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Hello and good evening. I'm hoping this is sending out Hi. Welcome to the edge to help get serious money. Is Freddy Cooper trust making annoying noise? Uh, because the atrial. Okay, serious, uh, session on bone to me. Well, first of two sessions we're gonna have on bone anatomy. Um, so, look, look, I'm pretty. I'm a third year medical student at King's College, London. Unfortunately, I am on my own tonight. Since the sad face, I have no moderator for the chatter Day. Unfortunately, so pleased you put lots in the jet because I'm going to be relying on you guys for my interaction and, you know, socialization and all that sort of thing. So pleased to put us in the chair, ask questions. Anything you've got, please do on there with me a little bit, because I'll have to check the chatter myself periodically. So if I don't not see you immediately, That is why I have every week we put this up. Making the most are sessions feel very sick. Notes, notes of brilliant way to sort of still things in your brain, but also to look back on later and also to see where you have gaps, potentially ask questions. As I said, Please ask questions because obviously it's gonna be just me talking at you, and it's very, very boring for everyone involved. Please ask questions. Test me. Honestly, I probably if I don't know the answer, I can at least tell you where to go to find out and answer. But please ask questions. It's a great way again to keep yourselves interactive in the session on gaping towards what you're interested in, as well as filling gaps in your knowledge, potentially on the finally, their bits, you particularly joined. Please do send me an email more than happy to find you're more resources of people to talk to. Whatever about topics you're interested in. Awesome recession. Tonight is very bone heavy. It's bone anatomy so we can have sex and teaching anatomy resource. That is all, you know, push you towards people who work with. But it's not being myself. Particular highlights of this evening. There's my mail address. I'm sure everyone who tends has my email address. Given the fact I uh huh email the front it every time. So please do, uh, email me if you have any queries more than happy to answer them. You can follow us on Instagram and Facebook. I am useless updating the Instagram and Facebook. I'm very sorry about that. But least do get them a follow. We do try to at least when we have new sessions to announce. We try to put them on there. Uh, where are we currently? So here we are. This is our third session we're hosting in 2022. This is bone in that part. One that means that there's gonna be a bone anatomy part, too. Uh, I'm quite excited about going to be hard to I'm not teaching it. I have someone very interesting lined up to come and do that session. So should be good notes that the other ones haven't been, but that one should be particularly interesting. We're still waiting for a date to put in our nutrition Syria our nutrition lecture because it just hasn't been able to happen yet. Unfortunately, speaker is it's been very busy lately. So when we know more about her schedule, we'll try and put her in. All that being said, let's move on to bone anatomy. Part one, The trunk. Did you quickly check the chance. Ah, um, available for questions. They said, yes. You can ask. I hang around at the end of the end, Ask questions for out email questions. All of that works. Um, yes. Always feel free to Let's just ask them the chat here. You could email me them if you don't put them in the chat on. Actually, I check my email every day. So if you come up with something random in the middle of a week or you go, Oh, this is an interesting topic. I've heard that school or you need or wherever you are on be interested to know more, you know, feel free to send it were really happy to, um, interact basically help out where we can. That's sort of the point of the Siris. So, bone, actually, part one. The trunk here is a trunk. Here is the anatomy off the trunk. This is not the intended actually, last me for this evening, but that is an interesting place to start. This is apparently the muscular anatomy off elephant's trunk. Interestingly enough, there's no bones in the trunk. They don't have a nasal bone, so I didn't find out until I've already been writing this session? Um, yeah, There's lots of muscles in an elephant's trunk. This is what trunk we're all about today. So if you take a human body on, divide it up, it becomes sort of three segments. You have the head. We are not going to cover the head today. That's in my my definition, at least everything from the top 30 for upwards, well above the top that we covered that last year. If you look on the middle, we've got to find the links to it's Josh did a session on head and neck anatomy. I've also done a session on your anatomy. It wasn't the best session. I won't deny I was being unwell at the time, but ah, I tried. I think my voice went by the end of it. But it between those two recovered the majority that the bony and asked me of the head came under those. The trunk is the bit then the neck down to the pelvis, which will go through today and then finally have the limbs. So the limbs are gonna be what's happening on the 10th of March without other speaker on they Well, yeah, This is your entire human body. There are 200 something bones in it. Think some people say 206. But it does actually, very depending on what you count as an individual bone. And what you count is a group of bones and the vast majority of them, I believe that did work this out at one point. It's saying like over half of them are in the limbs and then most of the rest are in the head with all the restaurant head on the trunk. We're gonna go through the trunk today. This is a bit more of a breakdown of what we're expecting within the truck as a session is bony anatomy. I'm going to focus purely on bones. There is one set of muscles I am going to talk about because that's quite important. S O. R. Trunk can be divided into upper, middle and lower upper being sort of chest made being sort of the abdomen and lower being sort of the pelvic area. But sometime you know, always divided that way. Normally, you would say four AKs, abdomen, pelvis and sort of identify it based on the actual structures. There rather than the sort of arbitrary boundaries. But if you want to divide the trunk into those can do, then also got I hate this bit because upper leg shouldn't exist. Your upper leg is actually your thigh, and then your lower leg is actually in your leg. Your leg ends your knee, but that's a bone to pick with those things anyone is actually very interested in at a meal or anyone at a university, I can recommend this resource. I've got highlighted here. Ken Hub I use can help quite a lot. I don't get sponsored for saying it. They're kind of expensive. You have to buy membership to them. But actually for most of my anatomy revision most of my anatomy learning they were results I use because they are quite good for learning sort of gross anatomy. They're not very good if you're trying to learn how the anatomy works, like you know what each muscle does. But if it's literally game of like learning what learning how to name things he spot Ken have is a very good resource. There are resources out there obviously available, so breaking down the trunk. So there are four main areas of bones in the trunk. Therefore, areas of bones not remain. There are four areas which, in cultures or thumb, it can be quite scary. Thought to just go well. Here is everything between your neck and your pelvis. Uh, name all the bones in there. But actually, when you break it down into the four bits on, sort of begin thinking about them individually becomes a much less daunting task, which is kind of pleasant. In my book, most of anatomy is quite difficult if you just sort of go hearing all of it is learn it. But if you learn it a bit by bit, much easier to build up. So we have the spine, which is over here. Hopefully, people can recognize the spine that is your spine. We have the rib cage I've put down here again. Hopefully, we can recognize the rib cage may be a bit less recognizable. It's the shoulder girdle, which we'll talk about what you're talking about. A little bit later, that's the shoulder girdle on. Finally, the pelvic girdle is down here, so we'll start off. Start