Chapter 8 *Lecture Outline *See separate FlexArt PowerPoint slides for all figures and tables pre-inserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chapter 8 Outline • • • • • • Pectoral Girdle Upper Limb Pelvic Girdle Lower Limb Aging of the Appendicular Skeleton Development of the Appendicular Skeleton Appendicular Skeleton Figure 8.1 Pectoral Girdle • • Clavicle Scapula Figure 8.2 Clavicle • S-shaped • Articulations – medially with manubrium of sternum – laterally with acromion of scapula Figure 8.2 Scapula • Broad, flat triangle – three borders, three angles • Articulations – Lateral: glenoid cavity for head of humerus • Other features – Posterior: bony ridge = spine – Lateral: acromion process – Anterior projection: coracoid process Scapula Figure 8.3 Upper Limb • 30 bones per “arm” –Humerus in brachium (upper arm) –Radius and ulna in antebrachium (forearm) –8 carpal bones in wrist –5 metacarpals in palm –14 phalanges in fingers Humerus Proximal features: • Head: articulates with scapula • Anatomical and surgical necks • Greater and lesser tubercles: for muscle attachment • Intertubercular sulcus: for biceps brachii tendon Humerus Anterior View Anatomical neck Head Greater tubercle Head Lesser tubercle Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Intertubercular sulcus Surgical neck Deltoid tuberosity Shaft Coronoid fossa Radial fossa Coronoid fossa Lateral epicondyle Medial epicondyle Figure 8.4 Capitulum Trochlea (a) Right humerus, anterior view right: © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Capitulum Trochlea Humerus • Distal features: – Shaft – Deltoid tuberosity for attachment of deltoid – Medial and lateral epicondyles for muscle attachments – Capitulum: round lateral articulation for radius – Trochlea: spool-like medial articulation for ulna Humerus Distal fossae (depressions): • Anterior – Radial: lateral depression for radius – Coronoid: medial, for anterior ulna • Posterior – Olecranon: largest, for posterior ulna Humerus – Posterior View Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Head Greater tubercle Anatomical neck Surgicalneck Deltoid tuberosity Radial groove Lateral epicondyle Olecranon fossa Olecranon fossa Medial epicondyle Lateral epicondyle Medial epicondyle Figure 8.4 Trochlea Trochlea (d) Right humerus, posterior view (right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Radius and Ulna Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. • Antebrachial bones Olecranon Olecranon Trochlear notch Head –parallel to each other –in anatomical position, radius is lateral to ulna Neck Radius Coronoid process Head Proximal radioulnar joint Tuberosity of ulna Neck Radial tuberosity Shaft Ulna Radius Ulna Interosseous membrane Interosseous borders Distal radioulnar joint Head Figure 8.5 Styloid process Styloid process (a) Right radius and ulna, anterior view a(right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Styloid process Radius • • • Proximal features: – Head: articulates with capitulum of humerus – Neck: narrowest region – Radial tuberosity: for biceps brachii muscle Shaft Distal features: – – Styloid process: lateral “wrist bump” Ulnar notch: medial dent for head of ulna • Ulna Proximal features: – – – – • Trochlear notch: for trochlea of humerus Olecranon: posterior “elbow bump” for triceps brachii muscle Coronoid process: anterior tip of trochlear notch Radial notch: lateral, for head of radius Distal features: – – Head: knoblike end Styloid process: posteromedial “wrist bump” Radius and Ulna Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Olecranon Olecranon Posterior View Head Proximal radioulnar joint Neck Shaft Ulna Radius Ulna Radius Interosseous membrane Interosseous borders Head Head Figure 8.5 Distal radioulnar joint Styloid processes Styloid processes (f) Right ulna and radius, posterior view (right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Radius and Ulna (proximal and distal features) Figure 8.5 Carpus • 8 “wrist” bones – Figure 8.6 Two rows (1 proximal and 1 distal) of four Carpals Proximal Row (lateral to medial) Distal Row (lateral to medial) 1. 