Introduction to AnatomyIntroduction to Anatomy

Prof. MihProf. Miháály, Andrly, Andráás, MD, PhD, DScs, MD, PhD, DSc

Lecture #1

2nd September 2014

The Anatomy DepartmentThe Anatomy Department(Kossuth L. sgt. 40.; http://anatomy.szote.u(Kossuth L. sgt. 40.; http://anatomy.szote.u--

szeged.hu/Anatomy/)szeged.hu/Anatomy/)

•• Professor Dr. Professor Dr. MihMiháályly, Andr, Andráás MD, PhD, DSc, director of the Departments MD, PhD, DSc, director of the Department

•• Professor Dr. Professor Dr. NNóógrgráádidi, Antal MD, PhD, DSc deputy director, Antal MD, PhD, DSc deputy director

•• Associate professor: Dr. Associate professor: Dr. KovKováácscs, Annam, Annamáária, MD, PhDria, MD, PhD

•• Assistant professors: Dr. Assistant professors: Dr. BBáálintlint Erika MD, PhD, Dr. Erika MD, PhD, Dr. CzignerCzigner Andrea MD, PhD, Andrea MD, PhD,

Dr. Dr. DobDobóó Endre MSc, PhD, Dr. Endre MSc, PhD, Dr. GyegyGyegyóúóújfalvijfalvi--LLáázzáárnrnéé, Dr. , Dr. HegedHegedőőss Hajnalka Hajnalka

DMD, Dr. DMD, Dr. MolnMolnáárr Gergely MSc, PhD, Dr. Gergely MSc, PhD, Dr. PPóórr IstvIstváán, DPh, Dr. n, DPh, Dr. SzabadosSzabados Andrea Andrea

MD, PhD, Dr. MD, PhD, Dr. SzigetiSzigeti Csaba, MSc, PhD Csaba, MSc, PhD

•• Senior research assistant: Dr. Senior research assistant: Dr. SSüülele ZoltZoltáán, PhDn, PhD

•• Senior teaching assistant: Senior teaching assistant: KrisztinnKrisztinnéé PPéévava BeBeááta MSc, ta MSc, FejesnFejesnéé BakosBakos MMóónika nika

MSc, Dr. MSc, Dr. JuhJuháászsz ZoltZoltáán, MD n, MD

•• Teaching assistants (MSc): Teaching assistants (MSc): KruppaKruppa Eszter, Eszter, MMáátytyááss Adrienne, Adrienne, KKáárolyroly Norbert, Norbert,

HarkaiHarkai AnikAnikóó

•• Physician: Dr. Physician: Dr. PPóórr ErzsErzséébetbet

•• Senior medical students (demonstrators): 13 medical student CollSenior medical students (demonstrators): 13 medical student Colleagues, eagues,

helping in teaching, dissection and research (listed on the webphelping in teaching, dissection and research (listed on the webpage of the age of the

Department).Department).

Main topics in AnatomyMain topics in Anatomy

•• Gross anatomy:Gross anatomy: descriptive anatomy of organs descriptive anatomy of organs and organ systems. The chapters of this are and organ systems. The chapters of this are named after the topic: osteologynamed after the topic: osteology--syndesmology, syndesmology, myology, angiology, neuranatomy, anatomy of the myology, angiology, neuranatomy, anatomy of the viscera (respiratory, digestive, urogenital,viscera (respiratory, digestive, urogenital,…… etc etc apparatuses).apparatuses).

•• Cytomorphology and histology:Cytomorphology and histology: microscopic microscopic anatomy of cells and tissues. Important in anatomy of cells and tissues. Important in pathology and cytodiagnostics (e.g.: hematology).pathology and cytodiagnostics (e.g.: hematology).

•• Embryology:Embryology: development of the organs and development of the organs and organ systems, anatomy of the pregnancy. organ systems, anatomy of the pregnancy.

