Instituto Tolteca de México ZAragoza http://on.fb.me/xrhfisioterapia Anatomia de extremidades Temario del curso de Anatomia de extremidades, el cual ha sido diseñado para los alumnos de 2do semestre (ciclo escolar 2011-2012 “B”) de la licenciatura en fisioterapia del Instituto Tolteca de México Zaragoza. Es nuestro deseo que estos temas resulten ser tan apasionantes como el tiempo que se ha dedicado en la elaboración y revisión de cada uno de ellos. Felicidades por el curso que hoy inicias, y esperamos continues con ese mismo entusiasmo hasta el final. .:. XRH .:. Temario Bloque 1.Osteología de la extremidad superior 2 1.1 Generalidades.............2 1.2 Huesos y articulaciones (Figura 6) 2 1.2.1 A. Clavicle (collarbone)2 1.2.2 B. Scapula (shoulder blade) 2 1.2.3 C. Humerus (see Figure 2-1) 2 1.2.4 D. Radius (Figure 2-2). 3 1.2.5 E. Ulna (see Figure 2-2) 1. Olecranon 3 1.2.6 F. Carpal bones (see Figure 2-2) 4 1.2.7 G. Metacarpals.........4 1.2.8 H. Phalanges...........4 1.3 Cuadros...................5 1.4 Figuras...................8 1.5 Ejercicios...............23 Fta. & Blgo. Xavier Rivera Hernández Pág. 1
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Instituto Tolteca de México ZAragoza
http://on.fb.me/xrhfisioterapiaAnatomia de extremidades
Temario del curso de Anatomia de extremidades, el cual ha sido diseñado para los alumnos de 2do semestre (ciclo escolar 2011-2012 “B”) de la licenciatura en fisioterapia del Instituto Tolteca de México Zaragoza.
Es nuestro deseo que estos temas resulten ser tan apasionantes como el tiempo que se ha dedicado en la elaboración y revisión de cada uno de ellos. Felicidades por el curso que hoy inicias, y esperamos continues con ese mismo entusiasmo hasta el final.
.:. XRH .:.
TemarioBloque 1. Osteología de la extremidad superior 2
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Fta. & Blgo. Xavier Rivera Hernández Pág. 2
Instituto Tolteca de México ZAragoza
http://on.fb.me/xrhfisioterapiaAnatomia de extremidades
Bloque 1. Osteología de la extremidad superior1.1 Generalidades
Las articulaciones dividen la extremidad superior en cuatro regiones principales: el hombro, el brazo, el antebrazo y la mano (Figura 6 y Error: Reference source not found).
La cintura escapular (hombro) es un anillo incompleto formada por los huesos de la escápula derecha e izquierda y la clavícula, que se unen medialmente al manubrio del esternón.
1.2 Huesos y articulaciones (Figura 6)
1.2.1 A. Clavicle (collarbone)
Is a commonly fractured bone that forms the pectoral (shoulder) girdle with the scapula , which connects the upper limb to the axial skeleton (sternum), by articulating with the sternum at the sternoclavicular joint and with the acromion of the scapula at the acromioclavicular joint.
Has the medial two thirds tilted convex forward and the lateral one third flattened with a marked concavity.
Is the first bone to begin ossification during fetal development, but it is the last one to complete ossification , at about age 21 years.
Is the only long bone to be ossified intramembranously.
1.2.2 B. Scapula (shoulder blade)
1. SPINE OF THE SCAPULA
Is a triangular-shaped process that continues laterally as the acromion.
Divides the dorsal surface of the scapula into the upper supraspinous and lower infraspinous fossae.
Provides an origin for the deltoid and an insertion for the trapezius.
2. ACROMION Is the lateral end of the
spine and articulates with the clavicle. Provides an origin for the deltoid and an insertion for the trapezius.
3. CORACOID PROCESS
Provides the origin of the coracobrachialis and biceps brachii and the insertion of the pectoralis minor.
Provides an attachment site for the coracoclavicular, coracohumeral, and coracoacromial ligaments and the costocoracoid membrane.
