This document provides information on the structure and function of various ligaments in the body. It begins by defining a ligament as a band of connective tissue that connects two bones or cartilages. It then discusses the histology and microstructure of ligaments. The document outlines the components and roles of several major ligaments including those in the knee (ACL, PCL), shoulder (coracohumeral), ankle (deltoid, lateral), and hip (iliofemoral, ischiofemoral, pubofemoral). It compares ligaments to tendons and describes ligament attachments and functions in stabilizing joints and absorbing shock.
This document discusses the three types of muscle tissue: skeletal, cardiac, and smooth muscle. It provides details on their characteristics, such as whether they are striated or not, voluntary or involuntary, and their locations and functions in the body. Skeletal muscle is voluntary, attached to bones, and enables movement. Cardiac muscle is involuntary and makes up the heart wall. Smooth muscle is involuntary and located in organs like the stomach.
This document provides an overview of muscle anatomy and physiology. It discusses the three types of muscles - skeletal, smooth and cardiac - and their microscopic structures. Skeletal muscle is composed of fascicles containing bundles of striated muscle fibers. Each fiber contains myofibrils made up of actin and myosin filaments that generate the power of muscle contraction. Nerve signals trigger calcium release and the sliding of these filaments. The document also covers muscle naming conventions, blood supply, innervation and types of contraction.
This document provides information on various topics related to muscle action and work. It discusses different types of muscle contraction including isotonic, isometric, and isokinetic contractions. It also describes muscle contraction facts related to the cross-bridge cycle during concentric, eccentric, and isometric contractions. Additionally, it covers motor units, recruitment strategies, and factors that affect active muscle tension generation.
The wrist joint, also known as the radiocarpal joint, is a complex synovial joint that involves the distal end of the radius, articular disc, and three carpal bones. It allows for flexion, extension, abduction, and adduction movements and is supplied by branches of the median, radial, and ulnar nerves. Common injuries to the wrist joint include fractures of the scaphoid bone and Colles' fracture of the radius.
This document summarizes the radioulnar joints of the forearm. It describes the proximal and distal radioulnar joints as pivot joints that allow for pronation and supination. The proximal joint is located near the elbow and involves the head of the radius articulating with the radial notch of the ulna. The distal joint is located near the wrist and involves the ulnar notch of the radius articulating with the ulnar head. Both joints are enclosed in capsules and allow rotation of the radius within the forearm.
Tendons consist of parallel bundles of collagen fibers that provide great tensile strength to anchor muscles to bones. Ligaments contain bundles of elastic fibers and some collagen, making them more flexible than tendons but offering less strength to hold bones together. Fibroblasts secrete the fibers and ground substance of connective tissue and are called fibrocytes when not actively engaged in synthesis. The poor blood supply to tendons and ligaments affects their behavior in the body.
The document discusses the structure and function of the thorax and chest wall. It contains the following key points:
1. The thorax consists of ribs, sternum, costal cartilages, and thoracic vertebrae that form the rib cage.
2. The rib cage has several types of joints that connect the bones including costovertebral, costotransverse, costochondral, and sternocostal joints.
3. Movement of the rib cage is complex, with the ribs moving in different planes depending on their position. Upper ribs move more in the sagittal plane while lower ribs move more in the frontal plane.
The document discusses the anatomy and physiology of bone. It covers the functions, classification, microscopic structure, development, growth and common disorders of bone. Key points include that bone provides structure, protection and movement; is made of collagen fibers and hydroxyapatite; develops through intramembranous or endochondral ossification; and can be affected by conditions like fractures, osteoporosis or cancer.
This document provides an overview of joint structure and function. It defines a joint and lists the intra-articular and extra-articular structures. It describes the basic principles of joint design and complexity matching function. It explains Wolff's law relating bone structure to function. It details the cellular and extracellular components of connective tissue, including collagen and elastin fibers. Finally, it discusses joint classification, motions, and the response of connective tissues to loads.
There are three main types of joints in the body - fibrous, cartilaginous, and synovial joints. Fibrous joints are immovable, cartilaginous joints allow slight movement, and synovial joints can move freely. Synovial joints are further classified by their shape and include hinge, ball-and-socket, and saddle joints. Each joint has a fibrous capsule, ligaments, synovial membrane, articular cartilage, and in some cases articular discs or bursae to facilitate movement and reduce friction between bones.
Joints are classified structurally based on how bones connect and functionally based on degree of movement. Structural types are fibrous, cartilaginous, and synovial. Fibrous joints allow little movement, cartilaginous more than fibrous but less than synovial. Synovial joints have the most mobility and include ball-and-socket, hinge, and gliding joints. Functionally, joints are synarthrosis (no movement), amphiarthrosis (slight movement), and diarthrosis (varied movement like flexion). Key parts of joints are articular cartilage, synovial cavity, articular capsule, synovial fluid, and ligaments.
