Anatomy

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Muscle:
It is a structure formed by a group of fibers that are composed of muscle cells that contain actin and myosin.
-Match: Fiber smooth (involuntary muscle contraction) and fiber striated (voluntary contraction)
According to their flattened fusiform shape can be long or short.
The muscle is composed of a tendon, and other tendon fibers. Its function is to stabilize and move the levers that make bone joints.

BONE:
It is a highly vascularized structure. The fundamental unit of bone is the osteon. There is a channel in which is a venule, arteriole nerve and is called Channel Havens. Form around cells that are called ostiblastos interstitial substance forming the bone. As we age the bones are harder but brittle, they lose elasticity.
In the long bone extremities we identify 2: proximal epiphysis (closest to the shaft) and distal (farthest). The epiphyses are covered with cartilage, cartilage and below we will find a compact bone consists of cancellous bone. What unites the two epiphysis is the spinal canal, formed by bone marrow. In the growth of bones is very important vit D. There are also short bones with spongy tissue.

WAIST-PELVIS:
The pelvis has two circles, the greater pelvis and the pelvis. The innominate bone is formed by 3 the isqueo, ilium and pubis. There is an outside surface which is also called external and hilíaca pit inside the internal iliac fossa. What is the upper edge is the cost hiliaca. There are two slopes an anterior and a posterior. Following the leading edge begins the pelvic bone and continuing with the obturator foramen. The hamstring is a C-shaped bone that is continuous with the pubis. Obturator foramen by passing vessels and nerves. The inner side is what keeps all the organs that are in the pelvis and also keep the muscle Hiliana inserted into the iliac fossa and moves down to take integration to the femur.
The muscles of the buttocks with the gluteus maximus which is inserted into the pit and internal hiliaca medium tamb inserted into the pit but on the femur. The gluteus minimus is inserted as the gluteus medius but on the other side of the femur. Very imp.para give stability to the hip.

Femur:
It is a long bone that has a distal and a proximal epiphysis. Called the proximal femoral head, which is bound by a sort of trunk bone connecting the femoral head with the body of the femur called the femoral neck. Form a large boulder called greater trochanter which is continuous with the shaft. In contrast the greater trochanter is the lesser trochanter. The femur is continuous with the bone marrow to consist of the lower extremity. In the distal epiphysis articulates the patella. Clavicle:
Long bone lazy S-shaped. The inner curve has a concavity oriented toward the chest, on the outside of the curve is upside down and is harder to feel it. You have two extremes: the external (more bulky) and the acromial (but flattened).



Shoulder Girdle:
Def: Meeting proximal upper limb that extends from base of neck to the 4th or 5th rib. The device skeletal bonding between the trunk and upper limb. Consists of 2 blades, 2 clavicles, chest and 2 humeri.The joints of the shoulder girdle are 4:
-Iscapulo humeral articular surfaces has for the humerus and scapula. In the flue is located at the head of the humerus and the scapula in the glenoid.
The media union of art. They are the capsule (fibrous sheet in the shape of cuff that covers the edges of the articular surface), the capsule is reinforced by ligaments of reinforcement that are 3 upper, middle and bottom, and the synovial membrane is a liquid that lines the inside of the capsule in its entirety.
Iscapulo humeral joint is the most mobile joint (adduction, abduction, flexion, extension, rotation circunducion and internal and external)
-Externoclavicular: constituted by the internal extremity of the clavicle, which provides a flat surface in double projection angle opposing the incoming angle formed by the clavicle which is at the top of the manubrium and the medial in the superior aspect of first costal cartilage. Belongs to the genre of art.de saddle, although sharing a artrodia. The joining means is a capsule, 4 ligaments and synovium. His movements are for lifting the clavicle with respect to receiver esterno sack of retroposition decline with preemption and the same)
-Acromioclavicular: formed by the end of the clavicle and the inner edge of the acromion, which offer flat surfaces. Presents a interarticular fibrocartilage or meniscus. The joining means is a capsule, 2 ligaments (sup and inf), synovial coracoclavicular ligaments. Their movement is sliding.
_Escapulotorácica: Not a true joint. Thanks to her scapula slides over the rib cage. It consists of two spaces (escpaular and serratus serratus thoracic). The subscapularis thigh overlying the scapula and thigh intercostal cover the ribs. The scapula has gliding movements in all directions with a circle between the 1st and 9th rib.

Muscles of the shoulder and upper limb.
DELTOID: muscle covering the shoulder. It has multiple attachments but 3 are very important (in liters anterior border of the clavicle at the outer edge of the acromion, and scapular spine). From there it extends to the humerus. It is the flexor, abductor and extensor art.escapohumeral.

