Imaging Anatomy: Text and Atlas Volume 3 (eBook)

Bones, Joints, Muscles, Vessels, and Nerves

Farhood Saremi, Meng Law, Dakshesh Patel, Hiro Kiyosue, Damian Sanchez-Quintana, R. Shane Tubbs (Autoren)

eBook Download: EPUB

2024 | 1. Auflage
958 Seiten
Georg Thieme Verlag KG
978-1-63853-612-3 (ISBN)

Infos

<p><strong>An in-depth guide to upper and lower extremity anatomy based on the latest imaging techniques</strong><br></p><p>While the study of anatomy plays a fundamental role in the practice of medicine, most textbooks don't rely on modern imaging and post-processing methods to depict and increase its understanding. <em>Imaging Anatomy Text and Atlas Volume 3: Bones, Joints, Muscles, Vessels, and Nerves </em>is the third in a series of four richly illustrated radiologic references edited by distinguished radiologist Farhood Saremi. The atlas is coedited by esteemed colleagues Dakshesh B. Patel, Damián Sánchez-Quintana, Hiro Kiyosue, Meng Law, and R. Shane Tubbs and features contributions from an impressive group of international experts. The succinctly written text and superb images fill a gap in the literature, with descriptions of relevant anatomical components in the context of current advances in imaging technology and science.</p><p>This exquisitely crafted atlas combines fundamental core anatomy principles with modern imaging and post-processing methods to increase understanding of intricate anatomical features. Twenty-four concise chapters cover terminology and classification of musculoskeletal structure, bones, muscles, joints, arteries, veins, nerves, and lymphatics. High-quality dissecting imaging anatomy, discussion of anatomical variants, postsurgical anatomy, and important pathology examples provide a strong foundation for differentiating normal versus pathologic anatomy.</p><p><strong>Key Highlights</strong></p><ul><li>State-of-the-art CT, MR, angiography, and ultrasound techniques infused with 3D reformations, color coded volume rendering, and 3-7 Tesla MR views delineate anatomy in great detail</li><li>Cross-sectional and topographic cadaveric views and illustrations by world-renowned anatomists improve the ability to grasp difficult radiology concepts<br></li><li>Consistently formatted chapters including an introduction, embryology, review of anatomy, discussion of anatomical variants, surgical anatomy, and congenital and acquired pathologies enhance learning<br></li></ul><p>This unique atlas provides a virtual, user-friendly dissection experience, making it a must-have reference for medical students, radiology residents and veteran radiologists, internists, and general surgeons, as well as vascular and transplant surgeons. </p><p>This book includes complimentary access to a digital copy on <a href='https://medone.thieme.com./'>https://medone.thieme.com.</a></p><p><strong>Publisher's Note: Products purchased from Third Party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product.</strong></p>

Textauszug

1Bones, Muscles, Tendons, Joints, and Cartilage

Farhood Saremi

Introduction

This chapter is an overview of the development, structural anatomy, morphologic categories, physiology, biomechanics, and imaging of the bones, skeletal muscles, tendons, joints and cartilage, and related structures.

Bones

The adult skeleton is comprised of 206 bones with the largest being the femur and the smallest being the stapes of the middle ear. There are 126 bones in the extremities or appendicular skeleton, 74 bones in the axial skeleton, and 6 auditory ossicles. Additionally, there are many small sesamoid bones in different locations near the joints.1,2

The bones have been divided into four general morphologic categories: long bones (i.e., femur, metacarpals, and phalanges), short bones (i.e., carpal and tarsal), flat bones (i.e., skull and scapula), and irregular bones (i.e., vertebrae and hyoid).