The document discusses the motor unit, which consists of a motor neuron and the muscle fibers it innervates. It explains that motor units are recruited in order from smaller to larger units as the strength of the neural signal increases. Precise movements involve fewer muscle fibers per neuron, around 2-3, while imprecise movements involve more fibers, around 100 per neuron. Examples are requested of precise and imprecise movements.
The document discusses the three arches of the foot: the medial and lateral longitudinal arches and the transverse arch. The medial longitudinal arch is composed of more bones and joints and is higher and more mobile, acting in propulsion. The lateral longitudinal arch is lower and less mobile and receives body weight. Both arches act as shock absorbers and are supported by various muscles, ligaments, and bones. The transverse arches spread body weight across the sole. Clinical conditions involving high or low arches like pes cavus and pes planus are also covered.
A joint is formed where two or more bones come into contact and are attached by ligaments or cartilage. There are several types of joints including fibrous joints which have no movement, cartilaginous joints which allow limited movement, and synovial joints which are freely movable and lubricated by synovial fluid within a joint capsule. Common synovial joints include ball-and-socket joints like the shoulder, hinge joints like the knee, and gliding joints between wrist and ankle bones.
This document discusses the three types of joints in the body - fibrous, cartilaginous, and synovial joints. It focuses on fibrous joints, which are connections between bones held together by collagen fibers or other fibrous connective tissues, making them largely immobile. Examples of fibrous joints include sutures in the skull, syndesmoses between bones of the limbs, and gomphoses where teeth attach to alveolar sockets. While fibrous joints allow little to no movement, they provide strength and stability at sites of bone connection throughout the body.
The document discusses the musculoskeletal system and defines key anatomical terms. It describes the three cardinal planes - sagittal, frontal, and transverse - that divide the body into halves. It also discusses parallel and diagonal planes. Direction terms like superior, anterior, and medial are defined. The document outlines different types of movements that occur in each plane, including flexion, abduction, and rotation. It introduces the three anatomical axes that movements occur around - the x, y, and z axes.
The hip joint is a ball-and-socket synovial joint located between the femur and pelvis. It allows flexion, extension, abduction, and rotation of the thigh. The joint is stabilized by strong ligaments and surrounding muscles. It receives its main blood supply from the medial and lateral circumflex femoral arteries and is innervated by nerves from the lumbar plexus.
1. The vertebral column is made up of 33 vertebrae divided into 5 regions with intervertebral discs between them.
2. It has both primary curves that are present from birth and secondary curves that develop with upright posture.
3. Each vertebra has a vertebral body in front and a vertebral arch in back, connected by pedicles with trabecular systems inside responding to stresses.
4. The intervertebral discs have a gelatinous nucleus pulposus surrounded by an outer fibrous anulus fibrosus and cartilage end plates separating it from the vertebrae.
Joints are connections between bones that allow movement. There are 230 joints in the body. Joints are classified structurally based on how the bones connect and functionally based on their range of motion. The main types of joints are fibrous, cartilaginous, and synovial joints. Synovial joints have the most mobility and include ball-and-socket joints of the shoulder and hip. Key parts of synovial joints include the articular cartilage, joint capsule, synovial membrane, and sometimes articular discs.
The wrist joint, also called the radiocarpal joint, is a synovial ellipsoid joint formed by the proximal row of carpal bones and the distal end of the radius. Scaphoid fracture is the most common carpal bone injury, often resulting from a fall on an outstretched hand which puts the wrist in hyperextension. Clinical evaluation looks for tenderness and deformity while radiological evaluation with x-rays, CT, MRI, and arthrography can diagnose fractures and ligament injuries. Common fractures include Colles' fracture of the distal radius and fractures of the scaphoid and lunate bones.
The document summarizes the biomechanics of the vertebral column. It describes the typical structure and regions of the vertebral column. It then discusses the typical vertebrae structure, intervertebral discs, articulations, ligaments, curves of the spine, and kinetics and kinematics including forces like compression, bending, torsion and shear. It also provides details on the specific structure and features of the cervical spine regions.
Ligaments are bands of fibrous connective tissue that connect bones and support organs. They have collagen fibers, elastin, and fibroblast cells. Ligaments stabilize joints and provide proprioception. They have either indirect or direct insertions into bone, with the latter having transitional fibrocartilage zones. Important ligaments include the anterior and posterior cruciate ligaments in the knee, which prevent anterior/posterior tibial translation, and the medial and lateral collateral ligaments, which stabilize the ankle.
The document discusses the biomechanics of the spine. It describes the structure of the spine including the 33 vertebrae and intervertebral disks. It discusses the articulations between vertebrae including the intervertebral joints between vertebral bodies and disks, and the zygapophyseal joints between articular processes. It also describes the ligaments that connect vertebrae like the anterior and posterior longitudinal ligaments. The spine functions to provide support, stability, and mobility and withstands various forces like axial compression, tension, bending, torsion and shear stresses.
The document provides information about ligaments, including their structure, function, and biomechanical properties. It describes ligaments as collagenous tissues that connect bone to bone and restrict joint motion. Ligaments have a crimped structure and act as tensile restraints. Their stress-strain curve exhibits a toe region, linear region, and failure region. Ligaments' biomechanical role is to control joint movement and stability. Various factors can affect their properties, such as aging and immobilization.
