A) BONE EXAMINATION In order to facilitate a systematic examination of bones, it is best to divide human bones to: a) bones of the skull (Cranium) b) bones of the spine (Columna vertebralis) c) limb bones d) other bones
a) BONES of the skull The human skull consists of several large cranial bones, which are mutually connected so-called sutures (Suturae). The bones of the brain consist of the cranial vault (Calvaria) and the base of the skull (Basis cranii). Inside that is the human brain. Base of skull is firmly fused with the bones of the face in addition to the cranial vault. There are several openings at the base of the skull through which veins and arteries pass, as well as nerves and the connection of the spinal cord (Medulla spinalis) with brain. If we look at the base of the skull from the top inside, three cranial pits are visible:
1. front (Fossa cranii anterior), 2. middle (Fossa cranii media) and 3. rear (Fossa cranii posterior). In the front are placed: whole and olfactory parts of the cerebrum. It is sieved in the middle bone with openings for the olfactory nerves. In the middle pits there are parts of the medulla with pituitary gland and temporal lobes. The temporal lobes are separated by the sphenoid bone, and on its in the saddle (Sella turcica) there is a pituitary gland. A little further towards the whole part are the openings for vision nerves (Canalis opticus). At the end of the middle cranial fossa passes the trigeminal nerve (Nervus trigeminus). In the middle of the base of the skull there is a sphenoid bone (Os sphenoidale). Rear the cranial bones of the fossa enclose the brain, pons and parietal lobe. When examining the skull bones the main thing is to examine the skull bones, which are located on the outside of the skull and theirs seams. The vault of the skull consists of six bones: the whole bone (Os frontale), two parietal bones (Os parietale), two scales of the temporal bones (Squama temporalis) and the occipital bone (Os occipitale). The bones of the face are the nasal bones (Os nasale), cheekbones (Os zygomaticum), and maxilla bones (Os maxillaris). These are all immovable facial bones. It remains only mobile lower jaw bone (Os mandibularis). During the examination, we work in such a way that we turn the plumb line in the right hand, and with the left hand systematically touching individual parts of the head, concentrating all attention on searching for a place which do not emit radiation, we slowly, systematically examine the bones of the head. If we are good o learned the position of individual bones on the head and if we only focused on the examination of the bones heads, and not what is inside them, i.e. cerebrum, cerebellum and everything else located there, then we will get information only about the condition of the bones of the skull. If we are not sure, if we have concentrated well, we can also use anatomical images during the examination atlas, which will only be a means of better concentration for us here. Often we will find that some bone is not right. Most often, it is the occipital bone and hers seams. It may happen that she does not cause any problems, but then it is usually a sign of someone old a blow to the head, which can originate from childhood, if someone still feels some disturbances in that area, it is necessary to refer it to the appropriate doctor for treatment, so that he can give the right one diagnosis.
The bones of the base of the skull cannot be felt with the hand. In this case it is best to take for with the help of a suitable anatomical atlas and focus on the images of the relevant bones, especially if it was a recent or old fracture of the base of the skull, which is the case today in traffic accidents accidents are not rare. When examining the skull bones, you should stay a little longer in those places, on which the plumb line showed anomalies, and mentally establish whether it is something acute or chronic, and even determine the degree of damage, and act accordingly, certainly in a way not to cause any panic in the patient and to send him to the doctor for treatment. A capable and gifted dowser can often make a diagnosis of a disease, but he must keep it to himself for myself.
b) BONES OF THE SPINE (vertebral column) This part of the review could be simplified so that the vertebrae from which it is composed We divide the spine anatomically into: 1. Cervical vertebrae (Vertebrae cervicales) 2. Thoracic vertebrae (Vertebrae thoracicae) 3. Lumbar vertebrae (Vertebrae lumbales) 4. Sacral vertebrae (Vertebrae sacrales) 5. Coccyx (Os coccygis)
1. Neck vertebrae (Cervical vertebrae) When examining the spine, we must first be clear about whether we are going to examine it only the vertebrae, as bony formations, or we will immediately perform an examination of the intervertebral joints space inside which are cartilaginous plates (Discus intervertebralis), and connective tissue which it holds all these vertebrae together in a strong bond. At the ends of the vertebrae are openings through which the the spinal cord leaves the cerebrospinal nerves. In the beginning, it is better to do a separate inspection each vertebra one by one. There are seven vertebrae in the neck area. Going down the first is the so-called. Atlas, and the other Axis. These two are functionally connected. The atlas on which the skull rests is different made of other vertebrae. Each vertebra has its own number, so it is in the cervical spine Atlas number 1, Axis number 2, and so on in order 3, 4, 5, 6 and 7. If we mentally concentrated on examination of the bony part of each vertebra, then we will only get anomalies of the bony part, a these are calcium deficiency, degenerative changes in the vertebrae, etc. When we have gained some practice, we will be able to examine the vertebrae together with by examining the discs and the roots of the spinal nerves that come out of the intervertebral spaces and ligaments. In the beginning, it is better to do it separately. As before, with the plumb line in the right hand and the left hand as an antenna, we cross one one vertebra at a time and we find out which one is not good. In order not to interrupt the work, someone present the examination can record the results of the examination on paper. It may seem like it's going slow. U in the beginning it will be like that, but later, when you gain practice in the work, it goes much faster. It is possible use an anatomical atlas, as well as mental pictorial concentration on a single vertebra.
