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Chapter 7
The Skeletal System: The Axial Skeleton
Lecture Outline
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INTRODUCTION
• Familiarity with the names, shapes, and positions of
individual bones helps to locate other organs and to
understand how muscles produce different movements due
to attachment on individual bones and the use of leverage
with joints.
• The bones, muscles, and joints together form the
musculoskeletal system.
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Chapter 7
The Skeletal System:The Axial Skeleton
• Axial Skeleton
– 80 bones
– lie along longitudinal axis
– skull, hyoid, vertebrae, ribs,
sternum, ear ossicles
• Appendicular Skeleton
– 126 bones
– upper & lower limbs and
pelvic & pectoral girdles
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DIVISIONS OF THE SKELETAL SYSTEM
• The axial skeleton consists of bones arranged along the
longitudinal axis of the body. The parts of the axial skeleton,
composed of 80 bones, are the skull, hyoid bone, vertebral
column, sternum, and ribs (Figure 7.1).
• The appendicular skeleton comprises one of the two major
divisions of the skeletal system.It consists of 126 bones in
the upper and lower extremities (limbs or appendages) and
the pectoral (shoulder) and pelvic (hip) girdles, which attach
them to the rest of the skeleton.
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Types of Bones
• 5 basic types of bones:
– long = compact
– short = spongy except
surface
– flat = plates of compact
enclosing spongy
– irregular = variable
– sesamoid = develop in
tendons or ligaments
(patella)
• Sutural bones = in joint
between skull bones
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BONE SURFACE MARKINGS
• There are two major types of surface markings.
– Depressions and openings participate in joints or allow
the passage of soft tissue.
– Processes are projections or outgrowths that either help
form joints or serve as attachment points for connective
tissue.
• Table 7.2 describe the various surface markings along with
examples of each.
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Bone Surface Markings
from Table 7.2
•
•
•
•
•
•
•
•
•
Foramen = opening
Fossa = shallow depression
Sulcus = groove
Meatus = tubelike passageway or canal
Condyle = large, round protuberance
Facet = smooth flat articular surface
Trochanter = very large projection
Tuberosity = large, rounded, roughened projection
Learning the terms found in this Table will simplify your study of the
skeleton.
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SKULL
• The skull, composed of 22 bones, consists of the cranial
bones (cranium) and the facial bones (face) (Figures. 7.3
through 7.8).
• General Features
– The skull forms the large cranial cavity and smaller
cavities, including the nasal cavity and orbits (eye
sockets).
– Certain skull bones contain mucous membrane lined
cavities called paranasal sinuses.
– The only moveable bone of the skull, other than the ear
ossicles within the temporal bones, is the mandible.
– Immovable joints called sutures hold the skull bones
together.
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The Skull
• 8 Cranial bones
– protect brain & house ear ossicles
– muscle attachment for jaw, neck & facial muscles
• 14 Facial bones
– protect delicate sense organs -- smell, taste, vision
– support entrances to digestive and respiratory systems
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The 8 Cranial Bones
Frontal
Parietal (2)
Temporal (2)
Occipital
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Sphenoid
Ethmoid
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Frontal Bone
•
•
•
•
Forehead, roof of orbits, & anterior cranial floor
Frontal suture gone by age 6 (metopic suture)
Supraorbital margin and frontal sinus
A “black eye” results from accumulation of fluid and blood in the upper
eyelid following a blow to the relatively sharp supraorbital margin
(brow line).
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cranial bone functions
• They protect the brain.
– Their inner surfaces attach to membranes that stabilize
the positions of the brain, blood vessels, and nerves.
– The outer surfaces of cranial bones provide large areas
of attachment for muscles that move the various parts of
the head.
– Facial bones form the framework of the face and protect
and provide support for the nerves and blood vessels in
that area.
• Cranial and facial bones together protect and support the
special sense organs.
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Parietal & Temporal
Bones
• Parietal
– sides & roof of cranial cavity
• Temporal
– temporal squama
– zygomatic process forms part
of arch
– external auditory meatus
– mastoid process
– styloid process
– stylomastoid foramen(VII)
– mandibular fossa (TMJ)
– petrous portion (VIII)
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Temporal and Occipital bones
• Temporal
– carotid foramen
(carotid artery)
– jugular foramen
(jugular vein)
• Occipital
– foramen magnum
– occipital condyles
– external occipital protuberance
attachment for ligamentum
nuchae
– superior & inferior nuchal lines
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Sphenoid bone
• Base of skull
• Pterygoid processes are attachment
sites for jaw muscles
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Sphenoid in Anterior View
• Body is a cubelike portion holding sphenoid sinuses
• Greater and lesser wings
• Pterygoid processes
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Sphenoid from Superior View
• Lesser wing & greater wing
• Sella turcica holds pituitary gland
• Optic foramen
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Ethmoid Bone
• The ethmoid bone forms part of the anterior portion of the cranial floor,
the medial wall of the orbits, the superior portion of the nasal septum,
and most of the superior side walls of the nasal cavity. It is a major
superior supporting structure of the nasal cavity (Figures 7.11, 7.13).
• Crista galli attaches to the membranes that cover the brain
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Ethmoid bone
• Lateral masses contain ethmoid sinuses
• Perpendicular plate is upper part of nasal septum
• Superior & middle nasal concha or turbinates
– filters & warms air
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14 Facial Bones
Nasal (2)
Mandible (1)
Inferior nasal conchae (2)
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Maxillae (2)
Lacrimal (2)
Zygomatic (2)
Palatine (2)
Vomer (1)
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Maxillary bones
•
•
•
•
Floor of orbit, floor of nasal cavity or hard palate
Maxillary sinus
Alveolar processes hold upper teeth
Cleft palate is lack of union of maxillary bones
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Zygomatic Bones
• Cheekbones
• Lateral wall of orbit along with sphenoid
• Part of zygomatic arch along with part of temporal
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Lacrimal and Inferior Nasal Conchae
• Lacrimal bones
– part of medial wall of orbit
Inferior Nasal Conchae
– lacrimal fossa houses lacrimal sac
• Inferior nasal concha or turbinate (not part of ethmoid)
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Mandible
•
•
•
•
Body, angle & rami
Condylar & coronoid processes
Alveolar processes for lower teeth
Mandibular & mental foramen
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TMJ
• The mandible articulates with the temporal bone to form the
temporomandibular joint (Figure 7.4).
