THE SKELETON THE SKELETON • Composed of bones, cartilages, joints, and ligaments, accounts for about 20% of body mass (30 pounds in a 160 pound person) – Bones make up most of the skeleton – Cartilages occur only in isolated areas • Nose, parts of the ribs, and the joints – Ligaments connect bones and reinforce joints, allowing required movements while restricting motions in other directions – Joints, the junction between bones, provide for the remarkable mobility of the skeleton Axial Skeleton • Structured from 80 bones segregated into three major regions: – Skull – Vertebral column – Bony thorax • Supports the head, neck, and trunk, and protects the brain, spinal cord, and organs in the thorax AXIAL SKELETON The Skull • The skull consists of 22 cranial and facial bones that form the framework of the face, contain cavities for special sense organs, provide openings for air and food passage, secure the teeth, and anchor muscles of facial expression • The cranial bones (cranium) enclose and protect the fragile brain and furnish a site for attachment of head and neck muscles • Facial bones: – Form the framework of the face – Contain cavities for the special sense organs of sight, taste, and smell – Provide openings for air and food passage – Secure the teeth – Anchor the facial muscles of expression, which we use to show our feelings The Skull • Except for the mandible, which is joined to the skull by a freely movable joint, most skull bones are flat bones joined by interlocking joints called sutures – Suture lines have a sawtoothed or serrated appearance • Major sutures that connect cranial bones are: – Coronal – Sagittal – Squamous – Lambdoid EXTERNAL LATERAL SKULL POSTERIOR SKULL The Skull • Most other skull sutures connect facial bones and are named according to the specific bones they connect – Examples: • Frontonasal suture • Occipitomastoid suture ANTERIOR SKULL POSTERIOR SKULL Overview of Skull Geography • The anterior aspect of the skull is formed by facial bones, and the remainder is formed by a cranium, which is divided into: – 1. Cranial vault (calvaria): • Forms the superior, lateral, and posterior aspects of the skull, as well as the forehead EXTERNAL LATERAL SKULL The Skull • 2. Cranial base (floor) (a): inferior superficial view – Forms the skull’s inferior aspect – Internally (b+c): • (b): superior view of the floor of cranial cavity • (c): schematic view of the cranial cavity floor • prominent bony ridges divide the base into three distinct “steps” or fossa: – Anterior cranial fossa – Middle cranial fossa – Posterior cranial fossa INFERIOR SKULL SUPERIOR SKULL The Skull • The cavities of the skull include: – Cranial cavity: • Houses the brain – Ear cavities – Nasal cavity – Orbit cavities: • House the eyeballs – Air-filled sinuses: • Lighten the skull SKULL CAVITIES The Skull • The skull has about 85 named openings that provide passageways for the spinal cord, major blood vessels serving the brain, and the cranial nerves – Named: • Foramina • Canals • Fissures Cranium • Consists of eight strong, superiorly curved bones • 1. Frontal bone: – Forms the anterior cranium – Most anterior part of the frontal bone is the vertical frontal squama (forehead) – Articulates posteriorly with the parietal bones via the coronal suture, extends forward to the supraorbital margins, and extends posteriorly to form the superior wall of the orbits and most of the anterior cranial fossa ANTERIOR SKULL EXTERNAL LATERAL SKULL Parietal Bone • 2. Two large, rectangular bones on the superior and lateral aspects of the skull – Form the bulk of the cranial vault • The four largest sutures of the skull are located where the parietal bones articulate with other bones: – Coronal: parietal bones meet the frontal anteriorly – Sagittal: the parietal bones meet superiorly at the cranial midline – Lambdoid: parietal bones meet the occipital bone posteriorly – Squamous: where a parietal and temporal bone meet on the lateral aspect of the skull POSTERIOR SKULL EXTERNAL LATERAL SKULL Occipital Bone • Articulates with the parietal, temporal, and sphenoid bones • Forms most of the posterior wall and base of the skull • The foramen magnum, a large opening through which the brain connects to the spinal cord, is located in the base of the occipital bone • Rockerlike occipital condyles articulate with the first vertebra of the spinal column in a way that permits a nodding movement of the head POSTERIOR SKULL EXTERNAL LATERAL SKULL Temporal Bone • Lateral skull surface • Articulate with the parietal bones and form the inferolateral aspects of the skull and parts of the cranial floor • The temporal bone is characterized by the small, oval mandibular fossa on the inferior surface of the zygomatic process – It receives the condyle of the mandible (lower jawbone) forming the freely movable temporomandibular joint EXTERNAL LATERAL SKULL MID SAGITTAL SKULL INFERIOR SKULL Temporal Bone • Tympanic region surrounds the external acoustic meatus (external ear canal) • Housed in the petrous region are the middle and inner ear cavities, which contain sensory receptors for hearing and balance TEMPORAL BONE Temporal Bone • • Jugular foramen: passage of internal jugular vein and three cranial nerves Carotid canal: passage of the internal carotid arteries (both supply 80% of blood to the brain) – • Closeness to the inner ear cavities explains why, during excitement or exertion, we sometimes hear our rapid pulse as a thundering sound in the head Mastoid process: felt as a bump just posterior to the ear – – Anchoring site for some neck muscles Full of air cavities (mastoid sinuses: air cells) • • • Position adjacent to the middle ear cavity (high-risk area for infections spreading from the throat) puts it at risk for infection itself Mastoid sinus infection (mastoiditis) is difficult to treat Separated from the brain by only a very thin bony plate – Infections may spread to the brain INFERIOR SKULL TEMPORAL BONE TEMPORAL BONE Sphenoid Bone • Spans the width of the middle cranial fossa (furrow or shallow depression) • Keystone of the cranium because it articulates with all other cranial bones • Pterygoid processes anchor the pterygoid muscles which are important in chewing • Optic canals: allow passage of optic nerve SUPERIOR SKULL SPHENOID BONE SPHENOID BONE Ethmoid Bone • Lies between the sphenoid and nasal bones • Forms most of the bony area between the nasal cavity and the orbits • Superior surface (cribriform plate) helps form the roof of the nasal cavities and the floor of the anterior cranial fossa • Olfactory foramina: allows passage of the olfactory nerve • Perpendicular plate: forms superior part of the nasal septum, which divides the nasal cavity into right and left halves ETHMOID BONE ETHMOID BONE Sutural Bones • Sutural, or