off just actually with some very basic bits, which is what bones do we have in the body on bones? The human body Chen two broken down into these categories. So flat bones, sometimes used realistically flat bones or sometimes ignores as well. You have flat bones in your skull. You have flat bones in your ribs. They're flat bone on your scapula on your back. You have short bones. These are little bones. Simply put, they're not very long. So therefore, they're short long bones. Long bones are actually the ones predominately in the limbs. So the ones in your arms, the ones in your thigh and link you have your regular bones. We gonna talk about few of them today because they make up your vertebra. They also make up a lot of the bones in your head. But we're not really all about them today. And you have sesamoid bones. There is one sesamoid bone in the human body, and that doesn't come into my session. Honey, what is particularly wilting to be particularly, uh, well, test themselves. Name the one sesamoid bone. Um, if you can name the one sesamoid bone, then I will be quite impressed. Get a couple of minutes to see that because I would also just put in the chapter. They can hear me because I just had someone put what time will be starting. And I'm worried you can't hear me. Little bit worried that getting lots of forms. Ups of things. Yes, that's good messages appearing now. Oh, beautiful. Thank you very much. Sorry, I got a little bit worried that I always forget that there's a couple of second delay. So actually, I asked this and then you guys will hear it a bit later, and it takes a little bit. Kind of type R. Thank you. All wonderful people for confirming that. Thank you. Um, yes. So good is anyone wants. Try name the one sesamoid bone we have in the body. You're welcome to give it a go. If not, it will come up in the next session. Which kind of a hint for those of you who want hint Shoulder? No, not in a shoulder. Unfortunately. Think lower and not trunk. It's like, well, the most weird niche questions, but it's quite a useful bit of it is actually kind of a fun fact. Sometimes you get a pop quiz jawbone that's not lower than shoulder of afraid, but just ride. Give let one more guess. Knee spot. Also in your knee is your patella bone. So your patella bone a sesamoid bone is basically a floating bone. So it sits within attendant, and your patella bone sits within your patella tendon on. So it's sort of floats within that joint, and its entire point is to try and hold your knee in place, patella or kneecap. That someone else is our Let's put it here. So, yeah, you need the patella, So yeah, well, don't goes. Um although, actually, do you like this point? So we'll just put your hands? Yes, technically, down from your shoulders would be your hands. I didn't think about that. I went down always, anyway. Yeah, that's your type of bone, One of these things that you're taught a lot in a lot of ways, but then it actually doesn't really hold very much application because actually, you don't really need to know what sort of bone most bones are. You just need to know what they do is a beautiful quote I have from one of the presses in my unit. And that is that the beauty of bones is that their form is their function, so anatomy his physiology there form is their function. Let your your lungs. You look at your lungs and they do many, many things. And those many, many things aren't related to how they look but with a bone. If a bone is shaped a certain way, that tells you exactly what it does. We'll talk a little bit more about that in a minute. I think the next slows what I wanted. Know quite, Um, you'll learn more about that particular with the limbs, because the limbs of the easier bones understand how the shape convey varied due to the function. But generally the way, however bone is shaped, determines what it's doing. And so it's anatomy is it's physiology or it's for is its function. So we'll start off with spine starts. Fine. I think that makes a lot of sense. If you think about it. The whole trunk of the body is sort of built off of the spine. The spine is the core effectively. It's the framework off of which will the rest of the bones originate? Older of bone sort of sick. So start with the spine. The's basically key fax to remember in In service introducing the spine There are 33 bones. There's a lot of bones. These vertebrae vertebrate or yeah, basically, literally every individual bone in your spine is a vertebrae. It's, um it's called Vertebral column. There's other things involved in it, but basically each bone is a vertebrae. There are five version five categories of these, um, the main ones to remember a survival for a sick and lumbar say krill sort of gets ignored. And actually, sometimes it's just counted as one bone in adults because they all fused together s It was actually several bones, but they're all of one sort of block that and then your coccyx say early, fairly pointless in modern man, they're sort of where a tail could be if we were to have a tail. But they we don't have a tail. So the coccyx sort of bit pointless nowadays over the fact they hurt a lot. If you break them, that's sort of their main function. But so cervical in the neck for a sick in the chest and lumbar in the sort of the bank, the lower back, middle back. Have you wanted to find the bit below your chest. Um, his how those break down again. Don't be too scared when you look at these. Initially, there are two specifically named vertebra. It's that's not just they have a code they're unable to see. 1234567 t one through 12 L1 through five. Sacrum sometimes s one through five, but actually normally just say cream. But at the very top of the cervical vertebra, see, one is good atlas, which you remember from in Greek mythology. Atlas was the Titan who held up the sky. In this case, Atlas is the vertebrae that holds up your skull. It's the point which your spine meets your scale. So it's kind of important. Also, this was holding up your head on access because that is free, which atlases able to sort of rotate. So an access, or C, is a point of irritation. Um, so your access is what Atlas rotates in. Those two are named, uh, other than that. The rest of them are just numbers, which I was found it funny. I think someone at some point will go along and just name the rest of them for the sake of it, because it be really, really boring task that something that you can go and claim you've done on, probably worth some sort of credits at some point. But to be honest, no really worth the effort. As I said, these three main categories are the most important ones to really think about your cervical vertebra or up in your neck. They have a lot of nerves coming off between them that also controls your arms because coming top, they also have a lot of function in terms of innovating your chest so your lungs you'll die. A friend helps me breathe functions, sometimes to the face. Come off at that sort of the top below between sort of see one and the skull. So you've got damage in this area could be devastating on Concordes, you to have sort of parral it, paralysis of the lungs. You can't breathe anymore on off signal. Be very severe in terms of knocking out large, large like areas of the body that will no longer have feeling or no longer have function, you will be able to control them the main sort of function of the spine. Really is in protecting the nerves that go down it in control of the rest of the body. So if you damage these vertebrae and they collapse, they can impinge those nerves or even seven those nerves and and stop those nerves doing their jobs further down the thoracic vertebra. Every for acid vertebral. Have a rib attached to it. We'll talk more about that in a minute, but again, damage in this area can be quite devastating. It's still quite high up in the spine. Ankle impinge a lot of know pathways further down on. Then find it the lumbar spine, which is sort of in the lower part of your back. The's a really big, really chunky. That's great. They are very important for weight bearing off. There's not any other bones in the area. So if you think below your revocation above your pelvis, these are kind of the only bones in the entire area, so they do a lot of work. But again, there's a lot of conditions involving them becoming a bit broken or involving them in pinching the nerves in the area. Things like sciatica, which