• Temporomandibular joint (TMJ) syndrome is dysfunction to
varying degrees of the temporomandibular joint. Causes
appear to be numerous and the treatment is similarly
variable.
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Palatine & Vomer
• Palatine
– L-shaped : one end is back part of hard palate,
other end is part of orbit (see previous picture)
• Vomer
– posterior part of nasal septum
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Nasal Septum
• The nasal septum is a vertical partition that divides the nasal
cavity into right and left sides (Figure 7.11).
• A deviated nasal septum is a lateral deflection of the septum
from the midline, usually resulting from improper fusion of
septal bones and cartilage.
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Nasal Septum
• Divides nasal cavity into left and right sides
• Formed by vomer, perpendicular plate of ethmoid and septal
cartilage
• Deviated septum does not line in the midline
– developmental abnormality or trauma
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The orbits (eye sockets)
• The orbits contain the eyeballs and associated structures
and are formed by seven bones of the skull (Figure 7.12).
• Five important foramina are associated with each orbit
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Bones of the Orbit
–
–
–
–
–
Roof is frontal and sphenoid
Lateral wall is zygomatic and sphenoid
Floor is maxilla, zygomatic and sphenoid
Medial wall is maxilla, lacrimal, ethmoid and sphenoid
Orbital fissures and optic foramen
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Foramina of the Skull
• Table 7.4 describes major openings of skull
• In which bone would you find the following and what is their
function?
– foramen magnum
– optic foramen
– mandibular foramen
– carotid canal
– stylomastoid foramen
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Unique Features of the Skull
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Sutures
• Sutures are immovable joints found only between skull
bones and hold skull bones together.
• Sutures include the coronal, sagittal, lamboidal,and
squamous sutures, among others (Figures 7.4, 7.6).
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Sutures
• Lamboid suture unites parietal and occipital
• Sagittal suture unites 2 parietal bones
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Sutures
• Coronal suture unites frontal and both parietal bones
• Squamous suture unites parietal and temporal bones
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Paranasal Sinuses
• Paranasal sinuses are cavities in bones of the skull that
communicate with the nasal cavity.
– They are lined by mucous membranes and also serve to
lighten the skull and serve as resonating chambers for
speech.
– Cranial bones containing the sinuses are the frontal,
sphenoid, ethmoid, and maxillae.
– Sinusitis occurs when membranes of the paranasal
sinuses become inflamed due to infection or allergy.
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Paranasal Sinuses
•
•
•
•
Paired cavities in ethmoid, sphenoid, frontal and maxillary
Lined with mucous membranes and open into nasal cavity
Resonating chambers for voice, lighten the skull
Sinusitis is inflammation of the membrane (allergy)
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Paranasal Sinuses
•
•
•
•
Paired cavities in ethmoid, sphenoid, frontal and maxillary
Lined with mucous membranes and open into nasal cavity
Resonating chambers for voice, lighten the skull
Sinusitis is inflammation of the membrane (allergy)
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Fontanels
• Fontanels are dense connective tissue membrane-filled
spaces between the cranial bones of fetuses and infants.
They remain unossified at birth but close early in a child’s
life (Figure 7.14).
– The major fontanels are the anterior, posterior,
anterolaterals, and posterolaterals .
• Fontanels have two major functions.
– They enable the fetal skull to modify its size and shape
as it passes through the birth canal.
– They permit rapid growth of the brain during infancy.
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Fontanels of the Skull at Birth.
• Dense connective tissue membrane-filled spaces
(soft spots)
• Unossified at birth but close early in a child's life.
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HYOID BONE
• The hyoid bone is a unique component of the axial skeleton
because it does not articulate with any other bones.
• The hyoid bone consists of a horizontal body and paired
projections, the lesser and greater horns. (Figure 7.15)
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Hyoid Bone
– U-shaped single
bone
– Articulates with no
other bone of the
body
– Suspended by
ligament and
muscle from skull
– Supports the
tongue & provides
attachment for
tongue, neck and
pharyngeal
muscles
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VERTEBRAL COLUMN
• The vertebral column, along with the sternum and ribs,
makes up the trunk of the skeleton.
• The 26 bones of the vertebral column are arranged into five
regions: cervical, thoracic, lumbar, sacral, and coccygeal
(Figure 7.16a).
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Vertebral Column
• Backbone or spine built of 26
vertebrae
• Five vertebral regions
– cervical vertebrae (7) in the
neck
– thoracic vertebrae ( 12 ) in
the thorax
– lumbar vertebrae ( 5 ) in the
low back region
– sacrum (5, fused)
– coccyx (4, fused)
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Intervertebral Discs
• Between adjacent vertebrae absorbs vertical shock
• Permit various movements of the vertebral column
• Fibrocartilagenous ring with a pulpy center
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Normal Curves of the Vertebral Column
• The four normal vertebral curves are the cervical and
lumbar (anteriorly convex curves) and thoracic and sacral
(anteriorly concave curves) (Figure 7.16b).
• Between adjacent vertebrae, from the first cervical (atlas) to
the sacrum, are intervertebral discs that form strong joints,
permit various movements of the vertebral column, and
absorb vertical shock (Figure 7.16d).
– In the fetus, there is only a single anteriorly concave
curve (Figure 7.16c).
– The cervical curve develops as the child begins to hold
his head erect.
– The lumbar curve develops as the child begins to walk.
– All curves are fully developed by age 10.
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Normal Curves of the Vertebral Column
• Primary curves
– thoracic and sacral are formed during fetal development
• Secondary curves
– cervical if formed when infant raises head at 4 months
– lumbar forms when infant sits up & begins to walk at 1
year
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Vertebrae
• Parts of a typical vertebra include a body, a vertebral arch,
and several processes (Figure 7.17).
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Typical Vertebrae
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• Body
– weight bearing
• Vertebral arch
– pedicles
– laminae
• Vertebral foramen
• Seven processes
– 2 transverse
– 1 spinous
– 4 articular
• Vertebral notches
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Intervertebral Foramen & Spinal Canal
• Spinal canal is all vertebral foramen together
• Intervertebral foramen are 2 vertebral notches together
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Regions of the Vertebral Column
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Cervical Region
• There are 7 cervical vertebrae (Figure 7.18a).
– The first cervical vertebra is the atlas and supports the
skull (Figure 7.18a, b).
– The second cervical vertebra is the axis, which permits
side-to-side rotation of the head (Figure 7.18a, c).
