46:42hearing my cookia and balance and
46:45equilibrium. So all my inner ear
46:47structures are housed inside here to
46:50protect it. This is called the petrus
46:52part. Another bony marking of the
46:54temporal bone. When I look at the
46:57ethmoid bone
47:00part of it I can see sticking out on the
47:02anterior cranial fossa here. this space.
47:05The other part of it is inside the nasal
47:08cavity. So this bone sits right in here.
47:11When I look at this whole middle plate
47:14here, that's called the nasal septum.
47:16It's a general term to describe two
47:19bones coming together. But the top half
47:21of this is called the perpendicular
47:25plate. The perpendicular plate is one of
47:27our bony markings of the ethmoid bone.
47:30So the top half is perpendicular plate.
47:34it'll come up and combine
47:37with some of our structures here that's
47:39still part of the ethmoid bone. So as I
47:41turn it this way, there's a projection
47:44here that kind of looks like a shark's
47:46fin. And this is called the crisali. The
47:49crisali that projection that sticks up
47:52crisal. The crisali sits on what we call
47:56a cribopform plate. A cribopform plate.
47:59The cristagali sits on the cribopform
48:01plate. So this is really small because
48:04this is all just the ethmoid bone just
48:06in this area where that crystal galley
48:09sits is on either side where I have the
48:12curbopform plate. And what's unique
48:14about it is I'll have if the pipe
48:16cleaner was my nerve my oldactory nerves
48:20for smell sit on either side of this.
48:22I'll you also use the cristy galley for
48:25some of our menenes attachments for dura
48:28modder. But when I look at my cribopform
48:31plate, it has holes in it. And those
48:33holes are called olfactory foramina.
48:37Framins are holes. Plural is framina.
48:40Olactory foramina. So when I breathe and
48:44I smell the molecules of whatever I'm
48:46breathing in, it's going to go through
48:47the nasal cavity through those olfactory
48:50foramina and stimulate the olfactory
48:52nerve. So I have cristagali
48:55which means crest of the rooster.
48:58And then cribopform plate is what it
49:02sits on on either side. And then the
49:04holes within the cribopform plate are
49:07all factory foramina. Now I look at the
49:10sphinoid bone which I said was part of
49:13the the floor of the middle cranial
49:15fossa. When I look at the sphinoid bone
49:18I can see that it has what's called
49:19lesser wings and greater wings. The
49:22lesser wings
49:24are at the anterior side here. So lesser
49:28wings at the top and when you look at
49:30the bone disarticulated
49:32it looks like the antlers of a bat. So
49:36this is lesser wings. The rest of this
49:41is greater wings. So greater wings
49:45and then the small lesser wings. What's
49:48going through the lesser wings is the
49:50optic canal. as I put my pipe cleaner
49:55through the holes of the lesser wing.
50:01So, I have the pipe cleaner going
50:03through the holes of the lesser wing.
50:05And that lesser wing has that hole for
50:08one specific reason. It's called the
50:10optic canal. So, the optic canal
50:14is for the eyeball. So, I'm using the
50:17optic nerve, pretend my pink pipe
50:19cleaner is my optic nerve to connect to
50:22my eyeball. So, going through the lesser
50:24wing, there's a hole called the optic
50:27canal. And so, as you're studying this,
50:29write that in your notes that it's the
50:31hole in the lesser wing. In between my
50:34two wings,
50:37lesser and greater, I have what's called
50:40the superior orbital fissure. So in
50:44between my wings I have a gap and that's
50:46called a fissure. Superior orbital
50:50fissure. And so when I show it this way
50:52it's another for blood vessels and
50:54nerves. But this attachment and I'm
50:57going to pull out the optic nerve. So
51:02then you can see that space in between
51:05is superior orbital fissure.
51:08So two holes there right at the lesser
51:10wings and the greater wings. And then I
51:12have this cradle here. We call this the
51:16celotica, which means Turkish saddle.
51:20And it's curved like a sea. And what
51:22it's supposed to do is I'm going to use
51:24this slime. And I'm just going to put it
51:27inside here to show you how I can sit
51:31seat the pituitary gland. So one of our
51:33glands, pituitary gland, sits in the
51:36celotica.
51:38So that space as I take this out is
51:42celotica
51:44and it's literally like a a bed or a
51:46crib or a cradle to hold
51:51my pituitary gland. Okay. And then we're
51:54going to learn three holes coming off
51:57the greater wing. So three holes in the
51:59greater wing are called forammen
52:01rotundum, framino valley and fammen
52:04spinosum.
52:07When I look here, three holes. This
52:10first hole is called fammen rotundum.
52:14And this will repeat on both sides in
52:16the greater wing. But frammen rotundum.
52:18And then I have frammen ovali.
52:22And then right below it I have frammen
52:25spinosum. So there's three holes that
52:27run on the sides through the greater
52:29wings. And we always have these holes
52:31for something. It's either blood supply,
52:33nerve supply, or both. So famin
52:36rotundum, framino valley and fammen
52:39spinosum.
52:41I covered that a little bit with the
52:43purple but that is spinosum. So if you
52:45can see three holes there I just
52:48remember ros
52:50rotundum o valley spinosum. So three
52:54holes that we look at. The other thing
52:56is when I go through the the feet of the
53:00spinoid bone, it's like kind of like
53:02looking at the bat underneath
53:05it sticks out on either side. This is
53:08called the terragoid process. Terragoid
53:11process. And it's just these little
53:13sections of the bone. And when I show
53:15you this picture, you can kind of see
53:18how it sits inside the cranium. But
53:22those projections that come underneath
53:27tragoid process with the silent P. And
53:30now we're covering facial bones. So all
53:32of our facial bones and then we'll look
53:34at some of the actual landmarks
53:36associated with those bony landmarks
53:39within the bones. And then also we'll
53:41look at the eye socket. The eye sockets
53:43actually seven bones. In our next video,
53:46we'll describe those seven bones that
53:48make up the bony orbit or the orbital
53:51complex. So, when we look at our facial
53:53bones, part of it makes up the eye
53:54socket. And what we'll look at is we
53:57already covered frontal bone. Then we
53:59move on to nasal bones. So, the bridge
54:02of my nose is nasal bone. The rest of it
54:06is mostly cartilage. This is my nasal
54:08bone. In between the two nasal bones is
54:12where I have a suture called the
54:13interasal suture. And then coming up
54:17that runs across this is frontto nasal
54:22suture. Front nasal suture because it's
54:25connecting nasal bones to the frontal.
54:27And then very light but just that little
54:31squiggly line there. This is frontal
54:33suture also called mtopic suture. So
54:36this is frontal suture running across
54:40like it's an upside down T
54:43frontto nasal suture and then interasal
54:47suture in between my nasal bones. So I
54:50look at I have my nasal bones when I
54:52come inside the eye
54:56just this little small area here is the
54:59lacrial bone and it's where your tears
55:02come out when you're crying when you got
55:03to learn all this stuff. This is called
55:05the lacrial bone.
55:08And lacrimal bone
55:11will help as we produce tears here and
55:13it rolls across my eyes. It'll fill up
55:15in in a duct here that we'll talk about
55:17later. But where that occurs, it's so
55:20small. The bony landmark is pretty much
55:23all of the bone and it's called the
55:25lacrial sulcus or the lacrial groove. So
55:28this is my lacrial bone, but the
55:30landmark is the lacrial groove. So when
55:33we talk about identifying things is it
55:35the bone versus the bony marking it
55:37depends on how it's asked. So the
55:39landmark is the lacrimal sulcus.
55:43When I come down and we look at my
55:45cheek, this is zygomatic bone. Zygomatic
55:49and zygomatic bone has a process here
55:52that's called the temporal process. And
55:55the temporal process connects to the
55:58temporal bone, but it's connecting by
56:00way of the zygomatic process of the
56:03temporal bone. That should be confusing
56:05the first time I say it. The two bones
56:08come together, zygomatic bone and
56:10temporal bone. Those create what we call
56:13the zygomatic arch which is that nice
56:16curve of the cheek. What we're
56:18describing are the two bony landmarks
56:20that are coming together. So the process
56:23is the opposite of the bone. So if this
56:25is zygometic bone and I divide all of
56:28this in just half. This anterior portion
56:31is called the temporal process. The
56:34other side is the zygomatic process.
56:37That's part of the temporal bone. So
56:39zygomatic bone temporal bone the
56:42processes are the opposite zygomatic
56:44process temporal process
56:47as I come down then where I grow a
56:50mustache and it'll come up along the
56:52sides of the nasal bone this is all max
56:54or maxillary bone max or maxillary bone
56:59and then I also have the vulmer bone the
57:02vulmer previously we talked about the
57:04nasal septum which is that whole middle
57:06sheath that whole middle sheath is the
57:09nasal septum but the top half of this
57:12sheath is the perpendicular plate of the
57:15ethmoid bone. The bottom half is the
57:18vulmer. Those two come together to
57:21become the nasal septum. If they break
57:22or they don't fuse together straight,
57:24it's called a deviated septum. The other
57:27thing we can see inside which is its own
57:30separate bone
57:32is the inferior nasal conci. So on
57:36either side this fold just on the bottom
57:39here and here is inferior nasal conci.
57:45And so we also have middle and superior
57:48that are part of the ethmoid bone on the
57:50picture that I'll show in the video. You
57:52can see that a little bit better. But as
57:54I describe all these folds inside,
57:56they're called conci. So it's everything
57:58besides the nasal septum. As I breathe,
58:01it creates a turbulence to help clean,
58:03warm and humidify the air in preparation
58:05for respiration. So I look inside the
58:09bottom folds on either side inferior
58:11nasal coni. The bone that comes down
58:14here the project is the vulmer and we
58:18were leading to then the mustache bone
58:20is the maxillary bone which also
58:23includes the roof of the mouth on the
58:26anterior side. So this is anterior. the
58:30roof of the mouth.
58:32This is all still the maxillary bone,
58:35but the bony marking is called the
58:37palatine process. The palletine process.
58:40As I go to the posterior, then we see
58:43the palatine bone. So I highlighted that
58:46with green there, palatine bone. So this
58:49can be confusing because the anterior
58:51portion is the maxillary bone. The
58:55posterior bone is the palatine bone. The
58:58actual name of the landmark or bony
59:00marking is the palatine process. So I
59:03have two bones that really are creating
59:05that roof of the mouth. When I look at
59:07the teeth and we see where the teeth are
59:09coming together, but I have these
59:11projections and not the teeth itself,
59:13but these are called alvolar process.
59:15These are alvolar parts. So we'll often
59:18see alvolar parts is just referring
59:20these little projections that help
59:21create that socket for the teeth to go
59:23into. we'll see part of the maxillary
59:25bone, but then when we see it on the
59:27mandible. So, let's get into the
59:29mandible. As I look at my jaw or my
59:31mandible, it's really just a nice L and
59:35it just repeats on both sides. So, when
59:37I describe the L, the mandibular ramis
59:40is the first part of the L and then the
59:43body is continuing on with the letter L.
59:46So, mandibular ramis, mandibular body.
