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Anatomy teaching Session 1 Introductory to anatomy and RadiologyDisclaimer • The following presentation has been made for students by students and we are not held accountable for any inaccuracies. This is a learning tool that has not been reviewed by the University of Sheffield and therefore the use of this session is to facilitate your learning only.Aims and objectives • Introduction to radiology • Looking through the common anatomical terminology • Understanding what is meant by the appendicular and axial skeleton. • Understanding the common terminology used to describe movement. • Identifying different types of joints and muscles • Understanding the gross anatomy of the limb and the spine • Understanding the structure of the central and peripheral nervous systems. • Describing the similarities of the sympathetic and parasympathetic nervous systems. • Understanding how anatomy is used in Radiology.What is Radiology • Radiology is the medical specialty that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals.X-rays • Usually X-rays are taken in Posterior to anterior direction. As it makes the image higher quality. • Can you think why sometimes it might be done anterior to posteriorly?Anatomical position Descriptor Meaning Example Superior Above The brain is superior to the heart. Key words Inferior Below The pelvis is inferior to the thorax. Anterior / Ventral Front (in front of) The nose is anterior to the ears. Posterior / Dorsal Back (behind) The spine is posterior to the sternum. Medial Closer to the centre line The big toe is medial to the little toe. Lateral Further away from the centre line The thumb is lateral to the palm. Proximal Closer to the origin The elbow is proximal to the wrist. Distal Further away from the origin The toes are distal to the knee. Ipsilateral The same side of the body The right arm and right leg are ipsilateral to each other. Contralateral The opposite side of the body The right arm and left leg are contralateral to each other. Deep Further away from the surface The heart is deep to the sternum. Superficial Closer to the surface The skin is superficial to muscle. Supine (position) Lying down on one’s back, facing up With the patient supine, they are facing the ceiling. Prone (position) Lying down on one’s front, face down With the patient prone, they are facing the floor. Cranial Towards the head The brain is cranial to the spinal cord. Caudal Towards the ‘tail’ The pelvis is caudal to the abdomen. Rostral Towards the face The frontal lobe of the brain is rostral to the occipital lobe.Key phrasesAnatomical plane Skeleton Axial: The core 80 Appendicular: Basically everything else 126Joint typesDescribing movement Descriptor Meaning Flexion Bending (decreasing the angle between the two parts). Extension Straightening (increasing the angle between the two parts). Lateral flexion Unique to the vertebral column: bending sideways. Abduction Movement away from the midline. Adduction Movement towards the midline. Internal rotation Rotating (around an axis) towards the midline (also known as medial rotation). External rotation Rotating (around an axis) away from the midline (also known as lateral rotation). Pronation Unique to the forearm: internal rotation of the radius, so that the palm faces posteriorly (our forearm and hand are prone when we type using a keyboard). Supination Unique to the forearm: external rotation of the radius, so that the palm faces anteriorly (i.e. the anatomical position). Opposition Unique to the thumb and little finger: flexion and rotation of the thumb or little finger so that each one can reach the other. Circumduction Combination of flexion, extension, abduction, and adduction such that the appendage traces a circular or conical pattern. Dorsiflexion Unique to the ankle: the foot and toes move superiorly towards the shin (pointing the foot and toes ‘up’). Plantarflexion Unique to the ankle: the foot and toes move inferiorly (pointing the foot and toes ‘down’). Inversion Unique to the foot: medial flexion so that the sole of the foot faces medially. Eversion Unique to the foot: lateral flexion so that the sole