– The third to sixth correspond to the structural patterns of
the typical cervical vertebrae (Figure 7.18d).
– The seventh called the vertebra prominens is somewhat
different (Figure 7.18)
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Typical
Cervical
Vertebrae
(C3-C7)
• Smaller bodies but larger spinal canal
• Transverse processes
– shorter, with transverse foramen for vertebral artery
• Spinous processes of C2 to C6 often bifid
• 1st and 2nd cervical vertebrae are unique - atlas & axis
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Atlas & Axis
(C1-C2)
• Atlas -- ring of bone, superior facets for occipital condyles
– nodding movement at atlanto-occipital joint signifies “yes”
• Axis -- dens or odontoid process is body of atlas
– pivotal movement at atlanto-axial joint signifies “no”
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Thoracic Region
• There are 12 thoracic vertebrae (Figure 7.19).
• These vertebrae articulate with the ribs.
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Thoracic Vertebrae
(T1-T12)
• Larger and stronger bodies
• Longer transverse & spinous
processes
• Facets or demifacets on
body for head of rib
• Facets on transverse
processes (T1-T10) for
tubercle of rib
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Lumbar Region
• There are 5 lumbar vertebrae (Figure 7.20).
• They are the largest and strongest vertebrae in the column.
• Table 7.4 summarizes the major structural differences
among the cervical, thoracic, and lumbar vertebrae.
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Lumbar Vertebrae
• Strongest & largest
• Short thick spinous &
transverse processes
– back musculature
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Sacrum
• The sacrum is formed by the union of 5 sacral vertebrae
(Figure 7.21a) and serves as a strong foundation for the
pelvic girdle.
• Table 8.1 shows the differences between the male and
female sacrum.
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Sacrum
• Union of 5 vertebrae (S1 - S5) by age 30
– median sacral crest was spinous processes
– sacral ala is fused transverse processes
• Sacral canal ends at sacral hiatus
• Auricular surface & sacral tuberosity of SI joint
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Coccyx
• The coccyx is formed by the fusion of 4 coccygeal vertebrae
(Figure 7.21).
• Caudal anesthesia (epidural block), frequently used during
labor (in childbirth), causes numbness in the regions
innervated by the sacral and coccygeal nerves
(approximately from the waist to the knees).
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Coccyx
• Union of 4 vertebrae (Co1 - Co4) by age 30
• Caudal or epidural anesthesia during delivery
– into sacral hiatus anesthetize sacral & coccygeal
nerves
– sacral and coccygeal cornu are important
landmarks
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THORAX
• The term thorax refers to the entire chest.
• The skeletal part of the thorax (a bony cage) consists of the
sternum, costal cartilages, ribs, and the bodies of the
thoracic vertebrae (Figure 7.22).
• The thoracic cage encloses and protects the organs in the
thoracic and superior abdominal cavities. It also provides
support for the bones of the shoulder girdle and upper limbs.
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Thorax
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Thorax
– Bony cage flattened
from front to back
– Sternum (breastbone)
– Ribs
• 1-7 are true ribs
(vertebrosternal)
• 8-12 are false ribs
(vertebrochondral)
• 11-12 are floating
– Costal cartilages
– Bodies of the thoracic
vertebrae.
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Sternum
• The sternum is located on the anterior midline of the
thoracic wall.
• It consists of three parts: manubrium, body, and xiphoid
process (Figure 7.22).
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Sternum
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• Manubrium
– 1st & 2nd ribs
– clavicular
notch
• Body
– costal
cartilages of 210 ribs
• Xiphoid
– ossifies by 40
– CPR position
– abdominal
mm.
• Sternal puncture
– biopsy
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Ribs
• The 12 pairs of ribs give structural support to the sides of
the thoracic cavity (Figure 7.22b).
– The first 7 pairs of ribs are called true ribs; the remaining
five pairs, false ribs (with the last two false ribs called
floating ribs).
– Figure 7.23a shows the parts of a typical rib.
– Rib fractures are the most common types of chest
injuries.
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Ribs
•
•
•
•
Increase in length from ribs 1-7, thereafter decreasing
Head and tubercle articulate with facets
Body with costal groove containing nerve & blood vessels
Intercostal spaces contain intercostal muscles
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Rib Articulation
• Tubercle articulates with transverse process
• Head articulates with vertebral bodies
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DISORDERS: HOMEOSTATIC IMBALANCES
• Protrusion of the nucleus pulposus into an adjacent
vertebral body is called a herniated (slipped) disc (Figure
7.24). This movement exerts pressure on spinal nerves,
causing considerable pain.
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Herniated (Slipped) Disc
• Protrusion of the
nucleus pulposus
• Most commonly in
lumbar region
• Pressure on spinal
nerves causes pain
• Surgical removal
of disc after
laminectomy
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DISORDERS: HOMEOSTATIC IMBALANCES
• Abnormal curvatures of the vertebral column include
scoliosis, an lateral bending of the vertebral column;
kyphosis, an exaggerated curve of the thoracic curve; and
lordosis, an exaggeration of the lumbar curve (Figure 7.25
a-c).
• Spina bifida is a congenital defect caused by failure of the
vertebral laminae to unite at the midline. This may involve
only one or several vertebrae; nervous tissue may or may
not protrude through the skin (Figure 7.26).
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Clinical Problems
• Abnornal curves of the spine.
– scoliosis (lateral bending of the column)
– kyphosis (exaggerated thoracic curve)
– lordosis (exaggerated lumbar curve)
• Spina bifida is a congenital defect
– failure of the vertebral laminae to unite
– nervous tissue is unprotected
– paralysis
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end
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Chapter 8
The Skeletal System: Appendicular Skeleton
Lecture Outline
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INTRODUCTION
• The appendicular skeleton includes the bones of the upper
and lower extremities and the shoulder and hip girdles.
• The appendicular skeleton functions primarily to facilitate
movement.
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Chapter 8 The Skeletal System:
Appendicular Skeleton
• Pectoral girdle
• Pelvic girdle
• Upper limbs
• Lower limbs
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Pectoral (Shoulder) Girdle
The pectoral or shoulder girdle attaches the bones of the
upper limbs to the axial skeleton (Figure 8.1).
