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Appendicular Skeleton Appendicular Skeleton • Contains 126 bones between 4 groups: – Pectoral girdle (4) – Arms (60) – Legs (60) – Pelvic girdle (2) Pectoral Girdle: attaches the upper appendage to the thorax Pectoral Girdle • Includes 2 bones (on each side)- clavicle and scapula. • Weaker girdle than the pelvic girdle – Not designed to be weight bearing – Small point of attachment with the axial skeleton (at the sternoclavicular joint) – Most of the girdle is supported by back muscles. Clavicle: the anterior bone of the pectoral girdle • S-shaped • Collarbone • Articulates with the manubrium of the sternum (sternoclavicular joint). This is a diarthrosis (gliding joint). Clavicular Landmarks • Sternal end: the thickened medial end of the clavicle that articualtes with the manubrium of the sternum. • Acromial end: the thinner lateral end of the clavicle that articulates with the acromion of the scapula. • Conoid tubercle: a small projection found on the inferior surface of the lateral end of the clavicle. – This can help determine if it is the left/right clavicle. Scapula: the posterior bone of the pectoral girdle. • Larger than the clavicle • Triangular shaped • Attached to the axial skeleton through the joint it forms with the clavicle (acromioclavicular joint). • Held in place by the larger muscles of the back. Anterior Scapular Landmarks • Superior angle: the highest point on the scapula. • Superior border: the superior edge of the scapula. • Inferior angle: the lowest point on the scapula. • Medial (vertebral) border: a thin ridge of bone found close to the vertebral column. • Lateral (axillary) border: a thick ridge of bone found close to the humerus and inferior to the Glenoid fossa. Anterior Scapular Landmarks cont… • Scapular notch: a small “cut out” in the superior border of the scapula, medial to the coracoid process. – Allows blood vessels to pass over the superior border in order to feed and drain the arm. This notch protects the vessels. • Subscapular fossa: a large shallow depression found on the anterior surface of the scapula. – In this case, “sub” means “underneath”. Anterior Scapular Landmarks cont… • Coracoid process: a long, tube-like projection found medial to the Glenoid fossa. – Where the pectoralis minor and biceps brachii attach. Posterior Scapular Landmarks • Spine: a prominent ridge of bone found on the posterior surface of the scapula. • Acromion: a wide flat projection found on the lateral end of the spine. – Angled 90° anterior to the spine. – Articulates with the acromial end of the clavicle at the acromioclavicular joint. • Supraspinous fossa: a shallow depression found superior to the spine of the scapula. – PFMA. Posterior Scapular Landmarks • Infraspinous fossa: a large shallow depression found inferior to the spine of the scapula. – PFMA • Glenoid (cavity) fossa: a shallow depression found superior to the lateral (axillary) border. – Articulates with the head of the humerus to form the shoulder joint. This helps form the socket of the “ball and socket”. This joint is not a tight fit which allows a range of motion. The Upper Appendages • 30 bones in each arm • Proximal Distal: Humerus Radius Ulna Carpals (8) Metacarpals (5) Phalanges (14) • Humerus: single bone of the upper arm. – Largest bone of the arm Proximal Humeral Landmarks • Head: the rounded proximal end of the humerus. – Articulates with the glenoid fossa (not tightly which allows for a wide range of motion) • Anatomical neck: a small line found just distal to the head of the humerus. – Site of the epiphyseal line (where the growth plate has completely ossified). • Greater tubercle: a large blunt projection found on the proximal end of the humerus, lateral to the head. Proximal Humeral Landmarks cont.. • Lesser tubercle: a small blunt projection found on the proximal end of the humerus on the anterior surface. – This helps determine if it is the right/left humerus because it is only on the anterior surface. • Intertubercular (sulcus) groove: an elongated channel (groove) found between the greater and lesser tubercles. – Allows the tendon of the biceps brachii muscle to pass over the head on its way to the scapulawithout being bent. Proximal Humeral Landmarks cont.. • Surgical neck: the constricted region found inferior to the intertubercular sulcus. – This is a term created by doctors. – Most commonly fractured region of the humerus. – Where the compact bone of the diaphysis thins to transition to spongy bone of the epiphyses. • Deltoid tuberosity: a large slightly rounded projection found on the lateral surface of the diaphysis. – Point for the deltoid muscle attachment. Distal Humeral Landmarks • Capitulum: the rounded lateral condyle of the humerus. – Articulates with the head of the radius to help stabalize the elbow joint. • Trochlea: the pulley-shaped medial condyle of the humerus. – Articulates with the ulna to form the “functional” part of the elbow that allows it to be a hinge joint. * Most condyles are specifically named but these 2 are shaped so