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© 2016 Pearson Education, Inc.
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Part 2: The Appendicular Skeleton
Consists of bones of the limbs and their girdles Pectoral girdle Attaches upper limbs to body trunk Pelvic girdle Attaches lower limbs to body trunk © 2016 Pearson Education, Inc.
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7.4 The Pectoral Girdle Pectoral girdle (shoulder girdle) consists of clavicles (anteriorly) and scapulae (posteriorly) Attach upper limbs to axial skeleton Provide attachment sites for muscles that move upper limbs Offer great degree of mobility because: Scapulae are not attached to axial skeleton Socket of shoulder joint is shallow and does not restrict movement © 2016 Pearson Education, Inc.
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Figure 7.25 The pectoral girdle with articulating bones.
Acromio- clavicular joint Clavicle Scapula © 2016 Pearson Education, Inc.
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Clavicles Also called collarbones
S-shaped sternal end articulates with sternum medially Flattened acromial end articulates laterally with scapula Anchor muscles and act as braces to hold the scapulae and arms out laterally © 2016 Pearson Education, Inc.
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Right clavicle, superior view
Figure 7.26a The clavicle. Sternal (medial) end Posterior Anterior Acromial (lateral) end Right clavicle, superior view © 2016 Pearson Education, Inc.
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Right clavicle, inferior view
Figure 7.26b The clavicle. Acromial end Acromial end Anterior Trapezoid line Sternal end Posterior Conoid tubercle Right clavicle, inferior view © 2016 Pearson Education, Inc.
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Scapulae Also called shoulder blades; thin, triangular flat bones on dorsal surface of rib cage, between ribs 2 and 7 Each scapula has three borders Superior: shortest, sharpest border Medial (vertebral): runs parallel to spine Lateral (axillary): near armpit, ends superiorly in glenoid cavity fossa (shoulder joint) © 2016 Pearson Education, Inc.
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Scapulae (cont.) Each scapula has three angles where borders meet:
Superior angle: between superior and medial Lateral angle: between superior and lateral Inferior angle: between medial and lateral © 2016 Pearson Education, Inc.
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Scapulae (cont.) Bone features Spine: prominent ridge posteriorly
Acromion: lateral projection that articulates with acromial end of clavicle to form acromioclavicular joint Coracoid process: anterior projection that anchors bicep muscle of arm Suprascapular notch: opening for nerves Several large fossae named according to location © 2016 Pearson Education, Inc.
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Right scapula, anterior aspect
Figure 7.27a The scapula. Acromion Suprascapular notch Superior border Coracoid process Superior angle Glenoid cavity Subscapular fossa Lateral border Medial border Inferior angle Right scapula, anterior aspect © 2016 Pearson Education, Inc.
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Right scapula, posterior aspect
Figure 7.27b The scapula. Coracoid process Suprascapular notch Superior angle Acromion Supraspinous fossa Glenoid cavity at lateral angle Spine Infraspinous fossa Medial border Lateral border Right scapula, posterior aspect © 2016 Pearson Education, Inc.
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Right scapula, lateral aspect
Figure 7.27c The scapula. Supraspinous fossa Supraspinous fossa Supraglenoid tubercle Acromion Coracoid process Infraspinous fossa Subscapular fossa Glenoid cavity Spine Posterior Anterior Infraspinous fossa Infraglenoid tubercle Subscapular fossa Inferior angle Right scapula, lateral aspect © 2016 Pearson Education, Inc.
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7.5 The Upper Limb 30 bones form skeletal framework of each upper limb
Arm Humerus Forearm Radius and ulna Hand 8 carpal bones in the wrist 5 metacarpal bones in the palm 14 phalanges in the fingers © 2016 Pearson Education, Inc.
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Arm Humerus: only bone of the arm; the largest and longest bone of upper limb Articulates superiorly with glenoid cavity of scapula Articulates inferiorly with radius and ulna © 2016 Pearson Education, Inc.
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Arm (cont.) Bone features
Head: proximal end that fits into glenoid cavity of scapula Anatomical neck: slight constriction inferior to head Greater tubercle is separated from lesser tubercle by the intertubercular sulcus Sites of attachment of rotator cuff muscles Surgical neck: most frequently fractured part of humerus © 2016 Pearson Education, Inc.