• Consists of scapula and clavicle
• Clavicle articulates with sternum (sternoclavicular joint)
• Clavicle articulates with scapula (acromioclavicular joint)
• Scapula held in place by muscle only
• Upper limb attached to pectoral girdle at shoulder
(glenohumeral joint)
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Clavicle
• The clavicle or collar bone lies horizontally in the superior
and anterior part of thorax superior to the first rib and
articulates with the sternum and the clavicle (Figure 8.2).
• The clavicle, one of the most frequently broken bones in the
body, transmits mechanical force from the upper limb to the
trunk.
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Clavicle (collarbone)
• S-shaped bone with two curves
– medial curve convex anteriorly/lateral one concave anteriorly
• Extends from sternum to scapula above 1st rib
• Fracture site is junction of curves
• Ligaments attached to clavicle stabilize its position.
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Scapula
• The scapula or shoulder blade articulates with the clavicle
and the humerus (Figure 8.3).
• The scapulae articulate with other bones anteriorly, but are
held in place posteriorly only by complex shoulder and back
musculature.
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Anterior Surface of Scapula
• Subscapular fossa filled with muscle
• Coracoid process for muscle attachment
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Posterior Surface of Scapula
• Triangular flat bone found in upper back region
• Scapular spine ends as acromion process
– a sharp ridge widening to a flat process
• Glenoid cavity forms shoulder joint with head of humerus
• Supraspinous & infraspinous fossa for muscular
attachments
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UPPER LIMB (EXTREMITY)
• Each upper limb consists of 30 bones including the
humerus, ulna, radius, carpals, metacarpals, and phalanges
(Figure 8.4).
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Upper Extremity
• Each upper limb = 30 bones
– humerus within the arm
– ulna & radius within the forearm
– carpal bones within the wrist
– metacarpal bones within the palm
– phalanges in the fingers
• Joints
– shoulder (glenohumeral), elbow,
wrist, metacarpophalangeal,
interphalangeal
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Humerus
• The humerus is the longest and largest bone of the upper
limb (Figure 8.5).
• It articulates proximally with the scapula and distally at the
elbow with both the radius and ulna.
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Humerus --- Proximal End
• Part of shoulder joint
• Head & anatomical neck
• Greater & lesser tubercles for muscle
attachments
• Intertubercular
sulcus or bicipital
groove
• Surgical neck is
fracture site
• Deltoid tuberosity
• Shaft
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Humerus --- Distal End
anterior and posterior
• Forms elbow joint with
ulna and radius
• Capitulum
– articulates with head of radius
• Trochlea
– articulation with ulna
• Olecranon fossa
– posterior depression for
olecranon process of ulna
• Medial & lateral epicondyles
– attachment of forearm
muscles
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Ulna and Radius
• The ulna is located on the medial aspect of the forearm
(Figure 8.6).
• The radius is located on the lateral aspect (thumb side) of
the forearm (Figure 8.6)
• The radius and ulna articulate with the humerus at the elbow
joint (Figure 8.7a), with each other (Figure 8.7b, c), and with
three carpal bones. (Figure 8.8)
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Ulna & Radius --- Proximal End
• Ulna (on little finger side)
– trochlear notch articulates with
humerus & radial notch with radius
– olecranon process forms point of elbow
• Radius (on thumb side)
– head articulates with capitulum of
humerus & radial notch of ulna
– tuberosity for muscle attachment
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Ulna & Radius --- Proximal End
• Ulna (on little finger side)
– trochlear notch articulates with
humerus & radial notch with radius
– olecranon process forms point of elbow
• Radius (on thumb side)
– head articulates with capitulum of
humerus & radial notch of ulna
– tuberosity for muscle attachment
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Elbow Joint
•
•
•
•
Articulation of humerus with ulna and radius
Ulna articulates with trochlea of humerus
Radius articulates with capitulum of humerus
Interosseous membrane between ulna & radius provides site
for muscle attachment
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Ulna and Radius - Distal End
• Ulna --styloid process
– head separated from wrist joint by fibrocartilage
disc
• Radius
– forms wrist joint with scaphoid, lunate & triquetrum
– forms distal radioulnar joint with head of ulna
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Carpals, Metacarpal, and Phalanges
• The eight carpal bones, bound together by ligaments,
comprise the wrist (Figure. 8.8).
• Five metacarpal bones are contained in the palm of each
hand (Figure 8.8).
• Each hand contains 14 phalanges, three in each finger and
two in each thumb (Figure 8.8).
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8 Carpal Bones (wrist)
• Proximal row - lat to med
– scaphoid - boat shaped
– lunate - moon shaped
– triquetrum - 3 corners
– pisiform - pea shaped
• Distal row - lateral to medial
– trapezium - four sided
– trapezoid - four sided
– capitate - large head
– hamate - hooked process
• Carpal tunnel--tunnel of bone &
flexor retinaculum
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Metacarpals and Phalanges
• Metacarpals
– 5 total----#1 proximal to thumb
– base, shaft, head
– knuckles (metacarpophalangeal
joints)
• Phalanges
– 14 total: each is called phalanx
– proximal, middle, distal on each
finger, except thumb
– base, shaft, head
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Hand
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PELVIC (HIP) GIRDLE
• The pelvic (hip) girdle consists of two hipbones (coxal
bones) and provides a strong and stable support for the
lower extremities, on which the weight of the body is carried
(Figure 8.9).
• Each hipbone (coxal bone) is composed of three separate
bones at birth: the ilium, pubis, and ischium.
• These bones eventually fuse at a depression called the
acetabulum, which forms the socket for the hip joint (Figure
8.10a).
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Pelvic Girdle and Hip Bones
• Pelvic girdle = two hipbones united at pubic symphysis
– articulate posteriorly with sacrum at sacroiliac joints
• Each hip bone = ilium, pubis, and ischium
– fuse after birth at acetabulum
• Bony pelvis = 2 hip bones, sacrum and coccyx
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The Ilium
• The larger of the three components of the hip bone and
articulates (fuses) with the ischium and pubis (Figure
8.10b,c).
• Bone marrow aspiration or bone marrow biopsy are
frequently performed on the iliac crest in adults.
• The ischium is the inferior, posterior portion of the hip bone
(Figure 8.10b,c).
• The pubis is the anterior and inferior part of the hip bone
(Figure 8.10b,c).
