Skull from the front 4 Anterior nasal spine Body of mandible Frontal bone Frontal notch Frontal process of maxilla Glabella ater wing of sphenoid bone Infra-orbital foramen Infra-orbital margin 10 Inferior nasal concha 41 Inferior orbital fissure 32 Lacrimal bone 44 Manila 45. Mental foramen 36 Mental protuberance 47 Middle nasal conche 48 Nasal bone 49 Nasal septum 20 Nasion 24 Orbe (orbital 22 Ramus of mand 25 Supre-orbital m 26 Zygomatic bone The term “skull includes the mandible, and “cranium refers to the skull without the mandible The calvarium is the vault of the Skul cranial vault or skull-ap) and \s the Upper part of the Cranium that srcloses the brain The front part of the skull forms The supra-orbital, infra-orbital ane mental foramina (24, 8 and 15) le In approximately the same vertical plane are given on pags 18-27, of the bones of the orbit and nose on page 12, and of the testh on,Skull muscle attachments, from the front uperioris superiors alaeque 35. Zygomaticus major 46 Zygomaticus minorSkull radiograph, occipitofrontal 15° projection Floor of masillary sinus (antrum) Foramen rotunda Frontal sinus jing of sphenoid suture Latoral mass of atlas (rst corvical Lesser wing of sphenold Mastold process "Nasal septumSkull from the right 41 Anterior lacrimal crest 10 Frontal bone 20 Mental foramen 30 Ramus of mandible 2 Anterior nasal spine 11 Frontal process of maxilla. «21. Mental protuberance 31. squamous part of temporal 3 Body of mandible 42 Frontazygomatie suture 22 Nasal bone bone 4 Condylar procoss of the 33 Giabolla 23. Nasion 32 Stylold process of tomporal manible 14 Greater wing of sphenoid «24 Occipital bone bone 5 Coronal suture ne 25 Orbital plate of ethmold 33. Superior temporal line & Coronoid process of mandible 45. Inferior temporal line bone 34 Tympanic part of tompor 7 Extomal acoustic meatus of 16. Lacrimal 26 Parietal bone bone temporal bone 17 Lambdoid suture 27 Pituitary fossa (sellaturcica) 35. Zygomatic arch @ External ocepita 48 Mastold process of temporal (Gee Figure A on page 5) 36 Zygomatic bone protuberance (inion) bone 28 Posterior lacrimal crest 37 Zygomatic process of 9. Fossa for lacrimal sac 19 Maxila 29. Pterion (ence! temporal bone Pterion (29) isnot a single point but an are where the frontal (10), Its an important landmark for the anterior branch of the middle parietal (26), squamous part of the temporal (31) and greater wing, _meningoal artery, which underlies this area on the inside of the skull bf the sphenold Bone (14) adjoin one another. (age 1)Skull radiograph, lateral projection coloured bones See label list on page 4 for A and C labels scalp dissection Scalp layers S, skin; C, connective tissue; A, aponeurosis of Cctcipitofrontalls:L loose areoiar tissue; ®, periosteum, Aponeutosis of occipitofrontals ‘Dura mater Frontalis muscle (covered by loose areolar tissue) Loose areolar issue ‘Middle meningeal artery impression on dura mater Parietal Branch of the superficial temporal artery Subcutaneous tssue 12 Tomporalis muscle 410 Temporal bone 41 Temporal fasciaSkull muscle attachments, from the right Buccinator Corrugator super Depressor angull oris Depressor lab interiors Levator anguli ors Levatorlabiisuperioris Levatorlabli superioris alaeque nas Masseter Nasalis Occipital part of occiptofrontals Orbiculars ocul Platysma Procerus Sternocleldomastoid ‘Temporalls ‘Temporomandibular Joint 2ygomaticus major 2ygomaticus minor Te bony attachments of the buccinator muscle (1) are to the upper and lower jaws {maxila and mandible) opposite the three molar teeth, (The teeth are Identified on, pages 13-19) The upper attachment of temporalis (upper 15) occupies the temporal fossa (the narrow space above the zygomatic arch at the side of the skul). The lower attachment of temporals lower 15) extends from the lowest part of the mandibular notch of the mandible, over the coronoid process and down the front of the ramus almost as far as the fast molar tooth, Massetor (8) extends from the zygomatic arch to the lateral side of the ramus of the mandible— © Skull from behind External occipital protuberance (inion) Highest nuchal line Inferior nuchal ine Lambdold suture Occipital bone Parietal bone Parietal foramina sagittal suture Superior nuchal line Senveusuns See label list below for C and D. © Skull right infratemporal region, obliquely from below Articular tubercle External acoustic meatus Horizontal plate of palatine bone Inferior orbital fissure Infratemporal crest Infratemporal (posterior) surface of maxilla Infratemporal surface of greater wing of sphenold bone Lateral ptorygoid plate ‘Mandibular fossa 410 Mastoid notch 11 Mastold process 42 Medial pterygoid plate 13 Occipital condyle 14 Occipital groove 15. Prerygoid hamulus 116 Prerygomanilary fissure and pterygopalatine fossa 117 Pyramidal process of palatine bone 48 Spine of sphenold bone. 19 Styloid process and sheath 20 Third maxillary molar tooth 21 Tuberosity of maxilla 22 Vomer 23 Zygomatic archSkull from above Skull internal surface of the cranial vault, central part os a a Se 2 5 6 =) 8< i t 7 ) f { ree x pee 77 at A 1 3 4 4 4 bregma 1 coronal tre 3 Cerda! suture | inti sal the parital eminence are prominent (A 2 eprosion for erachnodgranulatons 3 Frontal bone The point where the sagittal suture (A10) meets the coronal suture 3 Frontal bone 4 Lambda (A2) Is the bregma (A1). At birth, the unossified parts of the 4 Frontal crest 5 lambdoid sure fromal and penta hos ts ragion form the memvanous | oove for superior sata sus § Suapteltone” | tanner oe & rows me manna vse 2 faretal bone, | the point hero the sagittal suture (a1) meats tho tambacld | Part bone 2 pata eminence | [ture (as) nthe amb (ad). at Bt, the uneaig pares ofthe Zante fram 43 atta foramen | Gita and occ boner nth region frm the memrancus posterior fontanelle (page 14, C13) The label A3 In the cantre of the frontal bone indicates the line of the frontal suture In the fetal skull (page 14, AS). The suture may, persist in the adutt skull and ie sometimes known as the metopie ‘The arachnoid granulations (page 62, B1), through which cerebrospinal fluid drains into the superior sagital sinus, cause the Irregular depressions (82) on the parts of the frontal and parietal ‘bones (83 and 7) that overlie the sinus.The palatine processes of the maxilla (32) and the horizontal plate of the palatine bone (14) form the hard palate (roof of the mouth and floor of the nasal cavity). The carotid canal (3), recognized by its round shape on the inferior surface of the petrous part of the temporal bone, does not pass straight upwards to open Into the Inside of the skull but takes a right-angied turn forwards and medially within the petrous temporal to open into the back of the foramen lacerum (3) Skull external surface of the base Apex of petrous part of temporal bone Articular tubercle Condylar canal (posterior) Edge of tegmen tympani External acoustic meatus External occipital crest External occipital protuberance Foreman lacerum Foramen magnum Foramen ovale Foramen spinosum Greater palatine foramen Horizontal plate of palatine bone Hypoglossal canal Incisive fossa Inferior nuchal tine inferior orbital fissure Infratemporal crest of greater wing of sphanoia bone Jugular foramen, Lateral pterygoid plate Lesser palatine foramina Mandibular fossa Mastoid foramen Mastoid notch Mastold process Medial pterygoid plate Median palatine (intermaxiiary) suture Occipital condyle Occipital groove Palatine grooves and spines Palatine process of maxilla Pharyngeal canal Patrosquamous fisure Petrotympanic fisure Pharyngeal tubercle Posterior border of vomer Posterior nasal aperture (choana) Posterior nasal spine Prerygold hamulus Pyramidal process of palatine bone Staphoid fossa Spine of sphenoid bone Squamotympanic fissure Squamous part of temporal bone stylold process Stylomastold foramen Superior nuchal line Transverse palatine (palatomaxiliay) suture Tuberosity of maxita ‘Tympanic part of tempor Vomerovaginal canal Zygomatie archSkull muscle attachments, external surface of the base Green line = capsule attachments of atlanto-occipital and temporomandibular joints 1 Capsule attachment of atlanto ‘occipital joint 2. Capsule attachment of temporomandibular joint 3 Deep head of medial pterygoid 4 Levator val palatinl 5 Longisimus capitis, 6 Longus capitis 7 Masseter 8 Musculus uvulee 9 Occipital part of occipitofrontalis 10 Palatopharyngeus 1411 Pharyngeal raphe 32. Posterior bally of digastele 33. Rectus capitis anterior +44 Rectus capitis laterals 115. Rectus capitis posterior major 36 Rectus capitis posterior minor 17 Somispinals capitis 118 Splenius capitis, 19. Stormocieldomastold 20 Stylogiossus 21 stylohyoid 22 stylopharyngous 23. Superficial head of medial pterygoid 24 Superior constrictor 25. Superior oblique 26 Tensor tympani 27 Tensor vel palatini 28 Trapezius 29 Upper head of lateral pterygoid The medial pterygoid plate has no pierygoid muscles attached to tt. It asses stright backwards, giving brigin at its lower end to part of the superior constrictor of the pharynx: a, The lateral pterygoid plate has both pilerygoid muscles attached to i: medial and lateral muscles from the ‘medial and lateral surfaces, respectively (3 and 23). The plate becomes twisted