Teaching program of AnatomyTeaching program of Anatomy

•• 1st semester:1st semester: anatomy of the limbs (bones, joints, anatomy of the limbs (bones, joints, muscles, blood vessels and nerves). Anatomy of muscles, blood vessels and nerves). Anatomy of the trunk and the skull. Basic tissues.the trunk and the skull. Basic tissues.

•• 2nd semester:2nd semester: cardiovascular anatomy, cardiovascular anatomy, respiratory and alimentary tract anatomy. respiratory and alimentary tract anatomy. Anatomy of the urogenital organs. Histology of the Anatomy of the urogenital organs. Histology of the cardiovascular, respiratory, alimentary and cardiovascular, respiratory, alimentary and urogenital organs. The endocrine organs, the urogenital organs. The endocrine organs, the immune system and the blood.immune system and the blood.

•• 3rd semester:3rd semester: anatomy and histology of the brain anatomy and histology of the brain and spinal cord. Head and neck anatomy. and spinal cord. Head and neck anatomy. Anatomy and histology of the eye and the ear. Anatomy and histology of the eye and the ear. Embryology: fertilisation, segmentation and Embryology: fertilisation, segmentation and embryogenesis.embryogenesis.

Exams in AnatomyExams in Anatomy

•• Practical Exams:Practical Exams: practical practical viva voceviva voce exams in the exams in the dissecting room and histology room, two times in a dissecting room and histology room, two times in a semester. The marks (1semester. The marks (1--5) are written in the index book at 5) are written in the index book at the end of the semester. Successful practical exams are the end of the semester. Successful practical exams are necessary for the entry to the semester exams and for the necessary for the entry to the semester exams and for the credit of the practices.credit of the practices.

•• Semester exams (2):Semester exams (2): comprehensive comprehensive viva voce viva voce exams in exams in the examination period with different question types, the examination period with different question types, cadavers, atlas pictures and radiological images which cadavers, atlas pictures and radiological images which are presented on the lectures, seminars and practices.are presented on the lectures, seminars and practices.

•• Final exam:Final exam: comprehensive examination after the 3rd comprehensive examination after the 3rd semester. The exam has written and oral parts, where the semester. The exam has written and oral parts, where the students have to prove their knowledge of the anatomy, students have to prove their knowledge of the anatomy, histology and embryology. The oral parts consist of histology and embryology. The oral parts consist of theoretical and practical sections: in the practical section theoretical and practical sections: in the practical section the student demonstrates a dissected cadaver.the student demonstrates a dissected cadaver.

How to learn: the students have to use their textbooksHow to learn: the students have to use their textbooks

(gross antomy, histology and embryology), the handouts(gross antomy, histology and embryology), the handouts

of the Department, the electronic aids supplied by theof the Department, the electronic aids supplied by the

Department (found on the webpage), and their own notes.Department (found on the webpage), and their own notes.

It is highly recommended to make lecture notes and use themIt is highly recommended to make lecture notes and use them

in study. The participation on practices and seminars isin study. The participation on practices and seminars is

compulsory (see Regulations of the Faculty).compulsory (see Regulations of the Faculty).

Textbooks are absolutely necessary for Textbooks are absolutely necessary for

study: recommended booksstudy: recommended books

•• GrayGray’’s Anatomy for Students (Drakes Anatomy for Students (Drake--VoglVogl--Mitchell)Mitchell)

•• Concise Histology (GartnerConcise Histology (Gartner--Hiatt)Hiatt)

•• Snell, RS: Clinical Anatomy by Regions Snell, RS: Clinical Anatomy by Regions (Wolters Kluwer)(Wolters Kluwer)

•• DonDonááth: Lexicon Anatomiae (published by th: Lexicon Anatomiae (published by Semmelweis University Publishing House)Semmelweis University Publishing House)

Morphology:Morphology: science describing shape (morphscience describing shape (morphéé = shape)= shape)Anatomy:Anatomy: science of dissection science of dissection (anatemnein = to cut apart)(anatemnein = to cut apart)

Systematic anatomy:Systematic anatomy: description of organ systems.description of organ systems.Regional anatomy:Regional anatomy: description of body regions, and the description of body regions, and the topography of structures within. topography of structures within. Surface anatomySurface anatomy..Applied anatomy:Applied anatomy: surgical anatomy, radiological anatomy. surgical anatomy, radiological anatomy. Microscopic anatomy: Microscopic anatomy: cell morphology and histology.cell morphology and histology.