Supraspinatus: stay in the supraspinous fossa of scapula and there ends in a tendon which inserts into the greater tuberosity. It deltoid auxiliary, helping in the abduction of the arm.

Infraspinatus: infraspinous goes to the greater tuberosity fossa. It is external rotator and innervation comes from the brachial plexus.

Teres minor: axillary border of the scapula to the greater tuberosity.

Teres major, from the inferior angle of the scapula to the bicipital groove. It shoulder internal rotator and adductor also. Une humeral head and glenoid. Its nerve supply comes from the brachial plexus.

Arm muscles.
BRACHIAL BICEPS: consists of 2 bodies muscular, one comes from the coracoid process and the other in the outer corner of the scapula, above the glenoid. The muscle ends in a tendon which inserts into the bicipital tuberosity of the radius. Its main function is to flex the elbow but also the shoulder flexor and adductor. It is innervated by the musculocutaneous nerve.

Coracobrachialis: apophysis is inserted into the coracoidal and anteromedial face of the humerus. It flexor and adductor of the arm and is innervated by the nerve musuclocutáneo.

BRACHIAL anteior: inserts proximally on the faces anteior of the humerus and distally at the base of the coracoid process of the ulna. It also elbow flexor is innervated by the musculocutaneous nerve.

Triceps brachii: it has a threefold origin: long head, from subglenoideo scapular ridge, vastus medialis and vastus esterno, inserted at the back of the humerus, medially and laterally. It is extensor of the elbow and his shoulder adductor long portion.

Elbow joint:
Gear bone that connects the humerus to the forearm bones: the radius and ulna. Allows flexion-extension movements and pronosupination. In one piece there are 2 types of joint:
-Distal humerus: we distinguish the following morphological features a condyle, trochlea, olecranon fossa and coronoid fossa and medial epicondyle and lateral epicondyle. In the back we see the trochlea but not the condyle. The pit in the front is called the coronoid fossa and the dorsal olecranon fossa.
-Tip proximal radius and ulna:
Radio: represented by a cylinder-shaped epiphyses called radial head or radial dome. It is intended to receive the capitulum.
Ulna: its shape is consistent with the trochlea of the humeral palette. Shows two major processes, a posterior (olecranon) and one anteroposterior (coronoid process) from which delimit a cavity in a half moon with a central ridge and 2 lateral layers converged to articulate with the humeral trochlea.
The radius and ulna articulate with each other (art. Radioulnar above) in which he outlines the annular ligament. Within the elbow joint, we distinguish 3 joints differentiated radiohumeral, cúbitohumeral and proximal raciocubital.



FOREARM MUSCLES:
For their study distinguished 3 regions:
A) anterior region, with 4 levels: level 1, pronator teres, carpi, palmaris longus and carpi ulnaris. All originatein the medial epicondyle and go to the middle third of the diaphysis of the radius, base of 2nd metacarpal, palmar aponeurosis superficial pisiform hand and elbow flexors, respectively, are also active in and forearm pronation and wrist flexion. They are innervated by the median nerve, except the anterior ulnar nerve that supplies the ulnar. 2nd level, common flexor surface of fingers. From the medial epicondyle, ulna and radius, after splitting in 4-digit finishes in the 2nd phalanx of the last 4 fingers. Flex the elbow, wrist and metacarpophalangeal and proximal interphalangeal joints of his toes. Is innervated by the median. 3rd level, long flexor of the thumb itself, deep common flexor of the fingers. It goes from radio to the distal phalanx of the thumb. Flex the metacarpophalangeal and interphalangeal joint of the thumb. Profundus of the fingers is inserted proximally in the radius and ulna, interosseous membrane, divided in 4 digits after reaching the distal phalanx of the last four fingers, flexing his joints and metacarpophalangeal and wrist. 4 th level, pronator quadratus, meaning across in the fourth distal forearm. It is inserted into the radius and ulna. It pronator of the forearm and the innervated by the median nerve.
B) outer region, with two levels: surface level, the 3 músuclos of this plane are inserted staggered top to bottom: on the outer edge of the distal radius and the brachioradialis carpi radialis in the second external radial epicondyle. From there head to the processes estiloidal base radius and the 2nd and 3rd metacarpal, respectively. Brachioradialis is an elbow flexor. Are the radial wrist extensors. All are innervated by the radial. Deep level, the short supinator has two heads, one from the epicondyle superficial and a deep source of the fourth proximal ulna, the two end rolled to the proximal third of the radius. Contraction moved the forearm supination.
C) posterior region, whose muscles are also arranged in two levels: surface level, anconeus, extensor carpi ulnaris, extensor digiti minimi and extensor digitorum, they all originate with the 2nd external radio by a common tendon which inserts at the epicondyle.From here, extend respectively to the proximal ulna, the 5th metacarpal base, last 2 phalanges of the 5th finger and base of the distal phalanx of the last 4 fingers. Its functions are respectively: extensor of the elbow extensor and Lateralized ulnar extensor of wrist and fingers and wrist for all innervated by the radial nerve. Deep level, adductor longus, extensor pollicis brevis, extensor pollicis longus and extensor indicis proprius. The 4 muscles lie in stages over the middle third of the ulnar shaft. The adductor longus is directed to the base of the first metacarpal, extensor pollicis longus to the base of the distal phalanx and the distal extensor of the index coincides with the flat tendon of extensor carpi digitorum for this finger (so it attaches to the base of the distal phalanx of the index). All are innervated by the radial nerve.



