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Hello and welcome to the atrial healthcare Siris. Uh, sorry. I'm just checking to see if this camera works. Sorry, I'm on a computer. That's not normally my That's not mine. So strongly. That works. Excellent. And so we can tell me if they can hear me. That would be really useful. Just pop in the queue and I didn't hear me. Hello? My name's Freddie Cooper. I'm gonna be presenting this evening because originally speaker of what? She had a family emergency. I'm a third year medical student. King's College, London. This is a photo of early today because I was in theaters and I thought it would be useful for this Siris. It's a pill. It's May in a scrub cap. Uh, I don't quite Unfortunately, it's me on my own again this evening. I don't have a moderator, so please do bear with please ask lots of questions. Please interact with me. It's really useful for me because that's not me just talking to myself like a crazy person. It's may interacting with you guys, which I love on D. But do please bear with me that I will be checking the checked, you know, as I go along. I don't have someone there to check it for me and read them out that I put this up every week. I'm sure that you have been to a couple of these by now. Will be used to it, but simply making the most the session. Do you take notes? This helps put things in your head and helps you remember them. Please ask questions. Please ask questions. These things are so much more fun when you guys interact and we get to talk to you questions and we get sort of work together on these on Finally, if you enjoy any bits, please do drop mean email. I'm more than happy to send you go that additional residuals, resources and places we can find more resources to continue building on things. You're enjoying any queries? That's my email address. I think everyone should have it by email it round regularly. Uh, well, seven instagram. I haven't updated it in far too long. I'm sorry with Facebook, which again I've collected. Unfortunate because I haven't gotten my laptop this week. I haven't actually gotten ability to get on there, but pleased to give us a following over those you like, uh, where are we? I didn't update this slide. That was terrible of me. So it had bone, actually. Part one. That was a couple weeks ago. That's a little metal. Or by the joining link from last time. If anyone wants to go back and have a look, uh, this week we have money and asked me part, too, but not in part to the limbs. So last session I put this one up, just a sort of given idea of what the differentiation of the human body is. So you go ahead sometimes includes the neck. I don't know. We include the neck on it. I think the neck is part of the trunk. That's what it's called. The overlap. You then have the trunk, which we did last time. And this time it's the lips. That's the to upper limit that to lower limbs. Uh, how these break down? So we put you haven't upper limb on a hand, a low, um, at a foot. The upper limb contains the upper arm and forearm, the lower limb, the thigh and the leg and then the foot in the hand. I'm sure you guys can figure out what a foot. Other hand it's. I brought it up last time as well, just to give a bit of an idea of different sort of bones we have going on predominately today. In the limbs. We have long bones, and we have short bones. There is, to my mind, no irregular bones that I can think of my head that would be involved today. On there are sesamoid boats, which is different from last session. I can't think of any flat bones so long and short, predominately on a couple of sessions. I also want to just bring up the difference between a ligament and a tendon. So a lot of the limb, basically a muscle, connects fire attendant to a bone. This is how muscle anaxa movement a ligament, connects a bone toe about the sort of hold things in place stop sliding around, falling apart. Where is the tender enables of movement? Violent muscle? And we'll talk more about that later on. I just wanted to clarify that start because of times today I will make reference to ligaments and tendons. So with the upper limit, quickly check. There's no problems raised in the chats. Nothing that's far excellent. Let's move on. So, upper lip the up Alexis off three elements. You have your, um, forearm. I have indifferent Let you have three joints. The shoulder where the upper limb joints trunk. You have the elbow where the upper arm, the lower arm meets the forearm. The upper arm meat on you have the wrist where the hand before I eat. Very straightforward. We're also going to quickly touch on some of the blood vessels in this area because they're quite useful. When we talk about, um, we use them quite a lot of general health care, Uh, so we'll stop with the up from There's only one bone in the upper arm. It's the humerus, and it's not particularly funny. They call sometimes when you hit your elbow, they call it Funny Bone. I think that has something to do with the fact that it is called the Humerus heart. Uh, like Aleve, a long bones. It's called ahead. Let's go the neck, Um, and then it's got what ever condyles. These are bony protrusions on these are sites attachment for ligaments or tendons, so things are gonna hold it to another bone or things are unable to move this at the top in the shoulder. We have been called the Acromion, which is part of the scapula. So that's one of the both we talked about in the trunk. Um, basically, it's the shoulder blade that comes across the acromion