Embryology:Embryology: growth and morphogenesisgrowth and morphogenesisof the human body and organs from the conception toof the human body and organs from the conception tothe birth (and after).the birth (and after).

Levels of biological organizationLevels of biological organization

•• Cells and extracellular space.Cells and extracellular space.

•• Tissues (epithelia, connective tissue,Tissues (epithelia, connective tissue,……).).

•• Organs (brain, liverOrgans (brain, liver……).).

•• Organ systems (cardiovascular system, Organ systems (cardiovascular system,

urinary tract,urinary tract,……).).

•• Body parts (thorax, limbs,Body parts (thorax, limbs,……).).

•• The human body.The human body.

Parts of the human bodyParts of the human body

•• Head Head (caput)(caput)

•• Neck Neck (collum, cervix)(collum, cervix)

•• Trunk Trunk (truncus)(truncus): chest : chest (thorax)(thorax), belly , belly

(abdomen)(abdomen), , pelvispelvis

•• Limbs (extremities): upper limb Limbs (extremities): upper limb

(extremitas superior)(extremitas superior), lower limb , lower limb

(extremitas inferior)(extremitas inferior)

Trunk partsTrunk parts

•• Chest (pectus, thorax)Chest (pectus, thorax)

•• Belly (abdomen, venter)Belly (abdomen, venter)

•• Groin (inguen, inguinal region)Groin (inguen, inguinal region)

•• Back (dorsum)Back (dorsum)

•• Loin (Loin (waistwaist; lumbus, lumbar ; lumbus, lumbar

region)region)

•• Buttocks (regio glutea)Buttocks (regio glutea)

Parts of the limbsParts of the limbs

•• Pectoral girdle (scapula and clavicle)Pectoral girdle (scapula and clavicle)

•• Arm (brachium)Arm (brachium)

•• Forearm (antebrachium)Forearm (antebrachium)

•• Wrist and hand (manus, carpus, metacarpus, Wrist and hand (manus, carpus, metacarpus, digiti)digiti)

•• Pelvic girdle (hip or coxa)Pelvic girdle (hip or coxa)

•• Thigh (femur)Thigh (femur)

•• Leg (crus)Leg (crus)

•• Foot (pes)Foot (pes)

Collum, cervixCollum, cervix

PectusPectus

(thorax) (thorax)

Abdomen, venterAbdomen, venter

InguenInguen

umbilicusumbilicus

waistwaist

CaputCaput

Collum, cervixCollum, cervix

ThoraxThorax

(cavitas thoracis)(cavitas thoracis)

AbdomenAbdomen

(cavitas abdominis)(cavitas abdominis)

PelvisPelvis

(cavitas pelvis)(cavitas pelvis)

Lungs, heartLungs, heart

Liver, stomach, spleen,Liver, stomach, spleen,

pancreas, intestinespancreas, intestines

Prostate, urinaryProstate, urinary

bladder, rectumbladder, rectum

Brain, eyesBrain, eyes

Dorsum (back) Dorsum (back)

LumbusLumbus

(waist)(waist)

Regio gluteaRegio glutea

(buttocks)(buttocks)

Introduction to osteologyIntroduction to osteologyos, ossis: bone os, ossis: bone

EPIPHYSIS DIAPHYSISEpiphysis-cartilage remnant

Cavum medullare

METAPHYSIS

ANATOMY OF LONG LIMB BONESANATOMY OF LONG LIMB BONES

Substantia spongiosa Substantia compacta

SPONGY BONE IN THESPONGY BONE IN THE

PROXIMAL EPIPHYSISPROXIMAL EPIPHYSIS

OF THE FEMUROF THE FEMUR

SubstantiaSubstantia

compactacompacta

(compact bone)(compact bone)

Substantia spongiosaSubstantia spongiosa

(spongy or cancellous bone)(spongy or cancellous bone)

Cavum medullareCavum medullare

Spongy boneSpongy bone

Spongy bone underscanning EM. Theminute cavitiescontain bone marrow,lined by endosteum.

