• Dwarfism
–
Achondroplasia
•
Abnormal projection from a bone due to bony overgrowth
–
Bony spur
• Pain in bone
– Ostealgia
• Bone inflammation
– Osteitis
• Inflammation of bone and bone marrow caused by pus-forming bacteria
– Osteomyalitis
• Bone cancer in a long bone of limb
– Osteosarcoma
• Fracture in diseased bone involving slight (coughing or quick turn)
–
Pathological fracture
• Placing sustained tension on a body region to keep fractured bone in alignment
– Traction
1

• Name the 5 zones
Resting cartilage
Proliferation
Hypertrophy
Erosion (Calcification)
Diaphysis (ossification)
2

•
1.
Chondro’s resting in
Lacunae
2.
Not mitotically dividing
3.
Not actively contributing to bone growth
4.
Near epiphysis
5.
Scattered chondro’s
•
What is the Role of this zone?
1.
To anchor the rest of the epiphyseal plate to the epiphysis
3

•
1.
Chondro’s proliferating and dividing
2.
Supplying new chondro’s to replace those lost to lengthening of bone
3.
Proliferating cells stick up into narrow cells
4.
Cells resemble stack of coins
4

•
1.
Cellular breakdown
2.
Chondro’s begin to break down and produce alkaline phosphatase
3.
Enzyme facilitates calcification of extra cellular matrix
4.
Large chondro’s arranged in columns
5

•
1.
Calcium salts deposited in cartilage matrix by osteoids
2.
Osteogenesis, osteoblasts laying down the matrix
3.
Only a few cells thick
4.
Dead cells because the matrix around them became calcified
5.
Calcified matrix destroyed by osteoclasts
(acids and enzymes), then invaded by osteoblasts and capillaries from diaphysis
6.
Diaphyseal border of the plate firmly cemented to the bone of the diaphysis
6

•
1.
Long spiracles
(tuberculae) that form spongy bone produced
7

• Clavicle:
–
Medially with sternum manubrium
–
Laterally acromium of scapula
•
Scapula:
–
Lateral with head of humerus at glenoid cavity
–
Distally, medial ulnar notch of radius to ulna and carpals
• Ulna: (little finger side)
–
Proximal – trochlea of humerus
–
Distal – medial with radius at radioulnar joint
•
Humerus
–
Proximal with scapula
–
Distal with radius and ulna
• Radius: (lateral thumb side)
–
Proximal with capitulum of humerus
–
Medial with radial notch of ulna
8

•
A rounded articulating process
– Condyle
•
Any bony projection
– Process
•
A projection located above a condyle
– Epicondyle
•
A large rounded or irregular process
– Tuberosity
•
A small rounded process
– Tubercle
•
A very large, often blunt process
– trochanter
•
A sharp, slender process
– Spine
• A hook-shaped process
–
Hamulus
• A very slight ridge of bone
– Line
• A prominent ridge of bone
– Crest
•
A smooth flattened articulating surface
– Facet
9

• A hole in a bone through which nerves and blood pass
–
Foramen
•
A tunnel-like passage through a bone
–
Meatus or canal
• A cavity within a bone
– Sinus
• A furrow on a bone’s surface
–
Sulcus or Groove
• A slit-like opening in a bone
–
Fissure
•
A shallow depression
–
Fovea
10

• Tubular shaft of the long bone
– Diaphysis
• Part of long bone where growth occurs
–
Epiphysis
•
Irregularly arranged lamellae and osteocytes interconnected by canaliculi
–
Spongy bone (Cancellous,
Trabeculae bone)
• Marrow cavity in the shaft of long bone
–
Medullary cavity
• Hematopoietic tissue found within trabecular cavities of spongy bone
–
Red marrow
• Fat that fills cavities of bones
– Yellow marrow
• Membrane covering internal bone surfaces
– Endosteum
• Highly vascularized membrane covering the exterior of the diaphysis
– Periosteum
• Disc of hyaline cartilage that grows during childhood to lengthen the bone
– Epiphyseal plate
11

•
Support
• Bones support the body and organs
• Protection
– Protect vital organs: skull, sternum, vertebrae, ribs
• Movement
– Skeletal muscle contraction causes movement
• Mineral storage
– Calcium and other minerals stored in bone can be released into the bloodstream when needed (hormonal control)
•
Formation of blood cells
– Hematopoiesis occurs in blood marrow resulting in the production of red and white blood cells and platelets
12

•
–
–
•
–
13

• Long bone
– Shaft with a wide portion at both ends
–
Primarily compact bone with spongy at the widened areas
– Humerus, radius, ulna, femur, tibia, fibula, phalanges
•
Short bones
– Cube shaped, mostly cancellous bone
– Wrist, ankle
–
Sesamoid – short bones embedded within tendon (patella)
•
Flat bone
–
Thin and flat
– 2 layers of compact with spongy between
– Sternum, ribs, skull
•
Irregular bone
– Spongy with odd shape
–
Vertebrae and hip
14

•
Composed of?
–
Osteons or Haversion systems
•
Interspersed with?
–
Blood, lymphatic vessels and nerves
•
Concentric rings of compact bone called ____________ surround hollow passageways called ____________________
–
Lamella, Haversion canals
•
What connects Haversion canals?
– Volkman’s canals
•
Canals are lined with what tissue?
–
Endosteum
•
Where do osteocytes reside?
–
Lacunae
•
What connects the lacunae?
–
Canaliculi
• What are the canaliculi’s function?
–
Permit nutrients and oxygen to pass between osteocytes
–
Remove wastes
•
What are interstitial lamellae?
–
Layers of bone that fill gaps between osteons
•
What are circumferential lamellae?
–
Large rings of bone extending around the entire shaft of the bone
15

16

• What are the organic components of bone?
–
Osteocytes, osteoblasts, osteoclasts
– osteoid
• What is the Osteoid comprised of?
–
Collagen fibers, proteoglycans, and glycoproteins
• What is its function?
–
Flexibility and tensile strength on bone
•
What are the inorganic components?
– Hydroxyapatites (mineral salts) which are mostly calcium phosphates
(tiny crystals from the blood stream deposited among collagen fibers)
• What are they responsible for?
–
Hardness of the bone
• What are bone markings?
–
Bulges, depressions, rough spots, holes on the exterior surface of the bone
–
Most are muscle or ligament attachment sights
17

•
•
18

•
What is it?
–
The process of bone developing from a fibrous tissue
• What bones are formed this way?
– Flat bones such as the skull and clavicles
• Explain the process:
–
Fibrous connective tissue in developing fetus become?
– scattered with osteoblasts that begin secreting organic matrix.
–
Osteoid is?
– then mineralized and osteoblasts become osteocytes
– Osteoid accumulates in?
– small networks of collagen fibers called trabeculae.
– This early bone formation is called?
– woven bone.
–
The periosteum forms around the?
– woven bone.
–
Trabeculae thickens until they become?
– plates of bone.
–
Eventually these plates of woven bone are replaced by?
– compact bone.
– Spongy bone remains in the center of the bone and the vascular tissue within it?
– differentiates into red marrow (formation of diploe)
19

20

21

22

23

•
What is it?
–
The process of bone formation where hyaline cartilage is used as the model for constructing bone. Most bones are formed this way
• Explain the process:
– The perichondrium surrounding the hyaline cartilage bone model becomes infiltrated with?
– blood vessels, converting it into periosteum.
– Osteoblasts in the periosteum secrete?
– osteoid externally onto the shaft of the hyaline bone
–
The matrix deep within the shaft of the cartilage begins to?
– deteriorate
–
A periosteal bud containing arteries, veins, nerves and lymph vessels
– invades?
the internal cavity of the forming bone.
–
Osteoblasts from the periosteal bud begin to?
– deposit osteoid, forming trabeculae of bone (early spongy bone)
– Osteoclasts break down new spongy bone and open a?
– medullary cavity in the center of the shaft
– Secondary ossification centers form shortly before or after?
– birth in the epiphyses of the bone.
–
Spongy bone is eventually formed with hyaline cartilage remaining
– only at the?
epiphyseal plate and the articular cartilages
24

Hyaline cartilage
Primary ossification center
Secondary ossification center
Articular cartilage
Epiphyseal blood vessel
Spongy bone
Deteriorating cartilage matrix
Spongy bone formation Medullary cavity
Epiphyseal plate cartilage
Bone collar
Blood vessel of periosteal bud
Formation of bone collar around hyaline cartilage model.
Cavitation of the hyaline cartilage within the cartilage model.
Invasion of internal cavities by the periosteal bud and spongy bone formation.
Formation of the medullary cavity as ossification continues; appearance of secondary ossification centers in the epiphyses in preparation for stage 5.
Ossification of the epiphyses; when completed, hyaline cartilage remains only in the epiphyseal plates and articular cartilages
25