is probably quite well heard of, is that it's a nerve injury relating to these. So they are. We don't like vertebral falling apart. We need them intact. In terms of however, Teber itself is shaped here is sort of a breakdown of it. Um, the spine, each different level. So as the vertebra get down the back, they change in shape slightly. So your thoracic vertebra, different shapes to use the Vicodin vertebra. That's the Vicodin, Byetta, bro. On drastic vertebral, different from your lumbar vertebra. And then your sake room is just weird because it's all fused together. So that makes his own funky shape on your coccyx will have their own mind that I think any to coccyx really look the same. Um, so it's Yeah, angels that goes for the appointments to remember. See if you've got your your main body of the vertebra, which is the most white patch here at the bottom, you have the spine is processes the pointy bit that sticks out the back. And if anyone feels down the back of their neck, you'll feel lots of bumps on. That is the spice processes of your cervical vertebra off, so you can probably feel them as well. If you feel low down your lumbar ones and your fasting ones. This is part just protecting the spine. You also have your transversus processes, which are important because they stick out the two sides again. It's for protecting side on damage. Uh, and it's also they're old sights of, uh, ligament attachment. So many bone, where you've got a bit that sticks out. That's because there's as you're growing there something that pulling on it. Normally a ligament was a ligament is what taxes to a bone so that that bone originally start sort of nice and flat as that ligaments been pulling on it continuously as you grow. That's gonna make more bone form in that area, and you end up with a process that's the side of attachment for ligaments. Uh, very souls, um, also can talk about all the different ones because there's 33 different vertebra, and it'll take me forever to tell you about thousands of ligaments. But just remember that basically, anything that sticks out tends to have something attached to it in order to make it stick out. And that sort of whites there it helps rotate, helps hold it in place for something else. rotates they have. There's different reasons. Um, it's here that I want to mention entirely. The rest of it is more down to just the shaping of it. On this nice hole in the middle is important because this hole in the middle of this bony part is what contains the spinal cord itself. So the actual, like nervous pathways, which passed through the spine, live in this sort of triangular shape gap. So if something would happen and break and a bit that bone was to poke into this gap, you know, start interrupting those nerves, um, which we don't particularly want. So we like these to stay nicely into shape. So on the big banks of the bottom of the reason it's got it's spongy look is because that contains contains slash contains, depending on the stage in life, the cells that are producing new bones. This is where bone is growing from two, then replace old bone or toe make bone. This's where sort of lots of blood congeal Oh through via these little spongy looking holes in or two supply those cells, which then can make bone on this, the main sort of function of this large disc of bone here, which every vegetable has is that this is doing the weight bearing job. So obviously a lot of a lot of weight will go for your spine on. This is the job of this bit of bone to sort of withstand it. So, as I said, they vary in shape is they get down. Generally higher up. Your cervical vertebra will have proportionality wise, quite a wide gap and quite a small body. The body is smaller office because there's less weight to carry when you're at the top. So it's just holding up your head, whereas the ones in the bottom in your lumbar holding up the weight of your entire upper body. Uh, the actual shape of it, called the foramen of foramen, is a hold simply normal. Some people to find as a whole of nerve passes through. It's It's not quite accurate because you have foramen in other parts of the body. That nose don't pass through in this case and nervous passing through it. But it's very triangular shape. Where is later on? It becomes a circular and then triangular again, Um, and then the other one that's more mentioning is just that. See one. So apple is that's one of the very top doesn't have, um, the process. It doesn't have the sort of spiky because basically talking right up into your skull, um, other than off. So you can read these at your own leisure, but basically the body part gets bigger as it goes down the proportion that is open the foramen compared to the body gets smaller. Uh, and the other big thing is that for acid, vertebral will have a site of attachment for a rib. Where's and then the other ones will, because it was have ribs. Uh, and that's sort of the main that's had, like you to sort of remember what it is. Anything else specific that I want to mention this point. Realistically, when you've looked at a 30 vertebrae, you can sort of get quite good picking one up and going. This is probably a thoracic vertebra, or this is probably a survival vertebra and then knowing if it's a slightly larger one, it's probably a later thoracic vertebra or an early for acid vertebra, and you can sort of start getting used to start differentiating them. Will you ever need to. Probably not, maybe for unexamined once if you go down like a med school route. But realistically, these are very it's knowledge. It's worth knowing because you might be tested on it. But outside of a test, knowing the specific bits of the vertebrae probably isn't that applicable. Well, here we go. Let me have a quick ganda, But questions? Bone marrow Where is bone marrow present? So bone marrow predominantly is in long bones or larger bones? We'll talk a little bit about it in terms of the sternum because of bit in the sternum. Uh, generally bone marrow is in that with that, which produces blood doesn't tend to exist so much in smaller bones like these. Really, because bone marrow makes blood and you need quite a lot of bone to like, How's it that makes sense and just It's sort of been wasted space in your spine where there's not much spine there. Uh, on then, do you have any tips on how to identify the spinal level in practice? Landmarks, etcetera. We'll see if it's got a rib attached to it is for a sick. So if you're looking at someone spine and it looks like a room should be there. There is a rib there, you know that's in that middle section. If it's above where the ribs are, you can office ago survival. If it's below that lumbar, Um, there is also varying human human. There are some bits that you can just pick out on like some people. One particular vertebrae is mawr protrusive than others. But I can't remember exactly the rules about how it varies. There's one that's like things like T seven or T eight or sometimes t six or sometimes t five is the one that sticks the most out of your back. But I think that's sort of middle of the thoracic vertebra somewhere. That's quite good point to go from, um, otherwise. Realistically, not entirely, um, but generally, if you get the simplest, ask that one. This is more practicality thing. That is a scientific thing. If you're trying to go, I think that's a problem in this area given area. Say it's somewhere between this rib, this vertebra and this vertebra. You know it's between T five and t seven, because it might be t five, it might be 87. It might be t six. I'm not entirely sure, but the truth is, until someone has an actual look at it on a scan, then I'm gonna be entirely sure either more tell someone goes down and painstakingly counts down all the vertebra to it. They're not gonna be entirely sure either. Ah, a lot of the time in anatomy teaching we teach. The various things are various spinal levels. We sort of use it almost like a measuring tape down the back of the human body. It doesn't work. I remember having an argument with one of my anatomy professors in first year when he said that the was it was the creek was at the Carina. Think is the Carina part of the lung was always this particular spinal left sitting. But what happens if you've got a really long spine or really short spine? And then looking at one of the anatomy models, one of the donated skeletons and you can tell