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Ilium
•
•
•
•
•
Iliac crest and iliac spines for muscle attachment
Iliac fossa for muscle attachment
Gluteal lines indicating muscle attachment
Sacroiliac joint at auricular surface & iliac tuberosity
Greater sciatic notch for sciatic nerve
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Ischium and Pubis
• Ischium
– ischial spine &
tuberosity
– lesser sciatic notch
– ramus
• Pubis
– body
– superior & inferior
ramus
– pubic symphysis is pad
of fibrocartilage
between 2 pubic bones
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Pelvis
• Pelvis = sacrum, coccyx
& 2 hip bones
• Pelvic brim
– sacral promontory to
symphysis pubis
– separates false from
true pelvis
– false pelvis holds
only abdominal
organs
• Inlet & outlet
• Pelvic axis = path of
babies head
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True and False Pelves
• Together with the sacrum and coccyx, the two hipbones
(coxal bones) form the pelvis.
• The greater (false) and lesser (true) pelvis are anatomical
subdivisions of this basin-like structure (Figure 8.11a).
• Pelvimetry, the measurement of the size of the inlet and the
outlet of the birth canal, is important during pregnancy
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Female and Male Skeletons
• Male skeleton
– larger and heavier
– larger articular surfaces
– larger muscle attachments
• Female pelvis
– wider & shallower
– larger pelvic inlet & outlet
– more space in true pelvis
– pubic arch >90 degrees
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COMPARISON OF FEMALE AND MALE PELVES
• Male bones are generally larger and heavier than those of
the female; the male’s joint surfaces also tend to be larger.
• Muscle attachment points are more well-defined in the
bones of a male than of a female due to the larger size of
the muscles in males.
• A number of anatomical differences exist between the pelvic
girdles of females and those of males, primarily related to
the need for a larger pelvic outlet in females to facilitate
childbirth (Table 8.1).
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Female
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Male
108
COMPARISON OF PECTORAL AND PELVIC
GIRDLES
• The pectoral girdle does not directly articulate with the
vertebral column; the pelvic girdle does.
• The pectoral girdle sockets are shallow and maximize
movement; those of the pelvic girdle are deeper and allow
less movement.
• The structure of the pectoral girdle offers more movement
than strength; the pelvic girdle, more strength than
movement.
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LOWER LIMB (EXTREMITY)
• Each lower extremity is composed of 30 bones, including
the femur, tibia, fibula, tarsals, metatarsals, and phalanges
(Figure 8.12).
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Lower Extremity
• Each lower limb = 30 bones
– femur and patella within the
thigh
– tibia & fibula within the leg
– tarsal bones in the foot
– metatarsals within the forefoot
– phalanges in the toes
• Joints
– hip, knee, ankle
– proximal & distal tibiofibular
– metatarsophalangeal
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Femur
• The femur or thighbone is the largest, heaviest,
and strongest bone of the body (Figure 8.13a, b).
• It articulates with the hip bone and the tibia.
– head articulates with acetabulum (attached by
ligament of head of femur)
– medial & lateral condyles articulate with tibia
• neck is common fracture site
• greater & lesser trochanters, linea aspera, &
gluteal tuberosity-- muscle attachments
• patellar surface is visible anteriorly between
condyles
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Femur
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Patella
• The patella or kneecap is a sesamoid bone located anterior
to the knee joint (Figure 8.14).
• It functions to increase the leverage of the tendon of the
quadriceps femoris muscle, to maintain the position of the
tendon when the knee is bent, and to protect the knee joint.
• Patellofemoral stress syndrome is a common knee problem
in runners.
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Patella
• triangular sesamoid bone
• increases leverage of quadriceps femoris tendon
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Tibia and Fibula
• The tibia or shinbone is the larger, medial, weight-bearing
bone of the leg (Figure 8.15).
• The fibula is parallel and lateral to the tibia (Figure 8.15).
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Tibia and Fibula
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Tibia
• medial & larger bone
of leg
• weight-bearing bone
• lateral & medial
condyles
• tibial tuberosity for
patellar lig.
• proximal tibiofibular
joint
• medial malleolus at
ankle
117
Tibia and Fibula
Fibula
• not part of knee joint
• muscle attachment only
• lateral malleolus at ankle
lateral view of tibia
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Tarsals, Metatarsals, and Phalanges
• Seven tarsal bones constitute the ankle and share the
weight associated with walking (Figure 8.16).
• Five metatarsal bones are contained in the foot (Figure
8.16).
• Fractures of the metatarsals are common among dancers,
especially ballet dancers.
• The arrangement of phalanges in the toes is the same as
that described for the fingers and thumb above - fourteen
bones in each foot (Figure 8.16).
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Tarsus
• Proximal region of
foot (contains 7 tarsal
bones)
• Talus = ankle bone
(articulates with tibia
& fibula)
• Calcaneus - heel
bone
• Cuboid, navicular & 3
cuneiforms
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Metatarsus and Phalanges
• Metatarsus
– midregion of the foot
– 5 metatarsals (1 is most
medial)
– each with base, shaft and
head
• Phalanges
– distal portion of the foot
– similar in number and
arrangement to the hand
– big toe is hallux
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Arches of the Foot
• The bones of the foot are arranged in two non-rigid arches
that enable the foot to support the weight of the body;
provide an ideal distribution of body weight over the hard
and soft tissues, and provide leverage while walking (Figure
8.17).
• Flatfoot, clawfoot, and clubfoot are caused by decline,
elevation, or rotation of the medial longitudinal arches.
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Arches of the Foot
• Function
– distribute body weight over foot
– yield & spring back when weight is lifted
• Longitudinal arches along each side of foot
• Transverse arch across midfoot region
– navicular, cuneiforms & bases of metatarsals
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Clinical Problems
• Flatfoot
– weakened ligaments
allow bones of
medial arch to drop
• Clawfoot
– medial arch is too
elevated
• Hip fracture
– 1/2 million/year in US
– osteoporosis
– arthroplasty
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DEVELOPMENTAL ANATOMY OF THE SKELETAL SYSTEM
• Bone forms from mesoderm by intramembranous or endochondrial
ossification. (Figure 6.6)
• The skull begins development during the fourth week after fertilization
(Figure 8.18a)
• Vertebrae are derived from portions of cube-shaped masses of
mesoderm called somites (Figure 10.10)
• Around the fifth week of embryonic life, extremities develop from limb
buds, which consist of mesoderm and ectoderm (Figure8.18b).