2. 3. 4. 5. 6. 7. 8. Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate Metacarpals • 5 in palm – named by Roman numerals I–V from medial to lateral Figure 8.6 Phalanges • 14 per hand – 3 per finger #2–5 • Proximal, middle, and distal – 2 in pollex (thumb) • Proximal and distal Figure 8.6 Pelvic Girdle • Girdle = right and left ossa coxae – with sacrum and coccyx = the pelvis Figure 8.7 Os Coxae • The “hip bone” – fusion of ilium, ischium, and pubis at 13–15 years of age • Articulations: – anteriorly with other os coxae – posteriorly with the sacrum – laterally with femur at acetabulum • all three bones of the os coxae contribute to the acetabulum Acetabulum Figure 8.9 Ilium • Largest of the three fused bones • Superior portion of os coxae and acetabulum • Features: – Ala: wide, fan-shaped portion – Arcuate line: ridge along inferior border of the ala – Iliac fossa: large depression on medial surface – Anterior, posterior, and inferior gluteal lines: lateral site of muscle attachments Ilium Copyright © The McGraw-Hill Companies, Inc. 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Iliac crest Iliac crest Ala Iliac fossa Anterior gluteal line Posterior gluteal line Anterior super ioriliac spine Posterior superior Iliac spine Anterior superior iliac spine Posterior superior iliac spine Inferior gluteal line Auricular surface Anterior inferior iliac spine Posterior inferior iliac spine Greater sciatic notch Anterior inferior iliac spine Posterior inferior iliac spine Arcuate line Greater sciatic notch Lunate surface Acetabulum Body of ischium Ischial spine Lesser sciatic notch Superior pubic ramus Pubic crest Pectineal line Ischial spine Superior pubic ramus Lesser sciatic notch Body of ischium Pubic tubercle Pubic tubercle Ischial tuberosity Symphysial surface Inferior pubic ramus Obturator foramen Obturator foramen Ramus of ischium Ilium Posterior Iliaccrest Anterior Ischium Ilium Anterior Lateral view Ramus of ischium Posterior Pubis Pubis Ischial tuberosity Inferior pubic ramus Iliac crest Ischium Medial view Ala Posterior superior iliac spine Anterior gluteal line Iliac fossa Posterior gluteal line Posterior superior iliac spine Posterior inferior iliac spine Anterior superior iliac spine Anterior superior iliac spine Inferior glutealline Greater sciatic notch Anterior inferior iliac spine Auricular surface Posterior inferior iliac spine Anterior inferior iliac spine Arcuate line Body of ischium Lunate surface Greater sciatic notch Acetabulum Ischial spine Ischial spine Pectineal line Lesser sciatic notch Superior pubic ramus Lesser sciatic notch Superior pubic ramus Body of ischium Pubic tubercle Ischial tuberosity Pubic crest Pubic tubercle Inferior pubic ramus Symphysial surface Obturator foramen Ischial tuberosity Ramus of ischium Obturator foramen Ramus of ischium Inferior pubic ramus (b) Right os coxae, medial view Figure 8.9 (a) Right os coxae, lateral view (bott):© The McGraw-Hill Companies, Inc./Photo by Christine Eckel Ilium • Additional features: – Iliac crest: superior ridge – Anterior and posterior, superior and inferior iliac spines: projections along iliac crest – Greater sciatic notch: for sciatic nerve entering lower limb – Auricular surface: medial articulation with sacrum Ischium • Superior/posterior margin of acetabulum • Features: – Ischial spine: prominent medial process – Ischial tuberosity: rough inferior region that supports weight of body when seated – Ischial ramus: bridge from tuberosity to pubis Ischium Copyright © The McGraw-Hill Companies, Inc. 