•
–
•
–
•
The widening of bones
26

•
•
•
•
•
•
•
The top layer (epi side) of hyaline cartilage plate contains actively dividing chondrocytes that are pushed towards the ________________?
•
Diaphysis
What does this do?
•
Causes the entire bone to lengthen
•
What happens to the chondrocytes as they get closer to the shaft?
They enlarge and eventually die
•
What occurs at the junction of the epiphysis and the diaphysis?
Osteoblasts begin to secrete bone matrix and form small spicules of bone
•
What promotes the adolescent growth spurt and eventually leads to the closure of epiphyseal plate?
Sex hormones
•
What happens as adolescence ends?
The epiphyseal plate becomes smaller and is entirely replaced by bone tissue
•
What is the result of this occurring?
Bone growth ends
27

28

29

• The process used to?
– Widen bones
•
_____________ beneath the _____________ form new
______________ systems on the outer surface of the bone
– Osteoblasts, periosteum, Haversian
• ________________ on the ________________ break down bone to enlarge the ______________ cavity.
–
Osteoclasts, endosteum, medullary
30

Artery
Periosteal ridge
Periosteum
Penetrating canal
Central canal of osteon
1 Osteoblasts beneath the periosteum secrete bone matrix, forming ridges that follow the course of periosteal blood vessels.
2 As the bony ridges enlarge and meet, the groove containing the blood vessel becomes a tunnel.
3 The periosteum lining the tunnel is transformed into an endosteum and the osteoblasts just deep to the tunnel endosteum secrete bone matrix, narrowing the canal.
4 As the osteoblasts beneath the endosteum form new lamellae, a new osteon is created. Meanwhile new circumferential lamellae are elaborated beneath the periosteum and the process is repeated, continuing to enlarge bone diameter.
31

•
What is bone remodeling?
–
Process where bone is resorbed and deposited at periosteal or endosteal surfaces
•
What should the rate of bone resorption be in healthy adults?
–
The same rate as deposition so the total mass remains constant
• What is bone deposit?
–
Osteoblasts laying down new osteoid which is later mineralized into bone
•
How is bone resorption carried out?
– by osteoclasts secreting enzymes onto the bone that digest organic matrix. The osteoclasts also secrete acids that help to make the calcium salts more soluble
•
What is PTH?
–
Parathyroid hormone
–
Hormone produced by the parathyroid gland in response to low blood calcium levels.
–
It stimulates bone resorption so that calcium is released and put back into the blood
•
What is Calcitonin?
– A protein produced by specialized “C” cells in the thyroid and secreted when blood calcium levels rise
–
Inhibits bone resorption and enhances calcium deposit in the bone matrix
32

• How much of our bone mass is recycled every week?
–
5 to 7%
• How often is spongy bone replaced? Compact bone
–
Every 3 to 4 years
–
Every 10 years
• What are remodeling units?
–
Packets of adjacent osteoblasts and osteoclasts that coordinate bone remodeling
• What is bone deposit?
– Added bone for injured or strength of bone
•
What is an osteoid seam?
– The marking of new matrix deposits by osteocytes (band of gauzy looking bone matrix)
• What helps trigger calcification?
–
Calcium and phosphate ions
33

• What happens when calcium and phosphate mix reach a certain level?
–
Tiny crystals of hydroxyapatite form and catalyze further crystallization of calcium salts in the area
• What are other factors involved?
–
Matrix proteins binding and concentrating calcium
–
Alkaline phosphatase mineralizing
• When the conditions are met, what happens?
–
Calcium salts are deposited all at once and with great precision throughout the mature matrix
34

• What accomplishes this?
–
Osteoclasts
• As they move along the bone surface what do they do?
–
Dig grooves called resorption bays and break down bony matrix
• How does the area of bone destruction seal off?
–
By osteoclasts that touch the bone forming a ruffled membrane that clings to the bone, sealing it off
•
What does the ruffled border secrete and what does this do?
– Lysosomal enzymes – digest organic matrix
– Hydrocholoric acid – converts calcium salts into soluble forms in order to make them pass easily into solution
• What happens to these products?
–
They are endocytosed and then released into the blood
• What cells are important in this process?
–
T cells
35

• What regulates remodeling?
–
2 control loops:
•
Negative feedback that maintains Ca 2 Homeostasis in the blood
•
Gravitational forces acting on skeleton
• Why is calcium so important for the body?
– Nerve impulses
–
Muscle contractions
–
Blood coagulation
– Gland and nerve cell secretions
–
Cell division
• Where is 99% of calcium in the body?
– Bone minerals
• What range does the hormonal loop keep calcium?
– 9-11 mg per 100 ml of blood
• Where is calcium absorbed from?
–
Intestine
36

• What does the hormonal mechanism involve?
–
PTH – parathyroid hormone – parathyroid gland
– Calcitonin – produced by parafollicular cells (C-cells) of thyroid gland
• When is PTH released?
–
When calcium levels decline
• What does it do?
–
Stimulates osteoclasts to resorb bone, release calcium into blood
• What happens?
– Osteoclasts break down old and new matrix
•
What escaped digestion and why?
– Osteoid
– Because it lacks calcium salts
•
When does the stimulus for PTH end?
– When blood concentrations of calcium rise
37

• What is secreted when calcium levels rise?
–
Calcitonin
• What is its function?
–
Inhibit resorption, encourage deposition
–
Reduce blood calcium
• What happens when blood calcium levels fall?
–
Calcitonin release wanes
• Are these responses to preserve bone strength?
–
No. They are for maintaining blood calcium homeostasis
• What happens if levels are low for a long time?
–
Bones demineralize and develop large, punched out holes
38

39

• What is Wolff’s law?
– Bones grow and remodel in response to the demands placed on it?
• What are other observations of Wolff’s law?
– Long bones thickest midway along diaphysis (where stress is greatest)
– Curved bones thickest where most likely to buckle
–
Trabeculae form trusses along lines of compression
– Large bony projections occur where active heavy muscles attach
•
How do forces communicate with remodeling cells?
–
Electrical signaling
•
What are hormonal loops function in remodeling?
– Whether and when remodeling occur
•
What are mechanical stresses functions?
– Where remodeling will occur
40

•
Location of bone after fracture:
– Non-displaced – normal end positions
– Displaced – out of normal alignment
• Completeness of break:
–
Complete – all the way through
–
Incomplete – not all the way
•
Orientation:
–
Linear – parallel of long axis
– Transverse – perpendicular to axis
• Skin penetration:
– Open – penetrates the skin
–
Closed – skin not penetrated
41

1.
Hematoma formation:
1.
Clotted blood forms at site
2.
Bone cells die, tissue becomes inflamed
2.
Fibrocartilaginous callus formation:
1.
Capillaries grow into hematoma
2.
Phagocytes begin cleaning debris
3.
Fibros and osteos begin reconstructing bone
4.
Fibros repair collagen, chondros repair cartilage
5.
Osteos form spongy bone secrete bulging cartilage matrix that later calcifies
6.
Fibrocartilaginous callus splints broken bone
3.
Bony Callus formed:
1.
Trabeculae appear in callus, convert it to bony callus
4.
Bone remodeling:
1.
Bony callus remodeled
42

•
–
Fragments into 3 or more pieces (aged, brittle boned)
•
– Crushed
•
–
Ragged break, excessive twisting (sports)
•
– Epiphysis separated from diaphysis
•
–
Broken inward
•
–
Incomplete break on one side, other side bends
43

• What does electrical stimulation do to a fracture?
–
Dramatically increases healing time
• What is the piezo electric effect?
–
Minute electrical currents are produced when minerals are stressed
• What happens in regions of negative electrical charge? Positive?
–
Negative – bone deposited
–
Positive – bone resorbed
• What effect does ultrasound treatment produce on fractures?
–
Reduce healing times 35 to 45%
• What is VEGF? Function?
–
Vascular endothelial growth factor
–
Stimulates blood vessel growth
44

•
What is osteoporosis?
–
Group of diseases in which bone resorption occurs more than bone deposit
• What are the results of the disease?
–
Reduced bone mass
•
Which bones are most susceptible?
– Vertebrae, neck of the femur
•
Who is most likely to have this disease?
–
Postmenopausal women
• Why?
–
Estrogen loss
•
What are some contributors?
–
Insufficient exercise
–
Poor calcium intake
–
Vitamin D or Calcitonin metabolism problems
–
Smoking, drinking
–
Immobility
45

•
What is it?
– Inadequate bone mineralization
– Osteoid deposited but calcium salts are not
•
Weight bearing bones?
–
Fracture, bend, deform
•
What are Rickets?
–
Bowing of the legs and deformed pelvis
• What causes this?
–
Insufficient calcium or vitamin D intake
46

• What is Paget’s Disease?
– Excessive, abnormal bone formation and resorption
•
What causes this?
– High ratio of woven bone to compact bone and bone mineralization reduction
•
What is the result?
– Soft, weak bones
47

