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Aromalyne Training
Level 3 Diploma in Aromatherapy (ABC)
LEVEL 3 DIPLOMA IN AROMATHERAPY
MODULE 10
KNOWLEDGE OF ANATOMY, PHYSIOLOGY & PATHOLOGY FOR
COMPLEMENTARY THERAPIES
THE SKELETAL SYSTEM
MODULE 3
COURSE MANUAL
CHRISTINA LYNE
[email protected]
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Level 3 Diploma in Aromatherapy (ABC)
THE SKELETAL SYSTEM
Bone is a complex and dynamic living tissue that is continually being remodelled –
new bone is built and old bone is broken down. Each individual bone is an organ
because bone is composed of several different tissues working together: bone,
cartilage, dense connective tissues, epithelium, various blood-forming tissues,
adipose tissue and nervous tissue.
FUNCTIONS OF THE SKELETAL SYSTEM
1. Storage of energy – yellow bone marrow present in some bones stores lipids
which serve as an important energy reserve in the body.
2. Protection - of vital, underlying organs and delicate tissues:
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the skull protects the brain
the backbone protects the spinal chord
the ribcage protects the heart, lungs, liver, kidneys and spleen
3. The manufacture of blood cells - billions of red and white cells, and
platelets are made in the red bone marrow by a process called haemopoiesis.
4. Mineral reservoir - calcium, phosphorous and magnesium salts are stored in
bones and released when needed by the body.
5. Movement - all the joints in the skeleton allow for movement. Muscles are
attached to bone, which, when moved, pull them into their various different
positions. Bones provide levers for muscular action.
6. Support - without it, the soft parts of the body – muscles, tendons and organs
- would have no support framework.
7. Shape – bones give the body its basic shape.
BONE COMPOSITION
Bone tissue is a hard, living connective tissue which is very strong and durable. It is
mainly composed of a two thirds mixture of calcium salts (mainly calcium carbonate)
and the remaining one third is a material called osteoid, which is composed mainly
of collagen. Collagen is very strong and gives bone slight flexibility. It prevents bone
from being too brittle and hard.
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GENERAL STRUCTURE OF A LONG BONE
A long bone comprises a shaft (diaphysis) and two extremities (epiphyses). They
are made of mainly compact bone tissue with some spongy bone tissue.
Long bones are almost completely covered with periostium. This is a thin, fibrous
membrane that covers the entire outer surface of a bone, except at a joint when it is
covered with hyaline cartilage. Periostium is essential for bone growth and repair.
Long bones receive their nutrients via blood vessels and the sensory supply usually
enters the bone at the same site as the nutrient artery, and branches throughout the
bone.
The diaphysis is made up of compact bone tissue with a central canal containing
fatty yellow bone marrow. This canal is known as the medullary cavity. This cavity is
lined by a membrane called the endosteum which contains cells which are needed
for bone formation. In adults, the fatty yellow bone marrow stores lipids.
The epiphyses are made of spongy bone tissue and contain red bone marrow. This
is where blood cells are produced. Each epiphysis has a thin outer covering of
hyaline cartilage called articular cartilage. Thickening of a bone occurs by the
deposition of new bone tissue under the periostium.
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GENERAL STRUCTURE OF SHORT, IRREGULAR, FLAT AND SESAMOID
BONES
These have a fairly thin outer layer of compact bone with mainly spongy bone inside.
They are enclosed by periostium.
BONE CELLS
Osteogenic cells – throughout life, these cells undergo cell division and develop
into osteoblasts. They are found in the inner portion of the periostium and in the
endosteum.
Osteoblasts - these are the cells responsible for bone formation. They secrete
collagen and minerals. They are found in the centres of immature bone. As bone
hardens they eventually mature and become osteocytes.
Osteocytes - these mature bone cells are the main cells in bone tissue. Their
function is to maintain bone tissue - they ensure the exchange of nutrients and
waste with the blood. Like osteoblasts, osteocytes do not undergo cell division.
Osteoclasts - their function is to break down or resorb bone. This breakdown of
bone matrix is part of the normal development, growth, maintenance and repair of
bone. Resorption takes place on the surface of bones.