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Arm (cont.) Bone features (cont.)
Deltoid tuberosity: about midway down shaft; site of deltoid muscle attachment Radial groove: carries radial nerve Trochlea: distal hourglass-shaped condyle Capitulum: distal ball-like condyle Medial and lateral epicondyles: points of muscle attachment Medial and lateral supracondyle ridges Fossae: coronoid, olecranon, and radial © 2016 Pearson Education, Inc.
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Illustration, anterior view Illustration, posterior view
Figure 7.28 The humerus of the right arm and detailed views of articulation at the elbow. Greater tubercle Head of humerus Head of humerus Greater tubercle Lesser tubercle Greater tubercle Anatomical neck Inter- tubercular sulcus Surgical neck Radial groove Deltoid tuberosity Deltoid tuberosity Medial supracondylar ridge Lateral supracondylar ridge Coronoid fossa Olecranon fossa Radial fossa Radial fossa Medial epicondyle Lateral epicondyle Capitulum Trochlea Photo, anterior view Illustration, anterior view Illustration, posterior view © 2016 Pearson Education, Inc.
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Anterior view at the elbow region Posterior view of extended elbow
Figure 7.28 The humerus of the right arm and detailed views of articulation at the elbow (continued). Humerus Coronoid fossa Humerus Olecranon fossa Capitulum Medial epicondyle Olecranon Lateral epicondyle Medial epicondyle Head of radius Trochlea Coronoid process of ulna Head Radial tuberosity Neck Radial notch Radius Ulna Ulna Ulna Radius Anterior view at the elbow region Posterior view of extended elbow © 2016 Pearson Education, Inc.
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Forearm Two parallel bones form forearm skeleton: ulna and radius
Proximal ends articulate with humerus and each other Distally articulate with each other at the radioulnar joint Interosseous membrane connects radius and ulna along their entire length © 2016 Pearson Education, Inc.
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Forearm (cont.) Ulna Medial bone in forearm
Forms major portion of elbow joint with humerus Bone features Olecranon and coronoid processes: grip trochlea of humerus, forming hinge joint Processes separated by trochlear notch Radial notch: articulates with head of radius Ulnar head: knoblike distal portion Ulnar styloid process: ligament attachment © 2016 Pearson Education, Inc.
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Forearm (cont.) Radius Lateral bone in forearm Bone features
Head: articulates with capitulum of humerus and radial notch of ulna Radial tuberosity: anchors biceps Ulnar notch: articulates with ulna Radial styloid process: anchors ligaments © 2016 Pearson Education, Inc.
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Figure 7.29 Radius and ulna of the right forearm.
Radial notch of the ulna Olecranon Olecranon Coronoid process Head Trochlear notch Head of radius Head Neck Coronoid process Neck Radial tuberosity Neck of radius Radial tuberosity Proximal radioulnar joint Interosseous membrane Ulna Ulna Radius Radius Ulnar notch of the radius Radius Head of ulna Ulnar styloid process Ulnar styloid process Radial styloid process Radial styloid process Distal radioulnar joint Radial styloid process Photo, anterior view Illustration, anterior view Illustration, posterior view r © 2016 Pearson Education, Inc.
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Figure 7.29 Radius and ulna of the right forearm (continued).
Ulnar notch of radius Olecranon Articulation for lunate View Trochlear notch Articulation for scaphoid Coronoid process Radial styloid process Radial notch Head of ulna Ulnar styloid process View Proximal portion of ulna, lateral view Distal ends of the radius and ulna at the wrist © 2016 Pearson Education, Inc.
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Hand Bones of the hand include carpus, metacarpus, and phalanges
Carpus (wrist): eight bones in two rows Proximal row: lateral to medial Scaphoid, lunate, triquetrum, and pisiform Distal row: lateral to medial Trapezium, trapezoid, capitate, and hamate Only scaphoid, lunate, and triquetrum form wrist joint © 2016 Pearson Education, Inc.