Wormian, bones are groups of irregularly shaped bones or bone clusters located within sutures (most often in the lambdoid suture) that vary in number and are not present on all skulls – Formed during fetal development – Structurally unimportant POSTERIOR SKULL Facial Bones Mandible • • • • • U-shaped bone Lower jawbone Largest, strongest bone of the face Body forms the chin Two upright rami – Each ramus meets the body posteriorly at a mandibular angle – Superior margin of each ramus are two processes separated by the mandibular notch • The anterior coronoid process is an insertion point for the large temporalis muscle that elevates the lower jaw during chewing • The posterior mandibular condyle articulates with the mandibular fossa of the temporal bone, forming the temporomandibular joint on the same side FACIAL BONES Mandible Facial Bones Mandible • Mandibular body anchors the lower teeth: – Its superior border, called the alveolar margin, contains the sockets (alveoli) in which the teeth are embedded – In the midline of the mandibular body is a slight depression, the mandibular symphysis, indicating where the two mandibular bones fused during infancy FACIAL BONES Mandible ANTERIOR SKULL Facial Bones Mandible • Large mandibular foramina: – One on the medial surface of each ramus – Permit the nerves responsible for tooth sensation to pass to the teeth in the lower jaw – Dentist inject Novocain into these foramina to prevent pain while working on the lower teeth • Mental foramina: – Openings on the lateral aspects of the mandibular body – Allow blood vessels and nerves to pass to the skin of the chin and lower lips FACIAL BONES Mandible Facial Bones Maxillary Bones • Maxillae (b) • Form the upper jaw and central portion of the face • Articulates with all other facial bones except the mandible – Hence the maxillae are considered the keystone bones of the facial skeleton • Maxillae carry the upper teeth in their alveolar margins • Just inferior to the nose the maxillae meet medially, forming the pointed anterior nasal spine at their junction Facial Bones Maxillary Bones Facial Bones Maxillary Bones • Palatine processes of the maxillae project posteriorly from the alveolar margins and fuse medially, forming the anterior 2/3 of the hard palate, or bony roof of the mouth • Posterior to the teeth is a midline foramen, called the incisive fossa – Serves as a passageway for blood vessels and nerves MID SAGITTAL SKULL INFERIOR SKULL Facial Bones Maxillary Bones • Frontal processes extend superiorly to the frontal bone, forming part of the lateral aspects of the bridge of the nose • Regions that flank the nasal cavity laterally contain the maxillary sinuses, the largest of the paranasal sinuses – They extend from the orbits to the upper teeth Facial Bones Maxillary Bones SINUSES Facial Bones Maxillary Bones • Laterally, the maxillae articulates with the zygomatic bones via their zygomatic processes ANTERIOR SKULL EXTERNAL LATERAL SKULL Facial Bones Maxillary Bones • Inferior orbital fissure is located deep within the orbit at the junction of the maxilla with the greater wing of the sphenoid – Permits the zygomatic nerve, the maxillary nerve (branch of cranial nerve V), and blood vessels to pass to the face • Just below the eye socket on each side is an infraorbital foramen that allows the infraorbital nerve and artery to reach the face ANTERIOR SKULL Facial Bones Zygomatic Bones • Commonly called cheek bones • They articulate with the zygomatic process of the temporal bones posteriorly, the zygomatic process of the frontal bone superiorly, and with the zygomatic processes of the maxillary bones anteriorly • Form the prominences of the cheeks and parts of the inferolateral margins of the orbits ANTERIOR SKULL EXTERNAL LATERAL SKULL Facial Bones Nasal Bones • Form the bridge of the nose • Articulate with the frontal bone superiorly, the maxillary bones laterally, and the perpendicular plate of the ethmoid bones posteriorly • Inferiorly they attach to the cartilages that form most of the skeleton of the external nose ANTERIOR SKULL EXTERNAL LATERAL SKULL Facial Bones Lacrimal Bones • Located in the medial wall of the orbits • Articulate with the frontal bone superiorly, ethmoid bone posteriorly, and maxillae anteriorly • Contains a deep groove that helps form a lacrimal fossa – Houses the lacrimal sac, part of the passageway that allows tears to drain from the eye surface into the nasal cavity ANTERIOR SKULL EXTERNAL LATERAL SKULL Facial Bones Palatine Bones • Consist of bony plates that complete the posterior portion of the hard palate • Form part of the posterolateral walls of the nasal cavity, and small parts of the orbits INFERIOR SKULL NASAL CAVITY Facial Bones Vomer • Lies in the nasal cavity, where it forms part of the nasal septum • Plow-shaped ANTERIOR SKULL Facial Bones Inferior Nasal Conchae • Paired thin, curved bones in the nasal cavity • Project medially from the lateral walls of the nasal cavity, just inferior to the middle nasal conchae of the ethmoid bone • Largest of the three pairs of conchae and, like the others, they form part of the lateral walls of the nasal cavity ANTERIOR SKULL NASAL CAVITY Special Characteristics of the Orbits and Nasal Cavity • The orbits are bony cavities that contain: – The eyes which are firmly encased and cushioned by fatty tissue – Muscles that move the eyes – Tear-producing glands lacrimal glands – The walls of each orbit are formed by parts of seven bones—the frontal, sphenoid, zygomatic, maxilla, palatine, lacrimal, and ethmoid bones – Superior and inferior orbital fissures – Optic canals ORBIT ORBIT Facial Bones Nasal Cavity • Constructed of bone and hyaline cartilage • Roof of the nasal cavity is formed by the cribriform plate of the ethmoid • Lateral walls are largely shaped by the superior and middle conchae of the ethmoid bone, the perpendicular plates of the palatine bones, and the inferior nasal conchae – The depressions under cover of the conchae on the lateral walls are called meatuses (superior, middle, inferior) NASAL CAVITY Facial Bones Nasal Cavity • It is divided into right and left parts by the nasal septum, which consists of portions of the ethmoid bone and vomer – A sheet of cartilage called the septal cartilage completes the septum anteriorly NASAL CAVITY Nasal Cavity • Nasal septum and conchae are covered with a mucus-secreting mucosa that moistens and warms the entering air and helps cleanse it of debris – The scroll-shaped conchae increase the turbulence of air flowing through the nasal cavity • This swirling forces more of the inhaled air into contact with the warm, damp mucosa and encourages trapping of airborne particles (dust, pollen, bacteria) in the sticky mucus Paranasal Sinuses • • • • Five skull bones—frontal, sphenoid, ethmoid, and