A fine balance of osteoblast and osteoclast activity maintains normal bone structure
and functions. Bone is not completely solid but has many spaces between its cells
and matrix components. Some spaces are channels for blood vessels that supply
bone cells with nutrients. Other spaces are storage areas for red or yellow bone
marrow. Depending on the size and distribution of the spaces, the regions of a bone
may be categorised as either compact or cancellous. Overall, about 80% of
skeleton is compact and 20% is cancellous.
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TWO TYPES OF BONE TISSUE:
1. Compact Bone Tissue - contains few spaces. It forms the outer layer of
bones and makes up most of the shaft of long bones. Its function is to
surround softer, spongy bone providing protection (an outer shell), giving
support and durability. It can withstand the stresses that come with weight
and movement.
Compact bone is made up of a large number of parallel tube-shaped units called
osteons (Haversian systems). Osteons are each made up of a central canal
surrounded by a series of expanding rings.
Lamellae - these are cylindrical plates of bone arranged around each central canal.
They are made up of mineral salts (mostly calcium and phosphates) which give bone
its hardness and collagen fibres which provide its strength.
Lacunae - these are the small spaces / cavities found between the lamellae. Each
contains osteocytes (mature bone cells).
Canaliculi - these minute canals project from the lacunae and provide a passage for
nutrients to and waste from osteocytes. They are filled with interstitial fluid. The
canaliculi connect lacunae with one another and, eventually, with the central canals.
This miniature canal system throughout the bones provides many routes for
nutrients and oxygen to reach the osteocytes and for wastes to diffuse away.
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Haversian canal – these run through the centre of the lamellae and contain blood
and lymph vessels and nerves.
2. Cancellous Bone Tissue - this is the spongy bone tissue and to the naked
eye, looks like honeycomb. This bone tissue is light, which reduces its overall
weight, so that it moves more readily when pulled by a skeletal muscle.
Cancellous bone is a framework made up of trabeculae which consists of a few
lamellae and osteocytes interconnected by canaliculi. Osteocytes are nourished by
interstitial fluid seeping into the bone through the tiny canaliculi. It does not contain
osteons. The spaces between the trabeculae contain red bone marrow.
Short, flat, irregular and sesamoid bones are made up of this bone tissue.
All bones contain both types of tissue. The amount of each depends on the type of
bone.
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BONE MARROW
The spaces inside cancellous bone are often filled with bone marrow. This is a soft
fatty tissue and may be red or yellow in colour. At birth, red bone marrow is present
in all bones, but in the long bones it gradually becomes yellow marrow and loses its
capacity to produce blood cells. Red bone marrow produces all of the red blood
cells, platelets, and most of the white cells. Yellow marrow is composed mainly of
connective tissue and fat.
DEVELOPMENT OF LONG BONES
Ossification is the name of the process by which cartilage is converted into bone.
This process starts when an embryo is 8 weeks old and is not fully completed until
the 21st year of life.
At the embryonic stage, when the skeleton is forming, it consists mainly of cartilage.
Later as the blood supply develops, cartilage turns into bone tissue as osteoblasts
secrete osteoid into the bone shaft. The bone lengthens. At around birth,
secondary centres of ossification develop in the epiphyses and the medullary canal
is formed. During childhood, long bones continue to lengthen because the
epiphyseal plate at the end of each bone, which is made of cartilage, continues to
produce new cartilage on its diaphyseal surface. This cartilage is then turned into
bone. As long as cartilage production matches the rate of ossification, then bone
continues to lengthen. At puberty, under the influence of the hormones androgen
and testosterone, the epiphyseal plate growth slows down and stops. Once the
whole epiphyseal plate is turned into bone, no further lengthening of the bone is
possible.
DEVELOPMENT OF SHORT, FLAT and IRREGULAR BONES
Osteoblasts use calcium and phosphorous to form new compact bone between the
periostium and the older bone tissue. Osteoclasts break down calcium from the
interior of the bone to allow the bones to get larger without becoming too dense and
heavy. The tendons from muscles attach to the periostium. As the muscle
contracts, it pulls the periostium away from the bone, creating a space. The
osteoblasts fill these spaces with the new bone tissue.
BONE RESORPTION AND REMODELLING
New bone tissue constantly replaces old, worn-out or injured bone tissue through a
process called remodelling.