•
–
20%
•
– 206
•
– Fibrous tissue that connect bones at joints
48

•
•
– 80
•
– Skull, vertebrae, rib cage
•
•
– 126
•
–
Upper, lower limbs, shoulders, hips
49

• How many bones?
–
22 including cranial and facial
•
What kind, how do they articulate?
–
Flat, sutures
• What is the top, lateral and posterior of skull called?
– The Calvaria
• What are the 3 base regions?
– Anterior, middle, posterior cranial fossae
• What are the 4 pair of cavities called and what are they?
–
Paranasal sinuses - Sphenoid, Ethmoid, Maxillary, Frontal
– Lighten the skull and give resonance to the voice
• What is each cavity lined with?
–
Mucous membranes that form the mucus that drains into the nasal cavity
•
What are Orbits?
–
Eye cavities
–
Surrounded by fatty tissue
– Formed by 7 bones
50

• What is the Nasal cavity composed of?
–
Bone and hyaline cartilage
• What is the roof, superior/lateral walls and superior nasal septum formed by?
–
Ethmoid bone
• What is the floor formed by?
–
Anteriorly – maxilla
–
Posteriorly – palatine bones
• What is the cavity divided by?
–
Nasal septum
• What is the Nasal septum formed by?
–
Perpendicular plate of ethmoid, vomer, and septal cartilage
• Where is the nasal concha and what does it do?
–
Lateral walls
–
Increase turbulence of air to help trap particles in mucus
51

•
What are the conchae and septum lined with and what does it do?
–
Mucosa
–
Helps lighten air and secrete mucus
• What is the Cribriform plate and what does it do?
– Part of ethmoid bone in roof of nasal cavity
– Has small openings for olefactor (smell) nerves to pass through on their way to the brain
52

• How many vertebrae?
–
33 , some fused in adults
• What separates them?
–
Fibrocartilage called intervertebral disc
–
Inner portion of disc contain jelly-like sub for elasticity
• What is a herniated disc?
–
Jelly-like sub is pushed out by pressure putting pressure on spinal nerve
• What are the curvatures of the vertebrae?
– Thoracic – bow out
–
Lumbar – curve in
53

• What makes up the appendicular skeleton?
–
Pectoral and pelvic girdle
– Upper and lower limbs
• What is the only attachment of arms to body?
–
Scapula
• Does the fibula articulate with the femur?
–
No. Only with the Tibia
• What do both the fibula and tibia articulate with distally?
–
Talus bone to form the ankle
54

55

• What is body’s most complex structure?
–
Skull
•
What bones form it? How many?
–
Cranial and facial bones
–
22
• What are the functions of the facial bones?
–
Form framework for face
–
Contain cavities for sense organs for sight, taste, smell
– Air and food passageways
–
Secure teeth
– Anchor expression muscles
• What kind of bones are found in the skull?
–
Flat (except mandible)
• What unites these bones?
–
Interlocking sutures
• What are the major sutures?
– Coronal
–
Sagittal
–
Squamous
– Lambdoid
56

• What is the cranial vault?
–
The Calvaria
– The superior, lateral and posterior aspects of the head including the forehead
• What is the cranial base or floor?
–
Inferior aspects of skull
• What are the 3 internal fossae of the base of the skull?
–
Anterior, middle and posterior cranial fossae
• What sits in these fossae?
–
The brain
•
What are the smaller cavities of the skull?
– Middle, inner ear
– Nasal
–
Orbits
• How many openings are in the skull?
– 85
•
What are their functions?
– Spinal cord passage
– Blood vessels
– nerves
57

•
– 8
•
– Parietal (pair)
–
Frontal
– Occipital
–
Sphenoid
– Ethmoid
–
Temporal (pair)
•
–
The helmet around brain
58

• What is medical term for forehead?
–
Frontal squama
• What are the supraorbital margins?
–
Thick, margin under eyebrows
• What does the anterior cranial fossa support?
–
Lobes of the brain
• What allows the supraorbital artery and nerve to pass to the forehead?
–
Supraorbital foramen
• What is the smooth portion between the eyes called?
–
Glabella
• What are the nasal sutures called?
–
Frontonasal sutures
• What is riddled around the glabella?
– Frontal sinuses
59

• Where are these bones?
–
Superior and lateral skull
• They form the bulk of the cranial ________?
–
Vault
• What occurs where the parietal bones articulate with other cranial bones?
–
The four largest sutures
60

•
– Coronal
•
–
Sagittal
•
–
Lambdoid
•
– squamous
61

• What is it?
–
Lower jaw
•
What does it consist of?
–
Body, ramus, mandibular notch, condyles, coronoid process
• What does the mandibular body do?
– Anchors the lower teeth
• What is the alveolar margin for?
–
Contains the sockets where teeth are embedded
• What does the mandibular symphysis indicate?
–
Where the 2 mandible bones fused during infancy
•
What are the nerve entrances called?
–
Mandibular foramina
62

–
Insertion for temporalis muscle
•
–
Articulate with temporal bones for movement of jaw
•
–
Fusion point of mandible
•
–
Teeth sockets
•
–
Admit inferior alveolar nerve
•
–
Blood vessel and nerves to chin and lower lip
63

• What area of face?
–
Upper jaw, central portion
•
What articulates with it?
–
All facial bones except mandible
• Why is it keystone of face?
– All bones articulate with it. (- mandible)
• What part of maxilla carry upper teeth?
– Alveolar margin
• What is the function of incisive fossa?
–
Passage for blood vessels, nerves
•
What articulates with the maxilla laterally?
–
Zygomatic process
• What forms the bony roof of the mouth?
– Palatine processes
• What is at the junction of maxilla and greater wing of the sphenoid?
–
Inferior orbital fissure
64

• Alveoli
–
Tooth socket
• Zygomatic processes
–
Form zygo arch
• Palatine
–
Form anterior hard palate
• Frontal
–
Form lateral part of nose bridge
• Incisive fossa
–
Admit blood vessels, nerves through hard palate
• Inferior orbital fissure
–
Admit maxillary branch of cranial nerve V, zygo nerve, blood vessels
• Infraorbital foramen
– Nerve to skin of face
65

• Zygomatic:
• Articulation:
– Zygomatic processes of temporal posteriorly
–
Zygomatic processes of frontal superiorly
–
Zygomatic processes of maxilla anteriorly
• Nasal bones:
• Articulation:
–
Frontal bone superiorly
– Maxilla laterally
–
Perpendicular plate posteriorly
– Inferiorly to cartilage that form external nose
• Lacrimal bones:
• Articulation:
– Frontal superiorly
–
Ethmoid posteriorly
–
Maxilla anteriorly
66

• Palatine bones
• Articulation:
• What are the important plates?
–
Horizontal, perpendicular
• What are the 3 processes?
–
Pyramidal
–
Sphenoidal
–
Orbital
67

Lesser wing of sphenoid
Orbital plate of frontal
Supraorbital foramen
Superior
Orbital fissure Optic canal
Zygo process of frontal
Greater wing of sphenoid
Orbital surface of zygo
Infraorbital fissure
Infraorbital groove
Zygomatic bone
Infraorbital foramen
Medial wall:
Sphenoid body
Orbital plate of ethmoid
Frontal process of maxilla
Lacrimal
Nasal bone
Floor of orbit:
Orbital process of palantine
Orbital surface of maxillary
Zygomatic bone
68

• What is it constructed of?
–
Bone and hyaline cartilage
•
What is the roof formed by?
–
Cribriform plate of ethmoid
• What shapes the lateral walls?
– Superior, middle conchae of ethmoid, perpendicular of palatine
• What are the depressions under the conchae?
– Superior, middle, inferior meatus
• What is the floor formed by?
–
Palatine processes of maxillae and palatine bones
•
What divides the nasal cavity?
–
Septum
• What is the bony part of septum?
– Vomer
• What cartilage completes the septum anteriorly?
–
Septal cartilage
69

Superior, middle, and
Inferior meatus
Frontal sinus
Superior nasal concha
Middle nasal concha
Inferior nasal concha
Nasal bone
Anterior nasal spine
Maxillary bone
(Palatine process)
Sphenoid sinus
Pterygoid process
Palatine bone
Perpendicular
Palatine bone horizontal
70

71

• Where?
–
Just inferior to mandible in the neck
• What is unique about this bone?
–
Does not articulate directly with any other bone
• What is anchored by?
–
Stylohyoid ligaments
• To What?
–
Styloid processes of temporal
• What is its function?
–
Move tongue
– Attach muscles that raise/lower larynx for speech, swallowing
72

1.
Frontal Bone
2.
Supra-Orbital Foramen
3.
Orbit (Orbital Cavity)
4.
Superior Orbital Fissure
5.
Inferior Orbital Fissure
6.
Zygomatic Bone
7.
Infra-Orbital Foramen
8.
Maxilla
9.
Mandible
10.
Mental Foramen
11.
Incisive Fossa
12.
Symphysis
13.
Vomer
14.
Inferior Nasal Concha
15.
Middle Nasal Concha
16.
Perpendicular Plate of
Ethmoid
17.
Nasal Bone
18.
Lacrimal Bone
73