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Hand (cont.) Metacarpus (palm) Phalanges (fingers)
Five metacarpal bones (I to V from thumb to little finger) form the palm Bases articulate with carpals, and heads articulate with proximal phalanges Phalanges (fingers) Fingers (digits): numbered I to V starting at thumb (pollex) Digit I (pollex) has two bones: no middle phalanx Digits II to V have three bones: distal, middle, and proximal phalanx © 2016 Pearson Education, Inc.
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Figure 7.30 Bones of the right hand.
Phalanges • Distal • Middle • Proximal Metacarpals • Head Sesamoid bones • Shaft • Base Carpals IV III II V • Hamate I Carpals II III IV I V Carpals • Capitate • Trapezium • Hamate • Pisiform • Trapezoid • Capitate • Triquetrum • Scaphoid • Triquetrum • Lunate • Lunate Ulna Radius Ulna Anterior view Posterior view © 2016 Pearson Education, Inc.
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Clinical – Homeostatic Imbalance 7.4
Median nerve and tendons travel through carpal tunnel Tunnel formed by ligaments through wrist Carpal tunnel syndrome can occur from overuse and inflammation of tendons, which can compress median nerve, causing tingling and numbness © 2016 Pearson Education, Inc.
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7.6 The Pelvic Girdle Also called hip girdle; is formed by 2 hip bones (coxal bones, or os coxae) and sacrum Attach lower limbs to axial skeleton with strong ligaments Transmit weight of upper body to lower limbs Support pelvic organs Less mobility but more stability than shoulder joint Three fused bones form coxal bone Ilium, ischium, and pubis Deep socket, acetabulum, formed at point of fusion receives head of femur © 2016 Pearson Education, Inc.
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Base of sacrum Iliac crest Sacroiliac joint Iliac fossa Anterior
Figure 7.31 Pelvis. Base of sacrum Iliac crest Sacroiliac joint Iliac fossa Anterior superior iliac spine llium Sacral promontory Hip bone (coxal bone or os coxae) Sacrum Anterior inferior iliac spine Pubis Coccyx Pelvic brim Acetabulum Pubic tubercle Ischium Pubic crest Pubic symphysis Pubic arch © 2016 Pearson Education, Inc.
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Ilium Ilium Ischium Pubis Superior region of coxal bone
Auricular surface articulates with sacrum (sacroiliac joint) Ischium Posteroinferior part of hip bone Pubis Anterior portion of hip bone Pubis joins at pubic symphysis joint © 2016 Pearson Education, Inc.
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Ilium (cont.) Superior region of hip bone
Consists of body and winglike ala Iliac crests: thickened superior margin of ala Iliac crest ends at anterior superior iliac spine and posterior superior iliac spine Greater sciatic notch: sciatic nerve passage Gluteal surface contains three ridges: posterior, anterior, and inferior gluteal lines Iliac fossa: concavity on ala Auricular surface articulates with sacrum Arcuate line: defines pelvic brim © 2016 Pearson Education, Inc.
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Ischium Posteroinferior part of hip bone Consists of body and ramus
Three important markings: Ischial spine Lesser sciatic notch Ischial tuberosity © 2016 Pearson Education, Inc.
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Pubis V-shaped anterior portion of hip bone
Consists of the body and superior and inferior pubic rami Anterior border forms the pubic crest Lateral end forms pubic tubercle Obturator foramen: large opening formed by rami and body Pubic bones join at pubic symphysis Pubic arch (subpubic angle): formed by rami; main difference between male and female pelves © 2016 Pearson Education, Inc.
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Figure 7.32a The hip (coxal) bones.
Ilium Anterior gluteal line Ala Posterior gluteal line Iliac crest Anterior superior iliac spine Posterior superior iIiac spine Inferior gluteal line Posterior inferior iliac spine Anterior inferior iliac spine Greater sciatic notch Acetabulum Ischial body Ischial spine Pubic body Lesser sciatic notch Pubis Ischium Ischial tuberosity Obturator foramen Inferior pubic ramus Ischial ramus Lateral view, right hip bone © 2016 Pearson Education, Inc.
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Figure 7.32b The hip (coxal) bones.