Spongy bone is also called trabecular bone, andSpongy bone is also called trabecular bone, and

the trabecules of the epiphysis and metaphysisthe trabecules of the epiphysis and metaphysis

are arranged according to trajectories of theare arranged according to trajectories of the

forces generated by the body weight (B).forces generated by the body weight (B).

SpongiosaSpongiosa

Compacta Compacta

Marrow cavityMarrow cavity

The surface of the bone is uneven: tuberosities, eminences, cristae, pecten.

Blood vessels enter through foramina.

Distal epiphysisDistal epiphysis Proximal epiphysisProximal epiphysis

Diaphysis Diaphysis

HH

1122

3344

5566

Compact bone is built of osteons. In the center of the osteonCompact bone is built of osteons. In the center of the osteon

the Haversian (H) canal is visible, containing the blood vessel.the Haversian (H) canal is visible, containing the blood vessel. The HaversianThe Haversian

canal is surrounded by bone lamellae (1canal is surrounded by bone lamellae (1--6) arranged concentrically. The cells6) arranged concentrically. The cells

of the bone (osteocytes) reside in minute cavities (lacuna of the bone (osteocytes) reside in minute cavities (lacuna –– arrows). arrows).

The osteocytes possess thin, long processes travelling in canaliThe osteocytes possess thin, long processes travelling in canaliculi.culi.

Blood supply of the bone is rich. Epiphyses and diaphyses are suBlood supply of the bone is rich. Epiphyses and diaphyses are supplied bypplied by

separate vessels. Diaphyseal arteries enter the medullary cavityseparate vessels. Diaphyseal arteries enter the medullary cavity. They supply. They supply

the medullary cavity, bone cortex and the bone marrow; the medullary cavity, bone cortex and the bone marrow;

from the cavity they step back into the compact bone and form a from the cavity they step back into the compact bone and form a rich vessel rich vessel

system in the canals of Volkmann and Havers. system in the canals of Volkmann and Havers.

The compacta is also supplied from the periosteal arteries. The compacta is also supplied from the periosteal arteries.

The vessels of the compacta run in the VolkmannThe vessels of the compacta run in the Volkmann-- éés Haversian canals s Haversian canals

(see the osteon).(see the osteon).

Endosteum and periosteumEndosteum and periosteum

•• Endosteum:Endosteum: continuous layer, covering every inner continuous layer, covering every inner cavity of the bone. Endosteum consists of cavity of the bone. Endosteum consists of a fine a fine layer of collagen fibrils plus one cell layerlayer of collagen fibrils plus one cell layer with with different cells (osteoprogenitor cells, osteoblasts different cells (osteoprogenitor cells, osteoblasts and osteoclasts).and osteoclasts).

•• Periosteum:Periosteum: connective tissue layer covering the connective tissue layer covering the entire outer surface of the living bone (except entire outer surface of the living bone (except articular surfaces). Periosteum contains two layers: articular surfaces). Periosteum contains two layers: 1. stratum fibrosum (outer fibrous connective 1. stratum fibrosum (outer fibrous connective tissue); 2. stratum osteogenicum (osteoblasts, tissue); 2. stratum osteogenicum (osteoblasts, osteoclasts, osteoprogenitor cells).osteoclasts, osteoprogenitor cells). Periosteum has Periosteum has a rich blood vessel supply and thin nerve fibers (pain a rich blood vessel supply and thin nerve fibers (pain fibers).fibers).

