Quadriceps muscle.

There are four muscles present in the anterior compartment of thigh. Those four muscles provides stability to the knee joint and helps in extention of knee. 

Name of quadriceps muscles - 

1. Rectus femoris

a. Origin - From anterior inferior iliac spine and groove above brim of acetabulum.

b. Insertion - Base of patella. 

c. Nerve supply - Femoral nerve (L1, L2,          L3).

d. Action - Extension of knee.

2. Vastus lateralis

a. Origin - Upper part of intertrochanteric         line of femur.

b. Insertion - Lateral and upper border of        patella.

c. Nerve supply - Femoral nerve.

d. Action - Extention of knee.

3. Vastus medialis

a. Origin - Lower part of intertrochanteric         line of femur.

b. Insertion - Upper and medial border of        patella. 

c. Nerve supply - Femoral nerve. 

d. Action - Extention of knee. 

4. Vastus intermedius

a. Origin - Upper 2/3rd anterior and lateral      surfaces of shaft of femur

b. Insertion - Lateral border of patella.

c. Nerve supply - Femoral nerve. 

d. Action - Extention of knee.

NOTE - 

Vastus medialis has also two  parts

1. Vastus medialis longus(VML)

2. Vastus medialis oblique(VMO) 

VMO exercises are very helpful in knee pain specially in arthritis

VMO isometric contraction

Femoral artery.

Femoral artery is a continuation of external iliac artery after passing through the inguinal ligament.  

Femoral artery has three divisions -

1. Superficial

Superficial femoral artery has following three branches -

a. Superficial epigastric artery

b. Superficial external pudendal artery

c. Superficial circumflex iliac artery

2. Deep

Deep femoral artery has following three branches - 

a. Deep external pudendal artery

b. Muscular artery

c. Profunda femoris artery

3. Descending genicular artery 

It is itself a branch of femoral artery which supplies to the knee joint.

Diagram of femoral artery -

Rotator cuff

It is a fibrous sheath formed by four tendons which strengthens the capsule of shoulder joint from all sides except inferiorly. 

Rotator cuff muscles also stabilises humeral head to keep it in its position so there is stable range of motion of shoulder joint.

Note :- As the rotator cuff muscles doesn't strengthens the capsule joint from inferior side so dislocation of the humerus occurs most commonly in a downward direction.

Origin and insertion of rotator cuff muscles.

Muscles of rotator cuff muscle arises from scapula and are inserted into lesser and greater tubercle of humerus.

 Rotator cuff muscles name -

1. Subscapularis

2. Supraspinatus

3. Infraspinatus

4. Teres minor

Clinical - 

1. Rotator Cuff Tear - 

Tearing of the muscles or tendons of rotator cuff.

2. Rotator Cuff Tendinitis - 

Acute inflammation of the tendons of rotator cuff.

3. Rotator Cuff Tendinopathy -

Chronic degeneration of the rotator cuff tissue.

4. Impingement syndrome -

Biomechanical dysfunction of the shoulder complex with causes abnormal wear and tear on the rotator cuff soft tissue.

5. Bursitis -

Inflammation of the bursa around the rotator cuff muscle. 

Femoral triangle.

It is a femoral trigone present in the supero medial part of anterior thigh.

It can be seen during - 

1. Flexion of hip joint.

2. Abduction of hip joint

3. Internal rotation of hip joint

BOUNDARY OF FEMORAL TRIANGLE

1. Lateral - 

Sartorius muscle

2. Medial -

Adductor longus muscle 

3. Base -

Inguinal canal (present between anterior superior iliac spine and pubic tubercle).

4. Apex - 

It is a point where the lateral and medial boundary meet.

ROOF OF FEMORAL TRIANGLE

1. Skin

2. Superficial fascia

3. Deep fascia

FLOOR 

1. Medial - Adductor longus

2. Lateral - Iliopsus (Psoas major and iliacus)

CONTENTS

1. Femoral nerve and its branches such as pectineus nerve and genito femoral nerve.

2. Femoral artery.

3. Femoral vein.

4. Lymph node.

5. Great saphenous vein.

6. Flexor sheath

NOTE :- The contents of femoral traingle is divided into three compartments for artery, vein and lymph. The three compartments are called media, lateral and intermediate compartment. The compartments are tied together by a flexor sheath. Flexor sheath holds the artery, vein and lymph nodes as there is higher pressure of blood in them.