slightly laterally Dbacause of the constant pull of these muscles which pass backwards and Taterally to thelr attachmonts to the mandible (pagos 18-19)Skull internal surface of the base (cranial fossae) Anterior clinoid process arcuate eminence Carotid groove lives Cribritorm plate of ethmoid bone Crista gall Diplow Dorsum seiae Foramen caecum Foramen lacerum Foramen magnum Foramen rotundum Foramen spinosum Frontal crest Frontal sinus Greater wing of sphenoid bone Groove for anterior ethmoldal nerve and vessels Groove for infelor petrosal sinus Groove for sigmoid sinus Groove for superior petrosa sinus Groove for superior Sagittal sinus Groove for transverse sinus Grooves for middle meningeal vessels Hiatus and groove for greater petrosal nerve Hiatus and groove for lessor petrosal Hypoglossal canal Internal acoustic meatus Internal oceipital protuberance Jugular foramen Jugum of sphenoid bone Lessor wing of sphenold bone Occipital bone (Cerebellar fossa) Optic canal orbital part of frontal bone Parietal bone (postero-inferior angle only) Petrous part of temporal bone Pituitary fossa (sella turcica) Posterior clinold process Prechiasmatic greove Squamous part of temporal bone Superior orbital Tssure Tegmen tympani Trigeminal Impression Tuberculum sellae Venous (emissary) foramen ‘The anterior cranial fossa (ACF) is limited posteriorly on each side by the free margin of the lessor ling of the sphenold (32) with its anterior clinold process (1), and centrally by the anterior margin of the prechiasmatic groove (40), ‘The middle cranial fossa (MCF) is butterfly shaped and consists of a central or median part and right and left lateral parts. The contral part includas the pitultary fossa (38) on the upper surface Of the body of the sphenoid, with the prechlasmatic groove (&0) in front and the dorsum sellae {@) with its posterior clinoid processes (38) behind, Each lateral part extends from the posterior ‘border of the lesser wing of the sphenold (32) to the groove for the superior petrosal sinus (21) (on the upper edge of the petrous part of the temporal bone. ‘The posterior cranial fossa (PCF), whose most obvious feature Is the foramen magnum (11), is behind the dorsum sollae (8) and the grooves for the superior petrosal sinuses (2). For cranial dural attachments and reflections, see pages $1-3 and 62.Skull bones of the left orbit Nasal cavity /ateral wall 1 Anterior ethmoidal foramen — 14 Manilla, forming floor In this midline sagittal section of the skull, with the nasal 2 Anterior lacrimal crest 415 Nasolacrimal canal septum removed, the superior and middle nasal conchae 3 Body of sphenols bone, 36 Optic canal have been dissected away to reveal the air cells of the fomning metal wel. 17 Geeiia bores ct ergomete ethmoidal sinus, in particular the ethmoidal bulla (5). «bene beri t in $ fotarenh Boer enemies yp obctcnnuiadan ae onal proc’ of ai ning rot 4 Alccalsofehmoldal sus_—-43. Maal prygol plat forming medial wall ‘19 Orbital plate of ethmold 3 Cribriform plate of ethmoid 15 Nasal spine of frontal bone 7 eats wing of sohenld bone ering cll wall cet 35 He eta ot fone on Seon formiig lara wall 20 Grotalproces opera g BOM 36 Opeieg of manny snus fo Intern rb sre eee um se ting proces of 3 faves terms 21 fone sino foramen 5 Eola bul 1 Parente of 1 Uactal bone forming 3. Superor ort fare , palatine 4a fsa ta tara) medial wall 24 Supre-orbtal foramen ‘i 22 Comes hata 12 Loser ming of phenol! 23 Zypomaticbore taming 8 31 Note henek ‘bone, forming roof lateral wall 10 Inferior nasal concha 23 Sphenopalatine foramen 3 Magne noes 30 Qigomatin-crtiie foreman 11 Lateral pterygoid plate 24 Uncinate process of ethmoid 3 tartphenodal se ben ‘The roof of the nasal cavity consists mainly of the cribriform plate (of the ethmoid bone (C3) with the body of the sphenold containing the sphenoidal sinuses (C21 and 12) behind, and the nasal bone (C1) and the nasal spine of the frontal bone (C15) at the front. “The floor of the cavity consists of the palatine process of the ‘maxilla (C17) and the horizontal plate of the palatine bone (C7). ‘The medial wall is the nasal septum which is formed mainly by two ‘bones - the perpendicular plate of the ethmold and the vomer ~ ‘and the septal cartilage, ‘The lateral wall consists of the medial surface of tho maxilla with its large opening (C16), overlapped trom above by parts of the ‘ethmold (C1, 5 and 24) and lacrimal bones, from behind by the perpendicular plate of the palatine (C18), nd below by the Inferior Concha (C10) Skull Left orbit, individual bones 1 Ethmoid 2 Frontal 3 Lecimal 8 sphonoid 4 Mandible 9 Temporal 5 Maxila 10 zygomatic Sinus pathology, see pages 80-82.es @ Permanent teeth from the left and in front 11 First (central) incisor 5 second premolar 2 Second (lateral) incisor 6 First molar 3 canine 7 Second molar 4 First premolar 8 Third molar ‘The corresponding teeth of the upper and lower Jaws have similar ‘names In clinical dentistry, the teeth are usually identified by the ‘numbers 1-8 (listed here) rather than by nam ‘The third molar is sometimes called the wisdom tooth. Upper and lower jaws from the left and in front e in the newborn with unerupted deciduous teeth @ ina cyearold child with erupted deciduous teeth and unerupted permanent teeth 1 First (central) incsor of 7 Second (lateral) incisor of deciduous dentition permanent dentition 2 Second (lateral incisor of 8 Canine of permanent deciduous dentition dentition 3 Canine of deciduous 9 First premolar of permanent dentition dentition 4. First molar of deciduous 10 Second premolar of dentition permanent dentition 5 Second molar of deciduous 11. First molar of permanent entition dentition 6 First (central) incisor of 42 Second molar of permanent permanent dentition dentition ‘The deciduous molars occupy the positions of the premolars of the permanent dentition. @ Edentulous mandible in old age, from the left 1 Angle 3 Mental foramen 2 Body 4 Ramus [With the loss of teeth, th ‘the mental foramen (3 margin of the bone. ‘The angle (1) betwoen the ramus (4) and body (2) becomes more ‘obtuse, resembling the infantile angle (as in € and F, above). veolar bone becomes resorbed, so that ibular canal lie near the upperSkull of a full-term fetus 1 Anterior fontanelio 11 Occipital bone from the front 2 Coronal suture 42 Parietal tuberosity 3 Elevations over deciduous 43. Posterior fontanelle teeth in body of mandible 44. Ramus of mandible frase the Neti stad eaghity below 4 External acoustic meatus 15 Sagittal suture 5 Frontal suture 46 Sella turelea from behind & Frontal tuberosity, 47 Semicicular canals, superior 7 Half of frontal bone 48 Sphenoidal fontanelle 8 Lambdold suture 19. stylomastold foramen, from above 9 Mastoid fontanelle 20 symphysis ment! 10 Manilla 21 Tympani ringSkull @ coloured left half of the skull in sagittal section Superior nasal concha ‘Miele nasal conch Inferior nasal concha Palatine bone See page 17 for additional label numbers. NB: The perpendicular plate of the ‘ethmoid has been removed to ‘expose the conchae, cleared specimen from the radiograph of facial bones, front, illuminated from behind occipitofrontal view 1 Body of mandible 10 2 Crista gall! n 3 Ethmoidal alr cals 2 4 Frontal cre. B 5 Frontal sinus 4 6 Greater wing of sphenoid 5 bone 6 7 Inferior nasal concha v7 B Infra-orbital margin 18 9 Lesser wing of sphenoid bone 19 ‘Compare with the skull on page 1. Mastoid process ‘Maxillary sinus Mental foramen Nasal septum Ramus of mandible Root of lower lateral incisor Root of upper central incisor Superior orbital fissure Supra-orbital margin Zygomatic archSkull left half of the skull in sagittal section ‘The inside of the left half of the skull is seen from the right, with the bony part of the nasal septum (36 and 45) preserved. 1. Alveolar process of maxilla 2 Angle of mandi 3 Body of mandible 4 cliws 5 Coronal suture & Crista galli of ethmoid bone 7 Dorsum salise {8 External occipital protuberance 9 Frontal sinus 0 n 2 3 Groove for mylohyoid nerve Groove for sigmoid sinus Groove for superior petrosal sinus Groove for transverse sinus ‘Grooves for middle meningeal vessls {anterior division) 15 Horizontal plate of palatine bone 16 Hypoglossal canal 17 Incisive canal 4B Internal acoustic meatus In petrous ppart of temporal bone 419 Internal occipital protuberance 20 Lambdoid suture 21 Lateral pterygoid plate 22 Loft sphenoldal sinus 23 Lingula 2 25 26 27 28 29 30 3” 3 33 Bt 35 36 37 38 39. 