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Dynamic Motion X-ray

Dynamic Motion X-Ray (DMX) Imaging Visualises Spinal Movement


“The Digital Motion X-Ray (DMX) imaging at the American private spinal surgery company ‘NeuroSpine Institute‘ is being used to identify injuries from a car accident or disc injury often missed by traditional X-rays and MRIs. The doctor can access diagnostic information in minutes instead of hours or days.”

N.B. C2/3 and L sidebending /rotation restriction? Also, interesting to see the stability of the C1/2 segment during movement in the intra-oral section, and how the upper cervical segments do most of the work of rotation, as expected.

….I bet they don’t have one at the local hospital though 🙁

 

REFERENCES

Neuro Spine Institute http://www.neurospineinstitute.org/

Dural Venous Sinuses

The RTM and Venous Sinuses

Dr. Robert Acland narrates a video illustrating the anatomy of the dural venous sinuses, and the related neurological and osteological structures. Particularly interesting to see the Cavernous Sinus in coronal cross-section at 5:40.

 

REFERENCES

Dr. Robert Acland, ‘Acland’s Video Atlas of Human Anatomy Neuroanatomy’ YouTube standard license https://aclandanatomy.com/

The TMJ

TMJ Anatomy And Function

I see a lot of patients with varying grades of TMJ dysfunction – from vague aching following dental intervention or bite change, to disc disorders in the joint and associated complexes of muscle tightness and pain with wider musculoskeletal consequences.

The TMJ joint demonstrates a two-phase mechanical movement during opening, mainly consisting of hinging then sliding/hinging movements of the mandibular condyle in the glenoid fossa of the temporal bone. In cases of dysfunction, the articular disc often becomes displaced and degenerated, so that a common presentation is TMJ clicking and even locking.

This video presents moving dissections of the joint, demonstrating normal function, opening and closing, medial and lateral disc displacements and posterior disc ligament ruptures. If you excuse the *slightly* dated music at the beginning and end of the film, it is a very clear demonstration of the anatomy of TMJ disorder.

0:38 – The Anatomy of the Joint

2:46 – The Normal TMJ Joint

3:30 – The Biconcave Disc – showing small central perforation

5:08 – Anterior Disc Displacement – clicking on closing AND opening

6:15 – Anteromedial Disc Displacement – showing biplanar disc and medial/lateral movement of the disc

7:30 – Medial Disc Displacement

8:25 – Anterior Disc displacement – disc consistently anterior to the condyle

9:25 – Degenerative Joint – large perforation

 

 

REFERENCES:

YouTube – TMJ Anatomy – Standard YouTube License

Sagittal section of the articulation of the mandible – Wikimedia Commons License

Cranial Foramen

Cranial Foraminae And Their Contents – HD Anatomy

An understanding of the anatomy of the skull is essential when working with the cranial mechanism. Learning the skull foraminae and their contents provides a particular challenge, but is also absolutely fundamental in this approach.

It has been said that the most effective way to learn this is to sit down in front of a skull specimen with a copy of Gray’s in one hand, and a glass of wine in the other (!)

However, the video above, clearly demonstrates the various foramen of the skull, and playback can be viewed in high resolution, (after pressing play click on the cog icon on the bar at the bottom and choose the quality from the list).

Once again, this is only an introduction to cranial anatomy relevant to osteopathic practice, and much more detail is available on our upcoming (July) 5-day course:

 

REFERENCES

YouTube – “The Skull Bones – Cranial Foraminae And Contents” RobbieGVT

Featured Image‘Skull and brainstem inner ear.svg’ Patrick J. Lynch, medical illustrator – Creative Commons License 2.5

The Sphenoid from Gray's Anatomy

The Sphenoid Bone – Quick Anatomy

While learning skull osteology, students often have trouble in orientating the sphenoid in relation to the other bones of the neurocranium and viscerocranium, and learning its many foraminae and features. This is perfectly understandable, as the sphenoid is an anatomically complex bone that fulfils many roles – housing the pituitary, forming part of the orbit, allowing many traversing nerves etc.

The junction with the occiput at the spheno-basilar symphysis particularly causes problems, (a common mistake is to place the basilar part of the occiput against the dorsum sellae) as well as the harmonic articulation of the pterygoid processes in the groove-like bone of the perpendicular plate of the palatine (part of the ‘speed reducers’ system as Sutherland called them).

The video above goes some way to helping us to visualise the sphenoid in situ. Labelled parts of the sphenoid are seen from 1min 33secs onwards, but for those that wish to enjoy guided tutorials on the osteology of the skull, you might like to consider taking part in our upcoming 5-day course in July (shameless plug!)

 

 

REFERENCES:

Video – YouTube: ‘Bone around Sphenoid bone’

‘Sphenoid’ Image – lithograph plate from Gray’s Anatomy – public domain – http://commons.wikimedia.org/wiki/File:Gray145.png

 

Brain in a drop of water

Brain Anatomy 101

Grab a cup of coffee, and in just under 20 minutes you will have completed a basic primer in brain anatomy, provided by these two videos from Anatomy Zone on YouTube.

Once you’re done, you can test yourself at this site run by the University of Utah (part of the Visible Human Project), which challenges you with a labelled dissections quiz.

Basic Parts of the Brain – Part 1

Basic Parts of the Brain – Part 2

 

REFERENCES:

Videos by Anatomy Zone on YouTube

Leaf-Brain photo by Vancanjay on freeimages.com

Fascia Collagen Tendrils

The Fascia – Strolling Under The Skin

Three clips from the amazing images of living fascia made by Dr. Claude Guimberteau, including views of sliding collagen fibres capable of instant morphological change, and also illustration of tensegrity phenomena. (warning – some images of dissection)

I write at length of the universality of the fascia to impress the reader with the idea that this connecting substance must be free at all parts to receive and discharge all fluids, and to appropriate and use them in sustaining animal life, and eject all impurities, that health may not be impaired by dead and poisonous fluids.

A knowledge of the universal extent of the fascia is imperative, and is one of the greatest aids to the person who seeks the cause of disease.
—A. T. Still Philosophy and Mechanical Principles of Osteopathy

The narrator often uses poor pronunciation (see ‘stab-ilise’, and ‘colla-gene’) but these endoscopic films of the fascia otherwise give a fascinating insight into the hidden world of our collagen framework.

Strolling Under The Skin

Strolling Under The Skin (Part 2)

Strolling Under The Skin Part 3

The Spheno-palatine Fossa

The Spheno-Palatine Fossa

This detailed presentation describes the bony, neural and vascular anatomy associated with the spheno-palatine (or pterygo-palatine) fossa.

This region is difficult to visualise and understand, and yet the spheno-palatine ganglion (SPG) alone can be responsible for a number of different symptomatic presentations.

In a 2004 paper on SPG blockade injection, the author states:

…accepted indications for the SPG block are sphenopalatine neuralgia, trigeminal neuralgia, atypical facial pain, acute migraine, acute and chronic cluster headaches, herpes zoster involving the ophthalmic nerve and a variety of other facial neuralgias

Anatomical understanding of this complex area is imperative when dealing with such presentations, not least the ‘lightning’ pain of trigeminal neuralgia or secreto-motor dysfunction in the nasal mucosa, as in chronic sinusitis.

Our upcoming 5-day course provides more guidance and practical help with cranial osteology


REFERENCES

1. Windsor, R. E. & Jahnke, S. Report of Technique Sphenopalatine Ganglion Blockade : A Review and Proposed Modification of the Transnasal Technique. 7, 283–286 (2004).

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