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HUMAN ANATOMY DR GAVIN SHANG SPORTS MEDICINE PHYSICIAN MBBCH (WITS) MPHIL SPORTS MEDICINE (UCT/SSISA) NO CONFLICT OF INTEREST OR FINANCIAL DISCLOSURES RELATED TO THIS TALK INTRODUCTION Basic understanding of the musculo-­‐skeletal system Use of medical terms of description Effective exercise programs involve understanding of functional anatomy, human performance and exercise physiology 4 S’S OF FITNESS Stamina: cardio-­‐respiratory / aerobic Uitness (improved aerobic Uitness = improved stamina) Strength: force generated during maximal contraction (endurance = capacity to repetitively exert a given force efUiciently over a period of time) Suppleness: degree of movement through range of motion around a joint (stretching improves Ulexibility) Speed: force / time (greater force over shorter time) SKELETAL SYSTEM Linked skeletal system makes movement possible Head and cervical vertebrae Thoracic vertebrae Lumbar vertebrae Pelvis Hip, knee, foot and ankle Shoulder girdle, elbow, wrist and hand FUNCTIONS OF THE SKELETAL SYSTEM Support: soft tissue growth support structure Movement: muscles attach to bones via tendons (muscle contracts motion occurs around levers) Protection: structure protects major organ systems (brain, spinal cord, heart, lungs, blood vessels etc) Storage: of minerals (calcium) RBC production: occurs in the red bone marrow JOINTS Joints are where bones connect / link Strong / stable (hip) vs. mobile / Ulexible (shoulder) Range of motion determined by shape of bones and Ulexibility of tissues Synovial cavity permits range of motion Fibrous: Uibrous connective tissue (skull sutures) Cartilaginous: cartilage connection (sternoclavicular) Synovial: articular capsule and ligaments with a synovial cavity (knee) Ligaments: thick / strong / inelastic Uibrous tissue connects bone to bone poor blood supply = poor healing Tendons: connects muscle to periosteum of bone poor blood supply = poor healing Cartilage: hyaline lining of boney articular surfaces reduces friction no pain Uibres Synovial Uluid: composed of hyaluronic acid and interstitial Uluid joint lubrication / nourishes articular cartilage Ball and socket: wide range of movement (shoulder / hip) Hinge: limited to mainly Ulexion / extension (elbow / knee) Vertebral: classiUied individually but move as a unit Sliding: wrist / ankle Pivot: C1 (atlas) rotates on odontoid process of C2 (axis) Saddle: CMC thumb MUSCULAR SYSTEM Myology = study of muscular system 40-­‐45% of the body = muscle tissue Contraction of muscle = force required for motion Running / cycling vs. writing vs. peristalsis / HR 85% of body heat due to muscle contraction Maintains posture CHARACTERISTICS OF MUSCLE TISSUE Excitability: receives impulse and responds to stimuli Contractility: concentric = shorten (generate force) eccentric = lengthen (reduce / resist force) Extensibility: capacity to stretch Elasticity: ability to return to normal resting state after contraction TYPES OF MUSCLE TISSUE Cardiac: heart muscle striated in appearance involuntary (not under conscious control) Smooth: blood vessel lining / stomach / intestines non striated in appearance involuntary (not under conscious control) Skeletal: striated (light vs. dark bands) voluntary (contract / relax under conscious control) MUSCLE SKELETAL INTERACTIONS Muscle attaches to bone via tendon Muscle contraction produces a force Force transferred via tendon to bone Results in movement Skeletal muscle has 2 attachment sites: Origin: Uixed end of the muscle Insertion: mobile end attachment of muscle Agonist: primary muscle involved in movement contracts concentrically to cause movement
(biceps brachii during a biceps curl) Antagonist: opposing action to agonist relaxes and lengthens to allow movement (triceps brachii during a biceps curl) Reciprocal inhibition = agonist antagonist relationship ANATOMICAL TERMINOLOGY Median: vertical midline plane (left and right halves) Sagittal: vertical parallel to median Frontal (coronal): vertical front (anterior) and back (posterior) halves Transverse (cross horizontal): upper (superior) and lower (inferior) halves ANATOMICAL TERMS OF DIRECTION AND POSITION Superior (cranial): closer to the head / higher than another structure Inferior (caudal): closer to the feet / lower than other structures Anterior (ventral): closer to the front of a structure Posterior (dorsal): closer to the back of a structure Medial: closer to the median plane Lateral: further from the median plane Proximal: closer to the root Distal: further from the root MOVEMENT TERMS Flexion: decreasing the joint angle from anatomical position Extension: increasing the joint angle to anatomical position Hyperextension: extension past the anatomical position Pronation: movement where the foot / hand is turned inward Supination: movement where the foot / hand is turned outward Plantar-­‐Ulexion: foot bent downwards Dorsi-­‐Ulexion: foot bent upwards Abduction: movement away from the midline Adduction: movement towards the midline Circumduction: circular motion Inversion: inward Eversion: outward NERVES AND MUSCULAR MOVEMENT Motor: creates movement Sensory: gives feedback on outcome of movement Motor unit: individual motor nerve + all muscle Uibres it innervates All or none theory: stimulus passes the threshold and stimulates the nerve all the muscle Uibres associated with that nerve contract Recruitment of muscle Uibre types: small diameter neurons serve slow twitch Uibres impulses travel at slow velocities slow twitch Uibres have a lower stimulus threshold large diameter neurons serve fast twitch Uibres impulses travel at high velocities fast twitch Uibres have a higher stimulus threshold greater intensity stimulus needed for recruitment of fast twitch muscle Uibres Slow twitch muscle Uibres: red in appearance / high myoglobin content high mitochondria / small diameter aerobic metabolism fatigue resistant posture Fast twitch muscle Uibres: pale in appearance / low myoglobin content low mitochondria / large diameter anaerobic metabolism readily fatigable SENSORY NERVES Relay information back to CNS concerning muscles / tendons / ligaments Joint receptor: embedded in -­‐ tendons / ligaments / bone / muscle / joint capsules relays information of -­‐ joint angle / pressure / acceleration of a joint Muscle spindle: embedded in the muscle concentrically contracts when stimulated Golgi tendon organ: embedded in musculo-­‐tendinous junction contrasts the muscle spindle activity relaxation STRETCHING Stretch – reUlex action: Static stretching: alternate hold / relax for 30 second intervals Ballistic stretching: bouncing (increased incidence of injury) Dynamic stretching: incorporates movement Proprioceptive neuro-­‐muscular stretching: muscle spindle / golgi tendon organ (max contraction leads to max relaxation)