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Iliac crest Ala Anterior gluteal line Posterior gluteal line Posterior superior iliac spine Anterior super ioriliac spine Inferior gluteal line Posterior inferior iliac spine Greater sciatic notch Anterior inferior iliac spine Lunate surface Body of ischium Ischial spine Acetabulum Lesser sciatic notch Superior pubic ramus Pubic crest Pubic tubercle Inferior pubic ramus Ischial tuberosity Obturator foramen Ramus of ischium Ilium Posterior Iliaccrest Anterior Ischium Pubis Ala Lateral view Anterior gluteal line Posterior gluteal line Posterior superior iliac spine Anterior superior iliac spine Inferior glutealline Anterior inferior iliac spine Posterior inferior iliac spine Greater sciatic notch Lunate surface Body of ischium Ischial spine Lesser sciatic notch Acetabulum Superior pubic ramus Ischial tuberosity Figure 8.9 Pubic crest Pubic tubercle Inferior pubic ramus Obturator foramen Ramus of ischium (a) Right os coxae, lateral view (bottom): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Pubis • Anterior region of os coxae • Features: – Superior and Inferior rami: struts to acetabulum and ischial ramus – Pubic crest: rough ridge on anterosuperior of superior ramus; ends as pubic tubercle – Obturator foramen: large space bordered by pubic and ischial rami – Pectineal line: ridge on medial surface of pubis continuing from arcuate line of ilium Pubis Figure 8.7 True vs. False Pelvis • True pelvis: bony basin inferior to pelvic brim containing pelvic organs • False pelvis: superior to pelvic brim bound by ilia laterally and abdominal wall anteriorly – Pelvic brim: continuous oval ridge formed by pubic crest, pectineal line, arcuate line, and sacral promontory • Pelvic inlet: superior entrance to true pelvis, at pelvic brim • Pelvic outlet: exit of true pelvis, defined by coccyx, ischial tuberosities, and inferior border of pubic symphysis Features of the Pelvis Figure 8.10 Female vs. Male Pelvis • Most reliable indicator of the sex of a skeleton is the pelvis, due to the requirements of pregnancy and childbirth • Major differences: – – – female ilia laterally flared = wider pelvis female pelvic inlet = wide oval, male’s = heart-shaped female subpubic angle wider, >100º vs. <90º in males Female vs. Male Pelvis Copyright © The McGraw-Hill Companies, Inc. 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Table 8.1 View Sex Differences Between the Female and Male Pelves Female Pelvis Male Pelvis Medial View Preauricular sulcus Wide greater sciatic notch Narrow greater sciatic notch Rectangular pubic body Triangular pubic body Triangular obturator foramen Large, oval obturator foramen Anterior View Wide subpubic angle Features Female Characteristic Narrow subpubic angle Male Characteristic General Appearance Less massive; gracile processes, less prominent muscle markings More massive; more robust processes, more prominent muscle markings General Width Hips are wider, more flared Hips are narrower and more vertically oriented, less flared Superior Inlet Spacious, wide, and oval Heart-shaped Acetabulum Smaller Larger Greater Sciatic Notch Wide and shallow Narrow and U-shaped, deep Ilium Shallow: Does not project far above sacroiliac joint Deep: Projects farther above sacroiliac joint Obturator Foramen Smaller and triangular Larger and oval Subpubic Angle Broader, more convex, usually greater than 100 degrees Narrow, V-shaped, usually less than 90 degrees Body of Pubis Longer, more rectangular Shorter, triangular Preauricular Sulcus Usually present Usually absent Sacrum Shorter and wider; flatter sacral curvature Narrower and longer; more curved (greater sacral curvature) Coccyx Posterior tilt Vertical Tilt of Pelvis Anterior tilt to superior end of pelvis Superior end of pelvis relatively vertical Ischiopubic Ramus Narrow and sharp Broad and fl at Ischial Spine Rarely projects into pelvic outlet Frequently rotated inward, projects into pelvic outlet a-b: © David Hunt/ Smithsonian Institution; c-d: © L. Bassett/ Visuals Unlimited Lower Limb • 30 bones per “leg” – femur in the femoral region (thigh) – patella (kneecap) in the patellar region – tibia and fibula in the crural region (leg) – 7 tarsals in ankle and proximal foot – 5 metatarsals in sole of foot – 14 phalanges in the toes Femur • Longest, strongest, and heaviest bone in the body • Proximal features: – Head: articulates with os coxae at acetabulum – Fovea: dent in head for ligament to acetabulum – Neck: constricted region just distal to head – Greater and lesser trochanters: massive processes for attachment of powerful hip and thigh muscles Femur Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Greater trochanter Neck Head Greater trochanter Head Anterior View Fovea Fovea Greater trochanter Neck Intertrochanteric line Neck Intertrochanteric crest Lesser trochanter Lesser trochanter Shaft (b) Right femoral head, medial view Head Shaft Patellar surface Shaft Lateral condyle Intercondylar fossa (c) Right femur, inferior view Lateral epicondyle Lateral epicondyle Figure 8.11 Lateral condyle Adductor tubercle Adductor tubercle Medial epicondyle Medial epicondyle Lateral condyle Patellar surface Medial condyle Patellar surface Medial condyle (a) Right femur, anterior view a(right), b,c: © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Medial condyle Femur • Additional features: – Intertrochanteric line: anterior between trochanters marking the distal edge of the hip capsule – Gluteal tuberosity: posterior rough region for attachment of the gluteus maximus muscle – Linea aspera: ridge on posterior shaft for attachment of many thigh muscles – Distally, linea aspera splits into medial and lateral supracondylar lines Femur Posterior view Figure 8.11 Femur • Distal features: – Medial and lateral condyles: smooth, rounded articular surfaces – Medial and lateral epicondyles: projections just superior to the condyles – Intercondylar fossa: deep posterior depression that separates the condyles – Patellar surface: smooth anterior region between condyles where patella articulates with the femur Patella • The “kneecap” – Triangular with broad superior border and inferiorly pointed apex – Articulates with patellar surface of femur Figure 8.12 Figure 8.13 Tibia and Fibula Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. • 2 bones in the leg –parallel to each other –tibia is medial to fibula Figure 8.13 Lateral condyle Intercondylar eminence Lateral condyle Medial condyle Medial condyle Articular facet Superior tibiofibular joint Head Head Tibial tuberosity Neck Neck Anterior border Fibula Tibia Fibula Tibia Shaft Interosseous borders Medial malleolus Lateral malleolus Inferior articular surface Inferior tibiofibular joint Lateral malleolus (a) Right tibia and fibula, anterior view Inferior articular surface a(right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Medial malleolus Tibia • Medial bone in crural region • Proximal features: – Medial and lateral condyles: smooth surfaces for articulation with femur – Fibular articular facet: articulation site for head of fibula under lateral condyle Tibia- Posterior View Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Intercondylar eminence Intercondylar eminence Medial condyle Medial condyle Lateral condyle Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Lateral condyle Superior tibiofibularjoint Intercondylar Intercondylar fossa eminence Head Neck Fibular articular facet Femur Tibia Medial condyles Tibia Lateral condyles Tibia Fibula Fibula Interosseous borders Shaft (e) Right knee joint, posterior view © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Medial malleolus Medial malleolus Fibular notch Inferior tibiofibularjoint Lateral malleolus (d) Right tibia and fibula, posterior view Figure 8.13 (right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Lateral malleolus Tibia • Other features: – Tibial tuberosity: rough anterior projection inferior to condyles; can be palpated just inferior to the patella; for attachment of patellar ligament – Tibial border: ridge along anterior surface extending from tuberosity distally; the “shin” – Medial malleolus: inferiormost prominent medial process; “ankle bump” – Articular surface: inferior surface articulates with the talus Tibia- Posterior View Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Intercondylar eminence Intercondylar eminence Medial condyle Medial condyle Lateral condyle Lateral condyle Superior tibiofibularjoint Head Neck Fibular articular facet Tibia Tibia Fibula Interosseous borders Shaft Figure 8.13 Medial malleolus