just looking at different skeletons that different things are different heights. It doesn't really work as well. In practice space, everything is a bit of a range, so in terms of cannot give you particular typist to figure out what particular vertebrae is. Give a range given up, you know, say it's between this one and this one because that's more accurate than saying I believe is exactly this point because his own you might miss. I don't if that answers the question or not. So if there's any more questions on the spine before we move on, please do feel free to ask them, Ah, bone marrow transplant. So it bone marrow transplant. So this is more probably gonna be in the next session about limbs. The most bone marrow we have is in our femurs. The femur is the bone in the side. A bone marrow transplant is that if you've got, ah, certain diseases things like leukemias and things that this which are affecting your blood cells, we can nuke radio, radiate or chemically destroy the bone murmur, basically kill it all off to stop you producing cancer cells. In that case, you have no bone marrow. You're not making any blood cells for yourself, and that's not a good place to be because, like a red blood cell loss, I think it's like if it's something like 40 to 60 days, some others not a long time when you think about it. If all your blood cells and then going be dead in two months, um, so we need to give you more. And so a bone marrow transplant involves drilling a whole in someone else's FEMA, taking out some bone marrow on putting it into you to fill you back up bone marrow Pretty much you only use the famous for it another bone that we'll talk about in a minute. The sternum also attends bit of bone marrow, but basically there is so little in your average bone like fragment of like a tiny dot. Because the bone itself is so small, that proportion, that is marrow is next to nothing that we can't use them in the almost worth discounting. Actually, some bones, I think you do complete this camp that basically just doesn't exist in them. The femur is a very big boned, I think. 10. I think it is the biggest bone in our body. That's the one in thigh. Understand, um, is a relatively big bone, so these are sort of the only ones that have enough bone enough mass off boat to have enough bone marrow to be sort of functional. Does that make sense? Um, that's a good question, I think one that our speaker in a couple weeks time will very confused by if you'd like to ask them. So if nothing else about spine, let's move on to ribs. I realize now also, this is not a bit of rib meat. I try to. I picked some random options. That power Point was giving me in terms of the decorating for this power point just to see what it did. It's this apparently this, I believe, is actually a lamb. Uh, cutlet. Ah, but that was from some brief googling about where this power point get his images, and that's what they told me. So I'm not It probably actually more looks more beefy to me. Anyway, the rib cage. So, uh, Europe change contains ribs. It also contains this sternum, which is this lovely plate of bone. You've got to the front on Accutane. Some cartilage. Uh, there are two types of rib. You have your true ribs and your false rips. Also sometimes known as you're floating ribs. Your true ribs join the sternum via costal cartilage said the rib ends and there's a bit of cartilage on the end of it to join it on to the sternum. Your false ribs float so they don't connect to the sternum. All they might connect to the sternum, sort of roughly, via just about joining on to a different rib by the cartilage. So normally, your 11th and 12th of floating your 10th probably floating your ninth could be floating. But again, there's been a variation there, person to person. Sometimes the 10th will be joined in. Sometimes their ninth won't be a little bit varied. Generally, you've got sort of between two and three normal two or three false ribs, and the rest are truth. The sternum is three bones the manubrium, which is the bit right at the top. So if you sort of feel in the top of the nocturia chest there, that's your manubrium. Below that is your body of your sternum, the main body on below. That is the safest earn, um, or there's if I'd process which effectively little sort of shard of bone sticking out downwards, Um, and that consists of what is actually in your rib catch ribs themselves flat and semi circular in a way. Um, they joined for acid vertebra at the back of your back in your spine. You have 12 for a sick vertebrae. So you have 12 ribs? Um, they are roughly in the same shape, regardless of where they are in the the rib cage, off to the ones at the top of smaller ones in the middle of bigger the ones that the bottom don't quite join all the way around. So they're sort of bit smaller again, but they also have the same rough shape. In between your ribs are your intercostal muscles. Anything that says costal tends to be rude related. Just a worthwhile thing to remember. And these intercostal muscles joined the ribs together. When we're breathing, these pulled the ribs towards each other to push a route that have poor part expiration. Um, and they relax so that we can breathe in during inspiration in terms of what already actually looks like his, uh labeled one worth ruling. Posterior is the back anterior is the front. So here is this nice sort of cap of costal cartilage which might join into the sternum. It might not be any of it's true or false is a rib, the external surface of rivers and staying nicely smooth. If you still feel down your rib cage, you'll feel they're all nice and smooth. Okay, they're a bit bumpy, but actually each individual rib is a nice, smooth surface, which is really important because that enables. It's, you know, skin to move against it and things like this without catching and being uncomfortable. Ribs have a head. Most bones have a head. The head tends to be the sort of the the main point of attachment other parts of the body. In this case, it was the head of taxes into the thoracic vertebrae. Uh, neck, like you have a neck touched your head bone stent, Have a neck attach the head. Uh, the only a bit I want to mention on this is one of the turbulence or tubercle. Um, typical is probably the better way to say it that I've heard Americans call it terrible chip ical. Uh, and that is effectively a notch of bone toe, which something is attached. So this would be a muscle or a ligament. In this case, I think it's one of the spinous ligaments normally with the ropes But don't quote me on that because my abilities name ligaments in the main body is kind of poor pill because there are a lot of ligaments and they have a lot of names. But yet so typical. This is the point was saying, We attach the rib to give it the ability to sort of pull bones don't move on their own something pulls the bone on ligament is what enables something to pull the bone. That's the rough estimate of a rib. They're all pretty similar. This is the other bit that I want to mention, because it is probably it clinically, the most useful bit to remember about, um and there is that the main supply for a rib goes underneath it. Uh, so basically, you have a vein and artery and a nerve that runs underneath each rib. You have a smaller version of this that runs on top of the rib, but realistically, this is they're pretty small. They're they're they're not too much of a worry if you damage them. But there are a lot of times in medicine or in various areas of health care that we need to put a needle or a knife, perhaps through an intercostal muscle. For example, if you don't like chest drain, you need to stick a needle in the needle or a knife to open up a whole into the the floor of the space with the lungs live. Um, you kind of want to go the top of a rib know immediately underneath the rib above a preferably nicely in the middle between the two. But you sort of want to err on the side of caution and avoid damaging the vein, the artery in the nerve below the rib above, because you can cause lost. It is the damage. Uh, whereas you got nice sort of gap of soft muscle. That's not really going to do too much if you damage it a little bit. That's really the main thing I wanted to point out. With this slide, there are three layers of muscle in the intercostals. I'm not going to go too much into them. They make more sense. After I talk about a different muscle, I'm