Dr. Maher T. Hadidi, Univ. of Jordan Shapes of bones Long bones. e.g. Humerus Short bones. e.g. Wrist bones Flat bones. e.g. Scapula Irregular bones. eg. Vertebra Sesamoid bones. eg. Patella Dr. Maher T. Hadidi, Univ. of Jordan

Divisions Two parts: Axial skeleton (80 bones). Appendicular skeleton Upper: Shoulder girdle Bones of upper limb Lower: Pelvic girdle Bones of lower limb

Bones of the axial skeleton 1- SKULL 2- VERTEBRAL COLUMN 3-THORIC CAGE

The Skull 1- Bones of the cranium (contain the brain) The skull is composed of several separate bones (22 bones) united at immobile joints called sutures. Only one moveable bone, the mandible which is united to the skull by the mobile Temporomandibular Joint The bones of the skull can be divided into: 1- Bones of the cranium (contain the brain) 2- Bones of the face The upper part of the cranium is The vault The base of the skull is the lowest part of the cranium

Skull- Superior View Four bones united by four sutures. 4 bones: Frontal Occipital 2 Partials 3 Sutures: Coronal Sagittal Lambdoid

The middle meningeal artery and vein Pterion: is an area located on the lateral side of the skull Where 4 bones meet at an H-shaped structure The pterion is the thinnest part of the lateral wall of the skull. it overlies the anterior division of The middle meningeal artery and vein Trauma to the pterion may result in Epidural bleeding

RAISED INTRACRANIAL PRESSURE Clinical Features of the Neonatal Skull FONTANELLES Palpation of the fontanelles enables the physician to determine : 1-The progress of growth in the surrounding bones 2-the degree of hydration of the baby ; A-if the fontanelles are depressed below the surface THE BABY IS DEHYDRATED B- a bulging fontanelle indicates RAISED INTRACRANIAL PRESSURE Samples of cerebrospinal fluid can be obtained by passing a long needle obliquely through the anterior fontanelle into the subarachnoid space When they close The anterior fontanelles after 18 months, Posterior Fontanelle: Close by the end of the 2nd month

The thorax

THE THORACIC WALL 1-STERNUM 2- Ribs 3-The Vertebral Column

STERNUM Lies in the midline of the anterior chest wall It is a flat bone Divides into three parts: 1-Manubrium sterni 2-Body of the sternum 3- Xiphoid process

The sternal angle (angle of Louis) formed by the articulation of the manubrium with the body of the sternum Can be recognized by the presence of a transverse ridge on the anterior aspect of the sternum The transverse ridge lies at the level of the second costal cartilage The point from which all costal cartilages and ribs are counted

Ribs There are 12 pairs of ribs, all of which are attached posteriorly to the thoracic vertebrae. The ribs are divided into three categories: True ribs: The upper seven pairs are attached anteriorly to the sternum by their costal cartilages False ribs: The 8th, 9th, and 10th pairs of ribs are attached anteriorly to each other and to the 7th rib by means of their costal cartilages and small synovial joints. Floating ribs: The 11th and 12th pairs have no anterior attachment

The ribs have subcostal groove which contains A-INTERCOSTAL VEIN B-INTERCOSTA L ARTERY C-INTERCOSTA L NERVE Therefore, the needle should be inserted above the superior border of the rib In the subcostal groove the structures of the neurovascular bundle Are arranged as follow: A-INTERCOSTAL VEIN B-INTERCOSTA L ARTERY VAN C-INTERCOSTA L NERVE هام

The vertebral column

The Vertebral Column is composed of 33 vertebrae 7 cervical 12 thoracic 5 lumbar 5 sacral (fused to form the sacrum) 4 coccygeal (the lower 3 are commonly fused)

through which run the spinal cord and its coverings A typical vertebra consists of: 1-a rounded body anteriorly 2-a vertebral arch posteriorly. They enclose a space called The vertebral foramen through which run the spinal cord and its coverings The vertebral arch gives rise to seven processes: a-One spinous b-Two transverse c- Four articular

upper and lower borders the superior and inferior The pedicles are notched on their upper and lower borders Forming the superior and inferior vertebral notches. On each side the superior notch of one vertebra and the inferior notch of an adjacent vertebra together form an intervertebral foramen. These foramina, in an articulated skeleton, serve to transmit the spinal nerves and blood vessels.

Each disc consists of a peripheral part, the anulus fibrosus, Intervertebral Discs Each disc consists of a peripheral part, the anulus fibrosus, and a central part, the nucleus pulposus The anulus fibrosus is composed of fibrocartilage, in which the collagen fibers are arranged in concentric layers or sheets. The nucleus pulposus in children and adolescents is an ovoid mass of gelatinous material containing a large amount of water, a small number of collagen fibers, and a few cartilage cells.

spinal cord and spinal nerves. local weakness and acute pain The pressure developed in the nucleus pulposus may be great enough to rupture the surrounding fibrocartilage (annulus fibrosus). If this occurs, the nucleus pulposus may herniate (protrude) posteriorly or into one of the adjacent vertebral bodies This condition is called a herniated disc The disc usually slips posteriorly toward the spinal cord and spinal nerves. This movement exerts pressure on the spinal nerves, causing local weakness and acute pain

to stand upright Curves of the Vertebral Column Curves in the Sagittal Plane In the fetus, the vertebral column has one continuous anterior concavity After birth, when the child becomes able to raise his or her head and keep it poised on the vertebral column, the cervical part of the vertebral column becomes concave posteriorly Toward the end of the first year, when the child begins to stand upright the lumbar part of the vertebral column becomes concave posteriorly.

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Abnormal Curves of the Vertebral Column Various conditions may exaggerate the normal curves of the vertebral column, or the column may acquire a lateral bend, resulting in abnormal curves of the vertebral column. Scoliosis : the most common of the abnormal curves is a lateral bending of the vertebral column ,usually in the thoracic region Kyphosis :(hump) Is an increase in the thoracic curve of the vertebral column Lordosis :bent backward is an increase in the lumbar curve of the vertebral column