59:50When I look at the projections that are
59:53up at the top here, the one that
59:56connects into the temporal bone, it's
59:58connecting into the mandibular fossa of
1:00:01the temporal bone. You see a little bit
1:00:03of cartilage there. It's actually
1:00:05fibroartilage for that shock
1:00:06compression, but it's going to sit
1:00:09inside there. What I'm describing is the
1:00:12condular process. So this is the
1:00:14condular process that's going to go into
1:00:17the mandibular fossa. On the anterior
1:00:20side it's called the coronoid
1:00:23process. So two processes condular
1:00:26process coronoid process but it's the
1:00:30condular process that goes into the
1:00:33temporal bone
1:00:35at that mandibular fossa. As I come down
1:00:38we see this mental protuberance.
1:00:42This is referring just how the jaw comes
1:00:44out here. Mental protuberance. And then
1:00:47I have two holes here which are called
1:00:50mental frammens. Remember holes are
1:00:53forammens. And I actually use that for
1:00:55remember holes are not just holes. We
1:00:57put something in there that's extensions
1:00:59of nerves. So I can feel that. So these
1:01:01holes in front are mental frame. We're
1:01:04covering the bony orbit or the orbital
1:01:07complex or the eye socket. We talked
1:01:10about some of our different cranial
1:01:11bones and facial bones. This is just a
1:01:13conceptual idea that the seven bones
1:01:15that make up the bony orbit fuse
1:01:18together to give me what holds my eye.
1:01:20So, we're describing just those. And I
1:01:22tried to color this the best I can, but
1:01:24this red circle as I pull it into this
1:01:28black circle, we're describing those
1:01:30bones that come together. So, there's
1:01:32seven bones. frontal, zygomatic,
1:01:34maxillary, spinoid, palatine, ethmoid,
1:01:38and lacrimal. Those fuse together to
1:01:40give me what's called my bony orbit. So
1:01:42frontal bone, which is my forehead,
1:01:45contributes down to my cheekbone, my
1:01:47zygomatic bone. We learned spinoid bone
1:01:50that makes up part of my middle cranial
1:01:52fossa, the floor inside when I open up
1:01:54the skull. And then also the same with
1:01:57ethmoid as we get towards the anterior
1:01:59cranial fossa. Remember ethmoid has that
1:02:01perpendicular plate and part of that
1:02:04will come down and stick out here with
1:02:06my nasal conci. My lacrimal bone is
1:02:10where my tears develop. So just on the
1:02:12corner of my eye here. So I get lacrial
1:02:15bone, ethmoid bone and palletine bone.
1:02:17And then down to my maxillary bone which
1:02:20is my mustache bone and part of the roof
1:02:23of my mouth but it still comes up all
1:02:25the way around my nose. So, we'll often
1:02:28use a pneumonic for these. You'll see
1:02:30different ones out there. I prefer you
1:02:32just learn the bones, but one I see
1:02:35students use is called please feed my
1:02:38zebra, but please spelled incorrectly.
1:02:42It's spelled as ple.
1:02:44So, the ple means palatine, lacrial,
1:02:48ethmoid, and spinoid. And then, so I
1:02:50said please feed just the f is my
1:02:54frontal. My the M is maxillary and zebra
1:02:59Z is a zygomatic. Sometimes not a fan of
1:03:02pneumonics as we've seen in previous
1:03:03video because now you're learning
1:03:04something completely different that's
1:03:06not associated with the I at all but
1:03:08some students like using them. So please
1:03:10feed my zebra but please is spelled P L
1:03:13E S. This is how you can remember the
1:03:15seven bones but you're already learning
1:03:18them independently.
1:03:20So this is just a concept of
1:03:22understanding the bony orbit or the
1:03:24orbital complex is how these seven bones
1:03:26fuse together to give me one distinct
1:03:28area to hold my eye. We're covering the
1:03:31vertebrae and we'll start by comparing
1:03:33the differences between cervical,
1:03:36thoracic, and lumbar just so we can tell
1:03:38the differences between them because in
1:03:41most exams or tests they ask them
1:03:43separately. So let's look at this. As we
1:03:46describe the three and we put them
1:03:48together, we can tell by size. This is a
1:03:51cervical vertebrae. This is a thoracic
1:03:54vertebrae. And this is a lumbar
1:03:57vertebrae. Now, just doing
1:03:59procelumination, the best way I can
1:04:01determine that I have a cervical is when
1:04:03I look inside, there's actually three
1:04:06holes that make up a cervical vertebrae.
1:04:10And what's unique to them are these
1:04:12holes that are in my transverse process.
1:04:15And these are called transverse
1:04:18foramina. Transverse forramina. These
1:04:21are unique to cervical ver vertebrae
1:04:23that I don't see in my thoracic
1:04:28or my lumbar.
1:04:30So just by pro elimination I could
1:04:32already determine is it cervical or not.
1:04:35And some of the cervical vertebrae, not
1:04:36all of them, but the on their spinus
1:04:40process, you can see these two little
1:04:42projections. That's called a bifid
1:04:44spinus process. That there's two heads
1:04:47coming off of it. Versus when I look at
1:04:49the other two types, thoracic
1:04:53and lumbar, they don't have those spinus
1:04:56processes that project two different
1:04:58pieces. So I can already rule out a
1:05:01cervical once I look at those two holes
1:05:04again which are transverse framina. When
1:05:06I compare
1:05:09thoracic versus lumbar the easiest way
1:05:11for me is when I look at the the hole in
1:05:14the center which is called the vertebral
1:05:16frammen. Remember frammans are holes. So
1:05:20that hole in the middle on the left this
1:05:23one's a thoracic and it's a nice circle.
1:05:26When I look at a lumbar, it's a
1:05:30triangle. So, I can compare the two just
1:05:32by that hole. The other thing I just
1:05:34look at is the design of it. When I look
1:05:37at the centrum or the body, it appears
1:05:39to have a heart shape for the body
1:05:42versus cervical and lumbar. I don't see
1:05:46that same heart shape. The other thing I
1:05:48just look at is just a general
1:05:50description of it. A lot of my students
1:05:51will say a thoracic looks like a giraffe
1:05:55or an elephant as if this was the
1:05:58elephant's trunk, which is the spinus
1:06:00process, versus a lumbar tends to look
1:06:04like a moose. So, I just go by these
1:06:07blunt processes and the appearance of it
1:06:09that a lumbar tends to look like a
1:06:11moose. Now as I get into the different
1:06:14structures, one thing to notice when we
1:06:17identify our processes that the spinus
1:06:20process is our further posterior
1:06:23structure bony landmark that this
1:06:27spinus process is always going to point
1:06:30down. This spinus process is always
1:06:32going to point down. And so we look at
1:06:35our spinus processes. These are the
1:06:37further posterior bony landmarks of each
1:06:41vertebrae. When I look at the sides as
1:06:44if it's like the wings,
1:06:47these are transverse
1:06:49processes. So transverse processes.
1:06:52Transverse process. Transverse process.
1:06:55Transverse process and a transverse
1:06:57process.
1:06:59When I look at a cervical, I know I have
1:07:02a transverse process. And that's because
1:07:04it has holes inside. Remember those are
1:07:07called transverse veramina which are
1:07:09unique to a cervical vertebrae. Now when
1:07:12I looked to how we create the actual
1:07:15vertebral arch and the circle around it.
1:07:18So as I go around and create this all
1:07:22these bony landmarks what we're
1:07:23describing first is all of them have
1:07:25this but as I look at the sententrum or
1:07:28the body I describe these as like
1:07:30bridges. So in order to get from the
1:07:33body or sentrum to the transverse
1:07:36process, I go through just this little
1:07:39bridge called a pedacle. A pedacle. And
1:07:42this is very small and difficult for
1:07:44students at first, but I just imagine as
1:07:46if I'm to drive from here to here, my
1:07:49body to my transverse process. I drive
1:07:52along this pedacle. In order to get from
1:07:58transverse process to what I'm holding
1:08:00is the spinus process. This bridge is
1:08:03called the lamina or lamina. So as I go
1:08:06from body
1:08:09to transverse process I have this little
1:08:12connection called a pedacle. In order to
1:08:14get from transverse process to spinus
1:08:16process I go through the lamina.
1:08:20So I'm describing those bridges. Now,
1:08:23how do I connect the vertebrae? What we
1:08:26use are called articular facets. And
1:08:28what I'm showing here is I'm going to
1:08:30take a couple thoracic and put them
1:08:32together. And where they're connecting
1:08:35are on these flat sections of the bone.
1:08:38And so where I'm sliding, these are
1:08:40called articular facets. And so when I
1:08:43look at it, to me, I described as if I'm
1:08:45holding my hand up with my arm. The flat
1:08:49smooth side of this
1:08:52is called the superior articular facets.
1:08:56So it's like the ears of the elephant.
1:08:59So superior articular facets and it's
1:09:04that smooth hand that's being held up by
1:09:07the arm. The arm behind it is the
1:09:10process superior articular process holds
1:09:14up the flat hand. Superior articular
1:09:16facet. So I'm using the superiors to
1:09:20attach to the inferior. So as I flip it,
1:09:23these superior tricular facets now
1:09:26appear flat on this side because this is
1:09:29the inferior articular facet. And what
1:09:33holds it up is the arm, the inferior
1:09:37articular process. So I'm using my
1:09:40processes and my facets to come together
1:09:44and they come together at those facets.
1:09:47So on top I'm using inferior articular
1:09:50facets to connect to my superior
1:09:53articular facets.
1:09:55The other unique thing about a thoracic
1:09:59vertebrae as I describe these is we're
1:10:02connecting ribs. So on my ribs I'm going
1:10:05to use my vertebral end of my ribs to
1:10:08connect to these little projections
1:10:10here, here, and here. This is superior
1:10:14costal faucet. This is inferior costal
1:10:18faucet and then on the transverse
1:10:20process that divot is transverse
1:10:23costtoal facet. So I can flip it on the
1:10:26other side too. The depression on the
1:10:28transverse process
1:10:31transverse costal faucet
1:10:34inferior costal faucet
1:10:36and superior costal faucet. Those are
1:10:40only unique to a thoracic vertebrae
1:10:44versus all the other bones have those
1:10:47other structures or bony markings that
1:10:49we learn. So transverse process, spinus
1:10:52process, superior articular facet behind
1:10:56it is the superior articular process for
1:10:59team forammen and body. So we can desri
1:11:02describe all the same for all three.
1:11:06When we look at how we describe our
1:11:10cervical vertebrae, what's unique to
1:11:12them
1:11:13is the first two and number seven. So
1:11:16now I'm going to show you
1:11:19one, two, and then we're going to get
1:11:22all the way down to seven. C7 because I
1:11:25have seven ser cervical vertebrae, 12
1:11:27thoracic, and five lumbar. This flattest
1:11:32one here, these are all cervical
1:11:34vertebrae. And how do I know that? This
1:11:36flat one still has transverse foramina.
