Presentation is loading. Please wait.

Presentation is loading. Please wait.

FOCUS Foundation - firm Observation – landmarks Concentration – in the moment, mindfulness Understanding – data, information, knowledge, mastery, wisdom.

Similar presentations


Presentation on theme: "FOCUS Foundation - firm Observation – landmarks Concentration – in the moment, mindfulness Understanding – data, information, knowledge, mastery, wisdom."— Presentation transcript:

1 FOCUS Foundation - firm Observation – landmarks Concentration – in the moment, mindfulness Understanding – data, information, knowledge, mastery, wisdom Systematic – Thought process of expert Dr. Frank C.T. Voon The Warrior & the Surgeon 13 July 2009

2 Medical Diagnosis Signs Symptoms Investigations

3 Medical Education SignsSymptoms Specialties SystemsStructures Regional AnatomyFunctional Anatomy Imaging Anatomy

4 Structures Bones Joints Muscles Nerves Arteries Veins Lymphatics Organs Structures Compartments

5 Systems Skeletal Articular Muscular Nervous Endocrine Circulatory – cardiovascular Immune - lymphatic Respiratory Digestive Excretory - renal Reproductive – female & male Integumentary

6 The Analytically Anatomical Approach Recognize the region(6) & subregion Determine the perspective –Anterior, posterior, sagittal, superior, inferior Locate the level –Superficial (skin) to deep (bones) –Vertical levels (vertebra or plane) Select the structure –B J M N A V L O S C Choose the format

7 Regions Head & neck Upper limb Thorax Abdomen Pelvis Lower limb

8 Region - Head Face Scalp Temporal region Infratemporal region Orbit Nasal cavity Oral cavity Ear - outer

9 Region - Neck Suprahyoid, infrahyoid Triangles – anterior & posterior Pharynx Larynx Carotid sheath

10 Region - Upper limb Shoulder –pectoral, scapular Arm –Flexor and extensor compartments Forearm –Flexor and extensor compartments Hand –Thenar, intermediate, hypothenar compartments The free upper limb, pectoral girdle

11 Region - Lower limb Gluteal region Thigh –Anterior compartment - extensor –Medial compartment - adductor –Posterior compartment - flexor Leg –Anterior compartment - extensor –Lateral compartment - peroneal –Posterior compartment - flexor Foot –Layers of the foot Muscle Tendon Muscle Bone

12 Region - Thorax Boundaries –Walls Anterior – manubrium, sternum, xiphisternum, costal cartilages Lateral – ribs, intercostal spaces Posterior – vertebrae, intervertebral discs, erector spinae –Roof – thoracic inlet/outlet –Floor – thoracic outlet/diaphragm Contents –Pleural cavities –Mediastinum Superior –Trachea, arch of aorta, esophagus, superior vena cava, brachiocepalic trunk, left common carotid artery, left subclavian artery Inferior –Anterior – thymus, internal thoracic vessels –Middle – pericardium, heart, pulmonary trunk, ascending aorta –Posterior – esophagus, descending aorta, azygos system, thoracic duct

13 Region - Abdomen Boundaries –Anterolateral abdominal wall rectus abdominis external oblique, internal oblique, transversus abdominis –Posterior abdominal wall Psoas major, quadratus lumborum –Inguinal region Contents –Compartments Peritoneal cavity –Organs Gut – foregut, midgut, hindgut Liver, pancreas, spleen Kidneys

14 Region - Pelvis Boundaries –Anterolateral abdominal wall rectus abdominis external oblique, internal oblique, transversus abdominis –Posterior abdominal wall Psoas major, quadratus lumborum –Inguinal region Contents –Compartments Pouch of Douglas, rectovesical pouch, uterovesical pouch –Organs Urinary bladder, prostate, seminal vesicles Uterus, vagina Rectum Perineum –Anal triangle, urogenital triangle, urogenital diaphragm

15 Bones Type –Long –short –flat –irregular –sesamoid Upper end, lower end, shaft Projections – tuberosities, condyles, neck Right or left – all 3 dimensions Ossification – endochondral, intramembranous

16 Bones Mandible – temporomandibular joint, parts Vertebrae – cervical, thoracic, lumbar, sacrum Rib – typical, 1 st Clavicle – intramembranous, sternoclavicular joint Scapula – muscles, rotation 60 degrees Humerus – surgical neck, midshaft, supratrochlear, medial epicondyle Radius – pivot joint, tuberosity (biceps) Carpus – scaphoid, trapezium, capitate, hamate Femur – neck, head, lesser trochanter (iliopsoas) Fibula – lateral malleolus (key to orientation) Patella – sesamoid bone, larger lateral facet Tarsus – talus (ball bearing)

17 Joints Definition –Articulation between 2 or more bones From outside in Capsule Synovial membrane Articular cartilage Ligaments Movements allowed

18 Joints TMJ - dislocation Atlanto-occipital – flexion/extension & lateral flexion, condyloid joint Atlanto-axial - pivot joint Intervertebral – cartilaginous joint Sternoclavicular – double plane Thoracic cage – bucket handle, pump handle Shoulder, wrist, elbow – ball & socket, ellipsoid, hinge Hip, knee, ankle 1 st carpometacarpal Axis of movements –Supination, pronation, inversion, eversion