WRIST AND HAND:
-Distal radius: is wider and it can distinguish the styloid
-Distal ulna: ends in the ulnar head, designed to articulate with the radius. As an extension of the head are the styloid process which gives attachment to the internal lateral ligament of the radio carpal joint.
Radius and ulna articulate distally by the internal radioulnar joint. This joint is covered with cartilage Hiliana. Between the radius and ulna are a fibrous membrane of great consistency, the interosseous membrane.
-Art. Radioulnar distal sigmoid cavity formed by the head of the radius and ulna. It is a trochoid. The joining means osn the capsule, the anterior and posterior radioulnar ligaments and the triangular ligament. Etween both radioulnar joints is carried out pronosupination forearm.
-Art. Radiocarpal: proximally is represented by the concave surface of the distal aspect of the caudal end of the radius and the lower side of the triangular ligament, distally convex surface formed by the upper face of the first 3 bones of the forearm carpal row. This is a joint condyle and enjoy flexion, extension and lateral (abduction and adduction)
CARPAL BONES: The carpus is composed of 8 bones and distributed in 2 rows (first and second row). The carpal bones are listed radial ulnar scaphoid, lunate, triquetrum and pisiform (proximal row) and trapezium, trapezoid, capitate and hamate (distal row).
Metacarpals and phalanges: they are long bones (though small). The metacarpals are 5 and form the skeleton of the hand itself, serving as a bridge between the carpus and fingers. The proximal extremity of the first metacarpal articulates with the trapezium to form a joint chair mount d: trapeziometacarpal joint. The phalanges are the bones of the fingers. Consists of three rows, except for the thumb only has two.
-Art. Intercarpal: we understand under this name all the joints of the carpal bones to each other and the articulation of the first and second row of the carpus. They artrodias and allow slippage.
-Art. Carpometacarpal: formed by the distal surfaces of the bones of the second row of the carpus and the proximal upper extremity of the metacarpal.
-Art. MCP consisting of the distal metacarpals and proximal phalanges of the first finger are condylar joints and therefore enjoy flexion-extension and lateral movements.
-Art. Interphalangeal: the thumb has only one interphalangeal joint therefore has only two phalanges. The 4 remaining fingers and having 3 phalanges, have two joints, called proximal and distal. Are hinge joints, thus enjoying flexion-extension movements.
INTRINSIC MUSCLES OF THE HAND: 19 small musc. Divided into 3 regions:
Thenar-Region: for the thumb. Formed by 4 musc. That of the surface to depth are: abductor pollicis brevis, short flexor, opponens and adductor. Its name reflects the function they perform. Medium are supplied by the abductor, opponens and flexor superficial portion of the short, while the ulnar nerve innervation takes deep head of flexor brevis and adductor.
Mortgage-Region: this for the little finger. Composed by 4 musc, in 3 planes: superficial (palmar cutaneous), midplane (adductor and short flexor digiti) and deep (opponens digiti). All innervated by the ulnar nerve.
Palmar-region rating: located between the two preceding and consisting of 11 muscles arranged in two levels: surface (4musculos lumbrical) and deep (7 interossei, 3 palm, and 4 occupying the spaces dorsal metacarpal space two at home (one palmar and one dorsal) except in the first interosseous space, which lack the palmar interosseous. These muscles flex the metacarpophalangeal joints and extend interphalangeal. palmar interossei close the fingers, while the ridges between them. They are innervated by the ulnar, except External lumbrical (1st and 2nd) which are along the median nerve.
KNEE AND LEG
-Knee: consists of two areas, the patellofemoral and femorotibial, but work together as a hinge joint. The bony elements involved (trochlea femoral, posterior tibial plateau and the patella) are covered by hyaline cartilage and held in contact by a joint capsule and ligaments of reinforcement. The ligaments of reinforcement are:
A) internal lateral ligament: attaches proximally to the medial femoral condyle and distally on the inner surface of the tibial plateau.
B) Lateral ligament: is attached above the lateral femoral condyle and caudal to the head of the fibula.
C) Anterior cruciate ligament: attaches preespinal down on the surface of the tibia and proximally to the posterior portion of the medial femoral condyle.
D) Posterior cruciate ligament: attaches to the surface retroespinal, and more distal to the posterior horn of the medial meniscus and above in the front of the medial aspect of medial condyle of the femur.
The lateral ligaments stabilize the knee in the frontal plane, while the Crusaders are in the sagittal plane. The internal lateral ligament rupture, consent to the outward shift of the tibia, the external of the inward, the ACL of forward and backward of the posterior cruciate.