1:11:40But it also has the widest vertebral
1:11:43forammen out of all of them. And that's
1:11:45because it's C1, also known as the
1:11:48atlas. And this is the vertebrae that
1:11:50helps us to say yes. And so I'm using
1:11:53these
1:11:55articular facets to actually connect to
1:11:57the occipital condiles of the occipital
1:12:01bone. So I have atlas which is my
1:12:05flattest
1:12:07bone and we look at it's got those wide
1:12:09features to it but it's flat versus
1:12:12number two or C2 cervical vertebrae is
1:12:16called the axis. So atlas and axis
1:12:21remember T becomes before X. So atlas
1:12:24helps to me to say yes. Axis helps me to
1:12:28say no. Now, what do I mean by that is
1:12:31that when I put the vertebrae on, we're
1:12:33going to use it to swivel to be able to
1:12:36say, "No, I don't want to learn this
1:12:38stuff." Or, "Yes, I do enjoy learning
1:12:40this stuff." How do I know this is
1:12:44axis? A lot of students will say it
1:12:46looks like Buddha and this is Buddha's
1:12:48head. And Buddha's head is called the
1:12:51dens, also known as the adontoid
1:12:54process. So, dens or adontoid process.
1:12:58And this is how I identify what's unique
1:13:00for all of our cervical vertebrae as C2
1:13:04the axis. And then lastly, we said our
1:13:07last vertebrae for cervical is C7.
1:13:10What's unique about C7? It starts to
1:13:12transform almost looking like thoracic
1:13:14where I have that long slender spinus
1:13:16process. But this spinus process is
1:13:19unique because we're going to attach a
1:13:22ligament here. We call this the
1:13:24vertebrae prominence. And this is going
1:13:27to attach one of our ligaments that goes
1:13:29to our cipal bone. So when we experience
1:13:32whiplash, it's impacting the cervical
1:13:35vertebrae. But we have more attachment
1:13:38points because we have a lot more
1:13:39movement in our cervical vertebrae. So
1:13:41that's a description of how we
1:13:43understand our different vertebrae.
1:13:46And then as we come down from lumbar,
1:13:50we're going to get to the sacrum. So,
1:13:52our last
1:13:56vertebrae, our number five lumbar is
1:13:58going to attach
1:14:00to my sacrum.
1:14:03And then after that, I'll attach the
1:14:07coxix. So, when we look at this now,
1:14:10we're describing how we have multiple
1:14:12landmarks for the sacrum and then the
1:14:14coxix. So the sacrum is five bones that
1:14:19have fused together versus the coxix or
1:14:23coxyal bone can be three to five. And
1:14:26typically we teach it as four but it
1:14:29varies on the person. In this case we're
1:14:31seeing four bones. When we look at the
1:14:33sacrum we're going to use this to attach
1:14:36as part of our pelvic girdle to the
1:14:38coxal bone. So, as we describe it, I'll
1:14:41show you it still has that weightbearing
1:14:43part of the centrum of the body. As they
1:14:46come down, we actually end up having
1:14:49some of our spinal nerve endings coming
1:14:51through what's called the sacral canal.
1:14:54and it'll go all the way down and
1:14:55there's a hole here called the sacral
1:14:57hiatus
1:14:59because the spinal cord ends around
1:15:01lumbar one lumbar 2 vertebrae and then
1:15:04it starts to expand in what we call the
1:15:06kada eina which means horse's tail. So
1:15:10when you look at a picture of you'll
1:15:11have all these nerve endings that are
1:15:13going down here to stay protected in a
1:15:15sacral canal but then you'll end up with
1:15:18still a hole that ends up here called
1:15:20the sacro hiatus.
1:15:22Along the sides you'll see more holes
1:15:26and these are called sacral
1:15:29framina. Remember frammans are whole
1:15:31plural is framina sacral framina. And
1:15:35then down the middle you'll see the
1:15:38median sacrum crest. Median sacral
1:15:41crest. And this is trying to show you
1:15:43all the spinus processes of those five
1:15:46bones that have fused together. So
1:15:49median sacral crest are foramina sacral
1:15:52foramina. And then on the sides I have a
1:15:56uricular surface on the lateral sides.
1:15:59Aruricular surface auricular surface.
1:16:03And this is to attach the sacrum. So we
1:16:07have sacrum and coxix. We're covering
1:16:10the bones of the hands and the feet.
1:16:13We're starting with a right hand and
1:16:15we're looking at the palmer view or
1:16:17anterior view in the anatomical
1:16:19position. And we're learning the
1:16:21carpals, the metacarpals, and the
1:16:23fanges. We'll start with our carpals.
1:16:26And in our wrist, we have eight bones.
1:16:28The way I teach this is with a pneumonic
1:16:31to start lateral and count four bones
1:16:34over to the medial side and then go back
1:16:36to the lateral side with four. We use
1:16:39the pneumonic so long to pinky.
1:16:45Here comes the thumb. So as we learn
1:16:49this, the first one that's the most
1:16:52proximal is scaffoid. And it's kind of
1:16:55shaped like an S. So I remember the S in
1:16:58scaffoid scaffoid
1:17:01lunate
1:17:02triquetum and we could see triquetum
1:17:05when we turn it. This is triricquetum
1:17:08and on top is pa form. So long to pinky.
1:17:15And now I continue back with the next
1:17:17four. Here comes the thumb. Hamate,
1:17:23capitate,
1:17:26trapezoid,
1:17:28and trapezium.
1:17:30Hamate, capitate,
1:17:32trapezoid, trapezium. Students tend to
1:17:35get these two last ones confused. I just
1:17:38remember that the D becomes before M and
1:17:40trapezoid
1:17:42and trapezium.
1:17:44Scaffoid, lunate, triquetum.
1:17:48Pisa form is the rock on top. Hamate,
1:17:53capitate,
1:17:54trapezoid, trapezium.
1:17:58Now to our metacarpals
1:18:011, two, three, and four and five
1:18:03metacarpals. Now we add the number
1:18:06number one metacarpal. Number two,
1:18:08number three, number four, number five.
1:18:11These are all my metacarpals. I just
1:18:13remember the big guys number one the
1:18:17thumb and the big toe are number one. So
1:18:19metacarpals
1:18:22to my digits or fanges.
1:18:24For the finger we call it the pollix.
1:18:27It's got two bones to it. It's got a
1:18:29proximal fangi and a distal fangi. So
1:18:33two bones. The rest of my fanges
1:18:36have a proximal middle distal. proximal,
1:18:40middle, distal, proximal, middle,
1:18:42distal. Now we can name them with the
1:18:44number one, two, three, four, and five
1:18:48plus its designation of proximal middle
1:18:50distal. And then it's a fangi.
1:18:53So this would be number three
1:18:57proximal fangi. This would be number
1:19:00four, middle fangi. This would be number
1:19:04five, distal fangi. This is my hand.
1:19:09When we look at the foot,
1:19:12this is a right foot. And we'll start
1:19:15with our seven tarscels, then the
1:19:18metatarscils, and then back to fanges.
1:19:21There's seven toarsils. Some students
1:19:24like to learn it with the pneumonic. I
1:19:26like to just learn the terms in this
1:19:28case because I think they're bigger
1:19:29bones, easier to learn as you study
1:19:32them.
1:19:34The big one which is the heel is the
1:19:37calccanous.
1:19:38So it's the heel what I step back on
1:19:41dorsal flexion and I have the calccanous
1:19:45on top. T for top this is all the talis
1:19:50and it curves here and it looks like
1:19:52more than one bone from here to here.
1:19:55This is all the talis.
1:19:58Calccanous
1:20:00and talis. Running across
1:20:04is nvicular.
1:20:07Calccanous. Talis. Novicular. And then I
1:20:11have one, two, and three ununiforms.
1:20:16I have a medial ununiform, intermediate
1:20:19ununiform, and a lateral ununiform. And
1:20:23then lastly on the lateral side, the one
1:20:25that's supposed to look like a cube.
1:20:26This is cub boy. So seven tarscels
1:20:30calccanous
1:20:32talis
1:20:35running across nvicular
1:20:38one two and three ununiforms
1:20:41medial intermediate and lateral
1:20:44ununiforms cuboid.
1:20:47Similar to the hand now we count our
1:20:49metatarscils except we go the opposite
1:20:51direction. Remember we said thumb and
1:20:53big toe are number one. So this would be
1:20:56one metatarsal, two, three, four and
1:21:00five metatarscils. My fanges
1:21:04for the toe we call the thumb the
1:21:07pollix. For the toe we call it the
1:21:10holix. Two bones just like the thumb.
1:21:13It's got a proximal distal fangi. For my
1:21:16toes,
1:21:18one, two, and three. Proximal, middle,
1:21:21distal. Proximal, middle, distal.
1:21:24Proximal, middle, distal, proximal,
1:21:25middle, and distal. Counting the
1:21:28numbers, this would be number two,
1:21:30proximal fangi. This would be number
1:21:33three, middle fangi. This would be
1:21:36number four, distal fangi. This is my
1:21:39foot. We're covering the bones of the
1:21:41hands and the feet. We're starting with
1:21:44a right hand and we're looking at the
1:21:46palmer view or anterior view in the
1:21:49anatomical position. And we're learning
1:21:51the carpals, the metacarpals, and the
1:21:53fanges. We'll start with our carpals.
1:21:56And in our wrist, we have eight bones.
1:21:59The way I teach this is with a pneumonic
1:22:01to start lateral and count four bones
1:22:04over to the medial side. And then go
1:22:07back to the lateral side with four. We
1:22:09use the pneumonic. So long to pinky.
1:22:16Here comes the thumb. So as we learn
1:22:20this, the first one that's the most
1:22:22proximal is scaffoid and it's kind of
1:22:25shaped like an S. So I remember the S in
1:22:28scaffoid scaffoid
1:22:31lunate
1:22:33triquetum and we could see triquetum
1:22:35when we turn it. This is triricquetum
1:22:38and on top is pa form. So long to pinky.
1:22:46And now I continue back with the next
1:22:48four. Here comes the thumb. Hamate,
1:22:54capitate,
1:22:56trapezoid,
1:22:58and trapezium.
1:23:00Hamate, capitate, trapezoid, trapezium.
1:23:04Students tend to get these two last ones
1:23:07confused. I just remember that the D
1:23:09becomes before M and trapezoid
1:23:12and trapezium.
1:23:14Scaffoid, lunate, triquetrum.
1:23:18Pa form is the rock on top. Hamate,
1:23:23capitate,
1:23:25trapezoid, trapezium.
1:23:28Now to our metacarpals.
1:23:311 2 3 and four and five metacarpals. Now
1:23:35we add the number number one metacarpal
1:23:38number two number three number four
1:23:40number five. These are all my
1:23:42metacarpals. I just remember the big
1:23:46guys number one the thumb and the big
1:23:48toe are number one. So metacarpals
1:23:52to my digits or fanges. For the finger
1:23:55we call it the pollix. It's got two
1:23:58bones to it. It's got a proximal fangi
1:24:01and a distal fangi. So two bones. The
1:24:04rest of my fanges
1:24:06have a proximal middle distal. proximal,
1:24:10middle, distal, proximal, middle,
1:24:12distal. Now we can name them with the
1:24:15number one, two, three, four, and five.
1:24:18Plus its designation of proximal,
1:24:20middle, distal. And then it's a fangi.