Tendon healing and grafting involves three phases:
1. History dating back to ancient Greece examining tendon function and repair techniques.
2. Anatomy exploring tendon structures like the paratenon and surrounding tissues important for gliding and nutrition.
3. Current practices reviewing tendon biomechanics, healing processes, transfer principles and engineering advances.
The document discusses the structure and function of the knee joint capsule. It describes how the capsule consists of an outer fibrous layer and inner synovial membrane. The synovial membrane folds within the joint and its intricate folds create separations within the capsule. The capsule provides stability and limits motion of the knee joint. It is reinforced medially, laterally and posteriorly by ligaments. The synovial membrane secretes and absorbs synovial fluid for joint lubrication.
The document discusses the anatomy and structure of the knee joint capsule. It describes how the capsule consists of an outer fibrous layer and inner synovial membrane. The synovial membrane folds and invaginates within the joint, surrounding structures like the cruciate ligaments. The fibrous layer provides passive support and is reinforced by capsular ligaments. The intricate structure of the capsule plays an important role in joint stability and function.
The document discusses tendon anatomy, histology, nutrition, healing, and clinical applications of tendon repair and grafting. It covers the 3 phases of tendon graft healing - cellular, collagen synthesis, and remodeling. Primary repair of tendon lacerations is indicated for clean wounds within days of injury. Goals of repair include restoring gliding function while avoiding scar adhesion. Early controlled motion after repair and techniques like tenolysis can improve outcomes.
histology of skeletal muscle by mankelklot kasahunBuyakasahun
The document provides an overview of a seminar on skeletal muscle tissue. It discusses the classification of muscle tissues, organization of skeletal muscle tissue, and the actomyosin cross-bridge cycle involved in muscle contraction. The objectives are to describe skeletal muscle characteristics, organization, contraction mechanism, fiber types, and innervation. Key points covered include the striated appearance of skeletal muscle, sarcomere structure, roles of actin and myosin filaments, and the molecular steps of the cross-bridge cycle.
GENERAL ANATOMY OF SKELETAL SYSTEM-JOINTS .pptxMuthuRoshni1
This document provides an overview of the general anatomy of joints. It begins with an introduction to joints, then describes the two main classifications of joints: functional and structural. The three types of joints are named under each classification. Synovial joints are described in further detail, including the articular cartilage, synovial fluid, synovial membrane, fibrous capsule, ligaments, and menisci. Examples of each type of joint are also provided.
The document discusses the structure and function of the knee joint capsule. It describes how the capsule consists of an outer fibrous layer and inner synovial membrane. The synovial membrane folds intricately within the joint and excludes fat pads and ligaments. The fibrous layer provides passive support and is reinforced by capsular ligaments. The joint capsule plays important roles in joint stability, lubrication and nutrition of avascular structures.
ANATOMY OF GASTROCSOLEUS COMPLEX AND TEAR OF TENDO.pptxmananshroff2
- The gastrocnemius and soleus muscles make up the gastrocnemius-soleus complex, also known as the calf muscles. The gastrocnemius crosses the knee, ankle, and subtalar joints, while the soleus only crosses the ankle and subtalar joints.
- Together, their tendons form the Achilles tendon, which inserts on the back of the calcaneus bone. Ruptures of the Achilles tendon commonly occur 2-5cm above this insertion.
- Surgical treatment for acute ruptures involves debriding the tendon ends and reattaching them, while chronic ruptures may require lengthening procedures, tendon transfers, or grafts
The document discusses the classification and functional anatomy of joints in the human body. It describes three main classifications of joints: structural (fibrous, cartilaginous, synovial), functional (synarthrosis, amphiarthrosis, diarthrosis), and regional (skull, vertebral, limb type). It then focuses on the different types of synovial joints, providing examples of ball-and-socket, hinge, pivot, and other joints. It also outlines the blood supply, nerve innervation, development, and factors contributing to stability in synovial joints.
This document summarizes a student's final year project report on cell-cell interactions in tendon development. The student investigated the 3D relationships between cells in developing chick tendons and their relation to matrix deposition using immunofluorescence microscopy. The student found that as tendons develop, there is an increase in matrix deposition and organization. Parallel rows of tendon cells are maintained via intracellular actin and adherens junctions. Tenascin is a marker for early tendon development. Collagen type III runs alongside longitudinal actin filaments. Procollagen processing occurs largely intracellularly prior to deposition in the extracellular matrix.
what biomechanics is and why it's important in understanding ligaments and tendons. structure and composition of ligaments and tendons. the roles of ligaments and tendons in the body and how they contribute to movement and stability. mechanical properties of ligaments and tendons, including strength, elasticity, and viscoelasticity.
introduction about joints, types of joints . joints are present with in upper limb, movements of all joints and finally with clinical correlation of all joints.