40 a 42 a3 a 45 Mandibular foramen, ‘Margin of foramen magnum ‘Mastoid (posterior inferior) angle of parietal bone Medial pterygoid plate ‘Mental protuberance ‘Mylohyoid line Nasal bone Occipital bone Occipital condyle Orbital part of frontal bone Palatine process of maxilla, Parietal bone Perpendicular plate of ethmoid bone Pituitary fossa (sella turcica) Posterior nasal aperture (choana) Pterion (encircled) Pterygold hamulus of medial pterygoid plate Ramus of mandible Right sphenoidal sinus ‘Squamous part of frontal bone Squamous part of temporal bone ‘vomer’ ‘The bony part ofthe nasl septum consists of the vomer (4) and the perpendicular plate of the ‘thoi bone (36). The anterior part of the Septum consis of he sepa cartage(nges 52 In this kul the spinodal sinuses (42 and 22) are largo, andthe right one (22) has extended to the lett of the micline. the pitultary fossa (37) projects ‘down into the lft sinus (22) ‘The grooves forthe mide meningeal vesos (14) pass upwards nd backward. Theil) marks ‘the region ofthe pterion, and corresponds to tho patio shown en the outside ofthe skull on age 4. smannenmmymennnnn g&from the front 2 Angie 15 Mental tubercle i eet 5 Body 18 Neck from the left and front 7 Digastric fossa 20 Posterior border of ramus. y 4 ‘ts J 5 q alsa nivian Minar aca eT “ constitute the condyle 4 ‘The alveolar part (1) contains the sockets for the roots of the teeth, The base (is the inferior border of the body (5), and becomes, continuous with the Inferior border (9) of the ramus (22) OrthopantomogramMandible muscle attachments from the front from behind from the left and front internal view from the left Green line = capsular attachment of temporomandibular joint; blue line = limit of attachment of the oral mucous membrane; pale green line = ligament attachment 1 Anterior belly of digastric 10 Mentalis 2 Buccinator 11 Mylohyoid 3 Depressor angull oris 12 Platysma 4 Depressor labl Interiors 13 Pterygomandibular raphe and 5 Genlogiossus superior constrictor & Geniohyoid 414. Sphenomandibular ligament 7 Lateral pterygoid 415. Stylomandibular ligament 8 Masseter 16 Temporalis 9 Medial pterygoid The lateral pterygoid (A7) is atached to the pterygoid fovea on the neck of the mandible (and also to the capsule of the temporomandibular Joint and the articular disc - see 228). The medial ptorygold (88, C9) Is attached to the medial surface of the angle of the mandible, below the groove for the mylohyoid -Masseter (CB) is attached to the lateral surface of the ramus. Temporal (C16) is attached over the corenold process, extending back as far as the deepest part of the mandibular notch and. downwards over the front of the ramus almost as far asthe last 2, 027, Buccinator (C2) is attached opposite the three molar teeth, at the back reaching the pterygomandibular raphe (C13). Genioglossus (85) Is attached to the upper mental spine and Geniohyoid (86) to the lower. Mylohyoid (11) is attached to the mylohyoid line. The attachment of the lateral temporomandibular ligament to the lateral aspect of the neck of the condyle fs not shown.Frontal bone external surface from the front external surface from the left from below internal surface from above and behind (right half removed; ethmoidal notch is inferior) Anterior ethmoldal canal (Position of groove) Ethmoidal notch Fossa for lactimal gland Frontal tuberosity Glabella Inferior temporal ine Nasal spine Orbital pert Position of frontal notch or a 6 6 v 1% » 20 2 Posterior ethmoldal canal (position of groove) Roof of ethmoldal alr clls Sagittal crest Superci Superior ta Supra-orbital margin Supre-orbital notch or Tochlear fovea (or tubercle) Zygomatic processRight maxilla " 2 2 4 from the front from the lateral side from the medial side Alveolar process Anterior lacrimal crost Anterior nasal spine Anterlor surface Canine eminence Canine fosse Conchal crest Ethmoidal crest Frontal process Greater palatine canal (postion of groove) incisive canal incisive fossa Inferior meatus Infra orbital canal 15 6 v 2 ” 20 2 2 23 24 25 26 7 28 from below from above from behind infra-orbital foramen intra-orbital groove infra-orbital margin Infratemporalsurtace Lacrimal groove Maxillary hiatus and sinus Middle m Nasal crest, Nasal notch Orbital surface Palatine process Tuberosity Unerupted third molar Zygomatic process Right lacrimal bone from the lateral (orbital) side from the medial (nasal) 29 Lecrimal groove 30 Lactimal hamulus 31 Nasal surface 32 Orbital surface 33 Posterior lacrimal crest Right nasal bone from the lateral side from the medial side 34 Internal surface and groove for anterior ‘ethmoidal nerve 35 Lateral surfaceRight palatine bone from the medial side from behind Articulation of the right maxilla and the palatine bone, from the medial side from the lateral side from above 1 Horizontal plate of palatine 2. Maxillary process of palatine irsaaTthal fant fan inelies 3 Palatine process of maxilla 41. Conchal crest 8 Orbital process 2. Ethmoidal crest 9 Perpendicular plate 3 Greater palatine groove 40 Posterior nasa spine 4 Horizontal plate 414 Pyramidal process 5 Lesser palatine canals 12 Sphenoidal process & Maxillary process 13. Sphenopalatine notch 7 Mosel crestRight temporal bone external aspect internal aspect from above from below from the front a 4 Aqueduct of vestibule Articular tubercle ‘Auditory (eustachian) tube Canal for tensor tympani Canaliculus for tympanic branch of glossopharyngeal Carotid canal Cochlear canaliculus Edge of tegmen tympani External acoustic meatus Groove for middle temporal artery Groove for sigmoid sinus Groove for superior petrosa Grooves for branches of middie meningeal vessels 1% 6 v 2 1% 20 n 2 2 24 25 26 a Hiatus and groove for greater petrosal nerve Hiatus and groove for lessor petrosal nerve Jugular fossa Jugular surface jandibular fossa Mastold canaliculus for auricular branch of vagus Mastold notch Mastoid process Occipital groove Parietal notch Petrosquamous fissure (from above) Petrosquamous fisure (from below) 20 23 30 n 32 33 3a 35 36 40 a Petrotympanic fissure Potrous pert Postglenold tubercle Sheath of styiold process Squamotympanic fissure Squamous part Styloid procoss Stylomastold foramen Subarcuate fossa Supramoataltrianglo Tegmen tympani Trigeminal impression on apex of petrous part Tympanie part zygomatic processRight parietal bone external surface internal surface Frontal (anterior) border Frontal (antero-superion) angle Furcows for frontal branch of middle meningeal vessels (anterior division) Furrows for parietal branch of middle meningeal vessels (posterior division) Groove for sigmoid sinus at mastold angle Inferior temporal line Mastoid (postero-inferior) angle Occipital (postoriot) border (Occipital (postero.superior) angle 40 Parietal foramen 31 Patiotal tuberosity 12 Sagittal (superior) border 413 Sphonoldal (antero. interior) angle 44 Squamosal (inferior border 45. Superior temporal line Right zygomatic bone lateral surface from the medial side from behind 1 Frontal process 2 Marginal tubercle 3 Maxillary border 4 Orbital border 5 orbital surface 6 Temporal border Temporal process Temporal surface Zygomatico-orbtal foramen Zygomaticofacal foramen Zygomaticotemporal foramen The zygomatic process of the temporal bone (page 4, 37) and the temporal process of the zygomatic bone (C7, 07) form the zygomatic arch (page &, 35)Sphenoid bone Vomer from the front from below from the right from behind from the left from behind from above and behind 1 Ala of vomer 10 Foramen spinosum 18 Optic canal 28 Scaphoid fossa 2 Anterior dinold process 41 Groove for nasopalatine 49. Orbital surface of greater 2: Sella turcica (pltultary fossa) 3 Body with openings of nerve and vessels wing 30 Spine sphenoldal sinuses 12 Infratomporal crest of greater 20 Posterior border of vomer 34. Superior orbital fissure 4 Carotid groove wing 21 Posterior clinold process 32 Temporal surface of greater 3 Corebral surface of greater 13. Infratemporal surface of 22 Prechiasmatic groove win wing greater wing 23 Pterygoid canal 33 Tuberculum sella 6 Dorsum seliae 14 Jugum 24 Prerygold hamulus 34 Vaginal process 7 Ethmoldal spine 45 Latoral pterygoid plate 25. Pterygoid notch 8 Foramen ovale 46 Lessor wing 26 Pterygoid process 9 Foramen rotundum 47 Medial pterygoid plate 27 RostrumEthmoid bone from above from the left from the front from the left, below and behind 1 Ala of crista gall 2 Anterior ethmoidal groove 3 Cribritorm plate 4 crista gal) 5 Ethmoldal bulla 6 Ethmoidal labyrinth (containing ethmokdal ai cols) 7 Middle nasal concha 8 orbital plate ‘9. Porpandicular plate 410 Posterior ethmoidal groove 111 Superior nasal concha (meatus) 12 Uncinate process Right inferior nasal concha from the lateral side from the medial side from behind Ethmoidal process Lacrimal process Maxillary process Medial surface Posterior end Maxilla Articulation of right maxilla, palatine bone and inferior nasal concha, from the medial side ‘Anterior end of inferior nasal concha Ethmoidal process of inferior nasal concha Frontal process of manila Horizontal plate of palatine Lactimal process of Inferior nasal concha Palatine process of maxilla Perpendicular plate of palatine Posterior end of Inferior nasal conchaOccipital bone external surface from below Internal surface external surface from the right and below bones of the base of the skull orange, occipital; red, temporal; blue, sphenoid Basilar part Cerebellar fossa Cerebral fossa Condylar fossa (and condylar canal in 8 condyle External occipital crest External occipital protuberance Foramen magnum Groove for inferior petrosal nd Groove for sigmoid sinus Groove for superior sagital Groove for transverse sinus Highest nuchal line Hypoglossal ca Inferior nuchal line internal occlpital crest Internal ecepital protuber Sugular noten sugular process Jugular tubercle Lambdoid margin Lateral angle Lateral part Mastoid margin Pharyngeal tubercle Squamous part superior angie Superior nuchal lineAnterior arch and tubercle Facet for dens of axis Groove for ver articular tubercle Transverse process and foremen ‘The