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BPT First Year Anatomy - Important Topics

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1. GENERAL ANATOMY (Foundation)

Anatomical Terminology

• Anatomical position, planes (sagittal, coronal, transverse), axes
• Terms: medial/lateral, proximal/distal, superficial/deep, anterior/posterior, superior/inferior
• Types of movement: flexion/extension, abduction/adduction, rotation, circumduction, pronation/supination, inversion/eversion

Types of Joints (Arthrology)

• Synovial joint components: articular cartilage (hyaline), joint capsule, synovial membrane, synovial fluid, ligaments, bursae
• Clinical note: Physiotherapy mainly deals with synovial joint dysfunction

Types of Muscles

• Skeletal, smooth, cardiac - structure & function
• Muscle fiber types: Type I (slow twitch), Type II (fast twitch) - very important for PT
• Attachment terms: Origin (proximal/fixed), Insertion (distal/movable)
• Muscle action types: agonist, antagonist, synergist, fixator

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2. UPPER LIMB

Bones of the Upper Limb

• Clavicle - most commonly fractured bone; middle 1/3 fracture is most common
• Scapula - spine, acromion, coracoid process, glenoid cavity, subscapular fossa
• Humerus - surgical neck (fracture site), greater/lesser tubercle, bicipital groove, medial/lateral epicondyles, capitulum, trochlea
• Radius & Ulna - radial head, coronoid process, olecranon, styloid processes
• Carpals (8 bones - mnemonic: Some Lovers Try Positions That They Can't Handle): Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate
• Scaphoid = most commonly fractured carpal bone

Shoulder Joint (Glenohumeral)

• Type: Multiaxial ball-and-socket synovial joint
• Articular surfaces: Head of humerus + glenoid cavity of scapula (deepened by glenoid labrum - fibrocartilage)
• Ligaments: Glenohumeral ligaments (superior, middle, inferior), coracohumeral ligament, transverse humeral ligament
• Rotator cuff muscles (SITS):
  • Supraspinatus - abduction (first 15 degrees)
  • Infraspinatus - lateral rotation
  • Teres minor - lateral rotation
  • Subscapularis - medial rotation
• Movements: Flexion/extension, abduction/adduction, medial/lateral rotation, circumduction
• Most common dislocation: Anteroinferior (axillary nerve injury risk → loss of deltoid + teres minor)
• Bankart lesion: Avulsion of anteroinferior glenoid labrum in recurrent dislocation
• Impingement syndrome: Supraspinatus tendon compressed under coracoacromial arch - very important for BPT

Elbow Joint

• Type: Compound hinge joint (3 articulations in one capsule)
  • Humeroulnar joint (hinge)
  • Humeroradial joint (hinge)
  • Superior radioulnar joint (pivot)
• Ligaments: Radial collateral, ulnar collateral, annular ligament (holds radial head)
• Carrying angle: 5-15 degrees (valgus); Cubitus valgus/varus - clinical relevance
• Movements: Flexion, extension (humeroulnar); Pronation/supination (radioulnar joints)
• Tennis elbow (lateral epicondylitis) vs. Golfer's elbow (medial epicondylitis) - key BPT clinical correlations

Wrist and Hand

• Wrist joint (radiocarpal): Radius + scaphoid + lunate; movements = flexion, extension, radial/ulnar deviation
• MCP, PIP, DIP joints - important for hand therapy

Brachial Plexus (Very Important!)

• Roots: C5, C6, C7, C8, T1
• Formation: Roots → Trunks → Divisions → Cords → Terminal branches

• Erb's palsy (C5,C6): "Waiter's tip" posture - arm adducted, medially rotated, elbow extended, forearm pronated
• Klumpke's palsy (C8,T1): Claw hand + Horner's syndrome
• Radial nerve injury at spiral groove: Wrist drop (loss of wrist/finger extension)
• Ulnar nerve injury at medial epicondyle: Claw hand (ring & little finger), loss of intrinsics
• Median nerve injury at carpal tunnel: Ape hand, thenar wasting, loss of pinch

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3. LOWER LIMB

Bones of the Lower Limb

• Pelvis: Ilium, ischium, pubis; acetabulum (fused junction); pelvic inlet/outlet
• Femur: Head, neck, greater/lesser trochanter, linea aspera, lateral/medial condyles, intercondylar fossa
• Neck-shaft angle: ~126 degrees; Coxa vara (<120°) vs. Coxa valga (>135°)
• Tibia: Tibial plateau, intercondylar eminence, tibial tuberosity (patellar tendon attachment), medial malleolus
• Fibula: Lateral malleolus; peroneal muscles attachment
• Patella: Largest sesamoid bone; protects knee tendon mechanism

Hip Joint

• Type: Multiaxial ball-and-socket synovial joint (stability > mobility)
• Articular surfaces: Spherical head of femur + lunate surface of acetabulum (deepened by acetabular labrum)
• Ligaments:
  • Iliofemoral (Y-ligament of Bigelow) - strongest ligament in the body; prevents hyperextension
  • Pubofemoral - prevents excess abduction
  • Ischiofemoral - prevents medial rotation
  • Ligament of head of femur (carries obturator artery branch to femoral head)
• Movements: Flexion, extension, abduction, adduction, medial/lateral rotation, circumduction
• Blood supply to femoral head: Medial femoral circumflex artery (mainly) - clinically important in femoral neck fractures (avascular necrosis risk)
• Muscle groups:
  • Flexors: Iliopsoas (main), rectus femoris
  • Extensors: Gluteus maximus (main), hamstrings
  • Abductors: Gluteus medius, minimus (important for Trendelenburg gait)
  • Adductors: Adductor longus, brevis, magnus, gracilis
  • Lateral rotators: "PGOQO" - Piriformis, Gemelli, Obturators, Quadratus femoris

Knee Joint (Most Important for BPT!)

