Radiological Anatomy – 1

“Extremities & Pelvis”

Prof. Dr. İsmet TAMER
İstinye University, Faculty of Medicine
Dept.of Family Medicine
Liv Hospital Bahçeşehir
Key facts about the basic anatomy and terminology
• Anatomical terminology: A list of terms that concern with the anatomy of the human body. It
gathers the terms that pertain to the anatomical regions and specific structures, planes,
directions and body movements.
• Anatomical planes: Imaginary planes that intersect the body, creating slices of inner body
structures at different levels.
Major planes: median (mid-sagittal), sagittal, frontal (coronal), transverse (axial).
• Directional terms: Anatomical terms used to describe the position and relation between various
structures (e.g. anterior, posterior, ventral, dorsal, proximal, distal, median, medial, lateral)
• Movements: Changing the position of a body part around a certain axis and in one of the
anatomical planes (e.g. flexion, extension, abduction, adduction)
• Anatomical regions: Areas of the human body defined by the landmarks provided by evident
structures that are easily palpable or visible.
Major regions: head, neck, thorax, abdomen, pelvis, upper extremity, lower extremity
• Human body systems: A group of organs that work together to perform one or more functions in
the body. Systems: circulatory, respiratory, digestive, nervous, excretory, endocrine, reproductive,
lymphatic , skeletal, and muscular systems
The most basic anatomy concept, and equally the most
important, is orientation.
• All structures and the relationships between them are referenced to the standard anatomical
position.
• In this orientation, the person is considered to be standing upright, with the arms hanging by the
side, palms facing forward, and thumbs pointing away from the body.
• The feet are slightly parallel, and toes oriented to the front.
• To compare the location of body parts relative to each other, anatomy uses some
universal directional terms: anterior, posterior, ventral, dorsal, distal, proximal, medial, lateral,
median, superior, inferior, external, internal, frontal, occipital, rostral, caudal, superficial, deep,
central, peripheral, ipsilateral, contralateral, cranial, and cephalic.
• Apart from the directional terms and relationships, you also need to know from which direction
you’re looking. This is provided by the three body planes and axes: coronal (frontal), sagittal,
and transverse (axial).
Directional terms and body planes
Human body systems
 There are approximately 79 human anatomy organs and they function in groups called systems.
 An organ system consists of many organs working together to accomplish similar tasks and reach
a common goal.
 There are 11 systems in the human body:
• circulatory (blood supply),
• respiratory (breathing),
• digestive (digestion and absorption),
• nervous (sensation and movement),
• excretory (waste elimination),
• endocrine (hormonal control),
• reproductive,
• lymphatic (defence),
• skeletal (support), and muscular (movement) systems. The last two are usually combined
together into the musculoskeletal system.
Musculoskeletal system
• The musculoskeletal system is made up of 3 parts: bones, joints, and muscles.

• The skeletal part, which functions mainly for support, consists of bones arranged
into 2 skeletons:

1. Axial skeleton: skull, auditory ossicles, hyoid bone, ribs, vertebral

column, sternum, sacrum, coccyx

2. Appendicular skeleton: shoulder girdle, upper limb, pelvic girdle, lower

limb.
Joints & Muscles
• Situated at the junction between two or more bones are structures called joints. There
are many in the entire human body, but the most important ones are the
cranial sutures, temporomandibular, shoulder, elbow, wrist, hip, knee, and ankle joints.
• Muscles are the contractile apparatus attached to the bones that move them around the
joints. They act as antagonist pairs. The main muscle type involved in the musculoskeletal
system is the skeletal muscle. There are hundreds of muscles, grouped together into five
anatomical regions:
1. Head muscles: Muscles of facial expression, muscles of
mastication (temporal, masseter, pterygoids)
2. Neck muscles: Suprahyoid and infrahyoid muscles, scalenes, platysma
3. Trunk muscles: Pectoral, intercostal, anterior abdominal, lateral abdominal, and
posterior trunk muscles
4. Upper extremity muscles: Shoulder, arm, forearm, and hand muscles
5. Lower extremity muscles: Gluteal, hip, thigh, leg, and foot muscles
Upper extremity imaging
• Radiological imaging of the upper limb joints;

1- Plain X-Ray.

2- Ultrasonography.

3- Computerized tomography (CT Scan).

4- Magnetic resonance imaging (MRI) study.

Shoulder & Arm
Anatomy of the Shoulder – 1
• The shoulder comprises bones, ligaments, tendons, and muscles that connect the arm to the
torso. The three bones that make up the shoulder joint include the clavicle (collarbone), scapula
(shoulder blade), and humerus (long bone of the arm).

• The shoulder has two joints that work together to allow arm movement.

• The acromioclavicular (AC) joint is a gliding joint formed between the clavicle and the
acromion. The acromion is the projection of the scapula that forms the point of the shoulder.
The AC joint gives us the ability to raise the arm above the head.

• The glenohumeral joint, or shoulder joint, is a ball-and-socket type joint. The "ball" is the
top, rounded part of the humerus, and the "socket" is the bowl- shaped part of the scapula,
called the glenoid, into which the ball fits. This joint allows the arm to move in a circular
rotation as well as towards and away from the body.
Anatomy of the Shoulder – 2
• The labrum is a piece of cartilage that cushions the humerus head and the glenoid. This
cartilage also helps to stabilize the joint.

• The rotator cuff is a group of four muscles that pull the humerus into the scapula. The rotator
cuff muscles stabilize the glenohumeral joint and help with rotation of the arm.

• Two sac-like structures called bursae are also located in the shoulder. The bursae secrete a
lubricating fluid, which helps reduce friction between the moving parts of the joint.