1:24:24So this would be number three,
1:24:27proximal fangi. This would be number
1:24:31four, middle fangi. This would be number
1:24:34five, distal fangi. This is my hand.
1:24:39When we look at the foot,
1:24:42this is a right foot. And we'll start
1:24:45with our seven tarscels, then the
1:24:48metatarscils, and then back to fanges.
1:24:52There's seven toarsils. Some students
1:24:54like to learn it with the pneumonic. I
1:24:56like to just learn the terms in this
1:24:58case because I think they're bigger
1:25:00bones, easier to learn as you study
1:25:03them.
1:25:04The big one which is the heel is the
1:25:07calccanous.
1:25:08So it's the heel what I step back on
1:25:11dorsal flexion and I have the calccanous
1:25:15on top. T for top this is all the talis
1:25:20and it curves here and it looks like
1:25:22more than one bone from here to here.
1:25:25This is all the talis.
1:25:28calccanous
1:25:30and talis running across
1:25:34is nvicular.
1:25:37Calccanous talis nvicular and then I
1:25:41have one, two and three ununiforms.
1:25:46I have a medial ununiform, intermediate
1:25:50ununiform, and a lateral ununiform. And
1:25:53then lastly on the lateral side, the one
1:25:55that's supposed to look like a cube,
1:25:57this is cuboid.
1:25:59So seven toarsils calccanous
1:26:03talis
1:26:05running across novicular
1:26:08one, two and three uniforms,
1:26:11medial, intermediate, and lateral
1:26:14uniforms. Cub boy
1:26:17similar to the hand. Now we count our
1:26:20metatarsils except we go the opposite
1:26:21direction. Remember we said thumb and
1:26:24big toe are number one. So this would be
1:26:26one metatarsal. Two, three, four and
1:26:30five metatarscils. My fanges.
1:26:34For the toe we call the thumb the
1:26:38pollix. For the toe we call it the
1:26:40holix. Two bones just like the thumb.
1:26:43It's got a proximal and distal fangi.
1:26:46For my toes
1:26:48one, two, and three. Proximal, middle,
1:26:52distal, proximal, middle, distal,
1:26:54proximal, middle, distal, proximal,
1:26:56middle, and distal. Counting the
1:26:58numbers, this would be number two,
1:27:00proximal fangi. This would be number
1:27:03three, middle fangi. This would be
1:27:06number four, distal fangi. This is my
1:27:09foot. We're covering the skeletal
1:27:11system. I'm going to mix the axillary
1:27:14and the appendicular system. We're going
1:27:16to start out with the sternum and then
1:27:18we're going to work our way all the way
1:27:19down to the arm. One of our previous
1:27:21videos, we looked at hands and feet. So,
1:27:23let's just start with the sternum. We
1:27:26can divide it into three sections. From
1:27:29my pointer up, this is all the
1:27:31manubrium. And then the bottom or distal
1:27:34portion is called the zyphoid process.
1:27:36Zyphoid means sword. Manubrium means
1:27:39handle. So, the handle is the manubrium.
1:27:42Everything in between the manubrium and
1:27:45the zyphoid process is the body. So I
1:27:48have three regions. Manubrium,
1:27:50body, zyoid process. Couple other
1:27:53landmarks or bony landmarks to learn. On
1:27:56the top this ridge here on top is called
1:27:59the jugular notch. So jugular notch on
1:28:03the sides for the clavicle clavvicular
1:28:06notches. So clavvicular notch, jugular
1:28:10notch. And then where the cartilage is
1:28:13connecting for the ribs, these are all
1:28:16costal notches. Costal referring to the
1:28:18ribs. So costal notches. Keep in mind
1:28:21this is not bone. This is cartilage.
1:28:23What type of cartilage is this? Remember
1:28:25there's three types of cartilage.
1:28:27Highland, fibrous, and elastic. This is
1:28:29highin cartilage. So this is the
1:28:31sternum.
1:28:33As we move on to a rib and connecting
1:28:37the rib, I have two ends that we're
1:28:40learning. The smoother end is referring
1:28:43to the sternal end because we're going
1:28:45to get that connection to the cartilage
1:28:48of the sternum. So sternal end is my
1:28:51smooth end. My rougher end where I have
1:28:54these projections is the vertebral end.
1:28:56So two ends, vertebral end and sternal
1:29:00end. couple of the landmarks that we'll
1:29:02learn. The actual end or the head of the
1:29:05vertebral end is the head and then in
1:29:08between is the neck. So at the vertebral
1:29:12end I have head and neck and then I have
1:29:15a tubacle. So I have this tubacle here.
1:29:19As I come down and I look on the
1:29:21inferior side, the inferior side and
1:29:25when I'm going in the posterior portion
1:29:27of the bone, this is costal groove or
1:29:29sulcus. May be hard to see on the
1:29:32screen, but when you rub your finger
1:29:33through here, you can see a groove. And
1:29:35that's protect some of our nerves and
1:29:36blood supply. And then when I determine
1:29:39right or left on this, remember I said
1:29:41that this is the sternal end. So, it's
1:29:44got to go to the sternum, either here or
1:29:47here. But I need that costal groove to
1:29:51be on the inferior side but also
1:29:54posterior. So this stays down. This has
1:29:57to go to my vertebral end. So this is a
1:29:59right rib if you can imagine it on my
1:30:01bottom. So right rib.
1:30:04As we move on to the clavicle. This is
1:30:08our collar bone but now we call it the
1:30:10clavicle. And when we look at this, the
1:30:13top part of it or superior part is
1:30:16smooth relative to the inferior portion.
1:30:20As we learn the inferior portion, that's
1:30:21where we identify a couple of our bony
1:30:23markings. Again, two ends. I have what's
1:30:27coming to the sternum. This is the
1:30:29sternal end. And this is the acromian
1:30:32end. And the chrom chromial end looks
1:30:34like a spoon to me. And it'll look like
1:30:37that on the scapula, too. So as I come
1:30:39down to the sternal end, this is going
1:30:41to connect to the sternum either like
1:30:43this or like this. And so sternal end
1:30:47acchromial end. So two ends. And when I
1:30:50turn it on the inferior side at the
1:30:52acromal end, we're learning this
1:30:54projection here which is the conoid
1:30:58tubrical.
1:30:59Conoid tubrical. So it's a little bulge
1:31:03or bump on the inferior side. When I
1:31:06come over to the sternal end, there's a
1:31:08rough projection here called the costal
1:31:11tuberosity. So these can be difficult
1:31:13for students. But as I look at the
1:31:16smooth side is my top or superior. The
1:31:20bottom is my inferior on the acchromial
1:31:22end. We are learning the conoid tubacle
1:31:26and the costal tuberosity is this rough
1:31:29projection as we get close to the
1:31:30sternal end. right or left with this. I
1:31:34use again that the top is my superior
1:31:37side. That's that smooth section. And
1:31:40when I follow the acchromial end, it
1:31:42curves like a spoon. And I want that
1:31:45spoon to project out anterior away from
1:31:48me. This is a right clavicle because I
1:31:50have to put this at the sternal end no
1:31:52matter what I do with this. But as I
1:31:55follow the acchromial end, it comes out
1:31:57and points away. So this is a right. If
1:32:00I turn this this way, the crumblen's
1:32:03going to stab me with that spoon. I
1:32:05don't want that. So, this is a right
1:32:08clavicle
1:32:09because we move on to the scapula or
1:32:13shoulder blade. It's kind of a triangle.
1:32:16So, three sides of a triangle. So, we
1:32:18name those as borders. This is a
1:32:21superior border. This is an axillary or
1:32:25lateral border because it's going to be
1:32:26at my armpit. And I know this is lateral
1:32:29because I have this connection here for
1:32:32my humorris. And that landmark is called
1:32:35the glenoid cavity. So that has to
1:32:38project lateral.
1:32:40And so that glenoid cavity is going to
1:32:42project this way. So I know this is my
1:32:44lateral side or lateral border, also
1:32:47known as axillary because it's my
1:32:48armpit. This is medial border because
1:32:51it's going to be more medial and it's
1:32:53also called the vertebral border because
1:32:55it's closer to the vertebral colum on
1:32:57top superior border. So three sides of
1:33:00the triangle lateral border, superior
1:33:03border and medial border. As I look at
1:33:06these projections, these are processes.
1:33:10And the big one on the posterior side,
1:33:13this end is called the acromian or
1:33:15chromium process. And it's connected to
1:33:18the scapular spine. And this is what you
1:33:21can feel on your posterior side of your
1:33:23back. So scapular spine runs and becomes
1:33:26the acromian process. Scapular spine.
1:33:30Scapular spine. Acromian orchromian
1:33:32process. If you notice, it looks similar
1:33:35to the acromian
1:33:37of the clavicle. So they look similar.
1:33:40So I still have that spoon appearance.
1:33:44Acchromian process. As I turn it and I
1:33:47go back to anterior
1:33:49coroid process, corocoid process. So
1:33:53with the C, you're going to see corocoid
1:33:55acromian process. And then when I look
1:33:59with this scapular spine, I have a space
1:34:02above it called the suprapinus fossa.
1:34:06Below it, infraspinus fossa. So above
1:34:10the spine, supraspinus fossa. Fossas are
1:34:13depressions. Infra below it. So we're
1:34:16learning those two spaces. When I go on
1:34:19the anterior side and to go anterior, I
1:34:22have to go deep. So we go sub or below.
1:34:26This space where I can rub my hand is
1:34:28called the subscapularis fossa.
1:34:31So subscapularis fossa, supraspinus
1:34:35fossa, infraspinus fossa. Why are we
1:34:38learning this? We're building the
1:34:39language. We're going to attach muscles
1:34:40here when we cover muscular system. When
1:34:43we look at that connection again, we
1:34:45said that space is called the glenoid
1:34:47cavity. There's two projections at 12:00
1:34:50and 6:00. One's called the supra glenoid
1:34:54tubrical at the top at the bottom infra
1:34:59glenoid tubrical. So 12 and 6:00 supra
1:35:03glenoid tubrical infra glenoid tubrical.
1:35:07How do I do right or left with this?
1:35:09Remember I said I need that connection
1:35:12for the humorris. So this has to point
1:35:14out either this way or I have to t turn
1:35:18it.
1:35:20It's going to go like that. But this is
1:35:21not going to sit well. When you feel
1:35:24this on your back, that spa subscapular
1:35:28area is going to be deep on my back. But
1:35:31the scapular spine has to point out
1:35:34posterior and I need that connection for
1:35:36the glenoid cavity. So this is a right
1:35:38scapula.
1:35:40Moving on to the humorris. The first
1:35:43thing I wanted to show you is these two
1:35:44colors with the pipe cleaners as we
1:35:46describe some of our necks. The rounded
1:35:49portion where we're going to connect to
1:35:51the glenoid cavity of the scapula is the
1:35:54head. So hummeral head. The neck,
1:35:57there's two different types of necks.
1:35:59When I go around with the pink one just
1:36:01underneath the head, this is called the
1:36:03anatomical neck. The green one is
1:36:06referring to the surgical neck. So two
1:36:09types of necks. Anatomical.