Medial malleolus Fibular notch Inferior tibiofibularjoint Lateral malleolus (d) Right tibia and fibula, posterior view (right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Lateral malleolus Fibula • Long, thin, lateral crural bone – Not weight-bearing • Features: – proximal head with flat articular facet for articulation with the tibia – narrow neck and slender shaft – distal end expands into lateral malleolus Fibula Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Intercondylar eminence Intercondylar eminence Medial condyle Medial condyle Lateral condyle Lateral condyle Superior tibiofibularjoint Head Neck Fibular articular facet Tibia Tibia Fibula Interosseous borders Shaft Medial malleolus Figure 8.13 Medial malleolus Fibular notch Inferior tibiofibularjoint Lateral malleolus (d) Right tibia and fibula, posterior view (right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Lateral malleolus Articulation of Head of Fibula with Tibia Posterior View Figure 8.13 Tarsus • 7 bones form ankle and proximal foot –Calcaneus: largest; forms the heel –Talus: superior-most; weightbearing; articulates with tibia –Navicular –Cuneiforms: medial, intermediate and lateral –Cuboid Tarsals Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Distal phalanx of hallux Distal phalanx of hallux Distal phalanx Distal phalanx Middle phalanx Proximal phalanx of hallux (great toe) Middle phalanx Proximal phalanx Phalanges Phalanges Proximal phalanx of hallux (great toe) Proximal phalanx II I I III II IV V IV V Metatarsals Medial cuneiform Medial cuneiform Lateral cuneiform Intermediate cuneiform III Metatarsals Intermediate cuneiform Lateral cuneiform Navicular Cuboid Navicular Cuboid Tarsals Talus Talus Calcaneus Tarsals Calcaneus (a) Right foot, superior view Distal phalanx Distal phalanx Middle phalanx Middle phalanx Phalanges Phalanges Proximal phalanx Proximalphalanx III II I (Sesamoid bones for flexor hallucis brevis tendons) II I Metatarsals III Metatarsals IV IV V V Medial cuneiform Medialcuneiform Lateral cuneiform Intermediate cuneiform Lateral cuneiform Cuboid Intermediate cuneiform Navicular Navicular Cuboid Tarsals Tarsals Figure 8.14 Talus Talus Calcaneus Calcaneus (b) Right foot, inferior view a(right), b(right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Metatarsals • 5 bones in sole of foot • Articulations: –proximally with tarsals –distally with phalanges • Identified by Roman numerals I–V from medial to lateral Phalanges • 14 bones per foot –3 phalanges per toes 2–5 • Proximal, middle, and distal –Great toe (hallux) only 2 • Proximal and distal Foot Bones Copyright © The McGraw-Hill Companies, Inc. 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Distal phalanx of hallux Distal phalanx of hallux Distal phalanx Distal phalanx Middle phalanx Proximal phalanx of hallux (great toe) Middle phalanx Proximal phalanx Phalanges Phalanges Proximal phalanx of hallux (great toe) Proximal phalanx II I I III II IV V IV V Metatarsals Medial cuneiform Medial cuneiform Lateral cuneiform Intermediate cuneiform III Metatarsals Intermediate cuneiform Lateral cuneiform Navicular Cuboid Navicular Cuboid Tarsals Talus Talus Calcaneus Tarsals Calcaneus (a) Right foot, superior view Distal phalanx Distal phalanx Middle phalanx Middle phalanx Phalanges Phalanges Proximal phalanx Proximalphalanx III II I (Sesamoid bones for flexor hallucis brevis tendons) II I Metatarsals III Metatarsals IV IV V V Medial cuneiform Medialcuneiform Lateral cuneiform Intermediate cuneiform Lateral cuneiform Cuboid Intermediate cuneiform Navicular Navicular Cuboid Tarsals Tarsals Figure 8.14 Talus Talus Calcaneus Calcaneus (b) Right foot, inferior view a(right), b(right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Foot Arches • • To prevent pinching of muscles, nerves, and blood vessels feet do not rest flat on floor Three major arches: – Medial: from heel to hallux; highest arch – Lateral: from heel to 5th toe; lowest arch – Transverse: perpendicular to other arches; along distal row of tarsals Foot Arches Figure 8.15