Bone resorption and remodelling occurs when hormones are released into the
bloodstream, triggering osteoclasts to respond to the site where new bone needs to
be produced.
Osteoclasts dissolve existing bone creating a cavity. Once the
osteoclasts have prepared the site, osteoblasts start secreting collagen fibres, which
will provide the framework for the new bone formation. Forming new bone requires
calcium and phosphorous. The hormones calcitonin and parathyroid hormone
activate the release of these minerals into the bloodstream. Calcitonin increases
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calcium uptake into bone and parathormone decreases it. The minerals bind to the
new collagen framework and new bone tissue is created.
HEALING PROCESS OF BONE
How healing takes place:
1. A haematoma (collection of clotted blood) forms between the ends of bone
and in surrounding soft tissues.
2. Acute inflammation develops.
Macrophages engulf and digest the
haematoma and small fragments of bone. Fibroblasts migrate to the site and
assist in tissue repair (producing collagen and elastin fibres), granulation
tissue and new capillaries develop.
3. New bone forms as large numbers of osteoblasts secrete spongy bone, which
helps the broken bone ends to mend, and is protected by an outer layer of
bone and cartilage - these new deposits of bone and cartilage are called
callus.
4. Over the next few weeks, the callus matures and the cartilage is gradually
replaced with new bone.
5. In time the bone heals completely with the callus tissue completely replaced
with mature compact bone. Often the bone is thicker and stronger at the
repair site than originally.
FRACTURES: A fracture is a breakage of bone, due either to injury or disease.
Bone fractures are classified as:
 Simple: the bone ends do not protrude through the skin
 Compound: the bone ends protrude through the skin
 Complicated: the broken bone damages tissue and/or organs around it
 Comminuted: a bone broken in several places
 Impacted: a broken bone where one end is driven into the other
 Greenstick: this is an incomplete fracture of a long bone. Prone in soft and
flexible bones, especially children’s.
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TYPES OF BONES
There are five different types of bones, defined according to their shape:
Type of bone
Examples
Long
Femur, humerus, fibula,
tibia, radius, ulna
Short
Tarsals (ankle bones)
Carpals (wrist bones)
Flat
Sternum, cranium, ribs, scapula
Irregular
Vertebrae and some facial bones –
ethmoid, palatine, maxilla / mandible
Sesamoid
Patella (knee cap)
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There are two types of skeleton that make up the skeletal system:
AXIAL SKELETON
The axial skeleton runs down the centre of the body. It contains the bones that make
up the central bony core of the body. It supports the head, neck and trunk and
consists of:
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The skull
The vertebral column
The ribcage
The sternum
THE APPENDICULAR SKELETON
The appendicular skeleton contains all the bones of the limbs, together with the
bony girdles that anchor them to the rest of the body. It consists of:
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The shoulder girdle
The upper limbs - arm, wrist, hand, fingers
The pelvic girdle
The lower limbs - leg, ankle, foot, toes
THE AXIAL BONES
THE SKULL
The cranium is an extremely strong case made up of 8 flat, irregular bones and one
small v-shaped bone.
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One frontal bone - forms the forehead
Two parietal bones - form the sides and roof of the head
Two temporal bones - make up the part around the ears
One occipital bone - forms the rear and base of the skull
One ethmoid bone - forms the part of the nasal cavity
One sphenoid bone - forms part of the floor of the cranium
One hyoid bone also makes up part of the cranium - this is found at the root
of the tongue.
The function of the skull is to surround and protect the brain.
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THE FACE
There are 14 facial bones:
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Two zygomatic bones - form the cheek bones
Two maxilla bones - form the upper jaw and carry the upper teeth
One mandible bone - forms the lower jaw and carries the lower teeth. This is the
only moveable bone of the skull.
One vomer bone - separates the nasal cavities
Two inferior concha or turbinated bones - form the outer part of the nasal cavity
Two palatine bones - form the bottom of the eye and nose cavities
Two nasal bones - form the bridge of the nose
Two lacrimal bones - are found behind the nasal bones in the eye sockets
THE STERNUM
This is also known as the breast bone. It is a flat bone that is connected to the ribs
by strips of cartilage. It is found just under the surface of the skin in the centre of the
chest. It has three parts:
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The manubrium - is at the top
The sternal body - is in the middle
The xyphoid process - is at the lower end, does not have any ribs attached to it.