paired maxillary bones—contain mucosa-lined, air-filled sinuses that cause them to look rather moth-eaten in an X-ray image Are air-filled sinuses that cluster around the nasal cavity – Small openings connect the sinuses to the nasal cavity and act as “two-way streets” • Air enters the sinuses from the nasal cavity • Sinus mucosae: – Forms mucus which drains into the nasal cavity – Helps to warm and humidify inspired air Lightens the skull Enhances resonance of the voice SINUSES Hyoid Bone • • • • Not really part of the skull U-shaped Lies inferior to the mandible in the anterior neck – It is the only bone of the body that does not articulate directly with any other bone • Anchored by the narrow stylohyoid ligaments to the styloid processes of the temporal bones Acts as a movable base for the tongue: – Its body and greater horns are attachment points for neck muscles that raise and lower the larynx during swallowing and speech HYOID BONE THE VERTEBRAL COLUMN • General Characteristics: – The vertebral column consists of 26 irregular bones (vertebrae) • Separated by intervertebral discs – Forms a flexible, curved structure extending from the skull to the pelvis – Surrounds and protects the spinal cord – Provides attachment for ribs and muscles of the neck and back – Divisions and Curvatures: • The vertebrae of the spine fall in five major divisions: – – – – 7 cervical 12 thoracic 5 lumbar 5 fused vertebrae of the sacrum – 4 fused vertebrae of the coccyx VERTEBRAL COLUMN Curvatures • Right lateral view • Cervical and lumber curvatures are concave (spherically depressed: bowl like) posteriorly • Thoracic and sacral curvatures are convex (curved sphere like) posteriorly • Curvatures of the spine increase resiliency and flexibility of the spine allowing it to function like a spring rather than as a rigid rod VERTEBRAL COLUMN Homeostatic Imbalance • • There are several types of abnormal spinal curvatures caused by: – Congenital (present at birth) – Disease – Poor posture – Unequal muscle pull on the spine Scoliosis: twisted disease – Abnormal lateral curvature that occurs most often in the thoracic region – Quite common during late childhood, particularly in girls, for some unknown reason – Sever cases result from abnormal vertebral structure, lower limbs of unequal length, or muscle paralysis – If muscles on one side of the body are nonfunctional, those of the opposite side exert an unopposed pull on the spine and force it out of alignment – Treated (with braces or surgery) before growth ends • Prevents permanent deformity and breathing difficulties due to compressed lung Homeostatic Imbalance • Kyphosis: hunchback – Dorsally exaggerated thoracic curvature – Common in aged individuals because of osteoporosis (loss of bone mass), but may also reflect tuberculosis of the spine, rickets, or osteomalacia (vitamin D deficiency, loss of calcium salts) • Lordosis: swayback – Accentuated lumbar curvature – Can result from spinal tuberculosis or osteomalacia – Temporary lordosis common in people with: – Pot bellies – Pregnant woman • In an attempt to preserve their center of gravity, these individuals automatically throw back their shoulders, accentuating their lumbar curvature Ligaments • The vertebral column cannot possibly stand upright by itself – It must be held in place by an elaborate system of cablelike supports • Straplike ligaments and the trunk muscles assume this role – Ligaments: band of regular fibrous tissue that connects bones • The major supporting ligaments of the spine are the anterior and posterior longitudinal ligaments, which run as continuous bands down the front (anterior) and back (posterior) surfaces of the spine from the neck to the sacrum VERTEBRAL DISC Ligaments • Anterior ligament: – – – • Strongly attached to both the bony vertebrae and the disc Broad and strong Along with its supporting role, it prevents hyperextension of the spine (bending too far backward) Posterior ligament: – – – – Attaches only to discs Narrow and relatively weak Resists hyperflexion of the spine (bending too sharply forward) However: • The ligamentum flavum, which contains elastic connective tissue, is especially strong – • Stretches on bending forward and recoils when we resume an erect posture Short ligaments connect each vertebra to those immediately above and below VERTEBRAL DISC Intervertebral Discs • Cushionlike pads: – Composed of two parts: • Inner gelatinous nucleus pulposus – Acts like a rubber ball, giving the disc its elasticity and compressibility • Annulus fibrosus: – Surrounds the nucleus pulposus – Strong collar composed of collagen fibers superficially and internally fibrocartilage – Limits the expansion of the nucleus pulposus when the spine is compressed – Holds together successive vertebrae and resists tension in the spine – Act as shock absorbers and allow the spine to flex, extend, and bend laterally • At points of compression, the discs flatten and bulge out a bit between the vertebrae – Flattened somewhat during the course of the day, so we are always a few centimeters shorter at night than when we awake in the morning VERTEBRAL DISC Homeostatic Imbalance • Severe or sudden physical trauma to the spine—for example, from bending forward while lifting a heavy object—may result in herniation of one or more discs – Herinated (prolapsed) disc: • Slipped disc • Usually involves rupture of the annulus fibrosus followed by protrusion of the spongy nucleus through the annulus – If protrusion presses on the spinal cord or on spinal nerves exiting from the cord, numbness or excruciating pain may result • Treatment: – – – – Moderate exercise Heat therapy Painkillers Surgical removal followed by a bone graft to fuse the adjoining vertebrae – Partial vaporization with a laser • Outpatient procedure VERTEBRAL DISC General Structure of Vertebrae • Each vertebra consists of an anterior body (centrum) and a posterior vertebral arch – Disc-shaped body is the weight-bearing region – Together, the body and vertebral arch enclose an opening called the vertebral foramen • Successive vertebral foramina of the articulated vertebrae form the long vertebral canal, through which the spinal cord passes General Structure of Vertebrae • The vertebral arch consists of two pedicles and two laminae, which collectively give rise to several projections – Pedicles (little feet): • Short bony pillars projecting posteriorly from the vertebral body • Form the sides of the arch – Laminae: • Flattened plates that fuse in the median plane • Complete the arch posteriorly General Structure of Vertebrae • The pedicles have notches on their superior and inferior borders, providing lateral openings between adjacent vertebrae called intervertebral foramen – Provide openings for the passage of spinal nerves General Structure