on. You also have, uh uh, yeah, and that's basically the point of which former shoulder cavity. There are three muscles that then form the the, uh What's the word? I'm looking for the ring. The muscular bringing with your shoulder sits. We won't talk about the muscular bit because we be and talk about the muscles against long and complicated too much for a now and a half session of uneven. We'll worry about the bones. Simply put, humor of sits in the shoulder. Some muscles hold it in place where the tendons attach those muscles, hold it in place. Uh, and then at the bottom office, it joints on to the elbow. And just remember that the condyle is a point in which a ligament or a tendon will attach his victory The shoulder again. Like I said here, although lovely lots of muscles and ligaments or holding it all together this is where your bicep begins, actually. So the bicep, the front, the muscle I think most people know the bicep. Is this muscle the larger looking muscle on the front of your arm? Uh, this actually hooks into the shoulder. So it's not just actually touched the arm statue up here, and the movement it makes is to move, uh, before by the shoulder. Here is a nice sort of complicated looking picture of all of this going on here that we could see also is the yellow in this picture is bone. So you got the various bones involved, A clavicle. You got parts of your scapula here, and you've got the humor's here and then lots of tendons on 10 heads, joining it all together on your rotator cuff. That's the word I was looking for a minute ago. They rotator cuff, which is what enables your shoulders sort of moving. All the different directions can consists of these four, uh, the tendons attached to these four muscles. Um, do you need to remember them eventually? Probably. Yes. For the time being, just remember that exist. That's how your shoulder moves. I think that's probably enough to remember the season. Shoulder dislocation. Sorry, if anyone doesn't particularly look at the picture. I chose a fairly in neat looking one, but I want to just mention this the shortest location when your rotator cuff is injured. So just when you rotate, it covers injured. When you have an injury in the shoulder, there is potential for the bones to come out of the position. You wanting them to be in here? It is on X ray, you can see. Also, the humeral head here has slipped out of the way from this lovely sort of cup in which it sits. Here's what it looks like in an actual person on. So there are two directions, predominantly a shoulder. Congar. Oh, you can go forward so anterior or it could go backwards. Posterior, I believe. More commonly they go anterior. But I can't remember the exact statistics about how many go which way on simply how do we fix it? You put it back in place, actually dislocate your shoulder. It can be quite complicated. That's a surgical bits involved to stop it happening again. But from the initial point of view, take painkillers and you put it back in place. It's quite straightforward management. You can. Anyone wants to see some? Really? It just wants to see one bond. I rescue the TV. Siris settled out Australian lifeguards. They have a few short of dislocations, actually, Quite common. I think it's quite common surfing injury, but yeah, I have a look on there. You can probably quite quickly find the relocation shoulder joint if you're interested. Moving to the forearm now chats. Nothing. They're beautiful. So in the forearm, we have two bones, which is twice as many as we have in the upper arm. We have the radius. This is on the fund side. It's really worth remembering that it's on the thumb side because then you can't lose it on the ulnar on the side of little finger. Important, really important that the radius to remember is the electrolytes. So the really bony bit right on the tip of your elbow is your electrolytes. Uh, and this is important because that is actually where the triceps, uh, bind in. And that's basically how you can move your arm. That way, they see movie old extension of the forearm. Uh, these two are held together by she's connected tissue interosseous membrane. Uh, ligament E. Yeah. Thanks. Tissue. Um, they want to be bound together. This enables you to sort of rotate your arm around. You can flip your hand up and over because you have these two bones moving past one. If you had one bone on its own, it's fixed it over, and you would really struggle to do that as well. It also gives a lot of protection. Helps with weight bearing means. You can hold things in funny positions and still you have the support you need. Um, the elbow involves both of these bones. The wrist only has the radius. So both of them in the elbow, only one in the radius. And it means that elbow dislocations have really complicated because it's Sunday, three bones involved and they're not very fun. Um, here's an X rays just because why not for some X rays in here? These are what what the what fractures look like in this area. So, up here we haven't told the fracture on the bottom is a diagram of what they could look like here. We have a radius on on the fracture. Here we have some nicely intact one's actually quite hard to find extra online off intact forearm bones. Most people seem to upload the funky X rays. His election looks like nice, solid bone material. He obviously see the fracture. They don't. They're inline properly here the same again. Both, um, don't very in line. And over here we can see a repair. So for this one, they put a plate in alongside it