The document discusses muscle structure and function, including:
1) Muscles contract through the sliding of actin and myosin filaments, powered by ATP hydrolysis in the myosin cross-bridges.
2) Calcium released from the sarcoplasmic reticulum binds to troponin, allowing myosin to bind to actin and the power stroke to occur.
3) Repeated binding and detachment of myosin cross-bridges causes the filaments to slide past each other, shortening the sarcomere and muscle.
Bone tumors can be benign or malignant. Benign tumors are encapsulated and compress surrounding tissue, while malignant tumors invade tissue and metastasize. Bone tumors are classified based on the type of tissue they form (e.g. bone, cartilage), their location in the bone, and whether they are primary or metastatic. Staging systems evaluate tumor grade, size, and spread to determine prognosis and guide treatment. Imaging including x-rays and MRI are used to identify tumor location, effects on bone, and presence of metastases to aid diagnosis.
This document discusses the biomechanics of the hip joint. It begins by defining biomechanics as the science examining forces acting on biological structures. It then describes the hip as both mobile and stable due to its strong bones, powerful muscles, and ligaments. The document goes on to discuss topics such as the femoral neck angle, acetabular version, muscles, joint reaction forces, gait biomechanics, and the effects of conditions like osteoarthritis. It concludes by covering the history and principles of hip biomechanics in total hip arthroplasty, including how procedures aim to decrease joint reaction forces.
This document discusses various angular deformities of the knee, including genu varum (bowlegged), genu valgus (knock-kneed), genu recurvatum, and genu procurvatum. It provides details on the causes, presentations, treatments, and assessments of genu varum and genu valgus. For genu varum, treatment may involve observation, bracing, or osteotomy, while genu valgus can be treated with observation, bracing, hemiepiphysiodesis, or osteotomy in more severe cases. Assessments involve measurements like intermalleolar distance and Q angle to evaluate deformities.
Legg-Calve-Perthes disease is a childhood condition caused by temporary loss of blood supply to the femoral head. It most commonly affects boys ages 4-8 and can cause deformity of the femoral head. Early containment of the femoral head via casts or surgery can prevent deformation and minimize long-term arthritis risk. Prognosis depends on the Herring classification, with surgery beneficial for lateral pillar group B/C cases after age 8. The goal of treatment is to maintain femoral head congruency and minimize secondary osteoarthritis.
Ewing sarcoma is a highly malignant bone tumor that most commonly affects children and young adults. It is characterized by small, round cancer cells of unknown origin that invade bone and sometimes spread to soft tissues or other bones. Diagnosis involves imaging tests and biopsy showing the characteristic cells. Treatment typically involves chemotherapy, surgery to remove the tumor if possible, and sometimes radiation therapy. While Ewing sarcoma has a poor prognosis if untreated, multidisciplinary treatment with chemotherapy, surgery, and radiation can result in 5-year survival rates of 60-75% for patients without metastasis at diagnosis.
Post traumatic myositis ossificans dr. k. prashanthPrashanth Kumar
This document discusses myositis ossificans, a condition where heterotopic bone forms in soft tissue, most often muscle, following trauma. Key points include:
- It is characterized by the development of mature bone in non-osseous tissues like muscle. Adolescents and young men are most commonly affected.
- Trauma is the most common precipitating factor. The pathogenesis involves cellular injury, necrosis, and proliferation of fibroblasts and mesenchymal cells that form bone.
- Radiographs show calcifications and ossification developing over weeks. Histopathology shows zones of ossification.
- Treatment involves rest, splinting, NSAIDs, and physical therapy to prevent loss of range
This document discusses microwave diathermy, which uses electromagnetic radiation between shortwave and infrared waves to generate heat deep in tissues for therapeutic purposes. It notes that microwave diathermy does not penetrate as deeply as shortwave diathermy due its higher frequency and shorter wavelength. The document provides details on microwave generators using 2450MHz frequency, applicators, absorption and penetration in different tissues, therapeutic effects, common applications for pain relief and increased circulation, as well as contraindications and treatment parameters.
Tarsal tunnel syndrome involves compression of the tibial nerve as it passes beneath the flexor retinaculum in the ankle. It causes pain, numbness and tingling in the foot. Non-surgical treatments include orthotics, stretching, weight loss and activity modification. Surgery to release the flexor retinaculum may be considered if non-surgical options fail. Anterior tarsal tunnel syndrome is a similar condition affecting the deep peroneal nerve. Risk factors include ankle injuries and activities that put repetitive stress on the ankle.
The document discusses viewing the knee as a biologic transmission with an envelope of function. It describes the various anatomic structures of the knee as parts of the transmission that accept, transfer, and dissipate loads. Factors like age, anatomy, kinematics, physiology, and treatment determine the envelope of function, or range of loads the knee can handle without failure. Conceptualizing the knee this way can help patients understand injuries and treatment in a more realistic way.