The skeleton serves as the structural support for the body which protects the internal organs and allows movement and activity. The bones also provide the environment for blood production within the marrow spaces, hold reserve of calcium and phosphate needed for the maintenance of serum homeostasis and acid–base balance, and finally serve as a reservoir of growth factors and cytokines.1 Bone is a mineralized structure made up of collagenous matrix, cells, vessels, and crystals of calcium compounds (hydroxyapatite). In contrast to cartilages, bones are highly vascular structures with the capability of repair and remodeling. Remodeling is a constant and ongoing process during life that is accomplished by osteoblasts and osteoclasts to reshape the bone by removing old damaged bone and replacing it with new bone. This process helps the bone to adapt to changing biomechanical forces and achieve the strength against mechanical forces.

Gross Appearance

The long bones are composed of a tubular shaft or diaphysis with two cone-shaped metaphyses at each side of it. Each metaphysis connects to one or more rounded epiphyses with their interface being called the growth plates. Each bone is surrounded by a shell of compacted bone called cortex, which comprises 80% of the skeletal mass. The cortex of the diaphysis is thick and surrounds the medullary space that contains bone marrow. The metaphysis and epiphysis are composed primarily of a honeycomblike meshwork of trabecular bone also known as spongy or cancellous bone filled with bone marrow and hematopoietic cells and all surrounded by a relatively thin shell of cortical bone. The cancellous bone is highly vascular and the major site of hematopoiesis. The vertebra is composed of one-third of cortical bone and two-thirds of trabecular bone, whereas the femoral head cortex forms 50% of the bone and the radial bone diaphysis cortex forms 95% of the bone.1 The trabecular bone is composed of plates and rods. Within long bones such as the femoral neck, the trabeculae are aligned along the mechanical forces that weight-bearing bones experience (see Chapter 20 “Hip”). The trabecular bone contributes to major mechanical support in the vertebral bodies.

The functional units of the cortical and trabecular bones are microscopic columns called osteons. In the cortex, the osteons are called haversian systems and the osteons of the trabecular bone are called packets. Haversian systems are cylindrical in shape, approximately 4-cm long and 2-cm wide at their bases, and form a branching network along the long axis of the cortical bone. Each column consists of multiple concentric lamellae, each containing osteoblasts and osteocytes around a central canal called the haversian canal where vessels and nerves pass (▶Fig. 1.1). The haversian canals connect the lacunae (the space around osteocytes) by tiny channels called canaliculi. The haversian canals are also connected with one another by Volkmann’s canals. All haversian columns are surrounded by outer circumferential lamellae and separated from each other by interstitial lamellae (▶Fig. 1.1). The interstitial lamellae are deformed and partially resorbed haversian columns.

The cortical trabecular osteons are normally formed in a lamellar pattern, in which collagen fibrils are laid down in alternating orientations. The lamellar pattern, just like a plywood, increases the bone strength. Disorganized deposition of the collagen fibrils results in a weak bone called woven bone. The woven bone is normally produced during formation of the primary bone. It is also seen in the callus of the repaired fractures and in pathological conditions such as in bone lesions of hyperparathyroidism and Paget’s disease.

The outer cortical bone is covered by a fibrous connective tissue called the periosteum, and the inner cortex and the trabecular bone and Volkmann’s canals are covered by a membranous layer called endosteum (▶Fig. 1.1). The periosteum does not extend into the joints where bone is lined by articular cartilage. It is attached tightly to the cortex by thick collagenous fibers called Sharpey’s fibers. The endosteum consists of a single layer of flat cells supported by a thin layer of reticular connective tissue. Both the periosteum and the endosteum contain blood vessels, nerve fibers, and osteoblasts and osteoclasts. The endosteal surface has higher bone formation activity than the periosteal surface.

Fig. 1.1 Bone and bone marrow anatomy and vascular supply. The normal bone marrow anatomy is composed of bone cells, blood vessels, and red and yellow marrow. Normal hematopoietic stem/progenitor cell (HSPC) reside in the red marrow where they differentiate into red blood cells, white blood cells, and platelets via different progenitor stages. Yellow marrow represents largely fat cells with minimal hematopoiesis. The interface of bone and bone marrow, also called the endosteum, is covered by bone-forming osteoblasts and bone-resorbing osteoclasts. The endosteal surfaces have a rich network of arterioles and sinusoids. Arteries enter the sinusoids, which coalesce to form the venous circulation. Sinusoids are specialized venules that form a reticular network of fenestrated vessels that allow cells to pass in and out of circulation (CAR cell, CXCL12-abundant reticular cell; HSC, hematopoietic stem cells).