going to talk about it later. So once you, for once I've talked about that, you can go back and have a look at intercostal muscles If you want to on, they'll make a little bit more sense. Yeah, so let me just did the last about ribs that ask the questions that are in the chat so true ribs and false ribs moves slightly differently, and this is kind of important in terms of how we breathe. So true. Rips will move with what's called a pump handle movement or pump handle motion. And that's basically means they just moved up and down simply like that. A little gether, and it lifts the sternum outwards and up with slightly. If you think about how irritation works, it's a pivoting. That's how it's gonna happen. Whereas false ribs, the ones that aren't attached to the sternum directly move. What's good? Buckle hat, bucket handle, movement or bucket handle motion? Uh, and they move a bit more like the bucket that the handle on a bucket effectively, they sort of move. I don't really know. I can't really describe about holding a bucket. I won't like, Um, these two phrases the pump handle and bucket handle like to be used in exams. They're they're they're quite certainly anything anatomy based exam wise. These tend to be sort of questions you might get. Um, what is the difference? The main the main bit is that pump handle, uh, move sort of upwards and outwards. That the same sort of time giving you the most expansion in the chest or as the bucket handle ones will move. Sort of. What's the word? Like a buck. It's effectively. They as they sort of dropped down, it will move up and down parallel to one another. But obviously there the tips will be closer to one another. Whatever point their act, I'm explaining that really poorly. I'm trying to do a much better way to explain that. Um, but they don't move apart from one another when they're moving. So the way that the even though they're not touching false ribs will move on. The space between the tips of both ribs will remain the same, but in a different place. God, I'm really doing a bad job trying to explain that. Hang on, I'm trying. Think what a better way to explain how bucket handle moves. Simply the best way to explain it. We go look at a bucket and see what I mean. You sort of understand it when you think about it and look at it for a bit. Yeah, and hopefully you know how better to explain it, which is terrible. But simply put that that allows more expansion in the lower part of the rib cage. Also giving you a better chance of breathing. But it doesn't quite collapses much as the pump handle ones would. Not enough. That really explains it. Very well. Um, again, even reading these slides took these from an actual anatomy website and again reading them. You don't really understand how a bucket moves if you haven't seen a bucket. Um, look at the bucket. That is that. That is the best bit of advice. I have you on this particular topic. Have a look at a bucket? Um, yeah. Just remember all See, true ribs, pump false ribs, bucket and actually, once again other than for anatomy questions they don't. This doesn't really come up in real life in real practice. Yeah, explain that poorly, but I think it's the best job I'm going to do with it. I'm afraid so. Any questions on ribs? Please don't be explained how bucket works because that apparently can't explain how bucket works what is a stem cell transplant? Long and complicated and sort of off topic from this one today system, yet long and complicated and not really part of this topic today. I think that's more one that's worth Googling, because again, I probably can't explain it scientific as scientifically as coogle. But if you can't find a good answer, please email me and I will happily explain the stem cell transplant to you. I just will take a while doing it. Does that make sense? Um, cataracts plot change DNA, so the material that's implanted won't have the same DNA as your body, so you'll have material in your body that holds different DNA to the rest of you. But the rest of you won't change DNA. If that makes sense, especially, you end up with a bit different. Yeah, don't if that really answered it, but so they also I guess there's no won't change with the unit. Just mean you've got of the DNA. I'm going to quickly share the feedback link in the chat in case people want to disappear early. But I'll share it in there, and I'll carry on with the next part of sharing again later. But if anyone is planning on running away, at least now you can do feet back for me. Thank you very much. If anyone comes up with questions, do you put them in the chat? I'll move on to pelvic. So again I apologize. This, I think, is a slide from an onion looking at it. But again, it's what Power Point decided to decorate my slides with your pelvic. Good is no pelvic. Girdle really is a picture of it. So this is that the the lowest point the trunk, these the bones that make up your hips, the bones that sort of give shape to your buttocks on the the point at which your lower limbs consult of exit. It gives him a basis for your lower limbs to come off. It's joined us as this lovely ring of bones. They're also fused together. Some. Sometimes people count it. Will this one bone? I don't really agree with that because it's still not one bone. If they were joined together, Um, it's important because it helps you walk upright. It's the basis for movement, and it's the basis for weight baring anything that's going for your legs. Uh, let's get to within it to the main bones. You got your ileum. So these are This is nice. Winged. Ah, wind bones up on the side. You've got your issue. Um, these are the bones that you sit on effectively. If you have felt so on her is a particularly bony bottom or you sat down for too long and your bum starts to hurt. It's because this is the bones in your your buttocks. And then you have your sacrum, which is this collection of vertebral fused together to make one sort of burning mass. Within that you got a couple of different anatomy points that you might talk about. Your iliac crest is sort of the age around your ileum. The spine is, ah, sort of now a process along it. You acetabuloplasty is the point at which your femur joins with your pelvis. This is sort of like a little bowl almost on either side of your pelvis, and the head of the femur sits inside that bowl, and that's where your legs, or is he based from on your pubis is the bit of the very front on. You have what's called the pubic symphysis, which is this sort of joint the front here where it'll joins together. And I believe it's technically the weakest point in your pelvis. But yeah, it's that's your pubic synthesis is a bit better labeled, actually like this one, because the pubic symphysis is a different color toe. Highlight the fact that your symptoms itself isn't bone. It's a joint between bones, your pubic crest again. This is just a bit of shape to the pubis, which is the bone here on top ileum pubis issue and then the same again the other side. If you cubists ileum and then the same cream or in the middle and the coccyx just hanging off the back Not really a part of the pelvis. It just hangs out with the pelvis. Um, and that creates your over your pelvis. Um, I got the next slide. I wanted, yes, important to note. So I'll go to the bit. So I want you to note to them to come back to this just to try and explain that better, um, so palaces A very large blood supply because all the blood that goes down towards your legs comes from it. You also got some quite important organs and sit in this area. Things like your your uterus if you're female, if you're atomic, me, uh, what's the correct? Well, the best way to phrase it is if you have a uterus, This is where your uterus sits. Your bladder If you start of a bladder or if you never had a bladder again so people don't necessarily have a bladder, you rectum and all this sort of sits in this area a swelling that you get all the blood vessels that passed through this area to get down into your legs, a little blood vessels that come towards external genitalia. These all come from the pelvis. Acetaminophen. That's quite a lot of blood. That's quite a lot of nerves, because a lot of things don't have any control on this quite big muscles. So, actually, if your pelvis gets damaged, it can cause a lot of bleeding. And it's quite a big open space to fill with blood, particularly if it breaks in