The cells of boneThe cells of bone

•• Osteocyte:Osteocyte: mature, functioning bone cell. The cells mature, functioning bone cell. The cells reside in the lacunae of bone. The cells possess thin reside in the lacunae of bone. The cells possess thin cytoplasmic processes which are in the bone cytoplasmic processes which are in the bone canaliculi, and communicate with each other through canaliculi, and communicate with each other through gap junctions.gap junctions.

•• Osteoblast:Osteoblast: cuboidal cell with strong basophilia. Cell cuboidal cell with strong basophilia. Cell actively synthesizes bone matrix molecules actively synthesizes bone matrix molecules ––osteoblast builds the bone.osteoblast builds the bone.

•• Osteoclast:Osteoclast: multinucleated large phagocyte of the multinucleated large phagocyte of the bone. Destroys bone matrix.bone. Destroys bone matrix.

•• Osteoprogenitor cell:Osteoprogenitor cell: young, undifferentiated cell in young, undifferentiated cell in the bone, from which osteoblasts differentiate under the bone, from which osteoblasts differentiate under the effect of mitogenic signals.the effect of mitogenic signals.

osteoclast

osteocytes

Osteoblasts

in endosteum

SECTION OF SPONGY BONESECTION OF SPONGY BONE

(hematoxylin(hematoxylin--eosin staining)eosin staining)

trabeculetrabecule

The extracellular matrix of boneThe extracellular matrix of bone

(organic: 30%; inorganic: 70%)(organic: 30%; inorganic: 70%)

•• Collagen fibers (90% of the organic)Collagen fibers (90% of the organic)

•• MatrixMatrix--proteins (10% of the organic): proteins (10% of the organic):

osteocalcin, osteonectin, osteopontin, osteocalcin, osteonectin, osteopontin,

proteoglycans, fibronectin.proteoglycans, fibronectin.

•• Hidroxylapatite (calciumHidroxylapatite (calcium--phosphate) crystalsphosphate) crystals

•• Fluoride, citrate ionsFluoride, citrate ions

•• Magnesium, iron, zinc, copper, strontium, Magnesium, iron, zinc, copper, strontium,

lead ionslead ions

•• Water (10Water (10--20%)20%)

Metabolic regulation of bone cellsMetabolic regulation of bone cells•• Parathyroid hormoneParathyroid hormone: stimulates osteoblasts (synthesis of : stimulates osteoblasts (synthesis of

the matrix the matrix –– osteoid). The osteoblast secretes cytokines, osteoid). The osteoblast secretes cytokines,

which stimulate the formation of osteoclast cells. The which stimulate the formation of osteoclast cells. The

osteoclast releases calcium and phosphorus from bone, osteoclast releases calcium and phosphorus from bone,

and elevates blood calcium and phosphorus levels.and elevates blood calcium and phosphorus levels.

•• CalcitriolCalcitriol (vitamin D): increases the absorption of Ca and P (vitamin D): increases the absorption of Ca and P

from the gut, and stimulates osteoblasts (synthesis of from the gut, and stimulates osteoblasts (synthesis of

matrix protein osteocalcin). Rickets, osteomalacia: lack of matrix protein osteocalcin). Rickets, osteomalacia: lack of

vitamin D.vitamin D.

•• CalcitoninCalcitonin: inhibits activity of osteoclasts (thus inhibiting : inhibits activity of osteoclasts (thus inhibiting

the release of Ca from the bone).the release of Ca from the bone).

•• EstrogensEstrogens and and androgensandrogens: increase osteoblast activity and : increase osteoblast activity and

inhibit osteoclasts. Lack of estrogen: osteoporosis.inhibit osteoclasts. Lack of estrogen: osteoporosis.

•• Vitamin CVitamin C: essential for normal collagen synthesis. : essential for normal collagen synthesis.