• Type: Modified hinge synovial joint (largest joint in body)
• Articulations:
  • Tibiofemoral (weight-bearing) - 2 condyles
  • Patellofemoral (directs quadriceps pull)
• Menisci: Medial (C-shaped, attached to tibial collateral lig.) and Lateral (more circular, mobile) - fibrocartilaginous; act as shock absorbers
• Ligaments:
  • Tibial (medial) collateral: broad, resists valgus force; attached to medial meniscus (hence "unhappy triad")
  • Fibular (lateral) collateral: cord-like, resists varus force
  • Anterior cruciate ligament (ACL): prevents anterior tibial displacement; "positive anterior drawer sign" when torn
  • Posterior cruciate ligament (PCL): stronger; prevents posterior tibial displacement
• "Unhappy triad" (O'Donohue): ACL + MCL + Medial meniscus torn together (common sports injury)
• Locking mechanism: Terminal rotation of tibia - "screw home" mechanism (popliteus unlocks it)
• Q-angle: Normal 10-20 degrees; increased in females; important for patellofemoral problems

Ankle and Foot

• Ankle joint (talocrural): Hinge joint; tibia, fibula, talus
  • Movements: Dorsiflexion (tibialis anterior), Plantarflexion (gastrocnemius + soleus = triceps surae)
• Lateral ankle ligaments (most commonly sprained): ATFL (anterior talofibular), CFL, PTFL
• Medial (deltoid) ligament: Fan-shaped, very strong, rarely torn
• Arches of foot: Medial longitudinal (highest), Lateral longitudinal, Transverse
  • Flat foot (pes planus) vs. High arch (pes cavus) - BPT clinical topics
• Plantar fasciitis: Inflammation of plantar fascia at calcaneal attachment

Lumbar Plexus & Sacral Plexus

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4. VERTEBRAL COLUMN & BACK

Regional Vertebral Characteristics

• C1 (Atlas): No body, no spinous process; supports skull (atlanto-occipital = nodding)
• C2 (Axis): Dens (odontoid process); pivoting "NO" movement
• L4-L5 disc and L5-S1 disc: Most common sites of disc herniation (compresses L5 and S1 nerve roots)

Intervertebral Discs

• Components: Nucleus pulposus (gelatinous, water content), Annulus fibrosus (fibrocartilage rings)
• Disc herniation: Posterolateral herniation of nucleus pulposus compresses spinal nerve
• Dermatomes to know: C6 (thumb), C7 (middle finger), C8 (little finger), L4 (medial leg), L5 (dorsum foot/big toe), S1 (lateral foot/sole)
• Clinical tests: SLR (straight leg raise) for lumbar disc; SLUMP test; Spurling's test (cervical)

Spinal Cord

• Ends at: L1-L2 (conus medullaris); below = cauda equina (clinically important for LP at L4-L5)
• Tracts:
  • Corticospinal (pyramidal) - motor, ipsilateral
  • Spinothalamic - pain & temperature, crosses within 2 segments
  • Posterior columns (dorsal columns) - vibration, proprioception, fine touch; ipsilateral until medulla

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5. THORAX

• Ribs: 1-7 true, 8-10 false, 11-12 floating
• Intercostal muscles: External (raise ribs during inspiration), Internal (lower ribs during expiration)
• Diaphragm: Main muscle of respiration; innervated by phrenic nerve (C3,C4,C5 - "C3,4,5 keeps you alive")
• Lung surfaces and fissures: Right lung - 3 lobes, 2 fissures; Left lung - 2 lobes, 1 oblique fissure
• Surface markings of lungs and pleura

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6. HEAD AND NECK (Basics for BPT)

• Cranial nerves overview (I-XII)
• Temporomandibular joint (TMJ): Condyloid joint; important for TMJ physiotherapy
• Cervical muscles: Sternocleidomastoid (SCM), scalenes, trapezius
• Neck triangles: Anterior (digastric, carotid, muscular) and Posterior triangles

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7. NEUROANATOMY BASICS

Central Nervous System

• Brain lobes and functions: Frontal (motor/personality), Parietal (sensory/body image), Temporal (hearing/memory), Occipital (vision)
• Primary motor cortex (precentral gyrus): Homunculus - upper limb occupies large area
• Primary sensory cortex (postcentral gyrus)
• Cerebellum: Coordination, balance, ipsilateral control; Romberg's test for proprioception

Upper vs. Lower Motor Neuron Lesion (Very Important!)

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8. CLINICAL ANATOMY CORRELATIONS (BPT-Specific)

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Most Exam-Focused Topics for BPT First Year

1. Brachial plexus - formation, cords, branches, injuries
2. Knee joint - ligaments, menisci, cruciate ligaments
3. Hip joint - ligaments, blood supply, Trendelenburg
4. Shoulder joint - rotator cuff, dislocations, impingement
5. Lumbar disc herniation - anatomy, dermatomes, nerve roots
6. Upper vs. Lower motor neuron lesion features
7. Muscle types and fiber types
8. Joints classification
9. Nerve injuries - radial/ulnar/median/common peroneal
10. Diaphragm and muscles of respiration

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