4. SCAPULAR NOTCH Is bridged by the superior
transverse scapular ligament and is converted into a foramen, which permits passage of the suprascapular nerve.
5. GLENOID CAVITY Is deepened by the
glenoid labrum for the head of the humerus .
6. SUPRAGLENOID AND INFRAGLENOID TUBERCLES
Provide origins for the tendons of the long heads of the biceps brachii and triceps brachii muscles, respectively.
1.2.3 C. Humerus (see Figure 2-1)
1. HEAD Has a smooth, rounded,
articular surface and articulates with the scapula at the glenohumeral joint.
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2. ANATOMIC NECK Is an indentation distal to
the head of the humerus and provides for the attachment of the fibrous joint capsule.
3. GREATER TUBER-CLE
Lies just lateral to the anatomic neck and provides attachments for the supraspinatus, infraspinatus, and teres minor muscles.
4. LESSER TUBERCLE Lies on the anterior
medial side of the humerus, just distal to the anatomic neck, and provides an insertion for the subscapularis muscle.
5. INTERTUBERCU-LAR (BICIPITAL) GROOVE
Lies between the greater and lesser tubercles, lodges the tendon of the long head of the biceps brachii muscle, and is bridged by the transverse humeral ligament , which restrains the tendon of the biceps brachii long head.
Provides insertions for the pectoralis major on its lateral lip , the teres major on its medial lip , and the latissimus dorsi on its floor.
6. SURGICAL NECK Is a narrow area distal to
the tubercles that is a common site of fracture and is in contact with the axillary nerve and the posterior humeral circumflex artery.
7. DELTOID TUBEROSITY
Is a V-shaped roughened area on the lateral aspect of the midshaft that marks the insertion of the deltoid muscle.
8. SPIRAL GROOVE Contains the radial nerve,
separating the origin of the lateral head of the triceps above and the origin of the medial head below.
9. TROCHLEA Is the medial articular
surface, shaped like a spool, and articulates with the trochlear notch of the ulna .
10. CAPITULUM Is the lateral articular
surface, globular in shape, and articulates with the head of the radius. P.21
11. OLECRANON FOSSA
Is a posterior depression above the trochlea of the humerus that houses the olecranon of the ulna on full extension of the forearm.
12. CORONOID FOSSA
Is an anterior depression above the trochlea of the humerus that accommodates the coronoid process of the ulna on flexion of the elbow.
13. RADIAL FOSSA Is an anterior depression
above the capitulum that is occupied by the head of the radius during full flexion of the elbow joint.
14. LATERAL EPI-CONDYLE
Projects from the capitulum and provides the origin of the supinator and extensor muscles of the forearm.
15. MEDIAL EPI-CONDYLE
Projects from the trochlea and has a groove on the back for the ulnar nerve and superior ulnar collateral artery.
Provides attachment sites for the ulnar collateral ligament, the pronator teres, and the common tendon of the forearm flexor muscles.
1.2.4 D. Radius (Figure 2-2)
Is shorter than the ulna and is situated lateral to the ulna.
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Is characterized by displacement of the hand dorsally and radially when fractured at its distal end (Colles' fracture).
1. HEAD (PROXIMAL END)
Articulates with the capitulum of the humerus and the radial notch of the ulna and is surrounded by the annular ligament .
2. DISTAL ENDArticulates with the
proximal row of carpal bones , including the scaphoid, lunate, and triquetral bones but excluding the pisiform bone.
3. RADIAL TUBEROS-ITY
Is an oblong prominence just distal to the neck and provides an attachment site for the biceps brachii tendon.
4. STYLOID PROCESS
Is located on the distal end of the radius and is about 1 cm distal to that of the ulna and provides insertion of the brachioradialis muscle.
Can be palpated in the proximal part of the anatomic snuffbox between the extensor pollicis longus and brevis tendons.
1.2.5 E. Ulna (see Figure 2-2) 1. Olecranon
Is the curved projection on
the back of the elbow that provides an attachment site for the triceps tendon.
2. CORONOID PROCESS
Is located below the trochlear notch and provides an attachment site for the brachialis.
3. TROCHLEAR NOTCH
Receives the trochlea of the humerus.