2. Thoracic vertebrae (thoracic vertebrae) Thoracic vertebrae are very similar in structure. There are twelve of them. They are the bearers of the ribs (Costae). The first seven ribs are attached to the sternum directly, and 8-10 through the cartilages make up the rib cage. The last two are free and do not touch the sternum. The review is performed exactly as described above.
3. Lumbar vertebrae (Vertebrae lumbales) These vertebrae are built stronger, because of the load on their upper parts load capacity and stability are greater. There are five of them. They are a very common cause of diseases in older people vertebrae, discs and nerves in this part of the spine. Therefore, special attention should be paid to them, and determine exactly which vertebrae are involved. The examination is carried out analogously to those before.
4. The sacral vertebrae (Vertebrae sacrales) Until 15-25 years of age, these vertebrae are separated from each other, and then they fuse together together they form the sacrum (Os sacrum). It ends with the posterior iliac vertebra spinal cord and spinal canal. The sacrum is bent in an arc. Five pairs come out of it nerves. The examination is carried out as before, only it is determined in the area of which cruciate intervertebral joints space something is wrong. Anomalies on this part of the spine are mostly caused by more serious ones rheumatic diseases, so a visit to a rheumatologist should be advised as soon as possible. 5. Coccyx (Os coccygis) The spine ends with the coccyx. It consists of three to five fused vertebrae. View as before!
c) BONES OF THE EXTREMITIES We divide the extremities into upper and lower.
The upper extremities include the hands and the lower legs. During the examination, it is usual examines the right side of the body first, and then the left.
1. Arm bones Starting from the shoulder joint, we encounter the upper arm bone (Humerus), then the elbow joint (Articulatio cubiti). Two bones are attached to it from the lower side and that thumb bone (Radius) and elbow bone (Ulna). Below this are the bones of the wrist (Ossa carpi), then the bones of the foot (Ossa metacarpi), and then the bones of the fingers (Ossa digitorum manus). So that we could be more precise during the examination, given that the bones of the wrist consist of seven bones, we are certainly at an advantage if we know the names of all of them. Above the bones thumb there is a polygonal bone (Os multangulum), next to it is a trapezoidal bone (Os trapezoideum), and further: Os capitatum, Os hamatum. Above these four lower ones are placed: scaphoid bone (Os scaphoideum), Os lunatum and Os triquetrum. By concentrating on these individual dice mentally, with or without a corresponding image, you can get exactly that dice which are damaged. The bones of the foot (Ossa metacarpi) are the five shorter bones, and are usually marked with Roman numbers I to V. Number I carries the bone that goes towards the thumb and then number II towards the index finger and so on respectively. The metacarpal bones are connected to the bones of the fingers by joints. These are the bones that we call phalanx (Phalanx). There are three phalanges on all fingers (Falanx proxiaalis, F. media and F. distalis) except on the thumb where there are only two (Phalanx proximalis and F. distalis). When examining the bones of the hand (first the right and then the left), we look for damage to the bones: old or more recent fractures, as well as damage due to rheumatic diseases, deformation of the shape of bones and composition of bone tissue (arthritis, osteoporosis, etc.). At the same time, the shortcomings that arise in bone marrow diseases. Everything that is found is immediately written down on paper, so that it does not get lost during further inspection forgot something.
2. Leg bones We start the examination from the right hip joint. The first bone is the femur or femur (Femur). We come to the knees. There is a cup (Patella) on the knee joint, so let's look at it along the way her. Below are two bones: the tibia and the fibula. They continue further bones of the root of the foot, bones of the midfoot and bones of the toes. The bones of the root of the foot (Ossa tarsi) consist of seven articular bones which are arranged differently from the bones in the wrist. These are: Calcaneus (heel bone), Talus (ankle bone). Os cuboideum (cuboid bone), Os naviculare (tray), then three sphenoid bones looking from the inside of the foot to the outside (Os cuniforme mediale, Os cuniforme intermedium and Os cuniforme laterale). Between the joints of these tiles, to soften the impact when moving, the cartilaginous plates stand.
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