1:36:12surgical. The reason we call it surgical
1:36:14is this is right at the region called
1:36:15the metaphysis where we have the
1:36:17epiphysial plate or the growth plate. So
1:36:20if we have damage or we break a fracture
1:36:22of the bone here, it could end up in
1:36:24surgery. So two necks to learn there.
1:36:27Now as we move on to the rest of the
1:36:29bone,
1:36:31I'm showing you a right. Remember we
1:36:33said this is the head. When I look
1:36:36anterior, this projection on the
1:36:38anterior side is the lesser tubacle.
1:36:42Lesser tubacle. On the lateral side,
1:36:46this big one here is greater tubacle.
1:36:50Greater tubicle. Because of those two
1:36:53tubacles, I have a space in between
1:36:57called the inner tubicular groove or
1:37:00inner tubicular sulcus. So lesser
1:37:03tubicle is more anterior. Greater
1:37:05tubicle is more lateral and then I have
1:37:08that sulcus or groove in between. As I
1:37:11come down the shaft, it'll bow here more
1:37:15on the lateral side and it'll get rough.
1:37:18And that rough portion is for the
1:37:20deltoid muscle. So we call this the
1:37:22deltoid tuberosity. So where it becomes
1:37:25rough and creates somewhat of a bow
1:37:27here, this is called the deltoid
1:37:29tuberosity.
1:37:30As we come down to the distal end, we're
1:37:33learning condiles. And there's four
1:37:36here. One, two, three, and four. So four
1:37:42condiles. As we learn this, these are
1:37:44two epicondiles.
1:37:47Epicondiles towards the edge. On this
1:37:50side, this is the lateral epicondile.
1:37:54The bigger one from here over, this is
1:37:57the medial epicondile.
1:38:00medial epicondile, lateral epicondile,
1:38:03and then the two specific condiles in
1:38:05between. The first one that's rounded
1:38:07like a cap to me remember like a
1:38:10baseball cap and the word cap is in
1:38:12capitulum. So capitulum capitulum
1:38:16and then from here to here all of this
1:38:20is called the troleia. And students will
1:38:22say it looks like two, but it's all one
1:38:24because it grooves down and turns and it
1:38:28looks like it's two. But all of this is
1:38:30troleia and we use that to hinge
1:38:34my ulna inside there.
1:38:37So we'll come back to the ulna but in
1:38:39review lateral epicondile medial
1:38:42epicondile
1:38:43capitulum
1:38:45and then all of this is ta
1:38:48tleia. Two fossas to learn one on front
1:38:52one on back. So on the anterior side
1:38:55coronoid fossa coronoid and we learned
1:38:59coriccoid process of the scapula. So it
1:39:01gets a little crazy on the anterior side
1:39:04coronoid fossa. Posterior the larger one
1:39:07is the electron fossa. Electron fossa
1:39:13right or left with this. I know all of
1:39:15these condiles have to be anterior. So
1:39:19if these are anterior, I need the smooth
1:39:22side of my hummeral head to go into my
1:39:25body on the medial side. So I use this
1:39:28to connect
1:39:30to my scapula. So this is a right. If I
1:39:33put this over here on my left side, now
1:39:35I have this rough greater tubicle that's
1:39:38going to hurt when it moves. So this is
1:39:40a right humorous. So then we look at a
1:39:44ulna, my elbow bone. Remember we said
1:39:48we're taking this and connecting into
1:39:51the troleia. How do we do that? It's
1:39:54through this C here called the tlear
1:39:58notch. Often called semi lunar notch
1:40:00because it's a half moon. So tlear notch
1:40:03because it hins inside the troleia. And
1:40:05how does it do that? Through these two
1:40:07processes. The top one which is
1:40:11essentially my elbow. The electronon
1:40:14process is that projection on the
1:40:16posterior side. On the anterior side we
1:40:20have the coronoid process. Coronoid
1:40:24coronoid process electronon process. So
1:40:28the two processes go into my two fossas.
1:40:32My
1:40:34electronon
1:40:36process is going into my electronon
1:40:39fossa. My coronoid process is going into
1:40:42my coronoid fossa. So they connect
1:40:45together.
1:40:47As I follow the coronoid process of the
1:40:51ulna, to me it looks like it kind of
1:40:53breaks open here. So all of a sudden
1:40:55there's this little ridge here to where
1:40:58it's like a nice circle and then it
1:41:00breaks. It doesn't literally break, but
1:41:01I just imagine that. And that point
1:41:03there is called the radial notch because
1:41:05I'm going to use that to attach the
1:41:09radial head. So the radial head goes in
1:41:12the radial notch of the and that'll help
1:41:15me with right or left. So radial notch
1:41:19as I come down the rough projection
1:41:21going more distal. This is the er
1:41:24tuberosity. So er tuberosity
1:41:29further distal ular head is the rounder
1:41:33portion ular head and then the styloid
1:41:36process ular styloid process. Now this
1:41:39is another styloid process you learned
1:41:41you learned it on the temporal bone as
1:41:43well. So er head ular styloid process.
1:41:46How do I do right or left with this? I
1:41:48said this is the radial notch. So I
1:41:50attach the radius for this in anatomical
1:41:54position. We said my radius is my rad
1:41:57bone on my lateral side in ant position.
1:42:00My pinky side is my ular bone. So if
1:42:03this has to be on the medial side, if I
1:42:06put it on the left, I can't connect my
1:42:09radius because the radial notch is on
1:42:11the wrong side. If I put this on my
1:42:14right side, now I can connect my radius.
1:42:18So this is a right.
1:42:21So if we add to that, here's my radius.
1:42:25The head switch. So now I have the head
1:42:28on the proximal side. So the round head,
1:42:32radial head. As I come distal, this is
1:42:34on the anterior side. This is called the
1:42:37radial tuberosity. So this bulge radial
1:42:41tuberosity. And that's how I connect my
1:42:43biceps brachi. It inserts at the radial
1:42:46tuberosity. So radial tuberosity as they
1:42:50come down to the distal side the
1:42:52furthest projection that bump there is
1:42:54the radial styloid process. So another
1:42:57styloid process and I imagine this kind
1:43:00of looks like my thumb when I place this
1:43:02out.
1:43:04So I use styloid process and then on
1:43:07this side on the medial side I have
1:43:11another groove here and that's called
1:43:13the er notch.
1:43:15ER notch. And why do I have an er
1:43:21head? So as I look at this, I'm using my
1:43:25radial head to connect to my radial
1:43:27notch of the ulna. I'm using my ular
1:43:30head to connect to my notch of the
1:43:33radius. So my heads and notches go
1:43:36together. So we're determining right or
1:43:38left with this. As I come down,
1:43:41I said my radial tuberosity is anterior.
1:43:45So I have to keep this anterior and I
1:43:47just remember again this kind of looks
1:43:48like my thumb in anton position this
1:43:51would stay
1:43:53on the anterior side. So this is a
1:43:56right. If I put this on my left side my
1:43:59styloid process is going the wrong way.
1:44:01So this is a right radius. So here's a
1:44:05quick review. We did manubrium body
1:44:08zyoid process. We learned that our
1:44:11clavicle has two ends, a chromial end
1:44:13and a sternal end. We learned that our
1:44:16scapula has three borders to it. A
1:44:18lateral border, a medial border,
1:44:21superior border. The main projections,
1:44:24corcoid process on the posterior side, a
1:44:27chromian process. I have a glenoid
1:44:29cavity with the super glenoid tubrical,
1:44:32infraenoid tubrical to connect to my
1:44:35humorris. And we said our humorris as I
1:44:38come down has a lesser tubal a greater
1:44:41tubicle with a inner tubicular groove
1:44:44deltoid tuberosity and my condis
1:44:48epicondiles lateral medial capitulum
1:44:52tleia. When I look at my ulna, we said
1:44:57my two processes electron process,
1:45:00coronoid process, trolear notch, radial
1:45:05notch. As I come down, er head, ular
1:45:09styloid process, and to the radius,
1:45:12radial head, radial tuberosity. As I get
1:45:15to the distal side, radial styloid
1:45:18process and ner notch. So this completes
1:45:21as we get down to the arm. You can
1:45:23review the video on hands and feet once
1:45:26we get past the ulna and radius. We're
1:45:28covering the rest of the appendicular
1:45:31skeletal system. So, we'll work through
1:45:32the coxal bone and down to the lower
1:45:34leg. We'll stop before we get to the
1:45:36feet because I did a previous video on
1:45:38hands and feet together. So, let's start
1:45:41with the coxal bone. The coxal bone or
1:45:43hipbone is a collection of three bones.
1:45:46So, I'm going to divide it into three
1:45:48bones from my green pipe cleaner up.
1:45:52This is all the iliam. So ilium. And
1:45:56then as I go to the posterior side, what
1:45:59I sit on from here over this is the is
1:46:03it. And I have a little piece of tape
1:46:05there to designate where the isium ends.
1:46:08All of this is coming over to become the
1:46:10isium. The anterior part that comes down
1:46:13to my pubic bone or the inguinal area,
1:46:16this is the pubis. So pubis, isium
1:46:21ilium. So, we're covering three bones
1:46:23and the landmarks of those three bones.
1:46:25To determine right or left, I just use
1:46:27that the medial side of the ilium is
1:46:30going to come to my ear and the pubic
1:46:32bone is how I talk. So, I put this
1:46:34nicely up like I'm talking with it. Hey
1:46:35Brad, how you doing? Versus when I do it
1:46:38this way, I can't connect it and then
1:46:40this sticks out awkwardly. So, this is a
1:46:43right coxal bone. So, as we learn this,
1:46:45right illium, right pubis, right issue.
1:46:49So, let's start with the illiam. and
1:46:51first identify just some of our
1:46:53projections that we see on the anterior
1:46:56side and then the posterior side. So
1:46:59we're learning spines. So directionally
1:47:02these two are called anterior superior
1:47:08iliac spine anterior inferior iliac
1:47:13spine. anterior superior anterior
1:47:18inferior iliac spine. On the posterior
1:47:22side, these two projections
1:47:25posterior superior iliac spine,
1:47:29posterior inferior iliac spine. So,
1:47:32you're using your directions
1:47:35and posterior posterior superior
1:47:38posterior inferior iliac spine. as I
1:47:41come over the top and it's rough but
1:47:44it's sharp on top relative to other
1:47:46landmarks. Not going to cut me but it is
1:47:48sharp. And this is a crest. On top is
1:47:52iliac crest. Iliac crest. When I go
1:47:56medial this is called the iliac fossa.
1:47:59Remember we're learning this for a
1:48:00reason. We'll put muscles and attach
1:48:02ligaments and tendons here. But the
1:48:04iliacis would fit here. So where I can
1:48:06hear with this is on the medial side and
1:48:10this is the iliac fossa. So iliac fossa
1:48:14iliac crest
1:48:16as they stay medial. We did iliac fossa
1:48:20and then we take this whole area and
1:48:21divide it into two halves. The top half
1:48:24is the iliac tuberosity.
1:48:28This whole rough area iliac tuberosity.