THE RIBCAGE
The ribcage is a strong bony frame consisting of 12 pairs of flat, curved bones called
ribs. The ribs are connected to each other by intercostal muscles. They move up
and down during breathing to make the lungs change shape. The rear end of each
rib is attached to a thoracic vertebra.
True ribs: the front ends of the upper seven pairs are attached to the sternum by
flexible strips of costal cartilage.
False ribs: the next three pairs are each connected to the ribs above.
Floating ribs: the lowest two pairs are attached only to the backbone and not to the
sternum.
The function of the ribcage is to assist with breathing and to protect the internal
organs of the thoracic cavity.
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THE SPINE or VERTEBRAL COLUMN
This is the strong, flexible chain of bones that run down the middle of the body. It
extends from the skull down to the pelvis. It consists of vertebrae that meet at joints.
Each joint allows a small amount of movement, but together they make the
backbone very flexible.
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Each bone is separated by an intervertebral disc. These discs have jelly-like centres
covered by fibrous cartilage. They form strong joints that give the spine its flexibility
and also help to cushion against sudden jolts by absorbing shocks.
The spine is divided up into groups of vertebrae. In total there are 33 individual
irregular bones, but only 24 are moveable, because the bones of the sacrum and
coccyx fuse.
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Cervical Vertebrae (7) - these are specially shaped to allow the skull to
rotate and move up and down.
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Thoracic Vertebrae (12) - these vertebrae form joints with the ribs.
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Lumbar Vertebrae (5) - these are the largest bones and need to bear the
heaviest load.
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Sacrum (5) - this is the flat, triangular bone at the base of the spine.
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Coccyx (4) - these bones fuse together as we approach adulthood.
The spine has several important functions:
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It supports the head
It encloses and gives protection to the spinal cord
It protects the spinal nerves
Is the site of attachment for the ribs and muscles of the back, allowing for
movement of the ribcage during breathing.
THE APPENDICULAR BONES
THE SHOULDER GIRDLE
Also known as the pectoral girdle, it is connected to the rest of the skeleton by joints
between the clavicles and the sternum.
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Clavicle or collar bones - 2 bones
Scapula or shoulder blades - 2 bones
The functions of the scapula are to form a shoulder joint with the arms, and also to
provide large areas of bone to which the muscles of the arm, back and chest are
attached. The shoulder joint is held in position by these muscles. The scapula is
able to move by sliding over the ribs. The function of the clavicle is to support the
shoulder joint.
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THE UPPER LIMBS
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Humerus
Radius
Ulna
The humerus is the longest bone in the upper arm. One end fits into the hollow of
the scapula, while the other end joins with the ulna and radius. These form the
elbow.
The radius runs from the elbow to the wrist on the thumb side. It is shorter than the
ulna.
The ulna also runs from the elbow to the wrist on the little finger side. It is longer
than the radius.
BONES OF THE WRIST AND HAND
Carpals (wrist bones)
The carpus (wrist) of the hand contains eight small bones, which are held together
by ligaments. The bones are arranged in two transverse rows, with four bones in
each row. Collectively, these bones are called the carpals.
Metacarpals (bones of the hand)
The metacarpus (palm) of the hand contains five bones called metacarpals. Each
metacarpal bone consists of a proximal base, and intermediate body and a distal
head. These bones are numbered 1 - 5 starting at the thumb. The heads of the
metacarpals are commonly called the knuckles and are readily visible in a clenched
fist.
Phalanges (finger bones)
The phalanges are the bones of the fingers. There are 14 of these bones in each
hand. Like the metacarpals, the phalanges are numbered 1 - 5 beginning with the
thumb. A single bone of a finger is called a phalanx. Like the metacarpals, each
phalanx consists of a proximal base, an intermediate body, and a distal head. There
are two phalanges (proximal and distal) in the thumb and three phalanges (proximal,
middle and distal) in each of the other four digits.
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JOINTS FOUND IN THE WRIST
The joint found at the wrist is a condyloid joint. A condyloid joint permits up-anddown and side-to-side movements. The distal end of the radius articulates with the
proximal ends of the scaphoid, lunate and triquetral.