of Vertebrae • Seven processes project from the vertebral arch – Spinous process (1): median posterior projection arising at the junction of the two laminae • Attachments sites for muscles that move the vertebral column and for ligaments that stabilize it – Transverse processes (2): extends laterally from each side of the vertebral arch • Attachments sites for muscles that move the vertebral column and for ligaments that stabilize it THORACIC VERTEBRAE General Structure of Vertebrae – Paired superior and inferior articular processes (2): • Protrude superiorly and inferiorly, respectively, from the pedicle-lamina junctions • The smooth joint surfaces of the articular processes, called facets (little faces), are covered with hyaline cartilage • The inferior articular processes of each vertebra form movable joints with the superior articular processes of the vertebra immediately below – Thus, successive vertebrae join both at their bodies and at their articular processes THORACIC VERTEBRAE VERTEBRA Cervical Vertebrae • Smallest vertebrae • Identified as C1-C7 • They typically have: – An oval body: wider from side to side than in the anteroposterior dimension – Except in C7, the spinous process is short, projects directly back, and is bifid (split at its tip) – Vertebral foramen is large and generally triangular – Each transverse process contains a transverse foramen through which the vertebral arteries pass to service the brain Cervical Vertebrae • The spinous process of C7 is not bifid and is much larger than those of the other cervical vertebrae – Its spinous process is visible through the skin – Used as a landmark for counting the vertebrae and is called the vertebra prominens (prominent vertebra) CERVICAL VERTEBRAE Cervical Vertebrae • The first two cervical vertebrae are unusual – Atlas and Axis • • • Have no intervertebral disc between them Have special functions Atlas (C1) has no body or spinous process – – Essentially, it is a ring of bone consisting of anterior and posterior arches and a lateral mass on each side Each lateral mass has articular facets on its superior and inferior surfaces • The superior articular facets articulate with the occipital condyles of the skull – – – They carry the skull just as Atlas supported the heavens in greek mythology These joints allow you to nod “YES” The inferior articular surfaces form joints with the axis below (inferiorly) Cervical Vertebrae • Axis (C2) has a body, spine, and other typical vertebral processes – Not as special as the atlas – Its only unusual feature is the knoblike dens (tooth), or odontoid process, projecting superiorly from its body • Acts as a pivot for the rotation of the atlas – Hence, this joint allows you to rotate your head from side to side to indicate “NO” CERVICAL VERTEBRAE Thoracic Vertebrae • • • • • 12 thoracic vertebrae (T1-T12) All articulate with ribs Gradually transition between cervical structure at the top, and lumbar structure toward the bottom Thoracic vertebrae have a roughly heart-shaped body Typically bears (demifacets: halffacets), on each side, one at the superior edge and the other at the inferior edge – The demifacets articuale with the ribs • • Circular vertebral foramen Spinous process is long and points sharply downward THORACIC VERTEBRAE Lumbar Vertebrae • 5 Lumbar vertebrae (L1-L5) • Receives the most stress • The enhanced weightbearing function is reflected in their sturdier structure • Large vertebrae that have kidney-shaped bodies • Triangular vertebral foramen • Short, thick pedicles and laminae • Short, flat, hatchet-shaped spinous processes LUMBAR VERTEBRAE Sacrum • Forms the posterior wall of the pelvis • It is formed by five, fused vertebrae in adults, and articulates with the fifth lumbar vertebra superiorly, the coccyx inferiorly, and the hip bones laterally via the sacroiliac joint • The vertebral canal continues through the sacrum, often ending at a large external opening, the sacral hiatus • Body’s center of gravity SACRUM/COCCYX VERTEBRAE Coccyx • The coccyx (tailbone) is a small bone consisting of four, fused vertebrae that articulate superiorly with the sacrum • Except for the slight support it affords the pelvic organs, it is a nearly useless bone • Occasionally, a baby is born with an unusually long coccyx – Snipped off SACRUM/COCCYX VERTEBRAE THE BONY THORAX • The bony thorax (thoracic cage) – Consists of the thoracic vertebrae dorsally, the ribs laterally, and the sternum and costal cartilages anteriorly • – – – Costal cartilage secure the ribs to the sternum It forms a protective cage around the organs of the thoracic cavity, and provides support for the shoulder girdles (pectoral) and upper limbs Provides attachment points for many muscles of the neck, back, chest, and shoulders Intercostal spaces between the ribs are occupied by the intercostal muscles, which lift and depress the thorax during breathing BONY THORAX Sternum • • The sternum (breastbone) lies in the anterior midline of the thorax Is a flat bone resulting from the fusion of three bones: the manubrium, body, and xiphoid process • The manubrium (superior portion) articulates with the clavicles and the first two pairs of ribs • The body (midportion) articulates with the cartilage of ribs two through seven • The xiphoid process (inferior portion) forms the inferior end, articulating only with the body – Serves as an attachment point for some abdominal muscles BONY THORAX Ribs • The sides of the thoracic cage are formed by twelve pairs of ribs that attach posteriorly to the thoracic vertebrae and curve inferiorly toward the anterior body surface • The superior seven pairs of ribs are called true, or vertebrosternal, ribs – They attach directly to the sternum via individual costal cartilages • The lower five pairs of ribs are called false ribs – They either attach indirectly to the sternum or lack a sternal attachment entirely BONY THORAX Rib • • • A typical rib is a bowed flat bone Bulk of a rib is simply called the shaft Wedged shaped head articulates with the vertebral bodies by two facets: – – • • • One joins the body of the samenumbered thoracic vertebra The other articulates with the body of the vertebra immediately superior Neck is the constricted portion of the rib just beyond the head Knoblike tubercle articulates with the transverse process of the samenumbered thoracic vertebra Costal cartilages provide secure but flexible rib attachments to the sternum TRUE RIB Appendicular Skeleton • Bones of the limbs and their girdles – They are appended to the axial skeleton that forms the longitudinal axis of the body • Pectoral girdles attach the upper limbs to the body trunk • Pelvic girdle secures the lower limbs APPENDICULAR SKELETON Pectoral Girdle • The pectoral (shoulder) girdle consists of the clavicle, which joins