differently! Distal Humeral Landmarks cont.. • Medial epicondyle: a large projection found proximal to the trochlea. – PFMA – This region is called the “funny bone”. The sensation that you feel when you hit this is actually due to the pressure put on the ulnar nerve that runs posteriorly to this. • Lateral epicondyle: a small projection found proximal to the capitulum. – PFMA Distal Humeral Landmarks cont.. • Coronoid fossa: a small projection found proximal to the capitulum. – It accepts the coronoid process of the ulna when the elbow is bent. – If we didn’t have this, we wouldn’t be able to bend the joint so far. • Olecranon fossa: a large shallow depression found proximal to the trochlea on the distal posterior surface of the humerus. – This accepts the olecranon of the ulna and allows the elbow to straighten. Radius • The lateral bone of the forearm. – On the thumb side – Helps to stabilize the elbow joint. • Head: the flattened proximal end of the radius. – Articulates with the capitulum of the humerus. • Radial tuberosity: a small round projection found on the anterior surface just distal to the head. – Where the biceps brachii attaches and pulls on the radius. Radius continued… • Styloid process: a small triangular projection found on the distal lateral surface. – PFMA – Can be felt as a bump on the distal, lateral surface. Ulna • The medial bone of the forearm. – On the pinky side • Trochlear notch: a “C” shaped notch found on the proximal anterior surface. – Articulates with the trochlea to form the functional part of the elbow. This is the pivot point for the hinge joint. • Coronoid process: a small triangular process found on the anterior surface of the trochlear notch. – Fits into the coronoid fossa of the humerus when the elbow is bent. Ulna continued… • Olecranon (process): a large blunt projection found on the proximal posterior surface. – PFMA – The part of the elbow that “sticks out” when it is bent. • Head: the smaller distal end. – The only bone that has the head at the distal end. • Styloid process: a small triangular projection on the distal medial surface. Carpals • A group of 8 short bones that form the wrist. • Function: – Evenly transfer forces from the palm to the radius and ulna. • Bones: Arranged in 2 rows of 4 bones “Tell the children how scotties like to play” • Distal row (lateral to medial) • Trapezium-Trapezoid-Capitate-Hamate • Proximal row (lateral to medial) • Scaphoid-Lunate-Triquetrum-Pisiform Metacarpals & Phalanges • Metacarpals: A group of 5 long bones that make up the palm of the hand. – Numbered #1-5 from lateral (thumb) to medial (pinky) • Phalanges: A group of 14 long bones that make up the digits of the hand. – Digit #1 is the thumb- has 2 bones (proximal and distal) – Digits #2-5- each have 3 bones (proximal, intermediate, and distal) – Phalanx- Singular form of phalanges (each individual finger bone) Pelvic Girdle • Attaches the lower appendages to the sacrum of the vertebral column • Immovable girdle • Designed to be weight bearing • Large bony point of attachment with the sacrum at the sacroiliac joint • Os coxae (coxa is singular) • Two bones of the pelvic girdle • Each is composed of 3 bones that are fused together Ilium • Large, superior bone of the os coxa • Forms the prominence of the hips Illiac Landmarks: (#1-5 are PFMA) • Anterior superior iliac spine (ASIS): a large blunt projection that marks the beginning of the iliac crest. • Iliac crest: a prominent ridge of bone that forms the superior border of the ilium. • What you feel when you put your hands on your hips. Ilium • Posterior superior iliac spine (PSIS): a large blunt projection that marks the end of ht eiliac crest. • Anterior inferior iliac spine (AIIS): a smaller blunt projection found inferior to the anterior superior iliac spine • Posterior inferior iliac spine (PIIS): a smaller blunt projection found inferior to the posterior superior iliac spine. Ilium • Greater sciatic notch: a large cut out area found anterior to the posterior inferior iliac spine. • This allows the large branch of the sciatic nerve to pass over the os coxa on its way to the leg. Ilium • Iliac fossa: a large shallow depression found on the anterior surface of the ilium. • Auricular surface: a roughened area found anterior to the posterior inferior iliac spine. • Articulates with the auricular surface of the sacrum to form the sacroiliac joint Ischium • The inferior, posterior bone of the os coxa. Ischial landmarks: • Ischial spine: a sharp flat projection found inferior to the greater sciatic notch. • Lesser sciatic notch: a small cut area found inferior to the ischial spine. • Allows a small branch of the sciatic nerve to pass over the ischium on its way to the leg. • Ischial tuberosity: a large, flat, blunt projection found inferior to the lesser sciatic notch. Pubis • The inferior, anterior bone of the os coxa. Pubis landmarks: • Pubic crest: a small ridge of bone found on the anterior surface. • Pubic tubercle: a small rounded projection found on the medial end of the pubic crest. • Superior pubic ramus: the short