such a way is it opens up. So if I get back to it Oh, so you got this nice. Where's my mouth? Steroid is, you know, it's nice big ring in the middle here, which could all filled with blood. You've got off still spaces around. All the bones could fill with blood. But if the pubic symphysis here was to break, for example, or one of the bones here was to break, this could open up somewhat wider on create even more space for a lot of blood to fill. So pelvic injuries are high risk for bleeding on. It's important to remember that so anyone who has potential pelvic injury need to think about internal bleeding there, but is that the pelvis itself widens. Drink female puberty. It creates a wider opening in the middle because a infant would have to pass through this middle part in order to exit during childbirth. Um, and so this becomes sort of wider anyway during puberty to make that process easier. But it also creates a wider hips base. In doing so, this'll means that generally people with wider hips have better weight carrying around their hips. Most people were narrow, narrow hip girdle tent, a better weight carrying around their shoulders. If anyone's ever done, Do you remember Award kind of a useful thing to remember, because you do it, your lower strap tighter. If you have bigger hips, you jump your shoulder strap tighter if you don't. One of the weird things I've done in my life was being a DV instructor. Uh, the Let me quickly check these. So what gets replaced in the hip replacements that again will come or under limbs? Because the limb side that gets replaced in terms off these structures we have here, actually in a hate replacement, none of this tends to get touched. The bit that gets replaced in what's called a hip replacement is actually the defense defendable side. But actually, sometimes in a very severe one, you might have some plastic replacing the acetabulum, which is this big here, this sort of nice, bony sort of cave almost in dent, which is where the famous sits. Acetabulum means acid bowl. So this is like a vinegar cup that the Romans used to use because apparently this looked like this particular sort of vinegar cup. That's why it's there. So it looks a bit like the inside of a cup. Yes, that might be replaced, or it might be coated potentially during your replacement, but actually mostly It's not a bone in your pelvis. Think it's replaced in the hip replacement? Um, what else have we got? Ah, chemical composition of bone. It's largely calcium. There's a few other bits involved in terms of actual, like the structure, but it's counseling phosphates. That's lots of phosphate. Lots of calcium simply, Um, but there's other things in bone. So you know we have blood vessels running through it because there are cells in it which repair it will replace it or break it down. Osteoblasts are still clasts anything with what osteo, and it tends to have to do a bone, so I want the actual material is productive. Calcium phosphate. You also have quite a lot of organic matter in the area just to keep it alive. Um, and it will modify it. I don't know what that's in reference to. I'm afraid saying it will modify it. I'm going to see him. That's going back to the previous questions about bone marrow transplants on, So the are slightly. Be one. Modify your DNA. Your DNA would be Your DNA would still be your DNA. You'll just have someone else's DNA also in your body in those sounds, if that makes sense, Um, good, Like I'm liking all of questions. Guys, please do keep them up the last bit in terms of bones. I want to go over and there are a couple of it's after this one you're talking about quickly, but is the shoulder good? So your shoulder girdle has fewer bones in your pelvic girdle? Because there were two. And I like that fact. Two bones. No cities to remember. You have your clavicle or collarbone. It's the one of the front. Most people, when they're young, is quite common. Bone fracture When people young, super be everyone's not known someone when you were younger, Who did that on your scapula? See your scapula effects sometimes called the shoulder blades, thes in the bones, sort of more towards the back. Your scapula. It's free gliding, so it sort of slides over the ribs when you move around your shoulders on. Yet, um, your clavicle joins your sternum. Your scapular scapular joined sort of the rest of it to your shoulders, and that's how you can move your arms. Here is a bit mawr of a breakdown of it. So one of the things that we like to do a lot in healthcare in anatomy is to name everything you could ever possibly name. So where the sternum meets the clavicle, you have the sternal clinic, your joint where the clavicle meets the scapula. You have the acromegaly at chromium Oh, clavicular joint because this bit of the scapula up here the top It's called the Acromion. Um and you have the glenohumeral joint, which is with humorous the bone in the top, your arm joints mostly with the scapula, but also a lot of ligaments and stuff to help hold it in place. But it does the shoulder plexus. You have clavicle, and you have scapula. That's a clavicle joints turn of the scapular scapular joints onto the arm. And that sort of how it will basis off off, I think the off of your rib cage it Well, yeah, basically for your sternum off of your rib cage. Um, and that's the basis for where your arms attach. That's about all I really wanted to say on that, because the rest of it comes into limbs. If you have questions, please ask them otherwise. Yet most that will come on the limb session in a couple of weeks time? Uh, yeah, that beautifully. Beautifully short in terms off the shoulder plexus, shoulder girdle the next. But always talk about is this is a bit of muscle. Like I said, session mostly that's gonna be very heavily focused on muscle, but I thought this was an important, better muscle to talk about. So as we discussed the shoulders, the pelvis, the spine and the ribs, this does leave quite a large gap in which we have no boats, so all of the front or anterior surface of the abdomen is boneless. In that sense, we just don't need something there to hold it in place. We just don't hold it all together, and it's going to base it, keep you up, right? So we have the abdominal walk like that, ribs in the chest. We have the pelvis. Ah, I didn't phrase that very well. That's it's just ribs in the pelvis. There are no ribs and the pelvis, and in between, we just have the lumbar spine, really at the back. This helps give flexibility also helps make us lighter cause bone to be quite heavy. It also means we could have pregnancy and that's a large reason why we haven't got a bony abdomen it So there's a lot of space for growing infants. It also means if we get a beast, we don't squish all or internal organs and die s so that's pretty good thing as well. So we've got room for expansion in this area. Instead, we think of the abdominal wall, which is made up of four layers of muscle. The first ones remember is called rectus abdominus, which literally means up right in the abdomen. And this is two muscles that stretch from the base of the rib cage down to the pubic symphysis down the bottom just straight down the middle. So you have two of these and they don't cover the entire abdomen. The only sort of come in the very front of it on these sort of the muscles you'd use if you were doing sit ups, for example, they're sort of jobs that awfully pull you forward like that. But also being muscle, they've got much more ability to sort of stretch and get out the way. If, for example, you are pregnant behind them, you have your external oblique muscles. These are muscle fibers running in the same direction as the sort of crest of your pelvis. A way to remember it sometimes is that it's going in the direction of you putting your hands into your pockets If you've got trousers and these basically muscle fiber's going one way, you can have internal bleeding, which go that a tangent to them. So they go from sort of high in the middle, so low in the lower sides, Um, and these go opposite directions because it means you've got more ability to contract in various ways, gives you more ability to twist and everything like this and then find you have transversus of dominance, which basically just go transversus. They go right around the middle of it like a belt. Um, and these different layers of muscle enable us to keep all the internal