the sternum anteriorly, and the scapula, which is attached to the posterior thorax and vertebrae via muscular attachments • The pectoral girdles are very light and have a high degree of mobility due to the openness of the shoulder joint and the free movement of the scapula across the thorax Pectoral Girdle • • The paired pectoral girdles and their associated muscles form your shoulders Although the term girdle usually signifies a beltlike structure encircling the body, a single pectoral girdle, or even the pair, does not quite satisfy this description – Anteriorly, the medial end of each clavicle joins the sternum; the distal ends of the clavicles meet the scapulae laterally • However, the scapulae fail to complete the ring posteriorly, because their medial borders do not join each other or the axial skeleton • Instead, the scapulae are attached to the thorax and vertebral column only by the muscles that cover their surfaces PECTORAL GIRDLE Pectoral Girdle • The mobility is due to the following factors: – 1. Only the clavicle attaches to the axial skeleton, the scapula can move quite freely across the thorax, allowing the arm to move with it – 2. The socket of the shoulder joint (the scapula’s glenoid cavity) is shallow and poorly reinforced, so it does not restrict the movement of the humerus (arm bone) • Although this arrangement is good for flexibility, it is bad for stability • Shoulder dislocations are fairly common PECTORAL GIRDLE Clavicle • The clavicles (collarbones) extend horizontally across the thorax (a) • Articulating medially with the axial skeleton (sternum), and laterally with the scapula, bracing the arms and scapulae laterally • (b+c):Each clavicle is cone shaped at its medial sternal end, which attaches to the sternal manubrium, and flattened at its lateral acromial end, which articulates with the scapula PECTORAL GIRDLE Clavicle • Anchors many muscles in the shoulder region • Braces and holds the scapulae and arms out laterally, away from the narrower superior part of the thorax – This bracing function becomes obvious when a clavicle is fractured: the entire shoulder region collapses medially APPENDICULAR SKELETON Clavicle • Not very strong and are likely to fracture • Example: – When a person uses outstretched arms to break a fall • The curves in the clavicle ensure that it usually fractures anteriorly (outward) • If it were to collapse posteriorly (inward), bone splinters would damage the subclavian artery, which passes just deep to the clavicle to serve the upper limb PECTORAL GIRDLE Scapulae • The scapulae (shoulder blades) are thin, triangular flat bones that lie on the dorsal surface of the ribcage between ribs 2 + 7 – • Derived from words Spade/Shovel Each scapula has three borders: – Superior border: • – Medial (vertebral) border: • – Parallels the vertebral column Lateral (axillary) border: • • • Shortest, sharpest Thick Abuts the armpit and ends superiorly in a small, shallow fossa (glenoid cavity) Articulating with the humerus via the glenoid cavity, and the clavicle via the acromion forming the shoulder joint Scapula SCAPULA Scapula • Like all triangle, the scapula has three corners or angles – Superior scapular border meets the medial at the superior angle – Superior scapular border meets the lateral border at the lateral angle – The medial and lateral borders join at the inferior angle • The inferior angle moves extensively as the arm is raised and lowered PECTORAL GIRDLE SCAPULA Scapula • The anterior, or costal, surface is concave (depression) and relatively featureless • Posterior surface bears a prominent spine that is easily felt through the skin – Spine ends laterally in an enlarged, roughened triangular projection called the acromion (point of shoulder) • Acromion articulates with the acromial end of the clavicle, forming the acromioclavicular joint PECTORAL GIRDLE Scapula Scapula • Projecting anteriorly from the superior scapular border is the coracoid (beadlike) process – Looks like a little bend finger – Anchors the biceps muscle of the arm – Bounded by the suprascapular notch (a nerve passage) medially and by the glenoid cavity laterally Scapula Scapula Scapula • Several large fossae appear on both sides of the scapula and are named according to location: – Infraspinous fossa: inferior to the spine – Supraspinous fossa: superior to the spine – Subscapular fossa: shallow concavity formed by the entire anterior scapular surface Scapula Scapula Upper Limb • 30 separate bones form the bony framework of each upper limb • Each of these bones may be described regionally as a bone of the arm (anatomically is the part of the upper limb between the shoulder and elbow), forearm, or hand Arm: Humerus • Sole bone of the arm • Typical long bone • Largest, longest bone of the upper limb • Articulates with the scapula at the shoulder and with the radius and ulna (forearm bones) at the elbow APPENDICULAR SKELETON Humerus • Proximal end is its smooth, hemispherical head – Fits into the glenoid cavity of the scapula in a manner that allows the arm to hang freely at one’s side • • Tubercles (greater, inter, lesser) are sites where muscles attach Distal to the tubercles is the surgical neck – Named because it is the most frequently fractured part of the humerus – Midway down the shaft on its lateral side is the deltoid tuberosity • Attachment site for the deltoid muscle of the shoulder HUMERUS ARM HUMERUS Humerus • Distal end are two condyles – Medial trochlea (pulley): • Articulates with the ulna – Lateral capitulum (ball-like): • Articulates with the radius • Condyle pair (medial trochlea and lateral capitulum) are flanked by the medial and lateral epicondyles: – Muscle attachment – Directly above these epicondyles are the supracondylar ridges • Ulnar nerve runs behind the medial epicondyle and is responsible for the painful, tingling sensation you experience when you hit your “funny bone” (medial epicondyle of the humerus) HUMERUS ARM Humerus • Superior to the trochlea on the anterior surface is the coronoid fossa – Posterior surface is the deeper olecranon fossa – These two depressions allow the corresponding processes of the ulna to move freely when the elbow is flexed and extended • Small radial fossa, lateral to the coronoid fossa, receives the head of the radius when the elbow is flexed HUMERUS ARM Forearm • The forearm is the region between the elbow and wrist • It consist of two bones, the ulna and the radius FOREARM BONES Ulna • The ulna: – Proximal end forms the elbow joint with the humerus – Distal end forms joints with the wrist • Articulates with the bones of the wrist via a cartilage disc at the distal end – It articulates with the radius both proximally and distally at small radioulnar joints – Ulna and radius are connected along their entire length