• By the sixth week, a constriction around the middle portion of the limb
buds produces hand plates and foot plates, which will become hands
and feet. (Figure8.18c)
• By the seventh week, the arm, forearm and hand are evident in the
upper limb bud and the thigh, leg, and foot appear in the lower limb bud.
(Figure8.18d)
• By the eighth week the limb buds have developed into limbs.
(Figure8.18e)
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end
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Chapter 9
Joints
Lecture Outline
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INTRODUCTION
• A joint (articulation or arthrosis) is a point of contact
between two or more bones, between cartilage and bones,
or between teeth and bones.
• The scientific study of joints is called arthrology.
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Chapter 9
Joints
• Joints hold bones together but
permit movement
• Point of contact
– between 2 bones
– between cartilage and bone
– between teeth and bones
• Arthrology = study of joints
• Kinesiology = study of motion
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Classification of Joints
• Structural classification is based on the presence or
absence of a synovial (joint) cavity and type of connecting
tissue. Structurally, joints are classified as
– fibrous, cartilaginous, or synovial.
• Functional classification based upon movement:
– immovable = synarthrosis
– slightly movable = amphiarthrosis
– freely movable = diarthrosis
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Fibrous Joints
• Lack a synovial cavity
• Bones held closely together by
fibrous connective tissue
• Little or no movement
(synarthroses or
amphiarthroses)
• 3 structural types
– sutures
– syndesmoses
– gomphoses
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Sutures
• Thin layer of dense fibrous
connective tissue unites bones
of the skull
• Immovable (synarthrosis)
• If fuse completely in adults is
synostosis
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Syndesmosis
• Fibrous joint
– bones united by ligament
• Slightly movable (amphiarthrosis)
• Anterior tibiofibular joint and Interosseous membrane
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Gomphosis
• Ligament holds cone-shaped peg in bony socket
• Immovable (synarthrosis)
• Teeth in alveolar processes
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Cartilaginous Joints
•
•
•
•
Lacks a synovial cavity
Allows little or no movement
Bones tightly connected by fibrocartilage or hyaline cartilage
2 types
– synchondroses
– symphyses
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Synchondrosis
• Connecting material is hyaline cartilage
• Immovable (synarthrosis)
• Epiphyseal plate or joints between ribs and sternum
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Symphysis
• Fibrocartilage is
connecting material
• Slightly movable
(amphiarthroses)
• Intervertebral discs
and pubic symphysis
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• Synovial cavity separates
articulating bones
• Freely moveable
(diarthroses)
• Articular cartilage
– reduces friction
– absorbs shock
• Articular capsule
– surrounds joint
– thickenings in fibrous
capsule called
ligaments
• Synovial membrane
– inner lining of capsule
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Synovial Joints
140
Example of Synovial Joint
• Joint space is synovial joint cavity
• Articular cartilage covering ends of bones
• Articular capsule
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Articular Capsule
• The articular capsule surrounds a diarthrosis, encloses the
synovial cavity, and unites the articulating bones.
• The articular capsule is composed of two layers - the outer
fibrous capsule (which may contain ligaments) and the inner
synovial membrane (which secretes a lubricating and jointnourishing synovial fluid) (Figure 9.3).
• The flexibility of the fibrous capsule permits considerable
movement at a joint, whereas its great tensile strength helps
prevent bones from dislocating.
• Other capsule features include ligaments and articular fat
pads (Figure 9.3).
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• Synovial Membrane
Special
– secretes synovial fluid
Features
containing slippery hyaluronic acid
– brings nutrients to articular cartilage
• Accessory ligaments
– extracapsular ligaments
• outside joint capsule
– intracapsular ligaments
• within capsule
• Articular discs or menisci
– attached around edges to capsule
– allow 2 bones of different shape to fit tightly
– increase stability of knee - torn cartilage
• Bursae = saclike structures between structures
– skin/bone or tendon/bone or ligament/bone
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Nerve and Blood Supply
• Nerves to joints are branches of nerves to nearby
muscles
• Joint capsule and ligaments contain pain fibers and
sensory receptors
• Blood supply to the structures of a joint are branches
from nearby structures
– supply nutrients to all joint tissues except the
articular cartilage which is supplied from the
synovial fluid
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Sprain versus Strain
• Sprain
– twisting of joint that stretches or tears ligaments
– no dislocation of the bones
– may damage nearby blood vessels, muscles or
tendons
– swelling & hemorrhage from blood vessels
– ankle if frequently sprained
• Strain
– generally less serious injury
– overstretched or partially torn muscle
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Bursae and Tendon Sheaths
• Bursae
– fluid-filled saclike extensions of the joint capsule
– reduce friction between moving structures
• skin rubs over bone
• tendon rubs over bone
• Tendon sheaths
– tubelike bursae that wrap around tendons at wrist and
ankle where many tendons come together in a
confined space
• Bursitis
– chronic inflammation of a bursa
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TYPES OF MOVEMENT AT SYNOVIAL JOINTS
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Gliding Movements
• Gliding movements occur when relatively flat bone surfaces
move back and forth and from side to side with respect to
one another (Figure 9.4).
• In gliding joints there is no significant alteration of the angle
between the bones.
• Gliding movements occur at plantar joints.
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Angular Movements
• In angular movements there is an increase or a decrease in
the angle between articulating bones.
– Flexion results in a decrease in the angle between
articulating bones (Figure 9.5).
• Lateral flexion involves the movement of the trunk
sideways to the right or left at the waist. The
movement occurs in the frontal plane and involves the
intervertebral joints (Figure 9.5g).
– Extension results in an increase in the angle between
articulating bones (Figure 9.5).
– Hyperextension is a continuation of extension beyond the
anatomical position and is usually prevented by the
arrangement of ligaments and the anatomical alignment
of bones (Figures 9.5a, b, d, e).
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Flexion, Extension & Hyperextension
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Abduction, Adduction, and Circumduction
• Abduction refers to the movement of a bone away from the
midline (Figure 9.6a-c).
• Adduction refers to the movement of a bone toward the
midline (Figure 9.6d).
• Circumduction refers to movement of the distal end of a part
of the body in a circle (Figure 9.7).
– Circumduction occurs as a result of a continuous
sequence of flexion, abduction, extension, and
adduction.
– Condyloid, saddle, and ball-and-socket joints allow
circumduction.
• In rotation, a bone revolves around its own longitudinal axis
(Figure 9.8a).