Anatomy of the bones is wellAnatomy of the bones is well

visible on Xvisible on X--ray picturesray pictures

Introduction to syndesmologyIntroduction to syndesmologyarticulatio = jointarticulatio = joint

arthron = jointarthron = joint

syndesmos = ligamentsyndesmos = ligament

CLASSIFICATION OF JOINTSCLASSIFICATION OF JOINTS

•• Solid joints (synarthroses):Solid joints (synarthroses): fibrous fibrous joints, cartilaginous joints. Fibrous: joints, cartilaginous joints. Fibrous: suture, gomphosis, syndesmosis. suture, gomphosis, syndesmosis. Cartilaginous: synchondrosis, Cartilaginous: synchondrosis, symphysis.symphysis.

•• Cavitated joints (diarthroses):Cavitated joints (diarthroses): synovial synovial joints are classified according to the joints are classified according to the shape of the articular head and the shape of the articular head and the number of the axis of the movements.number of the axis of the movements.

TWO TYPES OF SOLID, CARTILAGINOUS JOINTS (SYNARTHROSES)TWO TYPES OF SOLID, CARTILAGINOUS JOINTS (SYNARTHROSES)

synchondrosissynchondrosis

symphysissymphysis

Histological differencesHistological differences

between bone andbetween bone and

cartilage: in cartilage,cartilage: in cartilage,

the matrix containsthe matrix contains

only a small amountonly a small amount

of inorganic material.of inorganic material.

Cartilage containsCartilage contains

mainly collagen,mainly collagen,

proteoglycans, proteins proteoglycans, proteins

andand

glycosaminoglycans,glycosaminoglycans,

and water.and water.

There are no bloodThere are no blood

vessels in cartilage,vessels in cartilage,

therefore regenerationtherefore regeneration

is difficult and slow.is difficult and slow.

Cells of cartilage:Cells of cartilage:

chondroblast,chondroblast,

chondrocyte,chondrocyte,

chondroclast.chondroclast.

Cartilage is compressible, therefore the articular surfaces contCartilage is compressible, therefore the articular surfaces contactact

each other broadly in cavitated joints. This helps stability andeach other broadly in cavitated joints. This helps stability and

movements, too.movements, too.

GENERAL COMPONENTS OF SYNOVIAL (CAVITATED) JOINTSGENERAL COMPONENTS OF SYNOVIAL (CAVITATED) JOINTS

1.1. Facies articularis Facies articularis –– articular surface (hyaline cartilage)articular surface (hyaline cartilage)

2.2. Articular capsule (membrana fibrosa, membrana synovialis)Articular capsule (membrana fibrosa, membrana synovialis)

3.3. Articular cavity (synovial fluid)Articular cavity (synovial fluid)

4.4. Articular ligamentsArticular ligaments

5.5. Discus articularis (special component found in some joints)Discus articularis (special component found in some joints)

6.6. Meniscus articularis (special component found in some Meniscus articularis (special component found in some

joints)joints)

HUMERUSHUMERUS

ulnaulna

RADIUSRADIUS

CapsuleCapsule

CartilageCartilage

Membrana interosseaMembrana interossea

Articular capsuleArticular capsule

Section of the elbow joint:Section of the elbow joint:

the humerothe humero--ulnar ginglymusulnar ginglymus

JOINTS OF THE WRIST AND HAND:JOINTS OF THE WRIST AND HAND:

RadiocarpalRadiocarpal-- (wrist) joint (wrist) joint

Intercarpal jointsIntercarpal joints

Carpometacarpal jointsCarpometacarpal joints

Articulatio carpometacarpea pollicisArticulatio carpometacarpea pollicis

Metacarpophalangeal jointsMetacarpophalangeal joints

Interphalangeael jointsInterphalangeael joints

This is a dry specimen:This is a dry specimen:

the joints, the articular capsulesthe joints, the articular capsules

and some ligaments are visible.and some ligaments are visible.