This document discusses various osteotomies around the hip joint, including their objectives, indications, and procedures. Proximal femoral and pelvic osteotomies are classified. Key points include that osteotomies are used to correct biomechanical alignment and load transmission across the hip joint. Procedures discussed in detail include Salter innominate osteotomy, Sutherland double innominate osteotomy, Steel triple innominate osteotomy, Ganz periacetabular osteotomy, and Pemberton osteotomy.
The document discusses the anatomy and physiology of lumbar intervertebral discs. It describes the normal structure and composition of discs, including the nucleus pulposus, annulus fibrosus, and endplates. Discs receive little blood supply and rely on diffusion for nutrition. With aging, discs undergo degeneration as proteoglycan content decreases, collagen content increases, and matrix turnover declines. This makes discs more prone to injuries like herniations and less able to function as effective shock absorbers.
Talus fractures involve the second largest tarsal bone. Hawkins classification system categorizes talus neck fractures into 4 types based on displacement and disruption of blood supply. Type 1 fractures are undisplaced while type 4 have the worst prognosis. Treatment depends on fracture type but generally involves anatomical reduction, stable fixation, and avoiding complications like avascular necrosis. Surgical approaches may be needed for types 2-4 to achieve and maintain reduction.
This document describes various surgical approaches to the knee joint. It begins by noting the knee is a hinge joint stabilized by muscles and ligaments. It then describes 7 open and 2 arthroscopic approaches. The medial parapatellar approach provides the most exposure and is commonly used for procedures like knee replacement. Arthroscopic approaches are now often preferred over open for treating conditions like meniscal tears. The document outlines principles for different surgical approaches and risks associated with various incisions near the knee.
This document discusses cervical spine injuries, their classification, mechanisms of injury, diagnosis, and management. Some key points:
1. Cervical injuries can be caused by traction, direct impact, or indirect forces like flexion, compression, or rotation. Imaging helps classify injuries and assess stability.
2. Unstable injuries with neurological deficits or multiple injuries may require urgent surgical stabilization. Otherwise, initial treatment focuses on immobilization using rigid collars, braces, halo traction, or halo vests.
3. Common injuries include fractures of C1-C2 and the odontoid process. Type II odontoid fractures are prone to displacement and non-union, so may need open reduction and fusion
This document provides information on claw hand deformities, including definitions, anatomy, classifications, evaluation, and surgical reconstruction techniques. It begins with defining claw hand as a flattening of the transverse metacarpal arch with hyperextension of the MCP joints and flexion of the PIP and DIP joints. It then discusses the anatomy and biomechanics involved in normal versus paralytic claw hands. Various classification systems for claw hands are presented based on etiology, pattern of nerve injury, degree of involvement, and physical characteristics. Evaluation techniques such as specific tests and angle measurements are outlined. Both static and dynamic surgical reconstruction methods are then described in detail, including tendon transfers, capsulotomies, and tenode
The document discusses the anatomy of the lower limb joints, including the hip, knee, and ankle joints. It describes the types of joints, articular surfaces, ligaments, movements, blood supply, clinical considerations, and gait for each joint. For the hip joint, it highlights the ball and socket construction, stability from muscles, ligaments and bone shape, and age-related diseases like osteoarthritis and fractures.
Diathermy uses electric currents to generate deep heat within tissues up to 2 inches below the skin's surface. It promotes blood flow and reduces pain and stiffness. Shortwave diathermy specifically uses radiofrequency currents between 10-100 MHz to heat tissues. It can treat musculoskeletal conditions like arthritis as well as injuries and infections by speeding recovery through increased circulation and metabolism. Risks include burns if not properly controlled or applied to people with medical implants. Proper electrode placement and settings are needed to target heating and avoid harming surrounding tissues.
Mail Server Configuration Using App passwords in Odoo 17Celine George
In Odoo 17, we can securely configure an email server to send and receive emails within the application. This is useful for features like sending quotations, invoices, and notifications via email. If our email service provider (e.g., Gmail, Outlook) supports app passwords, we can use them to authenticate our Odoo instance with the email server.
Demonstration module in Odoo 17 - Odoo 17 SlidesCeline George
In Odoo, a module represents a unit of functionality that can be added to the Odoo system to extend its features or customize its behavior. Each module typically consists of various components, such as models, views, controllers, security rules, data files, and more. Lets dive into the structure of a module in Odoo 17
2. DEFINITION:
a short band of tough, flexible fibrous
connective tissue which connects two bones
or cartilages at a joint or supporting an organ.
3. • HISTOLOGY:
• At the microscopic level, ligaments are much more
complex, being composed of cells called fibroblasts which
are surrounded by matrix.
• The cells are responsible for matrix synthesis and they are
relatively few in number and represent a small percentage
of the total ligament volume.
• Although these cells may appear physically and functionally
isolated, recent studies have indicated that normal
ligament cells may communicate by means of prominent
cytoplasmic extensions that extend for long distances and
connect to cytoplasmic extensions from adjacent cells, thus
forming an elaborate 3-dimensional architecture.
