Chapter 8 The Skeletal System • Overview of the skeleton • The skull • The vertebral column and thoracic cage • The pectoral girdle and upper limb • The pelvic girdle and lower limb Overview of the Skeleton • Regions of the skeleton – axial skeleton forms the central axis • skull, vertebral column, ribs, sternum and sacrum – appendicular skeleton includes the limbs & girdles • Number of bones – 206 in typical adult skeleton • varies with development of sesamoid bones (patella) – start at 270 at birth, decreases with age as bones fuse • Surface markings defined in Table 8.2 • 4 regions of the skeleton = skull, vertebral column & thorax, upper and lower limbs and girdles Surface Features of Bones Axial & Appendicular Skeleton • Axial skeleton in yellow – skull, vertebrae, sternum, ribs, sacrum & hyoid • Appendicular skeleton in blue – – – – pectoral girdle upper extremity pelvic girdle lower extremity Major Skull Cavities • Cranial cavity holds brain • Orbit contains eyeball & extraocular muscles • Ethmoid sinus • Nasal cavity • Maxillary sinus • Oral cavity The Skull • 22 bones joined together by sutures • Cranial bones surround cranial cavity – 8 bones in contact with meninges • frontal, parietal, – calvaria (skullcap) forms roof & walls • Facial bones support teeth & form nasal cavity & orbit – 14 bones with no direct contact with brain or meninges – attachment of facial & jaw muscles Cranial Fossa • 3 basins that comprise the cranial floor or base – anterior fossa holds the frontal lobe of the brain – middle fossa holds the temporal lobes of the brain – posterior fossa contains the cerebellum • Swelling of the brain may force tissue through foramen magnum resulting in death Frontal Bone • Forms forehead and part of the roof of the cranium • Forms roof of the orbit • Contains frontal sinus Parietal Bone • Forms cranial roof and part of its lateral walls • Bordered by 4 sutures – coronal, sagittal, lambdoid and squamous Temporal lines • Marked by temporal lines of temporalis muscle Temporal Bone • Forms lateral wall & part of floor of cranial cavity – squamous part • zygomatic process • mandibular fossa & TMJ – tympanic part • external auditory meatus • styloid process for muscle attachment – mastoid part • mastoid process – mastoiditis from ear infection • mastoid notch – digastric muscle Petrous Portion of Temporal Bone • Forms part of cranial floor – separates middle from posterior cranial fossa • Houses middle and inner ear cavities – receptors for hearing and sense of balance – internal auditory meatus is opening for CN VII (vestibulocochlear nerve) Openings in Temporal Bone • Carotid canal – passage for internal carotid artery supplying the brain • Jugular foramen – irregular opening between temporal & occipital bones – passageway for drainage of blood from brain to internal jugular vein Occipital Bone • Rear & much of base of skull • Foramen magnum holds spinal cord • Skull rests on atlas at occipital condyles • Hypoglossal canal transmits hypoglossal nerve (CN XII) supplying tongue muscles • External occipital protuberance for nuchal ligament • Nuchal lines mark neck muscles Sphenoid Bone • Lesser wing • Greater wing • Body of sphenoid • Medial and lateral pterygoid processes Sphenoid Bone • Body of the sphenoid – sella turcica contains deep pit (hypophyseal fossa) – houses pituitary gland • Lesser wing – optic foramen contains optic nerve & ophthalmic a. • Greater wing -- 3 foramen – foramen rotundum & ovale for brs. trigeminal nerve – foramen spinosum for meningeal artery Sphenoid Bone • Sphenoid sinus Ethmoid Bone • Found between the orbital cavities • Forms lateral walls and roof of nasal cavity • Cribriform plate & crista galli • Ethmoid air cells form ethmoid sinus • Perpendicular plate forms part of nasal septum • Concha or turbinates on lateral wall Ethmoid Bone • Superior & middle concha • Perpendicular plate of nasal septum Maxillary Bones • Forms upper jaw – alveolar processes are bony points between teeth – alveolar sockets hold teeth • Forms inferomedial wall of orbit – infraorbital foramen • Forms anterior 2/3’s of hard palate – incisive foramen – cleft palate Locations of Paranasal Sinuses Frontal Ethmoid Maxillary Sphenoid • Maxillary sinus fills maxillae bone • Other bones containing sinuses are frontal, ethmoid & sphenoid. Palatine Bones • L-shaped bone • Posterior 1/3 of the hard palate • Part of lateral nasal wall • Part of the orbital floor Zygomatic Bones • Forms angles of the cheekbones and part of lateral orbital wall • Zygomatic arch is formed from temporal process of zygomatic bone and zygomatic process of temporal bone Lacrimal Bones • Form part of medial wall of each orbit • Lacrimal fossa houses lacrimal sac in life – tears collect in lacrimal sac and drain into nasal cavity Nasal Bones • Forms bridge of nose and supports cartilages of nose • Often fractured by blow to the nose Inferior Nasal Conchae • A separate bone • Not part of ethmoid like the superior & middle concha or turbinates Vomer • Inferior half of the nasal septum • Supports cartilage of nasal septum