1:48:31The bottom half is called the uricular
1:48:34surface. and we're attaching the sacrum
1:48:36there. So on the posterior side staying
1:48:39medial iliac tuberosity uricular surface
1:48:44as I go underneath that this projection
1:48:47on the posterior side is called the
1:48:49greater sciatic notch. Greater sciatic
1:48:52notch. So we have the illium. As I go
1:48:56posterior to the isium this is the isial
1:49:00tuberosity. So this whole region here is
1:49:04tuberosity and this is what I sit on is
1:49:08tuberosity. As I come up I have isial
1:49:11spine. Isial spine. We did greater
1:49:15sciatic notch for the ilium but now we
1:49:17can do lesser sciatic notch of the
1:49:20isium. In between the notches I have a
1:49:23spine. Greater sciatic notch lesser
1:49:26sciatic notch and isial spine. We have
1:49:31issial tuberosity as it curves and
1:49:34elongates until I get to my blue tape
1:49:37here. This is the ramis. Isial ramis is
1:49:41spine issial tuberosity. When it curves
1:49:44and elongates, issial ramis.
1:49:49When I move over to the pubis, the
1:49:51pubis, it really just has two angles to
1:49:54it. I come down and then over. This is
1:49:56the superior pubic ramis. inferior pubic
1:50:00ramis. So I just determined like this is
1:50:02like a C here but it's backwards. The
1:50:05top superior ramis. So superior pubic
1:50:08ramis inferior pubic ramis. So just
1:50:11those two pieces on top I have a tubacle
1:50:15the pubic tubacle. Pubic tubacle then I
1:50:18have my ramis and my ramis on either
1:50:22side. Couple other things to look at is
1:50:24the hole is called the opterator
1:50:27frammans. Remember frammanas are holes
1:50:30opterator framman we get the nervous
1:50:32system we'll talk about the opterator
1:50:33nerve that comes down impacts and
1:50:35interervates on our adductor magnus
1:50:37muscles opterator framman's the hole and
1:50:40then where I connect the femur this is
1:50:45all the acutabulum
1:50:47acutabulum
1:50:49and the projection inside is called the
1:50:52acutabular fossa this top region of it
1:50:56is the lateral surface of the
1:50:58acutabulum. So it depends on how you're
1:51:00learning it. A lot of text they just
1:51:03cover the whole thing is acutabulum.
1:51:06The fossa is the depression inside. I
1:51:08have the lateral surface on top and then
1:51:12I have the notch acutabular notch here.
1:51:16So this is referring to illiam pubis
1:51:19isium. As we connect the femur, the
1:51:23largest and longest bone in the body,
1:51:26we're using the head of the femur to go
1:51:29into the acutabulum or the acetabular
1:51:32fossa right at the lateral surface. So
1:51:35the head of the femur within the head I
1:51:38have this little hole or divot here.
1:51:40This is called the phobia or the phobia
1:51:43capitus. So on the head I have this
1:51:46depression phobia or phobia capitus.
1:51:50We're use that to attach a ligament head
1:51:54and it makes sense that then I have a
1:51:56neck. So just like my body it truly
1:51:58represents more of a head and then a
1:52:00neck. So around it. So as we turn it and
1:52:04look at the head now you can see more of
1:52:08the neck. So that's the neck. As I stay
1:52:11posterior, I can see these larger
1:52:13projections called a greater troanter
1:52:17and a lesser troanter. Greater troanter
1:52:23and lesser troanter. And I see this more
1:52:26on the posterior side. And then what it
1:52:29creates is inner troanteric crest. In
1:52:33between the two troancers I have this
1:52:36ridge called the inner troanteric crest.
1:52:41Inner troanteric
1:52:44crest. On the opposite side the anterior
1:52:47they call it a line in between the two
1:52:48troanters. I have inter trocanteric
1:52:52line. So a line in between the troanters
1:52:55on the anterior side a crest in between
1:52:58my greater and lesser troanter on the
1:53:01posterior side. That's a lot. As they
1:53:04come down the posterior side along the
1:53:06shaft, this line is called the linear
1:53:10espera running down the entire shaft.
1:53:13Lineia espera. Linear meaning line.
1:53:15Esper meaning rough. It's a rough line.
1:53:18We use that for muscle attachment.
1:53:20Lineia espera. As I come down to the
1:53:23further distal side, staying anterior,
1:53:26this smooth section is the patellar
1:53:28surface to attach my sesimoid bone, my
1:53:30patella. So, patellar surface and then
1:53:33when I twist it and I look, I have these
1:53:36big notches here that are called
1:53:38condiles. Condiles. Now, you need to
1:53:40know medial versus lateral. How do I
1:53:43know which size my medial? My head has
1:53:45to go in to my acutabula. So, this has
1:53:50to be on the medial side. And it's
1:53:52really no matter where I put it. So if I
1:53:54follow this is medial all the way down.
1:53:58This is the medial condile. So medial
1:54:02condile, lateral condile.
1:54:05Turn it this way. Doesn't matter. And
1:54:07look for the head. Medial condile,
1:54:10lateral condile. In between that I've
1:54:12got a space. We're use that for
1:54:14ligaments for the knee. Interular
1:54:17fossa. So intercondular
1:54:20fossa is the space in between my two
1:54:23condiles. How do I do right or left with
1:54:25this? Remember I said this is medial and
1:54:28I use all of this to be posterior. My
1:54:31troanters and my lineosphere have to be
1:54:34posterior. So if I stay posterior I need
1:54:37this to go into my body. So this is a
1:54:39right femur. So at the head the neck my
1:54:43greater trocanter lesser troanter. As I
1:54:46come down the shaft linear spa to my two
1:54:50condiles,
1:54:51medial condile, lateral condile,
1:54:54intercondular
1:54:55fossa. My two condis
1:54:59of the femur connect to my next largest
1:55:02bone of the tibia. So condiles match
1:55:05with the condiles.
1:55:08I have this condile and this condile. So
1:55:11these big round projections for my two
1:55:14condis to match with my two condiles.
1:55:16How do I know lateral versus medial? As
1:55:19I come down to the distal end, this
1:55:22projection is called the medial
1:55:25malololis. So we often say when we feel
1:55:28like the balls on our foot as we get
1:55:30close to our ankle, you're feeling that
1:55:32round projection on the medial side.
1:55:34This is the medial malololis.
1:55:38Medial malololis. So if this is medial
1:55:40malololis and I come all the way up,
1:55:43this is medial condile. So this is
1:55:46lateral condile. Medial condile, lateral
1:55:50condile. In between it,
1:55:53I have a couple tubricals. They're
1:55:56called lateral and medial tubrical. This
1:55:58is still medial.
1:56:01the two projections medial tubrical
1:56:04lateral tubrical but it's the tubacles
1:56:07of the intercondular
1:56:09eminence. So this landmark is called the
1:56:13intercondular eminence in between my two
1:56:15condiles intercondular eminence and it's
1:56:18created by the two tubacles medial
1:56:20tubrical and lateral tubacle as I come
1:56:24anterior
1:56:26to help connect the tendon. This is the
1:56:29tibial tuberosity. Tibial tuberosity. So
1:56:33my condiles tibial tuberosity. As I come
1:56:37down the shaft, it projects and has a
1:56:40crest to it. And it's called the
1:56:43anterior margin. So when you say you hit
1:56:45your shin or kicked your shin,
1:56:48this is the anterior margin of what
1:56:50you're actually hitting. So anterior
1:56:53margin. Sometimes you see anterior
1:56:55crest. And then like I said when they
1:56:57come down that most distal portion
1:57:00medial malololis. So that's the tibia.
1:57:04And now I'm gonna connect
1:57:08my fibula next to it. Before I do that,
1:57:11right or left? We said this is the
1:57:13medial malolola. So this has to stay
1:57:16medial. And then I just use the tibial
1:57:18tuberosity has to stay anterior. So this
1:57:21would be a right tibia. If I put it on
1:57:24my left side, that medial malololis is
1:57:27on the wrong side. So this is a right
1:57:29tibia. So now I can match it with
1:57:32my fibula. As I come down, when we look
1:57:36at the fibula, we're learning two ends.
1:57:41The rounder one that looks more like a
1:57:43rock to me. Use your imagination, but
1:57:46this is rounder. And this is the fibular
1:57:50head. As I come down the shaft to the
1:57:53distal side, I have this curved one that
1:57:56looks more like a spoon to me. Remember
1:57:58when we looked at the clavicle and
1:57:59scapula in the acchromian process looks
1:58:02like a spoon. To me, this looks like a
1:58:04spoon as well. And this is the lateral
1:58:06malololis. Some students will say it
1:58:08looks more like an arrow when I project
1:58:11it. So, as I come down, lateral
1:58:14malololis. And on your lateral side, you
1:58:16can feel that other ball next to your
1:58:18ankle. That's that ball and that's the
1:58:21lateral malololis. So I have two ends
1:58:24fibular head
1:58:26and lateral malololis.
1:58:29For me the right or left I do a couple
1:58:31things. One this has to project away
1:58:34from my body. So if this is on the side
1:58:37and I follow this to the right when I
1:58:40turn this that latter malololis is going
1:58:44out away. If I put it on the other side,
1:58:47it's going to stab me into my shoe. What
1:58:50I really use though is a trick to how do
1:58:52you eat with this? If I look inside the
1:58:56lateral malololis, there's a little
1:58:58spoon here and this little divot helps
1:59:00me to understand right or left. If I can
1:59:03eat with this, it's the correct way. So,
1:59:05if this is my spoon and I'm gonna eat
1:59:08food and I scoop it up, num num, this is
1:59:13a right fibula because I can use that
1:59:16spoon to eat with. If I turn this and
1:59:19use it as a left and here is my spoon.
1:59:23If I try to scoop food, there's no way
1:59:26to hold the food. This is going to fall
1:59:28out this way. So, this is incorrect. So
1:59:30if you can eat with it with that spoon
1:59:32on the lateral malololis, this is a
1:59:35correct way to do it. This is a right
1:59:37fibula. So in quick review as we do the
1:59:41lower leg, we did our two condis medial
1:59:44malololis. So medial condile, lateral
1:59:47condile, intercondular eminence, tibial
1:59:51tuberosity, anterior margin. And then we
1:59:54covered just the two ends of the fibula.
1:59:57The rounder end fibular head, the one
2:00:00that looks more like an arrow or to me a
2:00:02spoon is the lateral malololis. So this
2:00:05completes our lower leg bones. And we
2:00:08did a separate video that led into the
2:00:10toarsils, metatarscils, and flanges of
2:00:12the foot. Today we're covering the
2:00:14classifications of joints by their
2:00:16function, which means their movement. We
2:00:19don't get that function until we
2:00:20structurally put them together. And I
2:00:23did a previous video talking about how
2:00:26we classify them based on their
2:00:29connective tissue. And when we looked at
2:00:31different types of joints, we said we
2:00:33have ligaments that are primary made up
2:00:35of dense regular connective tissue,
2:00:38which is part of our connective tissue
2:00:40proper. And then when we get into our
2:00:42supporting, supporting is our bone. We
2:00:44put our bones together. And then we have
2:00:47different ways to connect them with
2:00:48cartilage. And we call those
2:00:49cartilagynous joints. They could be
2:00:52connected by hyelin cartilage or fibrous
2:00:55or fibroartilage. And we tend to call
2:00:57these a symphyses joint or a
2:01:00synchondroes joint when we name them by
2:01:03their vocabulary. So we look at them
2:01:05once we structurally put them together.