Development and Ossification

In general, the flat bones are formed by membranous bone formation, whereas the long bones are formed by a combination of endochondral and membranous bone formation that occurs in a centrifugal pattern spreading outward in both directions from the center of the bone (▶Fig. 1.2).

Fig. 1.2 (a) Endochondral ossification involves proliferation, hypertrophy, and mineralizing of chondrocytes. First, the mesenchymal cells condense and differentiate into chondrocytes to form the cartilaginous matrix. Later, the chondrocytes in the center of the shaft undergo hypertrophy and apoptosis while they change and mineralize their extracellular matrix. Following death of chondrocytes, blood vessels grow and bring in osteoblasts, which bind to the degenerating cartilaginous matrix and deposit bone matrix. Secondary ossification centers also form as blood vessels enter near the bone ends. At the same time, osteoclasts are derived from the blood macrophages and dissolve the bone matrix and contributes to the final shape of bones. (b) Intramembranous ossification. Osteoblasts are formed by condensation of mesenchymal cells and deposit osteoid matrix. These osteoblasts are arranged along the calcified margin of the matrix. Osteoblasts that are trapped within the bone matrix become osteocytes. No cartilage is seen to precede the formation of bone.

The cartilage, bone, and skeletal muscles are mainly formed by the mesoderm with some neural crest contribution.3,4,5 The intraembryonic mesoderm, located on either side of the neural groove between the endoderm and the ectoderm, is divided into the paraxial, intermediate, and lateral mesoderm. During the third week of gestation, the paraxial mesoderm forms blocks of cells called somites3 (▶Fig. 1.3). Each somite has two components: the dermamyotome and the sclerotome. The sclerotome of the somites contributes to the development of the craniofacial skeleton and most of the axial bone and cartilage. The cells in the lateral plate mesoderm contribute to the bones and cartilage of the limbs. The cranial neural crest contributes to the development of the craniofacial bones and cartilage. The dermamyotomes are the precursors of the dermis of the dorsal skin, the skeletal muscles of the back and body. The myoblasts close to the neural tube form the epaxial muscles (the deep muscles of the back), whereas the myoblasts remote from the neural tube produce the hypaxial muscles of the body wall and limbs. The cells in the middle of the dermamyotome are called the dermatomes that contribute to generation of the dermis and the mesenchymal connective tissue of the skin.

Fig. 1.3 (a–c) Development of the paraxial mesoderm. Transverse sections through the trunk of a chick embryo on days 2 to 4. The paraxial mesoderms form the somites and each somite contributes to development of the sclerotome cells and dermamyotome cells. Soon the sclerotome cells migrate toward the neural tube. The sclerotomes contribute to the development of the craniofacial skeleton and part of the axial bone and cartilage. On day 4, the dermamyotome cells divide. A layer of muscle cell precursors (the myotome) forms beneath the epithelial dermamyotome. The dorsomedial cells form an epaxial myotome...

Produkt-Details

• Erscheint lt. Verlag: 21.2.2024
• Reihe/Serie: Atlas of Imaging Anatomy
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Chirurgie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Orthopädie
• Themenwelt: Medizinische Fachgebiete ► Radiologie / Bildgebende Verfahren ► Radiologie
• Themenwelt: Studium ► 1. Studienabschnitt (Vorklinik) ► Anatomie / Neuroanatomie
• Themenwelt: Technik
• Schlagworte: anatomy • chest anatomy • heart anatomy • Imaging Anatomy • lung anatomy • normal radiologic anatomy • Surgical Anatomy
• ISBN-10: 1-63853-612-0 / 1638536120
• ISBN-13: 978-1-63853-612-3 / 9781638536123