Mandible • Only bone of the skull that can move – jaw joint formed between mandibular fossa of temporal bone & condyloid process • Holds the lower teeth • Attachment of muscles of mastication – temporalis muscle onto coronoid process – masseter muscle onto angle of mandible • Mandibular foramen • Mental foramen Ramus, Angle and Body of Mandible Bones Associated With the Skull • Auditory ossicles – malleus – incus – stapes • Hyoid bone – suspended from styloid process of skull by stylohyoid muscle and ligament – greater & lesser cornua The Skull in Infancy & Childhood • Spaces between unfused skull bones called fontanels – filled with fibrous membrane – allow shifting of bones during birth & growth of brain in infancy – fuse by 2 years of age • 2 frontal bones fuse by age six – metopic suture • Skull reaches adult size by 8 or 9 causing heads of children to be larger in proportion to trunk General Features of the Vertebral Column • 33 vertebrae & discs of fibrocartilage between them • Five vertebral groups – – – – – 7 cervical in the neck 12 thoracic in the chest 5 lumbar in lower back 5 sacral fused into the sacrum 4 coccygeal fused into coccyx • Variations in number of lumbar and sacral vertebrae Newborn Spinal Curvature • Spine exhibits one continuous C-shaped curve • Known as primary curvature Adult Spinal Curvatures • S-shaped vertebral column with 4 curvatures • Secondary curvatures develop after birth – lifting head as it begins to crawl develops cervical curvature – walking upright develops lumbar curvature Abnormal Spinal Curvatures • Result from disease, posture, paralysis or congenital defect • Scoliosis from lack of proper development of one vertebrae • Kyphosis is from osteoporosis • Lordosis is from weak abdominal muscles General Structure of a Vertebra • Body • Series of vertebral foramen form the vertebral canal • Neural arch – 2 lamina – 2 pedicles • Processes – spinous – transverse – articular (superior & inferior) Intervertebral Foramen & Discs • Intervertebral foramen – formed from vertebral notches of adjacent vertebrae – passageway for spinal nerves • Intervertebral discs – bind vertebrae together – absorb shock – inner gelatinous nucleus pulposus surrounded by annulus fibrosus (ring of fibrocartilage) – herniated disc puts pressure on spinal nerve or spinal cord Typical Cervical Vertebrae • Small body and larger vertebral foramen • Transverse process short with transverse foramen for protection of vertebral arteries • Bifid or forked spinous process in C2 to C6 • C7 vertebra prominens The Unique Atlas and Axis • Atlas (C1) supports the skull – concave superior articular facet • nod your head in “yes” movement – ring surrounding large vertebral foramen • anterior & posterior arch • Axis (C2) – dens or odontoid process is held in place inside the vertebral foramen of the atlas by ligaments – allows rotation of head -- “no” Atlas & Axis Articulation Typical Thoracic Vertebrae • More massive body than cervical but smaller than lumbar • Spinous processes pointed and angled downward • Superior articular facets face posteriorly permitting some rotation between adjacent vertebrae • Rib attachment – superior and inferior costal facets on vertebral body and transverse costal facets at ends of transverse processes for articulation of ribs Lumbar Vertebrae • Thick, stout body and blunt, squarish spinous process • Superior articular processes face medially – lumbar region resistant to twisting movements Sacrum (Anterior View) • 5 separate sacral vertebrae fuse by age 26 • Anterior surface – smooth & concave – sacral foramina were intervertebral foramen • nerves & blood vessels – 4 transverse lines indicate line of fusion of vertebrae Sacrum (Posterior View) • Rough surface of sacrum • Spinous processes have fused into median sacral crest • Transverse processes fuse into lateral sacral crest • Posterior sacral foramina • Sacral canal ends as sacral hiatus • Auricular surface is part of sacroiliac joint Coccyx • Single, small, triangular bone – 4 small vertebrae fused by age of 30 – Co1 to Co4 • Provides attachment site for muscles of pelvic floor • Cornua – hornlike projections on Co1 for ligaments attach coccyx to sacrum • Fractured by fall or during childbirth Thoracic Cage • Consists of thoracic vertebrae, sternum & ribs • Attachment site for pectoral girdle and many limb muscles • Protects many organs • Rhythmically expanded by respiratory muscles to draw air into the lungs Rib Structure Tubercle Head • Flat blade called a shaft – inferior margin has costal groove for nerves & vessels • Proximal head & tubercle are connected by neck • Articulation – head with body of vertebrae – tubercle with transverse process Numbered Rib Articulations True and False Ribs • True ribs (1 to 7) attach to sternum with hyaline cartilage • False ribs (8-12) – 11-12 are floating and not attached to sternum • 12 pairs of ribs in both sexes Pectoral Girdle • Attaches upper extremity to the body • Scapula and clavicle • Clavicle attaches medially to the sternum and laterally to the scapula – sternoclavicular joint – acromioclavicular joint • Scapula articulates with the humerus – humeroscapular or shoulder joint – easily dislocated because of its loose attachment Clavicle • S-shaped bone, flattened dorsoventrally • Inferior surface marked by muscle & ligament attachments • Sternal end is rounded -- acromial end is flattened Scapula • • • • • Triangular plate that dorsally overlies ribs 2 to 7 Spine ends as acromion process Coracoid process for muscle attachment Subscapular, infraspinous and supraspinous fossa Glenoid fossa is shallow socket for head of humerus Scapular Features Upper Limb • 30 bones per limb • Brachium or arm contains the humerus • Antebrachium or forearm contains the radius & ulna (radius on thumb side) • Carpus or wrist contains 8 small bones arranged in two rows • Manus or hand contains 19 bones in 2 groups – 5 metacarpals in the palm – 14 phalanges in the fingers Humerus • Hemispherical head forms shoulder joint above anatomical neck • Muscles attach to greater & lesser tubercles and deltoid tuberosity • Intertubercular groove holds biceps tendon • Rounded capitulum articulates with radius • Pulleylike trochlea articulates with ulna • Olecranon fossa holds olecranon process of ulna in straightened arm • Forearm muscles attach to medial & lateral epicondyles Ulna and Radius • Radius – head is disc that rotates freely during pronation & supination • articulates with the capitulum – radial tuberosity for biceps muscle • Ulna – olecranon and trochlear notch form proximal end – radial notch holds head of ulna • Interosseous membrane – ligament attaches radius to ulna along interosseous margin of each bone Carpal Bones • Form the wrist – allows flexion, extension, abduction & adduction • 2 rows of 4 bones each – proximal row is scaphoid, lunate, triquetrum & pisiform – distal row is trapezium, trapezoid, capitate & hamate Metacarpals and Phalanges • Phalanges are bones of the fingers – thumb or pollex has proximal & distal phalanx – fingers have proximal, middle & distal phalanx • Metacarpals are bones of the palm – base, shaft & head Pelvic Girdle • Composed of 4 bones: right & left os coxae, sacrum and coccyx • Supports trunk on the legs & protects viscera • Each os coxae is joined to the vertebral column at the sacroiliac joint • Anteriorly, pubic bones are joined by pad of fibrocartilage to form pubic symphysis • False and true pelvis are separated at pelvic brim • Infant’s head passes through pelvic inlet & outlet Os Coxae (Hip Bone) • Acetabulum is hip joint socket • Ilium is superior portion – iliac crest and iliac fossa – greater sciatic notch contains sciatic nerve • Pubis is anterior portion – body, superior and inferior ramus • Ischium is posterolateral portion – – – – ischial tuberosity bears body weight if sit ischial spine lesser sciatic notch lies between ischial spine & tuberosity ischial ramus joins inferior pubic ramus Comparison of Male & Female • Female less massive, shallower pubic arch greater than 100 degrees, and pubic inlet round or oval • Male heavier, upper pelvis nearly vertical, coccyx more vertical, and pelvic inlet heart-shaped, outlet smaller Femur • Nearly spherical head & constricted neck – ligament to fovea capitis • Greater & lesser trochanters for muscle attachment • Posterior ridge called linea aspera • Medial & lateral condyles and epicondyles found distally • Smooth patellar surface on anterior femur Patella and Tibia • Patella is triangular sesamoid bone • Tibia is thick, strong weightbearing bone on medial side of leg – broad superior head with 2 flat articular surfaces • medial & lateral condyles – roughened anterior surface can be palpated below the patella (tibial tuberosity) – distal expansion is medial malleolus Fibula • Slender lateral strut that helps stabilize the ankle • Does not bear any of the body’s weight – use as spare bone tissue to replace bone elsewhere • Head is proximal end • Lateral malleolus is distal expansion • Joined to tibia by interosseous membrane The Ankle and Foot • Tarsal bones are shaped & arranged differently from carpal bones due to load-bearing role of the ankle • Talus is most superior tarsal bone – forms ankle joint with tibia & fibula – sits upon calcaneus & articulates with navicular • Calcaneus forms heel (achilles tendon) • Distal row of tarsal bones – cuboid, medial, intermediate and lateral cuneiforms The Foot • Remaining bones of foot are similar in name & arrangement to the hand • Metatarsal I is proximal to the great toe (hallux) – base, shaft and head • Phalanges – 2 in great toe • proximal and distal – 3 in all other toes • proximal, middle & distal Foot Arches • Sole of foot does not normally rest flat on the ground • 3 springy arches absorb stress of walking – medial longitudinal arch extends from heel to hallux – lateral longitudinal arch extends from heel to little toe – transverse arch extends across the middle of the foot • Arches held together by short, strong ligaments – pes planis (flat feet) X ray of the Right Foot Bipedalism and Upright Stance Bipedalism and Limb Adaptations Bipedalism and Head Position