effectively to split the bone, hold it in place while it heals, and they put a bunch of screws for it in order to sort of hold it together while it can repair on hold the plate in place. Um, you can't have too many screws. There's a whole complicated thing about, like working at how exactly gonna do this. Basically, in this you hold the bone place allows the bone to heal on. Then you've got a wonderful functioning arm once more. It doesn't take over the function of the bone. I think that's quite something. I didn't really realize it quite recently. It actually that bone will heal. It'll go back to being a normal functioning bone, but it just has a metal plate stuck to it. Whereas I sort of had this idea that it was taking over the function of the bone for a while, just in case anyone else is having that sort of thought it doesn't. Moving on to the elbow or sonata is the radio humeral joint because it involves radius and humorous? Um, the radiation radio only humeral, right. Humeral joint, um, elbow is, except it's perfectly acceptable. I think some anatomist get funny And what the funny time. But well, though, go for it. I love it. Elbow and 60 of these bones will fit together. This is where the, uh, electron becomes really important. Sorry. I forgot the words. Remember the electron, because really important, Because this is the sliding part of the older across the head of the humerus. Uh, so acts a bit like a purpose, I guess. Uh, is it something else? Um, both the major muscle of the biceps and the triceps actually attached to the forearm bones rather than to the upper on bone. So this means that you get the ability to bend the arm on, but yes, if you constrict. If you contract your biceps muscle, your arm comes up. Contracture triceps. Muscle arm goes down straightforward, Uh, other than that, their smell of fancy names of various parts of these involved articular surface, a tick us a conference, anything articular means where things are joining together. Um, I don't think I really worry too much about those the time being so long as you understand vaguely the mechanics of the elbow. That's quite probably the most useful part. Um, on the opposite side from the elbow or the inner elbow surface is what's called the antecubital fossa. Don't mention this just because it is a really useful area in terms of blood vessels, we use this all the time is a beautiful, beautiful place to get access to Venus blood and from the radio blood. A zero blood gasket taken on arterial blood gets taken once from here so we can get a tear really blood. But really, we use it a lot of the time. If you're taking blood for blood tests like your place the cannula, which is like a little plastic device in order to give medication or fluid, and we also used this area for listening to the brachial artery. If we're going to be doing a BP, I don't think I've explained. Really. Have BP work entirely, But simply, you cut off the blood supply until you can't hear the brachial artery pumping on. Then you release until you can again seeking here and sort of points of which points which pressures are necessary to get past the tourniquet. The cuff that's pulling, exclaimed. But we're more about observations in the future. As you see here, this this individual I'm gonna see Male given the look of the arm so I could be wrong. Um, has these wonderful, quite nice, big bulging veins here sticking needles in that takes the blood out less and quite easy. Probably quite easy, though you never know. Sometimes they misbehave. There's the inactivity underneath the skin in terms of what's going on with these veins. And over here is bit more detail with the artery and some nerves in play. Really what you need to know and cubital fossa. It's the bit on the inside of the elbow on. It's really effective taking blood place in cannulas. Been taking BP be on hand in this, Let me quickly check the shots going Queries Nothing beautiful. So handed wrist starting vessels There are two main arteries in the risk, and we use these for taking pulses a lot. So you got the radial artery on the side of the radius, which is the side of the thumb, as I mentioned earlier on the older, which is the side of the baby finger side of the owner are on the boat. Um, these can. These are both branches off of the brachial artery, which is up in the cubital fossa we mentioned a minute ago. But we use these predominately for taking pulses. So the most common place you ever go take a pulse. Is that putting two fingers on radio artery feeling every surgeon blood goes through into seconds. We can also use these for school, not Erie. A blood gas. This is where we want to assess what's going on in someone's blood, particularly arterial blood normally relating to the actual how much oxygen, how much carbon is in there, how acidic it is. But the other things we look at as well you take a needle and place it into the radial artery to get blood, and it's a really quite effective place to get it from, because if something goes wrong with the radio artery. They still haven't older artery supplying the the hand as well. Okay, it's something where to go Wrong moving on the actual bones of the hand. So we'll start with the wrist bones. Also called the carpal bones. Carpal of rest. Say more or less. Same thing. Uh, you have two different roads, four bones. There are different ways of remembering these. I honestly can say I'm I'm not great remembering them in order. The sign of like, Yeah, see you later. It was See you later. Little thing, girl