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Abduction and Adduction
Condyloid joints
Ball and Socket
joints
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Circumduction
• Movement of a distal end of a body part in a circle
• Combination of flexion, extension, adduction and
abduction
• Occurs at ball and socket, saddle and condyloid joints
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Pivot and ball-and-socket joints permit rotation.
• If the anterior surface of a bone of the limb is turned toward
the midline, medial rotation occurs. If the anterior surface of
a bone of the limb is turned away from the midline, lateral
rotation occurs (Figure 9.8 b&c).
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Rotation
• Bone revolves around its own
longitudinal axis
– medial rotation is turning of
anterior surface in towards the
midline
– lateral rotation is turning of
anterior surface away from
the midline
• At ball & socket and pivot type
joints
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Special Movements
• Elevation is an upward movement of a part of the body
(Figure 9.9a).
• Depression is a downward movement of a part of the body
(Figure 9.9b).
• Protraction is a movement of a part of the body anteriorly in
the transverse plane (Figure 9.9c).
• Retraction is a movement of a protracted part back to the
anatomical position (Figure 9.9d).
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Special Movements of Mandible
•
•
•
•
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Elevation = upward
Depression = downward
Protraction = forward
Retraction = backward
157
Special Movements
• Inversion is movement of the soles medially at the
intertarsal joints so that they face away from each other
(Figure 9.9e).
• Eversion is a movement of the soles laterally at the
intertarsal joints so that they face away from each other
(Figure 9.9f).
• Dorsiflexion refers to bending of the foot at the ankle in the
direction of the superior surface (Figure 9.9g).
• Plantar flexion involves bending of the foot at the ankle joint
in the direction of the plantar surface (Figure 9.9g).
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Special Hand & Foot Movements
•
•
•
•
•
•
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Inversion
Eversion
Dorsiflexion
Plantarflexion
Pronation
Supination
159
Special Movements
• Supination is a movement of the forearm at the proximal
and distal radioulnar joints in which the palm is turned
anteriorly or superiorly (Figure 9.9h).
• Pronation is a movement of the forearm at the proximal and
distal radioulnar joints in which the distal end of the radius
crosses over the distal end of the ulna and the palm is
turned posteriorly or inferiorly (Figure 9.9h).
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Special Movements
• Opposition is the movement of the thumb at the
carpometacarpal joint in which the thumb moves across the
palm to touch the tips of the finger on the same hand.
• Review
– A summary of the movements that occur at synovial
joints is presented in Table 9.1.
• A dislocation or luxation is a displacement of a bone from a
joint.
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TYPES OF SYNOVIAL JOINTS
• Planar joints permit mainly side-to-side and back-and-forth
gliding movements (Figure 9.10a). These joints are
nonaxial.
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Planar Joint
• Bone surfaces are flat or slightly
curved
• Side to side movement only
• Rotation prevented by ligaments
• Examples
– intercarpal or intertarsal joints
– sternoclavicular joint
– vertebrocostal joints
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TYPES OF SYNOVIAL JOINTS
• A hinge joint contains the convex surface of one bone fitting
into a concave surface of another bone (Figure 9.10b).
Movement is primarily flexion or extension in a single plane..
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Hinge Joint
• Convex surface of one bones fits into
concave surface of 2nd bone
• Uniaxial like a door hinge
• Examples
– Knee, elbow, ankle, interphalangeal
joints
• Movements produced
– flexion = decreasing the joint angle
– extension = increasing the angle
– hyperextension = opening the joint
beyond the anatomical position
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TYPES OF SYNOVIAL JOINTS
• In a pivot joint, a round or pointed surface of one bone fits
into a ring formed by another bone and a ligament (Figure
9.10c). Movement is rotational and monaxial.
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Pivot Joint
• Rounded surface of bone articulates
with ring formed by 2nd bone &
ligament
• Monoaxial since it allows only rotation
around longitudinal axis
• Examples
– Proximal radioulnar joint
• supination
• pronation
– Atlanto-axial joint
• turning head side to side “no”
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TYPES OF SYNOVIAL JOINTS
• In an condyloid joint, an oval-shaped condyle of one bone
fits into an elliptical cavity of another bone (Figure 9.10d).
Movements are flexion-extension, abduction-adduction, and
circumduction.
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Condyloid or Ellipsoidal Joint
• Oval-shaped projection fits into oval depression
• Biaxial = flex/extend or abduct/adduct is possible
• Examples
– wrist and metacarpophalangeal joints for digits 2 to 5
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TYPES OF SYNOVIAL JOINTS
• A saddle joint contains one bone whose articular surface is
saddle-shaped and another bone whose articular surface is
shaped like a rider sitting in the saddle. Movements are
flexion-extension, abduction-adduction, and circumduction
(Figure 9.10e).
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Saddle Joint
• One bone saddled-shaped; other bone fits as a person would sitting in that
saddle
• Biaxial
– Circumduction allows tip of thumb travel in circle
– Opposition allows tip of thumb to touch tip of other fingers
• Example
– trapezium of carpus and metacarpal of the thumb
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TYPES OF SYNOVIAL JOINTS
• In a ball-and-socket joint, the ball-shaped surface of one
bone fits into the cuplike depression of another (Figure
9.10f). Movements are flexion-extension, abductionadduction, rotation, and circumduction.
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Ball and Socket Joint
• Ball fitting into a cuplike depression
• Multiaxial
– flexion/extension
– abduction/adduction
– rotation
• Examples (only two!)
– shoulder joint
– hip joint
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SELECTED JOINTS OF THE BODY
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Tempromandibular Joint (TMJ) (Exhibit 9.1 and
Figure 9.11)
• The TMJ is a combined hinge and planar joint formed by the
condylar process of the mandible, the mandibular fossa, and
the articular tubercle of the temporal bone.
• Movements include opening and closing and protraction and
retraction of the jaw.
• When dislocation occurs, the mouth remains open.
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Temporomandibular
Joint
lateral
medial
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•
•
•
•
•
Synovial joint
Articular disc
Gliding above disc
Hinge below disc
Movements
– depression
– elevation
– protraction
– retraction
176
Temporoman-dibular
Joint
•
•
•
•
•
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Synovial joint
Articular disc
Gliding above disc
Hinge below disc
Movements
– depression
– elevation
– protraction
– retraction
177
Shoulder Joint (Exhibit 9.2 and Figure 9.12).
• This is a ball-and-socket joint formed by the head of the
humerus and the glenoid cavity of the scapula.