superior articular facets (5) are concave and kidney-shaped. ‘The Inferior articular facts (a) are circular and almost fat. ‘The anterior ah (1) is straightor and shorter than the posterior arch (6) and contains on its posterior surface the facet for the dens ‘of the axis (2). ‘The atlas isthe only vertebra that has no body. @ cated withthe ata, trom above 1 Anterior arch of atlas 2 ifid spinous process 3 Body 4 Dens (odontoid peg) '5 Impression for alar ligament 6 Inferior articular facet n 9 Superior articular surface 10 Transverse process and riebral foramen ‘The axis Is unique in having the dens (4) which projects upwards from the body, representing the body of the atlas.Fifth cervical vertebra typical cervical vertebra from above from the front from the left 11 Anterior tubercle of transverse process 2 Bifid spinous process 3 Body 4 Foramen of transverse process 5 inferior articular process 6 Intertubercular lamella of transvers tomina Pedicle 9. Posterior tubercle of transverse process 10 Posterolateral lip (uncus) 114 Superior articular process 12. Vertebral foramen Seventh cervical vertebra vertebra prominens from above Foramen of transverse process intertuberculer lamella of transverse Pedicle Posterior tubercle of transverse process Posterolateral lip uncus) Spinous process with tubercle Superior articular process, Vertebral foramen Al cervical vertebrae (frst to seventh) have a foramen in each transverse process (as Ad) Typical cervical vertebrae (third to sixth) have superior articular processes that face backwards and upwards (A11, C11), posterolateral ips on the upper surface Of the body (A10), a triangular vertebral foramen (&12) and a bifid spinous process (A2), The anterior tubercle of the transverse ppracess of the sixth cervical vertebra Is Farge and known as the carotid tubercle. Tho sovonth corvical vertebra (vertebra prominens) has a spinous process that ends ina single tubercle (03), The rib element of a cervical vertebra is roprosented by the anterior root of the ‘transverse process, the anterior tubercle, the intertubercular lamella (with Its groove for the ventral ramus of a spinal herve) and the anterior part of the posterior tubercle (as at D1, 4 and 7) Seventh thoracic vertebra typical from above from the left from behind 1 Body 2. Costa facet of transverse process Inferior articular process Inferior costal facet Inferior vertebral notch Pedicle spinous process Superior articuler process Superior costal facet Superior vertebral notch Transverse process Vertebral forame: “Typical thoracle vertebrae (Gecond to ninth) are characterised by costal facets fon the bodies (F10, a), costal facets on the transverse processes (F2), @ round ertebral foramen (E13), 8 spinous process that points downwards as wall 35 backwards (F8, G8) and Superior articular processes that are vertical, flat and taco backwards and laterally (€8, £9, 69), =First thoracic vertebra from above from the front and the left 1 Body 2 Inferior articular process Inferior costal facet Lamina Pedicle Posterolateral lip (uncus) Spinous process Superior articular process Superior costa facot Transverse process with costal facet Vertebral foramen x + Tenth and eleventh thoracic vertebrae tenth thoracic vertebra, from the left eleventh thoracic vertebra, from the left 1 Body 2 costal facot 3 Infrior articular process 44 Isterior vertebral notch 5 Pedicle spinous process 7. Superior articular process ‘8 Transverse process Twelfth thoracic vertebra from the left from above from behind Body Costa facet Inferior articular process Inferior tubercle Lateral tubercle Pedicle Spinous process Superior articular process Superior tubercle The atypical thoracic vertebrae are the first, tenth eleventh and, twelfth The first thoracic vertebra has @ posterolateral lip (A6, 86) on ach sido of the upper surface of the body and a triangular vertebral foramen (features like typical cervical vertebrae), and complete (ound) superior costal facets (88) on the sides of the body. ‘The tenth, eleventh and twelfth thoracic vertebrae are characterised by a single complete costal facet on each side of the body that In succesive vertebrae comes to lie Increasingly far from the upper surface of the body and encroaches increasingly onto the pedicle (C22 and €2), There Is also no articular facet on the transverse processFirst lumbar vertebra 1 2 10 " 2 from above from the left from behind Accessory process Body Inferior articular process Inferior vertebral notch Lamina Mammillary process Pedicle spinous process Superior articular process Superior vertebral notch Transverse process Vertebral foramen Lumber vertebrae are characterised by the large sizo Of the bodies, the absonce of costal facets on the bodies ‘and the transverse processes, {triangular vertebral foramen (A12), a spinous process ‘that points backwards ‘and fs quadrangular or hatchet shaped (88) and superior articular processes that are vertical, curved, face backwards and medially (AS) and possess a mamillary process at their posterior rim 6). The rib olement of a lumbar vertebra is represented by the ‘transverse process (A11). ‘The level at which facet joint orientation changes botween ‘the thoracic and lumbar regions is variable Posterior view second lumbar vertebra third lumbar vertebra fourth lumbar vertebra fifth lumbar vertebra View from above fifth lumbar vertebra Body Pedicle Spinous process ‘Superior articular process Transverse process fusing with pedicle and body Vertebral foramen ‘Viewed from behind, the four articular procosses of the first ‘and socond lumbar vertobrae make a pattern (indicated by the interrupted line) of a vertial rectangle; those of the third or fourth vertebra make a square, and those of the fifth lumbar vertebra make a horizontal rectangle. ‘The fifth lumbar vertebra is unique in that the transverse process (H6) unites directly ‘with the side of the body (+7) 25 well a5 with the pedicle 3)Sacrum from the front and the right in the female in the male 1 auricular surface 2 Pelvle surface 3 Promontory Inthe female, the pelvic surface Is relatively straight over the frst three sacral vertebrae and becomes more curved below. In the male, the pelvie surface fs more uniformly curved, The capsule of the sacroiliac joint is attached to the margin of the auricular (articular surface (81, B3) Base of the sacrum upper surface in the female in the male 1 Body of first sacral vertebra 5 Sacral canal 2 Lamina & Spinous tubercle of median 3 Lateral part (ala) sacral crest ‘4 Promontory 7 Superior articular procoss In the male, the body of the frst sacral vertebra (udged by Its transverse dlameter) forms a greater part of the base of the sacrum than in the female (compare D1 with C1), IG, there & some degree of spina bifida (non-fusion of the laminae, 2, In the vertabral arch of the first sacral vertebra), Compare with the complete arch in D.Sacrum and coccyx 1 pelvic surface oceygeat cornu First coccygeal vertebra Fused second to fourth vertebrae intermediate sacral crest Lsteral part Lsteral Sacral crest Median sacral crest Promontory, Secral canal dorsal surface sacral cornu Sacral hiatus Second pelvic sacral foramen site of fusion of first and second sacral vertebrae Superior articular process Third dorsal sacral foramen Transverse process Upper surface of lateral part (ala) The sacrum is formed by the fusion of the five sacral vertebrae. The median sacral crest (Ba) represents the fused spinous processes, the Intermediate crest (65) the fused articular processes, and the lateral crest (87) the fused transverse processes The sacral hiatus (612) is tho lower opening of the sacral canal 10) ‘The coccyx is usually formed by the fusion of four rudimentary vertebrae but the rumbor varies from three to five. In this, Specimen, the first place of the coccyx (3) s not fused with the femaindor (2).Sacrum with sacralisation of the fifth lumbar vertebra pelvic surface dorsal surface, and sacral muscle attachments Body of fifth lumbar vertebra Coceygeus Erector spinae vertebra fused Fist dorsal sacral foramen First pelvic sacral foramen Foramen for dorsal ramus of fifth lumbar nerve Foramen for ventral ramus of fifth lumbar norve 10 n 2 3 4 3 16 Fusion of transverse process ‘and lateral part of secrum Gluteus maximus Miacus Piriformis Sacral canal spinous process of fifth lumbar vertebra Superior articular process of fifth lumbar vertebra In sacralisation of the fifth lumbar vertebra, that vertobra (1) is (Usually incompletely) fused with the sacrum. In the more rare. Condition of lumbarization of the fist sacral vertebra (not llustrated) the first piece of the sacrum is incompletely fused with the remainder. In this spacimen, as well as fusion of the fifth lumbar vertebra with the top of the sacrum, the body of the first coccygeal vertebra (4 I fused with the apex of the sacrum.Bony pelvis from in front and above female male from the front 4 Acotabulum 2 Anterior inferior Illa spine 3 Anterior superior iliac spine 4 Arcuate line 5 Coccyx 6 lac crest 7 lac fossa 8 ischial spine 9 Obturator foramen 10 Pectinea! line 11 Pubic symphysis 42 Pubic tubercle 413 Sacral promontory 44 Sacroiliac joint, 45 Sacrum The pelvic inlot (brim) is bounded by the sacral promontory (13), arcuate and