thing. Never mind that. Um hello. Here comes The thumb is the top ones. I never remember them in order. I'm really, really bad remembering the older these bones there, right? Remember, there are eight. You have your skateboard at the base of the thumb, actually, above that, you have the trapezium. So your thumb is on the trapezium. Your some swings on a trapeze on a trip? Easiest. If that's the way you want to think about it. Yeah, a trapeze. That The swing thing from the circus. Your son is swinging on the swing thing from the circus. Your thumb is on the Trapezium skate. Floyd, quite common site of fracture of someone falls over in in just their wrist. If you lose weight or to request from facing is three points, there's a form or P. Shape your hamate. Just, uh, it's got a hammer looking hook thing. So it looks like a hammer capitate sort of head. It's sort of a keystone in the middle and trapezoid annoyingly similarly named to the trapezium. Um, yeah, it tells a remembering them. I'm not good at it. I can't really give you a very good place for us to have to do it. Um, but remember there AIDS, remember there in to Rose and sort of remember, a couple of the names build them up from there? Uh, that's the best advice I can really give regarding them. Why they important? I talked about carpal tunnel, um, office. They called the carpal, both carpal tunnel. It's in. It goes on here, and I think a few people know about what carpal tunnel syndrome is, for example, or a common tunnel. Carpal tunnel injury on this is basically people get pain in the hand that's commonly associated people using like computer mice too much. Some people who worked like Electrician's think that this doing too much of screwdrivers they can end up with injuries. This area, um, eventually there's this leg. Facing is a ligament that runs over the carpal bones is called carpal ligament or the Flexeril take in nocuous complicated word for this time of the evening. Reticular Q. Um, on basically lives across the two rows, a couple bones underneath. It lives one of the nerves that supply the hand the median nerve. You can highlight the big here that it supplies in this lovely diagram here with the reading part of the hand. Um, it also have several tendons running through this, the gap beneath it, which enable you to flex your fingers. So basically they want to bend the fingers. Um, in a carpal tunnel injury, the ligaments. The carpal ligament becomes really dense. It's sort of hardens up, uh, partly from overuse, partly from where it is on. It means that the bits beneath that begin to get a bit squished and in particular, that nerve, the median nerve gets compressed. This means you get really horrible signals to the part that it normally supplies and it normally takes signals away from. So you get pain. You get numbness in the portion of the hand supplied by the median nerve. That's highlighted, Um, to resolve this simply you cut through the, uh, the rate of the couple ligament I watched on these done today. It's a lot more complicated than that. In terms of the actual surgery, it's quite difficult place to get into a lot to get through. But actually, the the resolution is basically just cutting through that ligament. Make sure things nice and stable and then close it back up again. Um, and that basically will release the pressure on the median nerve. And I'll quite quickly go back to being in a state of normality again. That's quite effective at the end of it. Most people don't have any pain afterwards. Get a normal sensation back, and we're very happy for this. Um, government owns in the hand, break down quite effectively. It's quite easy to remember them because they got two names metacarpals and phalanges. Ms. Couples, there are five basic. Each finger has a corresponding metacarpal. These are actually in the hand rather than and finger So although the scales It looks like a really long fingers. It doesn't the metacarpals actually in the hand or held together with serious and ligaments. But then, if you have the phalanges which make up the finger never actually every place that your finger folds has a philandering. So you've got three phalanges in most fingers, but only two in the fun, because you can only bend your thumb in one place rather than two places. Um, we named these basically where they are, So you have a proximal near the body middle books in the middle and distal far away. So you have your distal phalanges middle full Angie in proximal phalanges. But in the, uh, in the thumb, we only have two of them. So we only have a distant and approximately There's no middle. Oh, yeah, they're the bones of hand. We number metacarpals. So we number them. Number one is the thumb. So the phone side is one. Then you have 2345. It's acceptable to call the thumb the thumb instead of number one. But first full on first metacarpal is what's beneath the thumb on. Then I'll see 234 because people have different names what the fingers are called. Some people call it a middle thing. Pretty much always middle finger, actually these days, but I have people call it other things. Index finger may be pointing finger. Call it second finger. Call it third finger. Fourth finger. Little finger was fairly universally used as well, but it can be 50 um, numbering. It means everyone knows we're talking about, but yeah. How did that make sense? 