Ilium Posterior superior iliac spine Iliac crest Iliac fossa Anterior superior iliac spine Posterior inferior iliac spine Anterior inferior iliac spine Body of the ilium Auricular surface Arcuate line Greater sciatic notch Superior pubic ramus Ischial spine Pubic tubercle Lesser sciatic notch Obturator foramen Pubis Articular surface of pubis (at pubic symphysis) Ischium Ischial ramus Inferior pubic ramus Medial view, right hip bone © 2016 Pearson Education, Inc.
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Pelvic Structure and Childbearing
Pelvis: formed by hip bones, sacrum, and coccyx Female pelvis tends to be wider, shallower, lighter, and rounder than male’s Adapted for childbearing Pelvic brim (pelvic inlet): continuous oval ridge that runs from pubic crest through arcuate line and sacral promontory False pelvis: superior to pelvic brim True pelvis: inferior to pelvic brim; defines birth canal Pelvic outlet: inferior margin of true pelvis © 2016 Pearson Education, Inc.
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Table 7.4-1 Comparison of the Male and Female Pelves
© 2016 Pearson Education, Inc.
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Table 7.4-2 Comparison of the Male and Female Pelves (continued)
© 2016 Pearson Education, Inc.
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Table 7.4-3 Comparison of the Male and Female Pelves (continued)
© 2016 Pearson Education, Inc.
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7.7 The Lower Limb Carries entire weight of erect body
Subjected to exceptional forces during jumping or running Three segments of lower limb Thigh Leg Foot © 2016 Pearson Education, Inc.
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Thigh Femur is largest and strongest bone in the body, making up about one-fourth of person’s height Articulates proximally with acetabulum of hip and distally with tibia and patella Patella: sesamoid bone in quadriceps tendon that protects knee joint © 2016 Pearson Education, Inc.
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Thigh (cont.) Bone features Fovea capitis: small pit in ball-like head
Greater and lesser trochanters: muscle attachment sites Trochanters connected by intertrochanteric line and intertrochanteric crest Gluteal tuberosity blends into linea aspera, which diverges into medial and lateral supracondylar lines © 2016 Pearson Education, Inc.
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Thigh (cont.) Bone features (cont.)
Distally, femur ends in lateral and medial condyles that articulate with tibia Medial and lateral epicondyles: sites of muscle attachment Adductor tubercle: medial epicondyle bump Patellar surface: articulates with patella Intercondylar fossa: lies between condyles © 2016 Pearson Education, Inc.
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Figure 7.33 Bones of the right knee and thigh.
Neck Fovea capitis Greater trochanter Head Inter- trochanteric crest Lesser trochanter Intertrochanteric line Gluteal tuberosity Linea aspera Apex Anterior Facet for lateral condyle of femur Medial and lateral supra- condylar lines Facet for medial condyle of femur Lateral condyle Intercondylar fossa Lateral epicondyle Surface for patellar ligament Medial condyle Lateral epicondyle Adductor tubercle Posterior Patella (kneecap) Medial epicondyle Patellar surface Anterior view Posterior view Femur (thigh bone) © 2016 Pearson Education, Inc.
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Table 7.5-2 Bones of the Appendicular Skeleton, Part 2: Pelvic Girdle and Lower Limb (continued)
© 2016 Pearson Education, Inc.
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Leg Made up of two parallel bones, tibia and fibula
Connected by interosseous membrane Tibia: medial leg bone that receives weight of body from femur; transmits to foot Fibula Not weight bearing; no articulation with femur Several muscles originate from fibula Articulates proximally and distally with tibia © 2016 Pearson Education, Inc.
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Leg (cont.) Bone features Tibia Fibular: Medial and lateral condyles
Intercondylar eminence Tibial tuberosity Anterior border Medial malleolus Fibular notch Fibular: Head Lateral malleolus © 2016 Pearson Education, Inc.
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Figure 7.34a The tibia and fibula of the right leg.
Intercondylar eminence Lateral condyle Medial condyle Head Superior tibiofibular joint Tibial tuberosity Interosseous membrane Anterior border Fibula Tibia Inferior tibiofibular joint Medial malleolus Lateral malleolus Inferior articular surface Anterior view © 2016 Pearson Education, Inc.