1.
2.
3.
4.
Parietal Bone
Coronal Suture
Frontal Bone
Nasal Bone
5.
6.
7.
8.
Vomer
Lacrimal Bone
Orbital Part of Ethmoid
Zygomatic Bone
9.
Maxilla
10.
Body of Mandible
11.
Ramus of Mandible
12.
Coronoid Process
13.
Mandibular Condyle
14.
Mental Foramen
15.
Styloid Process
16.
External Acoustic Meatus
17.
Mastoid Process
18.
Zygomatic Process
19.
Temporal Bone
20.
Greater Wing of Sphenoid
21.
Inferior Temporal Line
22.
Superior Temporal Line
23.
Squamosal Suture
24.
Lambdoidal Suture
25.
Occipital Bone
74

1.
Parietal Bone
2.
Sagittal Suture
3.
Lambdoid Suture
4.
Occipital Bone
5.
External Occipital
Protruberance
6.
Superior Nuchal Line
7.
Inferior Nuchal Line
75

• Where is this bone?
–
Posterior wall and base of skull
• What sutures connect it to the temporal and parietal bones?
–
Lambdoid
–
Occipitomastoid
• What does the internal walls of occipital form?
–
Posterior cranial fossa
• What foramen is at the base of occipital?
–
Foramen magnum
• What are the occipital condyles?
–
Rocker like condyles that articulate with c1 and allow nodding of head
•
What does the external occipital crest secure?
– Ligamente nuchae
•
What do nuchal lines and bony regions do?
– Anchor many back muscles
76

• Foramen magnum
–
Spinal cord passage from brain stem to vertebral canal
• Hypoglossal canal
–
Passage of hypoglossal nerve (cranial nerve XII)
• Occipital condyles
–
Atlas articulation
• External protuberence/nuchal lines
–
Muscle attachments
• External Crest
–
Ligamente nuchae
77

1.
Occipital Bone
2.
Lambdoidal
Suture
3.
Parietal Bone
4.
Sagittal Suture
5.
Coronal Suture
6.
Frontal Bone
78

1.
2.
3.
4.
Frontal Sinus
Foramen Cecum
Crista Galli
Cribriform Plate
5.
6.
7.
8.
Anterior Cranial Fossa
Lesser Wing of Sphenoid
Chiasmatic Groove
Hypophyseal Fossa
9.
Dorsum Sella
10.
Optic Canal
11.
Anterior Clinoid Process
12.
Foramen Rotundum
13.
Foramen Ovale
14.
Foramen Spinosum
15.
Squamous Part of Temporal
16.
Petrous Part of Temporal
17.
Groove for Transverse Sinus
18.
Posterior Cranial Fossa
19.
Foramen Magnum
20.
Hypoglossal Canal
21.
Jugular Foramen
22.
Internal Acoustic Meatus
23.
Posterior Clinoid Process
24.
Foramen Lacerum
25.
Superior Orbital Fissure
79

1.
Mandibular
Condyle
2.
Mandibular Notch
3.
Coronoid Process
4.
Ramus
5.
Angle
6.
Oblique Line
7.
Body
8.
Alveolar Process
9.
Mental Foramen
10. Mylohyoid Line
11. Mandibular
Foramen
80

Parietal bone
Frontal squama
Of frontal bone
Nasal bone
Sphenoid
Temporal
Ethmoid
Lacrimal
Zygomatic
Infraorbital foramen
Maxilla
Mandible
Mental
Foramen
Mandibular
Symphysis
Frontal
Glabella
Frontonasal suture
Supraorbital foramen
Supraorbital margin
Superior Orbital fissure
Optic Canal
Inferior orbital fissure
Middle nasal concha
Perpendicular plate
Inferior nasal concha
Vomer
81

Coronal suture
Parietal bone
Temporal bone
Lambdoid suture
Squamous suture
Occipital bone
Zygomatic process
Occipitomastoid suture
External auditory meatus
Mastoid process
Styloid process
Mandibular condyle
Mandibular notch
Mandibular ramus
Mandibular angle
Frontal bone
Sphenoid bone
Ethmoid bone
Lacrimal bone
Lacrimal fossa
Nasal bone
Zygomatic bone
Maxilla
Alveolar margins
Mandible
Mental foramen
Coronoid Process
82

Sagittal suture
Parietal bone
Wormian bone
Lambdoid suture
Occipital bone
Superior nuchal line
External Occipital protuberance
Occipitomastoid suture
External Occipital crest
Occipital condyle
Inferior
Nuchal line
Mastoid process
83

Parietal bone
Squamous suture
Temporal bone
Lambdoid suture
Occipital bone
Occipitomastoid suture
External occipital Protuberence
Internal acoustic meatus
Sella Turcica of sphenoid
Pterygoid
Process of
Sphenoid
Palatine bone
Mandibular foramen Palatine process
Coronal suture
Frontal bone
Sphenoid bone
Frontal sinus
Crista galli
Nasal bone
Sphenoid sinus
Ethmoid bone
Vomer bone
Incisive fossa
Maxilla
Alveolar margins
Mandible
84

Maxilla
Palatine bone
Zygomatic bone
Temporal bone
Vomer
Mandibular fossa
Styloid process
Mastoid process
Temporal bone
Pharyngeal Tubercle of basoccipital
Parietal bone
External Occipital
Crest
External Occipital protuberence
Incisive fossa
Medial palantine suture
Infraorbital foramen
Maxilla
Sphenoid bone
Foramen ovale
Foramen lacerum
Carotid canal
External acoustic meatus
Stylomastoid foramen
Jugular foramen
Occipital condyle
Inferior nuchal line
Superior nuchal line
Foramen magnum
85

External Acoustic meatus
Squamous region
Mastoid region
Mastoid process
Styloid process
Zygomatic process
Mandibular fossa
Tympanic region
86

• How many? Where are they on skull?
–
2 (One on each side - inferior to parietal bones)
• What are the temporal’s four major regions?
–
Squamous,Tympanic, Mastoid, Petrous
• Functions of parts?
• Zygomatic process –
– helps form prominence of cheek
• External acoustic meatus –
– for hearing
• Styloid process –
– attach hyoid and neck muscles
•
Mastoid process –
– attach neck and tongue muscles
•
Carotid canal –
– passage of internal carotid artery
• Jugular foramen –
– passage of internal jugular vein and cranial nerves IX, X, XI
87

Greater wing
Hypophyseal
Fossa of sella turcica
Optic canal
Posterior clinoid process
Chiasmatic groove
Lesser wing
Greater wing
Anterior clinoid process
Foramen rotundum
Foramen ovale
Foramen spinosum
Dorsum Sellae
Body of sphenoid
88

Greater wing
Body of sphenoid
Posterior clinoid process
Superior orbital fissure
Foramen rotundum
Pterygoid process
Pterygoid plates
89

• Where?
–
Spans the middle cranial fossa
• Why is it considered the keystone of cranium?
–
Because it forms a central wedge that articulates with all other cranial bones
• What does it consist of?
– Central body, 3 pairs of wings
–
Greater, lesser, pterygoid processes
• What is the sella turcica?
– Area where pituitary gland is located
• What is the function of the anterior clinoid processes?
–
Anchor the brain to the skull
• What are the pterygoid processes functions?
–
Anchor pyterygoid muscles used for chewing
•
What are the optic canals for?
–
They allow optic nerves to pass to the eyes
• What is the superior orbital fissure’s function?
– It allows cranial nerves that control eye movements to enter the orbit
90

• Sella turcica
–
Seat of pituitary gland
• Optic canal
–
Passage of cranial nerve II, opthamolic arteries
• Superior Orbital fissures
–
Cranial nerves III, IV, part of V, opthamolic vein
• Foramen rotundum
–
Passage of maxillary division of cranial nerve V
• Ovale
–
Pass mandibular division of nerve V
• Spinosum
–
Pass middle meningeal artery
91

• Where?
–
Between sphenoid and nasal bones (between nasal and orbits)
• What forms roof of nasal cavity and floor of anterior cranial fossa?
–
Cribriform plate
• What are the tiny holes in cribriform that allow smell nerves to pass to the brain?
– Olfactory foramina
•
What is the crista galli’s function?
– Attach falx cerbri
•
What are some other parts of the ethmoid?
– Inferior, middle nasal concha
– Perpendicular plate
– Orbital plates
92

Olfactory foramina
Crista galli
Cribriform plate
Orbital plate
Ethmoid sinuses
Left lateral mass
Perpendicular plate
Middle nasal concha
93