by a flexible interosseous membrane – In the anatomical position, the radius lies laterally (on the thumb side) and the ulna medially • However, when you rotate your forearm so that the palm faces posteriorly (a movement called pronation), the distal end of the radius crosses over the ulna and the two bones form an X FOREARM BONES Ulna • • Main responsibility for forming the elbow joint with the humerus Proximally bears two prominent processes • • – – • • Olecranon process (elbow): Coronoid process Separated by a deep concavity: trochlear notch Together these two processes grip the trochlea of the humerus, forming a hinge joint that allows the forearm to be bent upon the arm (flexed), then straightened again (extended) On the lateral side of the coronoid process is a small depression, the radial notch, where the ulna articulates with the head of the radius Distally the ulna ends in a knoblike head: – – – Separated from the bones of the wrist by a disc of fibrocartilage Plays no role in hand movement Medial to the head is a styloid process, from which a ligament runs to the wrist FOREARM BONES Radius • Head is shaped like the head of a nail – – – • While the ulna contributes more heavily to the elbow joint, the radius is the major forearm bone contributing to the wrist joint – • Superior surface of this head is concave, and it articulates with the capitulum of the humerus Medially, the head articulates with the radial notch of the ulna Inferior to the head is the rough radial tuberosity, which anchors the biceps muscle of the arm When the radius moves, the hand moves with it It articulates with the carpels of the wrist and the ulna medially at the distal end FOREARM BONES RADIUS/ULNA HOMEOSTATIC IMBALANCE • Colle’s fracture is a break in the distal end of the radius • Common fracture when a falling person attempts to break his or her fall with outstretched hands FOREARM BONES Hand • Skeleton of the hand includes the bones of: – The carpus (wrist) – The metacarpus (palm) – The phalanges (bones of the fingers) Carpus • The carpus (wrist) consists of eight marble-size short bones (carpals), arranged in two irregular rows of four bones each, closely united by ligaments: – – Gliding movements occur between these bones Quite flexible • Proximal row (lateral to medial): – – – – • Distal row (lateral to medial): – – – – • Scaphoid: articulates with the radius to form the wrist Lunate: articulates with the radius to form the wrist Triquetral Pisiform Trapezium Trapezium Trapezoid Capitate Hamate Sally left the party to take Cathy home HAND BONES HOMEOSTATIC IMBALANCE • The carpus is concave anteriorly and a ligament roofs over this concavity, forming the notorious carpal tunnel – Besides the median nerve (which supplies the lateral side of the hand), several long muscle tendons crowd into this tunnel – Overuse and inflammation of the tendons cause them to swell, compressing the median nerve, which causes numbness of the areas served • Carpal tunnel syndrome Metacarpus (Palm) • Radiate from the wrist like spokes to form the palm of the hand • Not named but numbered – 1 to 5 from thumb to little finger • Bases articulate with the carpals proximally and each other medially and laterally • Bulbous heads articulate with the proximal phalanges of the fingers – When you clench your fist, the heads of the metacarpals become prominent as your knuckles HAND BONES Phalanges • Fingers (digits) • Numbered from 1 to 5 beginning with the thumb (pollex) – There are 14 phalanges (miniature bones) of the fingers: • Thumb (pollex) is digit 1, and has two phalanges • The other fingers (digits), numbered 2-5 have three phalanges each – Distal – Middle – Proximal HAND BONES HAND BONES PELVIC (HIP) GIRDLE • Attaches the lower limbs to the axial skeleton • Transmits the weight of the upper body to the lower limbs • Supports the visceral organs of the pelvis • Whereas the pectoral girdle is sparingly attached to the thoracic cage, the pelvic girdle is secured to the axial skeleton by some of the strongest ligaments in the body • Lacks the mobility of the pectoral girdle but is far more stable PELVIC (HIP) GIRDLE • It is formed by a pair of coxal bones, each consisting of three fused bones; the ischium, ilium, and pubis • Each coxal bone unites with its partner anteriorly and with the sacrum posteriorly BONY PELVIS PELVIC (HIP) GIRDLE • At the point of fusion of the ilium, ischium, and pubis is a deep hemispherical socket called the acetabulum on the lateral surface of the pelvis – The acetabulum receives the head of the femur, or thigh bone, at this hip joint • The deep, basinlike structure formed by the hip bones, together with the sacrum and coccyx, is called the bony pelvis BONY PELVIS ILIUM • (b): Lateral view of right hip • (c): medial view of right hip • Large flaring bone that forms the superior region of the coxal bone – It consists of a body and a superior winglike portion called the ala • When you rest your hands on your hips, you are resting them on the thickened superior margins of the alae, the tubercle of the iliac crests ILIUM ILIUM • • • • (b): lateral right (c): medial right Each iliac crest ends anteriorly in the blunt anterior superior iliac spine and posteriorly in the sharp posterior superior iliac spine – Anterior superior iliac spine is easily felt through the skin and is visible in thin people – Posterior superior iliac spine is revealed by a skin dimple in the sacral region • Located below these are the less prominent anterior and posterior inferior iliac spines All of these spines are attachment points for the muscles of the trunk, hip, and thigh ILIUM ILIUM • Inferior to the posterior inferior iliac spine, the ilium indents deeply to form the greater sciatic notch, through which the thick cordlike sciatic nerve passes to enter the thigh ILIUM ILIUM • Internal surface of the iliac ala exhibits a concavity called the iliac fossa • It articulates with the sacrum, forming the sacroiliac joint, and also with the ischium and pubis anteriorly – Weight of the body is transmitted from the spine to the pelvis through the sacroiliac joints BONY PELVIS Ischium • (b): lateral right • (c): medial right • The ischium forms the posteroinferior portion of the coxa (hip bone) • Roughly L-shaped or arcshaped • It has a thicker, superior body adjoining the ilium and a thinner, inferior ramus – Joins the pubis anteriorly Ischium Ischium • • (b): lateral right / (c): medial right Three important markings: • Ischial spine: – Projects medially into the pelvic cavity and serves as a point of attachment of the sacrospinous ligament from the sacrum Lesser sciatic notch: – Inferior to the ischial spine – A number of nerves and blood vessels pass through this notch to supply the anogenital area Ischial tuberosity: – Inferior