organs inside to give a lot of protection total. There. On the also said, they give you the ability to twist and move and rotate around with your abdomen, um, as well, you know, as you wish, um, the only a bit here, really. I want to mention is the linear Alba, which basically translates to a white line. And so this is what goes right down the middle, almost like a seam, and this is a weird sort of almost of a way of thoughts. It's basically connective tissue that goes right down the middle of the abdomen. In this area, there is no muscle. It's what's joining the transversus of dominance from one side with transverse it. Or it's the other side internal oblique. One site, internal bleeding the other side. External oblique, external oblique and then separates the to rectus abdominus muscles. And it's an area free, which there is no blood. It's just connective tissue. There's no blood supply. You can cut down it and it won't bleed. It's quite popular among surgeons because it's it's an area that is connected. Tissue can stitch you back up, and it's no problem. Um, it's not going to damage your muscle doing it. It's a really popular, not popular, is really useful means of opening up. The abdomen obviously start to get through like skin, but after you go through the skin and sort of connected Fashir on the outside of the abdomen, this is a really easy way to then open the abdomen and get in for, say, this is Aaron section or operating on the barrel. Maybe that's where noting the only thing that's in the middle of that is the underlying course which bypasses the linear Alba right in the center here. Um, what is this duty to remember? I think, really, For the most part, you know, it's there because it's quite it's quite important structure, really, that we don't really think about in terms of what muscles are actually going on in the abdomen instead of bones. So you got your rectus abdominus Two of them, one each side, Uh, your external oblique internal oblique entrance versus abdominus muscles all joined up in the middle by the white line. Linear Elvir Um, yeah, that's the main bits of it. I want to point out with this one. And these are useful muscles, obviously, because they enable us to stay upright. They enable us to People are internal organs from falling out on day. Also allow us to still expand X rays were pretty sits any questions at this point and then I'll finish with the last. But I want to talk about which was X rays and imaging nothing appearing. Thus far excellent. So final bit so x ray. I'm sure everyone's heard about X rays. I'm sure plenty of you had X rays. X rays are a form of radiation, which can pass through soft tissues that or rebounded or absorbed by density issues such as a bone or by non organic materials like metal. Ah, Using this, we conclude eight images based on how much is absorbed or how much isn't absorbed on that. Create shades of grey, so a white on an X ray. White material are probably bone, or they could be for instructions like it's a metal inside the body or glass or plastic. So this lost black materials so very dark tends to be gases or very light fluids like water on then. Obviously, the scale of in between between very solid and very not solid creates this whole spectrum of gray, which we can use to to read thumb. This is a chest X ray. I'm going to do to it, show you two different X rays. One will be a chest and one will be an abdomen. Just feeling is, that's the bits we covered. So as you see here, the black space is on this X ray is where there's lots of air in the lungs. I don't see concede, sort of outside of the person in the room. There's a lot of black because the room is full of air on then The very white structures are bone, so so you can see all these lovely ribs. We can see the spine, Uh, and we could see the clavicle up here in the bits of the scapula over here on. Then we got this thing called the Heart Shadow, because actually, the heart muscle is quite dense. The quite a muscle that's quite dense. It's also full of blood. Blood is a liquid, so it's a little bit darker than a little bit lighter than air. On these, it's a bit absorbs a bit more than a That's only thing with a lot of blood in it will also show up. So that's actually predominately. It's just the blood in the heart. And this could just call the heart shadow. This is what do you see? The heart. We got to get all this sort of fuzziness, you know, lung, and this is basically the blood supply to the lung. So This is where the blood vessels are in that lung, dispersing out throughout it. And then finally, we get this nice structure down here, which is the diaphragm, if the breathing a PSA briefly, just going over what we do. If we're interpreting a chest X ray, we start airway. So if we look at the very top up here, you can just about see it. You can see where the trachea comes down and bifurcate soft to the two sides to enter the lungs. Now we want that to be nicely in the middle. We don't want it to be leaning over one side. You don't want it to just not be there. We just sort of want to see that nice and straight. And then it's disappearing off into two columns. Breathing. This is involving looking at the lungs. So we look to make sure all the edges and I stand clear. We can see all the edges around the diaphragm beautiful, and it's mostly black. There's not too much fuzziness that's not like a large one amount of water. One of these lungs doesn't just will stop here and have, like a sharp cut off here where maybe over here is punctured. So looking just basically, are these lungs looking like lungs? Cardiac? We then look at the heart. We make sure that it's no massively over here. It is a bit of variation, depending on what angle you taken a chest X ray from If you're looking from back to front uh, you might back to front or front to back will vary how the heart look, but generally just looking to make sure the heart's not ridiculously oversized. Well, a tip toe what you'd expect for that particular angle. And you're making sure that it's all in the right places. Sorry. Click there. It's the heart looks good. Diaphragm. Is it smooth? Can you see all of the diaphragm? Can you see right down into a little corners where it meets the sides? I need to stop clicking. And in this case, officer, you can nice clear diaphragm on is everything else. This is the bones. Can we see that the bones are all intact? Don't even look at it to be broken. There's a bit of very white something going on here, but I think that might just be where it's very densely bony. spine itself. Can we see that the spine is there? Does the spine look nice? It's not like bulging out to one side. It's not crumbly and looking like it's falling apart. All the rooms look that they're intact. There's nothing that looks scary on here. We're not looking at it. And there's like a lump of action man, so has managed to breathe in. There's no like a peanut sat here. There's not anything particularly worrying. It's It's a very brief overview of how we'd look at this chest X ray, and that's all how we'd look at the bones in the chest for the most part, to see what's going on with them. Person is the abdomen, so I have a left abdomen and a right abdomen as looking at my screen. One of them is a female. One of them is a male. Uh, let's see if you guys in the chat can tell me which one is which. Basically, if you think, uh as I'm gonna call them left Lefty and righty. Uh, So tell me, do you think leftie is the mail order thing? Left? Is the female on, and vice versa. I'll give you about two minutes because it does take about two minutes in terms of delay for you replies to come through who had never heard opposite ideas instantly. Ah, Nikki, Someone here who is called Nikki. You have nailed it. You simply done so. Most people seem to be getting this one. So left is our lady, right is our jet. And as Nick keep it, er in what? Her comments it was published. Um, sorry, that is Put your name there. Most people are anonymous of Sorry. If you don't like the name, we have a wider pelvis that you can sort of tell relative to the fact of ribs still tapering off here where it's tapering off. There's not as much sort of rib to hit parade show going on here. Ripped pelvis ratio. Now we're also getting this shadowing here. That sort of graying around this area, which is called a breast shadow individual, has breasts which obviously it's