19 Muscles Origin – bone, then part Insertion – bone, then part Joint/s involved Movements possible – use the joint axis Nerve supply Blood supply – arteries, veins, anastomosis Relations - Applied/clinical anatomy – major function,

20 Muscles – H&N Muscles of mastication – 1 st arch Muscles of facial expression – 2 nd arch Extra-ocular muscles – LR6,SO4 Soft palate Tongue Supra- & infra- hyoid muscles Sternocleidomastoid & trapezius Scalenus anterior & medius

21 Muscles – UL Upper – shoulder & arm –Scapular group –Triceps –Flexors –Coracoid process –Pectoral girdle & humeral Lower – forearm & hand –Flexors – superficial & deep –Extensors – lateral, thumb, digits, elbow –Thenar, intermediate, hypothenar

22 Muscles – LL Thigh – extensors, adductors, flexors Gluteal & lateral rotators Leg - extensors, peronei, flexors Foot – muscle, tendon, muscle, bone

23 Muscles – Trunk Intercostals Diaphragm Obliques & transversus abdominis Pelvic diaphragm Urogenital diaphragm Erector spinae

24 Muscles – smooth & cardiac Intrinsic muscles of the eye Stapedius & tensor tympani Musculi pectinati, trabeculae carneae, Detrusor Gut – colic, outer longitudinal, inner circular Oesophagus – skeletal to smooth, 1/3 Sphincters of urethra & anal canal

25 Nerves Origin Root levels Branches Distribution Clinical - palsies

26 Nerves Cranial - trigeminal, facial & vagus Spinal –ARMUM –FOGS –Tibial; common, superficial & deep peroneal –Plantar – medial & lateral Autonomic –COPS –Splanchnics - greater, lesser & least; pelvic

27 Arteries Begins –A continuation of –Location, usually bony part nearby Ends (as above) Middle –If 3 parts, middle related to a muscle –4 parts (vertebral artery) –branches –distribution Relationships –V-A-N Histological layers –Endothelium, muscle (smooth), adventitia (elastic) Applied –Anastomosis, clinical procedures

28 Arteries External carotid –Soft palm –ST,L,F,O,PA,AP,ST,Mx Internal carotid - circle of Willis Aorta – ascending, arch, descending, abdominal Internal iliac Femoral, tibial, popliteal, plantar Brachiocephalic, subclavian, axillary, brachial, radial, ulnar, palmar arches (superficial & deep) Coronary arteries Choroid plexuses, anastomoses, coarctation of the aorta, medial umbilical ligaments (obliterated umbilical arteries)

29 Veins Superficial or deep Begins –A combination of –Location, usually bony part nearby Ends –Drains into –Location (surface marking) Middle –Vessels that drain into it –Area of drainage & organs or structures drained by it Relationships –V-A-N Valves, venous plexus Applied –Plexuses, clinical procedures (cut down), conditions (haemorrhoids) –Venous sinues

30 Veins Cranial cavity - venous sinuses Superior & Inferior vena cava - tributaries Upper limb – superficial & deep Lower limb – superficial, deep & perforators Portal vein – varices & haemorrhoids Falciform ligament (ligamentum teres of the liver - obliterated left umbilical vein), caput medusae

31 Lymphatics Lymph nodes Thoracic duct Cisterna chyli Spread of infections & tumors

32 Organs Form – shape, size Location Arterial input Venous drainage Organization – nervous or humoral Relations Special or uniqueness

33 Organs Thyroid Parotid, submandibular, sublingual glands Larynx, pharynx Heart, lungs, esophagus Liver, pancreas, spleen, kidneys, suprarenals Testes, prostate, ovaries, uterus, vagina

34 Compartments Spaces Shape –2 dimensional – femoral triangle –3 dimensional - pyramid, 3-sided, 4-sided, truncated, wedge Boundaries –Walls, roof, floor Contents –Arteries, veins, nerves, lymph nodes Examples –axilla, mediastinum, cubital fossa, popliteal fossa, ischiorectal fossa, cranial fossae, carpal tunnel, subsartorial (Hunter’s) canal, pouch of Douglas, nasal cavity, fascial compartments (of arm & leg)

35 Structures - extra Miscellaneous structures –ureter, urethra (male, female) –flexor retinaculum (carpal tunnel) –extensor expansion (dorsum of fingers) –fascia lata (gluteus maximus & tensor fascia lata) –plantar aponeurosis (longitudinal arch of foot) –perineal body (central tendon cf diaphragm)

36 Integration Images Visual (observational) –skin –clinical photographs Dupuytren’s contracture –videos Radiological - Xrays Scans – Ultrasound, CAT Imaging – MRI, PET


Download ppt "FOCUS Foundation - firm Observation – landmarks Concentration – in the moment, mindfulness Understanding – data, information, knowledge, mastery, wisdom."

Similar presentations


Ads by Google