horizontal portion of the pubis found lateral to the pubic tubercle. • Inferior pubic ramus: the longer vertical portion of the pubis found inferior to the pubic tubercle. Os coxa Landmarks • Acetabulum: a large cup shaped depression found on the lateral surface of the os coxa. • Formed by all 3 bones of the os coxa. • Articulates with the head of the femur to form the ball and socket hip joint. • Obturator foramen: a large opening through the os coxa formed by the joining of the ischium and the pubis. • PFMA Lower Appendages • 60 total bones (30 per leg) Proximal to Distal: femurpatellatibiafibulatarsals (7) Metatarsals (5)phalanges (14) • Femur: single bone of the upper leg. • Longest, largest and strongest bone of the body. • Articulates with the acetabulum of the os coxa. Femoral Landmarks • Head: the rounded proximal end of the femur. • Fits better with the acetabulum than the humerus does with the glenoid cavity. This gives it less range of motion but more weight bearing. • Fovea capitis: a small opening in the head of the femur that allows blood vessels to enter the proximal end of the femur. • Can only be seen when viewing the medial surface of the head. Femoral Landmarks • Neck: the constricted region of the femur just distal to the head. • Most commonly fractured site on the femur. • Greater trochanter: a large blunt, irregular projection found on the proximal lateral surface. • Largest bone landmark in the body. • Lesser trochanter: a smaller blunt projection found on the proximal, medial posterior surface. Femoral Landmarks • Intertrochanteric line: a small ridge of bone found between the greater and lesser trochanters on the proximal anterior surface. • Intertrochanteric crest: a large prominent ridge of bone found between the greater and lesser trochanters on the proximal posterior surface. • Gluteal tuberosity: a short vertical ridge of bone found inferior to the intertrochanteric crest. • Where the gluteus maximus tendon attaches. Femoral Landmarks • Linea aspera: a long vertical ridge of bone found inferior to the gluteal tuberosity on the posterior surface of the diaphysis. • Medial epicondyle: a small projection found proximal to the medial condyle. • Lateral epicondyle: a small projection found proximal to the lateral condyle. • Medial and lateral condyles: the rounded distal ends of the femur. • Articulate with the condyles of the tibia to form the knee joint. Femoral Landmarks • Intercondylar fossa: a large shallow depression found between the medial and lateral condyles of the femur. • Where ligaments attach that hold the knee joint together. Patella • Small triangular bone located anterior to the knee joint. • Sesamoid bone: bone that develops inside a tendon. • Function: protects the tendon of the quadriceps femoris muscle group as it crosses over the knee joint. • Landmarks: • Base: the blunt superior portion. • Apex: the pointed inferior portion. Tibia • Large, medial weight bearing bone of the lower leg. • Articulates with the condyles of the femur to form the knee joint. • Articulates with the talus to form the ankle joint. Tibial landmarks: • Medial and lateral condyles: the concave proximal ends. • Start out rounded and they flatten when the person starts walking. • Articulate with the condyles of the femur. Adult tibia Tibial Landmarks cont… • Intercondylar eminence: a paired triangular projection found between the medial and lateral condyles. • Point for ligament attachment- PCL and ACL attach to this and the intercondylar fossa of the femur. • Tibial tuberosity: a small rounded projection found on the proximal anterior surface. • PFMA • Anterior (crest) border: a sharp ridge of bone found on the anterior surface of the shaft. • PFMA Tibial Landmarks cont… • Medial malleolus: a large blunt projection found on the distal medial surface. • Forms the prominence of the ankle on the medial side. • Helps prevent medial dislocation of the ankle. Fibula • The smaller, lateral, non-weight bearing bone of the lower leg. • Point of attachment for the muscles that act on the foot. • This is why it is difficult to walk if the fibula is broken. Fibular landmarks: • Head: the rounded proximal end. • Lateral malleolus: the pointed distal end. • Forms the prominence of the ankle on the lateral side and helps prevent lateral dislocation. Tarsals • A group of 7 short bones that form the posterior arch of the foot. • Function to transfer force from the foot to the tibia when walking. Tarsal bones: Calcaneuscuboidlateral cuneiformintermediate cuneiformmedial cuneiformnaviculartalus “Crazy couples love introducing many new things” Metatarsals & Phalanges • Metatarsals: a group of 5 long bones that form the anterior arch of the foot. • Numbered 1st-5th (medial to lateral) • Phalanges: a group of 14 long bones that form the digits of the foot. • Great toe (hallux) has 2 phalanges (proximal and distal) • 2nd-5th have 3 phalanges (proximal, intermediate/middle and distal) ACT - UP The term condyles” is used to describe the proximal end of the tibia. Is this term being used correctly? Defend your answer.