Olfactory foramina
Anterior cranial fossa
Lesser wing
Greater wing
Tuberculum sellae
Hypophyseal fossa
Dorsum sellae
Posterior clinoid process
Middle cranial fossa
Temporal bone
Internal acoustic meatus
Posterior Cranial fossa
Parietal bone
Occipital bone
Foramen magnum
Frontal bone
Cribform plate
Crista galli
Ethmoid
Optic canal
Anterior clinoid process
Foramen rotundum
Foramen ovale
Foramen spinosum
Foramen lacerum
Jugular foramen
Hypoglossal canal
94

• How many bones? What kind of bones?
–
26, irregular
• Name some functions of vertebrae?
–
Transmits weight of trunk to lower limbs
–
Surround, protect spinal cord
– Attachment site for ribs and muscles of back and neck
• How many in fetus?
–
33 separate bones
• How many eventually fuse and what do they become?
–
9
– Sacrum, coccyx
• What are the divisions? How many bones in each?
–
Cervical – 7
– Thoracic – 12
–
Lumbar – 5
–
Sacrum
– Coccyx
95

• What are the four curvatures?
–
Cervical, lumbar – concave posteriorly
– Thoracic, sacrum – convex posteriorly
• What are some abnormal curvature disorders?
–
Scoliosis – Thoracic twisted
– Kyphosis – hunchback
• What are ligaments?
–
Bands of fibrous tissue that connect and support bones
• What are the ligs of the vertebrae?
–
Anterior, posterior longitudinal ligaments
• What are the intervertebral discs functions?
–
Shock absorbers during walking, jumping and running
96

•
What is the common structure of all vertebrae?
–
Body anteriorly
–
Vertebral arch posteriorly
–
Vertebral foramen for vertebral canal (spinal cord)
•
What forms vertebral arch?
–
Pedicles, laminae
•
What are pedicles?
–
Short, bony pillars that form side of arch (project posteriorly)
• What are laminae?
–
Flat plates that fuse in median plane (posterior)
•
How many processes project from vertebral arch?
–
7
Demifacet
(Thoracic
•
What are they?
Only
–
Spinous – median, at junction of 2 laminae
–
Transverse – lateral from each side of arch
–
Superior, inferior articular processes – smooth joints called facets (covered with hyaline cartilage) form movable joints with processes of vertebrae below and above them
Facet
(Thoracic
Only)
97

98

Cervical Thoracic Lumbar
99

100

101

• Characteristics:
–
Smallest, lightest
– First 2 unusual
–
Oval body
–
Wide
– Spinous short (except for C7)
–
Large foramen
–
Transverse foramen
– C7 is the vertebrae prominens
• C1 and C2 have
– no disc between
– Atlas – no body, spinous
•
Superior articular receive occipital condyle of skull
•
Inferior joins axis
– Axis –
•
Has dens (odontoid) process superiorly from body
•
Dens allow side to side movement
102

• Characteristics:
–
All articulate with ribs
– First looks like C7, last four look like
Lumbar
–
Increase in size from 1 st to last
–
Heart shape body
–
Demifacets on each side (superior and inferior) (T
10 to T
12 have single facet)
–
Demifacets receive ribs
–
Foramen circular
–
Long, pointed spinous
–
Superior and inferior facets lie mainly in frontal plane
103

• Characteristics:
–
Most stress
– Massive, kidney shaped body
– Pedicles and laminae shorter and thicker than other verts
–
Short, flat, hatchet shaped spinous (project backward)
–
Triangle foramen
–
Facets orientated different than other vertebrae
104

• Body:
–
C – small wide
– T – Larger than C, heart shaped
– L – Massive body
Cervical
• Spinous process:
– C – short, has V notch
– T – Long sharp, projects inferiorly
– L – Short blunt, projects posteriorly
•
Foramen:
– C – large triangle shaped
– T- small oval
–
L – small triangular shape
•
Transverse processes:
– C- contain foramen
–
T- Have facets for ribs
–
L – thin,tapered
Lumbar
Thoracic
105

1.
Anterior tubercle
2.
Anterior arch
3.
Facet for dens
4.
Transverse process
5.
Foramen transversarium or transverse foramen
6.
Superior articular facet on lateral mass
7.
Posterior arch
8.
Posterior tubercle
9.
Vertebral foramen
106

1.
Body
2.
Vertebral foramen
3.
Anterior tubercle
4.
Posterior tubercle
5.
Foramen transversarium or transverse foramen
6.
Demifacet for head of rib
7.
Superior articular process
8.
Pedicle
9.
Lamina
10.
Transverse process
11.
Spinous process or spine
12.
Lateral mass
13.
Posterior sacral foramina
14.
Coccyx
15.
Sacral hiatus
107

1.
Body
2.
Facet for head of rib
3.
Superior articular process
4.
Superior vertebral notch
5.
Pedicle
6.
Transverse process
7.
Inferior vertebral notch
8.
Inferior articular process
9.
Spinous process or spine
108

1.
C1 or atlas
2.
C2 or axis
3.
C3
4.
C4
5.
C5
6.
C6
7.
C7
8.
Body
9.
Vertebral foramen
10.
Bifid spinous process or spine
11.
Transverse process
12.
Foramen transversarium or transverse foramen
13.
Superior articular facet
109

1.
Superior
Articular
Surface
2.
Transverse
Foramen
3.
Transverse
Process
4.
Odontoid (Dens)
Facet
5.
Vertebral
Foramen
6.
Inferior
Articular
Surface
110

1.
Spinous Process
2.
Lamina
3.
Transverse Process
4.
Pedicle
5.
Superior Articular
Surface
6.
Odontoid Process
(Dens)
7.
Body
8.
Vertebral Foramen
9.
Inferior Articular
Surface
111

1.
Spinous Process
2.
Lamina
3.
Superior Articular
Surface
4.
Transverse
Foramen
5.
Transverse Process
6.
Body
7.
Pedicle
8.
Vertebral Foramen
112

1.
Spinous Process
2.
Lamina
3.
Superior
Articular
Surface
4.
Transverse
Process
5.
Pedicle
6.
Body
7.
Vertebral
Foramen
8.
Articular Facet for Rib
9.
Inferior
Articular
Surface
113

1.
Spinous
Process
2.
Lamina
3.
Superior
Articular
Surface
4.
Transverse
Process
5.
Pedicle
6.
Body
7.
Vertebral
Foramen
8.
Inferior
Articular
Surface
114

• Characteristics:
–
Formed by 5 fused verts
– Articulates superiorly with L
5
– inferiorly with coccyx, laterally with hip bone (sacroiliac joint)
–
Sacral promontory anterosuperior
–
Four ridges: The transverse lines cross concave anterior aspect, marking lines of fusion of sacral vertebrae
–
Ventral sacral foramina penetrate sacrum at lateral ends of transverse lines to transmit blood vessels and nerves
– Lateral to these and expanding superior are the alae
– Dorsal midline – median sacral crest
–
Dorsal sacral foramina
–
Lateral sacral crests
–
Vertebral canal – sacral canal
–
Sacral hiatus – opening where vert failed to fuse
115

1.
Promontory
2.
Transverse
Ridges (lines)
3.
Coccyx
4.
Body of Sacrum
5.
Sacral Canal
6.
Superior
Articular
Surface
7.
Median Sacral
Crest
8.
Sacrum to Ilium
Articular
Surface
9.
Dorsal Sacral
Foramina
10. Sacral Hiatus
alae
Ventral
Sacral foramina
Lateral sacral crest
116

1.
Articular Facet of
Rib
2.
Interarticular Crest
3.
Neck
4.
Articular Portion of
Tubercle
5.
Nonarticular Portion of Tubercle
6.
Angle of Rib
7.
Costal Groove
8.
Body (shaft) of Rib
9.
Articular Facet of
Transverse Process
10. Transverse Process
11. Spinous Process
12. Lamina
13. Vertebral Foramen
Sternal edge
117

Clavicular Notch
Costal facet
1.
Jugular Notch
2.
Manubrium
3.
Sternal Angle
4.
Body (Gladiolus)
5.
Xiphoid Process
118

119

• What is included in bony thorax?
–
Thoracic vertebrae dorsally, ribs laterally, sternum and costal cartilage anteriorly
•
How many ribs?
– 12 pairs
• What do they articulate with?
– Posteriorly – thoracic vertebrae
–
Anteriorly – superior 7 rib pairs – directly to sternum (true)
–
5 (false) – indirectly to sternum or no sternal
– Ribs 8-10 connect to cartilage joining to rib above
–
Ribs 11-12 – floating – no anterior attachment –
• Characteristics of ribs:
– Bowed flat bone
–
Superior smooth, inferior sharp and thin
–
Costal groove – lodges nerves and blood vessels
– Head and tubercle – join to the body and transverse process of vert
–
Tubercle is posterior and superior
120