135. Free for lunches for each finger. Only two for the thumb that will move on to the lower limb. Check shot quickly. Any questions? I'm not seeing any pop up. I hope I make you sense thus far. If anyone has questions, please do ask. So we'll move on to the lower lip. A lower limb again. We're gonna divide three segments. You have your thigh, your leg and your foot again. Your three joints, the hip and knee and the ankle. Also, lower limb is vital for weight bearing and everything to stand up. And there was a walk. Uh, there's a lot of large muscles in this area that able to do this because they're supporting the way to the rest your body. It's also capable of quite specific movements, so you don't just move your leg in one direction. You can do it to the side door circles. Um, and again, all that's important, the normal function of, like stuck walking in one direction. Um, we'll start with the thigh. There's only one bone in the thigh that's the femur is the largest bone in his body. It's actually contains most of the bone marrow as well. So this is a slight it which most blood cells are produced. Bread, blood cells on early stage, white blood cells, your cells. Some of them will go sweat and sure, but they produced here, Um, what's important to remember about the shape of the femur? You have the head and neck. As I mentioned with humorous earlier, the head stops up here. You don't have a neck on the main body shaft. You think of the greater trochanter any of the lessons counter again. These are similar. How we had a humorist in the epicondyle these air sites of attachment. So this is where muscles from in your body attach into your femur today for you to sort of move your leg on the bottle. We have ever condos again, symbols how he had on the bottom of humorous. Otherwise, they're functions in much the same way. Anything that's big and bony and sticks out is probably the site of attachment for something very, very powerful. All lots of things on the bottom here will join into the knee. The other bins worth mentioning here is to do a hip replacements. So, actually, during a hip replacement most of the time, what is replaced is actually the head and neck of the femur. What is repaired might have a ball to put through it, to hold it together rather than on the trunk side in the pelvis. This it's in the acetabuloplasty. That's if you don't feel that it's going back to our session from two weeks ago on review. For simply, the bones in the pelvis form a little cup, and that is where the head sits in order to school. Give us controlled with them. The bottom. What's his joints? It's windy. We're looking in the second floor, sweat remembering shaft, head neck. And then these big bony prominences of sites of attachment. Probably the best one to remember the name of it is the greater Trochanter gets involved in a few of things. A few things in different areas of health care. Um, yeah, Here's how it all fits into the hip. As I mentioned, the acid tabula here is sort of a cup produced by the bones of the pelvis. Have on here. Put this diagram has a bit of the ligament structure. Is there that actually hold it in place? Ligament of the head of the femur and the yes, tabular labor So the head sits inside the tablet. It's held in place where it's ligaments, doesn't go around. It was attached to it and then is once they go around the head to attach directly onto over the shaft or the counter, Um, and that basically holds your hip in place during hip replacement. As I said, the tabula tends to be intact. You can have problems with tabula Um, sometimes it does need repair itself, but predominantly it'll be the head or the neck that was broken, and you have to prepare them in some way. Uh, I think I mentioned that in one of the clinical set cases sessions a couple ago. Well again, another time, it was interesting moving further down. So now moving on to the leg. It's a bit of a weird concept, but in anatomy, your lower limb isn't all called the leg. You have a thigh and a leg. It's not some upper leg, lower leg. Um, hum, but the left femur else finds that weird. I found that quite weird. When I first learned it, I just assumed everything and the lower levels called the leg. So be it. Um, when the leg, we have two bones as well. Similar. Similar to how we did in the forearm. Uh, these are the, uh, tibia and the fibula. Actually, the fibula is sort of smaller and thinner. It provides support for the tibia, but similar way to how in the forearm. This enables you to rotate it mawr office. We don't tend to do that now that we're sort of a by people creature. But it means that we've got bit better support if our legs in a funny position means we not just weight bearing when I like the direct down and we have our legs splayed, we have legs in, we can stand on one leg and bit better balance because we still got more, uh, support. Um, in a similar way to the forearm. These are connected by a connective tissue. It's not showing on over these diagrams. What's worth remembering about these again? Like every Longbourn, they have a heads. They have a neck were condyles here, which again? Sites of bony sort of attachment. The ligaments, Um, and then malleolus little bit is to make sure at the bottom, at the base in the ankle, we have what's called the mail your life, like on that if you feel your ankle, you have a really bony prominence on one side and a really bony prominence on the other. You probably banged it really uncomfortable hit on. Ask the malleolus, um, relevance of it they can break. It's really uncomfortable if you do. That's one of the promises and that sort of there to protect the the ankle joint? Um, yes, going on to the knee. There