pectineal lines G@ and 10), the crest of the pubic bones and anteriorly the pubic symphysis (11) The female brim is more circular, the male more heart shaped. The female sacrum (15) Is wider, shorter and! less curved. The female ischial spines (8) are further apart. Tho female subpubic angle (white dotted lino on A) is wide (80-120") and the male subpuble angle (white dotted line on 8) only 60-0"Left scapula 4. Acromial angle 9 Neck (and spinoglenoid notch dorsal surface 2 Racial meee ae The spine (A10) ofthe scapula 3 Corecold process 10 Spine projec om fs don coal antere 5 ntresps ssa 32 Stperor orgie (2) atthe lateral end of the & Lateral border 43 Superior border spine 7. Margin of glenoid cavity 48 Suprascopular notch 8 Medial borde 45 Supraspinous fossaLeft scapula attachments 1 Conoid ligament of 12 Rhomboid coracodavicular ligament 43 Sorratus ante 2 Coracoacromial ligament 14 Subscapularis 3 Coracobrachials and short 48. Superior transverse scapular ad of bicops igamont 4 deltoid 16 Supraspinatus 5 Inferior belly of omohyoid 17. Tores major 6 Infraspinat 418. Tores minor and intervening 7 Latissimus dors (groove for circumflex 8 Levator scapulae Scapular artery 9 Long head of triceps 419 Trapezius 40 Pectoralis minor 20 Trapezoid ligament of 11 Rhomboid major coracoclavicular ligament The suprascapular notch is bridged by the superior transverse scapular ligament (15) The conoid (1) and trapezoid (20) ligaments together form the oracoclavieular ligament. which attachos the coracold process of the scapula to the under-surface of the lateral end of the clavicle dorsal surface costal surface The coracoscromlaligament (2) passes between the coracold Blue lines, epiphysial lines; green lines, capsular Broce end te scromon, fering with these boy proces an attachments of shoulder joint; pale green lines, ligament attachments@ Left clavicle from below for subclavius muscle ion for costoclavicular fend with articular ‘The stornal ond of the clavicle (87, C5) Is bulbous ‘the acromial end ( Is flattened. 1 Remedial two-thirds, and for the subdlavius ‘musclas on the inferior surface (C3). & @ Left scapula from the lateral side 6 infraspinous fossa 7 Lateral border 4 Inferior angie ‘2 Supraglenoid tubercle 5 Infraglenoid tubercle 40. Supraspinous fo @ Left scapula and clavicle articulation, from above 1 f clavicle 5 Shaft of cular joint mion 7 sternal acold pro 8 supras@ Left scapula attachments, from the lateral side Blue lines, epiphysial lines; green lines, capsular attachments of shoulder joint; pale gr ligament attachments Coracobrachialis and short head of biceps Coracohumeral ligament Deltoid Cee Long head of biceps @ Left scapula and clavicle articulation, from above Blue lines, epiphysial lines; green lines, capsular attachments of sternoclavicular and ‘acromioclavicular joints; pale green lines, ligament attachmen i Sternocieldomastold Superior te ligament @ Left cla attachments, from below Blue lines, epiphysial lines; green lines, capsular attachments of sternoclavicular and acromioclavicular joints; pale green lines, ligament attachments Conoia ligament Fractured clavicle, fractured scaRight humerus upper end from the front © trom behing @ trom the medial side © trom the lateral side from above anatomical neck Deltoid tu Greater tubercle Gr fal nerve tubercular groove ‘Modial lip of intertubercular groove Surgical neck ‘The intertubercular (bicpital) groove (A6) ison the front of the upper end ‘and is occupied by the tendon of the Tong head of biceps. For attachmentsRight humerus attachments, upper end from the front from behind from the medial side from the lateral side from above Blue lines, epiphysial lines; green lines, capsular attachment of shoulder joint 1 Brachialis 7. Medial head of triceps 2 Coracobrachialis 8 Pectoralis major 3 Deltora 9. Subscepularis 4 Infrespinatus 10 supraspinatus 5 Lateral head of triceps 11 Teres majo & Latisimus dorsi 42 Teres minor Deltoid is attached to the V-shaped deltoid tuberosity (A3 and 03) ‘on the lateral surface of the middle of the shaft. CCoracobrachialis Is attached to the medial surface of the middle of he shaft (C2) (opposite the deltoid tuberosity). Note the relative positions of the epiphysial and capsular lines: the ‘piphysis is partly intracapsular and partly extracapsular at the Upper end of the humerus.Right humerus /ower end from the front from behind from below from the medial side from the lateral side Anterior surface Capitulum Coronold Tossa Lateral edge of capitulum Lateral epicondyle Lateral supracondylar ridge Medial epicondylo Medial supracondylar ridge Medial surface of trochlea, Slecranon forsa Posterior surface Radial fossa Trochlea ‘The medial epicondyle (7) is more prominent than the lateral (5), The medial part of the trochlea (13) is ‘more prominent than the lateral part. The olecranon fossa (10) on the posterior surface fs deeper than the radial and coronold fossae on the anterior surface (12 and 3)Right humerus attachments, lower end © trom the front © trom behind @ from below @ from the medial side @ trom the tateral sce Blue lines, epiphysial lines; green lines, capsular attachments of elbow joint Brachalis Brachioradials Common extensor origin Common flexor origin Coronold fossa Extensor carpi radialis longus dial head of triceps 14 Radial fossaRight radius upper end ©) trom the front Q trom behind @ trom the media side @ from the lateral side interior border or oblique line interior surface Head Int border Lateral surface Nock Posterior border Post Rough area for pronator teres Tuberosity x + Right radius lower end @ trom the medial side Grom the atera side Anterlor surface Dorsal tubercle Groove for extensor carp radials longus Groove for extensor digitorum and extensor indics Groove for exten ‘ond of the radius is nterlory (atthe lower ‘with the ulnar noteh tubercle on the posterior surface (2),Right ulna upper end trom the front Q trom behind Q from the mesa © trom the tatera ch (1) faces forwards withthe racial notch (9) on the Isteral sce Right ulna lower end @ from the front @ tom behind @ trom the medial side © from the lateral sideRight radius and ulna upper ends, from above and in front Coronoid process of ulna Head of radius Neck of radius Olecranon of ulna Trochlear notch of ulna Tuberosity of radius Tuberosity of ulna Right radius and ulna lower ends, from below 1 Attachment of articular aise 2 Dorsal tubercle 3 Groove far extensor carpi radials 4 Groove for extensor cap! radials longus 55 Groove for extensor carpi ulnaris 6 Groove for extensor digitorum and 7. Groove for extensor pollicis longus 8 Styloid process of radius, 9 Styoid process of ulna 10 Surface! for dsc 11. Surface for unate 12, Surface for scaphoid Right humerus, is and ulna articulation from the front from behind. 1 Capitulum of humerus 2. Coronoid process of ulna 3 Head of radius 4 Lateral epicondyle of humerus 5 Medial epicondyle of humerus & Olecranon of ulna 7 Radial notch of ulna 8 Trochlea of humerus ‘The elbow joint and the proximal radioulnar joint share a common synovial cavity [o]Bones of the right hand palmar surface from the lateral side hamate from the medial side scaphoid, palmar surface The scaphoid,lunate, triquewal and plsform bones form the proximal row ef carpal bones The trapezium, trapezoid, capitate and hamate bones form the istal row of carpal bones The tubercle (33) and waist (35) are the non-aticular pars of the scaphoid and thoretore contain nutrient foramina. A fracture across the wast may therefore interfere with the Blood supply of the proximal pole ofthe bone and lead to avascular necroste (see 29 167). The waist of the scaphoid lies in the anatomical sutbox: the tubercle may be palpated infront of the radial Boundary of the nutfoox n 2 2 4% 6 % ” ate of fth metacarpal Base of fist metacarpal Base of mide phalanx of ‘middle finger ring finger Cptate Distal phalanx of ring finger Distal phalanx of thumb Groove for deep branch of sinar nerve, Head of fifth metacarpal Head of frst metacarpal Head of middle phalanx of Heed of proximal phalanx of fing finger Hook of hamate " 0 20 Fy 3 24 2 ng Proumal phalanx of litle Protimal phalanx of thumb Scaphoid Shaft of second metacarpal Shatt of fifth metacarpel Shaft of first metacarpal Shaft of middle phalanx of mmidale finger ‘Shaft of proximal phalan of fing tnger Surface for capitace Surface for Trapestum Trapezoid Tiqueral Tubercle of saphoid Tubercle of traperiam Wait of seapheidscapula, upper lateral part laviele, sternal end humerus, upper and lower ends radius, upper and lower ends ulna, upper and lower ends first metacarpal and phalanges of ‘thumb second metacarpal and phalanges of index finger Figures in years after birth, commencement of ossification > fusion. (F puberty) The first figure indicates the approximate date when ossification begins in the secondary centre, and the second figure (beyond the arrowhead) when the centre finally becomes fused with the rest of the bone. Single average dates have been given (both here and for the lower limb bone centres on pages 314 and 315) and although there may be considerable ividual variations, the ‘growing end’ of the bone (when fusion occurs last) is constant. The dates in females are often 2 year or more earlier