4. • Gap junctions have also been detected in
association with these cell connections raising
the possibility of cell-to-cell communication and
the potential to coordinate cellular and metabolic
responses throughout the tissue.
• Ligament microstructure can be visualized using
polarized light that reveals collagen bundles
aligned along the long axis of the ligament and
displaying an underlying "waviness" or crimp
along the length.
• Crimp is thought to play a biomechanical role,
possibly relating to the ligaments loading state
with increased loading likely resulting in some
areas of the ligament uncrimping, allowing the
ligament to elongate without sustaining damage
6. STRUCTURE:
Extracellular components consist of:
water
Type I collagen (70% of dry weight)
elastin
higher elastin content than tendons
lipids
proteoglycans
epiligament coat
present in some ligaments, not all
analogous to epitenon of tendons
Cellular component
the main cell type in both tendons and ligaments is the
fibroblast
both tendons and ligaments have low vascularity and cellularity
7. the crimped structure of the collagen fibre
bundles permits stretching by 10–15% before
failure.
This combination of strength and extensibility
enables ligaments to absorb more strain
energy per unit weight than any other
biological material, and makes them very
effective shock absorbers .
8. • Ligaments vs. tendons
– composition
• compared to tendons, ligaments have
–lower percentage of collagen
–higher percentage of proteoglycans and
water
–less organized collagen fibers
–rounder fibroblasts
9. An important mechanical difference between
tendons and ligaments is that ligaments often
contain bundles of collagen fibres orientated
in a range of directions, presumably because
bones can be moved apart in a range of
directions, whereas the fibres in a tendon are
aligned only in the direction in which the
muscle pulls on the tendon.
10. • Two types of ligament bone insertion
– indirect (fibrous insertion):
• most common form of bone insertion
• superficial fibers insert into the
periosteum
• deep fibers insert directly into bone via
perforating collagen fibers called Sharpey
fibers
• at insertion, endotenon becomes
continuous with periosteum
• examples
–MCL inserting into proximal tibia
11. –direct (fibrocartilaginous
insertion):
• has both deep and superficial fiber insertion
• deep fibers
–have four transitional zones of increasing
stiffness that allow for force dissipation and
reduce stress concentration
»Zone 1 (tendon or ligament proper)
• consists of well aligned type I collagen
fibers with small amounts of
proteoglycan decorin
12. Zone 2 (fibrocartilage)
consists of types II and III collagen, with small
amoutns of type I, IX and X collagen, and
proteoglycans aggrecan and decorin
Zone 3 (mineralized fibrocartilage)
consists of type II collagen, with significant
amounts of type X collagen and aggrecan
Zone 4 (bone)
is made up of type I collagen, with high mineral
content
examples
supraspinatus insertion
13. • FUNCTIONS:
a)STABILITY:
• One of the main functions of ligaments is mechanical
as they passively stabilize joints and help in guiding
those joints through their normal range of motion
when a tensile load is applied.
• Ligaments exhibit nonlinear anisotropic mechanical
behaviour and under low loading conditions they are
relatively compliant, perhaps due to recruitment of
"crimped" collagen fibres as well as to viscoelastic
behaviours and interactions of collagen and other
matrix materials.
14. • Continued ligament-loading results in
increasing stiffness until a stage is reached
where they exhibit nearly linear stiffness and
beyond this, then, ligaments continue to
absorb energy until tensile failure (disruption).
15. • b)VISCOELASTIC BEHAVIOUR:
• Another ligament function relates to its
viscoelastic behaviour in helping to provide joint
homeostasis.
• Ligaments "load relax" which means that
loads/stresses decrease within the ligament if
they are pulled to constant deformations.
• Ligaments also "creep" which is defined as the
deformation (or elongation) under a constant or
cyclically repetitive load.
• Creep is particularly important when considering
joint injury or reconstructive surgery as excessive
creep could result in laxity of the joint thus
predisposing it to further injury
16. • C)PROPRIOCEPTION:
• A third function of ligaments is their role in joint
proprioception, which is referred to as the conscious
perception of limb posi tion in space.
• In joints such as the knee, proprioception is provided
principally by joint, muscle and cutaneous receptors.
• When ligaments are strained, they invoke neurological
feedback signals that then activate muscular
contraction and this appears to play a role in joint
position sense.
• Although progress continues to be made to elucidate
the role of proprioception in normal ligament function
and during injury, more precise quantification is the
subject of ongoing analysis.
18. • Anterior sternoclavicular ligament:
• The anterior sternoclavicular ligament is
broad and attached above to the
anterosuperior aspect of the sternal end of
the clavicle.
• It passes inferomedially to the upper anterior
aspect of the manubrium, spreading onto the
first costal cartilage.
• Posterior sternoclavicular ligament :
• The posterior sternoclavicular ligament is a
weaker band posterior to the joint.
• It descends inferomedially from the back of
the sternal end of the clavicle to the back of
the upper manubrium
20. • Interclavicular ligament :
• The interclavicular ligament is continuous
above with deep cervical fascia, and unites the
superior aspect of the sternal ends of both
clavicles; some fibres are attached to the
superior manubrial margin.