is one more bone in the lower limb. I don't really know. Reviewed closet is a thigh bone or a leg bone. It's basically the new bone on its own, and that's the patella. It's the only regularly occurring sesamoid bone in the body. Some people actually don't have patellas. It's not great for if you want to walk, Uh, sometimes you get other system. Would bones appearing in the toes or the thumb tendons? No, Everyone has them. That sort of a variation we have in anatomy. Um, that's what we put a sesamoid bone is a a bone suspended within tendons, basically floating bug. Um, and that helps to hold the other bones of the neat place effectively. And it's a bit like a keystone. If anything, those much building fireplaces, keystones, common thing, they sort of The pressure goes through them to people. The others in place, um also provides protection against being hit. There's a quite important ligaments behind it. Well, you mentioned a bit of the ligament ligament. You're here. Um, because the ligaments than the one I I've memorized quite well. Anyone is into sports probably will learn quite well in the middle of your knee. Have to cruciate ligaments cruciate. Meaning cross shape because they cross over one another on these. Basically, stop your lower leg rotating so you don't want it to rotate. Every time you take a step, you don't want your need to twist. You want to sort of stay nice and rigid so that you can maximize that sort of movement. You get out of each step. Um, if you have damage to these because you twist the knee these contain it could be very painful, and it can leave only quite unstable. On that have is basically by over a mechanical twisting injury of the knee. Um, quite common to footballers. You often hear a footballer missing quite a large portion of a football season because of a damage cruciate ligament. They take a long time to recover. I'm not very pleasant if you do in gym. Um, alongside that we have these collateral ligaments are shown in green on this diagram on board. Basically sit around the edge of the knee again. These could be torturing or twisting injuries, but their job again is to sort of support the sides of the need. People are intact, Um, there. But I want to mention here of the Magnitsky on meniscuses minusca. I minutes guy on these effectively are sort of soft pads in the middle of the knee to stop bone rubbing on bone because bone on bone injuries are really uncomfortable again in a twisting injury. These could be tall, are damaged. You know, that was bone on bone pain in arthritis. Sometimes this could be worn away and, you know, with bone on bone rubbing, that's also not very nice. Um, basically, bones touch bones directly. Not very pleasant for for the person who's experiencing it. Um, yeah, probably the most important. It's remember of the knee. Really? We've got the the patella, the sesamoid, both in the middle to hold all the place. And then you've got these various ligaments. These are only a couple of them their arm. Or but these are the most important ones, I think, to learn your cruciate ligaments in the middle, you're collateral ligaments on the outside and then your meniscus to try and hold. Stop rubbing up against one another. And then it's where it looks with some muscles Put on top of it. So So you got quadriceps muscle above. We will know the quads, the hamstring muscles, going it behind on these joint onto the loan on to the leg in order to, except movement. I mean, I think that's a little bit so I kind of wanted to mention of people have questions. Please ask, uh, but I'm not seeing any of the moment. I'll move on the patella itself. So what? You need to remember about the Tela that exists? I think it's the most important on that. It is only it's held in place by these tendons. It's affecting a bit like a floating bone. It doesn't have any sort of, uh, what's the way? Right? Yeah, a floating bone. Effectively, it floats around being held by these tendons technically exists within a single tendon because there's the continuity of the patella and quadricep tendons, and it sort of six in the middle of them. But they are sort of divided point. They reach the patella. So your quadricep tendons your patella tendon on, then some more ligaments going on around it to keep it in place. First off, it's wandering off. If you were to dislocate the knee, often what happens is the patella will slide one way or the other, and that allows the bones of the need to sort of so apart. As I mentioned, it was the accident. Like Keystone. Um, that's not great. And normally, for relocation of it. You have to pull, pull the knee back into shape and push the patella back to where it should be. But during any dislocation, you could end up with damage to some of these ligaments that hold it in place. And people who routinely dislocate there just tell a disc in that knee. Two different injuries that people who routinely desiccating this will do this often actually tend to have a problem with one of these ligaments that hold it in place too long damaged some of this, um and normally, the best way to sort of stop it happening over and over again is to surgically repair. Tighten up one of these ligaments so that your patella can no longer slide around, fall out of place on stop you. They stop you from desiccating your me regularly, Um, because other sesamoid bones, as I mentioned, there are a couple sometimes appear in the thumb or in the hey, look's, which is a big toe. Um, these don't always occur. People have varied in terms