than in males, Right upper limb bones secondary centres of ossification Apart from the acromial,coracold and ‘ubcoracoid centres ilustrated (A), the scapula {ually has other centres forthe inferior angle, medial border, and the lower part of the rim of the glenotd cavity (al P+ 20, see ages 127 and 159) Te cavicle isthe first bone in the body to Start to osiy (ith week of gestation bstfiee In membrane, bat the ends of the bone have a cartilaginous phase of sification, «secondary centre appearing at ‘the sternal end (B) nites with the body at bout the 25th yeor The centre ilustrated at the upper end of the humerus (the rsuft ofthe union at 6 Years of centres forthe Head (1 year), greater Tubercle (@ years) and leser tuberde f yeas), At the lower end of the humerus (0) the Centres for the capitulum, trochlea and lateral Splcondyte fore together before uniting with the hate All the phalanges (asin) and the est metacarpal () have a secondary centre at ther prosioal ends; the ather metacarpal (os) fave one at ther ital ends. All the carpal bones are cartilaginous at birth nd none has 3 secondary cere. The largest, ‘he capate the frst 10 begin to oxy (in the second month after bith, followed In a month or30 by the hamate withthe ‘riquetralat 3 years, lunate at 4 years, scaphoid, trapezoid and trapezium at 5 years Sind the plstorm lact at 9 years or later There fre often variations in te sbove common patternLeft elbow and radioulnar joint © 10m the mesial side @ trom the ater side ed —ad Se. In A and B the forearm is flexed to a right angle. In D and E the forearm is partially flexed, and the synovial cavity jin the capsule (3) and the bursa beneath the biceps tendon (1) have been injected with green resin. 41 Biceps tendon and undertying 11. Olecanon proces of ulna bursa 12 Radial colatera ligament 2 Gapitulum 43 Supinator crest of ulna 3 Capsule (distended) 44 Goronod proces of ulna 5 Hendanaineck of radius 16 Ulnar collateral ligament: Covered by anlar ligament oblique Band § Interoseous membrane 17 Uinar collateral ligament: 7 Literal eprcondye Posterior band 4 Medial eprondyie 18 Uinar collateral ligament: 8 Oblique cord Upper band 10 Olecraron fossa oS blipzton ofthe rat had ee pages 170-172 Right elbow and radioulnar joi © from the media side Q trom the ater side Elbow radiographs Q tsterat projection @ & preiection Ccapitulum of humerus Coronaid process of uina Head of radus Humerus Lateral epicondyle ‘of humerus, Medial epcondyle cof humerus, Neck of radius lecranon fossa of humerus Olecranon process of uina Radios Trochlea of humerus Tothlear noteh of Una Tuberosity of radius Una Radioulna jointWrist and hand radiographs @ soropatmar projection Q ot at-yearcld @ ctque projection © posteroanteror projection @ Hie projection in B with the bony specimens in J and K on page 125. Base of frst metacarpal 16 Postion of articular dsc Base of phalanx (clangularflorcartage) Base of third metacarpal 17 Prosimal phalanx of mice Gpitate finger Distal phalanx of middle finger 48. Proximal phalan of thumb Distal phalanx of thumb 19 Scaphoid| Hamate 20 Sesamoid bone in flexor pois ead of fist metacarpal brews Head of phalane 21 Shaft of phalanx Head of third metacarpal 22. Silolé process at lowor end of Head af ulna rave Hook of hamate 23 Stloid proces of una Uunate 24 Trapeckim ‘Middle phalans of mile 25 Trapezoid finger 26 Tiquetral 15 Phaiform The epiphysis atthe lower end of the radius appears on 2 radiograph at 2 years and in the ulna at 6 year. The fst {arpa bone to appear isthe capitate at 19Left first rib (inner) Ribs and relationships and second rib (outer) @ ® vical rib and vertebra articulated, from above cache 9 © toe let sit ib om behind (a ypc! upper ib © trom below @ the tte seventh sib from behind (atypical lower rib) SE @ tre tte watt ib om the front, with atachmens ee ss ete el ron oi wth tints / °e 5S Head J Angle of rib 10 External intercostal 19 Quadratus lumborum 5 Nek 2 Area covered by pleura 11 External oblique 20 Shaft of rib 7 Scalene tubercie 3 Articular facet of head 12 Head 21 Serratus posterior bE cen See tin =< 9 Shaft troneverse process 44 Uavssmus dors 22 Tubercle 10 Tubercle 5S Articular part of tubercle 15 Levator costae 23 Upper costal facet of Hern cect = ere 5 wma | eee i ee ak 2 Seaitorn Cie | | eS ‘The atypical ribs are the first, second, tenth, eleventh and twetth. | Left first rib (inner) and second Liion'no angle ndne Comal geome The hatthassaperorana | iD (outer), attachments Intror suave Ba chal ecient ae aa fant oat comccoer cee © o eI ai tines epiptya tne, groan lines, capsule attachments eens aa ee nee ane Soe The twelfth nib has 2 head with one facet (F12) but there i no 1 Area covered by pleura 7 Seaterus medias tubercle, no angle and no costal groove, The shaft tapers at its end prise ale eee ao ce ee 2 Costocavicularigamen 8 Scalerus posterior (ihe ence mt other iden ott 3 intercostal muscles and 9 Seratus anterior membranes 10. Serratus posterior superior 4 Lateral costotransverse M1 Subclavias ligament TD Superior comtotransverse 5 Levator costae ligament 6 Stars anterior 13. Stpraploural membraneSternum ©) trom the front 1 ody 2. Cavieular notch 3 ugular noth 4 Manubeium 5 Notch for fith costal cartilage & Noten for fist costal cartlage 7 Noten for fourth costal eatage 8 Noteh for nth costal eartiage ‘9 Notch for third costal cartlage 10 Notenes for second coal carlage 1 Notches for seventh costal cartilage ‘2. Stermal angie and manubriosterna! Joint 1B. Xipniternal joint 4 Xiphoid process The sternum consists of the manubrium (8), body (1) and xiphold proces (14). ‘The body of the sternum (1) ls formed by the fusion of four sternabrae, the sites of the fusion ometimes being indicated by three sight tranwvers ridge The manubrium (4) and body (1) are bony but the nphold process (14), wich varies Considerably in size and shape, f cartilaginous Slthough it frequently shows some degree of ‘ossification The manubriosternal and siphsteral joints (12 and 13) are both symphyses, the surfaces being ‘covered by hyaline cartlage and united by 3 fibrocartiaginous dscSternum attachments ‘Area covered by left pleura ‘Area covered by right pleura ‘Area in contact wrth percardiam Diaphragm Rectus abdominis Sternocleidomastoid Sternohyoid Sternothyroid 40 Transverse thorais The two pleural sacs are in contact from the levels of the second to fourth costal cartages (€2 and 1). The thoracic inlet or outlet (upper aperture of the thorax) is Approximately the same size and shape as the outline of the Kidney, and is bounded by the fist thoracle vertebra (5), fist ribs (1), and costal cartilages 3) and the upper border of the tmanubrium of the sternum Gugular noth, 8) Te does nate Ina horizontal plane but slopes downwards and forwards. The second costal cartilage (12) joins the manubrium and body ‘of the stesnum (10 and 1) a the level of the manubriosternal Joint (8) This Ian important landmark, since the Joint line s palpable as a ridge at the sight angle between the manubrium ‘nd body and the second costal cartlage and nib can be identified lateral tof. Other ribs can be identified by counting down trom the second @ Thoracic inlet in an articulated skeleton, from above and in front Body of sternum Costochondial joint First costal cartlage Fist costochondra joint Fist thoracle vertebra Head of first ri srubrioternal joint (angle of Lous) Monubrium of sternum Neck of fee rib Second conal cartilage Second ro Second sernocostal joint Shatt of first nb Sternal end of clavicle Sternoclavicuar joint ioLeft hip bone Jateral surface Acetabular notch ‘neeror gluteal ine [Anterior inferior ihc pine “Anterior superior lia spine Boy of ure Body of ichium Body of pubis Greater Slate notch Misc eres feror gluteal ine for ramus of pubis leehial tuberosty ewer sate notch Obturator crest, Obturatar groove 21 Posterior gluteal ine 23 Posterior superior tlic spine 24 Pubic tubercle 25 Remus of tchium 26 Rim of setabulum 27 Superior ramus of pubs 28 Tuberde of lac crest ‘The hip (Innominate) bone Is formed by the union ofthe lium (6, schiue (?) and pubis @), Te two hip bones articulate in the rmdline anteriorly at the pubic Symphysis: poserery thay are Separated by the sacrum, forming the $Sero.lac joints The two hip bones swith the sterum and cacy const the peli Gee page 92)Left hip bone attachments, lateral surface nes, epiphysial lines lines, capsular attachment of hip joint Pale green lines, ligament attachments 1 2 3 a 5 > 8 9 0 " 2 3B “4 6 6 ” % 1» Fa 2 Adductor brevis Adauctor longus ‘Adductor magnus External oblique Ghuteus maximus feus meds Ghuteus minimus Mofemoral ligament Inguinal ligament Ischiotemoral ligament Obturator externus Quadratus femors Reflected head of rectus femoris Sartorius Semimembranosus Semitendinotus and long head of read of rectus femoris Tervorfescae lat ‘raneverse gamLeft hip bone medial surface 0 2 3 6 6 ” % » 20 a 2 Anterior superior ac spine Body of ischium Booy of pub Tie crest, . Mae fos Hie tuberosity Ischia spine Ischia tuberosity Leer sciatic naten Obturator foramen Pecten of pubs (pectinest Posterior inferior iliac spine Posterior superior ihe Pubic crest Superior ramus of pubis ‘he auricular surface of the ium (the articular Surface forthe saeri3¢ joint. The