121

•
Where?
–
Across superior thorax
•
Articulation:
–
Medial sternal end – to sternal manubrium
–
Lateral acromial end – scapula
• Medial 2/3’s convex anteriorly
• Lateral 3 rd concave anteriorly
• Superior surface is?
–
Smooth
•
Inferior surface is?
–
Ridged and grooved
•
Function
–
Anchor many muscles
–
Act as braces
–
Hold scapula and arms out laterally away from superior part of thorax
• Not very strong, easy to fracture
122

1.
sternal head
2.
superior surface
3.
sternal head
4.
inferior surface
5.
groove for subclavious muscle
6.
conoid tubercle
7.
trapezoid line
8.
acromial head
•
Identification aspects:
– Conoid tubercle always posterior/inferior
– Medial surface always convex, lateral concave
– Acromial - lateral
123

1.
Coracoid Process
2.
Scapular Notch
3.
Superior Border
4.
Supraspinous Fossa
5.
Superior Angle
6.
Scapular Spine
7.
Vertebral Margin
8.
Infraspinous Fossa
9.
Inferior Angle
10. Lateral Border
11. Glenoid Cavity
Margin (lateral angle)
12. Acromion Process
• Identification:
–
Spine-posterior
–
Glenoid - lateral
124

1.
superior angle
2.
vertebral (medial) border
3.
inferior angle
4.
subscapular fossa
5.
infraglenoid tubercle
6.
glenoid fossa
7.
coracoid process
8.
Acromion
9.
suprascapular notch
125

126

• Where?
–
Dorsal surface of rib cage, between ribs 2 and 7
• What are the 3 borders?
–
Superior – shortest, sharpest
–
Medial (vertebral) – parallels vertebral column
– Lateral (axillary) – abuts the armpit and ends superiorly in a small shallow fossa, the glenoid cavity
• Articulation
–
Glenoid cavity articulates with humerus of the arm
• What are the 3 angles? Where do they meet?
–
Superior scapular border meets medial border at superior angle and lateral border at the lateral angle
– Medial and lateral borders join at the inferior angle
127

•
Features:
•
Anterior surface is?
–
Concave and relatively featureless
•
Posterior surface?
–
Prominent spine easily felt through skin
–
Ends laterally in enlarged, roughened triangular projection called?
•
Acromion
–
Acromion articulates with?
•
Acromial end of clavicle
–
Which forms the?
•
Acromioclavicle joint
•
Projecting anteriorly from superior scapular border is what?
–
Coracoid process
• What is the coracoid process’ function?
–
Helps anchor the biceps of the arm
• Bounded by?
–
Suprascapular notch medially and glenoid cavity laterally
• Several large fossae appear on both sides of scapula. They are?
– Infraspinous and supraspinous fossae
–
Named for their location
–
Inferior and superior to the spine
•
What is the subscapular fossa?
– Shallow concavity formed by the entire anterior scapula surface
128

1.
Head
2.
Anatomical neck
3.
Lesser Tubercle
4.
Intertubercular Groove
5.
Greater Tubercle
6.
Surgical Neck
7.
Deltoid Neck
(tuberosity)
•
Identify:
• Head – medial
•
Shallow, distal coronoid fossa – anterior
•
Capitulum – anterior lateral
129

1.
Radial Fossa
2.
Lateral Epicondyle
3.
Capitulum
4.
Trochlea
5.
Medial Epicondyle
6.
Coronoid Fossa
7.
Olecranon Fossa
130

proximal to middle of the bone
• Location
–
Upper arm
• Articulation?
– proximal to the scapula (glenoid cavity)
– distal to the radius and ulna
•
What is at the proximal end?
–
Smooth hemispherical head
• What does it fit into to?
– Glenoid cavity
• What is immediately inferior to the head?
–
Anatomical neck
• What tubercles are just inferior to the neck?
–
Lateral greater tubercle
– Medial lesser tubercle
• What separates these tubercles?
–
Intertubercular (bicipital) groove
• What are tubercles function?
–
Sites where muscles attach
• What is distal to tubercles?
– Surgical neck
• What is midway down shaft laterally?
–
Deltoid tuberosity (roughened deltoid muscle attachment site)
• What runs obliquely down the posterior aspect of shaft marking the course of radial nerve?
– Radial groove
131

•
What are the 2 condyles at distal end?
– Medial trochlea – looks like hour glass tipped on side
–
Lateral capitulum – ball-like
•
What do these articulate with?
–
Ulna and radius
• What flanks these condyles?
–
Medial, lateral epicondyles (muscle attachment sites)
•
What is directly above these condyles?
–
Supracondyle ridges
•
What is responsible for the tingling feeling when “funny bone” is hit?’
–
Ulnar nerves that run behind the medial epicondyle
• Where is the coronoid fossa?
–
Superior to the trochlea on the anterior surface
•
Where is the Olecranon fossa?
–
Posterior to the coronoid fossa
132

• What is the function of the coronoid and olecranon fossae?
– They allow the corresponding processes of the ulna to move freely when the elbow is flexed and extended
• What receives the head of the radius when the elbow is flexed?
– Radial fossa
133

• Recognition aspects:
– Tuberosity – anterior/medial
– Styloid – lateral
– Concave surface above styloid - anterior
Radial Tuberosity
Anterior medial
Always anterior in
Anatomical position
134

• Location:
–
Lower arm
• Bones:
–
Radius, ulna
• Articulation
– Proximal end with humerus
–
Distal end forms joints with the wrist
–
Radius and ulna articulate with each other both proximally and distally at small radioulnar joints
•
What connects the radius and ulnar across their entire length?
–
Flexible, interosseous membrane
• What is the position of radius and ulna in anatomical postion?
– Radius – lateral on thumb side
–
Ulna – medial on little finger side
•
What happens in the prone position?
– Distal end of the radius crosses over the ulna and form an “X”
135

-right/ proximal/distal 1.
Olecranon process
2.
Trochlear notch
3.
Coronoid process
4.
Tuberosity
5.
Radial notch
6.
Ulna shaft
7.
Head of ulna
8.
Styloid process
• Identification aspects:
– Radial notch always lateral
– Styloid process-medial
136

•
Main responsibility?
–
Forming elbow joint with humerus
• What are the 2 main processes at proximal end?
–
Olecranon, coronoid processes
• What separates these?
– Trochlear notch
•
What does the locking of the olecranon process and olecranon fossa do?
– Keeps the forearm from moving posteriorly beyond the elbow joint
• Where does the ulna articulate with the head of the radius?
–
Radial notch
• Where is the ulnar head?
– At the distal end of the bone by wrist
• What is medial to the ulnar head?
–
Styloid process
• What separates the ulnar from the carpals?
–
A disc of fibrocartilage
• Does it have any role in hand movement?
–
Little to none at all
137

• What is the superior surface of the head – convex or concave?
– Concave
• Articulation
– Head proximal with the capitulum of the humerus
– Medially with the radial notch of the ulna
–
Distal where the radius expands, medial ulnar notch with the ulna
–
Carpal bones
•
The ulna contributes heavily to?
– The elbow
•
The radius contributes to?
– Wrist
•
What happens when the radius moves?
– The hand moves with it
138

1.
Styloid process of radius
2.
Navicular (Scaphoid)
3.
Lunate
4.
Triquetral
5.
Pisiform
6.
Trapezium
7.
Trapezoid
8.
Capitate
9.
Hamate
10. Metacarpal
11. Proximal Phalange
12. Middle Phalange
13. Distal Phalange
14. Styloid Process of Ulna
139

1.
Navicular (Scaphoid)
2.
Lunate
3.
Triquetral
4.
Pisiform
5.
Trapezium
6.
Trapezoid
7.
Capitate
8.
Hamate
9.
Metacarpal
10. Proximal Phalange
11. Middle Phalange
12. Distal Phalange
140

• What is the true wrist?
•
The carpus. The proximal part of the hand
•
How many bones are in the carpus? What are they called?
•
8 marble sized short bones
•
Carpals
• How are they arranged?
•
In 2 irregular rows of 4 bones each
• Which bones are in the proximal row? (lateral to medial)
• Scaphoid
•
Lunate
• Triquetral
• pisiform
• Which bones articulate with radius?
– Scaphoid, lunate
• What bones make up the distal row? (lat to med)
–
Trapezium
– Trapezoid
–
Capitate
–
Hamate
•
Sally – scaphoid
• Left – lunate
• The – triquetral
• Party – pisiform
• To- trapezium
•
Take – trapezoid
• Cathy – capitate
• Home - hamate
141

• How many? What are they named?
–
5, No name. They are numbered from 1 to 5 from thumb to little finger
• Articulation
–
Bases with carpals proximally
–
Each other medially and laterally
–
Heads with proximal phalanges distally
• What is meta #1 and why is it different from the rest?
–
The thumb
–
Does not have a middle phalanx
142

• What are other names for the phalanges?
–
Fingers, digits
• How are they numbered?
–
From 1 to 5 beginning with pollex (thumb)
• How many phalanges on each hand?
–
14
• What are the parts named?
–
Proximal
–
Middle
–
Distal
• Thumb no middle
143