21. • Acromioclavicular ligament:
• The acromioclavicular ligament is
quadrilateral.
• It extends between the upper aspects of the
lateral end of the clavicle and the adjoining
acromion.
• Its parallel fibres interlace with the
aponeuroses of trapezius and deltoid
22. • Coracoclavicular ligament :
• The coracoclavicular ligament connects the
clavicle and the coracoid process of the
scapula .
• Though separate from the acromioclavicular
joint, it is a most efficient accessory ligament,
and maintains the apposition of the clavicle to
the acromion.
24. • Coracohumeral ligament :
• The coracohumeral ligament is attached to the
dorsolateral base of the coracoid process and extends
as two bands, which blend with the capsule, to the
greater and lesser tubercles . Portions of the
coracohumeral ligament form a tunnel for the biceps
tendon on the anterior side of the joint.
• The rotator interval is reinforced by the coracohumeral
ligament.
• It also blends inferiorly with the superior
glenohumeral ligament.
26. • Anular ligament :
• This is a strong band, which encircles the radial
head,holding it against the radial notch of the
ulna.
• Forming about four-fifths of the ring, it is
attached to the anterior margin of the notch,
broadens posteriorly and may divide into several
bands.
• It is attached to a rough ridge at or behind the
posterior margin of the notch; diverging bands
may also reach the lateral margin of the trochlear
notch above and proximal end of the supinator
crest below.
• The proximal anular border blends with the
elbow joint capsule, except posteriorly where the
capsule passes deep to the ligament to reach the
posterior and inferior margins of the radial notch.
27. • From the distal ANULAR border a few fibres
pass over reflected synovial membrane to
attach loosely on the radial neck.
• The external surface of the anular ligament
blends with the radial collateral ligament and
provides an attachment for part of supinator.
• Subluxation of the radial head through the
anular ligament arising from a sudden jerk on
the arm is a relatively common injury in young
children (known as ‘pulled elbow’).
28. • This is because the anular ligament has
vertical sides in children compared with more
funnel-shaped sides in adults.
30. • Triangular fibrocartilage
complex (TFCC) and distal
radio-ulnar ligaments:
• The triangular fi brocartilage complex (TFCC) is a
ligamentous and cartilaginous structure which suspends
the distal radius and ulnar carpus from the distal ulna.
• The TFCC stabilizes the ulnocarpal and radio-ulnar joints,
transmits and distributes load from the carpus to the ulna,
and facilitates complex movements at the wrist .
• By definition,it is made up of the cartilaginous disc, the
meniscus homologue (an embryological remnant of the
‘ulnar’ wrist that is only occasionally present), volar and
dorsal distal radio-ulnar ligaments, ulnar collateral
ligament, floor of extensor carpi ulnaris subsheath,
ulnolunate and ulnotriquetral ligaments.
32. • FUNCTION:
a. The triangular fibrocartilage complex stabilizes
the wrist at the distal radioulnar joint.
b. It also acts as a focal point for force transmitted
across the wrist to the ulnar side.
• Traumatic injury or a fall onto an outstretched
hand is the most common mechanism of injury.
The hand is usually in a pronated or palm down
position.
• Tearing or rupture of the TFCC occurs when there
is enough force through the ulnar side of the
hyperextended wrist to overcome the tensile
strength of this structure.
33. • superficial and deep components of the distal
radio-ulnar ligaments which act as a functional
couple stabilizing the rotation of the ulnar
head on the sigmoid notch of the radius
34. • ligamenta flava : ligaments of the spine.
• They connect the laminae of
adjacent vertebrae, all the way from the
second vertebra, axis, to the first segment of
the sacrum.
35. • Function:
• Their marked elasticity serves to preserve the
upright posture, and to assist the vertebral
column in resuming it after flexion.
• The elastin prevents buckling of the ligament
into the spinal canal during extension, which
would cause canal compression.
• Clinical relevance:
• Hypertrophy of this ligament may cause spina
stenosis, particularly in patients with diffuse
idiopathic skeletal hyperostosis,]because it lies
in the posterior portion of the vertebral canal.
36. • Iliofemoral ligament:
• The iliofemoral ligament is very strong and
shaped like an inverted Y, lying anteriorly and
intimately blended with the capsule. Its apex
is attached between the anterior inferior iliac
spine and acetabular rim, its base to the
intertrochanteric line.
37. • FUNCTION:
• In a standing posture, when the pelvis is tilted
posteriorly, the ligament is twisted and tense,
which prevents the trunk from falling backwards
and the posture is maintained without the need
for muscular activity.
• In this position the ligament also keeps
the femoral head pressed into the acetabulum.
• As the hip flexes, the tension in the ligament is
reduced and the amount of possible rotations in
the hip joint is increased, which permits the
pelvis to tilt backwards into its sitting angle.
Lateral rotation and adduction in the hip joint is
controlled by the strong transversal part, while
the descending part limits medial rotation.