Cubital fossa

Cubital fossa is a triangular shaped depression over the anterior aspect lf elbow joint. It is an area between arm and forearm.

BORDERS - 

1. Medial 

Lateral border of pronator teres.

2. Lateral

Medial border of brachioradialis.

3. Base/ Superior

An imaginary line which joins both epicondyl of humerus.

4. Apex 

Meeting point of lateral and medial boundaries.

ROOF - 

1. Skin

2. Superficial fascia

3. Bicipital aponeurosis

4. Deep fascia

FLOOR - 

1. Supinator

2. Brachialis

CONTENTS - 

1. Radial nerve - 

Passes laterally in cubital fossa and divides into superficial and deep branch.

2. Biceps brachii (tendon) -

Passes centrally in cubital fossa and attaches to radial tuberosity of radius bone.

3. Brachial artery -

Present at the apex of cubital fossa and further divides into radial and ulnar artery.

4. Median nerve - 

It is the most medial content of cubital fossa which passes between the two head of pronator teres muscle.

Note - The roof of cubital fossa contains some superficial vein like median cubital vein, basilic vein and cephalic vein which has a clinical relevance.

CLINICAL ANATOMY - 

1. Median cubital vein is often the vein choosed for IV injections.

2. Blood pressure is universally recorded by auscultating the brachial artery present infront of elbow.

Note :- TRICK TO LEARN THE CONTENTS OF CUBITAL FOSSA (from medial to lateral)

M - Median nerve

B - Brachial artery

T - Tendon of biceps brachii

R - Radial nerve

Click here for the video

Vertebra bones

Vertebra consists of a number od seperate irregular bones which forms central axis of the body.

Function of vertebra - 

1.  Protects spinal cord.

2. Support body weight.

3. Provides movement of trunk.

CLASSIFICATION OF VERTEBRAL BONES - 

1. CERVICAL bones

- There are seven cervical bones which are again classified into typical and atypical bones. 

- Third to sixth cervical bones are termed as typical while 1st, 2nd and 7th cervical bones are termed as atypical.

2. THORACIC bones

- There are all total 12 thoracic bones which are classified into typical and atypical bones.

- Typical bones are from second to eighth thoracic bones while the rest are atypical bones.

3. LUMBAR bones - five in number.

4. SACRAL - One in number 

5. COCCYGEAL - One in number 

NOTE - Every vertebra bones have two parts that are body and arch. Body lies anteriorly while arch lies posteriorly and vertebral foramen is present between body and arch.

ANATOMICAL POSITION

- Vertebral body foreward.

- Vertebral arch backward

ARTICULATION

- Interbody joint.

- Atlanto occipital joint

- Atlanto axial joint

- Facet joint

- Costovertebral joint

- Sacro iliac joint

- Costo transverse joint

Note - 

Body of vertebrae has six surfaces - 

1. Upper surface

2. Lower surface

3. Posterior surface

4. Anterior surface

5. Two lateral surface

Vertebral arch has -

1. Pedicles

2. Laminae

3. Process - one spinous process, four articular process and two transverse process.

LIGAMENTS

1. Anterior longitudinal ligament

2. Posterior longitudinal ligament

3. Supraspinous ligament

4. Infraspinous ligament

5. Ligamentum flavum

CLINICAL ANATOMY 

1. Kyphosis

- Abnormality of thoracic region.

- Concave anterior curvature of thorax.

2. Scoliosis

- Lateral curvature of vertebral column increases.

- Abnormality of vertebral column.

3. Lordosis

- Abnormality of lumbar region.

- Concavity of posterior curvature of lumbar increases.

4. Torticolis

- Abnormality of neck muscles.

- Head is bent laterally one side and rotate the other side.

5. Sciatica

- Abnormality of hip region.

- Pain runs posterior thigh and leg.

6. Flat back

- Abnormality of lumbar region.

- Concavity of posterior curvature of lumbar decreases.

7. Ankylosing spondilitis

- Inflammation occurs at vertebral joints.

8. Spondylosis

- Degeneration of intervertebral disc.

- Degeneration leads to formation of bony spurs which causes nerve root compression.

9. Spondylolysis

- Abnormality of vertebrae 

- Defection in pairs inter articularis (pair of lamina between superior and inferior articular process).

10. Spondylolisthesis

- Abnormality of vertebrae

- One vertebrae slips foreward on other vertebrae.

11. Hangman's fracture

- Fracture of axis bone (second cervical bone)