Course Introduction

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Course Introduction

• Functional Anatomy
• OT 319/519

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Anatomical Position

• Body erect, feet slightly apart, palms forward,
  and thumbs pointed laterally.
• Regardless of the position of the body you are
  describing, terms of reference describe the body
  as though it were in anatomical position.
• Right and Left always refer to the patient /
  cadaver, not the side of the observer

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Planes of Orientation

• Sagittal (divides into left right)
• Frontal / Coronal (divides into anterior
  posterior)
• Transverse / Axial (divides into superior
  inferior)
• Oblique

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Terms of Orientation

• Superior (Cephalad) / Inferior (Caudal)
• Lateral / Medial
• Superficial / Deep
• Proximal / Distal
• Anterior / Posterior
• Ventral / Dorsal
• Ipsilateral / Contralateral
• Prone / Supine

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Brain Orientation
Dorsal
Anterior
Posterior
Ventral
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Multifidus vs. Splenius
Ipsilateral rotation
Contralateral rotation
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Terms to Avoid

• Above
• Below
• Over
• Under
• On top of
• In front of
• Behind

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Terms of Movement

• Flexion / Extension
• Abduction / Adduction
• Internal (Medial) Rotation / External (Lateral)
  Rotation (extremities)
• Pronation / Supination (forearm)
• Dorsiflexion / Plantarflexion (Talocrural joint)

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2 Common Descriptive Terms

• Varus bent or twisted inward toward the midline
  of the body.
• Valgus bent or twisted outward or away from the
  body.
• In clinical practice these terms are used to
  describe the distal portion of the distal bone.

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Varus or Valgus?
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Varus or Valgus?
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Varus or Valgus?
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Veins, Arteries Nerves

• Veins are vessels that carry blood toward the
  heart.
• We talk about veins as having tributaries.
• Arteries are vessels that carry blood away from
  the heart.
• We talk about arteries as having branches.
• Nerves can be differentiated from the arteries by
  their flat shape and the acute angles that their
  branches make.

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Nerves

• You have 31 pairs of spinal nerves that emerge
  from the spinal cord (8 cervical, 12 thoracic, 5
  lumbar, 5 sacral, and 1 coccygeal).
• Each of these is named according to the order
  (from superior to inferior) and the region in
  which they emerge. (Ex. C5, L1, S3) We will refer
  to these as spinal levels.
• Each named peripheral nerve in the body comes
  from one or more spinal levels. (Ex.
  Thoracodorsal nerve comes from spinal levels C6,
  C7, C8)

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More About Nerves

• Some nerves are associated with motor function,
  while others are associated with sensory function
  and the remainder are mixed (motor and sensory).
• When a nerve is described as an afferent, that
  means it is carrying information to the central
  nervous system, thus it is a sensory nerve.
• When a nerve is described as an efferent, that
  means it is carrying information away from the
  central nervous system, thus it is a motor nerve.

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Roots, Rami, Spinal Nerves

• Peripheral nerves initially emerge from the
  spinal cord as ventral and dorsal roots.
• By the time the neurons travel through the IV
  foramen, they have combined to form a spinal
  nerve.
• This nerve then splits into a larger ventral and
  smaller dorsal ramus.

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Roots vs. Rami
Ventral roots
Dorsal roots

• Spinal nerve roots emerge directly from the cord.
• The roots that emerge anteriorly carry motor
  commands (efferents) out to the PNS.
• The roots that emerge posteriorly carry sensory
  information (afferents) in to the CNS.

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Roots vs. Rami
Ventral Ramus
Dorsal Ramus

• When the roots join they become a spinal nerve.
• As you look lateral to that, you will see that
  the spinal nerve has some branches, these are the
  ventral and dorsal rami (ramus).
• In the rami, there are both sensory and motor
  fibers.

The fibers in the circle are associated with the
sympathetic nervous system.
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Dermatomes

• For every spinal nerve there is a dermatome.
• A dermatome is an area of sensation on the body.
• Dermatomes are named for the spinal nerve that
  provides sensation in that area.
• For example, T10 dermatome is from spinal nerve
  T10. It provides sensation in the area around the
  trunk at the level of the navel.

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Dermatomes

• Some dermatome landmarks to remember
• C5 lateral shoulder
• C6 Thumb
• C7 Digit 3
• C8 Digit 5
• T4 nipples
• T10 navel
• L3 medial knee
• L5 lateral knee
• S1 lateral foot

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Palpation

• Regardless of your program discipline (OT, PT,
  PA, CHR) you will be performing some degree of
  patient evaluation and the more comfortable you
  are performing an evaluation, the easier it will
  be on the patient.
• Palpation of a patient is often a component of
  your evaluation.

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Palpation Applications

• Vasomotor changes that would change the
  temperature of the skin.
• Localize sites of specific swelling.
• Identify specific anatomic structures and their
  relationship to one another.
• Identify points of tenderness.
• Evaluate circulatory status by checking pulses.

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Lab Practicals

• All student and instructor cadavers will be used
  as well as some models and demonstration
  specimens.
• Radiographs We are usually asking questions
  about either bony features or muscle attachments.
• Palpations There will be 6-10 index cards face
  down on the table and you will draw one. Written
  on the other side is either a bony feature or
  muscle which you will have to find on a teaching
  assistant.

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Lab Practicals

• Cross-Sections These questions concern the model
  that is cut into various segments in the
  transverse plane .
• Bonus question There will be one for each exam,
  so you can go ahead and allow yourself ONE
  mistake.

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Testing Content (What you are expected to know)

• Muscle attachments
• Muscle actions
• Muscle Innervation (Name of the peripheral nerve)
• Spinal levels of the relevant nerves
• Artery names and their sources
• Vein names
• Ligaments / Specialized Cartilage

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Waste Baskets

• You will notice two kinds of waste baskets in the
  lab, gray cans with lids and tan open cans.
• The gray cans are to be used exclusively for
  human tissue. That means no gloves, paper towels,
  cups, etc.
• The tan cans are used for all other waste that is
  not considered sharp.

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Superficial Deep Back

• Functional Anatomy
• OT 319 / 519

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