of anatomy. Realistically, this is the only sort of guaranteed zestimate bone in the body. Um, yeah, I think that's basically all I really wanted you to remember is that it sits between six within the sort of long tendon, which it divides called steps on the patella tendon on there, some ligaments that hold it in place on if he's damaged, you can end up often dislocating the patella, designating the knee. Uh, yeah, questions in that one question on that one. The foot. So mostly logically, the last place. Talk about there. So foot contains angle bones, and it contains foot buttons. There are fewer bones in the lower limb than in the hand. This is suitable. Contribute sister, not having so much fine movement in the foot. The hand. You do lots of some interesting things with but not so much. It also means that there's less that potentially move around. So you use less energy when walking. Whereas who had similar bones to what you have in the hand. In your foot, it was actually quite inefficient. Toe walk. You use a lot of energy. You'd risk a lot more injury. There's also serious arches that touch on because Foot arch is that something people talk about. Sometimes if you ever go have shoes stated or anything like this, Um, you have a sort of a bit of thought about arches. People with high arches probably know about high arches. You get foot pain from walking too much. If you don't have support of insoles to talk about them in a minute, we'll start with the ankle bones. Realistically, they're all well. There's no two rows. There's two big bones making at the ankle your talus, which is basically your ankle bone. This is the point bones. The leg joint on, too. On your said, the calcaneal or calcaneal depend on how you pronounce it, and that's your heel bone. So that's the bone that goes right to the tip of your heel. On these together, enter into the hell that into the ankle alongside the It's like, um, you have other bones in your foot as well. The storm up some of the the base of the foot you have your navicular and your cuboid cuboid is it's sort of a big square bone. Do they have three Kinnear forms, named according to where they are your medial, which means sort of in the middle. Such a walk that's on the side of your you're great toe that's the middle of the body. You're intermediate because in the middle and your lateral away from the middle. Um, been certain of a closely related species this fairies on you might have actually five India forms rather than a cuboid on this enables Mawr sort of flexibility in the feet and able to think enables creatures to being more able to grip with their feet. We've got a fusion. It means that we can't grip so easily. Feet even goes much flexibility in the foot. But it means we're mortification walking more efficient on two legs over a long distance. Um, yeah. Oh than that in the foot. Well, so then have metatarsals rather than better carpals. Otherwise, they work pretty much in the same ways in the hand. First metatarsal. 2nd, 3rd, 4 Going out with, um and again similar to in the hand. Four digits have three phalanges each they call phalanges the same as in the fingers. But the greater toe well, the big toe or so called Hey, look's only has two in a similar way to the thumb. Uh, technically, you should be able to bend your toes in two places. Actually, most people can't. You haven't got that control over them. We sort of giving away a lot of control over the sort of the fine motor control of our of our lower limb in order to be able to wait there. And I was walking out with a run. Where is a few steps back in the development of humanity, We would have had much more controlled or feet because we have been more climbing A more climbing creature. Um, yeah. Uh, when I don't Eventually. About this. I got a side on one to talk about cocaine. Ius no. Okay. Uh, the calcaneal calcaneal is the only bone in the heel, so therefore, it's quite weight bearing. It's quite stony bone. You don't damage it too much. What's quite weird to think about is actually that all between the end of the cocaine IUs on the limb, going up, the limb is just a big tender. So, actually, at the back of your heel, if you push, there is just a big, dense tender until you reach bone down there. The bottom asked me what we had thought. That it's not actually bone in that part. It's just a really dense bit of of ligament tendon. Um, tenderness in that tendon allows you to straighten your foot. Um, just the way it thought there. So you can't seven that you can cut that, Uh, very painfully. But it's not got that sort of bony protection in that part of the heel, so you can end up with people bruising it, and that becomes really stiff and really sore. And you know what? People cutting it because it's no bone there to protect it. I get, like, really, really quite nasty already wants to mention that one. Uh, I mentioned metatarsals and phalanges. What's the main difference between this and the hand? The hand is metacarpals. The foot has metatarsals. Um, of was same number, same sort of distribution in terms of for Landes. The only big thing to really remember is that your big toe can also be called the Great Toe can also be called the hey looks. It's got three different names, whereas thumb tense remain. Some technically can also be called the politics or the pollicis. But no one does like something. What? What is the thumb? Um and then, yeah, as I mentioned the difference in the kidney a forms. Here you have three. Can your forms and cuboid each can. Your