greater sciatic notch @) Is more hooked (shaped) Inthe mala, whereas the femaie notch ls more rightangled (shaped)Left hip bone attachments, medial surface Blue ines, epiphysial lines Sttachment of sacro-iac joint Pale green lines, ligament attachments,Left hip bone from above 41 Anterior inferior ise spine 2 Anterior superir il spine 3 Aecuste ine 4 Auricuar surface 5 lsc crex 6 ac ous 3 0 Tiopuble eminence Ischia spine Pecten 9f pubs (pectneal tine) Posterior inferior lac spine 11 Posterior superior ila spine 12 Pubic est 1B Pubieuberde 44 Tubercle of tac crest ‘The arcuate ne on the illum (3) and the pecten and crest of the publ © ‘and 12) form port of the brim ofthe Pelvis (the rst of the brim being Formed by the promontory and upper sirface ofthe lateral pare of the Sacrum ~see pages 90 and 92) The pecton of the publs @) is more Commonly called the pectineal ineLeft hip bone attachments, from above Blue lines, epiphysial lines Green line, capsular attachment of sacroiliac joint Pale green lines, ligament attachments 1 Anterior wall of rectus sheath 2 Conjoint tendon 3 Eeceral oblique 4 liacue 7 Inguinal ligament 8 Internal oblique 9 Interoneous taro ligament 10. Lacunar ligament " ” i“ 35 Psoas minor 16 Pyramidalis 47 Quadratus lumborum 1 Straight head of rectus femoris The inguinal ligament (is formed by the lower border of the aponeureds of the external oblique muscle, and fextends from the anterior superior ile spine to the pubke tubercle The lacunar ligament (10, sometimes called the pectineal part of the Inguinal ligament) Is the pat of the inguinal Iigement that extends backwards fom the medial end of the inguinal igament tothe pocten of the pubis ‘Tne pectnea igament (13) s the literal extension of the lacunar ligament along the pecten. Its not dasiied as a part of the Ingulral ligament, and must not be confused ‘with the alternative name forthe Taeunar ligament, Le- with the pactineal part of the Inguinal igament The conjoint tendon (2) is formed by the aponeuroses ofthe internal oblique fad transversus muscle, and is attached to the publ crest and the adjoining part of the pecten, blending medialy {vith the anterior wall of the rectus sheath@ Left hip bone ischial tuberosity, from behind and below 1 Acetabular noteh 2. Acetabulum 3 Iechia spine 4 echiopale ramus Lewer sciatic notch Longin ridge Obturator groove 30 Transverse ridge 11 Upper part of tuberosity @ Left hip bone from the front 41 Acetabular notch 2. Anterior inferior iliac spine 3 Anterior superior tac pine 4 Body of pubis 5 ac fous § tliopubie eminence 2 chil tuberosity 9 Obturatorcrest Is (Pectineal ine)@ Left hip bone attachments, ischial tuberosity, from behind and below Blue lines, epiphysial lines Green line, capsular attachment of hip joint Pale green lines, ligament attachments, 1 Adductor magnus 2 Inferior gemalus 3 lchiofernoral igament 4 Semimembranctue 5 ‘ Semitendinows and long head of bicepe Sunerior gemelias ‘The area on the lchial tuberosity ‘mesial to the adductor magn [tachment (1) covered by fibrofatty ‘Use and the lchial bursa Underying ‘luteus maxims, @ Left hip bone attachments, from the front Blue lines, epiphysial lines Green line, capsular attachment of hip joint Pale green lines, ligament attachments, Aaductor longus ‘Adductor mag} External oblique and inguinal ligament Graciis Miofemoraligament Internal oblique Ueunar ligament Lateral head of rectus abdominis Medial head of rectus abdominis Pectnea! ligament Pectineus Psoas minor Pubofemoral ligament Pyramidalis Quaaratus femoris Rectut sheath Reflected head of rectus femoris Ssrtorive Straight head of rectus femoris Transverse igement Traneversus abdominisLeft femur proximal end ) 0m the front i 3 Q trom the medial side i é 5 : . ° z Fovea of head Greater trochanter Head’ Intertrochanterc tine Lesser trochanter Nece Quacrate tubercle on Shatt Spiral ine Trochanterc fossa The interrochanterie fine (8) atthe junction of the neck (6) and shaft @) on the anterior surface; the intertrochanterc crest iin a Similar postion on the posterior surface (& and pg 205, AS). The neck makes an angle with the shaft of about 125° in an aaute The pectinea ine of the femur (7) must not be confused with the peetineal line (pacten) ofthe pubis (2, page 290), nor withthe Epil line ofthe femur (10) whieh i sully more prominent than the pectneal line.Left femur attachments, proximal end Q trom the front @ tom she mea side Blue lines, epiphysial lines Green line, capsular attachment of hip joint Pale green lines, ligament attachments Gluteus medive Ligament of Obturator Pritormis Psoas major and lacus ‘The tloternorl ligament has the shape of an inverted V, withthe stem attached to the anterior inferior lac spine of the hip bone {Gage 292,87, and the lateral and medial bands attached to the Upper (lateral) and lower (medial) ends ofthe intertrochanterie line (page 295, 6), blending with he capsule of the hip Joint. ‘The tendon of psoas major ie attached to the lesser trochanter (page 296, 8 many of the muscle fibres of lacus are Inserted Into the psoas tendon but some reach the femur below the trochanter,Left femur proximal end fod 1 Adductor tubercle at lower Leva trochanter trom behing ond $ Unes avers, Tie neck of te femur panes forwards 2 Ghuteal tuberosity 10 Medial condyle at as wells upwards and medially (C11), Q trom the lateral side 3 Greater trochanter lower end ‘making an angle of about 15° (in the 3 Head 11 Neck ‘Sut with the transverse axis of the 5 Intertrochanteric crest 12 Quecrate tubercle | lower end (the angie of femoral torsion Q tom above 5 parotereet ot 13 Sia in Ortemeral arte) 7 Lateral condyle at lower end 14. ‘Trochante ‘The lesser trochanter (8) projects backwards and medlalyLeft femur attachments, proximal end Q t10m bering @ trom te lateral side Q 110m above Blue lines, epiphysial lines Green line, capsular attachment of hip joint Pale green lines, ligament attachments Adductor brevis [adductor magnus luteus medi Wofemoral igament (lateral band) ObturatorInternus and rey Cn the front ofthe femur (page 295) the capsule ofthe hip font i attached to the intertrachanterie line, but a the back the capsule is attached tothe neck ‘of the femur and does not extend as far Taterally a the interrocnantere crest (Gage 296, AD),@ Left femur shaft, from behind 1 Glutea! tuberosity 4 Linea aspera 2. Lateral supracondylar line Medial supracondiylar line 3 Lesser wothanter & Pectine ‘The rough linea aspera (4) often shows dstinet medial and lateral lips: the lateral ip continues upwards asthe gluteal tuberosity (0). @ Left femur attachments, shaft, from behind 1 Adductor brevis 7 Quadratus femoris 2 Aagucr longue 1 Short head of biceps femoris For diagrammatic cary, the muscle attachments tothe linea aspera have been slighty separated, @ Left femur upper end, from the front This is the posterior half of a cleared and bisected specimen, to show the major groups of bone trabeculae, 1 Galea femorate From ater surface of hat to grater TWlangular area of few trabeculae The calear femorale (1) a dense concentation of trabeculae Basing rom the region ofthe leer ochanter othe under Surface of the neckLeft patella Q anterior surtace article (porterion surface 1 Apex 4 Facet for medial condyle 2 Ghee of femur 3 Facet for lateral condyle of femur § Vertical ridge Left patella attachments Qu Pale green line, ligament attachment surface (@) aticuar (posterior) surface 1 Area patellar fat pad 7_Vastus intermedius of quadriceps 2. rea for medal condyle th sor 3. Facets for femur in extension ndon 44 Facets for femur in flexion 9 Vartus medias of quadriceps $ Patel ligament tendon & Rect femors of quadriceps Left femur and patella articulated @ tom below with knee extended @ ‘rom teiow and behind with knee flexed In flexion, note the increased area of contact between the medial condyle of the femur (2) and the patella, ‘The most medial facet of the patella (02) only comes Into 4: ‘Later cone 2 Media condyle contact with the medial condyle in extreme Hexon asin FLeft femur distal end Q 0m the front Q tom borin Q trom the media side @ trom the intel side 5 Literal condyle § Literal epcondyle 7 Lateral supracondjar line 2 Medial condyle ‘9 Medial epicondyle 10 Medial sopraconda lineLeft femur attachments, distal end 4 0¥ Q trom te frome Q trom behind Q trom the mei side © trom the atest side Blue lines, epiphysial lines Green line, capsular attachment of knee joint Pale green lines, ligament attachments Adductor magnus [Anterior cruciate ligament ‘Arteularie gen Shor head of Bie femoris Tibial (media) collateral igament Vaetus intermediueLeft tibia proximal end Q trom te front Q tom behind [areal facet for fbula Groove for semimembranonus Inerosseous border Lateral condyle Lateral surface Medial border Medial condyle Mecha surface Solel ine Vertical ine The shaft ofthe tibia has three borders: anterior (1), medial) and interesseous (5)~ and three surfaces: medial (10) Tateral (7) 8nd posterior (11 Much ofthe anterior border (1) forms a slightly curved crs commonly Enown as the shin Most ofthe smooth medial surface (fo) is subcutaneous. The posterior surface contains the sleal and vertical ines (12 and 15). The tuberosity (14) is at the upper end ofthe anterior borderLeft tibia