surface of the ischial body – Rough and thickened – When we sit, our weight is borne entirely by the ischial tuberosities • Strongest parts of the hip bones • • Ischium Ischium • A massive ligament runs from the sacrum to each ischial tuberosity – This sacrotuberous ligament (not illustrated) helps hold the pelvis together Pubis • The pubic bones form the anterior portion of the coxae – They are joined by a fibrocartilage disc, forming the midline pubic symphysis joint • • In the anatomical position, it lies nearly horizontally and the urinary bladder rests upon it As the two rami of the pubic bone run laterally to join with the body and ramus of the ischium, they define a large opening in the hip bone, the obturator foramen through which a few blood vessels and nerves pass – Although it is large, it is nearly closed by a fibrous membrane in life Pubis • Inferior to the pubic symphysis joint, the inferior pubic rami angle laterally, forming an inverted V-shaped arch called the pubic arch – The acuteness of the pubic arch helps to differentiate the male and female pelvis – More acute in the males – Less than 90O (50O-60O) • Females: 80O – 90O Pubis Pelvic Structure and Childbearing • The female pelvis is modified for childbearing. It tends to be wider, shallower, lighter, and rounder than the male pelvis – Not only accommodates a growing fetus, but it must be large enough to allow the infant’s relatively large head to exit at birth Pelvic Structure and Childbearing • Pelvic brim: – Continuous oval ridge that runs from the pubic crest through the arcuate line and sacral promontory – Separates: false and true pelvis • The false (greater) pelvis superior to the pelvic brim – Really part of the abdomen and helps support the abdominal viscera – Does not restrict child birth • The true (lesser) pelvis inferior to the pelvic brim – Almost entirely surrounded by bone – Its dimensions (inlet and outlet) are critical to the uncomplicated delivery of a baby – Carefully measured by an obstetrician Pelvic Brim Pelvic Inlet/Outlet • Pelvic Inlet is the Pelvic Brim – Widest dimension is from right to left along the frontal plane – As labor begins, an infant’s head typically enters the inlet: • Forehead facing one ilium and the occiput (back part of the skull) facing the other ilium – A sacral promontory that is particularly large can impair the infant’s entry into the true pelvis Pelvic Inlet/Outlet • Pelvic Outlet: – Is the inferior margin of the true pelvis • Bounded anteriorly by the pubic arch, laterally by the ischia, and posteriorly by the sacrum and coccyx – Both the coccyx and the ischial spines protrude into the outlet opening » A sharply angled coccyx or unusually large ischial spines can interfere with delivery • Generally, after the baby’s head passes through the inlet, it rotates so that the forehead faces posteriorly and the occiput anteriorly – Thus, during birth, the infant’s head makes a quarter turn to follow the widest dimensions of the true pelvis Pelvic Structure and Childbearing • • Female: – – – – – Tilted forward Adapted for childbearing True pelvis defines the birth canal Cavity of true pelvis is broad, shallow, and has a greater capacity Bone thickness: • • • • – – – Broader: 80-90O More rounded Wider Shorter Sacral curvature is accentuated Coccyx: • • More movable straighter Tilted less forward Adapted for support of a heavier build and stronger muscles Cavity of the true pelvis is narrow and deep Bone thickness: • • • • – – More acute: 50-60O Sacrum: • • • – Larger Closer Pubic arch/angle: • – Greater Heavier Thicker Markings more prominent Acetabula: • • Sacrum: • • • – Smaller Farther apart Pubic arch/angle: • • – – – Acetabula: • • – Less Lighter Thinner Smoother Male: Narrow Longer Sacral promontory more ventral Coccyx: • • Less movable Curves ventrally HIP BONE Thigh • Is the region between the hip and knee • It has one bone, the femur • The femur is the largest, longest, and strongest bone in the body –It articulates proximally with the hip via a ball-like head, and distally with the knee at the lateral and medial condyles Femur • The ball-like head of the femur has a small central pit called the fovea capitis – The short ligament of the head of the femur (ligamentum teres) runs from this pit to the acetabulum, where it helps secure the femur • The ball-like head is carried on a neck that angles laterally to join the shaft – The neck is the weakest part of the femur and is often fractured, an injury commonly called a broken hip THIGH BONE Femur • At the junction of the shaft and neck are the lateral greater trochanter and posteromedial lesser trochanter – These projections serve as sites of attachment for thigh and buttock muscles Femur • Distally , the femur broadens and ends in the wheel-like lateral and medial condyles, which articulate with the tibia of the leg – Medial and lateral epicondyles (sites of muscle attachment) flank the condyles superiorly • The smooth patellar surface, between the condyles on the anterior femoral surface, articulates with the patella, or kneecap Patella • Is a triangular sesamoid (short bones embedded in tendons) bone enclosed in the (quadriceps) tendon that secures the anterior thigh muscles to the tibia – It protects the knee joint anteriorly and improves the leverage of the thigh muscles acting across the knee KNEE BONE THIGH BONE FEMUR LOWER LIMB • • • Leg: The leg is the region between the knee and ankle. It has two bones, the tibia and fibula • These two bones are connected by an interosseous membrane and articulate with each other both proximally and distally – But unlike the joints between the radius and ulna of the forearm, the tibiofibular joints of the leg allow essentially NO movement The medial tibia articulates proximally with the femur to form the modified hinge joint of the knee and distally with the talus bone of the foot at the ankle The fibula, by contrast, does not contribute to the knee joint and merely helps stabilize the ankle joint TIBIA/FIBULA Tibia • • • • The tibia (shinbone) receives the weight of the body from the femur and transmits it to the foot It is second only to the femur in size and strength At its broad proximal end are the concave medial and lateral condyles, which look like two huge checkers lying side by side – These are separated by an irregular projection, the intercondylar eminence – The tibial condyles articulate with the corresponding condyles of the femur Inferior to the condyles, the tibia’s anterior surface displays the rough tibial tuberosity, to which the patellar ligament attaches Tibia • Shaft is triangular in cross section – Its anterior border is the sharp anterior crest • Neither this crest nor the tibia’s medial surface is covered by muscles, so they can be felt just deep to the skin along