form corresponds to one of the digits, but then the final two digits share cuboid instead. The last, but I want to mention is arches. Before I do it that quickly share the feedback form in the chat. We do appreciate feedback on sessions. Um, if you wanted to share, that's also how you get hold off the attendance to see what the attendance. But we do appreciate feet, but please do give feedback to be honest and feedback. If you don't like our sessions, please tell us that we can improve them anyway until arches. Since the last thing we talk about this evening actually, your questions please ask. But there are three arches off the foot. What these do these sort of, uh, allow us to have impact on the foot without causing damage really allows to minimize the amount of energy loss we have each time we take a step, they are very useful. They are quite important, But they can be a problem and their natural state could be a problem. So we have three are for you to see it as lovely detail. Here's a B C. So from a to B with the anterior transverse arch that are front of the foot. And this sort of helps us if we're having sort of foot rotation is every time you take a step, this helps the foot swish down and come back up again. Um, and stocks, you ending up with injuries, sort of. Between the metatarsals. You have your B C between B and C, we have the lateral longer TUNEL arch. So along the outside, this arch tends to be okay in most people. But again, it sort of helps of impact energy expenditure on the outside of the foot, the one that tends to be more of a problem is medial longitudinal large between a and see that runs along the inside surface of your soul. See, here on this one becomes uncomfortable for most people. So if you've got high arches, this means that this one is quite highly strung, and it means every time you're taking a step, there's a lot of movement through the ligaments that hold that in place that we're paying where they're being used, but also, if you have quite a flat one. Here you're quite flat footed. That could mean you use Morrell urgy than you need to Every time you take a step and again, that cannot be great. There's a time certain military's we're enjoying if you're flatfooted, because that's his belief that you could march for a long while, you're more likely to be injured. Marching, Um, and you were like something from fatigue. If you're doing a lot of time in your feet, I think more or less that's been ruled out these days. It's not that big. It makes some difference for not as much as people have a thought. Um, I don't think flat for two people have a bar from joining any military that I know off a moment, although if I'm wrong, please do correctly if it happens that you know particular military that don't allow people with flat feet to join. Still, I would be genuine interested in that because it's, ah be a weird reason to prevent people joining um down here because we'll see how they sort of play into the actual foot structure. I won't go into too much detail about it. What you need to know about arches know they exist roughly know there are three of thumb. Roughly know that high arches on flat feet can cause people to have variations in and foot pain when walking on. Support of these is useful. If you have particular High arch, it's having foot Support is brilliant for reducing pain, walking long ways. People with high arch is also higher risk of knee injury. Basically, because this is collapsing a lot spring stress on other ligaments, you're more like to take the foot. You're more likely to twist the knee on. You're more like to cause yourself damage further up the body from that. Otherwise, that's all I really have to say on this matter. If anyone has any bits they want to ask questions about, please do otherwise we'll have quite a short session. Please ask questions. If you have any or any bets, you want me to go back over. Otherwise I will. Let's finish there. My final show shop There was a chimp For a long time. I was wrong in thinking that chimps had five near forms rather than 33. Can your forms of the keyboard tell exactly, Do you have a cuboid for their cuboid all that can you force like Bigger and the cuboid slight, smaller, but actually to go back towards fact, what's even more primitive than chimps? They start having the five Kenya forms, which is something that's more common in some of the small, very climbing monkeys. Spider monkey kind of things. Yeah, they have to sort of very grippy feet if anyone's interested in the monkey anatomy. Um, it was interesting other animal and asked me, Please don't let me know. I would love to do recessional penguins or something weird. I love the things. No, it's just ask us. Any questions, please? Do you feel that the feedback form of what we give 42nd one has any questions? Still free to ask anything, uh, voice your If no one has any questions, you are free to gun. Thank you for tending. This evening went through quite quickly because I think there was I was expecting more questioning than we had, Um, but hopefully it was a useful session. No, I'm seeing no questions. All right, I'll call it there. Anyone has any questions? They want to email me. You're welcome to Otherwise, I think you're over attending. Uh, I'll see you guys in two weeks' time for our psychology psychiatry session discussing mental health. Hopefully, the speakers will be available for that one. And it won't be again because I'm sure you're getting bored in my voice was Thank you. Everybody have a lovely you.