• Movements at the joint include flexion, extension, abduction,
adduction, medial and lateral rotation, and circumduction of
the arm .
• This joint shows extreme freedom of movement at the
expense of stability.
• Rotator cuff injury and dislocation or separated shoulder are
common injuries to this joint.
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Shoulder Joint
• Head of humerus
and glenoid cavity
of scapula
• Ball and socket
• All types of
movement
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Glenohumeral (Shoulder) Joint
• Articular capsule from glenoid cavity to anatomical neck
• Glenoid labrum deepens socket
• Many nearby bursa (subacromial)
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Supporting Structures at Shoulder
• Associated ligaments strengthen joint capsule
• Transverse humeral ligament holds biceps tendon in
place
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Rotator Cuff Muscles
• Attach humerus to scapula
• Encircle the joint supporting the capsule
• Hold head of humerus in socket
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Elbow Joint (Exhibit 9.3 and Figure 9.13)
• This is a hinge joint formed by the trochlea of the humerus,
the trochlear notch of the ulna, and the head of the radius.
• Movements at this joint are flexion and extension of the
forearm.
• Tennis elbow, little elbows, and dislocation of the radial
head are common injuries to this joint.
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Articular Capsule of the Elbow Joint
lateral aspect
medial aspect
• Radial annular ligament hold head of radius in place
• Collateral ligaments maintain integrity of joint
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Hip Joint (Exhibit 9.4 and Figure 9.14)
• This ball-and-socket joint is formed by the head of the femur
and the acetabulum of the hipbone.
• Movements at this joint include flexion, extension,
abduction, adduction, circumduction, and medial and lateral
rotation of the thigh.
• This is an extremely stable joint due to the bones making up
the joint and the accessory ligaments and muscles.
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Hip Joint
• Head of femur
and
acetabulum of
hip bone
• Ball and socket
type of joint
• All types of
movement
possible
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Hip Joint Structures
• Acetabular labrum
• Ligament of the head of the femur
• Articular capsule
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Hip Joint Capsule
• Dense, strong capsule reinforced by ligaments
– iliofemoral ligament
– ischiofemoral ligament
– pubofemoral ligament
• One of strongest structures in the body
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Knee Joints (Exhibit 9.5 and Figure 9.15)
• This is the largest and most complex joint of the body and
consists of three joints within a single synovial cavity.
• Movements at this joint include flexion, extension, slight
medial rotation, and lateral rotation of the leg in a flexed
position.
• Some common injuries are rupture of the tibial colateral
ligament and a dislocation of the knee.
• Refer to Tables 9.3 and 9.4 to integrate bones, joint
classifications, and movements.
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Tibiofemoral Joint
• Between femur, tibia and
patella
• Hinge joint between tibia
and femur
• Gliding joint between
patella and femur
• Flexion, extension, and
slight rotation of tibia on
femur when knee is flexed
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Tibiofemoral Joint
• Articular capsule
– mostly ligs & tendons
• Lateral & medial menisci =
articular discs
• Many bursa
• Vulnerable joint
• Knee injuries damage
ligaments & tendons since
bones do not fit together
well
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External Views of Knee Joint
• Patella is part of joint capsule anteriorly
• Rest of articular capsule is extracapsular ligaments
– Fibular and tibial collateral ligaments
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Intracapsular Structures of Knee
• Medial meniscus
– C-shaped
fibrocartilage
• Lateral meniscus
– nearly circular
• Posterior cruciate
ligament
• Anterior cruciate
ligament
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FACTORS AFFECTING CONTACT AND RANGE OF
MOTION AT SYNOVIAL JOINTS
•
•
•
•
•
•
•
•
Structure and shape of the articulating bone
Strength and tautness of the joint ligaments
Arrangement and tension of the muscles
Contact of soft parts
Hormones
Disuse
AGING AND JOINTS
Various aging effects on joints include decreased production
of synovial fluid, a thinning of the articular cartilage, and loss
of ligament length and flexibility.
• The effects of aging on joints are due to genetic factors as
well as wear and tear on joints.
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Arthroscopy & Arthroplasty
• Arthroscopy = examination of joint
– instrument size of pencil
– remove torn knee cartilages & repair ligaments
– small incision only
• Arthroplasty = replacement of joints
– total hip replaces acetabulum & head of femur
– plastic socket & metal head
– knee replacement common
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Techniques for cartilage replacement
• In cartilage transplantation chondrocytes are removed from
the patient, grown in culture, and then placed in the
damaged joint.
• Eroded cartilage may be replaced with synthetic materials
• Researchers are also examining the use of stem cells to
replace cartilage.
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DISORDERS: HOMEOSTATIC IMBALANCES:
Rheumatism and Arthritis
• Osteoarthritis is a degenerative joint disease commonly
known as “wear-and-tear” arthritis. It is characterized by
deterioration of articular cartilage and bone spur formation.
It is noninflammatory and primarily affects weight-bearing
joints.
• Gouty arthritis is a condition in which sodium urate crystals
are deposited in soft tissues of joints, causing inflammation,
swelling, and pain. If not treated, bones at affected joints will
eventually fuse, rendering the joints immobile.
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Hip Replacement
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DISORDERS: HOMEOSTATIC IMBALANCES:
• Lyme disease is a bacterial disease which is transmitted by
deer ticks. Symptoms include joint stiffness, fevers, chills,
headache, and stiff neck.
• Ankylosing spondylitis affects joints between the vertebrae
and between the sacrum and hip bone. Its cause is
unknown.
• Ankle Sprains and Fractures: The ankle is the most
frequently injured major joint. Sprains are the most common
injury to the ankle; they are treated with RICE. A fracture of
the distal leg that involves both the medial and lateral
malleoli is called a Pott’s fracture.
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Rheumatoid Arthritis
•
•
•
•
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Autoimmune disorder
Cartilage attacked
Inflammation, swelling & pain
Final step is fusion of joint
200
Osteoarthritis
• Degenerative joint disease
– aging, wear & tear
• Noninflammatory---no swelling
– only cartilage is affected not synovial membrane
• Deterioration of cartilage produces bone spurs
– restrict movement
• Pain upon awakening--disappears with movement
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Gouty Arthritis
• Urate crystals build up in joints---pain
– waste product of DNA & RNA metabolism
– builds up in blood
– deposited in cartilage causing inflammation & swelling
• Bones fuse
• Middle-aged men with abnormal gene
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end
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