A disc of white fibrocartilage sits in the joint cavity and separates the ulna from the
carpal bones.
Gliding joints are found between the wrist bones - the articular surfaces glide over
each other - allowing less freedom of movement.
CARPAL TUNNEL
A strong, fibrous band stretches across the front of the carpal bones and is called
the flexor retinaculum.
The concavity formed by the pisiform and hamate (on the ulnar side) and the
scaphoid and trapezium (on the radial side) constitute the space called the carpal
tunnel. The tendons of flexor muscles of the wrist joint and the fingers and the
median nerve pass through the carpal tunnel. Synovial membrane forms sleeves
around these tendons in the carpal tunnel. Synovial fluid prevents friction that might
damage the tendons as they move over the bones.
Narrowing of the carpal tunnel gives rise to a condition called carpal tunnel
syndrome in which the median nerve is compressed. The nerve compression
causes pain, numbness, tingling and muscle weakness in the hand.
The strong, fibrous band that extends across the back of the wrist is called the
extensor retinaculum.
Tendons of muscles that extend the wrist and finger joints are encased in synovial
membrane under the retinaculum. Synovial fluid is secreted and prevents friction.
JOINTS OF THE HANDS AND FINGERS
There are synovial joints between:
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the carpal bones
the carpal and metacarpal bones
the metacarpal bones and proximal phalanges
the phalanges
Hinge joint - found between the phalanges of the fingers. A hinge joint produces an
angular, opening-and-closing motion like that of a hinged door.
Saddle joint - found in the thumb, where the trapezius and metacarpal bone of the
thumb articulate. A saddle joint will allow movement round two axes.
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PELVIC GIRDLE
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The ileum (this is the largest bone and forms the hip)
The ischium & pubis (together these two bones form a ring)
Also known as the hip girdle, it consists of two hip bones (the right and left pelvis).
These bones meet at a joint at the front of the body (pubis symphisis), and are firmly
connected to the sacrum at the back. Together they form a strong ring of bone. The
upper leg bones (femur) fit into deep sockets at the sides. The pelvis of the female
is wider and shallower than that of the male. Oestrogens are responsible for the
wider female pelvis that develops during puberty, and for maintaining bone mass in
adult life.
The function of the pelvic girdle is to provide a strong structure to support the weight
of the upper part of the body and to take the strain of the attached muscles of the
legs, spine and abdominal wall. It also protects the contents of the lower part of the
abdomen.
THE LOWER LIMBS
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Femur
Tibia
Fibula
Patella
The femur is also known as the thigh bone. It is the longest and strongest bone in
the body. The end nearest the body has a rounded head that fits into the pelvis.
The other end has a grooved surface that forms part of the knee.
The tibia is also known as the shinbone. It is the largest bone below the knee. It
carries a lot of the body’s weight. It runs from the knee to the ankle.
The fibula is much smaller than the tibia and carries very little of the body’s weight.
Its upper end connects with the tibia just below the knee whilst the other end forms
part of the ankle. The fibula helps the foot to swivel.
The patella is also known as the kneecap. This is a small disc-like bone that lies
over the knees surface. Its function is to protect the knee from damage. It forms
inside a tendon, which holds it in place.
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BONES OF THE FEET
The foot is made up of 26 bones
TARSALS (ankle bones)
There are 7 tarsal bones. These form the posterior part of the foot. These are:
1 talus
1 calcaneus
1 navicular
3 cuneiform
1 cuboid
Talus - this articulates with the tibia and fibula at the ankle joint
Calcaneum - this is the main bone (heel bone). The talus rests directly upon it.
Cuneiforms - there are 3 bones - outer, middle and inner
Cuboid - this bone can be found on the lateral (outer) part of the foot
Navicular - this can be found on the medial (inner) part of the foot
METATARSALS (bones of the foot)
There are 5 metatarsals in each foot. These are the long bones within the foot.
They are not individually named. Instead they are numbered from 1-5 from their
medial (inner) to lateral (outer) aspect.