2:01:08They typically have three movements and
2:01:10these three movements are synarthosis,
2:01:13amphiarthosis and diarosis. In plural
2:01:17you add an e s to it. So syninarthoses,
2:01:20amphiarthoses and diarthosis. And when
2:01:23we look at this, I just use the acronym
2:01:25or pneumonic for this as S A and D that
2:01:29you're sad that you need to learn all
2:01:31this. But basically, we just put in
2:01:33three types of movement. Sinarosis or
2:01:36synarthosis means I have no movement
2:01:39relative to the other types of joints.
2:01:41Joints are two bones coming together as
2:01:43articulations. Amphiarthosis is I have a
2:01:46little bit of movement. some flexibility
2:01:49towards it and then diarosis or diarosis
2:01:52is full movement. So cinthosis,
2:01:55amphthosis, diarosis is describing once
2:01:58we put the bones structurally together.
2:02:01What is their function meaning their
2:02:03movement and that's our sad or sad. I
2:02:06gave you examples of this when we look
2:02:08at where we cannot move the bones
2:02:10relative to others synarthosis when we
2:02:13talk about our sutral joints. So we look
2:02:15at sutures as my cranium grows together
2:02:18the different bones remember we have
2:02:19eight cranial bones they're not designed
2:02:21to move. So synarththrosis is a sutural
2:02:25joint is a good example of how they're
2:02:27not supposed to move. Teeth is another
2:02:29good example. Our teeth are not designed
2:02:31to move. That's a gossis joint. So we
2:02:34have different types of joints where are
2:02:35not designed to move. Well then we do
2:02:37have a little flexibility. So
2:02:39ampharthosis or ampharthoses. The
2:02:42example I gave you is in between
2:02:45vertebrae at an inner vertebral disc. So
2:02:48the dis of cartilage which is our fibro
2:02:50or fibrous cartilage to allow for that
2:02:53shock absorption and compression but I
2:02:56don't have that much movement towards
2:02:58it. So that's called a symphyses joint
2:03:01by structure but by movement it's a
2:03:04athorosis joint based on how it actually
2:03:08functions. Another example is when we
2:03:10use highland cartage when I connect my
2:03:12ribs to my sternum there is movement
2:03:15there to allow that flexibility for
2:03:16inhalation exhalation but that's
2:03:18highland cartilage and we call that a
2:03:20synchondrosis joint so when we tend to
2:03:23see cartilage we will have a little bit
2:03:25of movement the longer the joint is the
2:03:28more movement we're going to have and
2:03:29then lastly diarosis sometime refer
2:03:32these as senovial and there's different
2:03:34types based on how they move but
2:03:36anywhere where I have a lot of movement
2:03:39And this is showing a hip socket, but
2:03:41this is called diarthosis. We will have
2:03:43some articular cartilage here to where
2:03:46we allow for some of that compression
2:03:49and movement to absorb that friction so
2:03:51I can move my hips and my shoulders
2:03:53hopefully the course of 90 years of my
2:03:55life. But that's made up of highland
2:03:57cartilage. And then what we tend to see
2:03:59in a ditherosis joint is what we call a
2:04:02senovial cavity. And a senovial cavity
2:04:05contains a fluid and it's a synenovial
2:04:08fluid that's produced by a membrane
2:04:10called a synenovial membrane. So in a
2:04:12dirosis
2:04:14actual joint we tend to see a little bit
2:04:16of space there to where we include some
2:04:18articular cartilage but also some space
2:04:21with the fluid that we call synenovial
2:04:23fluid. These are three types of joints
2:04:25by movement which means the function.
2:04:28They function by cinarosis, ampharthosis
2:04:31and diarosis. We're covering shoulder
2:04:33joint ligaments. As we describe how
2:04:36bones come together, which are
2:04:37articulations, we connect them in many
2:04:40cases with ligaments. Remember when we
2:04:42talk about ligaments, the type of tissue
2:04:45is a connective tissue and it's
2:04:48specifically
2:04:49dense regular connective tissue. Four
2:04:52types tissue in the body. Epithelial,
2:04:54connective, muscle and nervous. Of our
2:04:57connective, we learned three types.
2:04:59connective tissue proper, fluid and
2:05:02supporting. But our connective tissue
2:05:04proper includes our loosen or dense and
2:05:06we have dense regular connective tissue
2:05:09that helps support our tendons and
2:05:11ligaments. Remember ligaments connect
2:05:13bone to bone. So we're covering
2:05:15ligaments here and describing them at
2:05:17the shoulder of how do we connect some
2:05:20of the landmarks we learn when we're
2:05:22covering skeletal system. So some of the
2:05:24basic ligaments and we're using the
2:05:27processes that we learned when we
2:05:28covered the scapula and the clavicle and
2:05:30it tells you where it's going to. So
2:05:33when we talk about the acchromial
2:05:35clavvicular acchromia referring to the
2:05:37chromian or chromium process connecting
2:05:40to the clavicle. So I go from the
2:05:42acchromian process of the scapula to
2:05:46connect to the clavicle. And this is
2:05:48often referred to as the AC joint
2:05:50because you're describing that
2:05:51connection of the acchromian to the
2:05:53clavicle at those two sections. Now this
2:05:57one is on top. So I remember that AC air
2:06:00conditioning typically comes from the
2:06:02top. So my AC joint is on top.
2:06:06Acchromioclavicular.
2:06:08And then I take the two that are coming
2:06:10from the corocoid process and I just go
2:06:12up. So the first one we're learning is
2:06:14going back to the acromian process. So
2:06:17we call it corico acchromial. So coroco
2:06:21acchromial coricochromial
2:06:24connecting from the corocoid process to
2:06:27the acchromian process. And then I have
2:06:30two sections again starting from the
2:06:33corocoid process to the clavicle. Two
2:06:36pieces here one and two. One and two
2:06:39coroclavicular.
2:06:40So corococlavvicular
2:06:42from a corocoid process of the scapula
2:06:45to the clavicle. As you learn these it
2:06:48you tend to mix up the words. So it's
2:06:50easy to understand if you've learned the
2:06:51landmarks or where they connect. But I
2:06:53just start by remembering AC on top the
2:06:56chromioclavicular
2:06:58and then as I name my two for the
2:07:00corocoid I start from those and go up.
2:07:03So AC on top corcollicular.
2:07:08And then last one we'll cover on this as
2:07:10we describe the glenoumero and remember
2:07:14gleno is referring to the glenoid cavity
2:07:17of the scapula and we're connecting the
2:07:19head of the humorris. So two pieces to
2:07:22this as we describe it. We're describing
2:07:25where we connect to give me that. What
2:07:28type of movement or function is that?
2:07:29Remember we learned there are three
2:07:31types of function. Sinarosis ampthosis
2:07:33and diarosis. This is a diarthosis
2:07:36movement. So I continuously move. The
2:07:39glenoid cavity inside the scapula is
2:07:42connecting to the head of the humorris
2:07:44by way of the glenoumeral joint. So
2:07:47we're referring to the shoulder joint
2:07:49and how we create these supports for the
2:07:51structures of the bones and then we
2:07:53cover it with the muscles and we'll talk
2:07:54about the deltoid later. These are the
2:07:56shoulder joint ligaments. We're covering
2:07:59hip joint ligaments. We are getting into
2:08:02the last part of skeletal system looking
2:08:04at how we connect bones together which
2:08:06are articulations. When we cover
2:08:08ligaments remember this is a type of
2:08:10connective tissue. As I pull up this
2:08:13chart that we've covered previously
2:08:15we've looked at there's four type tissue
2:08:17in the body. Epithelial, connective,
2:08:20muscle and nervous. And now we're
2:08:22talking about connective tissue. There's
2:08:24three types. Connective tissue proper
2:08:26fluid and supporting. When we look at
2:08:29dense, regular connective tissue, that's
2:08:32what creates our tendons and ligaments.
2:08:34Remember, tendons connect muscle to
2:08:36bone. We're connecting bone to bone. So,
2:08:38this what we're covering today is as we
2:08:40talk about ligaments, dense, regular
2:08:42connective tissue. Remember, it contains
2:08:45specialized cells that make fibers. And
2:08:47those fibers include collagen, elastic,
2:08:50and reticular. And they're most abundant
2:08:52are collagen fibers because they give us
2:08:54that tensile strength. So, as we look at
2:08:56hip joint ligaments, I'm showing you an
2:08:58anterior view on the left and a
2:09:00posterior view on the right. First, as
2:09:02we describe how we connect the ilium
2:09:05bone to the lumbar vertebrae, we call it
2:09:09ilo femoral. So, like our previous
2:09:11videos, the words help to describe the
2:09:14joint where the two bones get come
2:09:16together and how we connect them with
2:09:17the ligaments. So, ilol lumbar, we're
2:09:20connecting my illium to my femur. on the
2:09:23anterior side to connect my ilium to my
2:09:27sacrum. Anterior sacroiliac. So anterior
2:09:31sacro iliac which means on the posterior
2:09:34side we have posterior sacroiliac.
2:09:38Posterior sacro iliac and anterior sacro
2:09:42iliac. As I get down to where we connect
2:09:45first the sacrum to the isial tuberosity
2:09:48and then the sacrum to the isial spine.
2:09:51we use those connections here. So these
2:09:54ligaments and they cross each other the
2:09:56one that's anterior and smaller is
2:09:59sacral spinus again from the sacrum and
2:10:02as I go posterior to the isial spine and
2:10:06when I look at sacro tuberous it's the
2:10:09bigger one on the posterior side but I
2:10:11can still see it crossing on the
2:10:12anterior. It's going from the sacrum to
2:10:15the isial tuberosity to the isial
2:10:18tuberosity. So sacral tuberous and
2:10:20sacross spinus
2:10:23as we dive into the actual hip joint
2:10:26where we connect the femur to the
2:10:27acutabulum and we're connecting to the
2:10:30coxal bone then we can see first where I
2:10:34have connections to the pubis to the
2:10:37femur pubo femoral so pubo femoral
2:10:42as I come up towards the anterior side
2:10:45and going superior there's actually two
2:10:48ilopmoral
2:10:49There's a vertical and a horizontal. So
2:10:52if you see those separately, there's two
2:10:55iliomorals. One that goes vertical and
2:10:58then one goes horizontal relative to
2:11:00each other. But it's connecting the
2:11:01ilium to the femur. So you can see ilo
2:11:04femoral and pubo femoral more on the
2:11:06anterior side. If I go the posterior
2:11:09side connecting the isium to the femur,
2:11:12issuoral.
2:11:14So all we're doing is using the names of
2:11:16the landmarks and bones we learned
2:11:18previously and connect them with our
2:11:19dense regular connective tissue to give
2:11:22me connections from the lumbar to the
2:11:24ilium and as we describe the rest of the
2:11:26coxal bones connecting to the femur.