more tissue more difficult for it. Teo, for X rays to pass, throw. And as a result, we end up with slight additional graying up here. That's the main thing. I wanted to point out source of God again I think both of these are healthy. I hope they're both healthy. I didn't take too long looking at them before putting them in and Googled healthy. Um, healthy abdominal X rays. Yeah. No, they do look both fairly healthy. Yeah, so that obviously female versus the mail and then the other. But I want to point out it's a bit of clouding going on here again. Like with the chest X ray. You could look at the bones. You could look at lung fields if they're in there. All of these things, but the but I'm more interested in showing you is just this sort of fogginess going on here on this x ray along here in this one. Does anyone want to have a hazard? Guess as to what the fogginess is. Why is the heart clearing the female? Rather in the mail? I think the mail one is just a bit lower down. If you look at how many groups you can see in the female one in the mail, when you see about three or four ribs, the female, you see most of them. So I think it's just a little larger, um, or cover would mail, Gynecomastia. Whole set of Russia. Yeah. Also, larger people. If they have a bit more fat, we'll just have a shadow from where they're there. That is basically whether they're more masses. Um, these are both quite skinny individuals. You can see this little salt in a bit here, but you can see this or shadowing here on the sides. This is probably where they're sort of skin is, um, since probably age of this individual, and this is the edge of this individual is Well, I'll see this one here, you can actually see her arms. And it was well, just from where they've taken the the image. And so, yeah, the if, for example, this individual was a bit more. It's hunt a bit. Mawr. Wait about him. You might see this come out of it further. Now, here you have more shadow where that's existing. Um, if he was particularly, uh, particularly skinny, you might see this hugging much more onto these lower ribs and coming across here a bit more hugging on to this bony structure here. Um, yeah, that that's just a bit of somehow shadowing and flesh works. What have we got? I've got impact impacted bowel or fecal loading for the shadow. I mean, you would see them. You are not wrong. You're not quite right. But you're not quite wrong. So basically, this fogginess is basically just fluid in the bowel. Says we could see here. This is the descending colon coming up into the transverse colon. Here. Just about. See, the ascending colon over here on this way up here is probably the base of the stomach. Probably coming in here that the Judean, um over here somewhere on do that simply is your bowel is full of fluid s. So it's it's liquid that's being re absorbed or it could be feces. But as correctly pointed out, if you had a bowel impaction or some of this so your bowels unable things weren't able to pass for your bowel. It is blocked. You would get a build up of this so you end up quite a lot. So over here, this this lady has quite a bit going on over here. I'm not quite able to see entirely what it is, but I feel like that probably is quite a bit on her. I can see what where the anatomy is hers. A bit less contrast ID that over there is the descending colon there. That's a sigmoid colon down into here. So it could just be that she just needs to open her bowels. I think maybe she's He's needing the bathroom a bit more. I was thinking maybe that could be a bladder, but it's been off side center. So that's probably where the small intestine has met the large intestine to come around here. Um, my thought is probably used to go to the bathroom. Uh, simple is that on then on this gentleman? He's got a nice, fairly clean set of bowel going on here. It's just got fluid in it. That's just what happens. I think if any of us had a abdominal X ray, we'd probably see some of that, purely because it's just it's natural. Simply, Um, yeah, So this is something you want to point out with them. We don't tend to do a huge amount of abdominal X rays, to be honest. Much far, far more common is the chest X ray, because the chest X ray can tell us all sorts of what's going on predominately of what's going on terms of chest infections so we can see a lot of the health of your lungs for a chest X ray. So this lung was very badly infected. It might be really fuzzy and cloudy. If there was problems where it's collapsing, you might see that it stops here suddenly, and there's a very dark space here or fluid space here. You might see that there is sort of fluid in the bottom of it if they've got pneumonia, for example. So this is a really good tool for diagnosing things that are wrong with the lungs, where as the abdominal X ray, I mean, if you're looking, maybe a spine, if you're looking at the pelvic bones, it's useful all potentially. You can use it if you're looking at well, if you look in foreign objects that stuck. So, for example, if someone presented to the accident emergency room because they stuck something up their bottom, what the stocks up in in the vagina and you trust, see where it is or what it's impacting with. Simultaneously, the implants do trying device. Sometimes they can go bit. They can wander off on this quite effective tool to find where it's gone, too, because actually ends the AFL open tubes open, so sometimes they can wander out the end of the fallopian tube and float off. It's not very common, but it can happen on this quite effective tool for finding it. Other than that, sometimes they used for bowel problems. You can see when someone's bowel has impacted. It's filling up. Um, yes, there's a less commonly used. We used the chest X ray a lot for for lung problems. These are just sort of the tool in the arsenal and a less less frequent. Um, yes, I think that's all I have to mention Any questions, please feel free to ask them. I'll hang around for a little bit. Otherwise, I've shut the, uh, the feedback once I'll share it again. Let me just double check actually works and all that. Uh, yes, it does appear to work good. So please do give feedback is how we sort of shaped these sessions and make them or you guys were after. It's also release off us to sort of reflect oils. In terms of teaching ESL, we get better a teaching, which is something we're really passionate about. doing? Um, if you have questions, please do ask them. I'm going to conclude with a baby elephants, because this was trunk anatomy. And I'm sorry I didn't cover more about elephant trunks because they would be really interesting. Much don't know enough about them to teach. Ah, uh, So yes, this question here about missing some other sessions the best way to do it via medal. All of our sessions upload long mental. Otherwise, they're all still accessible from the original link. So if you were sent the original link, that's the best way to get hold of it. If you've missed a particular session and you want the live link to it, please do just email me. I'm happy to send them out. If you tell me which sessions you want, that's a lot easier road that just saying, send me all of thumb. But if you say you know, I missed specifically Yeah, the head. And next session the end of last year. I can happily send you the link to that one, if you want to find it. Otherwise, that all on our middle page um thank you, guys. I hope that was a good It's been quite busy week for me, so I feel like maybe I rushed that slightly more than I should have. But like I said, any questions do feel free to ask them to feel free to email them? Uh, hopefully some of that was useful to you guys. And if no baby elephants who could ask for more Otherwise, I will give it another. I'll give it another 60 seconds and see if anyone has any more questions. Otherwise, you're all free to disappear. I hope you will have a wonderful evening. And I hope you all have their wonderful have. A longer is until the next. Have one of these sessions. Thank you all for attending. No, I just wish I could explain that bucket bit better. Like I said, God, look at YouTube. How Bucket works. It's really hard to try and explain it verbally. Maybe next time I'll try and implant an actual video of a bucket. Um, thank you, everybody. Right? I'll call it time. They're thank you all for attending and hopefully see you all next session. Goodbye,