of the foot faces laterally. Protraction Unique to the scapula and mandible: moving the scapula or mandible anteriorly (e.g. moving our upper limb out in front of us to push open a door). Retraction Unique to the scapula and mandible: moving the scapula or mandible posteriorly (e.g. ‘squaring’ the shoulders). Elevation Unique to the scapula and mandible: moving the scapula or mandible superiorly (e.g. shrugging the shoulders, closing the mouth). Depression Unique to the scapula and mandible: moving the scapula or mandible inferiorly (e.g. returning the shoulders after elevation, opening the mouth).Arms Can come up in your exam!Anatomical movementsGross anatomy of upper limbX-ray https://www.istockphoto.com/photos/arm-xrayGross anatomy of the lower limbX-ray of lower limb What is wrong with the left leg? An example of intramedullary ailing to immobilize and help healing of Tibia.T endons • Skeletal muscles are attached to bone or soft tissues by tendons, which are composed of strong connective tissue. AponeurosisShapes of muscles A motor unit is composed of a single motor neuron, its axon, and the muscle fibres it supplies. There is great variation in the size of motor units within muscles. your back muscles!fice precision for strength such asVertebral column • Cervical - 7 cervical vertebrae in the neck (C1 - C7) • Thoracic - 12 thoracic vertebrae in the thorax (T1 - T12) • Lumbar - 5 lumbar vertebrae in the abdomen (L1 - L5) • Sacral - 5 sacral vertebrae in the pelvis (S1 - S5) which are fused into the sacrum • Coccygeal - 4 coccygeal vertebrae in the pelvis (Co1 - Co4) which are fused into the coccyx. Kyphosis and Lordosis https://www.istockphoto.com/illustrations/spinal- cord-labeled Anatomy bookQuestion • Can you spot any abnormalities? https://www.nibib.nih.gov/science-education/science-topics/x-raysBrainDivisions of the nervous system Autonomic NS has sensory systems that are internal sensors.Anatomical divisionCerebrum • Folds gyri and grooves sulcus • Cerebral cortex and neocortex (the 6 layers)4 lobesBrainstemSpine • Spinal cord ends at around L1/2 (exam question) • There are 31 pairs of spinal nerves.Ventricles of the brain • provides nutrients to the brain. • protects the brain by providing a cushion against trauma. • prevents delicate nerves and vessels from being compressed between the brain and the internal surface of the skull.MeningesCircle of WillisCranial nerves 1973: ParasympatheticGangliaMyotomes and Dermatomes T5 : breast areola T10 : Umbilical cordBrain MRI • A patient is admitted to the hospital after a car accident. They are reported to have hit their head very hardly and appears to be conscious. A brain CT scan was ordered and the Radiologist confirmed the patient’s condition. • What could their condition be? • MRIs have higher resolution than CT scans. • Why didn’t the doctor order an MRI?Exam Questions • Which of the following bones is axial? • A) Scapula • B) Pelvis • C) Sternum • D) HumerusExam Questions • Which of the following bones is axial? • A) Scapula • B) Pelvis • C) Sternum • D) HumerusQuestion • What type of joint is the knee join? • A) Ball and socket • B) Condyloid • C) Saddle • D) HingeQuestion • What type of joint is the knee join? • A) Ball and socket • B) Condyloid • C) Saddle • D) HingeQuestion • What anatomical plane is this image of brain taken from? • A) Coronal • B)Sagittal • C)Transverse • D)AxialQuestion • What anatomical plane is this image of brain taken from? • A) Coronal • B)Sagittal • C)Transverse • D)AxialQuestion • What type of movement is this? • A) Flexion of the knee joint • B) Flexion of the hip joint • C) Extension of the knee joint • D) Extension of the hip jointQuestion • What type of movement is this? • A) Flexion of the knee joint • B) Flexion of the hip joint • C) Extension of the knee joint • D) Extension of the hip jointQuestion • What is the arrow pointing at? • A) Vertebral foramen • B) Transverse foramen • C) Foramen OvaleQuestion • What is the arrow pointing at? • A) Vertebral foramen • B) Transverse foramen • C) Foramen OvaleQuestion • What does the Blue box represent? • A) Vertebral foramen • B) Lamina • C) Pedicle • D) Spinous processQuestion • What does the Blue box represent? • A) Vertebral foramen • B) Lamina • C) Pedicle • D) Spinous processQuestion • Which of the following is true? • A) Gyri are the grooves of the brain • B) Neocortex is the central part of the brain • C) Brainstem consists of midbrain, pons and diancephalon • D) Midbrain is superior to the Pons • E) Midbrain is medial to the diencephalonQuestion • Which of the following is true? • A) Gyri are the grooves of the brain • B) Neocortex is the central part of the brain • C) Brainstem consists of midbrain, pons and diancephalon • D) Midbrain is superior to the Pons • E) Midbrain is medial to the diencephalonA patient is admitted to the hospital with a rash. They are diagnosed with shingles around their chest area. Which dermatome is it likely to be affected? • A)C2 • B)T4 • C)L6 • D)S1A patient is admitted to the hospital with a rash. They are diagnosed with shingles around their chest area. Which dermatome is it likely to be affected? • A)C2 • B)T4 • C)L6 • D)S1A patient comes into the clinic with a slipped disk. You are a medical student and the consultant asked you to identify this type of vertebrae that is damaged. Which of the following does this belong to? • A) Cervical • B) Thoracic • C) Lumbar • D) Sacral • E) CoccygealA patient comes into the clinic with a slipped disk. You are a medical student and the consultant asked you to identify this type of vertebrae that is damaged. Which of the following does this belong to? • A) Cervical • B) Thoracic • C) Lumbar • D) Sacral • E) CoccygealFeedback • https://app.medall.org/feedback/feedback- flow?keyword=4d6f9f16a2aa177ff1a2f8ee&organisation=sheffield- radsocThanks for Listening • Pouria Sanikhani • Radsoc • psanikhani1@Sheffield.ac.ukReferences • https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.osmosis.org%2Flearn%2FCranial_nerves&psig=AOvVaw0Vjf ZyGVerpi1uHVOPijbr&ust=1728514127210000&source=images&cd=vfe&opi=89978449&ved=0CBcQjhxqFwoTCNCf4ZHv_ 4gDFQAAAAAdAAAAABAK • https://www.google.com/url?sa=i&url=https%3A%2F%2Fteachmeanatomy.info%2Fencyclopaedia%2Fc%2Fcircle-of- willis%2F&psig=AOvVaw3L-0t4kF- BAEuaUlSf_Nme&ust=1728513890399000&source=images&cd=vfe&opi=89978449&ved=0CBcQjhxqFwoTCKjN3pbu_4gDFQAAAAAdAAAAA • https://www.google.com/url?sa=i&url=https%3A%2F%2Femedicine.medscape.com%2Farticle%2F1878388- overview&psig=AOvVaw2B9TJuFM1FasOr70RTN2_K&ust=1728514359518000&source=images&cd=vfe&opi=89978449&ved=0CBcQjhxqFw oTCLjt6_Xv_4gDFQAAAAAdAAAAABAU • https://www.google.com/url?sa=i&url=https%3A%2F%2Fteachmeanatomy.info%2Fthe-basics%2Fanatomical-terminology%2Fterms-of- location%2F&psig=AOvVaw3s59Tqf-onezivDTihTw- G&ust=1728860656697000&source=images&cd=vfe&opi=89978449&ved=0CBcQjhxqFwoTCKjF__35iYkDFQAAAAAdAAAAABAJ • https://www.google.com/url?sa=i&url=https%3A%2F%2Fen.wikipedia.org%2Fwiki%2FSupine_position&psig=AOvVaw0KuaA9AAVnHx1Cofp K_GbV&ust=1728860776044000&source=images&cd=vfe&opi=89978449&ved=0CBcQjhxqFwoTCLi4mbf6iYkDFQAAAAAdAAAAABAE • https://sequencewiz.org/2016/03/16/loosen-up-your-shoulders/ • https://www.rishacademy.com/oblique-plane/ • https://www.scienceabc.com/humans/what-are-the-different-types-of-joints-in-our-body.htmlReferences • http://johnrlau.blogspot.com/2019/10/supination-yes-pronation-no.html • https://open.oregonstate.education/aandp/chapter/9-5-types-of-body-movements/ • https://www.yogaru.ie/pause/anatomy-101-the-spine • https://radiopaedia.org/cases/extradural-haematoma • https://basicmedicalkey.com/introduction-to-the-upper-limb/ • https://basicmedicalkey.com/introduction-to-the-lower-limb/ • https://uk.pinterest.com/pin/rostral-vs-caudal-head-axis-description-for-head-anatomy-outline-diagram-- 732538695654050268/ • https://open.oregonstate.education/aandp/chapter/12-1-structure-and-function-of-the-nervous-system/ • https://www.researchgate.net/figure/The-primary-division-of-the-human-neocortex-into- lobes_fig7_215509007 • https://en.wikipedia.org/wiki/BrainstemReferences • https://www.thoughtco.com/ventricular-system-of-the-brain-3901496 • https://www.thoughtco.com/brain-anatomy-meninges-4018883 • https://www.osmosis.org/learn/Cranial_nerves • https://anatomytool.org/content/servier-drawing-dermatomes-labels