4. ULNAR TUBEROS-ITY
Is a roughened prominence distal to the coronoid process that provides an attachment site for the brachialis.
5. RADIAL NOTCH Accommodates the head
of the radius. 6. Head (distal end) Articulates with the articular disk of the distal radioulnar joint and has a styloid process.
1.2.6 F. Carpal bones (see Figure 2-2)
Are arranged in two rows of four (lateral to medial): Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, and Hamate (mnemonic device: Sandra Likes To Pat Tom's Two Cold Hands). (Trapezium precedes trapezoid alphabetically.)
1. PROXIMAL ROW (LATERAL TO MEDIAL): SCAPHOID, LUNATE, TRIQUETRUM, AND PISIFORM
Except for the pisiform, articulates with the radius and the articular disk (the ulna has no contact with the carpal bones). The pisiform is said to be a sesamoid bone contained in the flexor carpi ulnaris tendon.
2. DISTAL ROW (LATERAL TO MEDIAL): TRAPEZIUM, TRAPEZOID, CAPITATE, AND HAMATE
1.2.7 G. Metacarpals
Are miniature long bones consisting of bases (proximal ends), shafts (bodies), and heads (distal ends). Heads form the knuckles of the fist.
1.2.8 H. Phalanges
Are miniature long bones consisting of bases, shafts, and heads. The heads of the proximal and middle phalanges form the knuckles.
Occur in fingers (three each) and thumb (two).
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.:. XRH XRH .:. Aunque es habitual dividir el desarrollo humano en los períodos prenatal (anterior al nacimiento) y posnatal (después del nacimiento), el nacimiento constituye, simplemente, un fenómeno decisivo durante el desarrollo, en el que se produce un cambio de ambiente (Moore y Persaud, 2004b).
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1.3 Cuadros
Cuadro 1. Huesoso del esqueleto apendicular(63 huesoso en cada lado del cuerpo, 126 huesoso en total)
Cintura pectoral (escapular). 2 huesoso en cada cintura, 4 huesoso en total
Clavicula (2) Receptor nicotínico en las células musculares (canal de Na + activado por ligan-do)
Miastenia gravis
Escapula (omoplato; 2) Anhidrasa carbónica luminal en el túbulo contorneado proximal de la nefrona
Acidosis tubular renal proximal
Extremidad superior libre
Mediar una respuesta intracelular con ligan-dos extracelulares (Ej., las hormonas)
Receptor de la insulina Insensibilidad (re-sistencia) a la in-sulina en la diabe-tes mellitus de tipo II
Proteínas de anclaje
Células de estabiliza-ción
Espectrina Esferocitosis he-reditaria
Distrofina Distrofia muscular de Duchenne
Proteínas transporta-doras
Necesarios para el transporte facilitado
GLUT4 (cotransportador glucosa-sodio)
Diabetes mellitus
Identificador de proteínas
Identifica las células como "propia" o "aje-na" para el sistema in-munológico
Complejo Mayor de Histo-compatibilidad I
La expresión está sobreregulada en células viralmente infectadas
Cuadro 2. La comparación de la composición del líquido intracelular y extracelular
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Componente de cilios y fla-gelos.
tina) inhiben la función de los microtúbulos.La disfunción puede conducir a trastornos como el síndro-me de inmovili-dad ciliar y la in-fertilidad mascu-lina.
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1.4 Figuras
Figura 1. Posicion anatomica
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Figura 2.
Figura 3. Términos regionales. Las vistas anterior (a) y posterior (b) identifican a las principales regiones del cuerpo. Sus nombres comunes aparecen entre
paréntesis
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Figura 4.
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Figura 5.
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.
Figura 6. Organizacion de la cintura escapular y de la extremidad superior (vista superior). Están representadas las dos posiciones del antebrazo, esenciales para la habilidad manual del hombre. Supinación (extremidad derecha) y
pronación (extremidad izquierda).
Fta. & Blgo. Xavier Rivera Hernández Pág. 15
A. Cintura escapularB. BrazoC. AntebrazoD.CarpoE. MetacarpoF. Dedos de la mano