38. • Ischiofemoral ligament:
• The ischiofemoral ligament thickens the back of
the capsule and consists of three distinct parts.
The central part, the superior ischiofemoral
ligament, spirals superolaterally from the
ischium, where it is attached posteroinferior to
the acetabulum, behind the femoral neck to
attach to the greater trochanter deep to the ilio-
39. • Pubofemoral ligament:
• The pubofemoral ligament is triangular, its
base attaching to the iliopubic eminence,
superior pubic ramus, obturator crest and
obturator membrane.
• It blends distally with the capsule and deep
surface of the medial iliofemoral ligament.
40. • FUNCTION:
• The pubofemoral ligament stabilizes the hip
joint.
• It prevents the joint from moving beyond its
normal range of motion, front-to-back and
side-to-side.
• It also limits external rotation of the joint.
• The pubofemoral ligament is considered to be
a supporting element of the joint capsule.
• It reinforces the inferior and anterior capsule.
42. • Anterior cruciate ligament:
• The anterior cruciate ligament is attached to
the anterior intercondylar area of the tibia,
just anterior and slightly lateral to the medial
tibial eminence, partly blending with the
anterior horn of the lateral meniscus.
• It ascends posterolaterally, twisting on itself
and fanning out to attach high on the
posteromedial aspect of the lateral femoral
condyle .
43. • FUNCTION:
• it resist anterior translation & medial rotation
of the tibia,in relation to the femur.
• Congenital absence of the anterior cruciate
ligament is rare. The condition is usually
associated with lower limb dysplasia and may
be a cause of instability of the knee
45. • Posterior cruciate ligament:
• The posterior cruciate ligament is thicker and
stronger than the anterior cruciate ligament .
• It is attached to the lateral surface of the medial
femoral condyle and extends up onto the anterior
part of the roof of the intercondylar notch, where
its attachment is extensive in the anteroposterior
direction.
• They pass distally and posteriorly to a fairly
compact attachment posteriorly in the
intercondylar region and in a depression on the
adjacent posterior tibia.
• This gives a fan-like structure in which fibre
orientation is variable
46. • FUNCTION:it prevent the femur from sliding of
the anterior edge of tibia & to prevent the
tibia from displacing posterior to the tibia.
47. • Medial collateral ligament (deltoid
ligament):
• The medial collateral ligament (deltoid ligament) is a
strong, triangular band, attached to the apex and the
anterior and posterior borders of the medial malleolus
• Of its superficial fibres, the anterior (tibionavicular)
pass forwards to the navicular tuberosity, behind which
they blend with the medial margin of the plantar
calcaneonavicular ligament.
• intermediate (tibiocalcaneal) fibres descend almost
vertically to the entire length of the sustentaculum tali.
• posterior fibres (posterior tibiotalar) pass
posterolaterally to the medial side of the talus and its
medial tubercle.
• The deep fi bres (anterior tibiotalar) pass from the tip
of the medial malleolus to the non-articular part of the
medial talar surface.
48. • FUNCTION:
a) Superficial deltiod primarily resist eversion of
foot.
b) Tibionavicular portion suspends spring lig &
prevents inward displacement of head talus
,while tibiocalcaneal portion prevents valgus
displacement.
c) Deep deltiod lig extends the function of
medial malleolus& lateral displacement of
talus &prevents external rotation of talus.
50. • Lateral ligament :
• The lateral ligament has three discrete parts.
a) The anterior talofibular ligament extends
anteromedially from the anterior margin of the
fibular malleolus to the talus, attached in front
of its lateral articular facet and to the lateral
aspect of its neck .
FUNCTION:
a) Primary restraint to inversion in plantar flexion
b) Resists anterolateral translation of talus in he
mortise
Weakest of the lateral lig ,so mst cmnly injured
in sprains.
51. B) The posterior talofibular ligament runs almost
horizontally from the distal part of the lateral
malleolar fossa to the lateral tubercle of the
posterior talar process a ‘tibial slip’ of fibres
connects it to the medial malleolus.
FUNCTION:
a. Plays only a supplementary role in ankle stabilty
when the lateral lig is intact.
b. Limits posterior talar displacement within the
mortise as well as talar external rotation.
c. if ATFL and CFL are incompetent then
– short fibres of PTFL restrict internal and external
rotation, talar tilt, and dorsiflexion;
– long fibres inhibit only external rotation, talar tilt, and
dorsiflexion
52. C) The calcaneofibular ligament, a long cord,
runs from a depression anterior to the apex of
the fibular malleolus to a tubercle on the
lateral calcaneal surface and is crossed by the
tendons of fibularis longus and brevis .
• FUNCTION:
a. primary restrain to inversion in neutral or
dorsiflexed position
b. restrains subtalar inversion, thereby limiting
talar tilt within mortise
54. • Calcaneonavicular
Ligament (Spring
Ligament):
– attaches from the
sustentaculum tali to
the inferior aspect of
the navicular
• Function
– static stabilizer of the
medial longitudinal
arch and head of the
talus