their entire length – The anguish of a “bumped” shin is an experience familiar to nearly everyone Tibia • Distally the tibia is flat where it articulates with the talus bone of the foot – Medial to that joint surface is an inferior projection, the medial malleolus, which forms the medial bulge of the ankle – The fibular notch, on the lateral surface of the tibia, participates in the distal tibiofibular joint Fibula • Is a sticklike, nonweight-bearing bone • It has expanded ends that articulate proximally via the head and distally via the lateral malleolus with the lateral aspects of the tibia – The lateral malleolus forms the conspicuous lateral ankle bulge and articulates with the talus TIBIA/FIBULA HOMEOSTATIC IMBALANCE • Pott’s fracture occurs at the distal end of the fibula, the tibia, or both – Common sports injury TIBIA/FIBULA TIBIA/FIBULA Foot • Skeleton of the foot includes the bones of the: – Tarsus – Metatarsus – Phalanges (toe bones) • Two important functions: • 1. Supports our body weight • 2. Acts as a lever to propel the body forward when we walk and run Tarsus • • Consists of seven tarsal bones that make up the posterior half of the foot Body weight is carried primarily by the two largest, most posterior tarsals – Talus: ankle • Articulates with the tibia and fibula superiorly – Calcaneus: heel bone • Forms the heel of the foot and carries the talus on its superior surface • The thick calcaneal (Achilles) tendon of the calf muscles attaches to the posterior surface of the calcaneus • The part of the calcaneus that touches the ground is the tuber calcanei FOOT BONES Tarsus • Tarsal bones: – – – – – – Posterior Talus Inferior Calcaneus Lateral Cuboid Medial Navicular Anterior medial cunieform Anterior intermediate cunieform – Anterior lateral cunieform • The cuboid and cunieform bones articulate with the metatarsal bones anteriorly FOOT BONES Metatarsus • The metatarsus consists of five small, long bones called metatarsal bones which number 1 to 5 beginning on the medial (great toe) side of the foot • First metatarsal is short and thick and plays an important role in supporting body weight • Distally, where the metatarsals articulate with the proximal phalanges of the toes, the enlarged head of the first metatarsal forms the “ball” of the foot FOOT BONES Phalanges (Toes) • There are 14 phalanges of the toes: • Smaller than those of the fingers and thus are less nimble • There are three phalanges in each digit except for the great toe (hallux) – The great big toe (hallux) is digit 1 and has two phalanges – The other toes, numbered 2-5, have three phalanges each FOOT BONES Arches of the Foot • A segmented structure can hold up weight ONLY if it is arched • Foot has three arches: account for its awesome strength – Two longitudinal: • Medial arch • Lateral arch – One transverse arch • The arches of the foot are maintained by: – Interlocking shapes of the foot bones – Strong ligaments – Pull of some tendons during muscle activity FOOT ARCHES Arches of the Foot • Ligaments and muscle tendons provide a certain amount of springiness • Arches give or stretch slightly when weight is applied to the foot and spring back when the weight is removed, which makes walking and running more economical in terms of energy use than would otherwise be the case Arches of the Foot • If you examine your wet footprint, you will see that the medial margin from the heel to the head of the first metatarsal leaves no print – This is because the MEDIAL LONGITUDINAL ARCH curves well above the ground – The talus is the keystone of this arch, which originates at the calcaneus, rises to the talus, and then descends to the three medial metatarsals FOOT ARCHES FOOT BONES Arches of the Foot • Lateral longitudinal arch: – Is very low – It elevates the lateral part of the foot just enough to redistribute some of the weight to the calcaneus and the head of the fifth (5) metatarsal (to the ends of the arch) • Cuboid is the keystone bone of this arch FOOT ARCHES FOOT BONES Arches of the Foot • The two longitudinal arches (medial and lateral) serve as pillars for the transverse arch, which runs obliquely from one side of the foot to the other, following the line of the joints between the tarsals and metatarsals Arches of the Foot • Together, the arches of the foot form a half-dome that distributes about half our standing and walking weight to the heel bones and half to the heads of the metatarsals HOMEOSTATIC IMBALANCE • Standing immobile for extended periods places excessive strain on the tendons and ligaments of the feet (because muscles are inactive) and can result in fallen arches, or “flat feet,” particularly if one is overweight • Running on hard surfaces can also cause arches to fall unless one wears shoes that give proper arch support DEVELOPMENTAL ASPECTS OF THE SKELETON • Membrane bones of the skull begin to ossify late in the second month of development • At birth, skull bones are connected by fontanels, unossified remnants of fibrous membranes • Changes in cranial-facial proportions and fusion of bones occur throughout childhood – At birth, the cranium is much larger than the face, and several bones are still unfused – By nine months, the cranium is half the adult size due to rapid brain growth – By age 8-9, the cranium has reached almost adult proportions – Between ages 6-13, the jaws, cheekbones, and nose become more prominent, due to expansion of the nose, paranasal sinuses, and development of permanent teeth FETAL SKULL DEVELOPMENTAL ASPECTS OF THE SKELETON • Curvatures of the Spine – The primary curvatures (thoracic and sacral curvatures) are convex posteriorly and are present at birth – The secondary curvatures (cervical and lumbar curvatures) are convex anteriorly and are associated with the child’s development – The secondary curvatures result from reshaping the intervertebral disc DEVELOPMENTAL ASPECTS OF THE SKELETON • Changes in body height and proportion occur throughout childhood – At birth, the head and trunk are roughly 1 ½ times the length of the lower limbs – The lower limbs grow more rapidly than the trunk, and by age 10, the head and trunk are about the same length as the lower limbs – During puberty, the female pelvis widens and the male skeleton becomes more robust GROWTH RATES DEVELOPMENTAL ASPECTS OF THE SKELETON • Effects of age on the skeleton – The intervertebral discs become thinner, less hydrated, and less elastic – The thorax becomes more rigid, due to calcification of the costal cartilages – All bones lose bone mass HOMEOSTATIC IMBALANCE • Cleft Palate: – Condition in which the right and left halves of the palate fail to fuse medially • Dysplasia of the hip: – Acetabulum forms incompletely or the ligaments of the hip joint are loose, so the head of the femur slips out of its socket