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Figure 7.34 The tibia and fibula of the right leg (continued).
Lateral condyle Lateral condyle Fibula articulates here Tibial tuberosity Line for soleus muscle Anterior view, proximal tibia Posterior view, proximal tibia © 2016 Pearson Education, Inc.
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Figure 7.34c The tibia and fibula of the right leg.
Parts of fractured fibula X ray of Pott’s fracture of the fibula © 2016 Pearson Education, Inc.
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Foot Skeleton of foot includes bones of tarsus, metatarsus, and phalanges Tarsus: 7 tarsal bones form posterior half Body weight carried primarily by talus and calcaneus (heel) Calcaneal tuberosity: part that touches ground Sustentacular tali (talar shelf): supports talus Other tarsal bones: cuboid, navicular, and medial, intermediate, and lateral cuneiform bones © 2016 Pearson Education, Inc.
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Foot (cont.) Metatarsals Phalanges
Five metatarsal bones (I to V from hallux to little toe) Enlarged head of metatarsal I forms “ball of the foot” Phalanges 14 bones of toes Digit I (hallux, great toe) has two bones: no middle phalanx Digits II to V have three bones: distal, middle, and proximal phalanx © 2016 Pearson Education, Inc.
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Figure 7.35a Bones of the right foot.
Phalanges Distal Middle Proximal Medial cuneiform I ll lll Metatarsals IV V Intermediate cuneiform Lateral cuneiform Navicular Cuboid Tarsals Talus Trochlea of talus Calcaneus Superior view © 2016 Pearson Education, Inc.
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Figure 7.35b Bones of the right foot.
Medial malleolar facet Talus Navicular Intermediate cuneiform Sustentac- ulum tali (talar shelf) First metatarsal Calcaneus Medial cuneiform Calcaneal tuberosity Medial view © 2016 Pearson Education, Inc.
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Figure 7.35c Bones of the right foot.
Lateral malleolar facet Navicular Intermediate cuneiform Lateral cuneiform Talus Calcaneus Cuboid Fifth metatarsal Lateral view © 2016 Pearson Education, Inc.
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Foot (cont.) Arches of the foot
Maintained by interlocking foot bones, ligaments, and tendons Allow foot to bear weight Three arches Lateral longitudinal: low curve that elevates lateral part of foot Medial longitudinal: arch curves upwards Transverse: runs obliquely from one side of foot to other © 2016 Pearson Education, Inc.
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Figure 7.36a Arches of the foot.
Medial longitudinal arch Transverse arch Lateral longitudinal arch Lateral aspect of right foot © 2016 Pearson Education, Inc.
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Clinical – Homeostatic Imbalance 7.4
Fallen arches, also called “flat feet,” result from stress on tendons and ligaments of feet Can be caused by: Standing immobile for extended periods of time Running on hard surfaces without proper arch support © 2016 Pearson Education, Inc.
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Developmental Aspects of the Skeleton
Infant skull has more bones than adult skull Skull bones such as mandible and frontal bones are unfused Skull bones connected by fontanelles Unossified remnants of fibrous membranes Ease birth and allow brain growth Four fontanelles Anterior, posterior, mastoid, and sphenoidal © 2016 Pearson Education, Inc.
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Figure 7.37 Skull of a newborn.
Frontal suture Frontal bone Anterior fontanelle Ossification center Parietal bone Posterior fontanelle Occipital bone Superior view Frontal bone Sphenoidal fontanelle Parietal bone Ossification center Posterior fontanelle Mastoid fontanelle Occipital bone Temporal bone (squamous part) Lateral view © 2016 Pearson Education, Inc.
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Clinical – Homeostatic Imbalance 7.4
Congenital abnormalities may distort skull Cleft palate is the most common condition No medial fusion of right and left halves of palate Interferes with sucking Can lead to aspiration of food into lungs, which may result in aspiration pneumonia © 2016 Pearson Education, Inc.
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Figure 7.38 Cleft lip and palate.
A boy born with a cleft palate and lip The boy as a toddler, following surgical repair during infancy © 2016 Pearson Education, Inc.
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