• Together, all of these structures create one of the most flexible joints in the body.
Elbow, Forearm & Wrist
Anatomy of Elbow, Forearm & Wrist
• The elbow joint is a synovial hinge joint found in the upper limb between the distal arm and the
proximal forearm. It is the point of articulation of three bones including the humerus, radius, and
ulna. Functionally, the elbow is a hinge joint, allowing movement in only one plane: flexion and
extension. However, it also facilitates motion in the hand in the form of supination and pronation
of the forearm.

• The radius and ulna are the two bones of the forearm. They articulate with the humerus at the
elbow, and with the carpal bones at the wrist. In the anatomical position, the radius sits on the
lateral aspect of the forearm, while the ulna is found medially.

• The wrist is an area connecting the forearm to the hand and is mainly defined by the carpal
bones. Its main skeletal component is the radiocarpal (wrist) joint, that connects the radius to
the carpal bones of the hand and ensures the mobility of the hand as a whole.
• The hand is the most distal part of the upper limb. It consists of several groups of bones
connected via numerous articulations that enable the fine movements of the hand, such as
writing or drawing. From proximal to distal, these bones are divided into three groups: carpal
bones, metacarpal bones, and phalanges.
Elbow joint

Forearm & wrist

Lower extremity anatomy
• The lower extremities are a kind of two well-
oiled machines comprised of several complex
anatomical parts working together in perfect
harmony.

• The lower extremity can be divided into several

parts or regions:
 Hip
 Thigh
 Knee
 Leg
 Ankle
 Foot
Hip & Pelvis
Bones
• The structural framework of the hip region is provided by the pelvis, a structure composed of
the pelvic girdle and the coccyx. In turn, the pelvic girdle consists of two hip
bones and the sacrum, interconnected at the pubic symphysis and sacroiliac joints.
• Each hip bone has three parts (ilium, ischium, pubis) and accepts the head of the femur to form
the hip joint. This ball-and-socket joint is responsible for providing the lower extremity with an
extensive degree of movement.
Muscles
• Several hip muscles act on the hip joint, causing the thigh, and hence the lower extremity, to
move. They are divided into anterior and posterior muscle groups. The latter is further divided
into superficial and deep subgroups.
• The anterior muscle group includes iliacus, psoas major and psoas minor. The posterior
superficial muscles are the three gluteal muscles (gluteus maximus, gluteus medius, gluteus
minimus), and the tensor fascia latae.
• In turn, the posterior deep muscles are the piriformis, obturator internus, obturator
externus, superior gemellus, inferior gemellus, and quadratus femoris.
Thigh anatomy
Bones and muscles
• The thigh is located between the hip and the knee.
• It is the strongest and most prominent part of the
lower extremity, thus a personal favourite for fitness
enthusiasts to showcase.
• The scaffold of the thigh is provided by the femur, the
only bone of this region and the longest bone in the
body.
• Femur has an upper extremity, a shaft, and a lower
extremity, all of which are full of various structural
landmarks.
• Several muscles attach to, and act on, the femur. They
take full advantage of the mobility provided by two
joints.
Distal part of Femur
section
Knee anatomy
• The knee joint is formed by the close interaction
of three bones: femur, tibia ,
and patella (kneecap).
• In fact, the entire joint consists of two
articulations housed within one capsule, which is
strengthened by various extracapsular and
intracapsular ligaments.
• The knee joint is a hinged joint capable of mainly
flexion and extension, but also a small degree of
rotation. These movements are performed with
the help of several muscles of the thigh and leg.
• The knee extensors are the four muscles forming
the quadriceps femoris, while the flexors include
the biceps femoris, semitendinosus,
semimembranosus, sartorius, popliteus,
and gastrocnemius.
Knee
 Upper part of
Patella/Knee section
 Normal Knee
MRI

Articular liquids
Leg anatomy
• In the realm of anatomy, the ‘leg’ is strictly the region between the knee and
the ankle joints rather than the entire lower extremity, as erroneously referred
to in common language.

• The two main bones of the leg are the tibia (‘shin bone’) located medially and
the fibula, which is located more laterally.

• The tibia is the largest of the two, hence it is responsible for weight bearing.
Two joints hold the tibia and fibula together (the superior and inferior
tibiofibular joints), as well as an anatomical structure called the interosseous
membrane.

• The lateral compartment of the leg is the smallest one, containing only two
muscles: fibularis/peroneal longus and brevis.
Proximal shaft
of the tibia
level
Ankle & Foot
• The ankle (talocrual) joint is a hinged joint
capable of plantarflexion and dorsiflexion.
• It is composed of three bones: tibia, fibula,
and talus (ankle bone).
• Out of the three, the fibula only plays a
secondary and functional role, facilitating the
movement of the ankle rather than
structurally forming it.
• Providing the ankle with strength, but also
flexibility, are ten ligaments in total, one of
the most important being the deltoid
ligament.
• Sitting inferior to the talocrural joint is the
subtalar (or talocalcaneal) joint, providing the
foot with inversion and eversion capabilities.
Foot Bones
• The bone called the talus is
involved in the ankle joint.
• However, this is only one out of
many foot bones. These include
the 7 tarsals; calcaneus, talus,
navicular, cuboid, and cuneiform
(three in total) bones, as well as
the metatarsals, and phalanges.
• They are held together by
several ligaments, the most well
known being the collateral and
long plantar ligaments of the
foot.
Normal Feet & Ankle protocols for MRI
Thank you for joining!

ismet.tamer@istinye.edu.tr
: 0(532)332 09 29
@profdrismettamer