attachments, proximal end renter Beatenpagaion fo © trom behina attachment of knee joint rea ei attachments Posterior cruciate ligament Sortorias 2 3 a Pale green lines, ligament pat ‘ 7 3 Semimembranosus 10 Scieue 11 Tibal (media collateral 12 Thal anterior 13. Tbials postero 44 Vastus medalsLeft tibia proximal end Anterior Q trom the medial site 1 A gira 3 Mesa eae aas ae @ trom the lateral side 4 Groove for area ‘The articular facet for the fibula is on plateau) border 15 TuberosityLeft tibia attachments, proximal end from the medial side Blue lines, epiphysial lines 1 @ sroe the cnaatsde ienines eepear : attachments of knee joint Q trom tre tntarat side ha uperiortbiofibuiar” joint 4 Q From above (tibial Fale green lines, ligament $ plateau) attachments § 0 " Anterior o late ligament Extensor digitorum longus Interosseous membrane Peroneus (fibulars) longus Popliteus Posterior rucate ligament Anterior 2 2 “ % 6 ” % 1” 20 Ey Posterior horn of lateral osterior horn of medial Semimembranowus Sous Tibial (medial collateral Tia anterior Tibalis posterior Vestus medialisLeft tibia distal end GQ trom the medial side @ from the lateral side 1 2 4 5 6 7 a ‘Anterior surface Fibular note Groove fo tials posterior Medial malletus Medial su Porteror su Left tibia attachments, distal end @ from the medial side @ from the lateral side Blue line, epiphysial line Green line, capsular attachment of ankle joint Pale green lines, ligament attachment 11 Inferior transverse igamen The medial collateral ligament (Gas commanly known as the 2 3 3 ‘eltoid ligament 5Left tibia and fibula articulated proxima ends from behind © prenimal ends tom above @ Proximal end of fibula from above © sista ends from behind @ sisal ends trom balow 2 Articular facet (or superior tibiofibular joint) 43 Head of foula 5 Inferior surface of tibia (for ankle joint) 6 Inferior tibiofbular joint 7 Literal (artcuar surface of medial malleolus (for ankle joint) 8 Lateral condyle of tibia 9 Lateral malleolus 30 Malletar fossa 41 Media malleolus 432. Superior tibioibular joint ‘The superior tibiofbular joint (A12) is snovial The inferior Ubiofbular joint (06) fbrous. The lateral malleolus (09) extends lower than the medial smallelus (1). a 2 oy ron if1 Q trom the mea side @ trom te earl side 1 Anterior borser 2. Artculr surface of lateral malleolus 3. Groove for peroneus (fibular) brevis Interosseous borde (tera itera Malleolar fossa 4 5 7 3 Media crest 10 Posterior border 11 Posterior surface ‘2. Surface for interoseous ligament 113 Trangular subcutaneous area Q trom bebina Anterior border ‘Apex (syd process) Interosseous border Left fibula proximal end Q) trom te ron @ trom the media side © trom the interalside 6 3 8 ” " Lateral surface Medial crest Medial surface Posterior border ‘The fibula has three borders: anterior (A, interoseous (AS) and posterlor B10) — and three surfaces: medial (AB), lateral (G6) and posterior (811). {At fist sight, much ofthe shaft appears to have four borders ‘and fou surfaces, but this & because the posterior surface B11) ‘Sevded into two parts (meclal and ater) by te medial est 6.Left fibula attachments, proximal end trom te ront from the media side © trom behind © trom tne aera side Blue line, epiphysial line Green line, capsular attachment of superior tibiofibular joint Pale green lines, ligament attachments 1 Biceps femoris 6 Interotseout membrane 2. Extersor digitorum longus 7 Peroneus(ibulaa) Brevis 3 Extensor hall longue 3 eroneus (lan) longus 4 fibular colateral ligament 9. Soleus Flexor halls longus 10, Tbals posterior Left fibula attachments, distal end @ ‘rom the front @ from the media side @ tom betind @ trom the tteral side Blue line, epiphysial line Green line, capsular attachment of ankle joint Pale green lines, ligament attachments 1 Anterior talofibular ligament 8 Peroneus (fibular) brevis 2 Caleaneotinular ligament eroneus (fibular) tertiae 3 Extensor digitorum longus 10: Posterior talofibular 4 Extensor hallucls longus 5 Flexor hallvcls longue & Intercsteous igarent igarent 7 Interceteaus membrane 12. Tals porterior Posterior tbiofibularBones of the left foot trom above (dorsum) © tom below (tantar race 1 Anterior fakaneus 2 Base of fith metatarsal 3 Base of fst metatarsal 4 Cakeaneus 5 é ; erce of cubeld Distal phalanx of great toe Distal phalans of second 18 Groove on calcaneus for flexor hall longus peronevs (Hbulars) longus 410 Groove on talus for flexor halla longue 11 Grooves for sesamold bones in fexor hallues brevis 12 Head of ffth metatarsal 13 Head of first metatarsal 14 Head of talus 45 Intermediate cuneiform 46 Lateral cuneiform Y7 Lateral process of caleaneus 18 Lateral fubercie of talus 49 Mecial cunetform 20 Mosial process of cakaneus 21 Medial tuberele of tue 22 Midale plans of second 23: Naviculae 24 Neck of tals 25 Proximal phalanx of great 26 Proximal phalanx of second 27 Shaft of fifth metatarsal 28 Shatt of fist metatarsal 28 Sustentaculum tal of akaneus 320 Trochlea surface of body 31 Tupecosty of bate of th metatarsal 32 Tuberosiy of cubold 33 Tuberonry of navcularBones of the left foot attachments Q) trom above © tom teow Joint capsules and minor ligaments have been omitted Pale green lines, ligament attachments 1 Abeiuctor digit minimi 2 3 a 5 Abductor hall Adductor halle Caleaneocubold part of Caleaneonavicular part of bifureate ligament Extensor digitorum brevis Extensor digitorum longus Extensor digitorum longus and brevis Extensor hallucis brevis Extensor hallct longus Plantar interorseous or eight! mini! brevis Flexor digitorum breve Flexor digitorum longus Flexor halucs brews Flexor hallucs longus Fourth dorsal interoseous Long plantar igament Opponene digit minim (pare of 12) Peroneus(ibularis) brevis Peroneus(ibulars longus Peroneus(lbulars) tertus Plantar calcaneacuboia (hort plantar) igament Plantar ealcaneonavitlar (eoring) ligament Plantar Second dorsal interosseout Second plantar Interessoous Tendo calcanews (chiles Third dorsal interosseous Third plantar Interoseout Tibial anterior Tibial posteriorBones of the left foot Q 10m the mca side 1 Anterior tubercle of cakaneus 2 Cuboic 3 Frat metatarsal 4 Head of talus 5 Intermediate cune\form 6 Lateral cunestorm 3 Lateral mallotar surface of talus 8 Literal process of calcaneus © trom the ater side Lateral tubercle of talus Medial cunetform Medi! malielar surface of talus Medial process of calcaneus Medial surface of ealeaneus Medial tubercle of talus Novicular Neck of talus ” « % 2» 2 Perones! (fibular trochlea of Ststentaculum tl of ckanevs TUberay of bae of tnBones of the left foot Left calcaneus @ tom above @ tom behing Left talus @ from below 2 Anterior tlar aricular surface eu 3. Groove of calcaneus for flenor hallucis longus 44 Groove of tals for flexor hallus longus 5 Head of talus 6 > 8 Medial proces of calcaneus aleanean articlar surface of talus ular surface of caeaneut 10 Posterior surface of eslesneue 1 Posterior talar articular surface of calcaneus 13 Sulcus of talus 114 Surface of talus for plantar calcaneonavicular (spring) ligament 115 Sustentaculum tal of calcaneus Left calcaneus, attachments © from above @ tom behing Left talus, attachments @ fom betow Curved lines indicate corresponding articular surfaces: green, capsular attachment of talocalcanean (subtalar) and talocalcaneonavicular joints; pale green lines, ligament attachments Area for bursa ‘ares for fbrofaty tasue Catcaneocuboid part of bfurcate igament nectibular ligament 1 2 a 5 Calcaneona 6 Cervical lige 2 Extensor i 3 Inferior extensor retinaculum 9 Interoucour talocalcanean (cervical gement 0 2 3B part of bifurate ligament im brews Literal talocleanesn ligament Medal talocaleanesn ligament Plantar Tendocalcaneus (Achilles tendon) Tibiocakanean part of deltoid igament Te interoseous talocalcanean (cervical ligament (@his formed by thickening of the adjacent capsules ff te talocaleanean and talocslcaneonaviula joint For different interpretations of the term ‘subtalar joint’ see the notes on page 248,Left lower limb bones secondary centres of ossification ) tip bone, lower itera! part QQ tots. proximat and distal ends @ artcsneus @ cvetatarsl and phalanges of second toe @ rrecatarsal and phalanges of great toe Figures in years, commencement of ossification » fusion, P, puberty, 8, ninth i See introduction on a-uterine month— Note knee and ankle iphyses as seen on plain x-rays —— In the hip bone (A) one or more secondary centres appear Inthe YYahaped cartilage between lium, lichum and pubis Other centres (not lutrated) are usually present for the lac crest, anterior Inferior lac spine, and (possibly the puble tubercle and ube crest (as 25) The patella (not itustrated) begins to omy from one or more Centres between the thd and sixth yeat All the phalanges, and the fist metatarsal, have a secondary centre fat their pronimal ends the other metatarsals have one at their Of the tarsal bones, the largest, the calcaneus, begins to osiy in the thie intra-uterine month and the talus out three months later The cuboid may begin to os elther jst before or just after birth, withthe lateral cuneiform inthe fist yes, medial cuneiform St iwo years and the intermediate cuneiform and naviulat at three years The calcaneus (H) is the only tarsal bone to have 2 secondary