2:11:28These are hip joint ligaments. We're
2:11:31finishing up the skeletal system looking
2:11:33at ligaments. Remember ligaments are
2:11:36dense regular connective tissue. We've
2:11:38done this on previous videos. When you
2:11:40look at the hierarchy of connective
2:11:42tissue, four types of tissue in the
2:11:45body, epithelial, connective, muscle and
2:11:48nervous. When we look at connective,
2:11:50three types, connective tissue proper,
2:11:52fluid, and supporting. When we look at
2:11:54connective tissue proper, two types,
2:11:56loose and dense based on their fibers.
2:11:58When they're densely packed, we call
2:12:00them dense connective tissue. When we
2:12:02look at tendons and ligaments, it's made
2:12:04up of dense, regular connective tissue.
2:12:07So it's dense, it's regular, meaning
2:12:09uniform. And when we look at the fibers,
2:12:11remember there's three types of fibers.
2:12:13Collagen, elastic, and reticular.
2:12:16Collagen is our most abundant to give us
2:12:18tensile strength. So we see tendons and
2:12:20ligaments. Ligaments connect bone to
2:12:22bone. That's dense, regular connective
2:12:25tissue. So when we look at the knee, now
2:12:28we're focusing on a lot of the ligaments
2:12:30that are internal. We see a lot in
2:12:32sports injuries when we rupture things
2:12:34like the anterior cruciate ligament. But
2:12:37we'll start. This is a anterior view on
2:12:39the left and a posterior view on the
2:12:41right. When we first look at the
2:12:43patella, remember our sesimoid bone is
2:12:45mixed in with this tissue here that's
2:12:48connecting down to the tibial porocity
2:12:50and then it goes up to the quadriceps
2:12:52tendon. So on top it's actually a
2:12:55tendon. On bottom it's a ligament
2:12:57because this is muscle to bone. This is
2:12:59bone to bone. So patellar ligament is on
2:13:02the distal side here. So this is
2:13:04patellar ligament to come down to the
2:13:06tibial tuberosity. When we look at
2:13:09either side, they are collaterally put
2:13:11together.
2:13:13This is a right leg looking at both
2:13:16types. And I know this is a right leg
2:13:18because I see the fibula has to be on my
2:13:22lateral side in anatomal position. So my
2:13:25tibia is on my medial side. So this on
2:13:28the lateral side is called the lateral
2:13:31collateral ligament. as it can come
2:13:33comes up to both the femur and the
2:13:36fibula. It's also called the fibular
2:13:39collateral ligament, but most refer to
2:13:41it as the LCL lateral collateral
2:13:43ligament. On the opposite side, the
2:13:46medial side, I see medial collateral
2:13:50ligament because it's connecting from
2:13:51the tibia up to the femur. So, it's also
2:13:54called tibial collateral ligament. But
2:13:56in many cases, they refer to again MCL,
2:13:59medial collateral ligament. So I have my
2:14:02collaterals on my lateral and medial
2:14:04side. When I go internal and I look at
2:14:07how it crosses, the first one that's
2:14:09anterior is anterior cruciate ligament.
2:14:13This is the most well-known of the ones
2:14:15that gets teared in sports injuries. But
2:14:17it'll cross and cruciate means cross
2:14:19that I have anterior and then posterior
2:14:22when I look at the posterior side. So I
2:14:25can see the anterior here. I can
2:14:27slightly see the posterior crossing on
2:14:30the other side. So anterior cruciate
2:14:32ligament and then I have posterior
2:14:35cruciate ligament anterior and posterior
2:14:38cruciate ligament my ACL and my PCL. So
2:14:41those are my ligaments of dense regular
2:14:43connective tissue and then in between I
2:14:47have my meniscus or menisci and these
2:14:49are our shock absorption pads. These are
2:14:52not dense regular connective tissue.
2:14:54What type of tissue is it? It's
2:14:56cartilage. So it's our supporting
2:14:58connective tissue. Three types of
2:15:00cartilage. Hyelin elastic and fibrous.
2:15:04This is fibro or fibrous cartilage.
2:15:07Remember our fibroartilage is more of
2:15:09our compression shock absorption
2:15:11cartilage. We see that also in
2:15:13intervertebral discs. So when we look at
2:15:15the meniscus these pads these are made
2:15:18up of fibroartilage. And remember I'm
2:15:21using medial because that's the tibial
2:15:24side versus lateral meniscus which is my
2:15:27fibula side. So you have two types of
2:15:29tissue mixed in here. But to create that
2:15:32overall structural support of the knee
2:15:34and it was described the knee, we had
2:15:36the patella, the fibula, the tibia, and
2:15:38the fibula all coming together to give
2:15:41me that ability to flex and extend the
2:15:43knee. These are the knee joint
2:15:45ligaments. We're covering different
2:15:46types of synenovial joints and how they
2:15:49move. In previous videos, we organized
2:15:52our joints based on structure. We can
2:15:55organize them based on fibrous joints
2:15:57and fibrous connective tissue or
2:15:59cartilagynous joints because they're
2:16:01either hyelin or fibrous or
2:16:03fibroartilage. And then lastly,
2:16:06synenovial joints because they allow a
2:16:08little bit more movement because there
2:16:09is a space called a joint cavity that
2:16:12has a synenovial membrane that produces
2:16:15a synenovial fluid. So when we look at
2:16:18synenovial joints, we can now organize
2:16:20them in six ways based on how they move.
2:16:22So here's a graphic of the pictures of
2:16:25the arrows and how they might move, but
2:16:26then examples in the body where we find
2:16:29them. So we first look at a gliding,
2:16:33also known as a plain joint. And a plain
2:16:36joint or gliding joint is referring to
2:16:39when you have flat bones that are
2:16:41together and they can be slightly
2:16:43curved, but they're the same size. So
2:16:45the bo bones slide together. So the
2:16:48motion of the joint is small but it's
2:16:50also constrained by the ligaments with
2:16:52them. And because of that they can be
2:16:55movements in different ways. So you
2:16:56notice I called them monoaxial or
2:16:59uniaaxial
2:17:01meaning they only move on one plane but
2:17:04it depends on the ligaments. In some
2:17:05cases you can have more than one plane
2:17:08or movement with this type of joint. So
2:17:11as I look at a gliding joint what I'm
2:17:13describing here is the toarscil. So in
2:17:16between our toarsils or my ankle bones I
2:17:19have this type of movement. I also find
2:17:22them in between my hands. So when I look
2:17:25at my wrists or my carpals I see them
2:17:27when I look at the clavicle necromium
2:17:29ligament. So a chromioclavicular
2:17:31ligament. They're the same size. So you
2:17:33have that gliding or plain movement on
2:17:36one axis. When I look at a pivot a pivot
2:17:40joint is also on one axis una or
2:17:42monoaxial. And it's typically when you
2:17:45have a rounded portion of the bone. So a
2:17:48rounded portion and it's within a ring
2:17:51that's partially articulated with
2:17:52another bone. And the best example with
2:17:54this is our atlas to our axis. My two
2:17:58first cervical vertebrae, my C1 and C2.
2:18:01So you have this projecting process and
2:18:04we call that the dense or adontoid
2:18:06process of the axis. And that in that
2:18:10articulates with that inner portion of
2:18:12the atlas. And so it's held by a
2:18:14ligament, but it creates that rotation
2:18:16that we've talked about. So when we say
2:18:18we pivot and change course, we're
2:18:20pivoting as we move our head. And that's
2:18:23considered monaxial.
2:18:25When I look at hinge and we describe
2:18:27hinge, the best example is the elbow
2:18:30joint. So this is the humorris with the
2:18:33er. And when we look at that ulna side
2:18:36connecting to the humorris, what it's
2:18:38doing is you have one bone that's
2:18:40concave and then it's adjoining this
2:18:43bone and it's bending and just creating
2:18:46this one movement. So it's also mono
2:18:49axial. And this example you'll see is
2:18:52also including with that that tlear
2:18:54notch if you remember tlear notch of the
2:18:56ulna and it's going within the troleia
2:18:58of the humorris. You also see this with
2:19:01the knees and the ankles. So that's a
2:19:03hinge. When I look at saddle joint, now
2:19:06we're moving into something that's
2:19:08moving on two planes. And a saddle
2:19:10joint, I use the example we talk about
2:19:12our thumbs. So when we say we have
2:19:14opposable thumbs, when we talk about the
2:19:16movements, opposition, reposition. So in
2:19:19this case, you have the articulation to
2:19:21where you have two bones that fit
2:19:23together resulting like they're sitting
2:19:25on a saddle, like you're sitting on a
2:19:26horse. And this example we're using is
2:19:30that first carpal to the metacarpal. So
2:19:33you're looking right at the base of the
2:19:35thumb here. So it's ability for the palm
2:19:38to move on two planes with the thumb. So
2:19:41as I look at this, I can have to where
2:19:43I'm going like this or like this. So up
2:19:47back and forth, side to side. So I have
2:19:49two movements. And we talk about this a
2:19:52lot when we talk about grasping things.
2:19:55So when we describe this, it's like
2:19:57you're sitting on the saddle of a horse.
2:19:59That's why it's called a saddle joint.
2:20:02When we get a condular, condular is
2:20:05another baxial meaning on two planes.
2:20:07And codular is also referred to as an
2:20:09ellipsoid joint. Ellipsoid like you're
2:20:12on elliptical. The elliptical machine
2:20:14and it's concave. What's happening here
2:20:16is you're describing that movement in
2:20:18two different directions. So you have
2:20:20this shallow depression here where one
2:20:23bone is articulating with a rounded
2:20:26structure underneath. And where we see
2:20:28that is in the hand. And as I describe
2:20:31this, we're looking at our carpal bones.
2:20:34And we're looking at the scaffoid, the
2:20:36lunate, and the triricret. Remember, so
2:20:39long to pinky, here comes the sum. So so
2:20:42long two scaffoid lunate and triquetrum
2:20:46where it's articulating that point at
2:20:48the distal end of the radius and where
2:20:51you see that is where you have the
2:20:53movement and bending and straightening
2:20:55of the fingers. So as I can straighten
2:20:57the fingers and the second move is I can
2:20:59move side to side. So side to side and I
2:21:02can expand my fingers like this but as I
2:21:04expand go side to side. So as you move
2:21:07your hand in that lateral going
2:21:09direction, medial direction. So this is
2:21:12on a biaxial. And then lastly a ball in
2:21:15socket is where we have like multiple
2:21:18planes. So we call it triacial. We think
2:21:21about like my shoulder, my hips are good
2:21:23examples. And I'm showing you the
2:21:25connection of the humorris and the
2:21:27glenoid cavity of the scapula to where
2:21:30you have a ball in a socket to where
2:21:33it's that shallow portion to where the
2:21:35head sits inside there and it can move
2:21:37anterior, posterior, medial, lateral. So
2:21:40I can move in multiple directions with
2:21:42the ball and socket. So as we're
2:21:44describing all these synenovial joints,
2:21:46we're looking at the movements created
2:21:48by how they're connected. And it's
2:21:51increasing the movement because I'm
2:21:53enveloped in a cavity called a
2:21:55synenovial cavity. This is the
2:21:57classification of synenovial joints.