1.
Anterior Superior Spine
2.
Iliac Crest
3.
Posterior Superior Spine
4.
Posterior Inferior Spine
5.
Greater Sciatic Notch
6.
Body of Ilium
7.
Ischial Spine
8.
Lesser Sciatic Notch
9.
Body of Ischium
10. Ischial Tuberosity
11. Obturator Foramen
12. Inferior Ramus of Ischium
13. Inferior Ramus of Pubis
14. Body of Pubis
15. Acetabulum
16. Anterior Inferior Spine 144

Identification:
•Acetabulum – lateral
•Pubis – anterior
•Ischial- posterior
1.
Iliac Fossa
2.
Anterior Superior Spine
3.
Anterior Inferior Spine
4.
Arcuate Line
5.
Obturator Foramen
6.
Symphysis Pubis
Articulating Surface
7.
Ischial Tuberosity
8.
Lesser Sciatic Notch
9.
Ischial Spine
10. Greater Sciatic Notch
11. Sacrum Articulating
Surface
12. Posterior Inferior Spine
13. Posterior Superior Spine
14. Iliac Crest 145

•
What are its functions?
– Attach lower limbs to axial skeleton
– Transmit upper body weight to lower limbs
– Support visceral organs of the pelvis
•
What are the hip bones named?
–
Os coxae
• Articulation
– Each other anteriorly
– Sacrum posteriorly
•
What is the hip, sacrum and coccyx called?
–
Bony pelvis
•
What are the 3 bones of the pelvis?
– Ilium
– Ischium
– Pubis
•
Are they separate?
– In childhood. Fuse in adults
•
What is the name of the deep lateral socket on the pelvis?
– Acetabulum
• What is its function?
What is the joint called?
1.
Receives head of femur
2.
Hip joint
146

• Where on the coxal?
–
Superior region
•
What does it consist of?
–
Body
–
Ala – wing
• Where is it thickest at?
–
Tubercle of iliac crest
•
Where does each iliac crest end?
–
Anteriorly – anterior superior iliac spine
– Posteriorly – posterior superior iliac spine
• What is below these?
–
Anterior, posterior inferior iliac spines
• What are these spines for?
– Attachment points for muscles of trunk, hip, thigh
• Where is the greater sciatic notch? What is it for?
– Inferior to posterior inferior iliac spine
–
Where sciatic nerve passes to enter thigh
• What makes up the posterolateral surface of the ilium?
– Gluteal surface
• What 3 ridges cross it?
– Posterior, Anterior, inferior gluteal lines
• What is the interior, concave area?
– Iliac fossa
• What is posterior to this?
–
Auricular surface
• What does ilium join anteriorly?
– Ischium, pubis
147

• What part of hip bone?
–
Posteroinferior
• Articulation
–
Body – ilium
–
Ramus – pubis anteriorly
• What are the 3 major markings?
–
Ischial spine – medially into pelvic cavity
–
Lesser sciatic notch – just inferior to ischial spine
– Ischial tuberosity – strongest part of hip bone. Inferior surface of ischial body
• What helps hold the pelvis together?
–
Sacrotuberous ligament – massive ligament from sacrum to ischial tuberosity
148

• Where?
–
Anterior of hip bone
•
V shaped consisting of?
–
Superior, inferior rami
–
Medial body
• Articulation
–
Medial to ischium
–
Inferior to ilium
• What does the anterior border form?
–
Pubic crest
•
What is at the lateral end of pubic crest?
–
Pubic tubercle
• What is the large opening of the hip bone?
– Obturator foramen
• What is the name of the fibrocartilage joining the 2 pubic bones?
–
Pubic symphysis
• What is the arch that differentiates male and female pelve?
–
Pubic arch
149

1.
anterior superior iliac spine
2.
superior pubic ramus
3.
ischial tuberosity
4.
inferior pubic ramus
5.
pubic symphysis
6.
pubic tubercle
7.
Acetabulum
8.
anterior inferior iliac spine
9.
iliac fossa
150

1.
iliac crest
2.
greater sciatic foramen
3.
ischial spine
4.
ischial tuberosity
5.
Coccyx
6.
sacrum (dorsum)
7.
posterior superior iliac spine
151

•
What is the difference between female and male pelvis?
–
Female
• wider, shallower, lighter and rounder
• Tilted forward
• What are the false and true pelvis?
– False
• superior to the pelvic brim
•
Bounded by alae laterally; lumbar vertebrae posteriorly
•
Part of abdomen
• Does not restrict childbirth
– True
•
Inferior to pelvis brim
•
Forms deep bowl containing pelvic organs
•
Dimensions critical for childbirth
•
What are the pelvic inlet and outlet?
– Inlet – pelvic brim
– Outlet – inferior margin of true pelvis
152

1.
Head
2.
Neck
3.
Greater Trochanter
4.
Intertrochanteric
Line
5.
Lesser Trochanter
6.
Shaft of Femur
7.
Gluteal Tuberosity
8.
Intertrochanteric
Crest
9.
Linea Aspera
•
Identification:
• Distal Patellar Surface
– anterior
• Intercondyle notch posterior
Fovea
Capitis
153

Lateral Epicondyle
Adductor tubercle
Medial
Epicondyle
Intercondyle notch
154

• Location
–
Upper leg
•
Articulation
–
Proximal – hip bone/ acetabulum
–
Distal – tibia
•
What is the name of the small central pit at the head?
– Fovea capitis
• What is at the junction of the shaft and neck?
– Greater and lesser trochanters
• What connects these trochanters?
–
Intertrochanteric line anteriorly
–
Intertrochanteric crest posteriorly
• What does the gluteal tuberosity blend into?
–
Linea aspera inferiorly
• What does the linea aspera diverge into?
–
Medial and lateral suprachondyle lines
• What are all of these markings?
– Muscle attachment sites
•
Distally, the femur widens into?
– Lateral and medial condyles
•
What flanks the condyles superiorly?
– Medial and lateral epicondyles
155

• What is the patellar surface?
– Articulation site for the patella
• What is the deep U-shape on the distal posterior aspect of femur?
– Intercondyle notch
• What is superior to this?
–
Smooth popliteal surface
• What is the patella?
–
Triangular, sesamoid bone enclosed in quadriceps that secures anterior thigh muscles to the tibia
156

Distal
Tibiofibular joint
Proximal
Tibiofibular joint
1.
Intercondylar
Eminence
2.
Lateral Condyle
3.
Tibial Tuberosity
4.
Anterior Crest
5.
Medial Condyle
6.
Anterior Surface
7.
Medial Malleolus
• Identify aspects:
–
Tibial tuberosity always anterior
– Flattened side always lateral
–
Medial malleolus always medial
157

• Location
–
Anterior shin bone
•
Articulation
–
Proximal – femur – tibia condyles to the femur condyles
–
Distally – talus of the foot
– Lateral to the fibula (tibiofibular joint)
• Parts
–
Broad proximal end
•
Medial and lateral condyles
•
Intercondyle imminence
–
Inferior to this
•
Tibial tuberosity – anterior
•
Lateral tibial condyle – proximal tibiofibular joint
–
Middle of bone
•
Anterior crest
–
Distal end
•
Medial malleolus
•
Distal tibiofibular joint
•
Articular surface
158

1.
Head of Fibula
2.
Neck of Fibula
3.
Anterior Crest
4.
Lateral Malleolus
•
Identifying aspects:
– Lateral malleolus always lateral
159

• Location
–
Posterior, lateral shin
• Articulation
–
Proximal with the tibia
–
Distal with the tibia medially and the talus distally
• Name of proximal and distal ends?
–
Proximal – head
–
Distal – lateral malleolus (ankle bulge)
• Does the fibula bear weight?
–
No
160

1.
Calcaneus
2.
Talus
3.
Navicular
4.
Cuboid
5.
Cuneiform, Middle
6.
Cuneiform, Intermediate
7.
Cuneiform, Lateral
8.
Metatarsal
9.
Proximal Phalange
10. Middle Phalange
11. Distal Phalange
161

• How many bones? Name them?
–
7
– Calcaneus
–
Talus
–
Navicular
– Cuboid
–
1 st Cuneiform (Hallux), 2 nd Cuneiform, 3 rd Cuneiform
• What 2 tarsals carry most body weight?
– Talus, calcaneus
• What does the Achilles tendon attach to?
– Posterior surface of calcaneus
• What part of calcaneus touches the ground?
–
Tuber calcanei, calcaneal tuberosity, sustentaculum tali
•
Name the remaining tarsals:
–
Lateral cuboid
–
Medial navicular
– Intermediate, lateral cuneiform
• What do the cuboid and cuneiform bones articulate with?
–
Metatarsal bones anteriorly
162