Hyaline cartilage Hyaline cartilage

(cartilago articularis)(cartilago articularis)

Joint capsule (capsula articularis)Joint capsule (capsula articularis)

Cavity (cavitas articularis)Cavity (cavitas articularis)

Membrana synovialisMembrana synovialis

MeniscusMeniscus--like structurelike structure

Interphalangeal joint on histological sectionInterphalangeal joint on histological section

Histology of articular hyaline cartilage.Histology of articular hyaline cartilage.

There are a few joints which containThere are a few joints which contain

fibrocartilage instead hyaline cartilage:fibrocartilage instead hyaline cartilage:

sternoclavicular joint is one of them.sternoclavicular joint is one of them.

11

22

33

44

55

Hyaline cartilage Hyaline cartilage

CartilageCartilage--bone transitionbone transition

Mineralisation of cartilage Mineralisation of cartilage

Bone tissue Bone tissue

cartilagecartilage

cartilagecartilage

FibrousFibrous

capsule (C)capsule (C)SM: synovial membrane (blood vessels)SM: synovial membrane (blood vessels)

SYNOVIAL MEMBRANE: LIGHTSYNOVIAL MEMBRANE: LIGHT-- and ELECTRON MICROSCOPYand ELECTRON MICROSCOPY

Synovial membraneSynovial membrane

•• AA--type synoviocytetype synoviocyte: macrophage.: macrophage.

•• BB--type synoviocytetype synoviocyte: fibroblast : fibroblast →→ hialuronic hialuronic acid, matrixacid, matrix--proteins, connectice tissue proteins, connectice tissue fibers: synthesis and secretion.fibers: synthesis and secretion.

•• Lymph capillaries, blood capillaries, nerve Lymph capillaries, blood capillaries, nerve endings.endings.

•• Composition of the synovial fluid: hialuronic Composition of the synovial fluid: hialuronic acid, proteins (serum proteins, acid, proteins (serum proteins, glycoproteins, proteoglycans), electrolytes, glycoproteins, proteoglycans), electrolytes, glucose, water, few white blood cells.glucose, water, few white blood cells.

Ligaments insideLigaments inside

joint (cruciate lig.)joint (cruciate lig.)

Ligament outsideLigament outside

joint (collateral lig.)joint (collateral lig.)

Meniscus Meniscus

Syndesmosis tibiofibularisSyndesmosis tibiofibularis

Menisci of the knee fromMenisci of the knee from

above (arrows)above (arrows)

Articular lipArticular lip

(labrum articulare)(labrum articulare)

Lig. insideLig. inside

the jointthe joint

Different morphological types of cavitated joints: types accordiDifferent morphological types of cavitated joints: types according to theng to the

shape of the articular surfaces (arrows indicate movements)shape of the articular surfaces (arrows indicate movements)

Radiology is widely used in the investigation of joints. AnatomiRadiology is widely used in the investigation of joints. Anatomicalcal

details are also visible on traditional Xdetails are also visible on traditional X--ray photographs (knee).ray photographs (knee).

Shoulder arthroscopyShoulder arthroscopy

Surgical deviceSurgical device

Arthroscope is from dorsal direction, surgery device is from venArthroscope is from dorsal direction, surgery device is from ventral:tral:

both of them are introduced through small skin incisions.both of them are introduced through small skin incisions.

Arthroscopy video of the shoulder Arthroscopy video of the shoulder

during surgery through arthroscopyduring surgery through arthroscopy

Fixation of the biceps tendonFixation of the biceps tendon Shaving the glenoid labrumShaving the glenoid labrum

Pictures: BenninghoffPictures: Benninghoff--Drenckhahn: Anatomie, Urban & FischerDrenckhahn: Anatomie, Urban & Fischer

GrayGray’’s Anatomy, 40th edition, Elseviers Anatomy, 40th edition, Elsevier

Szegedi AnatSzegedi Anatóómiai Mmiai Múúzeumzeum

Thank you for your attention.Thank you for your attention.