PHALANGES (toe bones)
These are the bones of the toes. They are called phalanges and there are 14 in
each foot. The large toe has 2 phalanges and the other smaller toes have 3
phalanges. The phalanges articulate with the metatarsals. The toe bones, except
for those of the big toe, bear almost no weight when walking. Their function is to
give spring to the step.
FUNCTIONS OF THE FEET
The two main functions of the feet are:
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to support the weight of the body when it is in an upright position
to lever the body off the ground
When we walk, it is the talus that initially bears the entire weight of the body. Part of
this weight is then transmitted to the calcaneus and the remainder to the tarsal
bones.
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The calcaneus is the largest and strongest bone in the foot.
STRUCTURE OF THE ARCHES OF THE FEET
The arrangement of the bones of the foot is such that it is not a rigid structure. The
bones are arranged almost in a bridge-like manner and are supported by 19 muscles
and 107 ligaments. When the body is upright, its weight is transmitted through the
anklebone to the other bones of the foot and is shared with them. All the bones of
the foot are so placed that they catch and bear the entire weight of the body on four
arches.
There are 3 arches in the foot:One medial longitudinal arch
This is the highest of the arches and is formed by the calcaneum, navicular, three
cuneiform and the first three metatarsal bones. Only the calcaneum and the distal
end of the metatarsal bones should touch the ground.
One lateral longitudinal arch
The lateral arch is less prominent than that of the medial arch. It is only made up of
the cuboid, calcaneum and the two lateral metatarsal bones. Again, only the
calcaneum and metatarsal bones should touch the ground.
One transverse arch
This runs across the foot and is formed by the cuboid, the three cuneiforms and the
bases of the five metatarsal bones.
FUNCTIONS OF THE ARCHES
These arches are very important allowing flexibility of movement and helping the
body to balance. They are maintained by strong ligaments aided by muscles.
These arches are sturdy and sometimes have to act as shock absorbers, e.g. an
adult jumping from the height of several feet.
The arches help to bear the weight of the whole body and help to distribute it across
the entire foot. They act as a lever helping to propel the body forward in motion.
Sometimes, however, the arches become weakened and collapse. The condition
known as ‘flat foot ‘can result.
JOINTS FOUND IN THE ANKLE
The ankle joint is a hinge joint and is formed by the distal end of the tibia and its
medial malleolus, the distal end of the fibula (lateral malleolus) and the talus.
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JOINTS FOUND IN THE FEET AND TOES
There are synovial joints between:
The tarsal bones
Tarsal and metatarsal bones
The metatarsals and proximal phalanges
The phalanges
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MAJOR LIGAMENTS FOR ANKLE, KNEE, PELVIS, WRIST AND SHOULDER
Ligaments are tough, fibrous cords of connective tissue that surround the joints,
binding them together and joining bones to bones.
Ankle
Knee
Pelvis
Ligament
Function
Deltoid
Supports the medial side of the joint.
Anterior talofibular
Posterior talofibular
Supports the lateral side of the joint.
Calcaneofibular
Attaches to the lateral surface of the
calcaneous.
Cruciate
Transverse
Meniscofemoral
Meniscotibial
Patellar
Medial collateral
Oblique popliteal
Arcuate popliteal
The ligaments surrounding the knee joint offers
stability by limiting movements.
Anterior sacroiliac
Posterior sacroiliac
Interosseous
sacroiliac
Sacrotuberous
Sacrospinous
Anterior
sacrococcygeal
Posterior
sacrococcygeal
Lateral
sacrococcygeal
Interarticular
Anterior pubic
Posterior pubic
Superior pubic
Arcuate pubic
A highly durable network which gives the pelvic
joints tremendous strength.
Protects the articular capsule.
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Wrist
Ligament
Function
Palmar radiocarpal
Dorsal radiocarpal
Ulnar collateral
Radial collateral
Strengthens the radiocarpal joint.
Radiate carpal
Pisohamate
Palmar intercarpal
Interosseous
intercarpal
Dorsal intercarpal
Strengthens the midcarpal joint.
Shoulder Cocrocoacromial
Corococlavicular
Acromioclavicular
Superior, middle,
inferior and posterior
glenohumeral
Support the acromio-clavicular joint.
Connects humerus to glenoid.
The inferior glenohumeral splits into a front and
back half, acting like a hammock to support the
humerus in the joint.
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