CLINICAL ANATOMYII. COMMITTEEE

Kaan Yücel M.D., Ph.D. 17. December.2013 Tuesday

The Two Comedians, by Chris Peters

INTRORUCTION TOOSTEOLOGY

Kaan Yücel M.D., Ph.D. 19. November 2013 Tuesday

ACCESSORY BONES

.Accessory (supernumerary) bones develop when additional ossification centers appear and form extra bones.

Many bones develop from several centers of ossification, and the separate parts normally fuse.

Sometimes one of these centers fails to fuse with the main bone, giving the appearance of an extra bone.

HETEROTOPIC BONES

.Bones sometimes form in soft tissues where they are not normally present (e.g., in scars).

Horse riders often develop heterotopic bones in their thighs (rider's bones), probably because of chronic muscle strain resulting in small hemorrhagic (bloody) areas that undergo calcification and eventual ossification.

CHANGES IN BONES & BONE FRACTURES

.Trauma to a bone may break it. For the fracture to heal properly, the broken ends must be brought together, approximating their normal position. reduction of a fracture.

Fractures are more common in children than in adults.

CHANGES IN BONES & BONE FRACTURES

.Immediately after a fracture, the patient suffers severe local pain and is not able to use the injured part.

Deformity may be visible if the bone fragments have been displaced relative to each other.

OSTEOPOROSIS

.Bones become brittle, lose their elasticity, and fracture easily.

Bone scanning is an imaging method used to assess normal and diminished bone mass.

decreases in the organic & inorganic components of the bone by aging

(BONE) SCINTIGRAPHY

.

metabolic activity of bone and its affinity to uptake a detectable marker

image can be captured by a scan

a wide range of indications ranging from sports related injuries to detection of metastasis (spreading of cancer) to the bones.

BONE DENSITOMETRY (DEXA, DXA)

.enhanced form of x-ray technology used to measure bone loss most often used to diagnose osteoporosis

effective in tracking the effects of treatment for osteoporosis and other conditions that cause bone loss.

SKULL BONES

View of a Skull, 1489 by Leonardo Da Vinci

Kaan Yücel M.D., Ph.D. 5.10.2012

HEAD INJURIESHEAD INJURIESmajor cause of death and disability

complications HemorrhageInfectionInjury to the brain and cranial nerves

FRACTURES OF THE CRANIAL FOSSAEFRACTURES OF THE CRANIAL FOSSAE

In fractures of the anterior cranial fossa, the cribriform plate of the ethmoid bone may be damaged.

Fractures of the middle cranial fossa are common, because this is the weakest part of the base of the skull.

VERTEBRAL COLUMN, RIBS & STERNUM

Kaan Yücel M.D., Ph.D. 10. December.2013 Tuesday

by Isabella Kung

SCOLIOSISSCOLIOSIS

spine is curved from side to side2% of women,less than 0.5 % of men. Progressive disease Origin unknown (idiopathic)80% of the cases, evidence for a genetic and nutritional component

Greek skoliōsis skolios "crooked"

SCOLIOSISSCOLIOSIS

Often includes a twisting of the spine, resulting in distortion of the ribs and entire thorax.

Usually presents in pre-teens and adolescents.

Structural scoliosis may require surgical intervention; alternatively scoliosis may be corrected using orthotics (e.g. braces).

HYPERKYPHOSISHYPERKYPHOSIS

Kyphosis natural curvatures of the thoracic spine

Hyperkyphosis a pathologically exaggerated thoracic curvature, commonly called "hunchback."

Common in aging adults, usually aided by the vertebral collapse related to osteoporosis.

Other common causes trauma, arthritis, and endocrine or other diseases.

HYPERLORDOSISHYPERLORDOSIS

Lordosis natural curvature of the lumbar spine

hyperlordosis is a pathologically exaggerated lumbar curvature, commonly called "swayback.«

Symptoms may include pain and numbness if the nerve trunks are compromised.

HYPERLORDOSISHYPERLORDOSIS

Attributed to weak back muscles or a habitual hyperextension, such as in pregnant women, men with excessive visceral fat, and some dance postures.

Also correlated with puberty.

RIB FRACTURESRIB FRACTURES

• The short, broad 1st rib, rarely fractured • When broken ---structures crossing its superior aspect injured,

including the brachial plexus of nerves and subclavian vessels.• The middle ribs most commonly fractured.• The weakest part of a rib is just anterior to its angle.

SUPERNUMERARY RİBSSUPERNUMERARY RİBS

The number of ribs increased by the presence of cervical and/or lumbar ribsCervical ribs relatively common (0.5-2%) interfere with neurovascular structures exiting the superior thoracic aperture.Supernumerary (extra) ribs Clinical significance confusion in radiological diagnosis

Supernumerary ribs in a neonate

14 pairs of ribs in the chest X-ray

STERNAL FRACTURESSTERNAL FRACTURES

• Despite the subcutaneous location of the sternum, sternal fractures are not common. Airbag

• A fracture of the sternal body is usually a comminuted fracture (a break resulting in several pieces).

• The most common site in elderly people @ the sternal angle • The concern in sternal injuries heart injury or lung injury

MEDİAN STERNOTOMYMEDİAN STERNOTOMY

• To gain access to the thoracic cavity for surgical operations in the mediastinum—e.g., coronary artery bypass grafting—the sternum is divided (split) in the median plane and retracted.

• A good exposure for removal of tumors in the superior lobes of the lungs.

• After surgery, the halves of the sternum are joined using wire sutures.

STERNAL ANOMALİESSTERNAL ANOMALİES

Complete sternal cleft uncommon anomaly through which the heart may protrude ectopia cordis Partial clefts Sternal foramen

A receding (pectus excavatum, or funnel chest) or projecting (pectus carinatum, or pigeon breast) sternum