1.
Calcaneus
2.
Talus
3.
Navicular
4.
Cuboid
5.
Cuneiform, First
6.
Cuneiform,
Second
7.
Cuneiform, Third
8.
Metatarsal
163

• How many?
–
5 small bones
• Articulation
–
Distal – proximal phalanges of the toes
–
Proximal – tarsals
• What is the first metatarsal?
–
Great toe (Hallux)
• How are they identified?
–
By number laterally from big toe
164

• How many?
–
14
• 3 in each digit except the?
–
Hallux (big toe)
165

• A segmented structure can only hold weight if it is?
–
Arched
• What are the 3 arches of the foot?
–
Longitudinal – medial and lateral
–
Transverse arch
• What are the functions of these arches?
–
Strength
•
What maintains arches?
– Interlocking shape of foot bones
–
Strong ligaments
– Tendon pull during muscle activities
• Which arch curves above the ground?
–
Medial longitudinal
•
Which is very low?
–
Lateral longitudinal
•
Where is the weight of the body distributed by these arches?
– ½ to heel bones, ½ to heads of metatarsals
166

Kneeanterior/ posterior
1.
2.
3.
4.
5.
6.
7.
Tibial Collateral
Ligament
Medial Condyle of
Femur
Posterior Cruciate
Ligament
Anterior Cruciate
Ligament
Lateral Condyle of Femur
Fibular Collateral
Ligament
Lateral Condyle of Tibia
8.
9.
Lateral Meniscus
Medial Meniscus
10.
Medial Condyle of
Tibia
11.
Tibia
12.
Fibula
13.
Transverse
Ligament
167

168

• What types of cartilage does skeletal cartilage contain?
–
Hyaline, elastic, fibro
• What type of hyaline cartilage is in skeletal?
–
Articular – covers ends at movable joints
–
Costal – connect ribs to sternum
– Respiratory – skeleton of the larynx
– Nasal – support nose
• What type is elastic?
– External ear
– Epiglottis
•
What type is fibro?
– Discs between vertebrae
– knee
169

•
Appositional
– Cartilage-forming cells secrete new matrix against external face of existing cartilage
•
Interstitial
– Chondrocytes divide and secrete new matrix
–
Expand from within
•
When does growth end?
–
During adolescence
•
Is calcified cartilage bone?
–
No. Cartilage and bone are always distinct tissues
170

• What are the 2 groups?
–
Axial
– Appendicular
• What is the axial?
–
Skull, vertebrae, ribs
• Appendicular?
–
Upper/lower limbs, girdles (hips,shoulders)
171

•
Diaphysis
–
Shaft
–
Surrounds medullary cavity. Adults – yellow bone marrow
• Epiphysis
–
Bone ends
–
Interior spongy bone
–
Joint surface – articular cartilage
–
Epiphyseal line – between the diaphysis and epiphysis of adult bone; remnant of epiphyseal plate (hyaline that grows during childhood) Also called metaphysis
•
Membranes
–
Glistening white outer cover?
• periosteum
–
Where do nerve, blood, lymph enter diaphysis?
• Nutrient foramen
–
Periosteum secured to bone by?
• Sharpey’s fibers
• What covers internal bone surfaces?
– endosteum
172

•
– Thin plates of periosteum-covered compact bone sandwiching spongy bone in the middle
•
–
Shaft or epiphysis
•
–
Diploe
173

• Where is it found?
–
Within trabecular cavities in long bone
–
Diploe of flat bone
• What are those cavities called?
–
Red marrow cavities
• Where does blood production occur in adult long bone?
–
Only in head of femur and humerus
• What sites are usually more active and used for obtaining red marrow samples?
–
Diploe, irregular sites of flat bones (sternum, hip bone)
174

•
What do canaliculi do?
– Tie all the osteocytes in osteon together
– Permit nutrients and wastes to enter and exit
–
Maintain bone matrix
• What is interstitial lamellae?
–
Incomplete lamellae that fill the gaps between forming osteons
• What are circumferential lamellae?
– Lamellae just deep to the periosteum and superficial to the endosteum, that extend around the entire circumference of the diaphysis and resist twisting of the bone
175

• What is the skeleton of human embryo made of before week 8?
–
Entirely fibrous membranes and hyaline cartilage
• What is it called when a bone develops from fibrous membrane?
–
Intramembranous ossification
• What is the bone of this type of formation called?
–
Membrane bone
• What is it called when bone is formed by replacing hyaline cartilage?
–
Endochondral Ossification
• What is this bone called?
–
Cartilage or endochondral bone
176

• What bones are formed this way?
–
Skull
– Clavicle
• What type of bones formed this way?
–
Flat bones
• What are the 4 major steps?
Step One:
–
What appears in the fibrous tissue?
•
Ossification center
–
What do mesenchymal cells do at this stage?
•
Cluster
•
Differentiate into osteoblasts
•
Form the ossification center
Step Two:
– What do the osteoblasts do at this stage?
•
Secrete the osteoid
–
What do trapped osteoblasts become?
• osteocytes
177

Step 3:
–
What is formed in step 3?
•
Woven bone
•
Periosteum
–
What is a random network?
•
Accumulated osteoid laid down between blood vessels
– What does this form?
•
Trabeculae (spongy bone)
– What does vascularized mesenchyme condensing on the external face of woven bone become?
•
The periosteum
Step 4:
–
What does thickened trabeculae just deep to the periosteum form?
•
Woven bone collar
– What is this replaced by?
•
Mature lamellar bone
–
What is a diploe?
•
Compact bone sandwiching spongy bone
178

• What bones are formed this way?
–
All bones of the skeleton below the base of the skull
• What is the model this process uses?
–
Hyaline cartilage model
• When does the process begin?
–
2 nd month of fetal development
• What is the primary ossification center?
–
The region where long bone formation usually begins
• What sets the stage for this process to begin?
–
Perichondrium infiltrated by blood vessels converting it to periosteum
–
Mesenchymal cells specialize into osteoblasts
179

Step 1:
• What do the osteoblasts secretions against hyaline cartilage do?
– Encase it in a bone collar
Step 2:
• What does cartilage in the center of diaphysis do?
– Calcifies, cavitates (creates cavities)
• What do chondrocytes do at this stage?
– Hypertrophy (enlarge)
– Signal matrix to calcify
• What happens to the chondrocytes and the matrix at this stage?
– They die
–
Matrix deteriorates
• What happens to cartilage elsewhere?
– Remains healthy
–
Grows briskly
•
What does this cause the cartilage model to do?
– Elongate
180

Step 3:
• What is the periosteal bud?
–
Collection of elements
•
Nutrient artery
•
Vein
•
Lymphatics
•
Nerve fibers
•
Red marrow elements
•
Osteoblasts, osteoclasts
•
When does it appear?
– The 3 rd month of development
•
What are the osteoclasts and osteoblasts doing at this stage?
– Clasts – eroding calcified matrix
– Blasts – secreting osteoid around remaining cartilage
•
What is this forming?
– Trabeculae (earliest version of spongy bone)
181

• Step 4:
• What forms in stage 4?
–
Medullary cavity
182

183

• What are the 2 ways to classify joints?
–
Functional
– Structural
• Functional:
–
Synarthroses
•
Immovable (skull)
–
Amphiarthroses
•
Slightly movable (intervertebral, pubic symph)
– Diarthroses
•
Freely movable (limbs, joints of limbs)
• Structural:
– Fibrous
•
Bones joined by fibrous tissue – no joint cavity
•
Most immovable or slightly movable
184

• 3 types of fibrous joints:
• Sutures:
–
Rigid splices of interlocking bone
– Where’s the only place they occur?
•
Skull
•
Syndesmoses:
– Joints where bones connect by cord or sheet of fibrous tissue called a ligament
• Gomphoses:
–
Resembles peg or socket (teeth)
185

•
Bones connected by cartilage with no joint cavity
• 2 types:
• Synchondroses-
– Plate of hyaline cartilage connects the bones
– Epiphyseal plates of long bones, joint of 1 st rib and manubrium
•
Symphyses-
– Bones covered with articular hyaline cartilage fused to fibrocartilage plate.
– All amphiarthritic (intervertebral, pubic symphysis)
186

•
Articulating bones separated by fluid filled joint
• All have:
– Hyaline both bony surfaces
–
Joint cavity
–
2 layer joint capsule with outer fibrous layer
– Synovial membrane lining fibrous capsule
– All internal joint surfaces not covered with cartilage
– Synovial fluid fills joint capsule
•
May have:
– Wedges of fibro separating
– Sacs lined with synovial membrane
187

•
–
•
–
188

•
•
•
189

•
190

•
•
191

•
•
•
192

•
– Overstretched, torn ligaments
•
–
Torn or overused. Does not heal. Must remove
•
–
Bones forced out of position
•
–
Inflamed bursae, tendon sheath. Overuse, stress, bacterial, friction
•
–
Diseases that damage joints. Wear, bacteria, immune
193