-Distal femur: we can consider it as aa truncated square pyramid more inferior. The upper panel corresponds to the transition metáfisodiafisaria. Stresses in the anterior femoral trochlea on which runs the patella in knee flexion. On the underside the condyles of the femur, longer than wide in dorsoventral direction and distal convexity in both anteroposterior and transverse direction, previously confused with the femoral trochlea, but in its dorsal third are shown separated by the intercondylar notch. The inner and outer faces to provide paths tuberosities lis inserting lateral ligaments. On the back are showing the femoral condyles and the intercondylar notch and on such a rough surface.

-Patella: short bone is a triangular-shaped, upper basic and lower corner with a rear face, articulate almost entirely, which in turn are two demifacets (internal and external) that come together in a vertical ridge central, in correspondence with the facets and femoral trochlear groove. The external facet is wider than the inside. The front shows abundant vascular openings.



-Proximal end of the tibia: can we conceive to be studied, like the distal femur as a truncated square pyramid with the difference that there is the wider base being the lower proximal transition zone metáfisodiafisaria. The top surface, designed to articulate with the femoral condyles, shows respective fossae, also called tibial plateau. The internal ridges to the axis of both tibial tibial plateau rise tubers two separate highlighting its area of implementation are known by the name of tibial spine. In front and behind it are retroespinales surfaces before and distal to the insertion of the cruciate ligaments and the horns of both menisci. In front stands a tuberosity (tibial tuberosity) for the insertion of the patellar tendon.

The leg muscles are:
-tibialis anterior: a first wedge posterior end of the first metatarsal, with ankle extensor, adductor and foot supinator. Is innervated by the anterior tibial.
-extensor hallucis: ends at the base of the second phalanx of the great toe, which extends joints, acting in addition to the tibialis anterior. Also innervated by the tibial nerve.
-extensor digitorum: divided into four fingerings after ending each at the base of the distal phalanx of the last four fingers, which extends joints; secondarily collaborates with the anterior tibial ankle extension. Innervated by the peroneal nerve before dividing and the tibialis anterior.
- Peroneus tertius: is inserted into the base of the fifth metatarsal. It works with the extensor digitorum and is also innervated by the anterior tibial.
-peroneal longus: inserts distally on the basis of the first metatarsal, after breaching the lateral malleolus and then go to their destination by foot. It is the ankle flexor, abductor and pronator of the foot. Is innervated by the musculocutaneous branch of the peroneal.
peroneus-short: is inserted into the base of the fifth metatarsal, with their actions and innervation equal to the long side.
-twins: the number of two, internal and external, are inserted proximally at the posterior face of the respective femoral condyles and distally confluent with the soleus to form the Achilles tendon, which attaches to the back of the calcaneus. The combination of both twins and soleus muscle is known as the triceps surae, the large ankle plantar flexor (the twins are knee flexors), innervated by the peroneal and posterior tibial internal.
-plantaris: is inserted proximally in the femoral condyle and distally attaches to the inner edge of the Achilles tendon. It has synergy with and innervated the triceps surae and similar innervation.
-knee: inserts distally on the posterior aspect of the proximal tibia, turning obliquely upwards and outwards to end in the back and external femoral condyle. Bend your knee while you print an internal rotation. Innervated by the peroneal procedure.
- Flexor digitorum: its distal tendon passes behind the medial malleolus and divided into four fingerings after ending at the distal phalanx of fingers two through five, to which flexes, thereby participating in the same ankle flexion. Innervated by the posterior tibial.
- Tibialis posterior: its tendon crosses under the precedent, becoming the same in the medial malleolar region internal to end at the tubercle of the scaphoid. Flex the ankle and foot adducts and supine. Innervated by the posterior tibial.
- Flexor hallucis longus: reaching the sole of the foot after breaching the back of the distal tibia and the medial calcaneus to be inserted into the base of the distal phalanx of great toe, which flexes, also participating in flexion of the ankle. Innervated by the posterior tibial.
ANKLE AND FOOT:

-Distal end of the tibia: in its external side stresses the articular surface, for the distal tibiofibular joint. The front continues to the outer shaft. On the back are two separate objectify longitudinal grooves, which house the tendons of tibialis posterior, flexor digitorum and flexor hallucis own. The inner surface extends downward through a bottom vertex pyramidal process. The lower surface corresponds to the upper surface of the body of the talus.
Distal fibula-Tip: This consists of a pyramidal oval thickening lower corner, representing the external malleolus. Its inner surface attaches to the outside of the body of the talus and the articular surface of the distal tibia. The back offers a channel through which pass the tendons of the lateral perineal muscles.
TARSAL BONES: at number 7: talus, calcaneus, cuboid, navicular and three cuneiform tarsal or wedges, called inside-out, first, second and third, with the exception of the talus and calcaneus other name alludes to its morphology. We conceive them as ways to experience a particular cuboid modeling and can differentiate into all six sides: front, back, top, bottom, outside and inside. In the talus differ a head, neck and body, calcaneus, the most voluminous, ready below the talus, is the skeleton of the heel and the cuboid is placed in front of the calcaneus, tarsal navicular in front of the head of the talus and before him have the 3 cuneiform.
Metatarsals and phalanges: like the hands.
-Art. The ankle is made proximally by the distal extremities of the tibia and fibula and distally through the body of the talus. It is a hinge joint. You flexion-extension movements and the joining means are represented by the joint capsule, anchored proximally to the contour of the ankle mortice and distally in the body of the talus and by reinforcing the ligaments (internal and external lateral).
-Art. Intertarsal: consist of the talocalcaneal joint, or joint midtarsal Chopart (conjuantamente represented by the calcaneocuboid and talonavicular joint), joint escafoidocuboidea, escafoidales joints, joints and joint intercuneiform cuboidocuneal. We consider them all as though artrodias talonavicular joint is a condylar and calcaneocuboid, saddle. The movement of the foot pronosupination takes effect in the talocalcaneal joint.
-Art. Tarsometatarsal: results from the union of the five metatarsals with the three cuneiform and cuboid. Each wedge is articulated with the corresponding metatarsal (1st, 2nd and 3rd) and the cuboid with the 4th and 5th. They enjoy artrodias and gliding movements.
Intrinsic foot muscles: they are 20:
internal plantar region, for the big toe, equivalent to the thenar region of the hand, lacking in the opponent's foot muscle, the external plantar region, for the 5th finger on the mortgage, lacking the equivalent here of the hand cutaneopalmar and the medial plantar region the average span. Average span in the region there are two muscles that do not find correspondence in hand: the attachment of the flexor digitorum and flexor plantar short. The latter however would be the counterpart towards its distal insertion and its functional behavior, with the superficial flexor of the fingers. On the back foot is a muscle, its site. Innervation is provided by the sciatic nerve. The pedal is supplied by the anterior tibial, the rest are supplied by the plantar nerves.
Iliopsoas:
It is a muscle located in the abdominal cavity and the anterior thigh. It consists of two parts: psoas and iliacus: The psoas major and psoas portion is inserted in the vertebrae and the first five DXII lumbar and on the basis of the corresponding costiformes processes, and descends to the lower quadrant ofWhere hip meets the iliac portion. The vertebral attachment is peculiar, in a series of overlapping arcs from an intervertebral disc to another. The iliac portion is attached above the inner lip of the iliac crest, anterior superior iliac spines, upper and lower base of the sacrum, part of the internal iliac fossa, iliolumbar ligament and lateral side of the front of the sacrum. Both muscular bodies unite to pass under the inguinal ligament on the outer, inserting together on the lesser trochanter offemur. During its journey, the iliopsoas is related to important organs: diaphragm ma, kidneys, ureters, renal vessels, colon, blind, iliac arteries and external iliac arteries and veins. Especially close is their relationship with thelumbar plexus, which passes through the muscle. The iliopsoas muscle is innervated by direct branches of the lumbar plexus and nerve crural ar

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